Ukusilela kweBone Marrow: Masithethe ngale nto ngokweenkcukacha!

Umongo wethambo liziko eliphambili lokwenza igazi emzimbeni wakho. Ufana nomzi-mveliso. Lo mzi-mveliso wenza izinto ezifana neeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets ezinceda imizimba yethu ukuba ijiye. Khawucinge ukuba kuya kwenzeka ntoni ukuba lo mzi-mveliso uyeka ukusebenza ngequbuliso, okanye ukuba awusebenzi kakuhle? Yiloo nto ukusilela komongo wethambo. Makhe sithethe ngale nto ngokweenkcukacha ezithe vetshe.

Yintoni iBone Marrow Failure?

Ngamafutshane, ukungasebenzi kakuhle komongo wethambo kuxa umongo wakho wethambo ungakwazi ukuvelisa iiseli ezibomvu zegazi ezaneleyo, iiseli ezimhlophe zegazi, okanye iiplatelets zomzimba. Uhlobo ngalunye lweseli lunendima ethile emzimbeni wethu.

• Iiseli ezibomvu zegazi zezona zithwala ioksijini emzimbeni wonke. Ukuba ziphantsi, unokufumana ukudinwa kunye nokukhanya.
• Iiseli ezimhlophe zegazi zifana nomkhosi emzimbeni wethu. Zilwa nosulelo. Ukuba ziphantsi, amathuba okugula aphezulu.
• Iiplatelets zinceda ekuqhekekeni kwegazi, oko kuthetha ukuba ziyayeka ukopha xa wenzakele. Ukuba inani leeplatelets zakho liyehla, kwanesilonda esincinci sinokubangela ukopha okuninzi.

Ukungasebenzi kakuhle komongo wethambo kudla ngokuba yingxaki yesinye isifo. Kodwa ngamanye amaxesha oku kunokwenzeka ngaphandle kwesizathu esibonakalayo. Oogqirha banokukwazi ukulawula iimpawu ngamayeza kunye nonyango olwahlukeneyo. Nangona kunjalo, unyango oluhlala ixesha elide lwale meko kukufakelwa kweeseli ze-stem ze-allogeneic .

Ziziphi iintlobo eziphambili zale meko?

Kukho iintlobo ezimbini eziphambili zokungasebenzi kakuhle komongo wethambo:

1. Ifunyenwe: Iingcali azazi ukuba yintoni kanye kanye ebangela le meko. Kodwa uphando lubonise ukuba inokubangelwa zizifo ezithile, ukuchatshazelwa ziikhemikhali ezithile, okanye ukusetyenziswa kwamayeza athile. Olu hlobo lukhula kancinci kancinci ngokuhamba kwexesha.

2. Ilifa: Oku kwenzeka ukuba ufumana utshintsho kwimfuza (iinguqu) komnye wabazali bakho okanye bobabini. Oogqirha babiza le Bone Marrow Failure Syndrome .

Ixhaphake kangakanani le meko?

Esi asiyongxaki ixhaphakileyo. Umzekelo, malunga ne-65 kwizigidi zeentsana ezizalwa eMelika minyaka le zine-hereditary bone marrow failure syndrome. Omnye umzekelo yimeko ye-hereditary ebizwa ngokuba yi-"Fanconi Anemia." Ichaphazela malunga nenye kwisihlanu kwizigidi. Ngoko ke ungabona, oku kunqabile kancinci.

Zingaba yintoni iimpawu?

Iimpawu zingahluka ngokuxhomekeke kwisizathu sokungasebenzi kakuhle komongo wethambo. Umzekelo, umntu onesifo sokungasebenzi kakuhle komongo wethambo unokuqala ukubonisa iimpawu kwasekuqaleni kweminyaka emibini ubudala. Nangona kunjalo, uphando lubonisa ukuba umntu onolu hlobo lwesi sifo unokuqala ukubonisa iimpawu kwasekuqaleni kweminyaka engama-20 ukuya kwengama-25, okanye emva kweminyaka engama-65. Nokuba iqala nini, ezona mpawu ziqhelekileyo zezi:

• Intlungu emathanjeni
• Ukopha kakhulu (umz. ukopha impumlo, ukopha iintsini, ukopha kakhulu ukuya exesheni)
• Ukudinwa kakhulu nokudinwa
• Umkhuhlane oqhelekileyo
• Usulelo oluqhelekileyo lweebhaktheriya
• Intloko ebuhlungu
• Ubunzima bokuphefumla (i-Dyspnea)
• Umbala wolusu uya uphaphatheka ngakumbi kunesiqhelo
• Amabala amancinci abomvu phantsi kwesikhumba (iPetechiae)
• Ukugruzuka emzimbeni ngaphandle kwesizathu esaziwayo

Ukuba uqhubeka nokuba nenye okanye ngaphezulu kwezi mpawu, qiniseka ukuba ubona ugqirha.

Kutheni le nto umongo wethambo ungaphumeleli? Zithini izizathu?

Ezi zinto zilandelayo zinokubangela umngcipheko wokuba umongo wethambo ungaphumeleli:

• UneBone Marrow Failure Syndrome (esizuzwa njengelifa).
• Unesifo segazi, esinye isifo segazi, okanye ezinye izifo zegazi, umhlaza, okanye usulelo (ezi ziqala kamva, oko kukuthi, zezohlobo lwe-`(Acquired)`).
• Ukuchatshazelwa ziikhemikhali namayeza athile (oku kukwaphantsi kodidi `(Olufunyenweyo)`).

Ngamanye amaxesha, le meko inokwenzeka ngaphandle kwesizathu esicacileyo. Oogqirha bakwayibiza ngokuba " yi-idiopathic bone marrow failure." Abaphandi bakholelwa ukuba kukho unxibelelwano phakathi kwe-autoimmune kunye ne-bone marrow failure. I-Autoimmune yilapho inkqubo yomzimba wakho yokuzikhusela ihlasela ngempazamo i-bone marrow yakho.

Iimpawu zokungaphumeleli kweBone Marrow ezizuzwe njengelifa

Ezi zezinye zeemeko ezizuzwe njengelifa, ezinxulumene nazo, okanye ezineempawu ezifanayo:

• I-Congenital Agranulocytosis (i-Kostmann Syndrome): Oku kuchaphazela uhlobo lweseli emhlophe yegazi ebizwa ngokuba yi-neutrophils.
• I-Congenital Amegakaryocytic Thrombocytopenia (CAMT): Kule meko, kukho ukwehla kwenani leeseli ezibizwa ngokuba yi-megakaryocytes, ezinceda ekwenzeni iiplatelets, kumongo wakho wethambo.
• I-Diamond-Blackfan Anemia (i-Diamond-Blackfan Anemia): Le yimeko engapheliyo echaphazela ukuveliswa kweeseli ezibomvu zegazi.
• Dyskeratosis Congenita (Dyskeratosis Congenita - `(Dyskeratosis Congenita)`):Iimpawu zale meko ziquka utshintsho lolusu, olunokuba luphawu lokuqala lokungasebenzi kakuhle komongo wethambo.
• I-Fanconi Anemia (i-Fanconi Anemia): Le yeyona sifo sixhaphakileyo sokusilela komongo wethambo.
• I-Reticular Dysgenesis (I-Reticular Dysgenesis): Olu luhlobo lwe-Severe Combined Immunodeficiency (SCID). Kule meko, umzimba wakho awuvelisi ii-T-cells ezivuthiweyo ezaneleyo.
• I-Severe Congenital Neutropenia (Severe Congenital Neutropenia): Kule meko, ii-neutrophils zakho, uhlobo lweseli emhlophe yegazi, ziphantsi kunesiqhelo.
• I-Shwachman-Diamond Syndrome (iShwachman-Diamond Syndrome): Le meko ichaphazela i-pancreas yakho, umongo wamathambo kunye namathambo.

Ukuba omnye wabazali bakho unemeko kunye neempawu (oku kubizwa ngokuba yi-"Autosomal Dominant"), unethuba elingama-50% lokufumana le meko kunye nokufumana isifo sokonakala kwethambo.

Nangona kunjalo, ukuba bobabini abazali bakho bane-gene mutation enxulumene nohlobo olufanayo lwe-bone marrow failure syndrome, kodwa akukho namnye kubo oneempawu (oku kubizwa ngokuba yi-"Autosomal Recessive"), umngcipheko wakho wokufumana le meko uncitshiswa ube yi-25%.

Umhlaza Wegazi

Usengozini enkulu yokungasebenzi kakuhle komongo wethambo ukuba unenye yezi ntlobo zilandelayo zomhlaza:

• I-Lymphoma
• I-Multiple Myeloma
• Isifo seMyelodysplastic

Ezinye Iingxaki Zegazi

Abanye abantu bazalwa benezi meko. Abanye bakhula nazo ngokuhamba kwexesha. Ezi ziquka:

• I-Aplastic Anemia (i-Aplastic Anemia): Esi sisifo segazi esingaqhelekanga. Siyonakalisa umongo wakho wethambo kwaye siwuthintele ekubeni wenze iiseli zegazi ezintsha kunye neeplatelets. Oogqirha banokusebenzisa igama elithi "aplastic anemia" xa bethetha ngokusilela komongo wethambo.
• I-Cytopenias (Cytopenias): Oku kuquka iimeko ezifana ne-autoimmune neutropenia, i-idiopathic neutropenia, kunye ne-large granular lymphocyte leukemia.
• I-Paroxysmal Nocturnal Hemoglobinuria (I-Paroxysmal Nocturnal Hemoglobinuria): Kule meko, inkqubo yakho yomzimba yokuzikhusela itshabalalisa iiseli ezibomvu zegazi.
• I-Pure Red Cell Aplasia (i-Pure Red Cell Aplasia): Le yimeko ezuzwe njengelifa echaphazela ukuveliswa kweeseli ezibomvu zegazi.

Iintsholongwane zosulelo

Ezi ntsholongwane zilandelayo zinokwandisa umngcipheko wakho:

• I-Cytomegalovirus `(i-Cytomegalovirus)`
• Intsholongwane ye-Epstein-Barr
• Intsholongwane ye-Human Immunodeficiency Virus (HIV)
• I-Parvovirus B19 `(Parvovirus B19)`
• I-Hepatitis ebangelwa yintsholongwane

Unyango lwe-chemotherapy kunye/okanye unyango lwe-radiation lomhlaza lunokunyusa umngcipheko wokungasebenzi kakuhle komongo wethambo. Kwakhona, ukuchatshazelwa ziikhemikhali kunye nezinyibilikisi ezisetyenziswa kwezinye izibulali-zinambuzane kunye nezibulali-zinambuzane kunokunyusa umngcipheko wakho.

Zithini iingxaki zale meko?

Le yimeko enzima enokuba yingozi ebomini . Nokuba emva konyango, ezi ngxaki zilandelayo zinokwenzeka:

• Usulelo lweebhaktheriya okanye iintsholongwane
• Ukopha
• Umhlaza wegazi, umzekelo, i-acute myeloid leukemia okanye i-myelodysplasia
• Ezinye iithumba ezinomhlaza, umzekelo i-osteosarcoma kunye ne-rhabdomyosarcoma
• I-Carcinoma yeSeli yeSquamous

Uyixilonga njani le nto?

Ugqirha uza kuqala akubuze ngeempawu zakho, imbali yakho yezonyango, kunye nembali yezonyango yosapho lwakho. Baza kwenza novavanyo lomzimba. Banokuyalela uvavanyo lwegazi kunye novavanyo lwemifanekiso.

Uvavanyo lwegazi

Uvavanyo lwegazi lungabandakanya:

• Uvavanyo lweCeruloplasmin
• Inani elipheleleyo legazi (i-CBC)
• Uvavanyo lweFerritin
• Uvavanyo lokuNqanda iFolate
• Uvavanyo lokuNqanda iVithamini B12

Uvavanyo lokuFanekisa

Uvavanyo lomfanekiso lungabandakanya:

• Umzobo weMagnetic Resonance (i-MRI - `(Umzobo weMagnetic Resonance)` iskeni)
• I-Positron Emission Tomography (i-PET - iskeni ye-`(i-Positron Emission Tomography)`)
• Uvavanyo lwe-ultrasound `(Ultrasound)`

Ngokusekelwe kwiziphumo zovavanyo lwegazi kunye novavanyo lwemifanekiso, ugqirha wakho unokucebisa ukuba kwenziwe i-bone marrow biopsy . Angacebisa novavanyo lwe-genetic ukuze kuchongwe utshintsho lwe-genetic olubangela ukungasebenzi kakuhle kwe-bone marrow.

Ugqirha wakho unokuyalela iimvavanyo zokuxilonga izifo ezithile okanye akhuphe ezinye izifo. Baza kukuchazela isizathu sokuba benze uvavanyo ngalunye kunye noko uvavanyo lunokukubonisa.

Zithini iindlela zonyango?

Unyango olufumanayo luya kuxhomekeka kwizinto ezininzi, kuquka:

• Uhlobo lokusilela komongo wethambo (oko kukuthi, nokuba lufunyenwe njengelifa okanye lufunyenwe).
• Ubunzima bemeko yakho.
• Ubudala bakho kunye nempilo yakho iyonke.
• Iimpawu zakho.

Iindlela zonyango zingabandakanya:

• Ii-antibiotics , ii-antifungals, kunye namayeza okulwa neentsholongwane ukulwa nosulelo.
• Utofelo-gazi ukuze kwandiswe inani leeseli ezibomvu zegazi kwaye kuncitshiswe iimpawu ezifana nokopha nokudinwa.
• Izinto ezivuselela umongo wethambo zinceda umongo wakho wethambo ukuba wenze iiseli zegazi ezingaphezulu.
• Ii-immunosuppressants zinceda ekuthinteleni inkqubo yakho yomzimba yokuzikhusela ekuhlaseleni umongo wakho wethambo.
• Ukufakelwa kwe-Allogeneic Stem Cell (Bone Marrow) .

Ngaba kukho naziphi na iziphumo ebezingalindelekanga okanye iingxaki zonyango? (Iingxaki Zonyango)

Iingxaki kunye neziphumo ebezingalindelekanga ziyahluka ngokuxhomekeke kunyango, kodwa ukufakelwa kweeseli ze-stem (umongo wethambo) zezona zinokubangela iingxaki ezinkulu. Ezi ziquka isifo se-graft-versus-host (GVHD) kunye nosulelo.

Buza kuba njani ubomi xa kukho le meko? (Ingqikelelo)

Oko unokukulindela emva konyango (ukuxela kwangaphambili) kuxhomekeke kwizinto ezahlukeneyo, kuquka uhlobo lwesifo, ubudala bakho kunye nempilo yakho iyonke, kunye nendlela umzimba wakho osabela ngayo kunyango.

Ngokwesiqhelo, abantu abanengxaki yokonakala kwethambo bafuna unyango oluqhubekayo kunye nenkxaso . Kodwa ayinguye wonke umntu ofanayo. Yazi imeko yakho ngokuchanekileyo, kwaye ubuze ugqirha wakho ukuba kwenzeka ntoni emva konyango lwakho lokuqala.

Ingaba ukungasebenzi kakuhle komongo wethambo kuyingozi? (Ingaba kuyingozi?)

Le yimeko embi kakhulu, esongela ubomi . Uninzi lwabantu abanengxaki yomongo wethambo banyangwa ziingcali ezinamava ezifana neengcali zomhlaza kunye neengcali zegazi.

Kunokuthiwani ngobomi obulindelekileyo baba baguli? (Ubomi obulindelekileyo)

Ixesha lokuphila liqikelelwa ukuba umntu uza kuphila ixesha elingakanani emva konyango lwesimo esithile. Ixesha lokuphila kwabantu abanengxaki yomongo wethambo linokususela kwiinyanga ezimbalwa ukuya kubomi bonke.

Kodwa, ukhethekile, kwaye amava akho asenokungafani nawabanye abantu. Buza ugqirha wakho malunga noko unokukulindela, kunye nokuba ungalindela ixesha elingakanani lokuphila. Ngabo mthombo wakho wolwazi ongcono, kuba bayakwazi wena kunye nemeko yakho.

Ngaba umngcipheko ungancitshiswa? (Ukunciphisa umngcipheko)

Ngelishwa, akukho ndlela yokunciphisa umngcipheko wokungasebenzi kakuhle komongo wethambo. Nangona kunjalo, ukuphepha iikhemikhali ezaziwa ngokunciphisa ukusebenza komongo wethambo kunokunciphisa umngcipheko wokungasebenzi kakuhle komongo wethambo. Kwakhona, unyango lwasekuqaleni lunokunceda ekunciphiseni iimpawu zakho kwaye luphucule umgangatho wobomi bakho.

Ndingazinyamekela njani? (Ukuzinyamekela)

Eyona nto ingcono onokuyenza kukunyamekela impilo yakho iyonke . Umzekelo, musa ukusebenzisa iimveliso zecuba, ukunciphisa okanye ukuyeka ukusela iziselo ezinxilisayo. Nazi ezinye iingcebiso:

• Bona ugqirha wakho rhoqo. Ukungasebenzi kakuhle kwethambo lomongo kunokuba yimeko yobomi bonke. Ungadinga unyango oluqhubekayo. Kunokubangela iingxaki ezintsha zempilo. Ngoko ke kubalulekile ukuba uhlolwe rhoqo. Ugqirha wakho uza kujonga impilo yakho iyonke aze anyange naziphi na iingxaki ezintsha.
• Yitya ukutya okunempilo. Iimpawu zakho kunye nemiphumo emibi evela kunyango lwakho zinokwenza kube nzima kuwe ukutya okanye ukuphelelwa ngumdla wokutya. Ukuba awuqinisekanga ukuba ufumana isondlo osifunayo, thetha nogqirha wezondlo. Banokukunika iingcebiso ezifanelekileyo.
• Yenza umthambo. Ukuba nesifo esinzulu esifana nokusilela komongo wamathambo kunokuba luxinzelelo. Ukuzilolonga yindlela entle yokunciphisa uxinzelelo. Qiniseka ukuba uthetha nogqirha wakho ngaphambi kokuba uqale umthambo omtsha.

Kufuneka uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba unomongo ongasebenzi kakuhle, usengozini enkulu yosulelo kunye neengxaki zokopha. Kuya kufuneka uye kwigumbi likaxakeka ukuba ufumana nayiphi na kwezi zilandelayo:

• Ukuba nomkhuhlane onganciphiyo nangona sele usele amayeza okubulala iintlungu aqhelekileyo
• Ukuziva ubanda kwaye uqhaqhazela (Ukugodola)
• Ukopha okungenakunqandeka

Ndingayibuza yiphi imibuzo ugqirha?

Usenokuba nokusilela komongo ngenxa yezifo ezithile ezizuzwe njengelifa. Kodwa ngamanye amaxesha oku kungenzeka ngaphandle kwesizathu esicacileyo. Ungabuza ugqirha wakho imibuzo efana nale:

• Uyazi ukuba kutheni ndinengxaki yokungakwazi ukwenza umthambo wethambo?
• Ziziphi iindlela zonyango endinazo?
• Ngaba kuya kufuneka ndithathe unyango ngonaphakade?
• Ngaba oku kunganyangeka?

Ukuba unobuthathaka bomongo wamathambo, usenokuba sele ujongene nengxaki enkulu yempilo, njengesifo esizuzwe njengelifa, ingxaki yegazi, okanye umhlaza. Olu xilongo lutsha lunokukubangela imibuzo emininzi kunye neenkxalabo ezintsha, ezinokuba nzima kakhulu. Kuqhelekile ukuba nexhala kuba le inokuba yimeko esongela ubomi. Thetha neqela lakho lezonyango malunga nento omawuyilindele kunye nento omawuyenze emva koko. Baya kukuvuyela ukuphendula imibuzo yakho.

Khumbula njengesishwankathelo (Umyalezo Wokuya Ekhaya)

Ukusilela komongo wethambo yimeko enzima neyinkimbinkimbi . Kodwa khumbula, zininzi izizathu ezinokubakho, kwaye kukho iindlela ezahlukeneyo zonyango kunye namaqhinga okulawula. Eyona nto ibalulekileyo kukufumana uxilongo kwangethuba, ufune unyango kwiingcali ezifanelekileyo, kwaye uqhubeke nokulandela loo miyalelo.Ukuba unemibuzo okanye iinkxalabo malunga noku, ungoyiki ukuthetha nogqirha wakho. Bakho ukuze bakuncede.

Ukusilela kweBone Marrow, iiSeli eziBomvu zeGazi, iiSeli ezimhlophe zeGazi, iiPlatelet, ukufakelwa kweeSeli zeStem, izifo zeBone Marrow