Uvavanyo lwegazi olubizwa ngokuba lipheleleyo legazi, okanye i-CBC, libala amanqanaba akho amangqamuzana egazi obomvu, iiseli zegazi ezimhlophe kunye neeplatelet ezikunceda igazi lakho livale. Xa ukubalwa kweeseli kuphantsi, okanye kulindeleke ukuba kube phantsi, umongo wezondlo ovuselela iziyobisi unokunikezelwa ekukhuliseni umzi womzimba wakho weeseli zegazi.
Ezi zithunywa zineengozi ezinzulu kunye nemiphumo emibi, ngaphezu kweenzuzo zabo zokuphucula igazi, kwaye ke akuzona zonke iimeko "zokubala okuphantsi" ziphathwa ngamachiza.
Xa unyango lomhlaza, ukusetyenziswa kwethambo lomnxeba ukunyusa iziyobisi kuthathwa njengenyameko yokuncedisa , oko kuthetha ukuba le nkunkuma ayilwe ngqo nomhlaza, kodwa inceda ngezinye iindlela.
I-Bone Marrow yakho, Vala
Umongo we-Bone ngumzimba ophilileyo opakishwe ngaphakathi emathanjeni amathambo athile, ngokukodwa ama-hipbones kunye ne-vertebrae, okanye amathambo omqolo womgcini. Umongo wethambo apho ininzi yeeseli ze-hematopoietic stem zihlala zize zisebenze. Amaseli e-Hematopoietic stem ahlula kwaye avelise kuzo zonke iintlobo ezahlukeneyo zeeseli zegazi, kuquka iiseli ezibomvu, iiseli ezimhlophe kunye neeplatelet.
Ukukhupha umongo wenthambo , ukuveliswa kweemveliso-kubangelwa iiseli zegazi ezintsha ukuhamba ngokukhawuleza okanye ukulukisa iiseli, okanye iiseli ezifa njengempembelelo yecala lomhlaza. Umnkantso we-Bone ungasondelanga ngezizathu ezahlukeneyo. Kwimeko yamathambo egazi, okanye i-hematologic malignancies, umongo wesithambo uyisayithi yomhlaza, ngaphezu kwesiza esinobungozi besifo.
Yintoni i-Bone Marrow Ukukhuthazwa?
Umnatha wethambo ophilileyo uphendula iimpawu zeekhemikhali zomzimba ezithetha ngokubanzi imfuneko yokuphucula imveliso yeseli yegazi. Iingcali zenzululwazi ziye zafunda ukwenza ezinye zezibonakaliso zamachiza ngaphandle komzimba, kwaye zininzi, ukwenzela ukuba zisetyenziswe ngempilo ukukhulisa imveliso.
Zivame ukunikezwa ngamanani amakhulu kunokuba ziqhele ukuveliswa ngaphakathi komzimba.
"Iintsapho" ezahlukeneyo okanye ama-progenitors eentlobo zamaseli egazi kwi-marrow angaphendula kwiimpawu zamakhemikhali ezahlukeneyo. Elinye ixesha eliqhelekileyo lomqondiso wekhemikhali olwandisa ukuvelisa i- hematopoietic growth factor. Akunjalo zonke iziyobisi ezomeleza umongo wethambo zizinto zokukhula, nangona kunjalo.
Kutheni I-Bone Marrow Ishukumisa?
Ukulwa neNqanaba eliPhantsi
Ukukhuthaza umzimba ukuvelisa iiseli ezintsha zegazi kunokunceda xa enye okanye ngaphezulu kweseli yakho yegazi ibalwa okanye ukubala kwakho kulindeleke ukuba kube phantsi kakhulu. Ngokomzekelo, maxa wambi ithambo lomongo likhuthazwa kwangaphambili, njengesilinganisi sokukhusela, xa kubalwa kulindeleke ukuba liwele ngenxa yonyango lomhlaza.
Ezinye izigulane ezithobela i-cytotoxic chemotherapy zingaba namaxesha aphantsi kakhulu kwixesha elide. Amanqanaba egazi ezimhlophe ezibizwa ngokuba yi-neutrophils zilandelwa ngokucophelela. Amanqanaba aphantsi ala ma-neutrophils, ngokukodwa, ahambelana kakuhle nomngcipheko wosulelo. I-neutrophil ephantsi ibala ngaphantsi kombindi othile ngokuqhelekileyo kuthiwa yi-neutropenia, kwaye xa amanqanaba e-neutrophils ehla kakhulu, ayaziwa njenge-neutropenia enzulu.
Iingcali zibhalile imiqulu, iqulethe iiseti ezininzi zezikhokelo, malunga nokuba i-arhente yomnxeba evuselelayo kufuneka iyenze kwaye ayifanele isetyenziswe.
Ininzi yengxoxo ihla ukuze kuqinisekiswe ukuba ingozi kunye neenzuzo zilinganiswa kwisigulane. Kukho ininzi yeempawu zeeklinikhi ezahlukahlukeneyo zokuqwalasela.
Ukunceda Omnye
Ukuvuselela umongo we-Bone kusetyenziswa ngamanye amaxesha abantu abanobuchopho, xa beza kunika iiseli ezixhamla komnye umntu, kwinto ebizwa ngokuba yi- peripheral blood stem cell transplant . Kuvela ukuba inani elincinci lamaseli e-hematopoietic stem lifumaneka kwigazi, kwaye oogqirha baye bafunda ukuqokelela kubantu abaphilileyo; Amavolontiya anganikela ngamaseli abo okuxhamla ukutshintshwa kwe-cell / stem cell ukutshala nje ngokunikela ngegazi, kwezinye iimeko.
Ingxenye yale nkqubo iquka ukukhulisa umongo wethambo ukwenzela ukuba ezinye iisundu ze-stem zikwazi ukuqokelelwa kalula kwigazi elijikelezayo.
NgokweNkqubo yoMnikeli weSizwe weMarrow, okanye "Yiba ngumlinganiso," umntu onika ama-cell stem ufumana i-injections ye-filgrastim, inkalo yokukhula, ngaphezu kweentsuku ezi-5 ngaphambi kokunikela. I-Filgrastim isetyenziselwa ukwandisa inani leeseli ezenza igazi kwigazi. Ngaloo mini, ngomhla womnikelo, igazi levolontiya lithathwa ngedaliti engalo enye kwaye ludlulisela ngomshini oqokelela iiseli ezifunekayo zegazi. Igazi elisele libuyiselwa kwivolontiya ngenye ingalo.
Iintlobo zeMarrow Bone ezikhuthaza ukuxhatshazwa
Izinto zokukhula ziyimichiza edlalwa ngama-injections phantsi kwesikhumba. Ezinye zi no kunikwa kwangaphakathi, kwi-vein. Iqela lakho lononophelo lwempilo lingakwazi ukulawula leyeza ngamayeza, kwaye ngamanye amaxesha abantu kunye namalungu entsapho bafunda ukuwaphatha, nabo.
Izinto zokuKhula ukuThuthukisa iiGesi zeGesi eziMhlophe
Izinto ezikhulayo okanye "izinto ezikhuthaza abantu" ezinceda ukukhulisa iiseli zegazi ezimhlophe ziquka oku kulandelayo:
- I-Filgrastim kunye ne- lenograstim yi-granulocyte (i-G-CSFs)
- I-Pegfilgrastim ifom ye-G-CSF ende. Isebenza ngendlela efana ne-filgrastim kodwa ingahlawulwa rhoqo.
- I-Sargramostim yi-granulocyte i-macrophage-kolony stimulation factor (GM-CSF).
Zombini iintlobo zokukhula-i-G-CSF kunye ne-GM-CSFs-inokuphucula imveliso yamaseli egazi ezimhlophe. Iinkcukacha ezivela kwizilingo ezilawulwa ngokungaqhelekanga ngokuthelekiswa kwezi zimbini ze-boosters zegazi okwangoku zikhoyo. Uninzi lwamaziko ogqirha lisebenzisa iG-CSF, kwaye lo luhlobo olusisiseko kwaye luye lwafundwa kakhulu.
I-G-CSF ingahanjiswa ngexesha lomjikelezo wokuqala we-chemotherapy ukukunceda ukukhusela iingxaki ngenxa ye-neutropenia kuwo onke amajikelezo e-chemotherapy. I-G-CSFs inokunceda nokunciphisa iziganeko zentsholongwane kwizigulane ezine-neutropenia, kwaye zinokunciphisa isidingo sokubhedlelelwa esibhedlele. Zingasetyenziselwa kunye ne-chemotherapy ukwenzela ukuba unike amayeza aphakamileyo e-chemotherapy, kwiimeko apho ukunciphisa i-chemotherapy dose kunokukhokelela ekugqibeleni.
Ngezinye ii-G-CSF zinikezelwa ngonyango lwe-chemo xa umjikelezo wangaphambili we-chemotherapy wabangela umkhuhlane we-neutropenic, kunye nokunciphisa ubude besikhathi umntu one-neutropenia enzima xa engekho i-fever. I-G-CSF ayinakunyanzeliswa ukuba isetyenziswe xa isigulane esele sine -fever ne-neutropenia.
Izinto zokuKhula ukuKhuthaza iiCom i-Red Blood cells
Izinto ezikhulayo ezinceda ukukhulisa iiseli ezibomvu zegazi, okanye i-erythrocytes, zibandakanya oku kulandelayo:
- I-Erythropoietin yindlela yokukhula eyenza ukuveliswa kweefom yegazi ebomvu.
- I-Darbepoetin yindlela ebenziwa ixesha elide le-erythropoietin esebenza ngendlela efanayo kodwa ingafumaneka rhoqo.
Ukunika i-erythropoietin kunokunceda ukuphepha ukuxilongwa kweeseli ezibomvu zegazi kwezinye izigulane. Ukunika ezinye izigulane zombini i-erythropoietin kunye ne-G-CSF kuphucula impendulo yabo kwi-erythropoietin.
Njengoko kunye nokukhula okubangela ukuba kusetyenziswe iiseli zegazi ezimhlophe, kukho iinzame ezininzi zokuqulunqa izikhokelo kunye neengcebiso malunga nokuba i-erythropoietin kunye ne-darbepoetin kufuneka isetyenziswe njani. Isenzo sokulinganisa phakathi kweengozi kunye neenzuzo kubandakanyeka.
Ukuxhobisa iiPlatelet
Ukusetyenziswa ngokuqhelekileyo, isilwanyana esibizwa ngokuthi i-oprelvekin yindlela edidiyelwe yomsindo wamachiza obizwa ngokuba yi-interleukin-11, okanye i-IL-11. I-Oprelvekin ingasetyenziselwa ukuvuselela ukuveliswa kweplatelet emva kwekhemotherapy yomhlaza okanye kwezinye iimeko zonyango ezibandakanya iiplatelet eziphantsi (thrombocytopenia). Esi sidakamizwa sinokunceda ukwandisa isibalo seeplatelet kwezinye izigulane ngexesha, nangona kunjalo, akunakunceda kuzo zonke iintlobo zesigulane, nakuzo zonke iimeko zeeplatelet eziphantsi.
Olunye unyango olubizwa ngokuthi i-romiplostim luza kunceda ekuphuculeni iiplatelet, kodwa kuboniswa kuphela xa umntu eneeplatelet eziphantsi ezibangelwa yinto ethile ebizwa ngokuba yi-immune thrombocytopenia, okanye i-ITP engapheliyo. I-Romiplostim ayikho into yokukhula ngokwemvelo, kodwa isebenza ngokulinganisa i-thrombopoietin, ukukhula, kunye nophuhliso olukhuthaza amaplatelete.
Studies Future
Uphando olongezelelweyo luye lwaqaliswa ukuzama ukufumana indlela engcono yokuxelela ukuba iziphi izigulana zinokuzuza kwiimeko zokukhula ezikhuthaza i-cell cell kunye nokuveliswa kweplatelet.
Kwakhona kunomdla omkhulu ekuqaliseni indlela engcono yokudibanisa izinto zokukhula kunye kunye namanye ama-agent-kuquka i-chemotherapy kunye ne-hormone therapy.
Ngexesha lokujonga uDokotela wakho
Ukuba uthabatha umongo wento evuselela amayeza, xelela ugqirha ukuba unobungozi obunayo. Nxibelelana nomboneleli wakho wezempilo ngokukhawuleza ukuba ufumana naziphi na iimpawu ezilandelayo:
- Umlilo we-100.4 ° F (38 ° C) okanye ngaphezulu, izibonda-iimpawu ezinokuthi zentsholongwane
- Ukuqhawukelwa ngumphefumlo
- Intliziyo esheshayo
- Ukuhlamba okungayeki emva kwemizuzu embalwa
- Naluphina utsha olutsha olusesikhumbeni sakho
Ukuba utshelwe ukuba unobalo obuphantsi kwaye uzifumanisa ukuba kutheni ungafumani imithi yokunyusa igazi, letha le mibuzo kunye neqela lakho lezempilo. Ngokuqhelekileyo, kukho imigaqo ekhethekileyo yonyango, kwaye izigqibo zenziwa ngenxa yokugula kwakho, imbali yezonyango kunye nezicwangciso zonyango.
ILizwi
Ngenxa yeendleko kunye neziphumo ezinemiphumo emibi, iikomiti zeengcali zikhuphe nezikhokelo zokuhlaziya iminyaka, ukukunceda ababoneleli bezempilo ukuba basebenzise izinto ezivuselela iikholoni. Ukusetyenziswa kwezi zonyango kunokuxhomekeka kwizinto ezinjengehlobo oluthile lokugula, iminyaka yakho, kunye naziphi ezinye izicwangciso ezicwangcisiweyo.
Akubona wonke umntu ngumviwa olungileyo, kodwa kwimeko efanelekileyo, le myeza inokukunceda ukukhusela i-neutropenia enzulu, izifo kunye nezifo ezichaphazelekayo neziphumo ezimbi.
> Imithombo:
> Yiba Umdlalo weNkxaso kaMarrow kazwelonke. Izinyathelo zePBSC okanye uMnikelo weMarrow Bone.
> Smith TJ, Bohlke K, Lyman GH, et al. Iziphakamiso zokusetyenziswa kwezinto ze-WBC Growth Factors: I-American Society ye-Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol . 2015; 33: 3199-3212.
> Kuter DJ, Rummel M, Boccia R, et al. I-Romiplostim okanye i-Standard of Care of Patients With Immune Thrombocytopenia. N Engl J Med. 2010; 363: 1889-1899.