Kuongororwa kweropa kunozivikanwa sehuwandu hwekuverenga ropa, kana CBC, inowedzera mazana ako emasero matsvuku eropa, masero machena, uye maplatelet anobatsira ropa rako kuti rivhare. Kana masero ekuyera ari pasi, kana kutarisirwa kuva akaderera, mapfupa emapfupa anokurudzira zvinodhaka anogona kupiwa kukurudzira muviri wako kugadzirwa kwemasero eropa.
Aya mazamu ane njodzi dzingangove dzakakomba nemigumisiro, pamwe nekuwedzerwa kwekuwedzerwa ropa, uye naizvozvo haasi mamiriro ese e "pasi pasi" anobatwa nemishonga iyi.
Mukurapa kenza, kushandiswa kwemapfupa ekuwedzera madhiragi kunofungidzirwa kutarisirwa kunotsigira , zvinoreva kuti mushonga wacho hauna kurwisa zvakananga kenza, asi anobatsira mune dzimwe nzira.
Yako Bone Bone, Yakaswedera Pedyo
Bhuna marora ndiro mhuka inorarama yakazara mukati mehuni yemamwe mapfupa, kunyanya mahapbones uye vertebrae, kana mapfupa emutsara wemupfupa. Pfupa remapfupa ndiyo inowanikwa mazana emashizha ehematopoietic maitiro anoshanda nekushanda. Hematopoietic stem masero akaparadzanisa uye anopa kumarudzi ose emarudzi akasiyana eropa, kusanganisira masero matsvuku, masero machena, uye maplatelet.
Kuita kuti hutano huve hutano hwakanaka , mararamiro anotambura-masero matsva eropa haagoni kuitwa kuti arambe achifambidzana nekurasikirwa kwekare kana kuchenesa masero, kana masero anofa sechikamu chekuguma kwekenza kurapwa. Bone marora inogona kuva isina kunaka kune zvikonzero zvakasiyana-siyana. Mune zvimwe zvirwere zvekenza, kana hematologic malignancies, bone marrow ndiyo nzvimbo yekenza, kuwedzera kune nzvimbo yekusvibiswa kweutachiona.
Chii Bone Bone Marrow Kukurudzirwa?
Mushonga wemapfupa ane utano unopindura kumakemikari emumuviri wemuviri anonyatsokurukura kudiwa kwekuwedzera kushandiswa kwesero reropa. Masayendisiti akadzidza kuita mamwe emakemikari aya kunze kwemuviri, uye akawanda, zvekuti anogona kushandiswa mishonga pakuwedzera michina.
Inowanzopiwa muhomwe huru kupfuura iyo inowanzobudiswa mukati memuviri.
"Mhuri" dzakasiyana kana kuti mapurogenti eropa ropa maitiro mumumongo anogona kupindura pamakemikari akasiyana-siyana. Imwe nguva yakawanda yeikemikisi chiratidzo chinowedzera kukonzera is hematopoietic kukura. Hasi dzose zvinodhaka zvinokurudzira marora emapfupa zvirikukura zvinhu, zvisinei.
Nei Chirwere Marrow Chichigadziriswa Chiitwa?
Kurwisana Nharo Dzakaderera
Kukurudzira muviri kuti uwane mamwe masero matsva eropa kunogona kubatsira kana imwe kana akawanda yeropa rako rakawanda yakaderera kana zviyero zvako zvinotarisirwa kuti zvive zvakanyanya. Semuenzaniso, dzimwe nguva mapfupa emapfupa anokurudzirwa mberi, sechiyero chekudzivirira, kana chiitiko chinotarisirwa kuwira nekuda kwerongwa hwekenza yakarongwa.
Vamwe varwere vanogamuchira cytotoxic chemotherapy vanogona kunge vane nguva dzakanyanya kuderera kwenguva refu. Nhamba dzemasero machena eropa anozivikanwa seveutrophils anonyatsocherechedzwa. Kuderera kwema-neutrophils aya, kunyanya, kuwirirana zvakanaka nehutachiwana hwehutachiona. Low neutrophil inowedzera pasi apa imwe chikumbaridzo inowanzonzi neutropenia, uye kana mazinga eetrophils ari pasi-pasi, inozivikanwa sehukuru neutropenia.
Nyanzvi dzakanyora zvinyorwa, dzichinyora mitsara yakawanda yemitemo, pamusoro pekuti mapfupa emapfupa anokurudzira anoshandiswa anofanirwa sei uye haafaniri kushandiswa.
Zvakawanda zvekukurukurirana zvinowira pakuva nechokwadi kuti njodzi uye zvibatsiro zvakanyatsoenderana nemurwere. Kune zvakawanda zvezvikwereti zvakasiyana-siyana zvinofanira kuongororwa.
Kubatsira Mumwe Munhu Akasiyana
Bhabheri rinokanganisa marora rinoshandiswawo dzimwe nguva mune vanhu vane utano, pavanenge vachizopa masero ematsipa kune mumwe munhu, mune chimwe chinhu chinonzi peripheral blood stem cell transplant . Icho chinotarisa kuti nhamba shoma shoma yekuita ropa inonzi hematopoietic stem masero inogona kuwanika muropa, uye vanachiremba vakadzidza kuaunganidza kubva kuvanhu vane utano; vanozvipira vanogona kupa zviyero zvavo zvemasero marrow / stem cell transplant chete nokupa ropa, pane dzimwe nguva.
Chikamu chekuita izvi chinosanganisira kuwedzera marora emapfupa kuitira kuti mamwe masero emadzi inogona kuunganidzwa nyore nyore kubva kuropa rinopararira.
Maererano neNational Marrow Donor Program, kana kuti "Ivai Mechi ," munhu anopa masero ekudzivirira anogamuchira injections ye filgrastim, chinhu chinokura, kwemazuva mashanu asati apiwa. Filgrastim inoshandiswa kuwedzera huwandu hwemasero ekuumba ropa muropa. Zvadaro, pazuva rekupa, ropa rezvipiri rinotorwa kuburikidza nesingano paruoko rumwe ndokupfuura nomumashini unounganidza masero anodikanwa ekugadzira ropa. Ropa rakasara rinodzoserwa kune vanozvipira kuburikidza nerumwe ruoko.
Marudzi eB Bone Marrow Anokurudzira Mishonga
Kukura kwezvinhu zvinoshandiswa mishonga inowanzopiwa kuburikidza nemakandisi pasi peganda. Zvimwe zvinogonawo kupiwa mukati, muvhein. Bato renyu rezveutano rinogona kutungamirira mishonga iyi kuburikidza nejojo, uye dzimwe nguva vanhu uye nhengo dzemhuri dzidza kudzidzisa ivo, zvakare.
Kukura kwezvinhu zvekusimudzira majekiseni eAvha
Kukura kwezvinhu kana "hutori-zvinhu zvinosimudzira" zvinobatsira kusimbisa masero machena eropa zvinosanganisira zvinotevera:
- Filgrastim ne lenograstim ndezvinyorwa zveganulocyte-zvinokonzera (G-CSFs)
- Pegfilgrastim inhengo yeG-CSF yakareba. Inoshanda nenzira imwechete se filgrastim asi inogona kupiwa zvishoma.
- Sargramostim is a granulocyte macrophage-colony stimulating factor (GM-CSF).
Mhando mbiri dzekukura-G-CSFs uye GM-CSFs-dzinogona kugadzirisa kuchena kwemasero eropa. Dhiyabhorosi kubva kumaedzo anorongwa nemaitiro akasiyana-siyana achifananidza maitiro maviri ezvidzidzo zveropa iye zvino asiripo. Nzvimbo dzakawanda dzezvehutano dzinoshandisa G-CSF, uye iyi ndiyo yakanyanya kunyatsogadziriswa uye imwe yakadzidza kunyanya.
G-CSFs inogona kupiwa panguva yokutanga yekemotherapy kubatsira kubvisa zvinetso kubva neutropenia mune zvose chemotherapy maitiro. G-CSFs inobatsirawo kugadzirisa kukanganisa kwemafivha kune varwere vane neutropenia, uye vanogona kuderedza kudiwa kwekuchengetwa mumba. Zvinogonawo kushandiswa nekemotherapy kuitira kuti iwedzere maitiro echemotherapy, mumamiriro ezvinhu apo kuderedzwa kwemakemikari inotyisa kunogona kutungamirira kuwedzera kukura.
G-CSFs dzimwe nguva inopiwa panguva yekudzoka kwechimo chemo apo chiitiko chekare chemhemotherapy chakakonzera neutropenic fever, uyewo kupfupisa urefu hwemunhu munhu ane neutropenia yakaoma kubva chemo kana pasina fivha. G-CSFs haigoni kukurudzirwa kuti zvive nenguva kana murwere atova nefivha uye neutropenia.
Kukura Kwezvinhu Kuwedzera Dutu Rekudzivirira Ropa
Kukura kwezvinhu zvinobatsira kusimbisa masero matsvuku eropa, kana erythrocytes, zvinosanganisira zvinotevera:
- Erythropoietin chinhu chinokura chinokurudzira kusvibiswa kwemasero eropa.
- Darbepoetin inomirira kwenguva yakaita seyerythropoietin inoshanda nenzira imwe chete asi inogona kupiwa zvishoma.
Kupa erythropoietin kunogona kubatsira kudzivisa kuwedzerwa kwemasero matsvuku eropa kune vamwe varwere. Kupa vamwe varwere zvose erythropoietin uye G-CSF inovandudza mhinduro yavo kune erythropoietin.
Sezvo nekukura kwezvinhu zvinowedzera masero machena eropa, kwakave nekuedza kwakawanda kuronga mirayiridzo uye mazano pamusoro apo apo erythropoietin uye darbepoetin inofanira kushandiswa. Chiito chekuenzanisa pakati pezvipingamupinyi uye zvinobatsira zvinobatanidzwa.
Kuwedzera Platelets
Rinowanzoshandiswa, mushonga unonzi oprelvekin ndiyo injini yakagadzirwa nekemikemikari inonzi interleukin-11, kana IL-11. Oprelvekin inogona kushandiswa kukurudzira mapapletlet ekugadzirwa mushure mekenza chemotherapy kana mune dzimwe mamiriro ezvehutano zvinosanganisira pasi eplatelets (thrombocytopenia). Iyi mishonga inogona kubatsira kuwedzera mapeletletti emamwe varwere kwekanguva, zvisinei, hazvibatsiri mumhando dzose dzevarwere, kana kune dzose dzinotsika pasi maplatelet.
Imwe mishonga inonzi romiplostim inobatsirawo kusimbisa maplatelet, asi inongoratidzwa chete kana munhu ane pasi eplatelets inokonzerwa zvakananga nechimwe chinonzi chronic immune thrombocytopenia, kana chisingagumi ITP. Romiplostim haisi inowanzoitika kukura, asi inoshanda nekutevedzera thrombopoietin, kukura, uye kukurudzira kunowedzera maplatelet.
Future Studies
Zvimwe zvidzidzo zvakatangwa kuedza kuwana nzira yakanakisisa yekuudza vatori vangave vabatsire kubva pakukura kwezvinhu zvinowedzera ropa rekuyera uye platelet production.
Panewo zvakawanda zvinofadza pakugadzirisa nzira yakanakisisa yekubatanidza kukura kwezvinhu kune umwe neumwe-uye nevamwe vashandi-kusanganisira chemotherapy uye hormone therapy.
Nguva Yokuona Chiremba Wako
Kana uri kutora mapfupa emapfupa anokurudzira mishonga, zivisa chiremba wako kana uri kutarisana nemigumisiro ipi zvayo isina kuwanikwa. Taura nemudzidzisi wako wehutano nokukurumidza kana iwe uchinge uine chero chipi chezviratidzo zvinotevera:
- Fivha ye100.4 ° F (38 ° C) kana yakakwirira, chills-zviratidzo zvinokonzerwa nehutachiona
- Kupfupika kwemhepo
- Rapid heartbeat
- Kushambadzira kunoramba kusinga mushure memaminitsi mashomanana
- Chero zvitsva zvitsva paganda rako
Kana iwe wakamboudzwa kuti une nhamba shoma uye unozviwana uchishamisika kuti nei usingagamuchiri mishonga yekuwedzera ropa, taurira mibvunzo iyi pamwe neboka rako rehutano. Kazhinji, pane zvirevo zvakanyanya zvekurapa kwakadai, uye zvisarudzo zvinoitwa mukuona kwehutano hwako, nhoroondo yezvechiremba, uye zvirongwa zvekurapa.
Shoko Rinobva
Nemhaka yezvinodhura uye zvingava nemigumisiro yakakomba, nyanzvi dzemakomiti dzave dzichibudisa nekugadzirisa mitemo kwemakore, kubatsira kutungamirira vatano vezvehutano mukushandiswa kwemakoroni-anokurudzira zvinhu. Kushandiswa kwemishonga iyi kunogona kuvimba nezvinhu zvakadai sehuwandu hwehuipi, makore ako, uye mamwe marapirwo anorongwa.
Haasi munhu wese akanaka, asi mumamiriro ezvinhu akanaka, mishonga iyi inogona kubatsira kudzivirira zvakanyanya neutropenia, fever, uye zvirwere zvinosanganiswa nemigumisiro yakaipisisa.
> Sources:
> Iva Nechirongwa cheNyika yeMarrow National Program. Matanho ePBSC kana Bone Bone Mbairo.
> Smith TJ, Bohlke K, Lyman GH, et al. Mazano ekushandiswa kweWBC Growth Factors: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol . 2015; 33: 3199-3212.
> Kuter DJ, Rummel M, Boccia R, et al. Romiplostim kana Standard of Care in Patients With Immune Thrombocytopenia. N Engl J Med. 2010; 363: 1889-1899.