Dashen qashi

Marwayar kasusuwa hanya ce don maye gurbin lahani mai lalacewa ko lalacewa tare da ƙwayoyin ƙwayoyin lafiya na ƙashi.

Marasusuwan ƙashi shine mai taushi, nama mai ƙashi a cikin kashin ka. Kashin kashin baya samar da kwayoyin jini. Kwayoyin kara sune kwayoyin halitta wadanda basu balaga ba a cikin kasusuwan kasusuwa wanda ke haifar da dukkan kwayoyin halittar ku na jini.

Kafin dasawar, ana iya ba da magani, radiation, ko duka biyun. Ana iya yin hakan ta hanyoyi biyu:

• Ablative (myeloablative) magani - Ana ba da babban ƙwayar ƙwayar cuta, radiation, ko duka biyun don kashe duk ƙwayoyin cutar kansa. Wannan kuma yana kashe duk lafiyayyen ƙashi wanda ya rage, kuma yana bawa sabbin ƙwayoyin halitta damar girma cikin ɓarin ƙashi.
• Rage magani mai tsanani, wanda kuma ake kira karamin dasawa - Doananan allurai na chemotherapy da radiation ana basu kafin dasawa. Wannan yana ba tsofaffi damar, da waɗanda ke da sauran matsalolin kiwon lafiya don yin dashen.

Akwai nau'ikan dashe kashi guda uku:

• Autologous kashin kashi Kalmar auto na nufin kai. Ana cire ƙwayoyin ƙwayoyin jikinku daga gabanku kafin ku karɓi babban ƙwayar cutar sankara ko kuma kulawar radiation. Ana adana ƙwayoyin sel a cikin injin daskarewa. Bayan an sha magani mai karfin gaske ko kuma maganin radiation, za a sake dawo da kwayoyin halittar jikinka don yin kwayoyin jinin al'ada. Wannan ana kiran sa dashen ceto.
• Logwayar kasusuwa na allogeneic - Kalmar allo na nufin wani. Ana cire ƙwayoyin jikin mutum daga wani mutum, wanda ake kira mai bayarwa. Mafi yawan lokuta, kwayoyin halittar masu bayarwa dole ne aƙalla sashi ya dace da kwayoyin halittar ku. Ana yin gwaje-gwaje na musamman don ganin idan mai bayarwa ya dace da kai. Aan'uwa ko 'yar'uwa da alama sun fi dacewa da wasa. Wani lokaci iyaye, yara, da sauran dangi suna dacewa da juna. Masu ba da gudummawa waɗanda ba su da alaƙa da ku, amma har yanzu suna daidaitawa, ana iya samun su ta hanyar rajistar ƙasusuwan ƙasashe.
• Dasawar jinin mahaifa - Wannan nau'in dashen allogeneic ne. Ana cire ƙwayoyin sari daga igiyar cibiya sabon haihuwa bayan haihuwa. Kwayoyin sel suna daskarewa kuma ana adana su har sai an buƙata su dasawa. Kwayoyin jinin igiyar ciki ba su balaga sosai ba saboda haka akwai ƙarancin buƙatar daidaitawa daidai. Saboda ƙananan ƙwayoyin ƙwayoyin jini, ƙididdigar jini yana ɗaukar tsayi da yawa don murmurewa.

Ana yin dashen ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar jiki bayan an gama aikin chemotherapy kuma an gama radiation. Ana kawo kwayoyin kara a cikin jinin ku, yawanci ta bututun da ake kira catheter mai saurin jijiya. Tsarin yana kama da karɓar ƙarin jini. Kwayoyin jijiyoyin suna tafiya ta cikin jini zuwa bargon kashi. Mafi yawan lokuta, ba a bukatar tiyata.

Ana iya tattara ƙwayoyin masu bada taimako ta hanyoyi biyu:

• Girbin kasusuwa - Wannan ƙaramar tiyatar ana yin ta ne a ƙarƙashin maganin rigakafi. Wannan yana nufin mai ba da gudummawar zai yi barci ba tare da jin zafi ba yayin aikin. Ana cire kashin ƙashi daga bayan ƙasusuwan ƙugu biyu. Adadin bargon da aka cire ya dogara da nauyin mutumin da ke karɓar sa.
• Leukapheresis - Na farko, ana ba mai bayarwa kwanaki da yawa na harbi don taimakawa kwayoyin halitta su motsa daga kasusuwan kasusuwa cikin jini. Yayin leukapheresis, ana cire jini daga mai bayarwa ta hanyar layi na IV. Bangaren farin jinin wanda ya kunshi kwayar halitta sai a raba shi a cikin inji sannan a cire shi don daga baya a baiwa mai karba. Ana dawo da jajayen jinin ga mai bayarwa.

Mararjin ɓarkewar maye gurbin maye gurbin ƙashi wanda ko dai baya aiki yadda yakamata ko kuma an lalata shi (ya ɓata) ta hanyar cutar sankara ko radiation. Doctors sunyi imanin cewa saboda yawancin cututtukan daji, ƙwayoyin farin jini na mai ba da taimako na iya kai farmaki ga sauran ƙwayoyin cutar kansa da suka rage, kwatankwacin lokacin da fararen ƙwayoyin cuta ke farma ƙwayoyin cuta ko ƙwayoyin cuta yayin yaƙi da kamuwa da cuta.

Mai ba da sabis na kiwon lafiya na iya bayar da shawarar dashen ƙwayar ƙashi idan kana da:

• Wasu sankara, kamar cutar sankarar bargo, lymphoma, myelodysplasia, ko myeloma mai yawa.
• Cutar da ke shafar samar da ƙwayoyin ƙwayoyin kashin ƙashi, kamar su anemia mai ruɓewa, ƙauracewar ciki, cututtukan garkuwar jiki masu tsanani, cutar sikila, ko thalassaemia.

Mararjin ɓarna na iya haifar da waɗannan alamun bayyanar:

• Ciwon kirji
• Sauke cikin karfin jini
• Zazzaɓi, sanyi, flushing
• Abin dandano mai ban dariya a bakin
• Ciwon kai
• Kyauta
• Ciwan
• Jin zafi
• Rashin numfashi

Matsalolin da za a iya haifar da dasashi na kasusuwa ya dogara da abubuwa da yawa, gami da:

• Shekarunka
• Lafiyar ku gaba daya
• Yaya kyau na wasa da mai ba da gudummawar ku ya kasance
• Nau'in dusar ƙashin kashin da kuka karɓa (autologous, allogeneic, ko jinin cibiya)

Matsaloli na iya haɗawa da:

• Anemia
• Zuban jini a cikin huhu, hanji, kwakwalwa, da sauran yankuna na jiki
• Ciwon ido
• Yin zane a cikin ƙananan jijiyoyin hanta
• Lalacewa ga kodan, hanta, huhu, da zuciya
• Ragowar girma cikin yaran da suka karɓi dashen ƙashi
• Sauke al’ada da wuri
• Rashin aiki, wanda ke nufin cewa sabbin kwayoyin basa zama cikin jiki kuma sun fara samar da kwayar halitta
• Cututtukan da suka shafi graft-versus-host (GVHD), yanayi ne wanda kwayoyin gudummawa zasu afkawa jikinka
• Cututtuka, wanda na iya zama mai tsanani
• Kumburi da ciwo a cikin bakin, maƙogwaro, hanji, da ciki, wanda ake kira mucositis
• Jin zafi
• Matsalolin ciki, gami da gudawa, jiri, da amai

Mai ba ku sabis zai yi tambaya game da tarihin lafiyarku kuma ya yi gwajin jiki. Za a yi muku gwaje-gwaje da yawa kafin fara magani.

Kafin dasawa, zaka sami bututu guda 1 ko 2, ana kiransu catheters na tsakiya, wanda aka saka a cikin jijiyoyin jini a wuyanka ko hannayenka. Wannan bututun yana ba ka damar karɓar jiyya, ruwaye, da kuma wani lokacin abinci mai gina jiki. Haka kuma ana amfani da shi don ɗiban jini.

Wataƙila mai ba da sabis ɗinku zai tattauna game da damuwar da ke tattare da dashen ƙashin jijiya. Kuna iya saduwa da mai ba da shawara. Yana da mahimmanci kuyi magana da danginku da yaranku don taimaka musu fahimtar abin da zasu yi tsammani.

Kuna buƙatar yin shirye-shirye don taimaka muku shirya don aikin da kuma ɗaukar ayyuka bayan dasa ku:

• Kammala umarnin kulawa na gaba
• Shirya hutun likita daga aiki
• Kula da banki ko bayanan kudi
• Shirya kula da dabbobi
• Shirya wani don taimakawa a ayyukan gida
• Tabbatar da inshorar lafiya
• Biyan takardar kudi
• Shirya don kula da yaranku
• Nemi wa kanka da danginku mahalli kusa da asibiti, idan an buƙata

Sauya kashi na kashin baya yawanci ana yin sa ne a asibiti ko cibiyar kiwon lafiya wacce ta kware a irin wannan maganin. Mafi yawan lokuta, kuna zama a cikin sashin dusar ƙashi na musamman a tsakiyar. Wannan shine iyakance damar ku ta kamuwa da cuta.

Dogaro da magani da kuma inda aka yi shi, duk ko wani ɓangare na haɓakar kai tsaye ko aikin allogeneic za a iya yi a matsayin maras haƙuri. Wannan yana nufin ba lallai bane ku kwana a cikin asibitin dare ɗaya.

Tsawon lokacin da kuka zauna a asibiti ya dogara da:

• Ko kun ci gaba da wata matsala da ta danganci dasawa
• Nau'in dasawa
• Hanyoyin cibiyar kiwon lafiyar ku

Yayin da kake asibiti:

• Careungiyar kiwon lafiya za ta sa ido sosai a kan ƙididdigar jinin ku da mahimman alamu.
• Za ku karɓi magunguna don hana GVHD da hana ko magance cututtuka, gami da maganin rigakafi, antifungals, da maganin rigakafin ƙwayar cuta.
• Wataƙila kuna buƙatar ƙarin jini da yawa.
• Za a ciyar da ku ta jijiya (IV) har sai kun ci abinci ta baki, kuma illar ciki da ciwon baki sun tafi.

Bayan ka bar asibiti, ka tabbata ka bi umarni kan yadda zaka kula da kanka a gida.

Yaya kyau kuke yi bayan dasawa ya dogara da:

• Nau'in dashen qashi
• Ta yaya kwatancen masu ba da gudummawa ya dace da naka
• Wani irin ciwon daji ko rashin lafiya kuke da shi
• Yawan shekarunka da cikakkiyar lafiyarka
• Nau'in da sashi na chemotherapy ko radiation wanda kuke da shi kafin dasa ku
• Duk wani rikitarwa da zaku iya samu

Pwayar kasusuwa na iya warkewa gaba ɗaya ko wani ɓangare don magance cutar ku. Idan dasawa ta yi nasara, za ku iya komawa ga yawancin ayyukanku na yau da kullun da zarar kun ji daɗi sosai. Yawancin lokaci yakan ɗauki shekara 1 kafin ya warke sarai, gwargwadon abin da ya faru.

Rikitarwa ko gazawar dashen sashin kashin na iya haifar da mutuwa.

Dasawa - kasusuwan kasusuwa; Tantanin kwayar halitta; Hematopoietic stem cell dasawa; Rage ƙarfin dasashi ba da tsari ba; Mini dashi; Allogenic kashin kashi Canjin kashin kai na Autologous; Dasawar jinin mahaifa; Anlastic anlastic - ƙwayar kasusuwa; Cutar sankarar bargo - dasashi da jijiya; Lymphoma - daskarewa da kasusuwa; Myeloma da yawa - dashewar kashin kashi

• Zubar jini yayin maganin cutar kansa
• Marashin kashin kashi - fitarwa
• Tsarin catheter na tsakiya - canjin canji
• Tsarin katako na tsakiya - flushing
• Shan ruwa lafiya yayin maganin cutar daji
• Bushewar baki yayin maganin kansar
• Cin karin adadin kuzari yayin rashin lafiya - manya
• Cin karin adadin kuzari yayin rashin lafiya - yara
• Mucositis na baka - kulawa da kai
• Catunƙun cikin katakon katakon ciki - flushing
• Amintaccen abinci yayin maganin cutar kansa

• Burin kasusuwa
• Abubuwan da aka kafa na jini
• Kashin kashin ciki
• Jigilar-kasusuwa - jerin

Americanungiyar (asar Amirka ta Cibiyar Nazarin Lafiyar Lafiyar Jama'a. Mene ne dashewar kashin kashi (dasawar kwayar halitta)? www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/how-bone-marrow-transplant-stem-cell-transplant. An sabunta Agusta 2018. Iso zuwa Fabrairu 13, 2020.

Heslop SH. Bayani da kuma zabi na mai bayarwa na dashen dashen hematopoietic. A cikin: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Ka'idoji da Aiki. 7th ed. Philadelphia, PA: Elsevier; 2018: babi na 103.

Im A, Pavletic SZ. Tsarin dashen Hematopoietic. A cikin: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff na Clinical Oncology. Na 6 ed. Philadelphia, PA: Elsevier; 2020: babi na 28.