Ua ʻike mākou a pau i ka makaʻu a me ka hopohopo e hele mai me ka lohe ʻana mai ke kauka mai ua loaʻa i kahi lālā o ka ʻohana a i ʻole hoaaloha kahi maʻi koko koʻikoʻi a i ʻole ke kanesa koko. Akā mahalo i nā holomua o ka lāʻau lapaʻau i kēia lā, aia nā lāʻau lapaʻau ikaika e hiki ke ho'ōla i kēlā mau maʻi. ʻO kekahi o ia ʻano lāʻau lapaʻau e hoʻōla ai i ke ola ua kapa ʻia ʻo "Allogeneic Stem Cell Transplant." ʻOiai paha he paʻakikī ke ʻano o ka inoa, e kamaʻilio kākou e pili ana i nā mea e hana ʻia ma kēia me ka maʻalahi loa .
He aha maoli ke ʻano o ka hoʻoili ʻana o nā cell kumu allogeneic?
I ka ʻōlelo maʻalahi, pili kēia i ka wehe ʻana i nā hunaola kumu maʻi a maikaʻi ʻole mai kou kino a hoʻololi iā lākou me nā hunaola kumu olakino a kūpono mai kekahi mea ʻē aʻe (he mea hāʻawi).
I kēia manawa, e wehewehe iki aku kākou i kēia.
- Nā Kelepona Kumu: Hiki iā mākou ke kapa aku i kēia mau "kelepona makuahine" no ka mea ua like kēia mau kelepona me ka hale hana e hana ana i nā kelepona koko ʻē aʻe i loko o ko mākou kino (nā kelepona koko ʻulaʻula, nā kelepona koko keʻokeʻo, nā platelets). Loaʻa kēia mau kelepona kumu i loko o ko mākou iwi iwi.
- Allogeneic: ʻO ke ʻano o kēia huaʻōlelo "loaʻa mai kekahi kanaka ʻē aʻe." ʻO ke ʻano kēia, hoʻohana ka lāʻau lapaʻau i nā pūnaewele mai kahi mea hāʻawi olakino a kūpono, ʻaʻole naʻe kāu ponoʻī.
E noʻonoʻo ʻoe ua like ko kākou iwi me kahi mahinaʻai momona me ka lepo maikaʻi. Ma kēia mahinaʻai e ulu ai ko kākou mau hunaola koko. Akā i loko o kahi maʻi e like me ka leukemia, lilo kēia mahinaʻai i mea ʻino, a ulu nā nāhelehele (nā hunaola maʻi ʻaʻai) ma kahi o nā mea kanu maikaʻi. No laila, ma kēia lāʻau lapaʻau, ua wehe loa ʻia kēlā lepo ʻino (ka iwi maʻi) a ua pani ʻia me ka lepo hou, olakino, momona (nā hunaola kumu o ka mea hāʻawi). A laila, hoʻomaka nā hunaola koko olakino e ulu ma kēlā lepo hou.
He lāʻau ikaika kēia e hiki ke ho'ōla loa i kekahi mau maʻi koʻikoʻi. Hoʻohana pinepine nā kauka i kēia lāʻau i ka wā i hāʻule ʻole ai nā lāʻau ʻē aʻe a i ʻole ke hoʻi hou mai ka maʻi.
He aha nā ʻano kūlana e hoʻohana ʻia ai kēia lāʻau lapaʻau?
Hoʻohana pinepine ʻia ia no nā maʻi e pili ana i ke koko a me ka ʻōnaehana pale. Eia kekahi o nā maʻi nui.
| Kūlana olakino | He wehewehe maʻalahi |
|---|---|
| ʻO ka maʻi leukemia lymphoblastic koʻikoʻi (ALL) | ʻO nā Lymphocytes, kahi ʻano o ke koko keʻokeʻo i loaʻa i loko o ke koko a me ka iwi iwi, lilo i mau pūnaeho kanesa. |
| ʻO ka maʻi leukemia myeloid koʻikoʻi (AML) | ʻO ke kanesa o nā hunaola koko e ulu ana mai nā hunaola kumu myeloid. |
| ʻAnemia Aplastic | ʻO ka hōʻino ʻana i ka iwi iwi e pale aku ai i ke kino mai ka hana ʻana i nā hunaola koko hou e lawa ai. |
| ʻO ka maʻi ʻōpū | He maʻi ʻaʻai e kū ana i loko o ka ʻōnaehana lymphatic. |
| ʻO ka maʻi Myelodysplastic | Ka hana ʻana o nā hunaola koko olakino i loko o ka iwi iwi i ke ʻano kūpono ʻole. |
| Maʻi ʻeha o ke kelepona ʻokiʻoki | He maʻi hoʻoilina kahi e loli ai ke ʻano o nā hunaola koko ʻulaʻula a ua hoʻopilikia ʻia kā lākou hana. |
Pehea ʻoe e hoʻomākaukau ai no ka mālama ʻana?
Ma muli o kahi lāʻau lapaʻau nui kēia, e hana ke kime lapaʻau i kekahi mau hoʻokolohua ma mua e hōʻoia i hiki i kou kino ke ʻae iā ia.
- Nā hoʻāʻo koko: Hana ʻia nā mea e like me ka helu koko piha (CBC) e nānā i nā pae o nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo, a me nā platelets.
- Nā hoʻāʻo puʻuwai: He echocardiogram (e ʻike i ke ʻano o ka hana ʻana o ka puʻuwai) a me kahi electrocardiogram (EKG) e ʻike i ke kani o ka puʻuwai.
- Hana ʻia nā hoʻokolohua e nānā i ka hana o ke akepaʻa a me nā puʻupaʻa .
- Biopsy ʻIwi Momona: Inā loaʻa iā ʻoe ka maʻi kanesa, lawe ʻia kahi hāpana liʻiliʻi o ka iwi momona a hoʻāʻo ʻia e loiloi i ke ʻano o ka maʻi a me ka pilikia o ka hoʻi hou ʻana.
Ke pau kēia mau hoʻāʻo a pau a ua hoʻoholo ʻia he moho maikaʻi ʻoe, hoʻomaka ka ʻāpana koʻikoʻi o ka lāʻau lapaʻau, i kapa ʻia ʻo "pre-transplant conditioning." Pili kēia i ka chemotherapy kiʻekiʻe a i ʻole ka radiation therapy i ke kino holoʻokoʻa. He manawa paʻakikī paha kēia. Akā, he mea nui ia.
No ke aha he mea nui kēia ma mua o ka mālama ʻana?
- Hoʻopau ia i nā hunaola kanesa i koe i loko o kou kino.
- Hoʻopau ia i nā hunaola kahiko a maʻi mai kou iwi iwi a hana i wahi no nā hunaola hou e ulu ai.
- Hoʻonāwaliwali ia i kou ʻōnaehana pale kino no kekahi manawa. Hana ʻia kēia e pale i kou kino mai ka hoʻouka ʻana a me ka hōʻole ʻana i nā cell i hāʻawi hou ʻia.
Pono ʻoe e noho i ka haukapila no hoʻokahi a ʻelua paha pule no kēia lāʻau lapaʻau.
He aha ka mea e hana ʻia i ka lā o ke kāpili ʻana o nā cell?
He maʻalahi loa ke kaʻina hana o ka hoʻoili ʻana o nā cell a ʻaʻohe ʻeha , e like me ka hāʻawi ʻana i ke koko.
E hoʻokomo ke kime lapaʻau i kahi paipu kūikawā i loko o kahi aʻa nui ma kou umauma luna. Ua kapa ʻia kēia he Central Venous Catheter (CVC) . Hoʻopili ʻia ka ʻeke e loaʻa ana nā cell kumu olakino mai ka mea hāʻawi i kēia paipu. A laila e hoʻokomo mālie ʻia nā cell i loko o kou kino, ma o kou kahe koko, a i loko o kou iwi iwi, e like me ka wai saline.
Ma kahi o 30 mau minuke a i hoʻokahi hola ka lōʻihi o kēia kaʻina hana. I loko o kēia manawa, e noho ka hui lapaʻau ma kou ʻaoʻao a nānā i kou koko a me ka helu o ka puʻuwai. I kekahi manawa, hiki ke loaʻa nā hopena ʻaoʻao liʻiliʻi.
- Ke anu nei
- Ka paʻakikī iki o ka hanu ʻana
- He kuni
Akā, ʻaʻole koʻikoʻi kēia mau mea maʻamau.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
Hoʻomaka ka wā hoʻōla koʻikoʻi ma hope o ke kāpili ʻana o nā cell stem. Pono ʻoe e noho i ka haukapila a i ʻole kokoke iā ia no kekahi mau pule hou aʻe.
- Kaohi ʻana i ke kino: E hoʻomau ʻia ka hāʻawi ʻana iā ʻoe i nā immunosuppressants e pale aku i kou kino mai ka hoʻouka ʻana i nā cell hou a e pale aku i nā cell hou mai ka hoʻouka ʻana i kou kino.
- Nā hoʻoili koko: He manawa iki ka lōʻihi no nā hunaola kumu hou e hoʻomaka ai e hana a hana i nā hunaola ʻulaʻula hou a me nā platelets. I loko o ia manawa, pono paha ʻoe i nā hoʻoili koko.
- Ka palekana mai nā maʻi: Ua nāwaliwali loa kou ʻōnaehana pale i kēia manawa, no laila e uku nui ʻia ka mālama ʻana iā ʻoe iho mai nā maʻi bacteria a me nā viral.
ʻO ke kaʻina hana e hele ai nā pūnaewele hou i ka iwi iwi, e noho ma laila, a hoʻomaka e hana i nā pūnaewele koko hou ua kapa ʻia ʻo "engraftment." Hiki i kēia ke hala ma kahi o 10 a 14 mau lā.
ʻEhia ka lōʻihi e hoʻōla piha ai?
He hana lōʻihi kēia. Hiki ke hala i ʻelua mau makahiki a ʻoi aku paha e hoʻōla piha ai. Hiki ke hala ma kahi o hoʻokahi makahiki e hoʻōla ai kou ʻōnaehana pale.
Ka pilikia kūikawā e makaʻala ai: Graft vs. Host Disease (GVHD)
ʻO kēia ka pilikia maʻamau o kahi hoʻoili allogeneic. I ka ʻōlelo maʻalahi, hana ia i ka wā e hoʻouka ai nā pūnaewele pale hou mai ka mea hāʻawi (ka graft) i nā pūnaewele a me nā ʻiʻo o kou kino ponoʻī (ka mea hoʻokipa) . Ua like ia me kahi "malihini e hoʻouka ana i ka mea hoʻokipa."
Hiki i kēia ke ʻano akahai a koʻikoʻi paha. ʻO ia ke kumu e hāʻawi mau ʻia ai nā lāʻau immunosuppressant. Pono ʻoe e makaʻala pono i nā hōʻailona o kēia maʻi.
Nā hōʻailona e pono e hōʻike koke i kāu kauka
Ke hoʻi ʻoe i ka home ma hope o ka mālama ʻana, pono ʻoe e makaʻala loa i kekahi mau hōʻailona. Inā ʻike ʻia kekahi o kēia mau mea, e kāhea koke aku i kāu hui lapaʻau.
| Māhele hōʻailona | Nā hiʻohiʻona e nānā ai |
|---|---|
| ʻO nā hōʻailona o ka Graft vs. Host Disease (GVHD) e komo pū paha: | |
| ʻōpū | ʻEha ʻōpū, nausea a me ka luaʻi ʻana, diarrhea (bloating) |
| ʻIli a me nā maka | ʻŌhūhū ʻili, melemele o ka ʻili a me/a i ʻole nā maka (jaundice) |
| He mau hōʻailona paha ia o kahi maʻi | |
| Nā ʻano laulā | Kuni o 38 Celsius (100.4 Fahrenheit) a ʻoi aku paha, nā anu |
| ʻŌnaehana hanu | ʻUmiʻumi, ʻūhū, ihu wai, paʻakikī ka hanu ʻana |
| Nā hiʻohiʻona ʻē aʻe | ʻO ka poniuniu, ka mimi pinepine ʻana, a i ʻole ke kuni ʻana i ka wā e mimi ai |
ʻO ka ʻokoʻa ma waena o nā hoʻoili "allogeneic" a me "autologous"
Ua lohe paha ʻoe i ke ʻano o ka hoʻoili ʻana o nā cell stem autologous . ʻO ka ʻokoʻa nui ma waena o nā mea ʻelua ke kumu o nā cell.
- Allogeneic: Loaʻa nā pūnaewele mai kekahi kanaka ʻē aʻe (he mea hāʻawi).
- Autologous: Lawe ʻia nā pūnaewele mai ka mea maʻi . ʻO ke ʻano kēia, hōʻiliʻili mua ʻia nā pūnaewele kumu olakino ponoʻī o ka mea maʻi a laila hāʻawi ʻia iā lākou ma hope o ka chemotherapy kiʻekiʻe.
Hiki i kahi hoʻoili allogeneic ke ho'ōla loa i kekahi mau maʻi e hoʻoweliweli ana i ke ola. I ka manawa pinepine, hana ʻia kēia mau hoʻoili ola e nā mea hāʻawi i ʻike ʻole ʻia a mākou i ʻike ʻole ai. I kekahi manawa, lilo nā lālā o ka ʻohana i mau mea hāʻawi. ʻOiai he mau pilikia i kēia lāʻau lapaʻau, kiʻekiʻe loa nā pono. E wehewehe kāu kauka i kēia mau mea āpau iā ʻoe a kōkua iā ʻoe e hoʻoholo i ka hoʻoholo kūpono loa iā ʻoe.
Leka Lawe-Home
- ʻO ke kāpili ʻana o nā pūnaewele kumu allogeneic ka hoʻololi ʻana o ka iwi iwi maʻi me nā pūnaewele kumu mai kahi mea hāʻawi olakino.
- He lāʻau lapaʻau ikaika kēia i hoʻohana ʻia no nā maʻi koko koʻikoʻi e like me ka leukemia, lymphoma, a me ka anemia aplastic.
- He mea nui e hoʻomākaukau i ke kino me ka chemotherapy kiʻekiʻe a i ʻole ka radiation therapy ma mua o ka mālama ʻana.
- ʻO ka pilikia nui e hiki ke kū mai ma hope o ka mālama ʻana, ʻo ia ka Graft vs. Host Disease (GVHD), a he mea nui e makaʻala mau i kēia a me nā hōʻailona o ka maʻi.
- He hana ho'ōla lōʻihi kēia, a he mea nui loa e hoʻomaopopo koke i kāu kauka a i ʻole ka hui lapaʻau i kekahi mau pilikia.
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