Mhlawumbe udokotela ukhulume nelungu lomndeni noma umngane mayelana 'nokufakelwa i-stem cell'. Noma mhlawumbe uphakanyiswe lokhu kwelashwa kwesimo sezokwelapha esifana ne-leukemia. Kujwayelekile kakhulu ukuzizwa wesaba futhi ukhathazekile uma uzwa leli gama. Kodwa lokhu kuyindlela yokwelapha ebaluleke kakhulu engasindisa izimpilo eziningi. Ngakho-ke namuhla, ake sixoxe kalula nangokucacile ngokuthi kuyini lokhu 'ukufakelwa kwe-Allogeneic Stem Cell', kwenziwa kanjani, nokuthi yiziphi izingozi.
Kalula nje, kuyini ukufakelwa kweseli le-stem allogeneic?
Kulula kakhulu ukukuqonda lokhu. Ukufakelwa kwe-allogeneic stem cell kwenzeka lapho amaseli akho e-stem anesifo esuswa futhi athathelwe indawo amaseli e-stem avela kumuntu onempilo futhi ohambisanayo. Lawa maseli e-stem awuhlobo olukhethekile lweseli olutholakala emnkantsheni wethu wamathambo olungakhula lube yinoma yiluphi uhlobo lweseli legazi (amaseli abomvu egazi, amaseli amhlophe egazi, ama-platelet).
Uma la maseli anikelwe anempilo engena emzimbeni wakho, aya emnkantsheni wakho bese eqala ukukhiqiza amaseli egazi amasha anempilo. Lokhu kuyindlela yokwelapha enamandla engaze yelaphe ngokuphelele ezinye izifo ezinkulu. Odokotela bavame ukusebenzisa le ndlela yokwelapha lapho ezinye izindlela zokwelapha zehlulekile noma lapho isifo sesiphinde sabuya.
Yiziphi izimo ezisetshenziswayo lokhu kwelashwa?
Ukufakelwa kwamaseli e-stem e-allogeneic kusetshenziselwa kakhulu izifo ezihlobene negazi kanye nesistimu yomzimba yokuzivikela.
| Izimo eziyinhloko ziyalashwa |
|---|
| I-Acute Lymphoblastic Leukemia (YONKE) |
| I-Acute Myeloid Leukemia (AML) |
| I-Aplastic Anemia - Ukwehluleka kwe-bone marrow |
| I-Lymphoma - umdlavuza wama-lymph node |
| Isifo se-Myelodysplastic |
| Ama-Neoplasm e-Myeloproliferative (MPN) |
| Isifo Se-Sickle Cell |
Uzilungiselela kanjani ngaphambi kokwelashwa?
Njengoba lokhu kuyindlela yokwelapha enkulu, odokotela bazokwenza izivivinyo eziningana ukuze bahlole ukuqina komzimba wakho ngaphambi kwenqubo ukuqinisekisa ukuthi uyakwazi ukubekezelela imiphumela emibi yokwelashwa.
Ukuhlolwa okuyinhloko okwenziwe
Ithimba lakho lezokwelapha lizokwenza izivivinyo eziningana, ezifana nalezi:
- Ukubalwa Kwegazi Okuphelele (i-CBC): Kuhlola amazinga eseli lakho elibomvu legazi, amangqamuzana amhlophe egazi, kanye nama-platelet.
- I-Echocardiogram: Bona ukuthi inhliziyo isebenza kahle kangakanani.
- I-Electrocardiogram (EKG): Ihlola isigqi somsebenzi wenhliziyo.
- Ukuhlolwa kokusebenza kwesibindi nezinso.
- Ukuhlolwa Kwe-Bone Marrow: Uma unomdlavuza, kuthathwa isampula encane yomnkantsha wakho bese ihlolwa. Lokhu kusiza ekuhloleni izinguquko kulesi sifo kanye nengozi yokuthi lesi sifo sibuye ngemva kokwelashwa.
Ukulungiswa Kwangaphambi Kokufakelwa
Ngemva kwalezi zivivinyo, uzolaliswa esibhedlela futhi unikezwe ukwelashwa okubizwa ngokuthi 'i-conditioning'. Lokhu kuhilela ukusetshenziswa kwe -chemotherapy enamandla kanye/noma ukwelashwa ngemisebe yomzimba wonke . Lokhu kunezinhloso ezintathu:
1. Ukubhubhisa noma yimaphi amangqamuzana omdlavuza asele emzimbeni wakho.
2. Ukwakha isikhala emnkantsheni wakho ukuze kukhule amaseli amasha e-stem.
3. Ukwenza buthaka amasosha omzimba wakho. Lokhu kunciphisa ikhono lomzimba wakho lokuhlasela (ukwenqaba) amaseli amasha.
Le nqubo yokulungisa imvamisa ithatha isonto noma amabili.
Kwenzekani ngesikhathi sokufakelwa i-stem cell?
Lokhu akubuhlungu ngempela. Ithimba lakho lezokwelapha lizofaka ithubhu elincane elibizwa ngokuthi i-central venous catheter (CVC) emthanjeni omkhulu osesifubeni sakho esingaphezulu. Amaseli okuqala amasha azonikezwa emzimbeni wakho ngaleli thubhu.
Kuyinqubo elula, njengokunikela ngegazi. Amaseli okuqala aphilile esikhwameni sikasawoti afakwa egazini lakho ngepayipi le-CVC. Ukusuka lapho, aya emnkantsheni wakho.
Le nqubo ithatha cishe imizuzu engama-30 kuya kwengama-60. Phakathi nalesi sikhathi, ithimba lezokwelapha lizohlala eduze kwakho futhi liqaphe izimpawu zakho ezibalulekile. Lizophinde liqaphelisise noma yimiphi imiphumela emibi. Imiphumela emibi ayivamile futhi imvamisa incane. Isibonelo, ungase uzwe ukuthuthumela okuncane, ubunzima bokuphefumula, noma umkhuhlane.
Iyini inkinga eyinhloko yalokhu kwelashwa?
Inkinga enkulu nebucayi kakhulu yokufakelwa kwe-allogeneic isifo se-graft-versus-host (GVHD) .
Kalula nje, yilapho amangqamuzana amasha omzimba aphilile avela kumuntu onikelayo (i-graft) eqala ukuhlasela amangqamuzana nezicubu ezinempilo emzimbeni wakho (umnikazi). Kufana nebutho elisha elihlasela abantu ezweni lakini. Lesi simo singathinta isikhumba, isibindi, kanye nohlelo lokugaya ukudla. Kodwa akudingeki ukhathazeke, odokotela bangakunikeza imithi edingekayo yokulawula nokwelapha lesi simo.
Kwenzekani ngemva kokwelashwa? Kuthatha isikhathi esingakanani ukululama?
Ngemva kokufakelwa, kuzodingeka uhlale esibhedlela amasonto ambalwa. Phakathi naleso sikhathi, ithimba lezokwelapha lizokunakekela kahle. Uzoqhubeka nokuthola imithi yokucindezela amasosha omzimba ukuvimbela umzimba wakho ekwenqabeni amaseli asanda kufakelwa. Ungase udinge nokumpontshelwa igazi kuze kube yilapho amaseli amasha ekwazi ukukhiqiza amaseli egazi amasha.
Inqubo lapho amangqamuzana amasha angena khona emnkantsheni wamathambo futhi aqale ukwenza amangqamuzana egazi amasha ibizwa ngokuthi 'i-engraftment' . Lokhu kungathatha izinsuku eziyi-10 kuya kweziyi-14. Kodwa-ke, kungathatha izinyanga eziningana kuya onyakeni noma ngaphezulu ukuze amasosha omzimba wakho alulame ngokugcwele. Phakathi nalesi sikhathi, kubaluleke kakhulu ukuzivikela ezifweni.
Kungathatha iminyaka emibili noma ngaphezulu ukululama ngokuphelele, ngakho-ke lolu uhambo oludinga isineke nokulandela imiyalelo kadokotela wakho.
Yiziphi izimpawu ezidinga ukuthi ubonane nodokotela ngokushesha?
Uma ubuyela ekhaya ngemva kokwelashwa, kufanele unake kakhulu umzimba wakho. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela ithimba lakho lezokwelapha ngokushesha .
| Isigaba sezimpawu | Izici okufanele uziqaphele |
|---|---|
| Kungaba izimpawu zesifo se-graft-versus-host (GVHD) | |
| Uhlelo lokugaya ukudla | Ubuhlungu besisu, uhudo, isicanucanu, nokuhlanza. |
| Isikhumba namehlo | Ukuluma nokuxebuka kwesikhumba, ukuphuzi kwesikhumba kanye/noma amehlo (i-jaundice). |
| Kungaba izimpawu zokutheleleka | |
| Izici ezijwayelekile | Umkhuhlane ongama-38 Celsius (100.4 Fahrenheit) noma ngaphezulu, ukubanda, ukukhwehlela, ukuthimula, ikhala eligobhozayo. |
| Ezinye izici | Ukujuluka , ubunzima bokuphefumula, ukuchama njalo, noma ukushisa ngesikhathi sokuchama. |
Uyini umehluko phakathi kokufakelwa kwe-allogeneic kanye ne-autologous?
Umehluko omkhulu phakathi kwalokhu okubili umthombo wamaseli okuqala.
Ukufakelwa kwe-allogeneic: Amaseli e-stem atholakala komunye umuntu (umnikeli).
Ukufakelwa kwe-Autologous: Amaseli okuqala athathwa kuwe (amaseli akho athathwa ngaphambi kokuba unikezwe i-chemotherapy enamandla, bese ephinde afakwe emzimbeni wakho).
Ukufakelwa kwe-allogeneic kungalapha ezinye izifo ezisongela ukuphila. Lokhu kuvame ukwenzeka ngenxa yomusa wabantu ongabazi. Laba ngabantu abanikela ngama-stem cell. Ngezinye izikhathi abanikelayo bangamalungu omndeni. Kunezingozi ezihilelekile ekutholeni amaseli anikelwe. Zinike isikhathi sokuqonda izinzuzo nezingozi zale nqubo. Udokotela wakho angakusiza ulinganise izingozi nezinzuzo ukuze uzizwe uqiniseka ngesinqumo sakho.
Umlayezo Wokuya Nawe Ekhaya
- Ukufakelwa kwamaseli e-Allogeneic stem kuyindlela yokusebenzisa amaseli anempilo avela komunye umuntu ukwelapha izifo zegazi ezinzima njenge-leukemia.
- Ngaphambi kokwelashwa, umzimba ulungiswa ngokwelashwa okunamandla njengokwelashwa ngamakhemikhali.
- Kukhona ingozi yokuthi amangqamuzana omnikeli ahlasele umzimba wesiguli (isifo sokufakelwa ngokumelene nomnikazi), kodwa odokotela bayaqaphela kakhulu ngalokhu.
- Kuthatha isikhathi eside ukululama ngokugcwele, futhi ukulandela iseluleko sezokwelapha nokuhlolwa njalo kubalulekile phakathi nalesi sikhathi.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo, ukwesaba, noma ukukhathazeka ongase ube nakho. Leyo indawo engcono kakhulu yokuthola ulwazi olunembile kanye nempumuzo.
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