Ukufakelwa kwe-Bone Marrow

A ukufakelwa komnwe we-bone (BMT) inqubo yokushintsha amaseli omnkantsha anesifo esikhundleni samaseli anempilo. Kuye ngohlobo lokufakelwa, umthombo womnikeli, indawo, kanye nezinkinga, intengo yokufakelwa komnkantsha ingase ihluke. Ukufakelwa kwe-allogeneic, okusebenzisa ama-stem cells omnikeli, ngokuvamile kubiza ngaphezu kokufakelwa kwe-autologous, okusebenzisa ama-stem cells esiguli.

Kuyini Ukufakelwa Kwethambo Lomnkantsha?

Ukufakelwa komnkantsha kusetshenziselwa ukubuyisela umnkantsha oye wacekelwa phansi noma owonakaliswa ukugula, ukutheleleka, noma imiphumela emibi yokwelashwa ngamakhemikhali. Izindleko zomnkantsha ziyahlukahluka kuye ngenqubo. Phakathi nenqubo, udokotela ushintsha amangqamuzana egazi alimele afake anempilo, abese edluliselwa emnkantsheni. Lapha, bakha amangqamuzana egazi amasha futhi bakhuthaze ukuthuthukiswa komnkantsha omusha. Le nqubo ithuthukisa ukukhiqizwa kwamangqamuzana egazi abomvu anele, ama- platelet, noma amangqamuzana amhlophe egazi ngomzimba, okusiza ekuvimbeleni ukuphelelwa igazi, ukuphazamiseka kwegazi, nezinye izifo.

Ama-stem cells anempilo angatholakala kumnikeli noma emzimbeni womuntu. Ngemuva kokukhishwa kwama-stem cells, agcinwa. Ngemuva kokugcinwa, lawa maseli anempilo ayatshalwa kabusha. 

Kungani kudingeka ukufakelwa komnkantsha? 

Ukufakelwa Kweseli noma Ukufakelwa Kwethambo Lomnkantsha kufeza izinjongo ezintathu eziyinhloko:

• Ithatha indawo yamangqamuzana egazi alimele okubangelwa umthamo omkhulu we-chemotherapy noma imisebe esetshenziselwa ukuqeda amangqamuzana omdlavuza. Ngemva kokwelashwa komdlavuza, ukufakelwa kugcwalisa amangqamuzana athintekile nganempilo.
• Ngesikhathi sokwelashwa ngamakhemikhali, akuwona kuphela amangqamuzana omdlavuza ahlosiwe, kodwa amanye amangqamuzana egazi anempilo nawo alimala. Kule nqubo, odokotela basebenzisa ukufakelwa kwamaseli esikhundleni samaseli alimele ngamasha, anempilo.
• Ihlinzeka ngamaseli amasha angahlasela ngokuqondile futhi aqede amangqamuzana omdlavuza.

Yiziphi izinhlobo ezahlukene zokufakelwa komnkantsha?

Kunezinhlobo ezintathu zezinqubo zokufakelwa komnkantsha ezitholakalayo:

• Ukufakelwa kwe-autologous: Kule nqubo, amangqamuzana egazi esiguli aqoqwa ngaphambi kokwelashwa ngamakhemikhali, agcinwe, futhi kamuva abuyiselwe emzimbeni wesiguli ngemva kokwelashwa ngamakhemikhali noma ngemisebe, eyaziwa ngokuthi "ukufakelwa kokuhlenga." Lamangqamuzana angagcinwa isikhathi eside, futhi odokotela bawagcina kuze kube yilapho edingeka ukuze atshalwe kabusha.
• Ukufakelwa kwe-Allogeneic: Lapha, odokotela bathola amangqamuzana noma amangqamuzana egazi kumnikeli, okungaba ilungu lomndeni noma umuntu ongahlobene. Kubalulekile ukuthola onikelayo onomongo ofana nowesiguli. Lolu hlobo lokufakelwa luncike ekusebenzisaneni komnikezeli.
• Ukufakelwa igazi nge-umbilical cord: Ngokufanayo nokufakelwa kwe-allogeneic, le nqubo ihlanganisa ukuqoqa amangqamuzana noma umnkantsha enkabeni yosana olusanda kuzalwa ngokushesha ngemva kokuzalwa. Lawa maseli ayafrizwa futhi agcinwe kuze kube yilapho edingeka ukuze atshalwe kabusha. Ngemva kokwelashwa ngamakhemikhali noma ngemisebe, amangqamuzana aphindiselwa emuva egazini lesiguli ngepayipi le-venous eliphakathi, elifana nokumpontshelwa igazi, futhi ahamba esuka egazini aye emnkantsheni ngaphandle kwesidingo sokuhlinzwa.

Ziyini Izindleko Zokufakelwa Kwe-Bone Marrow eNdiya?

Izindleko zomnkantsha eNdiya zincike ezintweni eziningana, okuhlanganisa uhlobo lomnikeli, uhlobo lokufakelwa, inkimbinkimbi yenqubo yokuhlinzwa, kanye nesibhedlela noma umtholampilo lapho ukufakelwa kwenziwa khona. E-India, intengo yokufakelwa komnkantsha ngokuvamile isukela ku-Rs. 10,00,000/- kuya ku-Rs. 40,00,000/- lakh rupees. Le ntengo ihlanganisa zonke izindleko ezihambisanayo, njengalezo zenqubo yokufakelwa kabusha, ukuhlala esibhedlela, ukuhlolwa ngelebhu, imithi, nezinye izindleko. Ngokuya ngohlobo lokufakelwa kanye nobunkimbinkimbi benqubo, izindleko zingahluka.

Nalu uhlu lwamadolobha anezindleko ezijwayelekile ezihlukile zokufakelwa komnkantsha eNdiya:

Yiziphi Izindleko Ezithinta Umnkantsha Wethambo?

Okulandelayo yizici ezithinta izindleko zokushintshwa komnkantsha eNdiya:

• Izindleko Zokuhlola Ngaphambili - Ukuhlolwa okuningi kuyenziwa ngaphambi kokufakelwa ukuze kuqondwe izibalo ezibalulekile zesiguli. Le mibiko isiza odokotela ukuthi basebenzise lezi zibalo ukuthola ukuthi isiguli sikulungele yini ukuhlinzwa noma cha.
• Izindleko Zekhemotherapy - Izimo ezifana i-leukemia ingase idinge isiguli ukuba sithole imijikelezo embalwa ye-chemotherapy ngaphambi kokuthola ukufakelwa komnkantsha. Izindleko zokwelapha leso simo sisonke ziyakhuphuka ngenxa yohlelo lwe-chemotherapy.
• Uhlobo Lwesibhedlela - Ukwengeza, izindleko zokufakelwa komnkantsha ziyahlukahluka esibhedlela ngesibhedlela kanye nedolobha ngalinye. Ukuthi umuntu ukhetha isibhedlela se-multispecialty, umtholampilo, noma indawo yokufakelwa komnkantsha wethambo ngokuvamile kuthinta izindleko zizonke zokwelashwa komnkantsha. Intengo nayo iyahluka kuwo wonke amadolobha.
• Iminyaka Yeziguli - Esinye isici esithinta intengo yokufakelwa komnkantsha iminyaka yesiguli. Iziguli ezingaphansi kweminyaka engu-20 noma izingane ezincane ngokuvamile zithola izindleko eziphakeme. Lokhu kungenxa yokuthi badinga ukunakwa nokuhlolwa okwengeziwe, futhi ubude babo bonke bokulaliswa esibhedlela bude.

Ezinye zezinto ezithinta izindleko zokuhlinzwa komnkantsha eNdiya yilezi -

• Ukubonisana nodokotela
• Okuhlangenwe nakho kukadokotela
• Izindleko zokulandelela
• Izindleko zegumbi
• Izindleko zesibhedlela
• Izindleko ezihambisana nokubuyiselwa

Inqubo yokutakula

Ukululama ngemva kokufakelwa komnkantsha kuyinqubo eyinkimbinkimbi nehamba kancane eyahlukahluka kuye ngohlobo lokufakelwa (autologous, allogeneic, noma umbilical cord blood), impilo yesiguli iyonke, nanoma yiziphi izinkinga ezingase ziphakame. Nakhu ukubuka konke kwenqubo yokutakula evamile:

• Ukuhlala Esibhedlela: Iziguli ngokuvamile zichitha amasonto ambalwa esibhedlela ngemva kokufakelwa. Ubude besikhathi bungahluka ngokuya ngohlobo lokufakelwa, izinkinga, nokuthi isiguli silulama kanjani.
• Ukuqapha: Ngesikhathi sokuhlala esibhedlela, iziguli ziqashwe ngeso lokhozi ukuze kubhekwe izimpawu zokutheleleka, isifo se-graft-versus-host (GVHD), nezinye izinkinga ezingaba khona.
• Ukutholwa Kwesistimu Yamasosha omzimba: Ukwakha kabusha amasosha omzimba kuyisici esibalulekile sokululama. Kungathatha izinyanga ezimbalwa kuya eminyakeni ukuze amasosha omzimba alulame ngokugcwele, futhi phakathi nalesi sikhathi, iziguli zisengozini enkulu yokutheleleka ngezifo.
• Imithi: Ngokuvamile iziguli kudingeka ziphuze imithi yokucindezela amasosha omzimba (ama-immunosuppressants) nokuvimbela i-GVHD, kanye neminye imithi yokusekela inqubo yokululama.
• Ukudla nokudla okunomsoco: Ukugcina ukudla okunempilo kubalulekile, njengoba iziguli ezifakelwayo zingase zibe nemiphumela engemihle njengesicanucanu, isifo sohudo, noma izilonda zomlomo. Ukudla okunomsoco kubalulekile ekwelapheni.
• Ukunakekelwa Kokulandelela: Ukuqokwa kokulandelela njalo kuyadingeka ukuze kuqashwe ukuqhubeka, ukulawula izinkinga, nokulungisa imithi.

Yiziphi Izinkinga Ezihlukene ezihlobene Nokuhlinzwa Kwe-Bone Marrow Transplant?

Ukufakelwa komnkantsha wethambo kungabangela izinkinga eziningana. Nakuba ezinye iziguli zingase zibe nezinkinga ezincane, ezinye zingase zibe nezinkinga ezinkulu ezidinga ukunakekelwa kwezokwelapha ngokushesha. Lezi zinkinga ngezinye izikhathi zingasongela ukuphila. Ngemva kokufakelwa komnkantsha, kungase kuphakame izinkinga ezihlukahlukene, kuhlanganise:

• Izifo
• Lolu ngwengwezi lwakheka
• ukungazali
• Ukufa
• Ukuthuthukiswa komdlavuza omusha
• Ukulimala kwesitho
• Ukuhluleka kokufakelwa kwe-stem cell
• Isifo se-graft-versus-host, okuyinkinga kuphela ehlobene nokufakelwa kwe-allogeneic.

Ukufakelwa komnkantsha wethambo kungaba yindlela yokwelapha esindisa impilo yabantu abaningi abanezinkinga zegazi ezibulalayo. Ngisho noma ukufakelwa komnkantsha eNdiya kungase kubize, kusengenzeka ukuthola ukunakekelwa kwekhwalithi ephezulu ngezindleko ezifanele. Vakashela CARE Izibhedlela ukuze ukhulume nochwepheshe bethu futhi uqonde isimo sakho kangcono.

Disclaimer

Imininingwane yezindleko nezilinganiso ezinikezwe kule webhusayithi ezezinjongo zokwaziswa kuphela futhi zisekelwe ezimweni ezimaphakathi. Azihlanganisi isilinganiso esinqunyiwe noma isiqinisekiso sezindleko zokugcina.

Izibhedlela ze-CARE azimeli noma azikukhuthazi ukuqiniseka kwalezi zibalo zezindleko. Izindleko zakho zangempela zizohluka ngokuya ngohlobo lokwelashwa, izinsiza ezikhethiwe noma izinsizakalo, indawo yesibhedlela, impilo yesiguli, ukuhlinzekwa komshwalense, kanye nezidingo zezokwelapha ezinqunywe udokotela wakho. Ukusebenzisa kwakho okuqukethwe kwale webhusayithi kusho ukuthi uyakwamukela futhi wamukele lokhu kuhlukahluka nokuthi noma yikuphi ukuthembela ezindlekweni ezilinganiselwe kuzifaka engozini ngokwakho. Ukuze uthole ulwazi lwezindleko lwamanje kakhulu nolwenzelwe wena siqu, sicela usithinte ngokuqondile noma usishayele.

Imibuzo Evame Ukubuzwa

1. Ingakanani izindleko ezimaphakathi zokufakelwa komnkantsha? 

Izindleko ezimaphakathi zokufakelwa komnkantsha zingahluka kakhulu kuye ngezici ezifana nohlobo lokufakelwa (okuzenzakalelayo noma kwe-allogeneic), indawo yesiguli, isibhedlela, nezindleko zezokwelapha ezihambisanayo. Ngokwesilinganiso, ingasukela emashumini ezinkulungwane kuya kumakhulu ezinkulungwane zamaRandi. Kungcono ukuthintana nabahlinzeki bezempilo noma umshwalense wezempilo ukuze uthole izilinganiso zezindleko ezithile.

2. Yiziphi izinkinga ezihlukene ezihlobene nokuhlinzwa kokufakelwa komnkantsha? 

Izinkinga ezihlobene nokuhlinzwa kokufakelwa komnkantsha wethambo zihlanganisa isifo se-graft-versus-host (GVHD), izifo, ukulimala kwezitho zomzimba, ukopha, kanye nokusabela okungekuhle lapho ukufakelwa. Lezi zinkinga zingahluka ngobukhulu futhi zidinga ukunakekelwa kwezokwelapha okuqaphile.

3. Yisiphi isikhathi sokululama sokufakelwa komnkantsha? 

Isikhathi sokubuyisela ngemva kokufakelwa komnkantsha siyahlukahluka kuye ngohlobo lokufakelwa kanye nezici zomuntu ngamunye. Ngokuvamile kuhilela amasonto kuya ezinyangeni zokunakekelwa kwangemva kokufakelwa, futhi ukululama ngokugcwele kungase kuthathe isikhathi eside nakakhulu.

4. Ingabe zikhona izindleko ezengeziwe ngaphandle kokufakelwa kabusha?

Ngaphandle kokufakelwa ngokwakho, izindleko ezengeziwe zingabandakanya ukuhlolwa kwangaphambi kokufakelwa, imithi, ukunakekelwa kokulandelela ngemva kokufakelwa, indawo yokuhlala, nezindleko zokuhamba uma isikhungo sokufakelwa singesona esasendaweni. Umshwalense wezempilo ungase ukhokhele ezinye zalezi zindleko, kodwa iziguli kufanele ziqaphele izindleko ezingase ziphume ephaketheni.