Ndondomeko, Cholinga, ndi Zovuta za PBSCT
Chidule cha PBSCT
Matenda opatsirana a maselo osakaniza magazi, kapena a PBSCT, ndiwo njira zomwe zimabwezeretsanso maselo osungunuka omwe awonongedwa ndi mankhwala apamwamba a chemotherapy. Maselo am'munsi ndi maselo omwe amachititsa maselo a m'magazi - maselo ofiira ofiirira omwe amatenga mpweya, maselo oyera a magazi omwe amathandiza thupi kulimbana ndi matenda, ndi mapuloletti omwe amathandiza kuti magazi azimitsidwe.
Zikadakhala kuti zowonongeka za maselo zimachokera ku fupa la fupa . Ngakhale kuti maselo ambiri amapezeka mu fupa lamagazi, ena amakhala akutuluka - m'magazi amagazi. Izi zikhoza kusonkhanitsidwa ndiyeno kuikidwa kwa odwala kuti abwezeretse malo awo osungira maselo. Mitundu yambiri ya masentimita (koma osati zonse mwa zifukwa zingapo) tsopano ndi PBSCT. Asanapereke maselo ofooka, opereka ndalama amapatsidwa mankhwala omwe amachititsa chiwerengero cha maselo a tsinde m'magazi. Maselo a m'magazi amagazi amagwira ntchito bwino poyerekeza ndi mafupa a mafupa, ndipo kwenikweni, nthawi zina amatha kupanga mapulateletti ndi mtundu wa maselo oyera a m'magazi otchedwa neutrophils "kutenga" bwino kwambiri, pamene woperekayo sakugwirizana ndi wolandira .
Cholinga cha Kusuntha kwa Cell Shem
Pofuna kumvetsetsa momwe maselo ogwiritsira ntchito maselo amatha kugwira ntchito, zingathandize kulankhula pang'ono za maselo ofunika kwambiri.
Monga taonera pamwambapa, maselo amadzimadzi - omwe amadziwikanso kuti maselo amtundu wa hematopoietic - amachititsa mitundu yonse ya maselo a magazi m'thupi. Mwa kuika maselo a tsinde omwe amatha kusiyanitsa ndikusanduka mitundu yosiyanasiyana ya maselo a magazi - ndondomeko yotchedwa hematopoiesis - kusuntha kumatha kusintha m'malo mwa mtundu uliwonse wa maselo a magazi.
Mosiyana ndi zimenezi, mankhwala ochiritsira kuti athetse maselo onsewa ndi ovuta ndipo amatenga mavuto ambiri. Mwachitsanzo, mukhoza kupatsirana magazi, magazi ofiira maselo ofiira magazi, komanso kupatsa mankhwala kuti apangitse maselo ofiira a magazi ndi maselo oyera, koma izi ndi zovuta kwambiri, zovuta, ndipo zimakhala ndi zotsatira zambiri komanso zovuta.
Zifukwa za PBSCT
Chemotherapy yapamwamba kwambiri imayambitsa khansa yabwino, komanso imawononga maselo ofunika omwe alipo m'mafupa. Kusintha kwa maselo a maselo kumathandiza kubwezeretsa mafupa kuti wodwalayo athe kupirira mankhwala apamwamba a chemotherapy.
Mitundu
Pali mitundu itatu ya kusamba maselo:
- Zomwe zimachitika: pamene odwala amalandira maselo awo enieni.
- Mavitamini a allogeniki: pamene odwala amalandira maselo ofunika kuchokera kwa mbale, mlongo, kapena kholo. Wopereka wosagwirizana angagwiritsidwe ntchito.
- Zokwanira za Syngeneic: pamene odwala amalandira maselo ofanana ndi mapasa awo ofanana.
Kupereka Maselo Amagazi Akumagazi
Mphatso ya PBSC imaphatikizapo kuyendetsa maselo amagazi a magazi, osati maselo a mafupa, kotero palibe ululu wochokera ku fupa la fupa. Koma mu PBSC, mankhwala omwe amaperekedwa kuti ayambe kuchulukitsa chiwerengero cha maselo otsegula m'magazi omwe amaperekawo angathe kugwirizanitsidwa ndi thupi la aches, minofu ya minofu, mutu, ndi zizindikiro za chimfine.
Zotsatirazi zambiri zimaimitsa masiku angapo pambuyo pa mlingo womaliza wa mankhwala opatsirana pogwiritsa ntchito selo.
Zovuta za PBSCT
Pali zovuta zambiri zotheka za PBSCT. Mankhwala akuluakulu a mankhwalawa asanatengedwe, amawopsa kwambiri chifukwa cha kusowa kwa maselo oyera a magazi (immunosuppression) komanso mavuto okhudzana ndi kusowa kwa maselo ofiira a magazi (anemia) ndi aplatelet low (thrombocytopenia).
Kawirikawiri chiopsezo choterechi chikagwiritsidwa ntchito ndi mtundu wa matenda a graft versus host (GvH), omwe amachitika pafupifupi pafupifupi maselo onse a maselo. Matenda a GvH maselo opangidwa (kuchokera kwa woperekawo) amadziwa yemwe akulandira (wololera) monga alendo, ndi kuukira.
Pachifukwa ichi anthu amapatsidwa mankhwala osokoneza bongo amatha kusuntha.
Komabe mankhwala osokoneza bongo amachitanso ngozi. Kutsika kwa chitetezo cha mthupi chifukwa cha mankhwalawa kumawonjezera chiopsezo cha matenda akuluakulu, komanso kumawonjezera chiopsezo chokhazikitsa khansa zina.
Njira Zina
Kuchita PBSCT ndi njira yaikulu. Osati kokha kokha ndi mankhwala oopsa a chemotherapy, koma zizindikiro zowonongeka ndi matenda, ndi mavuto a mankhwala osokoneza bongo amachititsa kukhala njira yomwe nthawi zambiri imakhala yosungirako, komanso yathanzi kwambiri, anthu.
Njira imodzi yomwe ingaganizidwe kwa odwala omwe ali okalamba kapena okhudzidwa ndi thanzi losakanizidwa ndi seloablative stem cell transplant. Mwa njirayi, m'malo mochepetsera (fupa) fupa la mafupa omwe ali ndi mankhwala akuluakulu a mankhwala, mankhwalawa amagwiritsidwa ntchito. Chinsinsi cha mitundu iyi yazitsulo kwenikweni chimakhala mu mtundu wa graft versus host disease. Komabe, mmalo mwa kuphatikizidwa - maselo amkati opatsirana - kuyambitsa maselo "abwino" mu thupi lozilandila, maselo opatsiranawo amawongolera maselo a khansa mu thupi lozilandira. Chizoloŵezi chimenechi chimatchedwa "kuphatikiza motsutsana ndi chifuwa."
Komanso:
PBSCT, Pulogalamu Yopanga Maselo a Magazi a M'magazi
Malingaliro Ogwirizana:
HSCT = kutaya maselo amtundu wambiri
HCT = kutsegula kwa maselo amtundu
SCT = Kuika maselo ochepa
G-CSF = Chidziwitso cha Granulocyte-colony factor - chiwerengero cha kukula, mankhwala opatsirana pogwiritsa ntchito maselo, nthawi zina amaperekedwa kwa opereka ndalama kuti asonkhanitse maselo amtundu wamagazi ku fupa lamagazi kupita ku magazi.
Zotsatira:
National Cancer Institute. Kusuntha kwa Cell Shem. Kusinthidwa 04/19/15. http://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant
Singh, V., Kumar, N., Kalsan, M., Saini, A., ndi R. Chandra. Njira Yoperekera: Amapangitsa Maselo Amtundu wa Pluripotent (iPSCs). Journal of Stem Cell . 2015. 10 (1): 43-62.
Wu, S., Zhang, C., Zhang, X., Xu, Y., ndi T. Deng. Kodi pulogalamu yamagazi kapena mafupa a mafupa ndi gwero labwino la maselo osungiramo opaleshoni panthawi ya opereka osagwirizanitsa a HLA? Kusanthula meta. Zofufuza Zovuta pa Oncology ndi Hematology . 2015. 96 (1): 20-33.