Ukuhlola kwegazi okubizwa ngokuthi inani eliphelele legazi, noma i-CBC, libala amazinga akho amangqamuzana egazi abomvu, amaseli egazi amhlophe, namaplatelet asiza igazi lakho ukuba livale. Uma ukubalwa kwamaseli kuphansi, noma kulindeleke ukuba kube phansi, umongo we-bone oshukumisa izidakamizwa unganikezwa ukukhulisa ukukhiqizwa komzimba wakho kula maseli egazi.
Lezi zinhlaka zinengozi enkulu nemiphumela emibi, ngaphezu kwezinzuzo zabo zokuthuthukisa igazi, ngakho-ke akuzona zonke izimo "zokubala okuphansi" eziphathwa ngalezi zidakamizwa.
Lapho ukwelashwa umdlavuza, ukusetshenziswa kwemithi yamathambo okukhulisa izidakamizwa kuthathwa njengokunakekelwa okusekelayo , okusho ukuthi izidakamizwa azithinte ngqo umdlavuza, kodwa zisiza ngezinye izindlela.
I-Bone Marrow yakho, isondele
Umnkantsha wamathambo yizicubu eziphilayo ezipakwe ngaphakathi emathanjeni amathambo athile, ikakhulukazi ama-hipbones kanye nama-vertebrae, noma amathambo omgogodla womgogodla. Umnkantsha wamathambo wilapho iningi lamaseli akho ase- hematopoietic stem ahlala futhi asebenza. Ama-stem ama-hematopoietic ahlukanisa futhi aphakamisa zonke izinhlobo ezahlukene zegazi, kufaka phakathi amaseli abomvu, amaseli amhlophe, namaplatelet.
Uma unomsoco onomsoco onempilo , ukukhiqiza kuhlupheka-amangqamuzana egazi amasha angeke akhiwe ukuze aqhubeke nokulahleka noma axwayise amaseli, noma amaseli afana njengomthelela ohlangothini wokwelashwa komdlavuza. Umnkantsha we-bone ungase ungabi nampilo ngezizathu ezihlukahlukene. Endabeni yamanye amagciwane egazi, noma i-hematologic malignancies, umnkantsha wamathambo uyisayithi somdlavuza, ngaphezu kwesayithi elinobuthi obunobuthi obukwelashwa.
Kuyini Ukuguqulwa Kwemfuyo Yengculazi?
Umnkantsha ophilile uphendula izibonakaliso zamakhemikhali zomzimba ezikhuluma ngokusobala isidingo sokwandisa ukukhiqizwa kwamangqamuzana egazi. Ososayensi baye bafunda ukwenza ezinye zalezi zimpawu zamakhemikhali ngaphandle komzimba, futhi ngokuningi, ukuze zisetshenziswe ngemithi ukuze zithuthukise ukukhiqizwa.
Zivame ukunikezwa ngamanani amakhulu kunalokho okwakungavame ukukhiqizwa ngaphakathi komzimba.
"Imindeni" ehlukene noma ama-progenitors wezinhlobo zegazi ekhanda emanzini angase aphendule kumpawu ezihlukahlukene zamakhemikhali. Elinye igama elivamile lomsindo wamakhemikhali okhulisa ukukhiqizwa yi- hematopoietic growth factor. Akuzona zonke izidakamizwa ezithuthukisa umnto wethambo yizici zokukhula, noma kunjalo.
Kungani I-Bone Marrow Ukukhuthazwa Kwenziwe?
Ukulwa nokulingana okuphansi
Ukugqugquzela umzimba ukukhiqiza amangqamuzana amasha wegazi kungasiza uma omunye noma ngaphezulu kwesibalo sakho segazi ephansi noma ukubalwa kwakho kulindeleke ukuba kube phansi kakhulu. Ngokwesibonelo, ngezinye izikhathi umnkantsha wamathambo uvuselelwa kusengaphambili, njengesilinganiso sokuvimbela, lapho kubalwa kulindeleke ukuthi kuwele ngenxa yokwelashwa komdlavuza ohleliwe.
Iziguli ezithile ezithola i- cytotoxic chemotherapy zingase zibe nezikhathi eziphansi kakhulu isikhathi eside. Amazinga amangqamuzana egazi amhlophe aziwa ngokuthi i-neutrophils alandelwa ngokucophelela. Amazinga aphansi alawa neutrophile, ikakhulukazi, ahambisana kahle nengozi yokutheleleka. I-neutrophil ephansi ebala ngaphansi kwesibindi esithile ngokuvamile ibizwa ngokuthi i-neutropenia, futhi uma amazinga we-neutrophils ephansi kakhulu, ayaziwa njenge-neutropenia ejulile.
Ochwepheshe baye babhala okuningi, babhala amaqoqo amaningi emihlahlandlela, mayelana nokuthi ama-agent okuvuselela umongo we-bone afanele futhi akufanele asetshenziswe.
Izingxoxo eziningi zehla ziqinisekisa ukuthi izingozi nezinzuzo zilinganiswa ngesiguli. Kunezici eziningi ezihlukahlukene zokutholwa okufanele zicatshangelwe.
Ukusiza Umuntu Omunye
Ukuvuselelwa kwe-bone marrow kusetshenziswa futhi ngezinye izikhathi kubantu abanempilo, lapho bezonikela ngamaseli ama-stem komunye umuntu, kokuthile okuthiwa i- peripheral blood stem cell transplant . Kuvela ukuthi inani elincane kakhulu lama-stem cells we-hematopoietic angatholakala egazini, futhi odokotela baye bafunda ukuwaqoqa kubantu abaphilile; Amavolontiya anganikela ngamaseli abo okugcoba ukufakelwa kwe- marrow / stem cell ngokumane nje unike igazi, kwezinye izimo.
Ingxenye yale nqubo ihilela ukwandisa umnkantso wamathambo ukuze amanye ama-stem cells aqoqwe kalula egazini elijikelezayo.
Ngokusho kohlelo lweNational Marrow Donor Program, noma "Yiba Umlingani ," umuntu onika ama-stem cells athola amajojo e-filgrastim, isici sokukhula, esikhathini esingaphezu kwezinsuku ezingu-5 ngaphambi komnikelo. I-Filgrastim isetshenziselwa ukwandisa inani lamaseli okwenza igazi egazini legazi. Khona-ke, ngosuku lomnikelo, igazi levolontiya lidonsa ngenaliti engalweni eyodwa bese idlula emshinini oqoqa amaseli adinga igazi. Igazi elisele libuyiselwa kuvolontiya ngenye ingalo.
Izinhlobo ze-Bone Marrow Ezikhuthaza Imithi
Izici zokukhula ziyimithi evame ukunikezwa ngezijoka ngaphansi kwesikhumba. Ezinye zingabuye zinikezwe ngaphakathi, ngaphakathi kwe-vein. Ithimba lakho lokunakekelwa kwezempilo lingakwazi ukuphatha le mithi ngokujola, futhi ngezinye izikhathi abantu kanye namalungu omndeni bafunde ukuwaphatha, nabo.
Izinto Zokukhula Zokuthuthukisa Amaseli Egazi Amhlophe
Izici zokukhula noma "izinto ezikhuthaza abantu" ezisiza ukukhulisa amangqamuzana amhlophe egazi kufaka lokhu okulandelayo:
- I-Filgrastim ne- lenograstim yizici ze-granulocyte ezivuselela i-colony-stimulating (G-CSFs)
- I-Pegfilgrastim ifomu elide le-G-CSF. Isebenza ngendlela efanayo ne-filgrastim kodwa inganikezwa kaningi kancane.
- I-Sargramostim yi-granulocyte-macrophage-colony factor stimulating factor (GM-CSF).
Zombili izici zokukhula-G-CSF kanye ne-GM-CSF-zingathuthukisa ukukhiqizwa kwegazi elimhlophe. Idatha evela ekuhlolweni okulawulwa ngokungahleliwe ngokuqhathanisa lezi zinhlobo ezimbili zokuvuselela igazi okwamanje ayitholakali. Izinhlangano eziningi zezokwelapha zisebenzisa i-G-CSF, futhi yilona uhlobo olusungulwe kakhulu futhi oluye lwafundiswa kakhulu.
I-G-CSF inganikezwa ngesikhathi sokuqala komkhiqizo we-chemotherapy ukusiza ukuvimbela izinkinga ngenxa ye-neutropenia kuyo yonke imijikelezo ye-chemotherapy. Ama-G-CSF nawo asiza ekunciphiseni izifo zomkhuhlane kwiziguli ezine-neutropenia, futhi zinganciphisa isidingo sokubhedlela. Zingasetshenziswa futhi nge-chemotherapy ukuze zinikeze amanani aphezulu we-chemotherapy, ezimweni lapho ukunciphisa umthamo we-chemotherapy kungase kuholele ekuhlaselweni okubi nakakhulu.
Ngezinye izikhathi ama-G-CSF anikezwa ngesikhathi sokwelashwa kabusha kwe-chemo lapho umjikelezo wangaphambilini we-chemotherapy obangela umkhuhlane we-neutropenic, nokunciphisa ubude besikhathi umuntu one-neutropenia enamandla kakhulu kusuka ku-chemo uma kungekho fever. I-G-CSF ngokuvamile ayinconywa isimiso lapho isiguli sesivele sinomkhuhlane kanye ne-neutropenia.
Izinto Zokukhula Zokuthuthukisa Amaseli E-Red Red
Izici zokukhula ezisiza ukukhulisa amaseli abomvu wegazi, noma i-erythrocytes, zifaka okulandelayo:
- I-Erythropoietin yisici sokukhula esiqinisa ukukhiqizwa kwegazi elibomvu.
- I-Darbepoetin yindlela ehlala isikhathi eside ye-erythropoietin esebenza ngendlela efanayo kodwa inganikwa kancane kaningi.
Ukunikeza i-erythropoietin kungasiza ekugwemeni ukumpontshelwa kwamaseli abomvu kwezinye iziguli. Ukunikeza ezinye iziguli kokubili i-erythropoietin ne-G-CSF kuthuthukisa impendulo yabo ku-erythropoietin.
Njengezici zokukhula ezikhuthaza amangqamuzana amhlophe egazi, kube nemizamo eminingi yokuhlela iziqondiso nezincomo mayelana nokuthi i-erythropoietin ne-darbepoetin kufanele isetshenziswe kanjani. Isenzo sokulinganisa phakathi kwezinhlekelele nezinzuzo kuhilelekile.
Ukukhuthaza ama-Platelets
Ngokuvamile, umuthi obizwa ngokuthi i-oprelvekin wuhlobo olubunjiwe lwesignali yamakhemikhali okuthiwa i-interleukin-11, noma i-IL-11. I-Oprelvekin ingasetshenziselwa ukugqugquzela ukukhiqizwa kweplatelet ngemuva komdlavuza wamakhemikhali noma kwezinye izimo zezokwelapha ezibandakanya amaplatelet aphansi (thrombocytopenia). Lesi sidakamizwa singasiza ukwandisa izibalo zeplatelet zeziguli ezithile okwesikhashana, noma kunjalo, akusizo kuzo zonke izinhlobo zeziguli, noma kuzo zonke izimo zamaplatelet aphansi.
Enye imithi ebizwa ngokuthi i-romiplostim nayo iyakusiza ukukhulisa amaplatelet, kodwa iboniswa kuphela uma umuntu enepletletlet ephansi ebangelwa ngokuqondile into okuthiwa i-immune thrombocytopenia engapheliyo, noma i-ITP engapheli. I-Romiplostim ayiyona into ekhula ngokwemvelo, kodwa isebenza ngokulinganisa i-thrombopoietin, ukukhula nokuthuthukiswa okuthuthukisa amaplatelet.
Izifundo Zesikhathi Esizayo
Ucwaningo oluningi luqalisiwe ukuzama ukuthola indlela engcono kakhulu yokutshela ukuthi iziphi iziguli ezingase zizuze ezikhungweni zokukhula ezikhulisa i-cell cell kanye nokukhiqizwa kweplatelet.
Kukhona nesithakazelo esikhulu ekunqumeni indlela engcono kakhulu yokuhlanganisa izici zokukhula komunye nomunye-kanye namanye ama-agent-kuhlanganise ne-chemotherapy ne-hormone therapy.
Nini Ukubona Udokotela Wakho
Uma uthatha umnkantsha wamathambo oshukumisa imithi, yazise udokotela wakho uma uhlangabezana nanoma yimiphi imiphumela engenayo. Thintana nomhlinzeki wakho wezokunakekelwa kwempilo ngokushesha uma ubona noma yiziphi izimpawu ezilandelayo:
- Umkhuhlane we-100.4 ° F (38 ° C) noma ngaphezulu, izimpawu ezibonakalayo zokutheleleka
- Ukuphelelwa umoya
- Ukushaya kwenhliziyo okusheshayo
- Ukweqa okungayeki emva kwemizuzu embalwa
- Noma yikuphi ukusha okusha esikhumbeni sakho
Uma utshelwe ukuthi unezibalo eziphansi futhi uzithola uzibuza ukuthi kungani ungatholi imithi yokuvuselela igazi, ulethe le mibuzo ngeqembu lakho lokunakekelwa kwezempilo. Ngokuvamile, kunezinqubo eziqondile kakhulu zokwelapha okunjalo, futhi izinqumo zenziwa ngenxa yokugula kwakho, umlando wezokwelapha, kanye nezinhlelo zokwelashwa.
Izwi elivela
Ngenxa yezindleko kanye nemiphumela emibi yemiphumela emibi, amakomidi ochwepheshe baye bekhipha imihlahlandlela yokuvuselela nokuvuselela iminyaka, ukusiza abaqondisi bokunakekelwa kwezempilo ngokusebenzisa izinto ezikhusayo ze-koloni. Ukusetshenziswa kwala mithi kuncike ezintweni ezinjengehlobo oluthile lokulimala, iminyaka yakho, nokuthi yiziphi ezinye izindlela zokwelapha ezihlelwe.
Akuwona wonke umuntu omele ukhetho, kepha esimeni esifanele, le mithi ingasiza ekuvimbeleni i-neutropenia, imfiva, kanye nezifo ezimbi ezihlobene nemiphumela ebuhlungu.
> Imithombo:
> Yiba Uhlelo Oluxhasayo Lomklomelo Kazwelonke WeMarrow. Izinyathelo ze-PBSC noma i-Bone Marrow Donation.
> Smith TJ, Bohlke K, uLyman GH, et al. Izincomo zokusetshenziswa kwezinto ze-WBC Growth Factory: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol . 2015; 33: 3199-3212.
> Kuter DJ, Rummel M, Boccia R, et al. Romiplostim noma Standard of Care in Iziguli With Immune Thrombocytopenia. N Engl J Med. 2010; 363: 1889-1899.