Por Mateus Pitela e Leonardo Ferreira
Medula óssea é um tecido líquido-gelatinoso que ocupa o interior dos ossos, sendo conhecido popularmente por “tutano”. É ela quem desempenha um papel fundamental no desenvolvimento das células sanguíneas, pois é lá que são produzidos os leucócitos (glóbulos brancos), as hemácias (glóbulos vermelhos) e as plaquetas.
Os hemocentros regionais ou mais conhecidos como bancos de sangue públicos, são responsáveis por cadastrar os interessados em se tornar doadores de medula óssea. Os dados são agrupados em um registro único e nacional (Redome). Um indivíduo pode ser voluntário para a doação de sangue, doação de medula ou de ambos. É importante que este desejo seja explicitado no momento do cadastro. Mensalmente cerca de 150 pessoas são cadastradas na cidade de Ponta Grossa.
“O processo de busca do doador é simples e totalmente informatizado. O médico responsável inscreve as informações do paciente necessitado do transplante, incluindo o resultado do exame de histocompatibilidade – HLA (exame que identifica as características genéticas de cada indivíduo), no sistema do Registro Nacional de Receptores de Medula Óssea (Rereme). Após aprovação da inscrição do paciente, a busca é iniciada imediatamente”, explicou uma funcionária do hemonúcleo que não quis ser identificada na matéria.
Mas, para que serve o transplante de medula óssea? O tratamento é indicado para doenças relacionadas com a fabricação de células do sangue e com deficiências no sistema imunológico. Os principais beneficiados com o transplante são pacientes com leucemias originárias das células da medula óssea, linfomas, doenças originadas do sistema imune em geral, dos gânglios e do baço, e anemias graves (adquiridas ou congênitas). Outras doenças, não tão frequentes, também podem ser tratadas com transplante de medula, como as mielodisplasias, doenças do metabolismo, autoimunes e vários tipos de tumores. O transplante de medula óssea pode ser indicado para o tratamento de um conjunto de cerca de 80 doenças.
E o transplante consiste na substituição de uma medula óssea doente, ou deficitária, por células normais, com o objetivo de reconstituição de uma nova medula. O transplante pode ser autogênico ou alogênico. No caso dos autogênicos, a medula provém do próprio paciente. O alogênico é feito a partir de células precursoras de medula óssea obtidas de doador. A escolha entre um ou outro é baseada no tipo de câncer, na idade, no estado geral do paciente e na disponibilidade de um doador compatível. Depois de se submeter a um tratamento que destrói a própria medula, o paciente recebe a medula sadia como se fosse uma transfusão de sangue. Esse novo órgão é rico em células chamadas progenitoras, que, uma vez na corrente sanguínea, circulam e vão se alojar na medula óssea, onde se desenvolvem.
Durante o período em que estas células ainda não são capazes de produzir glóbulos brancos, vermelhos e plaquetas em quantidade suficiente para manter as taxas dentro da normalidade, o paciente fica mais exposto a infecções e hemorragias. Isso acontece por duas a três semanas e cuidados com a dieta, limpeza e esforços físicos são necessários. O paciente precisa ficar internado e, apesar de todos os cuidados, os episódios de febre são frequentes. Após a recuperação da medula, o paciente continua a receber tratamento, só que em regime ambulatorial, sendo necessário, em alguns casos, o comparecimento diário ao hospital.
A doação de medula óssea pode ser aparentada ou não aparentada. No primeiro caso, o doador é uma pessoa da própria família, em geral um irmão ou um dos pais. Há cerca de 25% de chances de encontrar um doador compatível na família. Já na doação não aparentada, as chances de o paciente encontrar um doador compatível são de uma em cada 100 mil pessoas, em média.
Havendo um irmão totalmente compatível (100%) este será a primeira escolha para ser um doador. Caso contrário, inicia-se a busca de alternativas para a realização do transplante.
Para quem quer se tornar um doador de medula óssea é necessário:
– Ter entre 18 e 55 anos de idade;
– Estar em bom estado geral de saúde;
– Não ter doença infecciosa ou incapacitante;
– Não apresentar doença neoplásica (câncer), hematológica (do sangue) ou do sistema imunológico.
Algumas complicações de saúde não são impeditivas para doação, sendo analisado caso a caso.
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