Iziphumo zeKhemotherapy zenza ukuba i-Myelosuppression iphumelele
Inkcazo
I-Myelosuppression ichazwa njengokunciphisa amandla omnatha wethambo ukuvelisa iiseli zegazi. Kuye kwenzeka ngokuqhelekileyo ngomhlaza njengesiphumo esisecaleni lwe-chemotherapy , kodwa kukho nezinye izizathu.
Iiseli ezithintekayo kwi-Myelosuppression
Ukutshutshiswa komzimba kungabangela ukunciphisa ukuveliswa kwe:
- Iiseli zegazi ezibomvu (iiRBC)
- Iiseli zegazi ezimhlophe (i-WBCs)
- Platelets
I-Hematopoiesis, iMarrow Bone kunye ne-Myelosuppression
Ukuqonda i-myelosuppression kuyincedo ukuthetha ngomsebenzi wethambo lomongo. Ngomnatha wethambo, zonke iiseli zegazi-amangqamuzana egazi obomvu, iiseli zegazi ezimhlophe kunye neeplatelet-ziqala ngolunye uhlobo lweseli: i- hematopoietic stem cell .
Iiseli ze-Hematopoietic stem zinamandla okuguqukela kunoma yiluphi udidi lwegazi. Ezi iiseli ziyahla iindlela ezihlukeneyo njengoko zihlukana kwiiseli ezibomvu zegazi, iiplatelets, kunye neeseli ezimhlophe zegazi, ize zibe kwiiseli ezikhethekileyo ezifana neentlobo ezahlukeneyo zeeseli zegazi ezimhlophe. Kodwa zonke ziqala ngeeseli ezinamabala. I-Myelosuppression ibhekisele kwinkqubo ephazamisa la maseli, kunye. ngenxa yoko, ichaphazela zonke iintlobo ezahlukeneyo zeeseli zegazi. Ixesha elithi myeloablation libhekisela kwi- myelosuppression enzima apho kungekho zisele zegazi ezenziwe.
Izizathu
Kukho iindlela ezininzi apho umongo wethambo ungaphazamiseka ukuze ungavelisi iiseli zegazi.
- Ukulimala kweeseli ezinamaqabunga - Isizathu esivamekileyo sokunyuka kwesifo sengqondo ngenxa yemithi ephuza amandla okwenziwa kweeseli kunye nenzala ekhethekileyo ukwahlula nokuphindaphinda. Zonke iiseli zethu zegazi ziyaqhubeka zizaliswa. Amachiza afana neyeza-chemotherapy ezibangelwa izidakamizwa zokunxilonga amathambo.
- Ukutshintshwa komongo wethambo / ukuqhutyelwa - Umongo wethambo unokuthi "uphelelwe ngaphandle" ngezinto ezinjengeengcingo zegazi okanye umhlaza wesifo se-metastatic ukuze kubekho "igumbi" lokuveliswa kweeseli zegazi eziqhelekileyo.
- Ukungaphumeleli komongo we-Bone - Esikhundleni sokuxhatshazwa ngamachiza, umongo wethambo unokutshatyalaliswa yi-toxins eyahlukahlukeneyo kunye neekhemikhali. Xa kunjalo, ukuyeka isilwanyana akuyi kubangela ukuba umthambo wethambo uphinde wenze umsebenzi wawo wokuvelisa iiseli zegazi.
Izizathu ezicacileyo zeMyelosuppression
Iinkqubo ezinokubangela ukuba i-myelosuppression ibandakanye:
- Ukunciphisa umongo we-okotherapy . I-Chemotherapy iyabulala zonke iiseli ezihlukana ngokukhawuleza ezifana neeseli zomhlaza, kubandakanywa neeseli eziba zonke iintlobo zeeseli zegazi.
- Iintsholongwane zethambo lomongo njengama-leukemi, i-lymphomas, i-myeloma, umhlaza wesifo somnxeba kumnxeba wethambo kunokubangela "ukunyuka" ngoko akukho ndawo i-hematopoiesis eyenzekayo.
- I-myelosuppression / i-myeloablation ngamabomu-ntetho-Kwi-cancer yomnxeba ehlobene negazi, i-chemotherapy ephezulu kakhulu isetyenzisiweyo isetyenziselwa ukutshintsha umongo wethambo. Xa umongo wethambo "ucacile" ukutsalwa komongo wethambo okanye ukufakelwa kwegazi kwipilisi ye-pipeline kwenzelwa ukuphindaphinda umongo wethambo ngamaseli angama-blood stem cells.
Ukusilela kweeNgcilo zeGazi
Xa iiseli ezinamaqanda azinyanga kwaye zahlula kwaye zizodwa kwiindidi ezahlukileyo zeeseli zegazi (xa kukho ukunciphisa umongo we-bone okanye ukutshutshiswa kwe-myelosuppression) kuluhlu lwamathambo egazi lubizwa ngokuba:
- I-anemia - I-anemia ibhekisela ekusileni kwamaseli obomvu. I-anemia ingabangela ukukhathala, ubuthathaka, ubuhlungu, inqanaba lentliziyo elikhawulezileyo, ukuphefumula okufutshane, kunye nentloko. I-anemia eyenziwa yi-Chemotherapy yinto ebangela ukukhathala ngexesha le-chemotherapy.
- I-Leukopenia - i-Leukopenia ibhekisela kukusilela kweeseli ezimhlophe zegazi. Ngabantu base-leukopenia bafumana umngcipheko wokusuleleka, ngoko iimpawu zibe ziimpawu zentsholongwane ezinjengomkhuhlane, ukukhwehlela, kunye nentlungu ngokuvuthwa. Ngomhlaza, ngokuqhelekileyo abantu baya kuva nge -neutropenia eyenziwa yi-chemotherapy . I-neutrophils yimizimba yegazi elimhlophe eliyintloko yethu yokukhusela kwakhona izifo ezinobhaktiriya, ii-virus kunye nefungi (kunye neeseli zeengqamzana.)
- I-Thrombocytopenia - I-Thrombocytopenia ibhekisela kukusilela kweeplatelet. Iqondo eliphantsi leeplatelets lingaholela ekutyumeni nasekuphumeni okukhulu. I-thrombocytopenia eyenziwa yi-Chemotherapy-induced may not be a problem as often as neutropenia kodwa ingabangela ukuphuma kwegazi kwabanye abantu.
Ngaba i-Myelosuppression efanayo ne-Immunosuppression?
Unokuzibuza ukuba ukunyanzelwa kwe-immunosuppression kunye ne-myelosuppression kuyafana. Kwimeko yokutshatyalaliswa kwe-myelosuppression, ukuveliswa kweeseli ezimhlophe zegazi kuyancipha, ngoko kuya kuba ne-immunosuppression. Kodwa ukuxilongwa kwe-immunosuppression akusoloko kuthetha ukutshutshiswa komzimba. Ngokomzekelo, iyeza (okanye enye inkqubo) inokumelana neeseli zegazi ezimhlophe okanye ezinye iindawo ezithile zesistim somzimba, kodwa angathinteli amangqamuzana egazi abomvu okanye amaplatelet.
Unyango
Unyango lwe-myelosuppression luya kubandakanya ukunyanga naziphi na izizathu zokutshutshiswa komzimba. Ukuba idibene neziyobisi okanye i-chemotherapy, unyango lumele lubekwe okanye lulibale. Ukuba kungenxa yokungena kwethambo lomnkantso, kwaye ukunyuka okuphezulu, unyango lomhlaza kwintolongo yethambo linyathelo elibaluleke kakhulu. Ukuba kubangelwa ukungaphumeleli komongo, kuya kubaluleka ukubona ukuba ukuhluleka komongo we-bone kungenakuphikiswa, kwaye ukuba akunjalo, unyango olunjengokutshintshwa kweeseli zegazi kunye nokutsalwa komongo we-bone kungadinga ukuba kuqwalaselwe.
Ngeempawu ezinxulumene nesifo sengqondo, unyango lunokuthi lujoliswe kwi-cell defence eyabangela iimpawu. Ukukhulelwa i-anemia, ukudluliselwa kwegazi, ukuxhaswa kwesebe, okanye izinto zokukhula ezinokunikezwa. Ngenxa ye-neutropenia eyenza umngcipheko wokusuleleka okanye ufikeleleko lwesifo, ukunyuka kwezinto (njenge-Neulasta) kunokusetyenziswa kwaye unyango luphathwa kakubi kunye ne-antibiotics. Kwinqanaba eliphantsi leeplatelets eziphakamisa umngcipheko wokumpontshelwa igazi kunokufuneka.
Iikhonkco ezingentla apha kwi-chemotherapy-induced anemia, neutropenia, kunye ne-thrombocytopenia icacise le mpiliso enokuthi ithathelwe ingqalelo ukuba ukutshutshiswa komzimba kuhambelana ne-chemotherapy.
Eyaziwayo ngokuba: Ukunciphisa umongo we-Bone
Imizekelo: Ngenxa yesifo esichukumisayo, u-Rick's oncologist wacebisa ukuba alinde iveki ngaphambi kokunyanga kwakhe kweyeza.
> Imithombo:
> I-Coates, T., i-Neutropenia eyenziwa ngamachiza kunye ne-Agranulocytosis. UpToDate . Ukuhlaziywa 08/01/16.
> Weinzierl, E., noD. Ukuxilongwa ngokungafaniyo kunye neMarrow Bone Ukuphononongwa kweNew-Onset-Pancytopnia. I-American Journal ye-Clinical Pathology . 2013. 139 (1): 9-29.