Kuika mafuta m'mafupa

Kukula kwa mafupa ndi njira yosinthira m'mafupa owonongeka kapena owonongeka ndi mafupa abwino am'mafupa.

Mafupa ndi minofu yofewa komanso yonenepa yomwe ili mkati mwa mafupa anu. Mafupa amapanga maselo a magazi. Maselo otupitsa ndi maselo osakhwima m'mafupa omwe amabweretsa maselo anu osiyanasiyana amwazi.

Asanafike, mankhwala a chemotherapy, radiation, kapena zonsezi zingaperekedwe. Izi zitha kuchitidwa m'njira ziwiri:

• Chithandizo cha Ablative (myeloablative) - Chemotherapy, radiation, kapena zonsezi zimaperekedwa kuti ziphe khansa iliyonse. Izi zimapheranso mafuta am'mafupa omwe atsala, ndikulola kuti maselo atsopano azikula m'mafupa.
• Kuchepetsa chithandizo champhamvu, chomwe chimatchedwanso mini kumuika - Mankhwala ochepetsa chemotherapy ndi radiation amaperekedwa asanafike. Izi zimalola anthu okalamba, komanso omwe ali ndi mavuto ena azaumoyo kuti athe kuziika.

Pali mitundu itatu yosinthira m'mafupa:

• Autologous mafupa kumuika - Mawu akuti auto amatanthauza kudzikonda. Maselo opatsirana amachotsedwa kwa inu musanalandire mankhwala a chemotherapy kapena mankhwala a radiation. Maselo amtunduwu amasungidwa mufiriji. Pambuyo pa mankhwala a chemotherapy kapena mankhwala a radiation, maselo anu obwezeretsa amabwezeretsedwanso m'thupi lanu kuti apange maselo abwinobwino amwazi. Izi zimatchedwa kuponyera kupulumutsa.
• Allogeneic mafupa osanjikiza - Mawu akuti allo amatanthauza zina. Maselo opatsirana amachotsedwa mwa munthu wina, wotchedwa wopereka. Nthawi zambiri, majini a omwe akuperekawo amayenera kufanana ndi majini anu. Kuyesedwa kwapadera kumachitika kuti muwone ngati woperekayo akufanana nanu. Mbale kapena mlongo nthawi zambiri amatha kufanana. Nthawi zina makolo, ana, ndi abale ena amakhala machesi abwino. Othandizira omwe sali pachibale nanu, komabe akufanana, atha kupezeka kudzera m'majambulidwe am'mafupa amitundu.
• Kuika magazi umbilical chingwe - Ichi ndi mtundu wa kupatsirana kwa allogeneic. Maselo opatsirana amachotsedwa mu umbilical wa mwana wakhanda akangobadwa kumene. Maselo am'madziwo amawundana ndipo amasungidwa mpaka atafunikira. Maselo a umbilical a magazi samakhwima kwambiri chifukwa chake sipafunikira kufanana kokwanira. Chifukwa cha kuchuluka kwama cell stem, kuchuluka kwa magazi kumatenga nthawi yayitali kuti munthu achire.

Kuika ma cell am'madzi nthawi zambiri kumachitika chemotherapy ndi radiation ikamalizidwa. Maselo amtunduwu amaperekedwa m'magazi anu, nthawi zambiri kudzera mu chubu chotchedwa central venous catheter. Njirayi ndi yofanana ndi kuthiridwa magazi. Maselo oterera amayenda m'magazi mpaka m'mafupa. Nthawi zambiri, palibe opaleshoni yofunikira.

Maselo opangira ma donor amatha kusonkhanitsidwa m'njira ziwiri:

• Kukolola mafuta a mafupa - Kuchita opaleshoni yaying'ono kumachitika pansi pa anesthesia wamba. Izi zikutanthauza kuti woperekayo adzakhala akugona komanso wopanda ululu panthawiyi. Mafupa amachotsedwa kumbuyo kwa mafupa onse a mchiuno. Kuchuluka kwa mafuta okwanira kumadalira kulemera kwa munthu amene akuulandira.
• Leukapheresis - Choyamba, woperekayo amapatsidwa kuwombera masiku angapo kuti athandizire maselo am'magazi kupita m'mwazi. Pakati pa leukapheresis, magazi amachotsedwa kwa woperekayo kudzera mu mzere wa IV. Gawo la maselo oyera amwazi omwe amakhala ndi tsinde limasiyanitsidwa pamakina ndikuchotsedwa kuti liperekedwe kwa wolandirayo. Maselo ofiira amabwezeretsedwanso kwa woperekayo.

Kukhazikitsidwa kwa mafupa m'malo mwa mafupa omwe sakugwira ntchito bwino kapena awonongeka (ablated) ndi chemotherapy kapena radiation. Madokotala amakhulupirira kuti kwa khansa zambiri, maselo oyera a woperekayo amatha kuwononga maselo amtundu uliwonse a khansa, ofanana ndi pomwe ma cell oyera amaukira mabakiteriya kapena ma virus akamalimbana ndi matenda.

Wothandizira zaumoyo wanu angakulimbikitseni kuti muike mafuta m'mafupa ngati muli:

• Khansa ina, monga khansa ya m'magazi, lymphoma, myelodysplasia, kapena myeloma yambiri.
• Matenda omwe amakhudza kupanga maselo am'mafupa, monga aplastic anemia, congenital neutropenia, matenda akulu amthupi, sickle cell anemia, kapena thalassemia.

Kuika mafupa kumatha kuyambitsa zizindikilo izi:

• Kupweteka pachifuwa
• Kutaya magazi
• Malungo, kuzizira, kuthamanga
• Kukoma koseketsa mkamwa
• Mutu
• Ming'oma
• Nseru
• Ululu
• Kupuma pang'ono

Zovuta zomwe zingachitike pakulowetsa m'mafupa zimadalira zinthu zambiri, kuphatikizapo:

• Zaka zanu
• Thanzi lanu lonse
• Momwe mothandizana ndi omwe woperekayo anali woyenera
• Mtundu wamafupa omwe mudalandira (autologous, allogeneic, kapena umbilical cord)

Zovuta zingaphatikizepo:

• Kuchepa kwa magazi m'thupi
• Kutuluka magazi m'mapapu, matumbo, ubongo, ndi madera ena a thupi
• Kupunduka
• Kutseka m'mitsempha yaying'ono ya chiwindi
• Kuwonongeka kwa impso, chiwindi, mapapo, ndi mtima
• Kukula kwakuchedwa kwa ana omwe alandila mafupa
• Kusamba koyambirira
• Kulephera kumezanitsa, zomwe zikutanthauza kuti maselo atsopanowo samakhazikika mthupi ndipo amayamba kupanga maselo am'magazi
• Matenda a Graft-versus-host (GVHD), momwe maselo operekera amaukira thupi lanu
• Matenda, omwe atha kukhala owopsa
• Kutupa komanso kupweteka pakamwa, pakhosi, m'mimba, ndi m'mimba, zotchedwa mucositis
• Ululu
• Mavuto am'mimba, kuphatikiza kutsegula m'mimba, mseru, ndi kusanza

Wothandizira anu adzafunsa za mbiri yanu yazachipatala ndikuwunika. Mudzakhala ndi mayeso ambiri mankhwala asanayambe.

Musanafike, mudzakhala ndi machubu 1 kapena 2, otchedwa central venous catheters, omwe amalowetsedwa mumtsuko wamagazi m'khosi kapena m'manja. Chubu ichi limakupatsani kulandira chithandizo, madzi, ndipo nthawi zina zakudya. Amagwiritsidwanso ntchito kutulutsa magazi.

Omwe amakuthandizani amakambirana za kupsinjika kwam'mafupa. Mungafune kukumana ndi mlangizi. Ndikofunika kukambirana ndi banja lanu komanso ana kuti muwathandize kudziwa zomwe akuyembekezera.

Muyenera kupanga mapulani okuthandizani kukonzekera momwe mungakwaniritsire ndikugwira ntchito mukatha kumuika:

• Lembani malangizo okonzekereratu
• Konzani tchuthi chamankhwala kuntchito
• Samalani ma banki kapena ndalama
• Konzani kusamalira ziweto
• Konzani woti azimuthandiza ntchito zapakhomo
• Tsimikizani inshuwaransi yazaumoyo
• Lipirani ngongole
• Konzani zakusamalira ana anu
• Pezani nyumba yanu kapena banja lanu pafupi ndi chipatala, ngati pakufunika kutero

Kuika mafuta m'mafupa nthawi zambiri kumachitika kuchipatala kapena kuchipatala komwe kumayamikiridwa ndimankhwala otere. Nthawi zambiri, mumakhala m'chipinda chapadera chopangira mafuta m'mafupa pakati. Izi ndikuti muchepetse mwayi wanu wopeza matenda.

Kutengera ndi chithandizo ndi komwe kwachitika, zonse kapena gawo lodzikongoletsa kapena la allogeneic litha kuchitidwa ngati kuchipatala. Izi zikutanthauza kuti simuyenera kukhala mchipatala usiku wonse.

Kutalika komwe mumakhala mchipatala kumadalira:

• Kaya mwakhala ndi zovuta zina zokhudzana ndi kumuika
• Mtundu wa kumuika
• Ndondomeko za malo anu azachipatala

Mukakhala mchipatala:

• Gulu lazachipatala lidzayang'anitsitsa kuchuluka kwa magazi anu ndi zizindikilo zofunika.
• Mulandila mankhwala oletsa GVHD ndikupewa kapena kuchiza matenda, kuphatikiza maantibayotiki, ma antifungals, ndi mankhwala othandizira ma virus.
• Mosakayikira mudzafunika kuthiridwa magazi ambiri.
• Mudzadyetsedwa kudzera mu mtsempha (IV) mpaka mutha kudya pakamwa, ndipo zoyipa zam'mimba ndi zilonda mkamwa zatha.

Mukachoka kuchipatala, onetsetsani kuti mwatsatira malangizo amomwe mungadzisamalire kunyumba.

Zomwe mumachita mukamubweza zimadalira:

• Mtundu wowonjezera mafupa
• Maselo a omwe akuperekawo amafanana kwambiri ndi anu
• Kodi muli ndi khansa kapena matenda amtundu wanji
• Msinkhu wanu komanso thanzi lanu lonse
• Mtundu ndi kuchuluka kwa mankhwala a chemotherapy kapena mankhwala a radiation omwe mudali nawo musanabadwe
• Zovuta zilizonse zomwe mungakhale nazo

Kuika mafupa kumatha kuchiza matenda anu kwathunthu kapena pang'ono. Ngati kumuika kuli bwino, mutha kubwereranso kuzomwe mumachita mukangomva bwino. Nthawi zambiri zimatenga chaka chimodzi kuti mupezenso bwino, kutengera zovuta zomwe zimachitika.

Mavuto kapena kulephera kwa kusakaniza mafuta m'mafupa kumatha kubweretsa imfa.

Kuika - m'mafupa; Kuphatikizira kwa cell; Kuika hematopoietic stem cell; Kuchepetsa mphamvu yosasinthasintha; Kuika Mini; Allogenic mafupa; Autologous mafupa kumuika; Kuika magazi kwa umbilical chingwe; Kuchepa kwa magazi m'thupi - kufalikira kwa mafupa; Khansa ya m'magazi - kuika mafupa; Lymphoma - kupatsira mafuta m'mafupa; Angapo myeloma - mafupa kumuika

• Kutuluka magazi panthawi yamankhwala a khansa
• Kuika mafuta m'mafupa - kutulutsa
• Catheter wapakati wapakati - kusintha kosintha
• Catheter wapakati - kuthamanga
• Kumwa madzi mosamala mukamalandira khansa
• Pakamwa pouma mukamalandira khansa
• Kudya ma calories owonjezera mukamadwala - akuluakulu
• Kudya ma calories owonjezera mukamadwala - ana
• Oral mucositis - kudzisamalira
• Peripherally anaikapo chapakati catheter - flushing
• Kudya mosamala panthawi ya chithandizo cha khansa

• Kukhumba kwamfupa
• Zinthu zopangidwa zamagazi
• Mafupa a m'chiuno
• Kuika mafuta m'mafupa - mndandanda

Tsamba la American Society of Clinical Oncology. Kodi kusamba mafupa ndikutenga chiyani? www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-bone-marrow-transplant-stem-cell-transplant. Idasinthidwa mu Ogasiti 2018. Idapezeka pa February 13, 2020.

Heslop IYE. Chidule ndi kusankha kwa omwe amapereka magazi a hematopoietic stem cell. Mu: Hoffman R, Benz EJ, Silberstein LE, et al, olemba. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 103.

Ndine A, Pavletic SZ. Kuika hematopoietic stem cell. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: mutu 28.