Ukufakelwa Kwe-Bone Marrow: Konke Odinga Ukukwazi

Ukwelapha umdlavuza nezifo ezithile, kwamukelwa ukwelashwa okukhethekile kweziguli okubandakanya ukuthatha ama-stem cells atholakala emnkantsheni kumuntu ophile kahle futhi awanike isiguli. Lokhu kwelashwa kwaziwa ngokuthi Ukufakelwa kwe-Bone Marrow.
Ukufakelwa komnkantsha wethambo kwenziwa ukuze kuthelwe amangqamuzana omnkantsha anempilo kumuntu ngemva kokuba umnkantsha wawo ulashelwe ukubulala izindawo zomdlavuza noma amangqamuzana anesifo. Kuwuhlobo lokuhlenga ngokwezokwelapha olwenziwa ngemva kokwelashwa noma ukulimala kwezifo.

Masiqonde izici ezihlukene ze-BMT (Ukufakelwa Komnkantsha Wamathambo).

Yini I-Bone Marrow?

Ukufakelwa komnkantsha, okwaziwa nangokuthi ukufakelwa kwe-stem cell, kuyindlela yezokwelapha ebandakanya ukubuyisela umnkantsha owonakele noma onesifo ngamaseli e-stem anempilo. Lawa ma-stem cells angakhula abe umnkantsha onempilo futhi akhiqize amaseli egazi amasha. Inqubo ivame ukusetshenziselwa ukwelapha izimo ezifana ne-leukemia, i-lymphoma, ukuphazamiseka okuthile kwamasosha omzimba, nezinye izifo zofuzo. Amaseli atshaliwe angavela kumnikeli (ukufakelwa kwe-allogeneic) noma esigulini ngokwaso (ukufakelwa okuzenzakalelayo), kuye ngesimo sezempilo esithile.

Ake sikudlulisele - Kungani sidinga ukufakelwa umnkantsha?

Isidingo Sokufakelwa Umnkantsha Wamathambo 

Ngemva imiphumela emibi yokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe, ama-stem cells omnkantsha ayabulawa. Zilimala unomphela futhi zicekelwe phansi. Kamuva, ukufakelwa komnkantsha kwenziwa ukuze kwelashwe izifo nomdlavuza. Ungase futhi ufakwe umnkantsha wethambo uma umongo wakho ucekelwa phansi yisimo sezempilo esingaphansi.

I-Bone Marrow Transplant yenziwa ukwelapha-

• Izifo ezifana ne-Myelofibrosis noma i-Leukemia zingaphazamisa ukusebenza komnkantsha. Ukufakelwa kungakunikeza okunempilo.
• Kwenziwa futhi ukuvuselela amasosha omzimba okungenzeka ukuthi acekelwa phansi ngenkathi kubulawa umdlavuza osele ongakwazi ukubulawa ngamakhemikhali noma ngemisebe.
• Ukubuyisela umnkantsha ekusebenzeni okujwayelekile ngemuva kwemithamo ephezulu ye-chemotherapy.
• Uma umuntu ehlushwa isifo sofuzo esifana ne-Hurler's Syndrome noma i-Adrenoleukodystrophy, angakwazi futhi ukuthola indawo yomnkantsha. 

Hlala uthintana nochwepheshe wakho wezempilo futhi nixoxe ngezingozi kanye nezinzuzo Zokufakelwa Komnkantsha Wamathambo. Ake sidlule kwezinye zezifo ezingelapheka nge-BMT.

I-BMT ingasiza ekwelapheni noma ekwelapheni izifo ezilandelayo-

• AmaLeukemias 
• I-Myelofibrosis
• Ama-syndromes we-Myelodysplastic
• I-myeloma eminingi 
• I-Myeloproliferative neoplasms 
• Lymphoma 
• Thalassemia 
• I-Aplastic Anemia Enzima 
• I-PNH (i-paroxysmal nocturnal hemoglobinuria)
• Izifo Zokuntula Amasosha omzimba 
• I-Solid Tumor Cancer 
• Izifo ze-neurological ezifana ne-Multiple sclerosis 

Xoxa nowakho udokotela uma i-BMT iyindlela yokwelapha engcono kakhulu kuwe. Uzohlola ukusabela kwamasosha omzimba wakho nezinye izici ukuze anqume uhlelo olulungile lokwelapha.

Izinhlobo Zokufakelwa Kwethambo Lamathambo 

Ukufakelwa komnkantsha wethambo kungahlukaniswa ngezinhlobo ezimbalwa ngokusekelwe ezicini ezihlukahlukene, okuhlanganisa umthombo wamaseli we-stem, ubudlelwano phakathi komnikeli nomamukeli, kanye nenjongo yokufakelwa. Nazi izinhlobo eziyinhloko:

• Ukufakelwa kwe-allogeneic bone marrow: Ama-stem cells atholakala kumnikeli onempilo uhlobo lwethishu olufana eduze nelomamukeli. Lolu hlobo lokufakelwa lunengozi enkulu yezinkinga kodwa lunganikeza ithuba lokwelapha njengoba amaseli anempilo omnikeli engakwazi ukuhlasela amaseli omdlavuza asele. Abanye abanikelayo bangafaka-

1. Umzali - Kubizwa nangokuthi umdlalo we-Identical Haploid. Yilapho onikelayo efaniswa nofuzo uhhafu neziguli.
2. I-BMT Engahlobene noma Umnikezeli Ofanisiwe Ongahlobene - Uma amaseli ethathwa kumnikeli ongahlobene kodwa ohambisana nofuzo. 

• Ukufakelwa igazi kwe-Umbilical Cord: Ama-stem cells atholakala egazini lenkaba ngemva kokubeletha futhi agcinwe ebhange legazi lentambo. Lawa maseli angasetshenziselwa ukufakelwa ezigulini ezidinga umnikezeli futhi ezingenakho okufanayo okufanelekile ekubhaliseni komnkantsha.
• Ukufakelwa komnkantsha we-autologous: Ama-stem cells atholakala kumnikeli onempilo uhlobo lwethishu olufana eduze nelomamukeli. Lolu hlobo lokufakelwa lunengozi enkulu yezinkinga kodwa lunganikeza ithuba lokwelapha njengoba amaseli anempilo omnikeli engakwazi ukuhlasela amaseli omdlavuza asele.
• I-Syngeneic Transplant: Lolu uhlobo oluthile lokufakelwa kwe-allogeneic lapho onikelayo eyiwele elifanayo lomamukeli. Ukufanisa uhlobo lwezicubu kuphelele kulokhu, kunciphisa ubungozi bokwenqatshwa noma izinkinga.
• Ukufakelwa kwe-Haploidentical: Kulolu hlobo lokufakelwa, onikelayo uyingxenye yokufanisa, ngokuvamile ilungu lomndeni (elifana nomzali noma ingane) elabelana ngesigamu sezimpawu zofuzo zomamukeli. Lokhu kuhambisana okubanzi kuvumela abanikeli abaningi abangaba khona kodwa futhi kungaholela ezinkingeni ezengeziwe.

Kungani Ukufakelwa Kwethambo Lomnkantsha Kwenziwa?

2. Ukuphazamiseka Kwegazi: Lo muthi usetshenziselwa ukwelapha izifo zegazi ezingenawo umdlavuza ezifana ne-aplastic anemia enzima, i-sickle cell anemia, ne-thalassemia, lapho umnkantsha wehluleka ukwakha amangqamuzana egazi anele noma asebenzayo.

3. Ukuphazamiseka Kwesistimu Yokuzivikela Ezifweni: Ivuselela isimiso somzimba sokuzivikela ezifweni ezinjengokuntuleka kokuzivikela komzimba okuhlangene okuqinile, ukuntula okuthile kwe-immunological, noma izifo ezizimele ngokujova ama-stem cells anempilo.

4. Ukuphazamiseka Kwezakhi Zofuzo: Isiza ezifweni ezitholakala ngofuzo ezithinta umzimba noma zofuzo zomnkantsha, njenge-Hurler syndrome, i-Hunter syndrome, ne-adrenoleukodystrophy, ngokushintsha amangqamuzana anamaphutha anempilo.

5. Ukwelapha Ngamakhemikhali/Ukuthola Ukubuyiselwa Kwemisebe: Ukufakelwa komnkantsha wethambo (ngokuvamile okuzenzakalelayo) kusiza ekubuyiseleni umnkantsha onempilo nokukhiqizwa kwamangqamuzana egazi ngemva kokwelashwa ngamakhemikhali okuqinile noma ukwelashwa ngemisebe yomdlavuza.

Izinkinga kanye Nemiphumela Emibi

Izinkinga zomnkantsha wethambo zincike ezicini ezihlukahlukene ezifana nohlobo lokufakelwa, isimo sezokwelapha, isimiso sokulungiselela, ubudala, kanye nempilo yonke yesiguli. 

Ezinye zalezi zinkinga ezilandelayo zingenzeka zodwa noma zihlangene-

• Izifo
• Ama-Platelets aphansi noma ama-RBC
• Ubuhlungu
• I-Mucositis
• Imikhuhlane
• Ukuhlanganiswa nokuqhathaniswa nezifo
• Ukwehluleka kokuxhunyelelwa (akuvamile)

Ngakwesokudla ukuxilongwa nokwelashwa, izinkinga kanye nemiphumela engemihle inganakekelwa kahle.

Ukulungiselela Ukufakelwa Umnkantsha Wamathambo 

Kunezinyathelo ezimbalwa ezihilelekile ekulungiseleleni ukufakelwa komnkantsha. Nazi izinto ezibalulekile okufanele uzikhumbule:

1. Ukuhlolwa Kwezokwelapha: Thatha zonke izivivinyo ezinqunyiwe, njengokuhlolwa kwegazi kanye nezikena, ukuze uqinisekise ukuthi uphile saka ngokwanele ukuba ushintshele.

2. Ukuthola Umnikezeli (uma kunesidingo): Nquma okufanelana kahle kakhulu nomuntu onikelayo, noma ngabe yilungu lomndeni, umuntu ongamazi, noma othile ovela ebhange legazi lezintambo. Lokhu kusekelwe ekufanisweni kwezicubu.

3. Xoxa ngoHlelo Lokwelapha: Qonda ukuthi kungani udinga ukufakelwa, okungenzeka, kanye nezici ezinhle nezingezinhle zokwelashwa. Konke kufanele kuxoxwe nabasebenzi bakho bezokwelapha.

4. Lungisa Umzimba Wakho: Ungadinga ukwelashwa ngamakhemikhali noma imisebe ngaphambi kokufakelwa ukuze ulungise umzimba wakho. Lokhu kusiza ukwenza isikhala emnkantsheni wakho wamaseli amasha kuyilapho kwehlisa amasosha akho omzimba.

5. Gwema Ukutheleleka: Hlala uhlanzekile, thola imigomo, futhi ugweme abantu abagulayo ukuze unciphise ingozi yokutheleleka ngaphambi kokufakelwa.

6. Phatha Imizwa Yakho: Qaphela ukuthi kungokwemvelo ukuba nemizwelo. Xoxa nganoma yikuphi ukucindezeleka noma izinkinga nabeluleki, izihlobo, noma amaqembu asekelayo.

7. Yidla kahle: Yidla ukudla okunomsoco ukuze usekele amasosha akho omzimba kanye nokwelapha. Xhumana nochwepheshe wezokudla mayelana nokudla okufanele.

8. Hlala Usebenza: Yenza imisebenzi elula ukuze uhlale usesimweni ngaphambi kokufakelwa. Nokho, hlala ulandela iseluleko sikadokotela wakho mayelana nokuthi kungakanani ongakwenza.

9. Dala Iqembu Lokusekela: Yiba nomndeni noma abangani abakulungele ukukusiza ngesikhathi nangemuva kokufakelwa. Bangasiza ngezinto zokuhamba nokunakekela, isibonelo.

10. Phatha izimali kanye Nezinto Zomthetho: Hlola umshwalense wakho, thola ukuthi izinto zingabiza malini, futhi unakekele noma yiziphi izinkinga ezingokomthetho noma zezezimali ngaphambi kokufakelwa kabusha.

Inqubo Yokufakelwa Komnkantsha Wamathambo

Inqubo yokufakelwa komnkantsha wethambo ihlanganisa izigaba eziningana, okuhlanganisa ukulungiswa kwangaphambi kokufakelwa kabusha, ukuvunwa kwama-stem cells (uma usebenzisa onikelayo), ukwelashwa kwe-conditioning, kanye nokufakelwa ngokwakho. Nakhu okufingqiwe kwezinyathelo ezijwayelekile ezihilelekile kunqubo yokufakelwa komnkantsha:

Pre-transplant Ukulungiselela:

• Ukuhlolwa kwezokwelapha kanye nokuhlola okuphelele, okuhlanganisa ukuhlolwa kwegazi, ukuthwebula izithombe, nokuhlolwa kokusebenza kwenhliziyo/amaphaphu kufanele kwenziwe.
• Izingxoxo nethimba lezokwelapha mayelana nohlelo lokwelapha, ubungozi, nezinzuzo zokufakelwa, kanye nokuqonda inqubo.
• Ukusesha onikelayo ofanelekile, okungaba yilungu lomndeni, umnikezeli ongahlobene, noma igazi lentambo.
• I-Conditioning Therapy: Ukulungiselela umzimba ukufakelwa kabusha ngokwenza i-chemotherapy, i-radiation therapy, noma inhlanganisela. Lokhu kuhloswe ngakho ukucindezela amasosha omzimba nokudala isikhala emnkantsheni wamaseli amasha.

Iqoqo le-Stem Cell:

• Ngokufakelwa kwe-allogeneic, ama-stem cells atholakala egazini lomnikezeli noma umnkantsha ngenqubo ebizwa ngokuthi i-apheresis noma i-bone marrow harvest.
• Ku-autologous transplant, ama-stem cells esiguli ayaqoqwa futhi agcinwe ngaphambi kokwelashwa kwe-conditioning.

Inqubo Yokutshala:

• Ukufakelwa kubandakanya ukufaka ama-stem cells avuniwe egazini lesiguli ngomugqa we-intravenous (IV). Le nqubo ifana nokumpontshelwa igazi.
• Amaseli e-stem afakiwe athola indlela eya emnkantsheni futhi aqale ukukhiqiza amangqamuzana egazi amasha ngokuhamba kwesikhathi.

Ukubuyisela kanye nokuthuthukiswa:

• I-Engraftment yinqubo lapho ama-stem cells atshalwe kabusha eqala ukukhula futhi akhiqize amangqamuzana egazi amasha emnkantsheni wesiguli.
• Phakathi nalesi sigaba, iziguli ziqashwe ngeso elibukhali ukuze zibone izimpawu zokungena, njengokukhuphuka kwezibalo zamangqamuzana egazi.
• Ukunakekelwa okusekelayo, okuhlanganisa ama-antibiotics, ukumpontshelwa, nokulawula izinkinga ezingase zibe khona, kunikezwa ukusiza isiguli ngalesi sigaba esibucayi.

Ukubuyiselwa Kwangemuva Kokufakelwa:

• Iziguli zihlala esibhedlela isikhathi eside ngemva kokufakelwa ukuze ziqaphe ukululama futhi zilawule noma yiziphi izinkinga ezingase zibe khona.
• Ngokuhamba kwesikhathi, njengoba umnkantsha omusha uqala ukusebenza futhi ukhiqize amangqamuzana egazi anempilo, amasosha omzimba esiguli ayaqina.

Ukulandelela Ukunakekela:

Ngemva kokukhishwa esibhedlela, iziguli zidinga ukunakekelwa okuqhubekayo kokulandelela, okuhlanganisa ukuhlolwa okuvamile, ukuqapha izinkinga ezingase zibe khona, nokusekelwa kokululama nokuvuselela.

Ukubuyiselwa Kwe-Bone Marrow:

Ngemva kokuba amangqamuzana akho amhlophe egazi ekhishelwa, noma abuye, emasontweni amabili kuya kwamathathu ngemva kokufakelwa, eziningi zalezi zimpawu zizophela. Ngakolunye uhlangothi, izinguquko zokunambitheka, ukukhathala, nokubanda kungathatha izinyanga ezimbalwa ezigulini ezithile.

Izingozi Zokufakelwa Komnkantsha Wamathambo

Impela, nazi izingozi nezinkinga ezihlobene nokufakelwa komnkantsha owethulwe ngamaphuzu amafushane:

• Ukwehluleka Kwe-Graft: Ama-stem cells atshalwe kabusha angase ahluleke ukukhula futhi asebenze emnkantsheni womamukeli.
• I-Graft-versus-Host Disease (GVHD): Amaseli omzimba anikelayo angase ahlasele izicubu ezinempilo zomamukeli.
• Amagciwane: Ukwanda kokuba sengozini ezifweni ezihlukahlukene ngenxa yobuthakathaka bokuzivikela komzimba ngemva kokufakelwa.
• Ukulimala Kwezitho: I-Chemotherapy noma imisebe esetshenziswa ekulungiseni isimo ingalimaza izitho ezinjengamaphaphu, isibindi, noma izinso.
• Ukopha kanye ne-Anaemia: Ukuncipha kokukhiqizwa kwamangqamuzana egazi okuholela ezinkingeni zokopha kanye ne-anemia.
• I-Mucositis: Ukuvuvukala nezilonda emlonyeni, emphinjeni, namathumbu, okubangela ubuhlungu nobunzima bokudla.
• Ubunyumba/Inzalo: Imiphumela yokwelashwa ingase iholele ekungazali kwesikhashana noma unomphela noma ubunyumba.
• Umdlavuza Wesibili: Ukuthuthuka okungenzeka komdlavuza wesibili ngenxa yokwelashwa kwangaphambilini.
• Izinguquko zeHormonal: Ukushintsha kwamazinga e-hormone okubangela ukungalingani kanye nezinkinga ezihlobene.
• Izinselele Zengqondo: Ukucindezeleka ngokomzwelo, ukukhathazeka, nokucindezeleka ngenxa yomthelela wokwelashwa kanye nezinkinga zakho.

Okufanele Ucabangele Ngaphambi Kokufakelwa

Nazi izinto ezibalulekile zokucatshangelwa ngaphambi kokufakelwa komnkantsha (BMT):

• Ukuhlolwa Kwezempilo: Ukuhlolwa okuphelele kwempilo jikelele kanye nokufaneleka kwenqubo.
• Ingxoxo Yokwelapha: Ukubonisana okujulile nethimba lezokwelapha mayelana nezingozi, izinzuzo, kanye nemiphumela engaba khona.
• Ukuvumelana komnikezeli: Ukukhethwa nokuhlolwa komnikeli ofanelekayo wokufakelwa kwe-allogeneic.
• Ukwelashwa Kokulungiselela: Ukuqonda nokulungiselela izindlela zokwelapha ezidingekayo.
• Ukuhlola Ubungozi: Ukuhlolwa kwezingozi ezingase zibe khona kanye nezinkinga ezenzelwe umuntu ngamunye.
• Uhlelo Lokusekela: Ukusungula inethiwekhi yosekelo eqinile ukuze uthole usizo phakathi nangemuva kokufakelwa.
• Ukuhlelwa Kwezezimali Nomthetho: Ukubuyekeza ukufakwa komshwalense nokubhekana nezici zezezimali nezomthetho.
• Ukulungiswa Kwengqondo: Ukulungela imizwa yezinselele nomthelela empilweni yansuku zonke.
• Ukuguqulwa Kwendlela Yokuphila: Ukujwayela indlela yokudla, ukuzivocavoca, namasu okuvikela ukutheleleka.
• Imibono Yesibili: Ukufuna ukubonisana okwengeziwe ukuze uthole ukuqonda okuphelele kohlelo lokwelapha.
• Lokhu kucatshangelwa kusiza abantu ukuthi benze izinqumo ezinolwazi futhi balungiselele ngokwanele ukufakelwa komnkantsha.

Isiphetho 

Umgomo wokufakelwa komnkantsha wamathambo uwukufaka esikhundleni somnkantsha ogulayo noma owonakele amangqamuzana asebenza kahle, okuvumela isimiso somzimba sokuzivikela ezifweni silulame futhi sikhiqize amangqamuzana egazi anempilo. Inqubo iyinkimbinkimbi futhi idinga ukubambisana ngokucophelela phakathi kochwepheshe bezokunakekelwa kwezempilo ukuze kuqinisekiswe imiphumela engcono kakhulu yesiguli. Isimo sesiguli ngasinye sihlukile, futhi lokhu kucatshangelwa kungase kuhluke ngokusekelwe ezimeni zezempilo ngazinye, uhlobo lokufakelwa, kanye nezinqubo ezilandelwayo ezilandelwa ithimba lezokwelapha. Ukuxoxa ngalezi zinto ngokugcwele nethimba lezokunakekelwa kwempilo kubalulekile ngaphambi kokwenza izinqumo mayelana nokufakelwa komnkantsha.

FAQ sika 

Ungakanani umkhawulo weminyaka wokufakelwa komnkantsha?

Umkhawulo weminyaka wokufakelwa komnkantsha (BMT) awuchazwa ngokuqinile. Kunalokho, ukufaneleka kuncike empilweni yomuntu ngamunye, izimo ezikhona, kanye nemibandela yesikhungo sokufakelwa. Yize ingekho iminyaka eqondile yokuyeka, iziguli ezindala zingase zibhekane nezingozi ezikhulayo ngenxa yezici zezempilo. Amaqembu ezokwelapha ahlola isimo ngasinye ngasodwa, ecabangela impilo iyonke kuneminyaka yodwa. Izinto ezinjengokufaneleka kwenqubo, impendulo ekuhlolweni, kanye nezingozi ezingase zibe khona ngokumelene nezinzuzo ziqondisa izinqumo mayelana nokungenela ukufakelwa komnkantsha.

Ukufakelwa komnkantsha (BMT) kungaba yingxenye ebalulekile ekwelapheni ezinye izinhlobo zomdlavuza njenge-leukemia noma i-lymphoma. Nakuba kungasiza ukuqeda amangqamuzana omdlavuza futhi kuzuze ukuthethelelwa, akulona ikhambi eliqinisekisiwe lomdlavuza. Impumelelo incike ezintweni ezifana nohlobo lomdlavuza, isigaba, impendulo ekwelashweni, kanye nempilo yonke. I-BMT ihlose ukufaka amaseli anempilo esikhundleni somnkantsha owonakele, kodwa kuyinqubo eyinkimbinkimbi enezingozi futhi ayiqinisekisi ukwelashwa unomphela komdlavuza kuzo zonke izimo. Ukuqapha ngokucophelela nokunakekelwa okuqhubekayo ngemva kokufakelwa kubalulekile emiphumeleni yesikhathi eside.

Ukufanisa umamukeli nomamukeli wokufakelwa komnkantsha wethambo kuhlanganisa ukuthayipha kwe-leukocyte antigen (HLA) yomuntu. I-HLA ingamaprotheni kumaseli alawula amasosha omzimba. Ukusondela kokufana phakathi kwezinhlobo ze-HLA zomnikeli nomamukeli, yehlisa ingozi yezinkinga ezifana nesifo se-graft-versus-host (GVHD). Ekuqaleni, abanganikelayo nabamukeli bahlolwa i-HLA, behlaziya omaka abathile ukuze kutholwe ukuhambisana. Izelamani zinethuba eliphezulu lokumatanisa ngenxa yesizinda sofuzo esifanayo, kodwa abanikeli abangahlobene nabo bayafunwa ngamarejista. Ukuhlola okuthuthukile kusiza ukuthola okufanayo okuseduze, kucatshangelwa omaka be-HLA nezinye izici, ukuqinisekisa ukufakelwa okuphumelelayo nokunciphisa ubungozi bezinkinga.