Ukufakelwa komnkantsha wethambo, okwaziwa nangokuthi ukufakelwa kwe-hematopoietic stem cell, kube yindlela yokuphila ezinkulungwaneni zeziguli ezinomdlavuza wegazi emhlabeni jikelele. Le nqubo esindisa ukuphila ihilela ukufaka ama-stem cell anempilo esikhundleni somnkantsha owonakele noma ongasebenzi kahle ukuze kubuyiselwe ikhono lesiguli lokukhiqiza amangqamuzana egazi anempilo. Nakuba ukufakelwa komnkantsha ngokungangabazeki kuye kwashintsha ukwelashwa komdlavuza wegazi, beza nezinselele zabo kanye nemikhawulo okumele umphakathi wezokwelapha ubhekane nayo ukuze uthuthukise imiphumela nokufinyeleleka kwazo zonke iziguli.

Ukuqonda Ukufakelwa Komnkantsha Wamathambo

Umnkantsha izicubu eziyisipontshi ezitholakala ngaphakathi emathanjeni ezidlala indima ebalulekile ekukhiqizweni kwamangqamuzana egazi, okuhlanganisa amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi namaplatelet. Umdlavuza wegazi, njenge-leukemia, i-lymphoma, ne-myeloma eminingi, ngokuvamile uphazamisa ukusebenza okuvamile komnkantsha, okuholela ekunciphiseni ukukhiqizwa kwamangqamuzana egazi anempilo.

Ukufakelwa komnkantsha wethambo kuhilela ukufakwa kwamaseli esiqu anempilo, ngokuvamile atholakala kumnikeli ohambisanayo, angene egazini lesiguli. Lama-stem cells abe esefudukela emnkantsheni futhi aqale ukukhiqiza amangqamuzana egazi anempilo, athathe indawo yamangqamuzana anomdlavuza noma angasebenzi kahle. Le nqubo ingaba yindlela yokwelapha ezigulini eziningi ezinomdlavuza wegazi, enikeza ithemba lokukhululwa noma ukwelashwa okuphelele.

Impumelelo Yokufakelwa Komnkantsha Wamathambo

Phakathi neminyaka edlule, ukufakelwa komnkantsha wamathambo kuye kwazuza amazinga empumelelo aphawulekayo ekwelapheni umdlavuza wegazi ohlukahlukene. Inqubo ingaholela ekwelashweni isikhathi eside ngisho nokwelapha kwezinye iziguli. Isihluthulelo sempumelelo yayo sisekutholeni onikelayo ofanelekayo uhlobo lwethishu olufana nelomamukeli. Lokhu kusebenzisana kunciphisa ubungozi be-graft-versus-host disease (GVHD), inkinga enamandla amakhulu lapho amaseli omzimba onikelayo ehlasela izicubu zomamukeli.

Ukufakelwa kwe-autologous bone marrow, lapho kusetshenziswa khona ama-stem cells esiguli, kuphinde kwakhombisa isithembiso ekwelapheni umdlavuza othile wegazi okuhlanganisa nengozi enkulu kanye nama-lymphomas abuyele emuva, i-myeloma eminingi kanye nokuphazamiseka okuthile kwe-autoimmune.

Izinselelo Ekufakelweni Kwamathambo Amathambo

Naphezu kwempumelelo yabo, ukufakelwa komnkantsha kuveza izinselelo ezimbalwa ochwepheshe bezempilo nabacwaningi abaqhubeka nokubhekana nazo:

Ukutholakala Komnikeli: Ukuthola umnikeli ofanelekayo kuhlala kuyisithiyo esibalulekile ezigulini eziningi. Ukuvumelana kuvame ukunqunywa ngokufanisa i-hla alleles ethile, futhi akuzona zonke iziguli ezinelungu lomndeni elihambisanayo noma umnikeli ongahlobene otholakala kalula.

I-Graft-Versus-Host Disease (GVHD): Nakuba ukusabela kwe-graft-versus-leukemia kubalulekile ukuze amangqamuzana atshalwe kabusha abone futhi aqede amangqamuzana anomdlavuza, i-GVHD ingaba inkinga esongela ukuphila lapho amangqamuzana omzimba onikelayo ehlasela izicubu ezinempilo zomamukeli. Ukuphatha i-GVHD ngaphandle kokubeka engcupheni ukusebenza kahle kokufakelwa kuyisenzo sokulinganisa esintekenteke.

I-Pre-transplant Conditioning: Ukulungiselela umzimba wesiguli ukufakelwa kabusha ngokuvamile kudinga umthamo omkhulu we-chemotherapy noma ukwelapha ngemisebe ukuze kuqedwe amangqamuzana omdlavuza nokudala isikhala emnkantsheni wamangqamuzana anikelayo. Le nqubo ingaba intela ngokomzimba nangokomzwelo ezigulini.

Amagciwane kanye Nezinkinga: Isikhathi esilandela ukufakelwa komnkantsha siphawulwa ngokuba sengcupheni okukhulu kwezifo nezinye izinkinga. Iziguli kufanele ziqashwe ngeso elibukhali futhi zithole ukunakekelwa okusekelayo ukuze kuncishiswe lezi zingozi.

Izindleko Nokufinyelela: Izindleko zokufakelwa komnkantsha zingaba phezulu ngendlela engafanele, zibenze bangafinyeleleki ezigulini eziningi, ikakhulukazi emazweni angenawo ukunakekelwa kwezempilo kwendawo yonke. Ukufinyelela kulezi zinqubo ezisindisa ukuphila kusewukukhathazeka okukhulu.

Intuthuko Yakamuva Nezixazululo Ezithembisayo

Naphezu kwalezi zinselele, intuthuko yakamuva emkhakheni wokufakelwa komnkantsha inikeza ithemba lokuthuthukisa imiphumela nokwandisa ukufinyeleleka:

I-Cord Blood Banking: Igazi lentambo, eliqoqwe enkabeni kanye ne-placenta ngemva kokubeletha, liye lavela njengomthombo obalulekile wama-stem cells wokufakelwa kabusha. Amabhange egazi ezintambo agcina la maseli, okwandisa amathuba okuthola umnikezeli ofanelekayo.

Isimo Sokuqina Okuncishisiwe: Abacwaningi bahlola izimiso zesimo ezinobuthi obuncane ezingase zifanelekele iziguli ezindala noma ezibuthakathaka, ehlisa umthwalo wokwelashwa kwangaphambili kokufakelwa.

Ukuphathwa Kwe-GVHD Okuthuthukisiwe: Intuthuko emithini yokuvimbela amasosha omzimba kanye nokwelapha isiza ekulawuleni kangcono i-GVHD, okuvumela ukufakelwa okuyimpumelelo kanye nezinkinga ezimbalwa.

I-Immunotherapy: Izindlela ezintsha, njengokwelashwa kwamaseli e-CAR-T, zibonisa isithembiso ekwelapheni umdlavuza othile wegazi ngaphandle kwesidingo sokufakelwa komnkantsha okuvamile. Lezi zindlela zokwelapha zisebenzisa amasosha omzimba esiguli ukuze aqondise futhi abhubhise amangqamuzana omdlavuza.

Imizamo Yokwehliswa Kwezindleko: Ukukhulumela izinguquko zokunakekelwa kwezempilo kanye nezinketho zokwelapha ezingabizi kakhulu kuyaqhubeka, ngenhloso yokwenza ukufakelwa komnkantsha kufinyeleleke kalula ezinhlobonhlobo ezibanzi zeziguli.

Ukufakelwa komnkantsha ngokungangabazeki kuguqule isimo sokwelashwa komdlavuza wegazi, okunikeza ithemba ezigulini ezibhekene nezifo ezisongela ukuphila. Nakuba izinselele ezinjengokutholakala kwabanikelayo, i-GVHD, nezindleko ziqhubeka, ucwaningo oluqhubekayo nokuthuthuka kwezobuchwepheshe kuvula indlela yemiphumela ethuthukisiwe kanye nokwanda kokufinyeleleka.

Njengoba siqhubeka nokuxazulula izinkinga kanye nobuciko bokufakelwa komnkantsha wamathambo, kubalulekile ukubeka phambili ukufinyelela kwesiguli, ukunciphisa izinkinga, kanye nokucwenga izinqubo zokwelapha. Ngokuzinikezela okuqhubekayo kanye nokusha, umphakathi wezokwelapha ungakha empumelelweni yokufakelwa komnkantsha wamathambo futhi uqinisekise ukuthi zihlala ziyindlela yokuphila yeziguli ezinomdlavuza wegazi iminyaka eminingi ezayo.

Isixhumanisi Esiyisethenjwa

https://www.indiatimes.com/health/bone-marrow-transplant-a-lifeline-for-blood-cancer-patients-and-the-challenges-ahead-616009.html