Hoʻoneʻe iwi iwi

ʻO ke kuʻi ʻana o ka iwi iwi kahi hana e pani ai i nā iwi o ka iwi iwi i hōʻino ʻia a i ʻole luku ʻia.

ʻO ka iwi iwi ka mea momona, momona ma loko o kou mau iwi. Hoʻopuka ka iwi iwi i nā huna koko. ʻO nā hunaola nā hunaola ʻole i loko o ka iwi o ka iwi e hoʻāla i kāu mau ʻāpana koko ʻokoʻa.

Ma mua o ke transplant, chemotherapy, radiation, a i ʻole ʻelua paha e hāʻawi ʻia. Hana ʻia kēia i nā ala ʻelua:

• Ablative (myeloablative) lapaʻau - Hāʻawi ʻia ka chemotherapy kiʻekiʻe, radiation, a i ʻole ʻelua e pepehi i nā hunaola maʻi ʻaʻai. Pepehi pū kēia i nā iwi iwi olakino āpau e koe ana, a ʻae i nā hunaola hou e ulu i ka momona o ka iwi.
• Hoʻemi i ka hoʻomaʻamaʻa ikaika ʻana, i kapa ʻia hoʻi he transplan mini - Hāʻawi ʻia nā lāʻau ma lalo o ka chemotherapy a me ka radiation ma mua o kahi transplant. ʻAe kēia i ka poʻe kahiko, a me nā mea me nā pilikia olakino ʻē aʻe e loaʻa kahi transplant.

ʻEkolu ʻano o ka hoʻohuli iwi iwi:

• Ke kuʻi iwi ʻōiwi Autologous - ʻO ka manaʻo ʻo ka huaʻōlelo ʻoia iho. Lawe ʻia nā pūnaewele paʻa mai iā ʻoe ma mua o ka loaʻa ʻana o ka chemotherapy o ka lāʻau kiʻekiʻe a i ʻole ka lāʻau radiation. Mālama ʻia nā pūnaewele koʻokoʻo i loko o ka pahu hau. Ma hope o ka hoʻomaʻemaʻe chemotherapy kiʻekiʻe a i ʻole radiation radiation, hoʻihoʻi ʻia kāu mau ʻōpala i loko o kou kino e hana i nā hunaola maʻamau. Kapa ʻia kēia he transplant transplant.
• Ka hoʻoneʻe iwi ʻōiwi Allogeneic - ʻO ka manaʻo ʻo allo he mea ʻē aʻe. Lawe ʻia nā hunaola kumu mai kekahi kanaka ʻē aʻe, i kapa ʻia he mea hāʻawi. ʻO ka hapanui o nā manawa, pono nā genes o ka mea hāʻawi e hoʻohālikelike i kāu mau ʻāpana. Hana ʻia nā hoʻokolohua kūikawā e ʻike ai inā he hoʻokūkū maikaʻi ka mea hāʻawi kālā nāu. ʻO ke kaikaina a kaikuahine paha he pāʻani maikaʻi. I kekahi manawa kūlike ʻole nā ​​mākua, nā keiki, a me nā ʻohana ʻē aʻe. ʻO nā mea hāʻawi pili ʻole iā ʻoe, akā kūlike nō naʻe, e ʻike ʻia ma o nā kākau inoa iwi iwi lā.
• Kuhi ke kaula uila - ʻO kēia kahi ʻano o ke transplal allogeneic. Lawe ʻia nā hunaola koʻokoʻo mai ka umbilical pēpē hou o ka pēpē ma hope pono o ka hānau ʻana. Hoʻopaʻa ʻia nā pūnaewele koʻokoʻo a mālama ʻia a hiki i ka wā e pono ai lākou no kahi transplant. ʻAʻohe nui o nā hunaola kaula kaula Umbilical no laila aia ka liʻiliʻi o ka pono no ke kūlike ʻole. Ma muli o ka helu liʻiliʻi o nā hunaola, ʻoi aku ka lōʻihi o ka helu ʻana o ke koko e ola hou ai.

Hana ʻia kahi transplant cell stem ma hope o ka pau ʻana o ka chemotherapy a me ka radiation. Hāʻawi ʻia nā hunaola i loko o kou kahawai, ma o ka paipu i kapa ʻia he catheter venous central. Ua like ke kaʻina hana me ka loaʻa ʻana o ke koko. Hele nā ​​hunaola i loko o ke koko i ka iwi o ka iwi. ʻO ka hapanui o nā manawa, ʻaʻole pono kahi ʻoki.

Hiki ke hōʻiliʻili ʻia nā pūnaewele Donor ma nā ʻano ʻelua:

• ʻOhiʻohi iwi - Hana ʻia kēia ʻoki liʻiliʻi ma lalo o ka anesthesia ākea. ʻO kēia ka mea e hiamoe ka mea hāʻawi a ʻaʻohe ʻeha ma ke kaʻina hana. Lawe ʻia ka iwi iwi mai ka hope o nā iwi ʻelua. ʻO ka nui o ka momona i hoʻoneʻe ʻia ma muli o ke kaupaona o ke kanaka e loaʻa ana.
• Leukapheresis - ʻO ka mea mua, hāʻawi ʻia ka mea hāʻawi i mau lā o ke kī ʻana e kōkua i nā neʻe kūmole e neʻe mai ka iwi iwi i loko o ke koko. I ka wā leukapheresis, lawe ʻia ke koko mai ka mea hāʻawi ma o ka laina IV. Hoʻokaʻawale ʻia ka ʻāpana o nā hunaola koko keʻokeʻo i loaʻa nā hunaola i loko o kahi mīkini a hemo e hāʻawi ʻia i ka mea loaʻa. Hoʻihoʻi ʻia nā hunaola ʻulaʻula i ka mea hāʻawi.

Hoʻololi kahi transplant o ka iwi iwi i ka momona o ka iwi i hana ʻole ʻia a luku ʻia paha (ablated) e chemotherapy a i ʻole radiation. Manaʻo nā kauka no nā maʻi maʻi he nui, hiki i nā mea keokeo o ke koko ke hāʻawi aku i nā hunaola maʻi ʻea i koe, e like me ka wā e hoʻouka ai nā hunaola keʻokeʻo i nā bacteria a i ʻole nā ​​virus ke kaua nei i kahi maʻi.

Hiki i kāu kauka olakino ke ʻōlelo i kahi neʻe iwi o ka iwi inā loaʻa iā ʻoe:

• ʻO kekahi mau maʻi ʻino, e like me leukemia, lymphoma, myelodysplasia, a i ʻole myeloma maha.
• ʻO kahi maʻi e hoʻopili ai i ka hana ʻana o nā hunaola iwi, e like me ka anemia aplastic, neutropenia hikiwawe, nā maʻi ʻōnaehana pale ʻole, anemia maʻi maʻi maʻi, a me thalassemia.

Hiki i kahi transplant o ka iwi iwi ke hana i kēia mau ʻōuli:

• ʻEha ʻeha
• E kulu i ke kaomi koko
• Fever, chills, flushing
• ʻOno ʻoluʻolu i ka waha
• ʻEha poʻo
• ʻO Hives
• Nusea
• ʻEha
• Pokole o ka hanu

ʻO nā pilikia kūpono o ka hoʻoneʻe iwi iwi pili i nā mea he nui, e like me:

• Kou makahiki
• ʻO kou olakino holoʻokoʻa
• Pehea ka maikaʻi o ke kūlike i kāu mea hāʻawi
• Ke ʻano o ka hoʻohuli ʻana o ka iwi iwi i loaʻa iā ʻoe (autologous, allogeneic, a i ʻole ke koko umbilical cord)

Komo pū nā pilikia:

• Anemia
• ʻO ke kahe ʻana i ka akemāmā, ʻōpū, lolo, a me nā wahi ʻē aʻe o ke kino
• Kālepaʻa
• ʻO ka paʻa ʻana i nā uaua liʻiliʻi o ke ake
• Poino i nā puʻupaʻa, ke ake, nā akemāmā, a me ka puʻuwai
• Hoʻolohi ʻia ka ulu ʻana o nā keiki i loaʻa ka hoʻoliʻiliʻi iwi iwi
• Menopause mua
• Hewa ka huehue, ʻo ia hoʻi ʻaʻole i paʻa nā hunaola hou i loko o ke kino a hoʻomaka i ka hana ʻana i nā hunaola koʻokoʻo
• ʻO ka maʻi Graft-versus-host (GVHD), kahi ʻano e hoʻouka ai nā mea hāʻawi i kou kino ponoʻī
• Nā maʻi ʻino, kahi hiki ke koʻikoʻi loa
• ʻO ka hoʻohaunaele a me ka ʻeha ma ka waha, ka puʻu, ka esophagus, a me ka ʻōpū, i kapa ʻia ʻo mucositis
• ʻEha
• Nā pilikia ʻōpū, me ka maʻi pākī, kahoho, a me ka luaʻi

E nīnau kāu mea hāʻawi e pili ana i kāu mōʻaukala olakino a hana i kahi hoʻokolohua kino. E loaʻa iā ʻoe nā hoʻokolohua he nui ma mua o ka hoʻomaka ʻana o ka mālama ʻana.

Ma mua o ke kāpili ʻana, loaʻa iā ʻoe he mau paipu 1 a 2 paha, i kapa ʻia he catheters venous central, i hoʻokomo ʻia i loko o kahi kīʻaha koko i kou ʻāʻī a i ʻole nā ​​lima. Hāʻawi kēia paipu iā ʻoe e loaʻa i nā lāʻau, nā wai, a i kekahi manawa ka meaʻai. Hoʻohana ʻia ia e huki i ke koko.

E kūkākūkā paha kāu mea hāʻawi i ke kaumaha o ka naʻau o ka lawe ʻana i ka iwi iwi. Makemake paha ʻoe e launa me ke kākāʻōlelo. He mea nui e kamaʻilio me kou ʻohana a me kāu mau keiki e kōkua iā lākou e hoʻomaopopo i ka mea e kali ai.

Pono ʻoe e hana i nā hoʻolālā e kōkua iā ʻoe e hoʻomākaukau no ke kaʻina hana a lawelawe i nā hana ma hope o kāu transplant:

• Hoʻopau i kahi kuhikuhi mālama mua
• Hoʻonohonoho i ka hoʻomaha olakino mai ka hana
• Mālama i nā hōʻike panakō a kālā paha
• Hoʻonohonoho hoʻonohonoho mālama holoholona
• E hoʻonohonoho no kekahi e kōkua i nā hana o ka hale
• E hōʻoia i ka ʻinikua olakino
• Uku uku
• E hoʻonohonoho no ka mālama ʻana i kāu poʻe keiki
• E ʻike i nā hale nou a i ʻole kou ʻohana kokoke i ka haukapila, inā pono

Hana ʻia kahi transplant o ka iwi iwi i ka haukapila a i ʻole kahi kikowaena olakino e loea i kēlā ʻano lapaʻau. ʻO ka hapa nui o ka manawa, noho ʻoe i loko o kahi ʻāpana hoʻoneʻe iwi iwi kūikawā i waenakonu. ʻO kēia ka palena o kou manawa o ka loaʻa ʻana i ka maʻi.

Kaukaʻi ʻia i ka lāʻau a me kahi e hana ʻia ai, e hana ʻia i nā mea āpau a ʻāpana paha o kahi autologous a allogeneic transplant paha ma ke ʻano he mea maʻi. ʻO kēia ʻaʻole pono ʻoe e noho i ka haukapila i ka pō.

Pehea kou lōʻihi e noho ai i ka haukapila e pili ana:

• Inā ʻoe i hoʻomohala i nā pilikia e pili ana i ke transplant
• Ke ʻano o ke transplant
• Nā kaʻina hana o kāu kikowaena olakino

ʻOiai ʻoe ma ka haukapila.

• E nānā pono ke kime mālama ola i kou helu ʻana i ke koko a me nā hōʻailona koʻikoʻi.
• E loaʻa iā ʻoe nā lāʻau e pale aku ai i ka GVHD a pale a mālama ʻana paha i nā maʻi, e laʻa me nā antibiotic, antifungals, a me nā lāʻau antiviral.
• E pono paha ʻoe i ka nui o ke kuʻi koko.
• ʻAi ʻia ʻoe ma o ke aa (IV) a hiki i kou wā e ʻai ai me ka waha, a ua hala nā ʻaoʻao a me nā ʻeha o ka waha.

Ma hope o kou haʻalele ʻana i ka haukapila, e mālama pono i nā ʻōlelo aʻo e pili ana i ka mālama ʻana iā ʻoe iho ma ka home.

Maikaʻi kāu hana ʻana ma hope o ka loli ʻana i ka:

• Ke ʻano o ka hoʻoneʻe iwi iwi
• Pehea ka maikaʻi o ke kūlike o nā hunaola o kāu
• He aha ke ʻano maʻi ʻaʻai a maʻi paha āu
• ʻO kou mau makahiki a me kou olakino holoʻokoʻa
• Ke ʻano a me nā mahele lāʻau o ka chemotherapy a i ʻole radiation therapy āu i loaʻa ai ma mua o kāu transplant
• Nā pilikia i loaʻa iā ʻoe

Hiki i kahi ʻōiwi ʻōiwi ke hoʻōla pono i kāu maʻi. Inā kūleʻa ke transplant, hiki iā ʻoe ke hoʻi i ka hapa nui o kāu mau hana maʻamau ke ʻike ʻoe i lawa maikaʻi. ʻO ka maʻamau maʻamau a 1 makahiki e hoʻōla piha, kaukaʻi ʻia i ka hopena o nā pilikia.

Hiki i nā kūpilikiʻi a i ʻole kūleʻa paha o ka hoʻoneʻe ʻana o ka iwi iwi ke make.

Transplant - iwi iwi; Ke hoʻoiho paʻa ʻōiwi; Ke kuʻi ʻana o ke koʻokoʻo Hematopoietic; Hoʻemi i ka hoʻoliʻiliʻi nonmyeloablative ikaika; Kaʻi liʻiliʻi; Ka hoʻoneʻe iwi ʻōiwi Allogenic; Ke kuʻi iwi o Autologous; Ka hoʻoliʻiliʻi koko Umbilical cord; Anplastic anemia - hoʻoneʻe iwi o ka iwi; Leukemia - hoʻoneʻe iwi o ka iwi; Lymphoma - hoʻoiho iwi; Myeloma maha - transplant o ka iwi iwi

• Kahe i ka wā o ka maʻi maʻi maʻi
• Hoʻoneʻe iwi iwi - hoʻokuʻu
• ʻO ka catheter venous waena - ka loli lole
• Catheter venous waena - flushing
• Ka inu ʻana i ka wai me ka palekana i ka wā o ka mālama ʻana i ka maʻi ʻaʻai
• ʻO ka waha maloʻo i ka wā o ka mālama ʻana i ka maʻi ʻaʻai
• Keʻai nei i nā calorie keu ke maʻi - nā mākua
• Keʻai nei i nā calorie keu ke maʻi - keiki
• Mucositis oral - mālama pono iā ʻoe iho
• Hoʻokomo ʻia peripherally catheter waena - flushing
• ʻAi palekana i ka wā o ka mālama ʻana i ka maʻi ʻaʻai

• ʻIʻini iwi iwi
• Nā mea i hana ʻia o ke koko
• ʻO ka iwi iwi mai ka pūhaka
• Ka hoʻoneʻe iwi-iwi

ʻAhahui ʻAmelika o ka Clinical Oncology pūnaewele. He aha ke kuʻi iwi o ka iwi (trans cell cell transplant)? www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-bone-marrow-transplant-stem-cell-transplant. Hoʻohou ʻAukake 2018. Loaʻa iā Pepeluali 13, 2020.

Heslop HE. ʻO ka nānā a me ke koho o ka mea hāʻawi o ka hematopoietic stem cell transplantation. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 103.

ʻO wau A, Pavletic SZ. Ke transplantation o ke koʻokoʻo Hematopoietic. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 28.