Na sɛ nkwammoaa foforo no bɛyɛ nipadua no tamfo nso ɛ? Nkyerɛkyerɛmu tiawa a ɛfa Graft vs. Host Disease (GvHD) ho bere a wɔde nipadua foforo ahyɛ obi foforo akyi

Fa no sɛ wɔama wo stem cell transplant a efi obi a ɔwɔ apɔwmuden hɔ sɛ yare bi te sɛ leukemia ayaresa. Wɔhwɛ kwan sɛ eyi bɛsa wo tebea no. Nanso ɛntaa nsi koraa sɛ, saa nkwammoaa foforo a ɛbaa sɛ wɔrebɛboa wo yi, wo nipadua no di mfomso sɛ "ɔtamfo" na efi ase tow hyɛ w'ankasa wo nkwammoaa so. Ɛno ne tebea a ɛyɛ den a yɛfrɛ no "Graft versus Host Disease" anaa GvHD tiawa.

Dɛn ne GvHD wɔ nsɛm a ɛnyɛ den mu?

Sɛ yɛbɛte eyi ase a, ɛsɛ sɛ yehu nsɛmfua abien. "Graft" kyerɛ ade a wɔde si ananmu, kyerɛ sɛ, ntini mu nkwammoaa a ɛwɔ apɔwmuden a wɔde ma wo fi abɔnten. "Host" kyerɛ host, kyerɛ sɛ, wo nipadua a egye saa nkwammoaa no. Enti "Graft versus Host" kyerɛ "graft ne host."

Mpɛn pii no, wɔyɛ saa ntini mu nkwammoaa a wɔde si ananmu yi a wɔfrɛ no allogeneic transplant de sa kokoram te sɛ mogya mu kokoram ne lymphoma, anaa nnompe mu ntini a entumi nyɛ adwuma yiye te sɛ aplastic anemia . Saa nkwammoaa a wɔde ahyɛ nipadua foforo mu yi ne nea efi ase wo nipadua no yɛ mogya mu nkwammoaa foforo.

Nanso, ɛtɔ da bi a saa nkwammoaa foforo yi nhu w’ankasa wo nkwammoaa. Wosusuw sɛ wɔyɛ ahɔho ntuafo. Enti, wofi ase tow hyɛ w’akwaa a ɛte apɔw, te sɛ wo honam ani, wo mmerɛbo, ne wo dwensɔtwaa so. Ɛno ne nea GvHD yɛ.

GvHD ahorow atitiriw abien na ɛwɔ hɔ:

Wobetumi akyekyɛ GvHD mu ayɛ no ahorow atitiriw abien. Bere bi a atwam no, na wɔkyekyɛ eyi mu sɛnea bere a yare no ho sɛnkyerɛnne no fi ase te. Nanso seesei, nnuruyɛfo nam yare no ho sɛnkyerɛnne, nea efii sɔhwɛ mu bae, ne bere a yare no ho sɛnkyerɛnne no fi ase a wɔhwɛ so na ɛkyerɛ ɔkwan pɔtee a wɔfa so yɛ no.

• Acute GvHD (aGvHD): Eyi taa ba wɔ nnafua 100 a edi kan wɔ nipadua no mu akyi. Nanso ɛtɔ mmere bi a ebetumi aba akyiri yi. Saa ɔkwan yi ka wo honam ani, yafunu mu nhyehyɛe (dwensɔtwaa), ne mmerɛbo titiriw.
• GvHD a enni sabea (cGvHD): Saa ɔkwan yi betumi aba bere biara wɔ nipadua foforo akyi, nanso ɛtaa ba wɔ mfe abien a edi kan no mu . Ebetumi aka nipadua no fã biara, a honam ani, ano, mmerɛbo, ahurututu, dwensɔtwaa, ntini, nkwaa, ne ɔbarima ne ɔbea nna ho.

Obi a wɔayɛ no foforo no betumi anya saa ahorow abien yi mu biako, abien no nyinaa, anaasɛ obetumi anya apɔwmuden a emu biara nka ho.

Dɛn ne GvHD ho sɛnkyerɛnne ahorow?

GvHD ho sɛnkyerɛnne betumi afi nea emu nyɛ den koraa, kosi nea ɛkɔ fam so, kosi nea emu yɛ den, na ɛde nkwa mpo to asiane mu. Momma yɛnhwɛ sɛnkyerɛnne ahorow a ɛbata saa ahorow abien yi ho.

Dɛn nti na saa GvHD yi ba?

Eyi yɛ nyansahu mu asɛm kakra, nanso mɛkyerɛkyerɛ mu tiawa.

Mpɛn pii no, yɛn nipadua mu nkwammoaa a ɛko tia nyarewa no bɔ yɛn ho ban fi nyarewa ho denam ahɔho a wɔtow hyɛ yɛn so te sɛ mmoawa ne mmoawa a wɔko tia no so. Nanso saa nkwammoaa no ntow nhyɛ yɛn ankasa nkwammoaa so da. Nea enti a ɛte saa ne sɛ protein soronko bi wɔ yɛn nkwammoaa nyinaa ani. Wɔfrɛ eyi Human Leukocyte Antigens (HLA) .

Gye mmanoma a wɔyɛ pɛ a, ɛsono obiara HLA.

Sɛ wonya stem cell transplant a, mogya nkwammoaa foforo a wɔde saa nkwammoaa no yɛ no wɔ onipa a ɔde nkwammoaa no maa wo no HLA. Sɛ saa HLA no yɛ soronko dodo wɔ wo HLA ho a, saa nkwammoaa foforo no hwɛ nkwammoaa a ɛwɔ wo nipadua mu no na wosusuw sɛ, "Eyi yɛ ntuafo, ne ID ne yɛn de no nhyia." Ɛno na saa nkwammoaa no fi ase tow hyɛ wo nipadua so.

Esiane eyi nti, nnuruyɛfo hwɛ nea ɔde ma no ne nea wɔde ma no no HLA yiye hwɛ sɛ wɔbɛn wɔn ho wɔn ho sɛnea wobetumi ansa na wɔayɛ nipadua foforo. Nanso gye sɛ wogye nkwammoaa fi mmanoma mu, asiane bi wɔ hɔ bere nyinaa sɛ wobenya GvHD.

Hena na ɔwɔ asiane kɛse mu sɛ obenya GvHD?

Asiane a ɛho hia sen biara ne HLA a ɛne ne ho nhyia, nanso nneɛma afoforo pii nso betumi adi dwuma.

Afei nso, sɛ woanya Acute GvHD (aGvHD) dedaw a, asiane kɛse wom sɛ wubenya Chronic GvHD (cGvHD).

Ɔkwan bɛn so na wohu tebea yi na wɔsa?

Nhwehwɛmu a wɔyɛe

Wo duruyɛfo no behu GvHD denam nipadua mu nhwehwɛmu a ɔbɛyɛ, wo yare no ho sɛnkyerɛnne a ɔbɛhwɛ, ne mogya mu nhwehwɛmu ne nipadua mu nhwehwɛmu a ɔbɛyɛ so. Nea ɛka biopsy ho ne sɛ wɔfa honam ani fã ketewaa bi anaa ntini a ɛka no na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu. Esiane sɛ GvHD a enni sabea ho sɛnkyerɛnne ahorow bi te sɛ tebea afoforo nti, wo duruyɛfo no bɛpow tebea afoforo ansa na wahu GvHD.

Ayaresa

Nea ɛbɛyɛ na woasiw GvHD ano wɔ nipadua foforo a wɔde bɛma wo akyi no, wɔbɛma wo nnuru a ɛmma nipadua no tumi ko tia nyarewa a esiw wo nipadua mu ahoɔden a ɛko tia nyarewa ano. Saa nnuru yi yɛ adwuma denam tumi a ahɔho nkwammoaa tumi tow hyɛ wo nipadua so no so tew so.

• Wɔ GvHD a emu yɛ den (aGvHD) ho: Mpɛn pii no, wɔde corticosteroids ma sɛ nnuru a wɔde twitwiw nipadua no, nnuru a wɔde twitwiw nipadua no mu, anaasɛ sɛ aduru a wɔde hyɛ honam ani. Sɛ eyinom ntumi nni yare no so a, wobetumi asusuw nnuru afoforo te sɛ Ruxolitinib (Jakafi®) anaa ayaresabea sɔhwɛ ahorow ho.
• Wɔ GvHD a Enni sabea (cGvHD) ho: Wɔma nnuru a ɛtra hɔ kyɛ a ɛma nipadua no tumi ko tia nyarewa nso ma eyi. Sɛ eyinom ntumi nni tebea no so a, ebia ɛho behia sɛ wɔde nnuru te sɛ Ruxolitinib (Jakafi®), Belumosudil (RezurockTM), Ibrutinib (Imbruvica®) anaa ayaresa titiriw te sɛ photopheresis di dwuma.

Nsunsuanso bɔne a efi ayaresa mu ba

Saa ayaresa ahorow yi siw wo nipadua mu tumi a ɛko tia nyarewa no ano, na ɛma wo nipadua no tumi ko tia nyarewa no so tew. Eyi ma asiane a ɛwɔ hɔ sɛ wubenya fungal, bacteria, ne virus nyarewa no yɛ kɛse. Wo duruyɛfo nso bɛkyerɛw nnuru a ɛbɛboa ma wɔasiw nyarewa a ebetumi de wo nkwa ato asiane mu yi ano.

Nsunsuanso afoforo a ebetumi aba esiane GvHD nti

So GvHD de nkwa to asiane mu?

Yiw, GvHD betumi de nkwa ato asiane mu. GvHD a enni sabea titiriw ne ade titiriw a ɛde owu ba wɔ ntini mu nkwammoaa a wɔde ma obi foforo akyi, a ɛnyɛ yare titiriw no. Ɛno nti na ɛho hia sɛ wo ne wo duruyɛfo susuw asiane ahorow no ho ansa na woayɛ ayaresa biara no.

So mfaso bi wɔ GvHD so?

Nea ɛyɛ nwonwa no, yiw. GvHD wɔ mfaso ahorow bi. Saa nkwammoaa foforo a ɛko tia nyarewa a ɛtow hyɛ wo nkwammoaa a ɛte apɔw so yi nso hwehwɛ kokoram nkwammoaa biara a ebia aka wɔ wo nipadua mu na wɔsɛe no. Wɔfrɛ eyi sɛ "graft-versus-tumor effect." Enti, nhwehwɛmu ahorow ada no adi sɛ ayarefo a wonya GvHD no ntaa nnya wɔn kokoram bio.

Nneɛma a wubetumi ayɛ ama w’ahobammɔ

Wo duruyɛfo bɛkyerɛkyerɛ sɛnea ɛsɛ sɛ wohwɛ wo ho bere a wɔde wo nipadua foforo ama wo no mu. Hwɛ yie titire wɔ saa nneɛma yi ho sɛ wowɔ asiane mu sɛ wobɛnya GvHD a.

• Bɔ wo ho ban fi owia ho: Owia a wobɛda no betumi ama GvHD asɛe kɛse. Enti hyɛ ntade a nsa tenten ne pantalon atenten bere a worekɔ abɔnten no. Fa aduru a ɛbɔ wo ho ban fi owia ho a anyɛ yiye koraa no SPF 50 wom di dwuma.
• Ano mu ahotew: Hohoro wo sẽ yiye na ama asiane a ɛwɔ hɔ sɛ wubenya anom yare no so atew.
• Aduan ne anonne: Kwati nnuan a ɛyɛ nnuhwam, srade, ne nnuan a ebetumi ama w’anom akisikuru.
• Bɔ wo ho ban fi mmoawa ho: Esiane sɛ wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw nti, kwati mmeae a nyarewa atrɛw ne mmeae a nnipa ahyɛ hɔ ma. Ma wo nsa ho ntew bere nyinaa.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Ɛho hia sɛ wobɔ wo duruyɛfo amanneɛ ntɛm ara sɛ wuhu nsakrae bi wɔ wo nipadua mu, titiriw sɛnkyerɛnne a ɛkyerɛ sɛ wowɔ ɔyare mmoawa anaasɛ atiridiinini a ɛyɛ digrii Celsius 38 (100.4 Fahrenheit) anaa nea ɛboro saa a. Nyarewa betumi ayɛ nea emu yɛ den ntɛmntɛm bere a worenom nnuru a esiw nipadua no mu tumi a ɛko tia nyarewa ano no.

Wo duruyɛfo bɛhwɛ wo daa wɔ wo nipadua foforo akyi de ahwɛ sɛ ebia nsɛnnennen te sɛ GvHD anaa. Sɛ sɛnkyerɛnne ahorow no ba a, wɔbɛsesa wo nnuru anaa wɔbɛkyerɛw foforo ama wo. Ɛho hia yiye sɛ wobɛnom nnuru a wɔakyerɛw ama wo nyinaa sɛnea wɔakyerɛ wo no na wudi wo duruyɛfo akwankyerɛ akyi.