Ukwehluleka Kwe-Bone Marrow: Ake sixoxe ngalokhu ngokuningiliziwe!

Umnkantsha uyisikhungo esiyinhloko sokwenza igazi emzimbeni wakho. Ufana nefektri. Le fektri yenza izinto ezifana namaseli abomvu egazi, amaseli amhlophe egazi, nama-platelet asiza imizimba yethu ukuthi ijiye. Cabanga ukuthi bekuzokwenzekani uma le fektri ingayeka ukusebenza ngokuzumayo, noma uma ingasebenzi kahle? Yilokho ukwehluleka komnkantsha. Ake sixoxe ngalokhu ngemininingwane ethe xaxa.

Kuyini Ukwehluleka Kwe-Bone Marrow?

Kalula nje, ukwehluleka komnkantsha wethambo kwenzeka lapho umnkantsha wakho wethambo ungakwazi ukukhiqiza amangqamuzana abomvu egazi anempilo, amangqamuzana amhlophe egazi, noma ama-platelet anele omzimba. Uhlobo ngalunye lwala maseli lunendima ethile emzimbeni wethu.

• Amaseli abomvu egazi yiwo athwala umoya-mpilo emzimbeni wonke. Uma ephansi, ungase uzizwe ukhathele futhi uphaphathekile.
• Amangqamuzana amhlophe egazi afana nebutho lemizimba yethu. Yiwo alwa nezifo. Uma ephansi, amathuba okugula aphezulu.
• Ama-platelet asiza ekuqhekekeni kwegazi, okusho ukuthi ayayeka ukuphuma kwegazi uma ulimala. Uma inani lama-platelet akho lehla, ngisho nesilonda esincane singabangela ukuphuma kwegazi okuningi.

Ukwehluleka kwethambo lomnkantsha kuvame ukuba yinkinga yesinye isimo sezokwelapha. Kodwa ngezinye izikhathi kungenzeka ngaphandle kwesizathu esibonakalayo. Odokotela bangakwazi ukuphatha izimpawu ngemithi kanye nokwelashwa okuhlukahlukene. Kodwa-ke, ukwelashwa kwesikhathi eside kuphela kwalesi simo ukufakelwa kweseli le-stem eliyi-allogeneic .

Yiziphi izinhlobo eziyinhloko zalesi simo?

Kunezinhlobo ezimbili eziyinhloko zokwehluleka kwe-bone marrow:

1. Okutholakale: Ochwepheshe abazi kahle ukuthi yini ebangela lesi simo. Kodwa ucwaningo lukhombisile ukuthi singabangelwa yizifo ezithile, ukuchayeka kumakhemikhali athile, noma ukusetshenziswa kwemithi ethile. Lolu hlobo lukhula kancane kancane ngokuhamba kwesikhathi.

2. Okuzuzwe njengefa: Lokhu kwenzeka uma uthola izinguquko zofuzo (ukuguqulwa kwezakhi zofuzo) komunye noma bobabili abazali bakho. Odokotela bakubiza lokhu ngokuthi i-Bone Marrow Failure Syndrome .

Sivame kangakanani lesi simo?

Empeleni lesi akusona isimo esivamile kakhulu. Isibonelo, cishe izingane ezingama-65 kweziyisigidi ezizalwa e-United States minyaka yonke zine-hereditary bone marrow failure syndrome. Esinye isibonelo yisimo esizuzwa njengefa esibizwa ngokuthi "i-Fanconi Anemia." Sithinta cishe oyedwa kwabahlanu kweziyisigidi. Ngakho-ke ungabona, lokhu kuyinto engavamile.

Zingaba yini izimpawu?

Izimpawu zingahluka kuye ngokuthi imbangela yokwehluleka komongo. Isibonelo, umuntu onesifo somongo esizuzwe njengefa angase aqale ukukhombisa izimpawu eseneminyaka emibili ubudala. Kodwa-ke, ucwaningo lubonisa ukuthi umuntu onohlobo lwesimo esitholakele angase aqale ukukhombisa izimpawu eseneminyaka ephakathi kuka-20 no-25, noma eseneminyaka engu-65. Kungakhathaliseki ukuthi siqala nini, izimpawu ezivame kakhulu yilezi:

• Ubuhlungu emathanjeni
• Ukopha ngokweqile (isib. ukopha ekhaleni, ukopha kwezinsini, ukopha okukhulu kokuya esikhathini)
• Ukukhathala okukhulu nokukhathala
• Umkhuhlane ovamile
• Ukutheleleka njalo kwamagciwane
• Ikhanda elibuhlungu
• Ubunzima bokuphefumula (i-Dyspnea)
• Umbala wesikhumba uba mhloshana kunokujwayelekile
• Amabala amancane abomvu ngaphansi kwesikhumba (i-Petechiae)
• Ukuphuka emzimbeni ngaphandle kwesizathu esaziwayo

Uma uqhubeka nokuba nesinye noma ngaphezulu salezi zimpawu, qiniseka ukuthi ubona udokotela.

Kungani lo mnkantsha wethambo uhluleka? Ziyini izimbangela?

Izinto ezilandelayo zingaba nomthelela engcupheni yakho yokuthola ukwehluleka komongo wamathambo:

• Une -Bone Marrow Failure Syndrome (esizuzwe njengefa).
• Une-cancer yegazi, esinye isifo segazi, noma ezinye izifo zegazi, umdlavuza, noma izifo (lezi ziqala kamuva, okungukuthi, zingezohlobo `(Olutholiwe)`).
• Ukuchayeka kumakhemikhali athile kanye nemithi (lokhu kuphinde kuwele ngaphansi kwesigaba `(Esitholiwe)`).

Ngezinye izikhathi, lesi simo singase senzeke ngaphandle kwesizathu esibonakalayo. Odokotela basibiza nangokuthi "ukwehluleka kwe-bone marrow okubangelwa yi-idiopathic ." Abacwaningi bakholelwa ukuthi kukhona ukuxhumana phakathi kwe-autoimmune kanye nokwehluleka kwe-bone marrow. I-Autoimmune yilapho amasosha omzimba wakho ehlasela ngephutha i-bone marrow yakho.

Izifo Zokwehluleka Kwe-Bone Marrow Ezizuzwe Njengefa

Lezi ezinye zezimo ezizuzwe njengefa, ezihlobene, noma ezinezimpawu ezifanayo:

• I-Congenital Agranulocytosis (i-Kostmann Syndrome): Lokhu kuthinta uhlobo lweseli elimhlophe legazi elibizwa ngokuthi ama-neutrophils.
• I-Congenital Amegakaryocytic Thrombocytopenia (CAMT): Kulesi simo, kuncipha inani lamaseli abizwa ngokuthi ama-megakaryocytes, asiza ekwakheni ama-platelet, emnkantsheni wakho wethambo.
• I-Diamond-Blackfan Anemia (i-Diamond-Blackfan Anemia): Lesi yisimo esingamahlalakhona esithinta ukukhiqizwa kwamangqamuzana abomvu egazi.
• I-Dyskeratosis Congenita (Dyskeratosis Congenita - `(Dyskeratosis Congenita)`):Izimpawu zalesi simo zifaka phakathi izinguquko zesikhumba, okungaba uphawu lokuqala lokwehluleka komongo.
• I-Fanconi Anemia (i-Fanconi Anemia): Lesi yisifo esivame kakhulu sokwehluleka kwe-bone marrow.
• I-Reticular Dysgenesis (I-Reticular Dysgenesis): Lolu uhlobo lwe-Severe Combined Immunodeficiency (SCID). Kulesi simo, umzimba wakho awukhiqizi ama-T-cell anele avuthiwe.
• I-Severe Congenital Neutropenia (Severe Congenital Neutropenia): Kulesi simo, ama-neutrophil akho, uhlobo lweseli elimhlophe legazi, aphansi kunokuvamile.
• I-Shwachman-Diamond Syndrome (i-Shwachman-Diamond Syndrome): Lesi simo sithinta ama-pancreas akho, umongo wamathambo kanye namathambo.

Uma omunye wabazali bakho enalesi simo kanye nezimpawu (lokhu kubizwa ngokuthi "i-Autosomal Dominant"), unethuba elingu-50% lokuthuthukisa lesi simo kanye nokuthuthukisa i-bone marrow failure syndrome.

Kodwa-ke, uma bobabili abazali bakho benokuguqulwa kwezakhi zofuzo okuhlobene nohlobo olufanayo lwe-bone marrow failure syndrome, kodwa akekho kubo onezimpawu (lokhu kubizwa ngokuthi "i-Autosomal Recessive"), ingozi yakho yokuthola lesi simo incishiswa ibe ngu-25%.

Umdlavuza Wegazi

Usengozini enkulu yokwehluleka komongo uma unenye yalezi zinhlobo ezilandelayo zomdlavuza:

• I-Lymphoma
• I-Multiple Myeloma
• Isifo se-Myelodysplastic

Ezinye Izinkinga Zegazi

Abanye abantu bazalwa benalezi zimo. Abanye bakhula nazo ngokuhamba kwesikhathi. Lokhu kufaka phakathi:

• I-Aplastic Anemia (i-Aplastic Anemia): Lesi yisifo segazi esingavamile. Silimaza umongo wakho wamathambo futhi siwuvimbele ekwenzeni amaseli egazi amasha nama-platelet. Odokotela bangase basebenzise igama elithi "aplastic anemia" lapho bekhuluma ngokwehluleka komongo wamathambo.
• Ama-Cytopenia (ama-Cytopenia): Lokhu kufaka phakathi izimo ezifana ne-autoimmune neutropenia, i-idiopathic neutropenia, kanye ne-large granular lymphocyte leukemia.
• I-Paroxysmal Nocturnal Hemoglobinuria (I-Paroxysmal Nocturnal Hemoglobinuria): Kulesi simo, amasosha omzimba wakho abhubhisa amangqamuzana abomvu egazi.
• I-Pure Red Cell Aplasia (i-Pure Red Cell Aplasia): Lesi futhi yisimo esizuzwe njengefa esithinta ukukhiqizwa kwamangqamuzana abomvu egazi.

Ukutheleleka Ngegciwane

Ukutheleleka ngegciwane okulandelayo nakho kungandisa ingozi yakho:

• I-Cytomegalovirus `(i-Cytomegalovirus)`
• Igciwane le-Epstein-Barr
• Igciwane le-Human Immunodeficiency Virus (HIV)
• I-Parvovirus B19 `(Parvovirus B19)`
• I-Hepatitis Ebangelwa Yigciwane

Ukwelashwa ngamakhemikhali kanye/noma ukwelashwa ngemisebe yomdlavuza nakho kungandisa ingozi yakho yokwehluleka komongo wamathambo. Futhi, ukuchayeka kumakhemikhali kanye nezinyibilikisi ezisetshenziswa kwezinye izibulala-zinambuzane kanye nezibulala-zinambuzane kungandisa ingozi yakho.

Yiziphi izinkinga zalesi simo?

Lesi yisimo esibucayi esingasongela impilo . Ngisho nangemva kokwelashwa, kungase kube nezinkinga ezilandelayo:

• Ukutheleleka ngamagciwane noma ngegciwane
• Ukopha
• Umdlavuza wegazi, isibonelo, i-acute myeloid leukemia noma i-myelodysplasia
• Ezinye izimila ezinomdlavuza, njenge-osteosarcoma kanye ne-rhabdomyosarcoma
• I-Carcinoma Yeseli Eliyisikwele

Ukuthola kanjani lokhu?

Udokotela uzoqala ngokukubuza ngezimpawu zakho, umlando wakho wezokwelapha, kanye nomlando wezokwelapha womndeni wakho. Bazokwenza nokuhlolwa ngokomzimba. Bangase futhi ba-ode ukuhlolwa kwegazi kanye nokuhlolwa kwezithombe.

Ukuhlolwa Kwegazi

Ukuhlolwa kwegazi kungafaka:

• Ukuhlolwa kwe-Ceruloplasmin
• Inani Eliphelele Legazi (i-CBC)
• Ukuhlolwa kwe-Ferritin
• Ukuhlolwa Kokuntuleka Kwe-Folate
• Ukuhlolwa Kokuntuleka Kwevithamini B12

Ukuhlolwa Kwezithombe

Ukuhlolwa kwezithombe kungafaka:

• Isithombe Sokubukeza Kwamagnetic (i-MRI - `(Umfanekiso Wokubukeza Kwamagnetic)` iskeni)
• I-Positron Emission Tomography (PET - `(Positron Emission Tomography)` iskeni)
• Ukuhlolwa kwe-Ultrasound `(Ultrasound)`

Ngokusekelwe emiphumeleni yokuhlolwa kwegazi kanye nokuhlolwa kwezithombe, udokotela wakho angase ancome ukuthi kwenziwe i-bone marrow biopsy . Angase futhi aphakamise ukuhlolwa kwezakhi zofuzo ukuze kutholakale izinguquko zezakhi zofuzo ezibangela ukwehluleka komongo wethambo.

Udokotela wakho angase futhi acele ukuhlolwa ukuze ahlole izifo ezithile noma akhiphe ezinye izimo. Bazokuchazela ukuthi kungani benza ukuhlolwa ngakunye nokuthi yini ukuhlolwa okungayibonisa.

Yiziphi izindlela zokwelapha?

Ukwelashwa okutholayo kuzoncika ezintweni eziningana, okuhlanganisa:

• Uhlobo lokwehluleka komongo (okungukuthi, kungakhathaliseki ukuthi luzuzwe njengefa noma lutholwe).
• Ubunzima besimo sakho.
• Ubudala bakho kanye nempilo yakho iyonke.
• Izimpawu zakho.

Izinketho zokwelapha zingafaka:

• Ama-antibiotic , ama-antifungal, kanye nemithi yokulwa namagciwane yokulwa nokutheleleka.
• Ukumpontshelwa igazi ukuze kwandiswe inani lamaseli abomvu egazi futhi kuncishiswe izimpawu ezifana nokopha nokukhathala.
• Izikhuthazi zomnkantsha wethambo zisiza umnkantsha wakho ukuthi wakhe amaseli egazi engeziwe.
• Ama-immunosuppressants asiza ukuvimba amasosha omzimba wakho ukuthi angahlaseli umongo wakho wamathambo.
• Ukufakelwa kwe-Allogeneic Stem Cell (Bone Marrow) .

Ingabe kukhona imiphumela emibi noma izinkinga zokwelashwa? (Izinkinga Zokwelashwa)

Izinkinga kanye nemiphumela emibi kuyahlukahluka kuye ngokwelashwa, kodwa ukufakelwa kwamaseli e-stem (umnkantsha) yikona okungenzeka kakhulu kubangele izinkinga ezinkulu. Lokhu kufaka phakathi isifo se-graft-versus-host (GVHD) kanye nokutheleleka.

Impilo izoba njani ngalesi simo? (Isibikezelo)

Lokho ongakulindela ngemva kokwelashwa (ukubikezela) kuncike ezintweni eziningana, okuhlanganisa uhlobo lwesifo, iminyaka yakho kanye nempilo yakho iyonke, kanye nendlela umzimba wakho osabela ngayo ekwelashweni.

Ngokuvamile, abantu abanenkinga yokwehluleka kwethambo badinga ukunakekelwa kwezokwelapha okuqhubekayo kanye nokusekelwa . Kodwa akubona bonke abantu abafanayo. Yazi kahle isimo sakho, bese ubuza udokotela wakho ukuthi kuzokwenzekani ngokulandelayo ngemva kokwelashwa kwakho kokuqala.

Ingabe ukwehluleka komongo wethambo kuyisimo esibulalayo? (Ingabe kuyisiphetho?)

Lesi yisimo esibi kakhulu, esisongela ukuphila . Iningi labantu abanenkinga yokungasebenzi kahle komnkantsha belashwa ochwepheshe abanolwazi njengodokotela bezifo zomdlavuza kanye nodokotela begazi.

Yini engathiwa ngobude besikhathi sokuphila salezi ziguli? (Ubude besikhathi sokuphila)

Isikhathi sokuphila siyisilinganiso sokuthi umuntu uzophila isikhathi esingakanani ngemva kokwelashwa kwesimo esithile. Isikhathi sokuphila sabantu abanokwehluleka komongo singasukela ezinyangeni ezimbalwa kuya empilweni yonke.

Kodwa, ukhethekile, futhi ulwazi lwakho lungase luhluke kolwabanye abantu. Buza udokotela wakho ngalokho ongakulindela, nokuthi ungalindela isikhathi esingakanani sokuphila. Bangumthombo wakho wolwazi ongcono kakhulu, ngoba bayakwazi wena nesimo sakho.

Ingabe ingozi ingancishiswa? (Ukunciphisa Ingozi)

Ngeshwa, ayikho indlela yokunciphisa ingozi yokwehluleka komongo wethambo okuzuzwe njengefa. Kodwa-ke, ukugwema amakhemikhali aziwa ngokunciphisa ukusebenza komongo wethambo kunganciphisa ingozi yokwehluleka komongo wethambo okutholiwe. Futhi, ukwelashwa kusenesikhathi kungasiza ekunciphiseni izimpawu zakho futhi kuthuthukise ikhwalithi yokuphila kwakho.

Ngizinakekela kanjani? (Ukuzinakekela)

Into engcono kakhulu ongayenza ukunakekela impilo yakho iyonke . Isibonelo, ungasebenzisi imikhiqizo kagwayi, unganciphisi noma uyeke ukuphuza utshwala. Nazi ezinye iziphakamiso:

• Bona udokotela wakho njalo. Ukwehluleka kwethambo kungaba yisimo sokuphila konke. Ungadinga ukwelashwa okuqhubekayo. Kungabangela nezinkinga ezintsha zempilo. Ngakho-ke kubalulekile ukuhlolwa njalo. Udokotela wakho uzoqapha impilo yakho iyonke futhi elaphe noma yiziphi izinkinga ezintsha.
• Yidla ukudla okunempilo. Izimpawu zakho kanye nemiphumela emibi evela ekwelashweni kwakho kungenza kube nzima ngawe ukudla noma ukulahlekelwa yisifiso sokudla. Uma ungaqiniseki ukuthi uthola yini ukudla okunomsoco okudingayo, khuluma nochwepheshe wezokudla. Bangakunikeza izincomo ezifanele.
• Zivocavoce. Ukuba nesimo esibucayi sempilo njengokwehluleka kwethambo kungaba yinto ecindezelayo. Ukuzivocavoca kuyindlela enhle yokunciphisa ukucindezeleka. Qiniseka ukuthi ukhuluma nodokotela wakho ngaphambi kokuqala inqubo entsha yokuzivocavoca.

Kunini lapho kudingeka uye e-Emergency Treatment Unit (ETU) ?

Uma unesifo somnkantsha wamathambo, usengozini enkulu yokutheleleka nezinkinga zokopha. Kufanele uye ekamelweni eliphuthumayo uma uhlangabezana nanoma yikuphi kwalokhu okulandelayo:

• Ukuba nomkhuhlane onganciphi ngisho nangemva kokuthatha umuthi ovamile wokuqeda izinhlungu
• Ukuzizwa ubanda futhi uqhaqhazela (Ukugodola)
• Ukopha okungenakunqandeka

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungase ube nokwehluleka komongo ngenxa yezifo ezithile ezizuzwe njengefa. Kodwa ngezinye izikhathi kungenzeka ngaphandle kwesizathu esicacile. Ungabuza udokotela wakho imibuzo efana nale:

• Uyazi ukuthi kungani nginenkinga yokungakwazi ukusebenza kahle kwe-bone marrow?
• Yiziphi izindlela zokwelapha enginazo?
• Ingabe kuzodingeka ngithathe ukwelashwa unomphela?
• Ingabe lokhu kungelapheka?

Uma unesifo somnkantsha, kungenzeka ukuthi usuvele ubhekene nenkinga enkulu yezempilo, njengesifo esizuzwe njengefa, ukuphazamiseka kwegazi, noma umdlavuza. Lokhu kutholakala okusha kungase kukubangele imibuzo eminingi emisha kanye nokukhathazeka, okungaba nzima kakhulu. Kuvamile ukuzizwa ukhathazekile ngoba lokhu kungaba yisimo esisongela impilo. Khuluma nethimba lakho lezokwelapha ngalokho ongakulindela nokuthi yini okufanele uyenze ngokulandelayo. Bazokujabulela ukuphendula imibuzo yakho.

Khumbula njengesifinyezo (Umyalezo Wokuya Ekhaya)

Ukwehluleka kwethambo lomnkantsha kuyisimo esibi nesiyinkimbinkimbi . Kodwa khumbula, kunezimbangela eziningi ezingaba khona, futhi kunezindlela eziningi ezahlukene zokwelapha namasu okuphatha. Into ebaluleke kakhulu ukuthola ukuxilongwa kusenesikhathi, ukufuna ukwelashwa kochwepheshe abafanele, bese uqhubeka nokulandela leyo miyalelo.Uma unemibuzo noma ukukhathazeka ngalokhu, ungesabi ukukhuluma nodokotela wakho. Bakhona ukuzokusiza.

Ukwehluleka Kwe - Bone Marrow, Amaseli Egazi Abomvu, Amaseli Egazi Amhlophe, Ama-Platelet, Ukufakelwa Kwamaseli E-Stem, Izifo Ze-Bone Marrow