Mang 2 DNA trong cơ thể: Cái giá đắt phải trả để tồn tại như một quái thú


Những người Chimera đã gây ra đủ mọi rắc rối, từ tội phạm thoát án tới chuyện bố đẻ không phải là cha ruột.

Một bộ phim năm 2015 có tựa đề là Bad Blood, kể về một cô gái bị vu cáo là sát thủ giết người. Điều đáng nói là mọi dấu vết cảnh sát tìm thấy ở hiện trường đều trùng khớp với mẫu DNA của cô.

Cũng một tập phim khác của series Law and Order SVU, kịch bản xảy ra tương tự nhưng ngược lại. Một kẻ hiếp dâm có thể nhởn nhơ ngoài vòng pháp luật vì DNA ở hiện trường không trùng khớp với mẫu DNA trong máu hắn.

Điều gì đã xảy ra? Chúng ta đều biết rằng mỗi mẫu DNA chỉ nhận dạng và định nghĩa lên một con người. Nó là cơ sở, không chỉ cho ngành pháp y, mà còn nhiều lĩnh vực khác trong khoa học và đời sống. Thế nhưng bây giờ, bạn phải biết rằng cơ sở này đã không còn đúng một cách tuyệt đối nữa:

Một người hoàn toàn có thể mang trong mình hai DNA khác nhau.

Không giống như trường hợp bệnh nhân đa nhân cách, tưởng tượng ra một con người khác bên trong đầu mình, người có 2 DNA đang sống chung cơ thể với một con người khác thực sự. Con người khác này là con người vật lý, bởi họ có thể biết được da, móng tay, gan hay máu… không phải là của mình. Chúng đang mang một DNA khác hẳn với phần còn lại của cơ thể.

Cuộc sống sẽ ra sao nếu có 2 DNA trong cơ thể?

Trong cả Bad Blood và Law and Order SVU, hai tên tội phạm đều đã từng trải qua một phẫu thuật ghép tủy xương. Kỹ thuật cấy các tế bào máu gốc này khiến cho người nhận tủy sản xuất ra các tế bào máu mang DNA của người hiến tặng.

Lúc này, những tên tội phạm có 2 loại DNA và được gọi là người Chimera, thuật ngữ đặt theo tên một quái thú ba đầu trong thần thoại Hy Lạp.

Chimera có nguồn gốc từ Tiểu Á, là con của Typhon và Echidna. Nó có họ hàng với chó ba đầu Cerberus và quái vật Hydra. Chimera có thân hình của một con sư tử, nhưng trên thân lại mọc ra một cái đầu dê và đuôi lại là một con rắn.

Theo Trung tâm Ung thư Seattle Cancer Care Alliance, thuật ngữ “Chimera” đang được sử dụng với khái niệm về những thực thể pha trộn, đề cập đến những người đã được ghép mô dị di truyền. Kỹ thuật chẳng hạn như ghép tủy xương, các tế bào máu gốc chưa trưởng thành có thể phát triển thành tế bào bạch cầu, hồng cầu và tiểu cầu trong cơ thể người nhận, nhưng chúng sẽ mang DNA của người hiến tặng.

Không chỉ có trong thần thoại và phim ảnh, bạn có tin trên hành tinh này, vào ngay thời điểm này, tồn tại hàng trăm ngàn người mang 2 DNA khác nhau? Theo thống kê tới năm 2013, cả thế giới dã ghi nhận 1 triệu ca ghép tủy, và một nghiên cứu chỉ ra rằng gần 50% những ca ghép sẽ tạo ra người Chimera.

a2
Quái thú Chimera trong thần thoại Hy Lạp

Những người Chimera đã gây ra đủ mọi rắc rối, từ việc những tên tội phạm thoát án tới chuyện bố đẻ không phải là cha ruột. Các nhà lập pháp vì vậy đã phải đưa yếu tố ghép tủy xương vào một trường hợp đặc biệt trong pháp y.

Tuy nhiên, bạn đừng nghĩ rằng bất kể một người Chimera nào cũng sống nhởn nhơ như một tên tội phạm trên phim ảnh. Thực tế, đó có thể là một tình trạng bất đắc dĩ, Chimera sẽ gây ra những nỗi thống khổ cho người sau ghép tủy: một cuộc chiến giữa tế bào ghép và tế bào chủ gọi là bệnh ghép chống chủ (graft vs. host disease- GVHD). Việc sở hữu tới 2 DNA, thực sự, giống như có 2 người đang giằng xé nhau bên trong cơ thể họ.

Ronni Gordon là một trong số những người Chimera như vậy, sau khi cô cấy tủy tới 4 lần vì bệnh ung thư máu. Cô đã chia sẻ câu chuyện của mình trên trang Motherboard kể về cái giá mà mình phải trả cho sự tồn tại dưới hình hài một “quái thú 3 đầu”. Nhóm máu của Gordon đã thay đổi thành máu của người hiến tủy, DNA trong máu của cô khác hẳn với DNA của cơ thể.

Gordon đã phải chống chọi với GVHD trong suốt 13 năm qua. Gan, da và hệ tiêu hóa của cô bị tàn phá bởi việc có tới 2 loại DNA. Nó khiến cho Gordon phải điều trị GVHD cho đến hết cuộc đời. Mặc dù vậy, cô luôn nói rằng mình chấp nhận cái giá của việc đội lốt Chimera, chỉ để tiếp tục được sống, được nhìn thấy con cái mình lớn lên và trưởng thành.

Cũng như hàng trăm ngàn người mắc ung thư máu khác, Gordon nợ mạng sống của mình cho một nhà khoa học: E. Donnall Thomas (1920-2012) còn được gọi là “Cha đẻ của ghép tủy xương”. Năm 1957, Thomas xuất bản một báo cáo khoa học trình bày phương pháp mới trong điều trị ung thư máu. Trong đó bao gồm 3 liệu trình: xạ trị, hóa trị và cuối cùng là truyền tủy xương.

“Công trình đó đã khởi đầu cho một chuỗi dài các thí nghiệm và thử nghiệm lâm sàng khác. Kéo dài suốt hơn một thập kỷ, các thủ tục điều trị đã đạt tới những thành công đầu tiên”, bác sĩ Frederick R. Appelbaum viết trên tạp chí The New England Journal of Medicine với đầy sự cảm kích dành cho Thomas.

Năm 1990, Thomas đoạt giải Nobel cho phát hiện của mình, ông nói: “Trong những năm 1960 và thậm chí cả thập niên 70 sau đó, rất nhiều bác sĩ đã nói rằng thủ thuật của tôi không bao giờ làm việc. Một số còn cho rằng lẽ ra nó chẳng nên được thử nghiệm”.

a3
E. Donnall Thomas (trái), cha đẻ của ghép tủy xương, trong lễ trao giải Nobel dành cho ông

Thế nhưng, thực tế Thomas đã trở thành một người vĩ đại. Năm 2013, một năm sau ngày mất của ông, mạng lưới toàn cầu Blood and Marrow Transplantation công bố cột mốc đáng nhớ: 1 triệu ca ghép tế bào gốc đã được thực hiện thành công trên toàn thế giới.

Theo chương trình Be The Match hoạt động trong lĩnh vực hiến tặng tủy, mỗi năm trên toàn thế giới có 50.000 bệnh nhân được ghép tủy, 53% từ chính tế bào gốc của họ và 47% nhận các tế bào từ người khác hoặc máu dây rốn. Mỗi năm, có khoảng 24.000 bệnh nhân nhận được các tế bào hiến tặng.

Ghép tủy là một thủ thuật khó khăn và có lí do tại sao nhiều nhà khoa học và bác sĩ cùng thời Thomas nói công việc của ông là vô nghĩa.

Ban đầu, mọi thứ chúng ta quan sát được là nếu cấy những mô và tế bào ngoại lai vào cơ thể, hệ miễn dịch chẳng sớm thì muộn sẽ giết chết chúng. Hoặc là các tế bào cấy ghép sẽ lật ngược lại phá hủy cơ thể bệnh nhân. Trừ khi chúng ta tìm được một nguồn hiến tặng giống hệt, từ một người anh em song sinh chẳng hạn.

Nhưng Thomas đã tìm cách để giải quyết được vấn đề này. Ông sử dụng các loại thuốc ức chế miễn dịch để không cho quá trình xảy ra. Từ đó, bệnh nhân có thể nhận được cấy ghép từ người hiến tặng ngoài gia đình, Thomas sử dụng uy tín của mình để thúc đẩy một chương trình hiến tủy trên toàn nước Mỹ. Đó là lí do tại sao mọi bệnh nhân ung thư máu đều cảm thấy họ nợ sự tồn tại của mình ngày hôm nay với Thomas.

a4
Ronni Gordon (ngoài cùng bên phải) trong lễ tốt nghiệp của con gái cô

Như Gordon đã kể lại trong một bài viết tự sự trên New York Times, năm 2003, cô nhận chẩn đoán ung thư bạch cầu. Gordon đã được hóa trị và ghép tủy ngay sau đó, nhưng bệnh tình đã tái phát đi tái phát lại dẫn đến việc cô phải ghép tủy tất cả 4 lần.

Sử dụng một loại thuốc giúp Gordon kiểm soát được GVHD, nhưng “giải quyết được một vấn đề thường lại tạo nên một vấn đề khác”, cô than thở. Gordon đã uống Prednisone, một loại thuốc làm hệ miễn dịch suy yếu cực độ. Tệ hơn nữa là nó khiến cô mắc ung thư da tế bào vảy.

“Trong khoảng thời gian ban đầu điều trị với Prednisone liều cao, cao hơn mức 1mg mà tôi đang dùng bây giờ, tôi chỉ có thể đứng lên và ngồi xuống 1 chiếc ghế”, Gordon cho biết. “GVHD xảy ra ở da bụng tôi khiến nó cứng lại như một quả bóng bowling, bàn tay của tôi phồng lên và da trên đùi thì giống như một miếng nilon bọt bóng”.

Tình trạng lại đòi hỏi một giải pháp, lần này, các bác sĩ quyết định thực hiện cho Gordon một liệu pháp quang hóa ngoài cơ thể ECP (extracorporeal photopheresis). Nghe rất viễn tưởng, Gordon phải nằm một chỗ trong 3 tiếng đồng hồ. Người ta sẽ rút dần máu của cô ra ngoài, tách riêng các tế bào bạch cầu và dùng tia cực tím chiếu vào chúng. Mục đích của quá trình là làm biến đổi DNA của bạch cầu, để tạm thời chúng không quấy rối thêm nữa. Máu sau đó lại được truyền vào cơ thể Gordon.

Khi cô bắt đầu liệu pháp này vào hơn 1 năm trước, hai lần một tuần, cô phải đi hơn 100km để tới trung tâm gần nhất có thể thực hiện ECP. Nó gần như khiến cô mất cả nửa ngày trời. Nhưng cứ sau mỗi tuần, hiệu quả trở nên rõ rệt, da của Gordon đã mềm mại trở lại. Chẳng mấy chốc cuộc sống của cô trở lại bình thường.

a7
Gordon chấp nhận cái giá của một Chimera, để được nhìn thấy con cháu mình trưởng thành

Bây giờ, nhìn lại hơn 13 năm của Gordon với ung thư máu, việc trở thành một Chimera đã khiến cô vô cùng khổ sở. Nhưng Gordon vẫn mạnh mẽ chiến đấu và không hề phàn nàn bất cứ điều gì.

“Năm 2003, tôi thậm chí không tin rằng mình sẽ được nhìn thấy đứa con trai đầu của mình tốt nghiệp trung học. Nhưng tôi đã làm được điều đó. Tôi cũng đã chứng kiến lần lượt cả ba đứa con tốt nghiệp đại học và chào đón một cháu gái của mình”, Gordon cho biết trong hạnh phúc. Cô nói rằng với mình “trở thành Chimera vẫn còn là một cái giá quá hời để trả”.

Tham khảo Motherboard


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