An allogeneic stem cell transplant kurapwa kwakasimba uko kwaunogamuchira kuisirwa donor (mumwe munhu) stem cell. Izvi zvakasiyana apo murwere anogamuchira masero avo kumashure, anonzi an autologous stem cell transplant. Izvi zvinokurukurwa pane imwe peji.
Kutariswa kweallogeneic stem cell transplants?
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
Allogeneic stem cell transplantation inoshandisa stem masero akaunganidzwa kubva kune anopa (mumwe munhu) kutsiva yako wega stem maseru. Izvi zvinoitirwa kurapa Lymphoma iri refractory (isingadaire kurapwa) kana kudzoka zvakare (lymphoma inoramba ichidzoka. Vanhu vazhinji vane lymphoma havadi stem cell transplant. Mu lymphoma, allogeneic (donor) transplants ishoma zvikuru pane autologous. self) transplants.
Lymphoma ikenza ye lymphocytes. Lymphocytes imhando yemasero machena eropa anokura kubva mumasero. Chinangwa che chemotherapy ndeyekubvisa masero e-lymphoma uye ese maseru stem anogona kukura kuita lymphoma. Kana maseru akashata abviswa, masero matsva anogona kukura kumashure ayo ane tarisiro kuti haasi kenza.
Munyaya yevanhu vakadzokera shure kana kuti refractory lymphoma, izvi hazvisi kushanda - lymphoma yakawanda inoramba ichikura pasinei nekurapa. Naizvozvo, kubvisa masero emushonga ane madosi akanyanya ekemotherapy, wobva watsiva masero emunhu iyeye neomumwe munhu zvinogona kukonzera immune system nyowani uko madonor stem masero anotora basa rekugadzira masero eropa asingashanduke kuita lymphoma.
Chinangwa che stem cell transplant
Pane zvikonzero zvinoverengeka nei varwere ve lymphoma vangangoda stem cell transplant inosanganisira:
- Kurapa varwere ve lymphoma vari mukuregererwa, asi vane 'njodzi huru' yekudzoka kwavo lymphoma
- Iyo lymphoma yakadzoka mushure mekutanga kwemaitiro ekutanga kurapwa, saka yakanyanya (yakasimba) chemotherapy inoshandiswa kuvadzosa mukuregererwa (hapana chirwere chinoonekwa)
- Iyo lymphoma inoramba (haina kunyatsopindura) kune yakajairwa yekutanga-mutsara kurapwa nechinangwa chekuwana kuregererwa.
Iyo allogeneic stem cell transplant inogona kupa mabasa maviri
- Iwo akanyanya madosi echemotherapy anobvisa lymphoma uye masero matsva evanopa anopa nzira yekuti immune system idzoke, ichideredza nguva yekuti immune system isisaite. Masero matsva evanopa anotora basa remasoja ekudzivirira muviri uye kugadzira masero eropa ane hutano, senge lymphocytes. Iyo donor stem masero anotsiva masero asingashande emurwere.
- Graft versus lymphoma effect. Apa ndipo apo donor stem masero (anonzi graft) anoziva chero akasara lymphoma masero uye anoarwisa, achiparadza lymphoma. Ichi chiitiko chakanaka apo donor stem masero ari kubatsira kurapa lymphoma. Zvakakosha kuziva kuti iyi graft versus lymphoma effect haiiti nguva dzose seizvi. Iyo lymphoma inogona kurwisana nevanopa stem masero, kana muviri wemugamuchiri (unonzi muenzi) unogona kurwisana nemasero evanopa (anonzi graft) zvichikonzera kubatanidza maringe nehosha yekugamuchira (dambudziko re allogeneic transplant).
Maitiro eiyo allogeneic stem cell transplant ine matanho mashanu
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
- Kugadzirira: izvi zvinosanganisira kuongororwa ropa kuti uone rudzi rwemasero aunoda. Dzimwe nguva vanhu vanoda kuve ne "salvage" chemotherapy kuedza uye kuderedza lymphoma vasati vadyarwa.
- Stem cell collection: iyi ndiyo nzira yekukohwa stem maseru, nekuti allogenic transplant inobva kune donor, timu yekurapa inoda kutsvaga mechi yekusiira.
- Conditioning treatment: iyi ndiyo chemotherapy, chinangwa chekurapa uye immunotherapy iyo inopihwa mumhando yepamusoro kwazvo kubvisa yese lymphoma.
- Reinfusion ye stem masero: kana mishonga yepamusoro yave yaitwa, masero e stem akaunganidzwa kubva kune anopa, anotungamirirwa.
- Engraftment: iyi ndiyo nzira iyo iyo donor stem masero anogara mumuviri uye anotora kushanda kweiyo immune system.
Kugadzirira kurapwa
Pachava nekugadzirira kwakawanda kunodiwa mukutungamira kusvika kune stem cell transplant. Kwese kuisirwa kwakasiyana uye timu yekutapurirana inofanirwa kuronga zvese zvemurwere. Dzimwe dzegadziriro dzekutarisira dzinogona kusanganisira:
Kuiswa kwemutsara wepakati
Kana murwere asati atova nemutsara wepakati, ipapo mumwe achaiswa musati waiswa. Mutsetse wepakati unogona kunge uri PICC (peripherally yakaiswa pakati catheter). Inogona kunge iri CVL (central venous line). Chiremba achasarudza kuti ndeupi mutsara wepakati wakanakira murwere.
Mutsara wepakati unopa nzira yekugamuchira mishonga yakawanda yakasiyana panguva imwe chete. Varwere vanowanzoda yakawanda yemishonga yakasiyana uye kuongororwa ropa panguva yekuisirwa uye mutsara wepakati unobatsira vanamukoti kutonga zvirinani kutarisirwa kwemurwere.
Kurapwa
High dose chemotherapy inogara ichiitwa sechikamu cheiyo transplantation process. Iyo yakakwirira dose chemotherapy inonzi conditioning therapy. Kunze kweiyo yakakwira dose chemotherapy, vamwe varwere vanoda salvage chemotherapy. Salvage therapy ndiyo iyo lymphoma ine hutsinye uye inoda kuderedzwa isati yasara yekusimwa inogona kuenderera mberi. Zita salvage inobva pakuedza kuponesa muviri kubva kune lymphoma.
Kutamiswa kunorapwa
Chete zvimwe zvipatara mukati meAustralia zvinokwanisa kuita allogeneic stem cell transplantation. Nekuda kweizvi, vangangoda kutama kubva kumba kwavo, kunzvimbo iri padyo nechipatara. Zvipatara zvakawanda zvinogara murwere zvinogara murwere uye mutarisiri. Taura nemushandi wezvemagariro evanhu panzvimbo yako yekurapisa kuti uzive nezvepokugara.
Kuchengetedza mbereko
Stem cell transplantation inokanganisa kukwanisa kwemurwere kuita vana. Zvakakosha kuti sarudzo dziripo kuchengetedza mbereko dzinokurukurwa.
Matipi anoshanda
Kuve ne stem cell transplant kazhinji kunosanganisira kugara muchipatara kwenguva refu. Zvinogona kubatsira kurongedza zvimwe zveizvi zvinhu:
- Mapeya akati wandei ehembe dzakapfava, dzakapfava kana mapyjamas uye dzakawanda dzemukati.
- Toothbrush (soft), toothpaste, sipo, gentle moisturiser, gentle deodorant
- Yako piro (inopisa geza pillowcase yako uye chero magumbeze emunhu / kanda maragi usati wapinda muchipatara - dziya geza kuti uderedze bhakitiriya sezvo immune system yako ichange ichinetseka zvakanyanya).
- Slippers kana shangu dzakagadzikana uye akawanda emapeya emasokisi
- Zvinhu zvako zvekuvhenekera kamuri yako yechipatara (mufananidzo wevaunoda)
- Varaidzo zvinhu zvakaita semabhuku, magazini, crosswords, iPad/laptop/tablet. Chipatara chinogona kufinha chose kana usina chekuita.
- Karenda yekuchengeta zuva, kubvumidzwa kwenguva refu muchipatara kunogona kudzima mazuva ese pamwechete.
HLA uye Tissue Typing
Paunenge uine allogeneic (donor) stem cell transplant, murongi wekutapurirana anoronga kutsvaga akakodzera stem cell donor. Iyo allogeneic stem cell transplant inogona kubudirira kana maseru eanopa achinyatsoenderana nemurwere. Kuti utarise izvi, murwere anoongororwa ropa kunonzi tissue typing iyo inotarisa mapuroteni akasiyana pamusoro pemasero anonzi human leukocyte antigens (HLA).
Masero emunhu wese anoita mapuroteni eHLA kubatsira immune system kuziva maseru ari mumuviri uye kuziva maseru asiri ake.
Kune akawanda emhando dzakasiyana dzeHLA uye timu yekurapa inoedza kutsvaga mupi ane mhando dzeHLA dzinoenderana nepedyo sezvinobvira.
Kana zvichibvira, vanoedzawo kuve nechokwadi kuti murwere uye mupi vakatarisana nemavhairasi akafanana, kunyange izvi zvisinganyanyi kukosha pane HLA-matching.
Hama kana hanzvadzi dzinowanzova nemapuroteni eHLA akafanana nemurwere. Around 1 pavatatu vanhu vane mukoma kana sisi vanowirirana. Kana murwere asina hama kana hanzvadzi, kana vasina kuenderana, timu yekurapa inotsvaga munhu anozvipira ane mhando yeHLA inofanana nevarwere zvakanyanya sezvinobvira. Izvi zvinozivikanwa semupiro anofananidzwa asina hukama (MUD) uye mamirioni evanozvipira vakanyoreswa nevenyika nepasi rose stem cell registries.
Kana mupi anofananidzwa asina hukama (MUD) akasawanikwa kumurwere, zvingave zvichikwanisika kushandisa mamwe masosi emasero. Izvi zvinosanganisira:
- Hama ine HLA mhando yehafu inofanana neyako: iyi inozivikanwa se 'haploidentical' donor
- Umbilical cord ropa kubva kumupi asina hukama: umbilical cord ropa haifanire kunge yakanyatsoenderana neHLA yako semamwe masosi e stem masero. Inonyanya kushandiswa kuvana pane vakuru nekuti ine masero mashoma pane mamwe masosi. Marejista eropa rakachengetwa remumbilical cord anowanikwa.
Kuunganidzwa kweStem Cells
Pane nzira mbiri mupi anogona kupa stem maseru.
- Peripheral blood stem cell collection
- Bone marrow stem cell donation
Peripheral blood stem cell donation
Peripheral stem masero anounganidzwa kubva kune peripheral blood stream. Mukutungamira kune peripheral stem cell kuunganidzwa, vanhu vazhinji vanogashira majekiseni ekukura chinhu. Zvinhu zvinokura zvinokurudzira kugadzirwa kwe stem cell. Izvi zvinobatsira stem cell kufamba kubva mumwongo, kupinda muropa, akagadzirira kuunganidzwa.
Kuunganidzwa kunoitika nekuparadzanisa stem maseru kubva kune rimwe ropa rose uye maitiro anoshandisa apheresis muchina. Muchina weapheresis unogona kupatsanura zvikamu zvakasiyana zveropa uye unogona kupatsanura stem masero. Kana ropa rafamba nechikamu chekuunganidza masero rinofamba richidzokera mumuviri. Iyi nzira inotora maawa akawanda (anenge 2 - 4 maawa). Anopa anogona kuenda kumba mushure mekuita, zvisinei, angangoda kudzoka zuva rinotevera kana pasina masero akakwana akaunganidzwa.
Apheresis hainyanyi kupindira pane kuunganidza mwongo uye ichi ndicho chikonzero nei iri nzira inosarudzika yekuunganidza stem cell.
Mune allogeneic (donor) transplants, mupi anoenda kune apheresis kune anogamuchira uye kuunganidza uku kunoitika padyo nezuva rekuisirwa sezvinobvira. Nekuti aya stem maseru anozounzwa nyowani kune anogamuchira pazuva rekuisirwa.
Bone Marrow stem cell donation
Nzira isinganyanyi kushandiswa pakuunganidza stem cells ndeyekukohwa mwongo. Apa ndipo panobviswa stem masero kubva mumapfupa pasi peanesthesia. Vanachiremba vanopinza tsono mubhonzo munharaunda yepelvic, inonzi iliac crest. Mwongo webhonzo unobviswa kubva muchiuno, kuburikidza netsono uye iyi mwongo inozopepetwa uye inochengetwa kusvika zuva rekuisirwa.
Cord blood mupiro unobva kubhengi reruzhinji uko mupiro we stem cell kubva muropa rakasiiwa mumbilical cord uye placenta mushure mekunge mwana azvarwa apihwa uye akachengetwa.
Iyo apheresis inoshanda sei
Kugadzirisa / kuchengetedza stem masero kana mwongo
Stem masero akaunganidzirwa allogeneic (donor) transplant, anounganidzwa pakarepo asati ashandiswa uye haana kuchengetwa chero hurefu hwenguva.
Masero emazita akaunganidzirwa autologous (self) transplant, anowanzo chengetwa uye anochengetwa mufiriji kusvika agadzirira kushandiswa.
Conditioning
Varwere vari kuisirwa vanotanga kupihwa mushonga unonzi conditioning regimen. Uku ndiko kurapwa kwepamusoro-dose kunoitwa mumazuva mashoma asati apinzwa. Conditioning therapy inogona kusanganisira chemotherapy uye dzimwe nguva radiation therapy. Zvinangwa zviviri zveconditioning therapy ndezvi:
- Kuuraya lymphoma yakawanda sezvinobvira
- Deredza stem cell huwandu
Kune akawanda akasiyana musanganiswa wechemotherapy, radiation therapy uye immunotherapy inogona kushandiswa mukugadzirisa mamiriro. Kune kusimba kwakasiyana kweconditioning kurapwa, ndeiyi:
- Full intensity myeloblative conditioning
- Kwete myeloblative conditioning
- Yakaderedzwa intensity conditioning
Mumarejisheni ese kurapwa kwakanyanya uye nekudaro, masero mazhinji ane hutano anofa pamwe neiyo lymphoma. Sarudzo yehurongwa hunoenderana nerudzi rwe lymphoma, nhoroondo yekurapa uye zvimwe zvinhu zvakaita sezera, hutano uye kusimba. Boka rinorapa richakurukura nemurwere kuti ndeipi chirongwa chekugadzirisa chinokodzera murwere.
Mune allogeneic transplant, varwere vanogona kugamuchirwa kuchipatara mazuva gumi nemana asati aiswa. Mhosva yega yega yevarwere yakasiyana uye chiremba wako anokuzivisa iwe paunozogamuchirwa. Varwere vanoramba vari muchipatara chero kubva 14 - 3 mavhiki mushure mekusimwa. Uyu ndiwo gwara; kuisirwa kwega kwega kwakasiyana, uye vamwe vanhu vanoda kurapwa kwakawanda kwenguva yakareba kupfuura mavhiki matanhatu.
Kana iwe uine allogeneic stem cell transplant uchishandisa stem maseru kubva kune asina hukama kana mukuru asina kufananidzwa mupi, ungangoda yakanyanya kusimba kugadzirisa kurapwa.
Iwe unogona kunge uine kurapa kwakasiyana-siyana kana iwe uine allogeneic transplant uchishandisa stem masero kubva mumbilical cord ropa kana kubva kuhafu-inofananidzwa hama.
Iwe unogona kuwana ruzivo rwakadzama pamusoro pekugadzirisa regimens pane Eviq webhusaiti.
Kudzoreredza stem masero
Mushure mekunge iyo intensive conditioning chemotherapy yapera, stem masero anodzoreredzwa. Aya masero anotanga zvishoma nezvishoma kugadzira masero eropa matsva, ane utano. Pakupedzisira, vanozogadzira masero ane hutano akakwana kuti adzorere mwongo wese, achizadza ropa rose nemasero ekudzivirira.
Kuita kuti stem masero adzorerwe inzira yakatwasuka. Zvakafanana nekuwedzerwa ropa. Masero anopiwa kuburikidza nemutsara mumutsara wepakati. Zuva iro masero anodzoreredzwa anonzi "Zuva Zero".
Nechero nzira yekurapa, pane njodzi yekuve nekuita kune stem cell infusion. Kune vanhu vazhinji hapana chekuita, asi vamwe vanogona kusangana:
- Kunzwa kurwara kana kurwara
- Kuravira kwakashata kana kunzwa kupisa mumuromo mako
- High blood pressure
- Allergic reaction
- Kurwara
Mune allogeneic stem cell transplants, sezvo aya maseru akapihwa anobata (kana engraft) mune anogamuchira (murwere). Vanotanga kushanda sechikamu chekudzivirira muviri uye vanogona kurwisa masero e-lymphoma. Izvi zvinodanwa graft-versus lymphoma effect.
Mune zvimwe zviitiko, kutevera allogeneic transplant, masero evanopa anorwisawo masero ane hutano emurwere. Izvi zvinonzi graft-versus-host disease (GVHD).
Kuiswa kwe stem masero ako
Engraftment ndipo apo masero matsva anotanga kutora zvishoma nezvishoma sekutanga masero. Izvi zvinowanzoitika mushure memavhiki maviri - matatu mushure mekuiswa kwemasero ema stem asi zvinogona kutora nguva yakareba, kunyanya kana masero matsva abva muguvhu ropa.
Nepo masero matsva anonyora, iwe uri panjodzi huru yekubata hutachiona. Vanhu kazhinji vanofanirwa kugara muchipatara kwenguva iyi, nekuti vanogona kurwara uye vanoda kukwanisa kurapwa ipapo.
Paunenge wakamirira kuti huwandu hweropa rako huvandudzwe, unogona kunge uine mamwe emishonga anotevera kutsigira kupora kwako:
- Kuwedzerwa ropa - kuderera kwemasero matsvuku eropa (anemia)
- Platelet transfusions - kune yakaderera platelet mazinga (thrombocytopenia)
- Mishonga inorwisa mabhakitiriya - yehutachiona hwehutachiona
- Antiviral mishonga - yehutachiona hwehutachiona
- Anti-fungal mishonga - yezvirwere zvefungal
Engraftment syndrome
Mushure mekugamuchira masero matsva, vamwe vanhu vanotanga zviratidzo zvinotevera mushure memavhiki 2-3, kazhinji panguva yekunyorwa kwesero:
- Fivha: tembiricha yakakwira ye38 degrees kana pamusoro
- Rash dzvuku
- Diarrhea
- Fluid retention
Izvi zvinonzi 'engraftment syndrome'. Izvo zvinowanzoitika mushure mekuita wega (autologous) stem cell transplant pane mupi (allogeneic) stem cell transplant.
Icho chinhu chinowanzobatanidzwa chekugadzirisa uye chinorapwa ne steroids. Zviratidzo izvi zvinogonawo kukonzerwa nezvimwe zvinhu, kusanganisira chemotherapy, uye zvinogona kunge zvisiri chiratidzo cheengraftment syndrome.
Mamwe maprotocol akajairwa muchipatara panguva yekuchinjirwa anosanganisira:
- Iwe unowanzogara muimba yechipatara iwe pachako kwenguva yaunogara
- Imba yechipatara inocheneswa nguva dzose uye machira nemapillowcase zvinochinjwa zuva nezuva
- Iwe haugone kuve nezvinomera zvipenyu kana maruva mumba mako
- Vashandi vepachipatara nevashanyi vanofanira kugeza maoko avo vasati vapinda mukamuri mako
- Dzimwe nguva vashanyi nevashandi vepachipatara vangangoda kupfeka magirovhosi, gown kana maapuroni, uye masks ekumeso kana vachikushanyira.
Vanhu havafanire kukushanyira kana varwara - Vana vari pasi pemakore akati vanogona kusatenderwa kushanya zvachose - kunyangwe zvimwe zvipatara zvichivabvumira kana vana vakapora
Kana huwandu hweropa rako hwapora uye murwere apora zvakakwana, vanogona kuenda kumba. Mushure menguva ino, ivo vanozoteverwa-pedyo neboka rekurapa.
Matambudziko kubva ku stem cell transplantation
Graft Versus Host Disease (GvHD)
Chirwere cheGraft-versus-host (GvHD) idambudziko rakajairika reiyo allogeneic stem cell transplant. Zvinoitika kana:
- Anopa maT-seli (anonziwo 'graft') anoona maantigen pane mamwe masero ari mumuviri weanogamuchira (anonzi 'host') semutorwa.
- Mushure mekuziva maantigen aya, mupi weT-seli anobva arwisa masero emugamuchiri wavo mutsva.
Izvi zvinogona kubatsira kana mupi mutsva T-seli akarwisa asara lymphoma masero (anonzi graft versus lymphoma effect). Nehurombo, mupi weT-masero anogonawo kurwisa matishu ane hutano. Izvi zvinogona kukonzera migumisiro yakakomba.
Kazhinji yenguva GvHD inokonzeresa zvinyoro-kusvika-zvine mwero zviratidzo, asi pano neapo, zvinogona kuve zvakakomba uye kunyange kutyisidzira hupenyu. Vasati vasiiwa uye mushure, varwere vanopihwa mishonga yekuderedza njodzi yekubata GvHD. Chikwata chekutapurirana chinonyatso tarisisa murwere kune chero zviratidzo zveGvHD kuitira kuti vagone kuchirapa nekukasira, kana chikakura.
GvHD inonzi 'acute' kana 'chronic' zvichienderana nezviratidzo nezviratidzo.
Ngozi yeKutapukirwa
Kutevera kuisirwa stem cell, iwo madosi epamusoro echemotherapy anenge abvisa akawanda eropa masero, kusanganisira chena sero reropa rinonzi neutrophils. Chiyero chakaderera cheneutrophils chinozivikanwa seneutropenia. Neutropenia yenguva refu inoisa mumwe munhu panjodzi huru yekuva nehutachiona. Zvirwere izvi zvinogona kurapwa, asi kana zvikasakurumidza kubatwa nekurapwa nekukasika zvinogona kuisa upenyu panjodzi.
Ndichiri muchipatara, pakarepo mushure mekuisirwa stem cell, boka rinorapa richange richitora matanho ekudzivirira kutapukira uye nekunyatsotarisisa zviratidzo zvehutachiona. Kunyangwe matanho mazhinji anotorwa kuderedza njodzi yekubatira hutachiona, varwere vazhinji vane allogeneic stem cell transplant vanowana hutachiona.
Mumavhiki ekutanga mushure mekutapurwa, varwere vari panjodzi huru yekuva nehutachiona hwehutachiona. Zvirwere zvakadai zvinosanganisira, zvirwere zveropa, mabayo, zvirwere zvekudya kana zvirwere zveganda.
Mumwedzi mishoma iri kutevera, varwere vari panjodzi yekutapukirwa nehutachiona uye aya anogona kunge ari mavhairasi anga akarara mumuviri asati aisirwa uye anogona kusimuka kana immune system yadzikira. Hazviwanzokonzera zviratidzo. Kuongororwa ropa nguva dzose mushure mekutapurwa kuchaitwa kuve nechokwadi chekuti hutachiona hwehutachiona hunonzi cytomegalovirus (CMV) hunoonekwa nekukurumidza. Kana kuongororwa ropa kunoratidza CMV iripo - kunyangwe pasina zviratidzo - murwere acharapwa nemishonga inorwisa mavhairasi. Inopfuura nzira imwe yekurapa inogona kudiwa uye kurapwa uku kunogona kurebesa kugara muchipatara.
Kuverengwa kweropa kunotanga kukwira pakati pemasvondo maviri kusvika mana mushure mekuisirwa allogeneic stem cell. Nekudaro, zvinogona kutora mwedzi yakawanda, kana dzimwe nguva kunyange makore, kuti immune system inyatsopora.
Kana vaburitswa muchipatara boka rekurapa rinofanirwa kuraira kuti ndezvipi zviratidzo zvehutachiona zvekutarisa uye ndiani wekubata kana paine hutachiona hunogona kuitika kana chimwe chinhu chingave chiri kunetsa kumurwere.
Mhedzisiro yemushonga wakanyanya chemotherapy
Varwere vangangosangana nemhedzisiro kubva kune yakakwira-dose anti-cancer kurapwa. Izvi zvinotevera mhedzisiro inogona kuve yakajairika uye rumwe ruzivo rwuri mu divi zvinokonzerwa chidimbu
- Oral Mucositis (muromo unorwadza)
- Anemia (yakaderera masero matsvuku)
- Thrombocytopenia (yakaderera platelet count)
- Nausea uye kurutsa
- Dambudziko rekudya (manyoka kana kuvimbiswa)
Graft kukundikana
Kukundikana kwegraft kunoitika kana masero e stem akadyarwa akatadza kugadzikana mumwongo uye kugadzira masero matsva eropa. Izvi zvinoreva kuti huwandu hweropa haudzoreki, kana kuti vanotanga kupora asi vozodzika zvakare.
Kutadza kwegraft kwakakomba asi kashoma mushure meiyo allogeneic stem cell transplant, kunyanya kana mupi ari mutambo wakanaka.
Chikwata chekurapa chinotarisisa kuverenga kweropa uye kana stem cell itsva ikatanga kutadza, murwere anogona kurapwa nekukura kwehomoni. Izvi zvinogona kukurudzira stem masero mumwongo kuti abudise mamwe maseru.
Kana iyo donor stem masero akasanyora, murwere angangoda chechipiri stem cell transplant. Ichi chechipiri chekudyara chinogona kubva kune imwechete stem cell donor kana imwe yakasiyana.
Late effects
Mamiriro ekupedzisira matambudziko ehutano anogona kukura mwedzi kana makore mushure mekurapa lymphoma. Nzvimbo zhinji dzekutapurirana dzakatsaurira nguva dzekupedzisira mhedzisiro masevhisi anopa zvirongwa zvekuongorora kuti zvione kunonoka mhedzisiro nekukurumidza sezvinobvira. Izvi zvinopa murwere mukana wakanakisa wekurapwa zvinobudirira kana akagadzira chero mhedzisiro yekunonoka.
Varwere vanogonawo kunge vari panjodzi yekuvandudza Post-Transplant Lymphoproliferative Disorder (PTLD) - lymphomas inogona kukura muvanhu vari kutora immunosuppressant mishonga mushure mekusimwa. Nekudaro, PTLD haiwanzo. Vazhinji varwere vakave nekuchinjirwa havagadziri PTLD.
Kuchengeta kwekutevera
Mushure mekuisirwa stem cell, pachava nenguva (vhiki nevhiki) kugadzwa nachiremba. Kutevera kunoenderera mberi kwemwedzi uye makore mushure mekurapwa, asi zvishoma uye zvishoma kazhinji nekufamba kwenguva. Pakupedzisira vanachiremba vanosimwa vanozokwanisa kupa rubatsiro rwekutevera, kuvarwere veGP.
Inenge mwedzi mitatu mushure mekuisirwa, a PET scan, CT scan uye / kana bone marrow aspirate (BMA) inogona kurongerwa kuongorora kuti kupora kuri kufamba sei.
Zvakajairika kuti udzokere kuchipatara kunorapwa mumavhiki nemwedzi inotevera kuisirwa asi nekufamba kwenguva, njodzi yematambudziko akakomba inoderera.
Varwere vangangove vachisangana nemhedzisiro kubva mukurapwa kwedosi yakanyanya uye vanogona kunzwa kusanzwa uye kuneta zvakanyanya. Nekudaro, kazhinji zvinotora rinotenderedza gore kuti apore kubva kune stem cell transplant.
CHIKWATA chezvechiremba chinofanirwa kupa zano pamusoro pezvimwe zvinhu zvinofanirwa kutariswa panguva yekupora. Lymphoma Australia ine online private Facebook peji, Lymphoma Down Under paunogona kubvunza mibvunzo uye kuwana rutsigiro kubva kune vamwe vanhu vakabatwa nelymphoma kana stem cell transplant.
Chii chinoitika mushure mekuisirwa stem cell?
Kupedza kurapwa inogona kuve nguva inonetsa kuvarwere vazhinji, pavanenge vachidzokera kuhupenyu mushure mekusikwa. Zvimwe zvezvinonyanya kunetseka zvinogona kuenderana ne:
- chisimba
- Pfungwa dzakanaka
- Utano hwepfungwa
- Relationships
- Basa, kudzidza uye zviitiko zvekugarisana nevamwe
Zvimwe Zvinyorwa
Steve akaonekwa kuti ane mantle cell lymphoma muna 2010. Steve akapona ne autologous uye allogeneic stem cell transplant. Iyi inyaya yaSteve.
Dr Nada Hamad, chiremba weHematologist & mapfupa ekutamisa mapfupa
Chipatara cheSt Vincent's, Sydney
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
Dr Amit Khot, chiremba weHematologist & chiremba wekuisira mwongo
Peter MacCallum Cancer Center uye Royal Melbourne Hospital
