Bone marrow kuisazve

Kupfupa kwemongo wemapfupa inzira yekutsiva yakanganisa kana kuparadza mwongo wemapfupa ane hutano mapfupa emongo masero.

Mongo wefupa ndiwo munyoro, une mafuta mukati memapfupa ako. Mongo wemapfupa unoburitsa masero eropa. Masero emadzinde maseru asina kukura mumongo wemapfupa ayo anopa masero ako eropa akasiyana.

Usati waisa, chemotherapy, radiation, kana zvese zviri zviviri zvinogona kupihwa. Izvi zvinogona kuitwa nenzira mbiri:

• Ablative (myeloablative) kurapwa - Yakakwira-dose chemotherapy, radiation, kana ese ari maviri anopiwa kuuraya chero gomarara maseru. Izvi zvakare zvinouraya ese ane mwongo wemapfupa akasara, uye inobvumira maseru matsva kuti akure mumongo wemapfupa.
• Yakaderedzwa yakasimba kurapwa, inonziwo mini kuisirwa - Mashoma ezasi echemotherapy uye radiation anopiwa usati waiswa. Izvi zvinobvumidza vanhu vakura, uye avo vane mamwe matambudziko ehutano kuve nekuiswa.

Kune matatu matatu emhando yemapfupa akachinjika:

• Autologous bone marrow kuisirwa - Izwi rekuti auto rinoreva wega. Masero emashizha anobviswa kubva kwauri usati wagashira yakakwira-dose chemotherapy kana kurapwa kwemwaranzi. Masero emadzinde akachengetwa mufiriji. Mushure mekumusoro-dhiza chemotherapy kana kurapwa nemwaranzi, ako masisitimu maseru anoiswa zvakare mumuviri wako kuti agadzire akajairwa masero eropa. Izvi zvinodaidzwa kununurwa kuisirwa.
• Allogeneic bone marrow kuisirwa - Izwi rekuti allo rinoreva zvimwe. Masero emadzinde anobviswa kubva kune mumwe munhu, anonzi mupi. Kazhinji kazhinji, majini eanopa anofanira kunge pamwe kuenzanisa magene ako. Miedzo yakakosha inoitwa kuti uone kana mupi ari mutambo wakanaka kwauri. Mukoma kana hanzvadzi anogona kunge ari mutambo wakanaka. Dzimwe nguva vabereki, vana, uye dzimwe hama mitambo yakanaka. Vanopa vasina hukama newe, zvakadaro vachiri mechi, vanogona kuwanikwa kuburikidza nenyika mapfupa emarenji marejista.
• Umbilical tambo yekuisa ropa - Iyi ndiyo mhando yeallogeneic transplant. Masero esisitimu anobviswa kubva kumucheche wembilical tambo achangozvarwa mushure mekuzvarwa. Masero emadzinde akaomeswa nechando uye akachengetwa kusvikira adikanwa pakuiswa. Umbilical tambo yeropa maseru haana kunyatso kukura saka pane zvishoma zvekudikanwa kwekukwana kwakaringana. Nekuda kwenhamba diki yemasero emadzinde, kuverenga kweropa kunotora nguva yakareba kuti kupora.

A stem cell transplant inowanzoitwa mushure mekunge chemotherapy uye radiation yapera. Masero emadzinde anounzwa muropa rako, kazhinji kuburikidza netubhu inonzi yepakati venous catheter. Maitiro acho akafanana nekuwedzerwa ropa. Masero emadzinde anofamba neropa achipinda mumongo wemapfupa. Kazhinji, hapana kuvhiya kunodiwa.

Masero evanopa anogona kuunganidzwa nenzira mbiri:

• Kukohwa mwongo wemapfupa - Uku kuvhiyiwa kudiki kunoitwa pasi peanesthesia. Izvi zvinoreva kuti mupi achave akarara uye asingarwadziwe panguva yekuita. Bhonzo repfupa rinobviswa kubva kumashure kwemapfupa maviri ehudyu. Huwandu hwemongo hwakabviswa zvinoenderana nehuremu hwemunhu ari kurigamuchira.
• Leukapheresis - Kutanga, mupiro anopiwa mazuva akati wandei ekupfura kuti abatsire maseru maseru kufamba kubva mumongo wepfupa kuenda muropa. Munguva yeleukapheresis, ropa rinobviswa kubva kune anenge apa kuburikidza ne IV mutsara. Chikamu chemasero machena eropa chine masero enhengo anobva apatsanurwa mumushini ndokubviswa kunozopihwa kumugashiri. Masero matsvuku eropa anodzorerwa kumupi.

Kuiswa kwemongo wemapfupa kunotsiva mwongo wepfupa uyo usinga shande zvakanaka kana kuti wakaparadzwa (wakabviswa) ne chemotherapy kana radiation. Vanachiremba vanotenda kuti kumakenza mazhinji, masero machena eropa anokwanisa kurwisa chero masero egomarara asara, akafanana neapo masero machena anorwisa mabhakitiriya kana hutachiona pakurwisa hutachiona.

Mutapi wako wezvehutano anogona kukurudzira kupfupa kwemongo wepfupa kana iwe uine:

• Dzimwe kenza, senge leukemia, lymphoma, myelodysplasia, kana yakawanda myeloma.
• Chirwere chinokanganisa kugadzirwa kwemapfupa emasero, akadai seaplastic anemia, congenital neutropenia, zvakanyanya immune immune zvirwere, sickle cell anemia, kana thalassemia.

Kuiswa kwemongo wemapfupa kunogona kukonzera zvinotevera zviratidzo:

• Kurwadziwa pachifuva
• Kudonha BP
• Fivha, kutonhora, kufashaira
• Kunakidza kuravira mumuromo
• Kutemwa nemusoro
• Mikoko
• Nausea
• Kurwadziwa
• Kufema kwekufema

Zvinogona kuitika zvemapfupa ekutsvaira mwongo zvinoenderana nezvinhu zvakawanda, zvinosanganisira:

• Zera rako
• Hutano hwako hwese
• Ainge akanaka sei machisi mupi wako aive
• Iko mhando yemapfupa ekuisa iwe yawakagamuchira (autologous, allogeneic, kana umbilical tambo yeropa)

Zvinetso zvinogona kusanganisira:

• Anemia
• Kubuda ropa mumapapu, ura, huropi, uye dzimwe nzvimbo dzomuviri
• Kurwara
• Kuvhara mutsinga diki dzechiropa
• Kukuvadza kune itsvo, chiropa, mapapu, uye moyo
• Kunonoka kukura muvana vanogamuchira bone marora kuisirwa
• Kutanga kuenda kumwedzi
• Graft kutadza, zvinoreva kuti maseru matsva haagadzikane mumuviri otanga kuburitsa masero emadzinde
• Graft-versus-host disease (GVHD), mamiriro ayo masero evanopa anorwisa muviri wako
• Zvirwere, izvo zvinogona kuve zvakakomba
• Kuzvimba uye kushushikana mumuromo, pahuro, esophagus, uye mudumbu, inonzi mucositis
• Kurwadziwa
• Matambudziko edumbu, anosanganisira manyoka, kuda kurutsa, uye kurutsa

Wako mupi achabvunza nezve yako nhoroondo yezvokurapa uye aite bvunzo dzepanyama. Unenge uine bvunzo dzakawanda kurapwa kusati kwatanga.

Usati waiswa, iwe unenge uine 1 kana maviri machubhu, anonzi epakati venous catheters, akaiswa mumudziyo weropa mumutsipa kana mumaoko. Iyi chubhu inokutendera iwe kuti ugamuchire kurapwa, zvinwiwa, uye dzimwe nguva kudya kunovaka muviri. Inoshandiswa zvakare kukweva ropa.

Wako mupi angango kurukura nezve kushushikana kwepfungwa kwekuve nekufema kwemongo. Ungangoda kusangana nemupi wezano. Zvakakosha kutaura nemhuri yako nevana kuvabatsira kuti vanzwisise zvavanotarisira.

Iwe unozofanirwa kuronga kuti ikubatsire kugadzirira maitiro uye kubata mabasa mushure mekutora kwako:

• Pedzisa rairo yekuchengetedza
• Ronga zororo rekurapa kubva kubasa
• Chengetedza mabhengi kana zvirevo zvemari
• Ronga kuchengetwa kwezvipfuyo
• Ronga kuti mumwe munhu abatsire pamabasa epamba
• Simbisa hutano inishuwarenzi kufukidza
• Bhadhara zvikwereti
• Ronga kuchengetwa kwevana vako
• Tsvaga imba yako kana yemhuri padyo nechipatara, kana zvichidikanwa

Kuiswa kwemongo wemapfupa kunowanzoitwa muchipatara kana nzvimbo yekurapa iyo inonyanya kugadzirisa kurapwa kwakadai. Kazhinji yenguva, iwe unogara mune yakasarudzika yemapfupa yekuisa yuniti pakati. Uku kudzikisira mukana wako wekutapukirwa.

Zvichienderana nekurapa uye kwazvinoitwa, zvese kana chikamu cheanogadzira kana allogeneic kuisirwa inogona kuitwa seanorwara kunze. Izvi zvinoreva kuti haufanire kugara muchipatara usiku hwese.

Inguva yakareba sei yaunogara muchipatara zvinoenderana ne:

• Kunyangwe iwe ukagadzira chero matambudziko ane chekuita nekutamisa
• Mhando yekuisa
• Maitiro ako epakati ekurapa

Paunenge uri muchipatara:

• Bato rezvehutano rinoongorora zvakanyanya kuwanda kweropa rako uye zviratidzo zvakakosha.
• Iwe uchagamuchira mishonga yekudzivirira GVHD uye kudzivirira kana kurapa hutachiona, kusanganisira maantibioti, antifungals, uye antiviral mushonga.
• Iwe ungangoda kuwedzerwa kuwedzerwa kweropa.
• Iwe unozopihwa kudya kuburikidza netsinga (IV) kusvikira iwe wagona kudya nemuromo, uye mudumbu mhedzisiro uye maronda emuromo apera.

Mushure mekubva muchipatara, ita shuwa yekutevera mirairidzo yekuti ungazvichengete sei kumba.

Iwe unonyatsoita sei mushure mekumisikidza zvinoenderana ne:

• Rudzi rwekupfupa kwemongo wemapfupa
• Masero emupi wemunhu anowirirana sei neyako
• Ndeupi rudzi rwekenza kana chirwere chauinacho
• Zera rako uye hutano hwakazara
• Mhando uye chipimo chemotherapy kana radiation iyo yawaive nayo usati waisa
• Chero matambudziko aungave nawo

Kupfupa kwemongo wemapfupa kunogona kurapa zvakakwana kana zvishoma kurwara kwako. Kana kuiswa kwacho kuri kubudirira, unogona kudzokera kune zvakawanda zvezviito zvako zvenguva pfupi paunenge uchinzwa zvakanaka zvakakwana. Kazhinji zvinotora kusvika gore rimwe kuti uwanezve zvizere, zvinoenderana nezvinetso zvinoitika.

Kuomarara kana kukundikana kwepfupa rekutsvaira kunogona kutungamira kurufu.

Kuisazve - mwongo wemabhonzo; Stem cell transplant; Hematopoietic stem sero kuisirwa; Yakaderedzwa kusimba nonmyeloablative kuisirwa; Mini kupinza; Allogenic bone marrow kuisirwa; Autologous pfupa mwongo kuisazve; Umbilical tambo yekuisa ropa; Aplastic anemia - bone marrow kuisirwa; Leukemia - kupinza kwemongo. Lymphoma - bone marrow kuisazve; Multiple myeloma - bone marrow kuisirwa

• Kubuda ropa panguva yekurapa kenza
• Bone marrow kuisirwa - kubuda
• Central venous catheter - kupfeka shanduko
• Central venous catheter - kubhururuka
• Kunwa mvura zvakachengeteka panguva yekurapa kenza
• Muromo wakaoma panguva yekurapa kenza
• Kudya mamwe macalorie kana uchirwara - vakuru
• Kudya mamwe macalorie kana uchirwara - vana
• Oral mucositis - kuzvitarisira
• Peripherally akaisirwa yepakati catheter - kufuridza
• Kudya zvakachengeteka panguva yekurapa gomarara

• Bone marora kushuvira
• Akaumba zvinhu zveropa
• Bone marora kubva muchiuno
• Bone-mwongo kuisirwa - akateedzana

American Society yeClinical Oncology webhusaiti. Chii chinonzi bone marrow transplant (stem cell transplant)? www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-bone-marrow-transplant-stem-cell-transplant. Yakagadziridzwa Nyamavhuvhu 2018. Yakasvika muna Kukadzi 13, 2020.

Heslop HE. Mhedziso uye kusarudzwa kweanopa yehematopoietic stem sero kuisirwa. Muna: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 103.

Ndiri A, Pavletic SZ. Hematopoietic stem sero kuisirwa. Mune: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 28.