Kana iwe kana munhu waunoda uchange uine mapfupa ekutemwa kwemafuta kana kupa masero ematsipa, zvinosanganisirei? Ndezvipi zvakasiyana-siyana zvepfupa remapfupa anoputika uye chii chakaitika kune vose mupi uye mutori?
Basics
Kushandiswa kwemapfupa emapfupa inzira inoshandiswa apo masero anokosha (anonzi shina masero ) anodzingwa kubva mumapfupa emapfupa kana chirwere cheropa, anonatswa uye anopiwa zvakare kumunhu mumwe chete kana kune mumwe munhu.
Sezvo isu iye zvino tine masero akawanda emadiro anodikanwa kubva muropa panzvimbo pemafupa emapfupa, kupfurikidza kwemapfupa ekuputika ikozvino kunowanzozonzi se stem cell transplant .
Nei Chirwere Marrow Chikafukwa Chikaitwa?
Boroora marora inowanikwa mumapfupa makuru mumuviri akadai semapfupa emapfupa. Ikopa marora ndiro nzvimbo yekugadzira masero emasero. Masero emasero "pluripotential" zvinoreva kuti masero acho ndiwo masero epamberi anokwanisa kuchinja mumhando dzakasiyana dzemasero eropa, akadai semasero machena eropa, masero matsvuku eropa, uye maplatelet.
Kana chimwe chinhu chakashata nemafuta emapfupa kana kubudiswa kwemasero eropa zvakaderera, munhu anogona kurwara zvikuru kana kufa. Mumamiriro ezvinhu akadai seaplastic anemia , bone marora inorega kubudisa masero eropa anodiwa mumuviri. Muzvirwere zvakadai sehuukemia , marora emapfupa anounza masero eropa asingazivikanwi.
Chinangwa chekutora marora kunokonzera kushandiswa kwemasero asina kubudiswa kana kutora masero asina kunaka ane utano hwakanaka.
Izvi zvinogona kushandiswa kurapa kana kuporesa chirwere ichi.
Kuwedzera kune leukemias, lymphomas, uye aplastic anemia, stem cell transplants dziri kuongororwa nokuda kwezvinetso zvakawanda, kubva pazviremera zvakasimba kusvika kune zvimwe zvisingaiti zvinouraya zvepfupa remafupa, kune multiple sclerosis.
Iko kune mbiri miviri yepamusoro yemapfupa emapfupa anoputika, autologous uye allogeneic transplants.
Autologous Bone Marrow Kubika
Izwi rechiGiriki rokuti "auto" zvinoreva kuti "iwe pachako." Mumoto wekutengesa, munhu anopa mvumo ndiye munhu uyo ​​achagamuchirawo kudhinda. Iyi nzira, iyo inozivikanwa se "kuponesa kupinza" inosanganisira kubvisa masero ako emasero uye kuvasvibisa. Iwe unogamuchira chikwata chemhemotherapy chakakutevera chichikanganiswa nekukanganiswa kwemasero akadzikisa masero. Inogona kushandiswa kurapa leukemias, lymphomas, kana multiple myeloma.
Allogenic Bone Marrow Kubika
Izwi rechiGiriki rokuti "allo" rinoreva "zvakasiyana" kana "zvimwe." Muchigadzirwa chemafu chinokonzerwa nemafuta, mupiro mumwe munhu ane ruzivo rwemashoko akasiyana nemunhu anoda kuiswa. Nemhaka yokuti mhando dzemaviri dzakagara nhaka, dzakafanana nemvere dzembudzi kana ruvara rweziso, zvinowanzoita kuti iwe uwane mupi akakodzera munhengo yemhuri, kunyanya munun'una. Zvinosuruvarisa, izvi zvinowanzova 25 kusvika ku30 muzana yenguva.
Kana nhengo yemhuri isingasviki nemupiki, dheseti reNational Marrow Donor Program Registry rinogona kushandurwa kune munhu asingabatanidzi uyo ane mhando yemaviri inofambidzana. Zvinowanzoita kuti mupi anouya kubva kumadzinza mamwechete kana kuti madzinza semupi wemugove achava nemhando imwechete yenyama.
Dzidza zvakawanda nezvekuwana mupiro we stem cell transplant .
Sources ye Bone Marrow Stem Cells
Bone marrow masero anogona kuwanikwa nenzira nhatu dzinokosha. Izvi zvinosanganisira:
- Kugadzira marora marora : Mukohwa marora, masero emasero anounganirwa zvakananga kubva mumapfupa emapfupa.
- Apheresis kana leukapheresis : Mune apheresis, masero emadziro anounganidza kubva kumativi eropa anotenderera masero eropa (PBSC.) Mutsara unopinza unoiswa muruoko rwako yakafanana kana iwe uchipa ropa.
- Umbilical tsvimbo yeropa: Masero emukati anogona kuwanikwa kubva muropa mumutsara wembilical nguva pfupi mushure mokuberekwa kwechecheche (cord blood banking.) Sezvo izvi masero emasero asati apera, pane zvishoma zvekuda kutarisana kwakakwana.
Ruzhinji rwe stem cell transplants runoshandiswa uchishandisa PBSC inounganidzwa ne apheresis ( peripheral blood stem cell transplants .) Iyi nzira inoita kuti ipe migumisiro yakanaka kune vose mupi uye mupiki. Iko kunogona kunge kuine mamiriro ezvinhu umo kukohwa kwemafuro emarongo kuchiitwa.
Chii icho Donor Experiences
Kupa masero emasero kana mapfupa emasese zviri nyore nyore. Muzviitiko zvakawanda, mhiko inoshandiswa kushandiswa kupararira stem masero (PBSC) inounganidzwa ne apheresis. Chokutanga, mupiro anogamuchira majekiseni emishonga kwemazuva mashoma anokonzera masero emadziro kuti abve kunze kwemafupa uye kupinda muropa. Nokuda kwemasero echitokisi chekuunganidza, mupiro unobatanidzwa kumashini netsanga inowanikwa mumutsipa (kufanana nekupa ropa). Ropa rinotorwa kubva mumhino, rakasvibiswa nemichina yekuunganidza masero ematsipa, ndokudzoka kumunhu anopa muchero kuburikidza nesingano mune imwe yoruoko. Icho chiripo chisina chidimbu chekuzorora nguva neyiyi nzira.
Kana masero emadziro ari kuunganidzwa nehombwe marora kukohwa (kunyanya zvishoma), mupi wega achaenda kuimba yekushanda uye apo akarara pasi peanesthesia uye nenyuchi ichaiswa mukati mehudyu kana kuti sefupa kuti atore mamwe marora emapfupa. Mushure mokumuka, panogona kunge kune humwe hurombo apo netare yakaiswa.
Zvakawanikwa Nezvakaitika
Kushanda kwemapfupa emapfupa kunogona kuva nzira yakaoma zvikuru kune uyo anogamuchira.
Nhanho yekutanga inowanzogadziriswa kukwirira kwemakemikari uye / kana mazairo kuti ibvise chero marota emapfupa aripo. Semuenzaniso, neukemukemia, inotanga kukosha kubvisa zvose zvisingasviki masero masero.
Kamwe kana munhu wepakutanga wemapfupa akaparara, masero matsva aya anojowa mukati, akafanana nekuwedzerwa ropa. Masero ematsva anobva awana nzira yavo kumapfupa uye anotanga kukura nekubereka mamwe masero (anonzi engraftment ).
Pane zvakawanda zvingave zvinetso. Nguva inonyanya kukosha ndeyepamusoro apo mapfupa emapfupa akaparadzwa kuitira kuti masero mashoma eropa agare. Kuparadzwa kwemafupa emapfupa kunokonzera kuwandisa kwakanyanya kwenhengo dzose dzemarudzi eropa ( pancytopenia ). Pasina masero masero eropa kune ngozi yakawanda yehutachiona, uye zvirwere zvekuchengetedzwa zvinoshandiswa muchipatara (kusarudzwa). Kuderera kwemasero matsvuku eropa ( anemia ) kazhinji kunoda kuwedzerwa ropa pawakamirira kuti masero matsva aya atange kukura. Kuderera kweplatelets ( thrombocytopenia ) muropa kunogona kutungamirira kubuda mukati.
Chimwe chinetso chinowanzoita 40 kusvika ku80 muzana chevakagamuchirwa ndechekubatanidza kubatana nechirwere chirwere . Izvi zvinoitika apo masero matsvuku eropa (T masero) mumasero anopiwa (kubatanidza) anorwisa mishonga mumugamuchiri (mutariri), uye anogona kutyisidzira upenyu.
Imwe nzira inoshandiswa iyo inonzi isiri myeloablative bone marrow transplant kana "mini-bone marrow transplant" yakasiyana neimwe. Mune nzira iyi, masero maduku emakemikrasi anopiwa kuti haabvise zvachose kana kuti "ablate" marinha emapfupa sezvinowanikwa mumapfupa ekutsvaira marora. Iyi nzira inogona kushandiswa kune mumwe munhu akwegura kana kuti zvimwe zvingasakanganise tsika dzetsika. Muchiitiko ichi, kubatanidzwa kunoita zvakasiyana nekurapa chirwere pamwe chete. Panzvimbo yekutora marara emapfupa, marora anopiwa anokwanisa kurwisa masero anokonzera mumuviri mumuitiro unonzi "kubatanidzwa pamwe nekuperesa."
Uri Kuda Kupa Bone Marrow?
Kana iwe uchida kuva muzvipi wezvipiri, iyo nzira yakarurama uye iri nyore. Chero ani zvake ari pakati pemakore 18 ne60 uye ane hutano hwakanaka anogona kuva mupiro. Pane chimiro chekuzadza uye samupa rekupa kupa; unogona kuwana ruzivo rwese rwaunoda pawebsite yeNational Marrow Donor Program. Iwe unogona kubatanidza motokari yemunharaunda munharaunda yako kana kuenda kunharaunda yeDonor Centre kuti uve neropa rekuedzwa rakaitwa.
Kana munhu achizvipira kuti ave mupiro, zvimwe kana ropa rake romuviri, sezvinotsanangurwa neruzivo rweropa (histocompatibility antigen test,) rakanyorwa muRegistry. Iyi "kuisa mavara" yakasiyana nemunhu A, B, kana O ropa rudzi. Rare Registry rinewo ruzivo rwekufambisa kune anopa, inofanira kunge yakagadzirwa nemhando yemhando.
Pasi Pasi
Bhuna marora kuputika kunogona kuva autologous (kubva kune iwe) kana allogeneic (kubva kune mumwe munhu.) Masero ematsipa anowanikwa kubva kuropa reropa, pfuti yekuunganidza marora kana kubva mundipa yeropa inoponeswa pakuberekwa.
Kune mupiro, iyo nzira iri nyore. Kune uyo anogamuchira, inogona kuva yakatora uye yakaoma nzira, kunyanya kana kukwirira kwakanyanya kwemakemikrasi kunoda kubvisa marora emapfupa. Zvinetso zvinowanzosanganisira uye zvinogona kusanganisira zvirwere, kubuda ropa, uye kubatanidza kurwara nehutachiwana pakati pevamwe.
Izvozvo zvakati, mapfupa emapfupa anoputika anogona kubata uye kunyange kuporesa zvimwe zvirwere izvo zvaimbove zvave zvichingove zvakafanana zvakafa. Kunyange zvazvo kuwana mupiro kwaive kwakaoma munguva yakapfuura, chirongwa cheNational Marrow Grantor chakawedzera kuti vanhu vazhinji vasina nhengo yemhuri inoenderana nayo iye zvino vanogona kuva nefupa / stem cell transplant.
> Sources:
> American Society of Clinical Oncology. Cancer.Net. Chii chinonzi Stem Cell Transplant (Bone Marrow Transplant)? Updated 01/16. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-stem-cell-transplant-bone-marrow-transplant
> US National Library of Medicine. MedlinePlus. Bone Marrow Kubika. Updated 10/03/17. https://medlineplus.gov/ency/article/003009.htm