Yini Ukufakelwa Komnkantsha Wethambo? Inhloso, Inqubo & Ukululama

Ukufakelwa komnkantsha wethambo kuyinqubo yezokwelapha ethatha umnkantsha wethambo olimele noma ogulayo iwuqede, iwuqede ngamaseli esiqu anempilo. Cabanga ngomnkantsha wakho wethambo njengemboni yamaseli egazi emzimbeni wakho - ihlala ngaphakathi kwamathambo akho futhi ikhiqiza amaseli abomvu egazi, amaseli amhlophe egazi, kanye nama-platelet akugcina unempilo. Lapho le mboni ingasebenzi kahle ngenxa yomdlavuza, izifo zofuzo, noma ezinye izimo, ukufakelwa kungakunika isiqalo esisha ngamaseli amasha, anempilo.

Yini ukufakelwa komnkantsha wethambo?

Ukufakelwa komnkantsha wethambo, okubuye kubizwe ngokuthi ukufakelwa kwamaseli esiqu, kuhilela ukufaka esikhundleni somnkantsha wakho wethambo ngamaseli esiqu anempilo avela kumuntu onikelayo noma emzimbeni wakho. Umnkantsha wakho wethambo yizicubu ezithambile, ezinama-spongy ngaphakathi kwamathambo akho akhiqiza wonke amaseli akho egazi.

Le nqubo isebenza ngokuthi kuqala ibhubhise umnkantsha wakho wethambo ogulayo ngemithi yokwelapha umdlavuza ngemithamo ephezulu noma imisebe. Bese, amaseli esiqu anempilo afakwa emgudwini wakho wegazi nge-IV, efana nokumpontshelwa igazi. Lawa maseli esiqu amasha ahamba aye emnkantshweni wakho wethambo bese eqala ukukhiqiza amaseli egazi anempilo.

Kunezinhlobo ezimbili eziyinhloko zokufakelwa komnkantsha wethambo. Ukufakelwa kwe-autologous kusebenzisa amaseli akho esiqu, aqoqwe ngaphambi kokuqala kokwelashwa. Ukufakelwa kwe-allogeneic kusebenzisa amaseli esiqu avela kumuntu onikelayo ofanelekayo, ngokuvamile ilungu lomndeni noma umuntu ozinikele oqeqeshiwe.

Kungani kwenziwa ukufakelwa komnkantsha wethambo?

Ukufakelwa komnkantsha wethambo kunconywa uma umnkantsha wakho wethambo ulimele kakhulu futhi ungenakukhiqiza amaseli egazi anempilo anele. Le nqubo esindisa impilo iphatha imidlavuza ehlukahlukene yegazi, izifo zofuzo, nezifo zesimiso somzimba sokuzivikela ezisabela kahle kwezinye izindlela zokwelapha.

Izizathu ezivamile kakhulu odokotela abancoma ngazo le nqubo zihlanganisa imidlavuza yegazi efana ne-leukemia, i-lymphoma, kanye ne-multiple myeloma. Le midlavuza ihlasela ngokuqondile amaseli akho akha igazi, okwenza kungabi nakwenzeka ukuthi umzimba wakho ukhiqize amaseli anempilo owadingayo ukuze usinde.

Ngaphandle komdlavuza, ukufakelwa komnkantsha wamathambo kungasiza ngezinye izimo eziningi ezingathi sína. Lokhu kuhlanganisa i-aplastic anemia eqinile, lapho umnkantsha wamathambo akho uyeka ukwenza amaseli egazi, kanye nezifo zofuzo njenge-sickle cell disease noma i-thalassemia ezithinta indlela amaseli akho egazi akheka futhi asebenza ngayo.

Ngezinye izikhathi, le nqubo iba yimpoqo ngemva kokwelashwa ngamakhemikhali noma ngemisebe ngemithamo ephezulu yezimila eziqinile. Lokhu kwelashwa okunonya kungalimaza umnkantsha wamathambo akho njengomphumela, okudinga ukufakelwa ukuze kubuyiselwe ikhono lomzimba wakho lokwenza amaseli egazi.

Iyini inqubo yokufakelwa komnkantsha wamathambo?

Inqubo yokufakelwa komnkantsha wamathambo yenzeka ezigabeni eziningana ezihlelwe ngokucophelela emasontweni noma ezinyangeni. Ithimba lakho lezokwelapha lizokuqondisa esinyathelweni ngasinye, liqinisekise ukuthi uyaqonda okulindelekile futhi uzizwe ukhululekile ngangokunokwenzeka kuyo yonke le nqubo.

Okokuqala, uzohlolwa kabanzi ukuze kuhlolwe impilo yakho yonke futhi kunqunywe ukuthi ungumuntu ofanelekayo yini ukufakelwa. Lokhu kuhlanganisa ukuhlolwa kwegazi, izifundo zokuthwebula izithombe, ukuhlolwa komsebenzi wenhliziyo namaphaphu, kanye nokubonisana nochwepheshe abahlukahlukene ukuze kwakhiwe uhlelo lokwelapha olubanzi.

Okulandelayo kuza isigaba sokulungisa, lapho uzothola khona i-chemotherapy yomthamo ophezulu noma ukwelashwa ngemisebe ukuze kubhujiswe umnkantsha wamathambo wakho ogulayo. Lokhu kuvamile ukuthatha izinsuku eziningana futhi kudinga ukulaliswa esibhedlela. Ngenkathi lesi sigaba singaba yinselele, ithimba lakho lezokwelapha lizokuqapha eduze futhi linikeze imithi yokuphatha imiphumela emibi.

Usuku lokufakelwa uqobo luvame ukubizwa ngokuthi

Ngemva kokufakelwa, uzoqala isigaba sokululama lapho uzohlala khona kuyunithi ekhethekile esibhedlela amasonto amaningana. Ngesikhathi lesi, amaseli amasha e-stem ahamba aya emnkantsheni wakho wamathambo bese eqala ukukhiqiza amaseli egazi anempilo - inqubo ebizwa ngokuthi ukufakwa okuthatha amasonto angu-2-4.

Ungalungiselela kanjani ukufakelwa komnkantshe wamathambo?

Ukulungiselela ukufakelwa komnkantshe wamathambo kuhilela ukulungela ngokomzimba nangokomzwelo, futhi ithimba lakho lezempilo lizokusekela kuyo yonke imininingwane yalokhu kulungiselela. Le nqubo ngokuvamile iqala emasontweni amaningana ngaphambi kosuku lwakho lokufakelwa.

Ukulungiselela kwakho kwezokwelapha kufaka phakathi ukuqeda zonke izivivinyo ezidingekayo nokuhlolwa ukuze kuqinisekiswe ukuthi unempilo eyanele yenqubo. Uzodinga futhi ukufakelwa i-catheter ye-venous emaphakathi, enikeza ukufinyelela okulula emithini, ukudonswa kwegazi, nokufakelwa ngokwako.

Ukunakekela impilo yakho engokomzimba ngaphambi kokufakelwa kubalulekile ukuze uthole umphumela ongcono kakhulu. Udokotela wakho angase ancome izinyathelo ezithile zokuthuthukisa isimo sakho:

• Ukugcina ukudla okunomsoco okuhle nokuhlala unamanzi
• Ukuthola imigomo enconyiwe ngaphambi kokuba amasosha akho omzimba acindezelwe
• Ukwelapha noma yiziphi izifo ezikhona noma izinkinga zamazinyo
• Ukuyeka imithi ethile engase iphazamise inqubo
• Ukulandela izincomo zokuzivocavoca ukuze ugcine amandla akho

Lokhu kulungiselela kusiza ekuqinisekiseni ukuthi umzimba wakho usesimweni esingcono kakhulu sokusingatha ukufakelwa futhi ululame ngempumelelo.

Ukulungiselela ngokomzwelo kubaluleke ngokulinganayo, njengoba lokhu kungaba yinto ekhathazayo. Cabangela ukuhlela ukusekelwa emndenini, kubangani, noma emaqenjini okusekela, futhi unganqikazi ukuxoxa nganoma yikuphi ukukhathazeka noma ukwesaba nethimba lakho lezempilo noma umeluleki.

Ungawafunda kanjani imiphumela yakho yokufakelwa komnkantshe wamathambo?

Ukuqonda inqubekela phambili yakho yokufakelwa komnkantsha wamathambo kuhilela ukuqapha izinkomba eziningana ezibalulekile ezikhombisa ukuthi amaseli akho amasha e-stem asebenza kahle kangakanani. Ithimba lakho lokunakekelwa kwezempilo lizolandela lezi zimakhi ngokusondelene futhi lichaze ukuthi zisho ukuthini ngokuphola kwakho.

Isilinganiso esibaluleke kakhulu ukufakwa, okukhombisa ukuthi ngabe amaseli akho amasha e-stem aphumelele yini ukuthatha indawo emnkantshweni wakho wamathambo. Odokotela bakho bazoqapha izibalo zakho zegazi nsuku zonke, befuna izimpawu zokuthi umnkantsha wakho wamathambo ukhiqiza amaseli amhlophe egazi, amaseli abomvu egazi, kanye namaplatelets.

Ukuphumelela kokufakwa ngokuvamile kwenzeka lapho inani lakho eliphelele le-neutrophil (uhlobo lweseli elimhlophe legazi) lifinyelela ngaphezu kwamaseli angama-500 ngemicrolitha ngemihla emithathu elandelanayo. Lokhu kuvame ukwenzeka phakathi kwezinsuku eziyi-10-30 ngemuva kokufakelwa, kuye ngohlobo lokufakelwa kanye nokuphendula kwakho ngakunye.

Ithimba lakho lezokwelapha lizobheka nezinye izimpawu ezibalulekile zokululama. Lokhu kufaka phakathi ukuthi inani lakho le-platelet likhuphuka ngaphezu kuka-20,000 ngaphandle kokusekelwa ukumpontshelwa, kanye nokuthi inani lakho lamaseli abomvu egazi lithuthuka ngokwanele kangangokuthi awusadingi ukumpontshelwa igazi njalo.

Impumelelo yesikhathi eside ilinganiswa ngokuthi izibalo zakho zegazi zihlala zizinzile, ukungabikho kwesifo sakho sokuqala, kanye nempilo yakho yonke kanye nekhwalithi yempilo yakho ethuthuka ngokuhamba kwesikhathi. Ukuqokwa okulandelayo njalo kuzoqhubeka izinyanga kuya eminyakeni ngemuva kokufakelwa kwakho.

Ungakusekela kanjani ukululama kwakho kokufakelwa komnkantsha wamathambo?

Ukusekela ukululama kwakho kokufakelwa komnkantsha wamathambo kuhilela ukuthatha izinyathelo ezithile zokuvikela amasosha akho omzimba abuthakathaka ngenkathi kukhuthazwa ukuphola. Ithimba lakho lokunakekelwa kwezempilo lizohlinzeka ngemihlahlandlela enemininingwane eyenzelwe isimo sakho, kodwa kunezimiso ezijwayelekile ezisebenza ezigulini eziningi.

Ukuvimbela ukutheleleka kuba yinto yakho eza kuqala ngesikhathi sokululama, njengoba amasosha akho omzimba azobe ebuthakathaka kakhulu izinyanga eziningana. Lokhu kusho ukuqapha ngokwengeziwe ngokuqeqeshwa, ukugwema izixuku, nokuhlala kude nabantu abagulayo.

Umsebenzi wakho wansuku zonke uzodinga ukufaka izinyathelo eziningana zokuzivikela ezingase zizwakale zikhulu ekuqaleni, kodwa zibalulekile ekuphepheni kwakho:

• Ukugeza izandla zakho njalo nangokucophelela
• Ukugqoka imaski ezindaweni zomphakathi noma lapho kunabanye abantu
• Ukugwema izithelo ezintsha, imifino, nokunye ukudla okungase kube namagciwane
• Ukuphuza yonke imithi ebekiwe ngendlela eqondile
• Ukuqapha izinga lokushisa lomzimba wakho nokubika noma yimuphi umkhuhlane ngokushesha
• Ukuphumula ngokwanele nokugwema imisebenzi eqinile

Lezi zinyathelo zokuzivikela zikusiza ukuthi uzivikele ngenkathi amasosha akho omzimba amasha ekhula futhi eqina ezinyangeni ezizayo.

Ukudla okunomsoco nokuthatha amanzi kubalulekile ekululameni kwakho. Cishe uzosebenza nodokotela wezokudla ukuqinisekisa ukuthi uthola ukudla okunomsoco okufanele ngenkathi ulandela imihlahlandlela yokuphepha kokudla ekusiza ukuthi uzivikele ezifweni.

Ziyini izici eziyingozi zezinkinga zokufakelwa umnkantsha wamathambo?

Izici eziningana zingakhuphula ingozi yakho yezinkinga ngemuva kokufakelwa umnkantsha wamathambo, futhi ukuqonda lezi zici kusiza ithimba lakho lezokwelapha ukuthi lithathe izinyathelo zokuvikela. Ubudala bakho, impilo yakho yonke, kanye nohlobo lokufakelwa olutholayo konke kunendima ebalulekile ekunqumeni izinga lakho lengozi.

Ubudala buyinye yezici eziyingozi kakhulu, njengoba iziguli ezindala ngokuvamile zibhekana nezingozi eziphakeme zezinkinga nokululama okuhamba kancane. Kodwa-ke, abantu abadala abaningi basathola ukufakelwa ngempumelelo, futhi ithimba lakho lezokwelapha lizohlola ngokucophelela ukuthi ungumuntu ofanelekayo yini kungakhathaliseki ubudala.

Impilo yakho yonke ngaphambi kokufakelwa ithonya kakhulu umphumela wakho. Ukuba nezinye izimo zezokwelapha ezinjengesifo senhliziyo, izinkinga zezinso, noma isifo sikashukela kungakhuphula ingozi yakho yezinkinga, kodwa lezi zimo azikukhiphi ngokuzenzakalelayo ekufakelweni.

Uhlobo lokufakelwa nalo luthinta iphrofayela yakho yengozi. Ukufakelwa kwe-Allogeneic (kusetshenziswa amaseli omlingani) kuthwala izingozi eziphakeme kunezokufakelwa ze-autologous (kusetshenziswa amaseli akho), ikakhulukazi ngesifo sokulwa nomsinga kanye nezifo, kodwa kungase futhi kusebenze kangcono ekwelapheni izimo ezithile.

Ezinye izinto ezingakhuphula izingozi zezinkinga zihlanganisa ukuba nokwelashwa ngamakhemikhali noma imisebe ngaphambilini, isigaba sesifo sakho ekufakelweni, nokuthi umlingani wakho uhambisana kanjani uma wamukela ukufakelwa kwe-allogeneic.

Ziyini izinkinga ezingaba khona zokufakelwa komnkantsha wamathambo?

Izinkinga zokufakelwa komnkantsha wamathambo zingahluka kusuka emiphumeleni eseceleni elawulekayo kuya ezimweni ezinzima ezidinga ukunakekelwa kwezempilo ngokushesha. Ngenkathi lokhu kungase kuzwakale kuthusa, khumbula ukuthi ithimba lakho lezokwelapha liqeqeshwe ngobuchwepheshe ukuvimbela, ukuqaphela, nokwelapha lezi zinkinga.

Izinkinga ezivame kakhulu zokuqala zenzeka ezinyangeni ezimbalwa zokuqala ngemuva kokufakelwa. Lokhu kufaka phakathi izifo ngenxa yesistimu yakho yokuzivikela ebuthakathaka, ukopha ngenxa yokwehla kwama-platelet, kanye ne-anemia evela ekukhiqizweni okunganele kwamaseli abomvu egazi.

Isifo sokulwa nomsinga (GVHD) yinkinga ethile engenzeka ngokufakelwa kwe-allogeneic. Lokhu kwenzeka lapho amaseli omzimba omlingani ehlasela izicubu zomzimba wakho, ewaphuthela njengabahlaseli bangaphandle. Ngenkathi i-GVHD ingaba yingozi, kukhona ukwelashwa okuphumelelayo okutholakalayo, futhi amacala amancane ngezinye izikhathi asiza ngisho nokulwa namaseli omdlavuza.

Ezinye izinkinga eziningana zingathuthuka emasontweni nasezinyangeni ezilandelayo ukufakelwa, futhi ithimba lakho lezokwelapha lizokuqapha eduze ngalezi:

• I-Mucositis, ebangela izilonda ezinobuhlungu emlonyeni nasemqaleni
• Ubuthi bezitho ezithinta isibindi, izinso, noma amaphaphu
• Isifo se-Veno-occlusive, lapho imithambo yegazi yesibindi ivaleka
• Imidlava yomdlavuza yesibili engase ithuthuke eminyakeni eminingi kamuva
• Izinkinga zokuzala nezinguquko zamahomoni
• Ama-Cataracts neminye imiphumela yesikhathi eside

Noma lolu hlu lungase lubonakale lukhulu, iziguli eziningi ziba nezinkinga ezincane noma azibe nazo nhlobo, futhi izinkinga eziningi zingalawulwa ngempumelelo ngokunakekelwa kwezempilo okufanele.

Izinkinga zesikhathi eside azivamile kodwa zingabandakanya i-chronic GVHD, izinkinga eziqhubekayo zesimiso somzimba sokuzivikela ezifweni, kanye nengozi eyengeziwe yezinye izinhlobo zomdlavuza. Ukunakekelwa okuvamile kokulandela ngemuva kusiza ukuthola nokulawula lezi zinkinga ekuqaleni.

Kufanele ngibone nini udokotela ngemva kokufakelwa komnkantsha wamathambo?

Ngemva kokufakelwa komnkantsha wamathambo, uzodinga ukulandela ngemva kwezokwelapha njalo impilo yakho yonke, kodwa zikhona izimo ezithile lapho kufanele uthinte khona ithimba lakho lezempilo ngokushesha. Ukuqonda lezi zimpawu zokuxwayisa kusiza ukuqinisekisa ukuthi uthola ukwelashwa ngokushesha uma kudingeka.

Kufanele ushayele udokotela wakho ngokushesha uma uba nomkhuhlane, ngoba lokhu kungase kubonise ukutheleleka okukhulu. Ngisho nomkhuhlane ophansi ongu-100.4°F (38°C) noma ngaphezulu udinga ukunakekelwa kwezempilo ngokushesha lapho isimiso sakho somzimba sokuzivikela ezifweni silimele.

Ezinye izimpawu ezidinga ukunakekelwa kwezempilo ngokushesha zihlanganisa isicanucanu esikhulu noma ukuhlanza okukuvimbela ukuthi ungagcini uketshezi, izimpawu zokuphuma kwegazi njengokulimala okungavamile noma ukuphuma kwegazi emakhaleni, kanye nobunzima bokuphefumula noma ubuhlungu besifuba.

Xhumana nethimba lakho lezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu ezikhathazayo:

• Ukuqunjelwa okuqhubekayo noma izimpawu zokuphelelwa amanzi emzimbeni
• Ikhanda elibuhlungu elibuhlungu noma izinguquko embonweni
• Ukuqubuka kwesikhumba noma izinguquko emibaleni yesikhumba
• Ukudideka noma izinguquko zobuntu
• Ukukhathala okukhulu ngaphezu kwalokho ovame ukukuzwa
• Ubuhlungu noma ukusha ngesikhathi sokuchama

Lezi zimpawu azisho ngaso sonke isikhathi ukuthi kunezinkinga ezinkulu, kodwa kubalulekile ukuzihlola ngokushesha ezigulini ezifakelwe.

Uhlelo lwakho lokulandela ngemva njalo luzoba nzima ekuqaleni, ngokuvakashelwa izikhathi eziningana ngesonto ekuqaleni, bese kancane kancane lwehla liye emihlanganweni yanyanga zonke, bese kuba yonyaka. Lokhu kuvakashelwa kuqapha ukubalwa kwegazi lakho, ukusebenza kwezitho, kanye nempilo yonke.

Imibuzo evame ukubuzwa mayelana nokufakelwa komnkantsha wamathambo

Ingabe ukufakelwa komnkantsha wamathambo kuyelapha umdlavuza?

Ukufakelwa komnkantsha wamathambo kungelapha imidlavuza eminingi yegazi, kodwa akuqinisekisi ukuthi kuzokwelapha wonke umuntu. Izinga lempumelelo lincike ezintweni ezifana nohlobo lomdlavuza, ukuthi usuthuthuke kangakanani, iminyaka yakho, nempilo yakho yonke. Kwabanye abantu, ukufakelwa kunikeza ukwelashwa okuphelele, kanti abanye bangafinyelela ekutheni bangabi nazo izimpawu zesifo isikhathi eside.

Udkt wakho wezifo zomdlavuza angakunikeza ulwazi oluqondile mayelana namazinga okwelashwa ngesimo sakho esithile. Noma ngabe ukufakelwa akukunikezi ukwelashwa, kuvame ukwelula impilo kakhulu futhi kuthuthukise izinga lempilo.

Ingabe ukufakelwa komnkantsha wamathambo kubangela ubuhlungu?

Inqubo yokufakelwa uqobo ayibuhlungu futhi izizwa sengathi uthola ukumpontshelwa igazi. Kodwa-ke, ukwelashwa ngamakhemikhali noma imisebe ngaphambi kokufakelwa kungabangela imiphumela emibi ebalulekile ehlanganisa ukukhathala, isicanucanu, nezilonda zomlomo.

Ithimba lakho lezokwelapha lizohlinzeka ngemithi yokulawula ubuhlungu nokungakhululeki kuyo yonke inqubo. Abantu abaningi bathola ukuthi ukulindela ubuhlungu kuvame ukuba kubi kakhulu kunokuhlangenwe nakho kwangempela, ikakhulukazi ngokuphathwa kobuhlungu obufanele.

Kuthatha isikhathi esingakanani ukululama ekufakelweni komnkantsha wamathambo?

Ukwelulama kokuqala kuvame ukuthatha izinyanga ezi-2-6, kodwa ukululama okuphelele kungathatha unyaka ongu-1-2 noma ngaphezulu. Ukubalwa kwegazi lakho kuvame ukululama phakathi kwamasonto ama-2-4, kodwa amasosha akho omzimba angathatha izinyanga eziyi-6-12 ukwakheka kabusha ngokugcwele.

Isikhathi sokululama siyahlukahluka kakhulu phakathi kwabantu futhi sincike ezintweni ezifana neminyaka yakho, uhlobo lokufakelwa, nokuthi ngabe uthola izinkinga. Abanye abantu babuyela emisebenzini ejwayelekile ezinyangeni ezimbalwa, kanti abanye badinga isikhathi eside.

Ngingasebenza ngemuva kokufakelwa komnkantsha wamathambo?

Abantu abaningi bayakwazi ukubuyela emsebenzini ngemva kokufakelwa komnkantsha wamathambo, nakuba isikhathi sihluka kakhulu. Ezinye iziguli zibuyela emsebenzini phakathi nezinyanga ezi-3-6, kanti ezinye zingase zidinge unyaka noma ngaphezulu, kuye ngokuthi ukululama kwazo kanye nohlobo lomsebenzi.

Ikhono lakho lokusebenza lizoxhomeka ezingeni lakho lamandla, ukululama kwamasosha omzimba, kanye nezidingo zomsebenzi. Iziguli eziningi zithola ukuthi zidinga ukwenza izilungiselelo ekuqaleni, njengokusebenza ekhaya noma ukunciphisa amahora.

Ngizodinga yini ukuthatha imithi unomphela ngemva kokufakelwa?

Isidingo semithi yesikhathi eside sincike ohlotsheni lwakho lokufakelwa nokuthi ululama kahle kangakanani. Iziguli zokufakelwa ze-Autologous ngokuvamile zidinga imithi yesikhathi eside encane kunezifo zokufakelwa ze-allogeneic.

Iziguli zokufakelwa ze-Allogeneic ngokuvamile zidinga imithi yokucindezela amasosha omzimba okungenani izinyanga eziningana ukuvimbela i-GVHD, futhi ezinye zingase zidinge leyo mithi isikhathi eside. Ithimba lakho lezokwelapha lizosebenza ukunciphisa imithi ngenkathi likugcina uphilile futhi livimbela izinkinga.