Kunezinhlobo ezimbili eziyinhloko zokufakelwa, i-autologous kanye ne-allogeneic stem cell transplants.
UDkt Nada Hamad, Udokotela Wegazi kanye nodokotela wokufakelwa komnkantsha
Isibhedlela iSt Vincent's, eSydney
Iyini i-stem cell?
- Amangqamuzana amhlophe egazi (kuhlanganise nama-lymphocyte - okungamaseli okuthi uma ephenduka abe umdlavuza abangele i-lymphoma)
- Amaseli abomvu egazi (lezi zinesibopho sokuthwala umoya-mpilo emzimbeni wonke)
- Amapulatifomu (amaseli asiza igazi ukuthi lihlule noma livimbele amahlule)
Kuyini ukufakelwa kwe-stem cell?
Ukufakelwa kwe-stem cell kuyindlela engase isetshenziselwe ukwelapha i-lymphoma. Zingasetshenziselwa ukwelapha iziguli ezine-lymphoma exolile kodwa maningi amathuba okuthi i-lymphoma iphinde ibuyele emuva (ibuya). Zingase futhi zisetshenziselwe ukwelapha iziguli ezine-lymphoma ebuyele emuva (buya).
Ukufakelwa kwe-stem cell kuyinqubo eyinkimbinkimbi futhi ehlaselayo eyenzeka ngezigaba. Iziguli ezifakelwa i-stem cell ziqale zilungiswe ngokwelashwa ngamakhemikhali kuphela noma kuhlanganiswe ne-radiotherapy. Ukwelashwa ngamakhemikhali okusetshenziselwa ukufakelwa kwe-stem cell kunikezwa ngemithamo ephezulu kunokujwayelekile. Ukukhethwa kwe-chemotherapy okunikezwa kulesi sigaba kuncike ohlotsheni kanye nenjongo yokufakelwa. Kunezindawo ezintathu lapho ama-stem cells okufakelwa kabusha angaqoqwa kuzo:
Amaseli omnkantsha: ama-stem cells aqoqwa ngokuqondile emnkantsheni futhi abizwa ngokuthi a 'ukufakelwa komnkantsha' (BMT).
Amaseli e-stem e-peripheral: ama-stem cells aqoqwa egazini le-peripheral futhi lokhu kubizwa ngokuthi a 'i-peripheral blood stem cell transplant' (PBSCT). Lona umthombo ovame kakhulu wama-stem cell asetshenziselwa ukufakelwa kabusha.
Igazi lentambo: ama-stem cells aqoqwa enkabeni ngemva kokuzalwa komntwana osanda kuzalwa. Lokhu kubizwa ngokuthi a 'ukufakelwa igazi ngentambo', lapho lezi zingavamile kakhulu kunokufakelwa kwe-peripheral noma umnkantsha wamathambo.
Izinhlobo zokufakelwa kwe-stem cell
Kunezinhlobo ezimbili eziyinhloko zokufakelwa, i-autologous kanye ne-allogeneic stem cell transplants.
Ukufakelwa kwe-Autologous stem cell: lolu hlobo lokufakelwa lisebenzisa ama-stem cells esiguli, aqoqwa futhi agcinwe. Uzobe usuthola imithamo ephezulu ye-chemotherapy futhi ngokulandela lokhu ama-stem cells akho azobuyiselwa kuwe.
Ukufakelwa kwe-Allogeneic stem cell: lolu hlobo lokufakelwa lusebenzisa ama-stem cells anikelwe. Onikelayo angase abe nesihlobo (ilungu lomndeni) noma umnikezeli ongahlobene. Odokotela bakho bazozama ukuthola onikelayo amaseli akhe afana kakhulu nesiguli. Lokhu kuzonciphisa ingozi yokuthi umzimba wenqabe ama-donor stem cell. Isiguli sizoba nemithamo ephezulu ye-chemotherapy futhi kwesinye isikhathi i-radiotherapy. Ngemva kwalokhu ama-stem cells anikelwe azobuyiselwa esigulini.
Ukuze uthole ukwaziswa okwengeziwe ngalezi zinhlobo zokufakelwa, bheka ukufakelwa kwe-autologous or amakhasi okufakelwa kwe-allogeneic.
Izinkomba zokufakelwa kwe-stem cell
UDkt Amit Khot, Udokotela Wegazi kanye nodokotela wokufakelwa komnkantsha
Peter MacCallum Cancer Center kanye nesibhedlela saseRoyal Melbourne
Iziguli eziningi ezitholwe zine-lymphoma ziyakwenza HHAYI udinga ukufakelwa i-stem cell. Kokubili ukufakelwa kwe-autologous kanye ne-allogeneic stem cell kusetshenziswa kuphela ezimeni ezithile. Izinkomba eziyinhloko zokufakelwa kwe-stem cell zihlanganisa:
- Uma isiguli se-lymphoma sine refractory i-lymphoma (i-lymphoma engaphenduli ekwelashweni) noma ubuyile i-lymphoma (i-lymphoma elokhu ibuya ngemva kokwelashwa).
- Izinkomba zokufakelwa kwe-autologous (amaseli uqobo) nazo zihlukile ezinkomba zokufakelwa kwe-allogeneic (amaseli anikelayo).
- Iziguli ze-lymphoma ngokuvamile zithola ukufakelwa kwe-autologous esikhundleni sokufakelwa kwe-allogeneic. Ukufakelwa kwe-autologous kunezingozi ezincane kanye nezinkinga ezincane futhi ngokuvamile kuphumelela ekwelapheni i-lymphoma.
Izinkomba zokufakelwa kwe-autologous (amaseli awo) i-stem cell zifaka:
- Uma i-lymphoma iphinda (ibuya)
- Uma i-lymphoma i-refractory (ingasabeli ekwelashweni)
- Ezinye iziguli okutholwe ukuthi zine-lymphoma okwaziwayo ukuthi zinethuba elikhulu lokuphindela emuva, noma uma i-lymphoma isisezingeni eliphezulu kakhulu, izocatshangelwa ukufakelwa kwe-autologous njengengxenye yohlelo lokuqala lokwelapha.
Izinkomba zokufakelwa kwe-stem cell allogeneic (donor) zifaka:
- Uma i-lymphoma iphindela emuva ngemva kokufakelwa kwe-stem cell okuzenzakalelayo (amaseli angowakho).
- Uma i-lymphoma iphikisana
- Njengengxenye yokwelashwa komugqa wesibili noma wesithathu we-lymphoma/CLL ebuyele emuva
Inqubo yokufakelwa kabusha
UDkt Amit Khot, Udokotela Wegazi kanye nodokotela wokufakelwa komnkantsha
Peter MacCallum Cancer Center kanye nesibhedlela saseRoyal Melbourne
Kunezinyathelo ezinhlanu ezinkulu ezihilelekile ekufakweni kokufakelwa:
- Ukulungiselela
- Ukuqoqwa kwama-stem cells
- Isimo
- Ukubuyisela i-stem cell
- Ukuzibandakanya
Inqubo yohlobo ngalunye lokufakelwa ingahluka kakhulu. Ukuze uthole ulwazi olwengeziwe:
UDkt Amit Khot, Udokotela Wegazi kanye nodokotela wokufakelwa komnkantsha
Peter MacCallum Cancer Center kanye nesibhedlela saseRoyal Melbourne
