Bone Marrow Transplantation Yevana

Bone Marrow Transplantation Yevana

Kuisirwa mapfupa emwana ane chirwere (BMT) inzira yekutsiva mapfupa emwana ane chirwere nemapfupa ane hutano nekuisa masero eropa ane ropa. Muvana, kuisirwa mapfupa emwana kunoshandiswa kurapa zvirwere zvinouraya pamwe nezvirwere zvisingarwadzi.

Chii chinonzi mwongo?

Bone marrow itemplate yakapfava iri mukati memapfupa makuru. Yakafanana nefekitori inogadzira masero ekutanga (masero evabereki kana masero anogadzira ropa). Mamasero ekutanga aya anotanga kupatsanurana nekukura kusvika akura zvakakwana, achiumba marudzi ese akasiyana emasero eropa: masero machena, maplatelet nemasero matsvuku eropa. Masero ekutanga anowanzo kuwanikwa mukati memapfupa makuru emapfupa makuru emapfupa. Nzira iri nyore yekuwana masero ekutanga ndeyekubva mumapfupa ehudyu.

Kunze kwemwongo wemapfupa, masero emuviri anowanikwa muropa remudumbu uye muropa rekunze.

Ndedzipi mhando dzemwongo wemapfupa?

Masero emuviri anogona kutorwa kubva mumuviri wemurwere kana kuti anogona kutorwa kubva kune mumwe munhu. Munhu uyu anozivikanwa semupi weropa.

Autologous Transplant

Masero emuviri anotorwa kubva muropa remurwere kuburikidza neapheresis achishandisa michina yakakosha (peripheral) uye ozodzoserwa kumurwere mushure mekurapwa kwekupora.

Allogeneic Transplant

Munhu anopa ropa iri ihama kana kuti haana hukama asi ane mhando yakafanana yeHuman Leukocyte Antigen (HLA). Kuenzanisa HLA yemunhu anopa ropa nemurwere kunoitwa nekuongororwa kweropa kana mate.

Kupa masero emuviri inzira yakachengeteka. Zvakajairika kutanga nekuedza hama nehanzvadzi, sezvo dziri idzo dzinokwanisa kupa mhando yakakodzera.

Anopa anofanira kunge aine hutano hwakanaka. Iye achanyatsoongororwa nachiremba kuti ave nechokwadi chokuti hapazovi nengozi kuutano hwake pachake kubva mukurapwa kwacho.

Zvakadini Kana Vanin'ina Vasingafananidzi Zvizere seVanopa?

• Vanopa Haploidentical: 50% yehama kana mubereki mumwe chete anogona kutorwa semupi weimwe nzira kana kuongororwa kwemasoja ekudzivirira chirwere cheDonor kwaratidza kuti murwere haana chirwere.
• Vapi Vasina Hukama: Vapi vanosarudzwa kubva ku stem cell registers (Vanozvimiririra mushure mekuongorora nekubvumirana)

Kuisirwa mwongo kunodiwa riini?

Masero eropa anotanga ari masero asina kukura. Anobuda mumongo wemapfupa opinda muropa mushure mekukura. Kana mungo wemapfupa wakuvara, unoburitsa masero eropa mashoma uye masero ekudzivirira muviri mashoma. Ndosaka, kuti mutsive mungo wemapfupa wakakuvara kana kuti une chirwere, munofanira kuisirwa mungo wemapfupa.

Zviratidzo zvekuisirwa mwongo:

• Dambudziko guru reLeukemia (kenza yemasero machena eropa) kana kuti leukemia yakadzokazve
• Matumbu akasimba akadai seHigh risk neuroblastomas, lymphomas, uye brain bundus
• Aplastic anemia (chirwere apo muviri unomira kugadzira masero matsva eropa)
• Chirwere cheSickle cell (chirwere chinokanganisa chimiro chemasero matsvuku eropa chinokanganisa hemoglobin)
• Thalassemia (chirwere chinokanganisa kugona kwemuviri kugadzira hemoglobin yakajairwa)
• Matambudziko emetabolism ekuzvarwa nawo (mamiriro ezvinhu emumajini anokanganisa metabolism)
• Zvirwere zvemuviri zvinorwisa dziviriro yemuviri - chirwere chepfungwa, multiple sclerosis.

Ndeipi nzira yekuisirwa mwongo?

Pre-transplant evaluation

Pachava nemiedzo yakasiyana-siyana uye nzira dzekuongorora hutano hwemwana wako, pamwe nekuona kuti mwana agadzirira zvakakwana kuiswa muchibereko. Miedzo iyi inogona kutora mazuva mashoma kana kupfuura uye inosanganisira kuongororwa kweropa murabhoritari, bvunzo dzemifananidzo, bvunzo dzekuongorora kunzwa, kuona, mashandiro emapapu, kuongororwa kwepfungwa nekukura, uye mashandiro emwoyo.

Kuunganidza stem masero ekutapurirana

Kana uchitarisirwa kuisirwa autologous, uchaita nzira inonzi apheresis yekuunganidza masero emuviri. Uchada donor kana uri kuita allogeneic transplant uchishandisa masero emuviri kubva kumupi. Kana donor angoonekwa, masero emuviri anobviswa pamunhu iyeye mukugadzirira kuiswa. Manyuko emasero emuviri anosanganisira:

• Masero eropa anowanikwa muropa rekunze:

Ivo vanowanwa neapheresis, vachishandisa yakakosha muchina. Kazhinji, mhando yakakosha yeIV (catheter) inoshandiswa kufambisa kubuda kweropa nemushini kuunganidza stem masero. Zvisinei, kana tsinga dzemwana wako dzisina kukura zvakakwana kuti awane kubuda kweropa kwakakwana, angada kuisirwa catheter yenguva pfupi kuitira kuunganidza. Iye zvino-a-mazuva iyi ndiyo nzira yakasarudzika yekuunganidza stem maseru.

• Bone marora

Stem masero anounganidzwa kubva kune iliac crest inova chikamu chehudyu bhonzo reanopa pasi peanesthesia.

• Umbilical Cord Ropa

Masero emuviri anotorwa kubva murukuvhute mushure mekuzvara mwana. Masero emuviri anoedzwa, anonyorwa, anoverengwa uye anoomeswa nechando kusvika agadzirira kusimwa.

Bone marrow transplant process:

Hapana kuvhiyiwa kunoitwa pakuisa murwere muchikamu chemuviri. Kupa masero emuviri inzira yakachengeteka kune vanopa kana vakaongororwa. Hapana chinorasika zvachose mumuviri semuenzaniso pakuisa masero muchikamu chemuviri muchikamu chemuviri cheitsvo. Masero emuviri anodzoka patsva mumazuva mashoma. Masero emuviri anoiswa mumuviri wemurwere sekupa ropa.

Pane matanho matatu makuru ekuisa mapfupa mumongo.

Danho 1: Kuunganidza masero emapfupa kana stem cells (kukohwa) kubva kune anopa.

Danho rechipiri: Kuparadza zvachose mupfupa uripo uye nokudaro kubatsira murwere kugamuchira masero matsva emuviri.

Danho rechitatu: Kuisa mupfupa kana masero emuviri kuburikidza nenzira yeropa, sekuwedzerwa ropa. Panogona kunge pasina zviratidzo zvekukura kwepfupa idzva kwemavhiki maviri kusvika matatu, uye dzimwe nguva zvinogona kutora nguva yakareba mupfupa mutsva usati wagadzira zvikamu zvese zveropa zvakakwana.

Ndeupi rudzi rwekuchinjisa rwakanyanya kunaka?

Chiremba wemwana wenyu anomurapa achakupai mazano emhando yepamusoro yekubvisa masero emuviri, ingava autologous kana allogeneic, pamwe chete nekwakakwana kwemasero. Kusarudzwa uku kunokonzerwa nezvinhu zvakasiyana-siyana, zvinosanganisira:

• rudzi rwechirwere chine mwana wako
• hutano hwemwana wako hwese

Pane here maside effects eBone marrow transplant?

Migumisiro yemupfupa inogona kuitika. Izvi zvinosiyana nemunhu wese. Zvinosiyana zvichienderana nerudzi rwekuisirwa, hutano hwemwana wako, nezvimwe zvinhu.

Migumisiro yapakarepo inogona kusanganisira hutachiona, chirwere chegraft-versus-host (GVHD) - mamiriro ezvinhu apo mupfupa wemapfupa wakaisirwa unopindirana nenyama yemupi (kana akaisirwa Allogenic), kuda kurutsa, kurutsa, maronda mumuromo, kuneta, mazinga mashoma emaplatelet, mazinga mashoma emasero matsvuku eropa (anokonzera anemia), uye manyoka.

Nguva yekufonera chiremba?

Bvunza chiremba ari kurapa nekukasika kana ukaona zviratidzo zvinotevera mumwana:

• chimhepo
• Marwadzo anotadzisa kudya, kutamba, kufamba, kana kufamba
• Kupfuurira mberi kukosora
• Zviratidzo zvinetso
• Zvinetso zveUriin
• Rashes
• Kuneta zvisina kujairika
• Kuchinja kwemaitiro ezvigaro
• Shanduko huru muchiitiko kana maitiro

Kuisirwa mwana pachizvaro kunokanganisa sei hupenyu hwemwana wangu? Mwana wangu anogona kuenda kuchikoro uye kuita mabasa enguva dzose here?

Nguva yemwana wako yekudzokera kuchikoro zvinoenderana nerudzi rwekuisirwa mwongo waakaitwa. Kazhinji, mwana anogona kudzokera kuchikoro mumwedzi mitanhatu kusvika kugore rimwe mushure mekusimwa. Izvo zvinodikanwa kuti udzivise mhomho uye udzidzire kuzviparadzanisa nevamwe kwemwedzi mitanhatu kudzivirira hutachiona. Chiremba wako achakuzivisa kana zvave zvakanaka kuti mwana atangezve kuita mabasa enguva dzose.

Mashoko aDr. Vipin Khandelwal , Mupi wezano, Haemto-oncology uye Chiremba weBone Marrow Transplant, Apollo Cancer Centres Navi Mumbai