Inkqubo, Injongo, kunye Neengxaki zePBSCT
Ubume bePBSCT
Igazi le-pipedal cell stplants, okanye i-PBSCT, yiinkqubo ezibuyisela iistim ze-stem ezonakaliswe ngamanani aphezulu e-chemotherapy. Amaseli esitembile iiseli ezinika iiseli zegazi - iiseli zegazi ezibomvu ezithwala i-oxygen, iiseli zegazi ezimhlophe ezikunceda umzimba ukulwa nezifo, kunye neeplatelets ezikunceda igazi ligule.
Kwakusetyenziselwa ukuba i-stem cell transplants ivela kwi- bone marrow . Nangona ubuninzi beeseli ze-stem zikhona emnxeni wethambo, ezinye ziphuma zijikeleza-kwi-blood circulation stream. Ezi zinokuqokelelwa kwaye zitshintshelwe kwizigulane ukubuyisela ukugcinwa kwazo kwesigxina se-stem. Uninzi lwezitshixo ze-cell stplants (kodwa kungekhona zonke ngezizathu ezininzi) ngoku zi-PBSCT. Ngaphambi kokunikela ngeeseli ezinamaqabunga, abaxhasi banikwa unyango olwandisa inani leeseli ezinamahlumela egazini. Amaseli egazini egazini asebenza kakuhle xa kuthelekiswa nokuguquka komongo we-bone, kwaye enyanisweni, kwezinye iimeko kunokubangela iiplatelet kunye nohlobo lweeseli ezimhlophe zegazi ezibizwa ngokuba yi-neutrophils "ukuthatha" ngakumbi, xa umnikeli engahambelani nommkeli .
Injongo yoTshintsho lweeStem
Ukuze uqonde ngokwenene indlela yokuguqula i-stem cell work, ingakunceda ukuthetha ngokuthe kancinci malunga nokuba yeyiphi i-cell stem.
Njengoko kuphawuliwe ngasentla, ii-cell stem - ezibizwa nangokuthi i-hematopoietic stem cells - zinika zonke iintlobo ezahlukeneyo zeeseli zegazi emzimbeni. Ngokutshintshela amangqamuzana angama-stem angakwazi ukwahlula kwaye aguquke kwiintlobo ezahlukeneyo zeeseli zegazi - inkqubo ebizwa ngokuthi i-hematopoiesis -ukufakelwa kungathatha indawo yokusilela kuyo yonke uhlobo lweeseli zegazi.
Ngokwahlukileyo, unyango lwezonyango oluya kutshintsha zonke iiseli ziyanzima kwaye zithatha iingxaki ezininzi. Ngokomzekelo, unako ukunikezela igazi, ugalelo lwegazi olubomvu, kwaye unike imishanguzo yokuvuselela kokubili ukwakheka kweeseli ezibomvu zegazi kunye neeseli ezimhlophe zegazi, kodwa oku kunzima kakhulu, kunzima, kwaye kunemiphumo emibi kunye neengxaki.
Izizathu zePBSCT
I-Chemotherapy ekhutshwa ngamanqanaba aphezulu ibhubhisa iisomhlaza kangcono, kodwa iphinda ibhubhise iiseli ezinokuthi zikhona emnzini wethambo. Ukuguqulwa kwesitampu se-stem kunceda ukubuyisela umongo wethambo ukwenzela ukuba isigulane sikwazi ukunyamezela ukunyuka kwamayeza e-chemotherapy.
Iintlobo
Kukho iintlobo ezintathu ze-stem cell transplant:
- Ukudluliselwa kwe-Autologous: xa izigulane zifumana ii-cell stem zazo.
- I-allogeneic transplants: xa izigulane zifumana iiseli ezinamahloni kumzalwana wazo, udade okanye umzali. Umnikeli ongabandakanyekanga nako unokusetyenziswa.
- Ukuguqulwa kweSyeneneic: xa izigulane zifumana iiseli ezinama-twintshi ezivela kwi-twin yazo efanayo.
Ukunikezela ngee-Stem Stells Cell
Umnikelo we-PBSC uquka ukuthatha ii-cell stem cells, kunokuba kusetyenziswe iiseli ezisuka kwintolongo yethambo, ngoko akukho ntlungu ekufikelelekeni komnatha wethambo. Kodwa kwi-PBSC, amayeza anikezelwe ukukhulisa inani lamaseli esitshixo kumjikelezo womniki-mali angabandakanywa nemizimba yomzimba, ama-acry muscle, i-headaches, kunye neempawu ezifana nezifo.
Ezi ziphumo zivame ukuyeka iintsuku ezimbalwa emva kwesilinganiso sokugqibela semithi yokuvuselela i-stem-cell.
Iingxaki zePBSCT
Kukho iingxaki ezininzi ezinokwenzeka kwi-PBSCT. I-high-dose chemotherapy phambi kokutshintshwa kubangela umngcipheko omkhulu wokusuleleka ngenxa yokungabikho kwamaseli amhlophe egazi (ukuxilongwa kwe-immunosuppression) kwakunye neengxaki ezinxulumene nokungabikho kwamaseli obomvu (i-anemia) kunye neeplatelets eziphantsi (thrombocytopenia).
Umngcipheko oqhelekileyo emva kokutshintshwa kweso sifo se- graft versus host (GvH), esenzeka kwinqanaba elithile phantse zonke iinguqu ze-cell stplants. Kwizifo ze-GvH iiseli ezitshintshiwe (ukusuka kumnikeli) zibona umphathi (ummkeli wokufakelwa) njengowaphandle, nokuhlaselwa.
Ngenxa yalesi sizathu abantu banikezwa izidakamizwa zokuzikhusela ezilandelayo emva kokutshintshwa kwe-cell stem.
Nangona kunjalo izidakamizwa zokuzikhusela izifo nazo zibeka ingozi. Ukunciphisa ukuphendula kwamagciwane ngenxa yezi yobisi kuphakamisa umngcipheko wesifo esiyingozi, kwaye kwandisa ingozi yokuphuhlisa ezinye i-cancer.
Ezinye iindlela
Ukungena kwi-PBSCT yinkqubo enkulu. Akukuphela nje kokuphambi kwe-chemotherapy enobugwenxa, kodwa iimpawu zesifo se-graft versus host, kunye neengxaki zezilwanyana ezingenayo i-immunosuppressive yenza ukuba yinkqubo edlalwa yinto encinci, kwaye ngokubanzi iphilile, abantu.
Enye inketho enokuqwalaselwa kwizigulane ezisebekhulile okanye kwimpilo esonakele yi-non-semoablative stem cell transplant. Kule nkqubo, esikhundleni sokuphelisa (ngokutshabalalisa) umongo wethambo onomthamo ophezulu kakhulu we-dose chemotherapy, umthamo ophantsi we-chemotherapy usetyenziswa. Imfihlelo emva kwale ndlela yokuguqulwa empeleni ixhomekeke kuhlobo lwesifo se-graft versus host. Nangona kunjalo, endaweni yokufakelwa kwee-cell stem - ukuhlaselwa "iindile" zamaseli kumalungu awamkelekileyo, amaseli asetshentshelweyo ahlawulela ahlasela amaseli omhlaza kumzimba owamkelayo. Oku kuziphatha kuthiwa "ulwahlulo olubhekiselele kwisisu."
Kwaziwa njenge:
I-PBSCT, iPheripheral Blood Stem Transplantation
Imigaqo ehambelanayo:
HSCT = i-hematopoietic stem cell transplantation
HCT = i-hematopoietic cell transplantation
I-SCT = ukutshintshela kwe-cell stem
I-G-CSF = I-Granulocyte-colony-stimulating factor - into yokukhula, i-stem cell stimulation medication, ngamanye amaxesha unikezelwa kubaxhasi ukuhlanganisa i-hematopoietic stem cells ukusuka emnzini wethambo ukuya kwigazi le-peripheral.
Imithombo:
National Cancer Institute. Utshintsho lweStem Cell. Updated 04/19/15. http://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant
Singh, V., Kumar, N., Kalsan, M., Saini, A., no R. R.. Indlela yokuchithwa: I-Pluripotent Stem Cells (iPSCs). Umbhalo weeStem cells . 2015. 10 (1): 43-62.
Wu, S., Zhang, C., Zhang, X., Xu, Y., kunye no-T. Deng. Ngaba i-blood pipeline okanye umongo weethambo ungumthombo ongcono weeseli ezinamaqabunga okutshintshwa kwimeko kwiimeko ze-HLA-ezifanayo nabaxhasi abangabandakanyekanga? Uhlalutyo lweemeta. Uphononongo oluPhambili kwi-Oncology kunye neHematology . 2015. 96 (1): 20-33.