Uma wena noma othandekayo uzoba nokufakelwa komnkantsha wamathambo noma unikele ngamaseli amancane, kuhilelani? Yiziphi izinhlobo ezahlukene zokuguquka komnkantsha wamathambo futhi yikuphi okuhlangenwe nakho okunjengombili umnikeli nomamukeli?
Okuyisisekelo
Ukufakelwa komnyoba wamathambo kuyindlela lapho amangqamuzana akhethekile (okuthiwa ama- stem cells ) asuswe emnothweni wamathambo noma egazini legazi, ahlungiwe futhi anikezwe emuva kumuntu ofanayo noma komunye umuntu.
Njengoba manje sithola amangqamuzana amaningi e-stem adingekayo egazini kunokuba umthambo wesithambo, ukufakelwa komnyoba wethambo manje sekubizwa ngokuthi ukuguqulwa kwe-stem cell .
Kungani I-Bone Marrow Isitshalo Esenziwe Ngayo?
Umnkantsha we-bone utholakala emathanjeni amakhulu emzimbeni afana namathambo aso. Lo mongo wesithambo uyindawo yokukhiqiza yama-stem cells. Ama-stem cells "ama-pluripotential" okusho ukuthi amangqamuzana angama-cell esandulelayo angahle aguquke ezinhlobonhlobo zamaseli egazi, njengama-white cell cells, amangqamuzana egazi abomvu namaplatelet.
Uma kukhona okungalungile ngomnkantsha noma ukukhiqizwa kwamaseli egazi kunciphile, umuntu angagula kakhulu noma afe. Ezimweni ezinjenge- anemia ye-aplastic , umnyo wethambo uyeka ukukhiqiza amaseli egazi adingekayo emzimbeni. Ezifo ezifana ne- leukemia , umnyofu wethambo uveza amangqamuzana egazi angavamile.
Ngakho-ke, injongo yokufakelwa komnyoba wamathambo ukubuyisela amangqamuzana angakakhiwa noma athathe amangqamuzana angama-stem angenampilo anempilo.
Lokhu kungasetshenziswa ukuphatha noma ukuphilisa lesi sifo.
Ngaphandle kwama-leukemias, i-lymphomas, ne-anemia ye-aplastic, izibalo ze-stem cell zihlolwe ngezifo eziningi, ezivela emathunjini aqinile kuya kwezinye izifo ezingekho ezimbi zomnyofu we-bone, ku-multiple sclerosis.
Kunezinhlobo ezimbili eziyinhloko zokufakelwa komnkantsha wamathambo, ukuguqulwa kwe-autologous kanye ne-allogeneic.
I-Autologous Bone Marrow Ukufakelwa
Isiqalo sesiGreki "auto" sisho "ukuzibamba." Esikhathini sokufakelwa kwe-autologous, umnikeli ngumuntu ozokwamukela futhi ukufakelwa. Le nqubo, eyaziwa nangokuthi "ukufakelwa kokuhlenga" ihilela ukususa ama-cell stem yakho bese uyabashisa. Uthola imithi yamakhemikhali ephezulu elandelwa ukukhipha ama-cell stem acwecwe. Kungasetshenziselwa ukwelapha i-leukemi, i-lymphomas, noma i-myeloma eminingi.
I-Allogenic Bone Marrow Ukufakelwa
IsiGreki sesiqalo "allo" sisho "okuhlukile" noma "okunye." Ku-allogeneic transplant bone, omunye umuntu onomzimba wesifo sofuzo esifana nomuntu odinga ukufakelwa. Ngenxa yokuthi izinhlobo zezicubu zizuze njengefa, zifana nombala wendwele noma umbala weso, cishe uzothola umnikeli ofanelekayo kulungu lomndeni, ikakhulukazi umntakwethu. Ngeshwa, lokhu kwenzeka kuphela amaphesenti angu-25 kuya kwangu-30 yesikhathi.
Uma ilungu lomndeni lingavumelani nomamukeli, imininingwane ye-Registry National Donor Program Registry ingasetshenziswa umuntu ongathintana naye ogama lakhe lomzimba lingumlingana oseduze. Kungenzeka ukuthi umnikeli ovela ohlanga olufanayo noma uhlanga njengomamukeli uyoba nezici ezifanayo zomzimba.
Funda kabanzi ngokuthola umnikezeli we-stem cell transplant .
Imithombo yamathambo e-Bone Marrow Stem
Amasela omnyo we-Bone angatholakala ngezindlela ezintathu eziyinhloko. Lokhu kufaka:
- Ukuvuna komnkantsha : Emvuneni wamathambo, ama-stem cells aqoqwa ngokuqondile emnothweni wethambo.
- I-Apheresis noma i-leukapheresis : Ku-apheresis, amangqamuzana e-stem aqoqiwe kusuka kumangqamuzana egazi ajikeleza i-peripheral (PBSC.) Umugqa wokugcoba ufakwa engalweni yakho kufana nokuthi unganikela ngegazi.
- I-umbilical cord blood: Ama- stem cells angatholakala futhi egazini emgodini we-umbilical ngemva nje kokuba umntwana azalwe (i-cord blood banking.) Njengoba la maseli ase-stem avulekile, kunesidingo esingaphansi komdlalo ophelele.
Iningi le-stem cell transplants lenziwa ngokusebenzisa i-PBSC eqoqwe i-apheresis (ukujikeleza kwegazi kwe-blood stem cell ). Le ndlela ibonakala ihlinzeka ngemiphumela engcono kokubili umnikeli nomamukeli. Kungase kube khona izimo lapho kuvunyelwe khona ukuvunwa komnkantsha wendabuko.
Okushiwo yi-Donor Experiences
Ukunikeza amangqamuzana ama-stem noma umnkantsha wamathambo kulula kakhulu. Ezimweni eziningi, umnikelo wenziwa ngokusebenzisa ama-stem cells (PBSC) aqoqwe yi-apheresis. Okokuqala, umnikeli uthola ukujova kwemithi yezinsuku ezimbalwa ezidala amangqamuzana amancane ukuba aphume emnothweni wamathambo futhi angene egazini. Ukuze iqoqo le-stem cell, umnikeli uxhumeke kumshini ngenaliti efakwe emthonjeni (njengokunikela ngegazi). Igazi lisuswa emthanjeni, lihlungiwe umshini ukuqoqa amaseli abuyele, bese ubuyela kumnikeli ngokusebenzisa inaliti kwenye ingalo. Asikho isidingo sokuthola isikhathi sokubuyisela ngale nqubo.
Uma ama-stem amaseli eqoqwa ngukuvuna komnkantsha (okungenani kakhulu), umnikeli uzoya ekamelweni lokusebenza futhi ngenkathi elele ngaphansi kwe-anesthesia kanye nenaliti kuyofakwa phakathi kwesikhumba noma isifuba sokuthatha umthambo wamathambo. Emva kokuvusa, kungase kube khona ubuhlungu lapho inaliti efakwe khona.
Okuhlangenwe nakho okutholwa ngabamukeli
Ukufakelwa komnkantsha wamathambo kungaba yinkambiso enzima kakhulu kumamukeli.
Isinyathelo sokuqala ngokuvamile sithola amanani aphezulu we-chemotherapy kanye / noma imisebe yokuqeda noma imuphi umongo we-bone. Isibonelo, nge-leukemia, kubaluleke kakhulu ukukhipha wonke amangqamuzana amangqamuzana amangcwaba amathambo.
Lapho umnkantsha wokuqala we-bone usubhujiswa, ama-stem amangqamuzana amasha ajojowe ngaphakathi, afana nokumpompela igazi. Ama-stem amaseli abese athola indlela yawo eya ethambo futhi aqale ukukhula futhi akhiqize amaseli amaningi (abizwa nge- engraftment ).
Kunezinkinga eziningi ezingase zibe khona. Isikhathi esibucayi kunazo zonke lapho umthambo wamathambo ubhujiswa khona ukuze amangqamuzana egazi ambalwa ahlale. Ukubhujiswa komnyosa wethambo kubangela izinombolo ezincishisiwe kakhulu zonke izinhlobo zamaseli egazi ( pancytopenia ). Ngaphandle kwamangqamuzana egazi elimhlophe kukhona ingozi enkulu yokutheleleka, futhi izinyathelo zokugwema izifo zisetshenziswa esibhedlela (ukuhlukaniswa). Amazinga aphansi amangqamuzana egazi obomvu (i- anemia ) ngokuvamile adinga ukumpontshelwa igazi ngenkathi elinde ama-cell stem amasha aqale ukukhula. Amazinga aphansi amaplantlet ( thrombocytopenia ) egazini angabangela ukuphuma kwangaphakathi.
Ukuhlukunyezwa okuvamile okuthinta abantu abangamaphesenti angama-40 kuya kwabangu-80 abamukeli isifo sesibindi se-graft versus host . Lokhu kwenzeka lapho amangqamuzana amhlophe egazi (ama-T cells) kumaseli anikelwe (ukuxhunyelelwa) ahlasela izicubu kumamukeli (umphathi), futhi angasongela ukuphila.
Enye indlela ebizwa ngokuthi ukuguqulwa komnkantsha okungewona okwenziwe ngamathambo noma i-"mini-bone bone transplant" ihlukile ngokuhlukile. Kule nqubo, kunikezwa amancane amakhemikhali ekhemotherapy ukuthi angagcini ngokuphelele noma "abhelise" umnkantsha wamathambo njengendlela yokufakelwa komnyofu ovamile. Le ndlela ingase isetshenziselwe umuntu osemdala noma kungenjalo angeke abekezelele inqubo yendabuko. Kulokhu, ukufakelwa kusebenza ngokuhlukile ukuphatha lesi sifo. Esikhundleni sokungena esikhundleni somnyofu, umnto onikelwe ungahlasela amangqamuzana anomdlavuza asele emzimbeni ngenqubo ebizwa ngokuthi "ukuhlanganiswa ngokumelene nokulimala."
Ingabe Uzimisele Ukunikela NgeMarrow Bone?
Uma ungathanda ukuba umnikelo wokuzithandela, inqubo ilungile futhi ilula. Noma ubani ophakathi kweminyaka engu-18 no-60 futhi enempilo enhle angaba umnikeli. Kukhona ifomu lokugcwalisa kanye nesampula segazi ukunikeza; ungathola lonke ulwazi oludingayo kwiwebhusayithi yohlelo lokuhlinzekwa ngabakwaMarrow National. Ungakwazi ukujoyina umshayeli we-donor endaweni yakho noma uye ku-Donor Centre yendawo ukuze uhlolwe igazi.
Uma umuntu ezithokozelayo ukuba abe umnikeli, izici zakhe ezithile zegazi, njengoba kunqunywa ukuhlolwa okukhethekile kwegazi (test histocompatibility test antigen), kubhalwe kwiRegistry. Lokhu "ukuthayipha kwezicubu" kuhlukile kumuntu we-A, B, noma O wegazi lomuntu. Irekhodi le-Registry liqukethe ulwazi lokuxhumana lomnikeli, kufanele kube nomdlalo wohlobo lomzimba.
Ngaphansi
Ukuguqulwa kwamathambo e-bone kungaba yi-autologous (okuvela kuwe) noma i-allogeneic (evela komunye umuntu.) Amaseli esitembu atholakala kusuka egazini legazi, ukuvunwa komnkantsha wamathambo noma kusuka entanjeni yegazi egcinwe ngesikhathi sokuzalwa.
Kumnikezeli, inqubo kulula. Kumamukeli, kungaba yinkqubo ende futhi enzima, ikakhulukazi uma ukuphakama okuphezulu kwamakhemikhali edingekayo ukuze kuqedwe umnkantsha wamathambo. Izinkinga zivame futhi zingabandakanya izifo, ukuphuma kwegazi, kanye nesifo se-graft versus host host phakathi kwabanye.
Lokho kusho ukuthi ukuguqulwa komnkantsha wamathambo kungaphatha futhi kuphulukise ezinye izifo ezazingakafaneli zibulawe. Ngenkathi ukuthola umhlinzeki kwakuyinselele esikhathini esedlule, Uhlelo loMnikeli weMarrha kaZwelonke lwandise ukuthi abantu abaningi abangenalo ilungu lomndeni elihambisanayo manje bakwazi ukufakelwa kabusha komnyobo / umthamo we-stem cell.
> Imithombo:
> Society of American of Clinical Oncology. I-Cancer.Net. Iyini Ukufakelwa Kwamaselula E-Stem (i-Bone Marrow Transplant)? Kubuyekezwe 01/16. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-stem-cell-transplant-bone-marrow-transplant
> I-Library Kazwelonke Kazwelonke Yezokwelapha. I-MedlinePlus. Ukufakelwa kwe-Bone Marrow. Kubuyekezwe ngo-10/03/17. https://medlineplus.gov/ency/article/003009.htm