Mí katã míenya vɔvɔ̃ kple dzimaɖitsitsi si dona tso eme ne míese tso ɖɔkta gbɔ be ʋumedɔ sesẽ aɖe alo ʋumekansa le ƒomea me tɔ alo xɔlɔ̃ aɖe ŋu. Gake le ŋgɔyiyi siwo wowɔ le atikewɔwɔ me egbea ta la, atike sẽŋuwo li siwo ate ŋu ada dɔléle mawo. Woyɔa atikewɔwɔ mawo dometɔ ɖeka si xɔa ame ɖe agbe be "Allogeneic Stem Cell Transplant." Togbɔ be ŋkɔa aɖi nya sesẽ hã la, mina míaƒo nu tso nusi dzɔna le esia me ŋu bɔbɔe ŋutɔ .
Nuka tututue nye allogeneic stem cell transplant?
Kpuie ko la, esia bia be nàɖe lãmenugbagbevi siwo le dɔ lém, siwo mewɔa dɔ nyuie o la ɖa le wò ŋutilã me eye nàtsɔ lãmenugbagbevi siwo le lãmesẽ me, siwo sɔ ɖe wo nɔewo nu, siwo tso ame bubu (ame si tsɔ nunala) gbɔ aɖo wo teƒe.
Azɔ mina míagaɖe nya sia me vie.
- Lãmenugbagbeviwo: Míate ŋu ayɔ esiawo hã be "dada lãmenugbagbeviwo" elabena lãmenugbagbevi siawo le abe dɔwɔƒe si wɔa ʋumenugbagbevi bubu siwo katã le míaƒe ŋutilã me (ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, ʋumenugbagbevi dzĩwo). Míaƒe ƒumeŋuɖui mee lãmenugbagbevi siawo le wu.
- Allogeneic: Nya sia gɔmee nye "woxɔe tso ame bubu gbɔ." Esia fia be atikewɔwɔa zãa lãmenugbagbevi siwo tso nunala si le lãmesẽ me, si sɔ gbɔ, ke menye wò ŋutɔ tɔwò o.
Tsɔe be míaƒe ƒumeŋuɖui le abe agble nyui aɖe si dzi anyigba nyui le ene. Agble sia mee míaƒe ʋumenugbagbeviwo tsina le. Gake le dɔléle abe ʋumenugbagbeviɣidɔ ene me la, agble sia gblẽna, eye gbewo (kansa lãmenugbagbeviwo) tsina ɖe nuku nyuiawo teƒe. Eyata le atikewɔwɔ sia me la, woɖea anyigba ma si gblẽ (ƒumeŋuɖui si ŋu dɔléle le) ɖa keŋkeŋ eye wotsɔa anyigba yeye si le lãmesẽ me, si tsea nu (ame si tsɔe na ƒe lãmenugbagbeviwo) ɖoa eteƒe. Emegbe, ʋumenugbagbevi siwo le lãmesẽ me dzea tsitsi gɔme le anyigba yeye ma dzi.
Dɔdamɔnu sia nye esi ŋu ŋusẽ le si ate ŋu ada dɔléle sesẽ aɖewo keŋkeŋ. Zi geɖe la, ɖɔktawo zãa atike sia ne dɔdamɔnu bubuwo do kpo nu alo ne dɔlélea gadze egɔme ake.
Nɔnɔme kawo ƒomevie wozãa atike sia na?
Zi geɖe la, wozãnɛ na dɔléle siwo do ƒome kple ʋu kple dɔlélenutsiŋutete. Dɔléle vevi aɖewoe nye esi.
| Atikewɔwɔ ƒe nɔnɔme | Numeɖeɖe bɔbɔe aɖe |
|---|---|
| Ʋumenugbagbeviɣidɔ Sesẽ (ALL) . | Lymphocytes, si nye ʋumenugbagbevi ɣi ƒomevi aɖe si le ʋu kple ƒumeŋuɖui me, va zua kansa lãmenugbagbeviwo. |
| Ʋumenugbagbeviɣidɔ (AML) . | Ʋumenugbagbevi siwo dona tso myeloid stem cells me ƒe kansa. |
| Aplastic Ʋusɔgbɔdɔ | Nusiwo gblẽ le ƒumeŋuɖui ŋu wɔnɛ be ŋutilãa mete ŋu wɔa ʋumenugbagbevi yeye siwo sɔ o. |
| Lãmetsiŋusẽ ƒe dɔléle | Kansa si dzɔna le ʋukawo me. |
| Myelodysplastic Dɔléle si woyɔna be Myelodysplastic Dɔléle | Ʋumenugbagbevi siwo le lãmesẽ me ƒe wɔwɔma edziedzi le ƒumeŋuɖui me. |
| Sickle Cell Dɔléle | Domenyiŋusẽ ƒe dɔléle si me ʋumenugbagbevi dzĩwo ƒe nɔnɔme trɔna eye woƒe dɔwɔwɔ me gblẽna le. |
Aleke nèdzrana ɖo ɖe atikewɔwɔ ŋu?
Esi wònye be esia nye atikewɔwɔ gã aɖe ta la, atikewɔlawo ƒe ƒuƒoƒoa awɔ dodokpɔ geɖe do ŋgɔ be woakpɔ egbɔ be wò ŋutilã ate ŋu ado dzi atsɔe.
- Ʋudodokpɔ: Wowɔa nuwo abe ʋu ƒe xexlẽme blibo (CBC) ene tsɔ léa ŋku ɖe ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ ŋu.
- Dzidodokpɔwo: Echocardiogram (be woakpɔ alesi dzia le dɔ wɔm nyuie) kple electrocardiogram (EKG) be woakpɔ dzia ƒe ʋuʋu.
- Wowɔa dodokpɔwo tsɔ léa ŋku ɖe aklã kple ayiku ƒe dɔwɔwɔ ŋu .
- Ƒumeŋuɖui Ŋuti Numekuku: Ne kansa le ŋuwò la, woɖea ƒumeŋuɖui sue aɖe hedonɛ kpɔna be dɔlélea ƒe nɔnɔme kple afɔku si le eme be wòagadzɔ ake.
Ne wonya wɔ dodokpɔ siawo katã eye wokpɔe be ènye ame nyui aɖe ko la, atikewɔwɔa ƒe akpa vevitɔ kekeake, si woyɔna be "pre-transplant conditioning" dzea egɔme. Esia bia be woazã atike alo keklẽŋusẽdɔdamɔnu si sɔ gbɔ ɖe ŋutilã bliboa me. Esia ate ŋu anye ɣeyiɣi sesẽ aɖe. Gake ele vevie ŋutɔ.
Nukatae atikewɔwɔ do ŋgɔ sia le vevie nenema gbegbe ɖo?
- Egblẽa kansadɔlékui ɖesiaɖe si susɔ le wò ŋutilã me.
- Eɖea lãmenugbagbevi xoxo siwo ŋu dɔléle le ɖa le wò ƒumeŋuɖui me eye wònaa teƒe lãmenugbagbevi yeyewo be woatsi.
- Egbɔdzɔa wò dɔlélenutsiŋutete hena ɣeyiɣi aɖe. Wowɔa esia be wòaxe mɔ na wò ŋutilã be wòagadze lãmenugbagbevi yeye siwo wona la dzi ahagbe wo o.
Ele be nànɔ kɔdzi kwasiɖa ɖeka alo eve hena atikewɔwɔ sia.
Nukae dzɔna le ŋkeke si dzi wodo lãmenugbagbeviawo na amea?
Le nyateƒe me la, lãmenugbagbeviwo dodo na ame ƒe ɖoɖoa le bɔbɔe ŋutɔ eye vevesese aɖeke mele eme o , abe ʋudodo ene.
Atikewɔlawo ƒe ƒuƒoƒoa ade mɔ̃ tɔxɛ aɖe ʋuka gã aɖe si le wò akɔta ƒe akpa si le etame la me. Woyɔa esia be Central Venous Catheter (CVC) . Wotsɔa akplo si me lãmenugbagbevi siwo le lãmesẽ me siwo tso nunala la gbɔ le la doa ka kple mɔ̃ sia. Emegbe wotsɔa lãmenugbagbeviawo dea wò ŋutilã me vivivi, toa wò ʋukawo me, kple wò ƒumeŋuɖui me, abe dzetsi ene.
Dɔ sia wɔwɔ xɔa abe miniti 30 va ɖo gaƒoƒo ɖeka ene. Le ɣeyiɣi sia me la, atikewɔlawo ƒe ƒuƒoƒoa anɔ axawò alé ŋku ɖe wò ʋu ƒe sisi kple dzi ƒe tsotso ŋu. Ɣeaɖewoɣi la, nu suesuesuewo ate ŋu ado tso eme.
- Vuvɔ ƒe seselelãme
- Gbɔgbɔ sesẽ vie
- Dzoxɔxɔ aɖe
Gake zi geɖe la, esiawo menyea nya veviwo o.
Nukae dzɔna le atikewɔwɔ vɔ megbe?
Ɣeyiɣi vevitɔ kekeake si me wohayana la dzea egɔme le lãmenugbagbeviwo dodo na ame megbe. Ahiã be nànɔ kɔdzi alo te ɖe eŋu kwasiɖa ʋɛ aɖewo kpee.
- Dɔlélenutsiŋutete dzi ɖuɖu: Woayi edzi anɔ dɔlélenutsiŋutete ƒe atikewo nam wò be wò ŋutilã nagadze lãmenugbagbevi yeyeawo dzi o eye be lãmenugbagbevi yeyeawo nagadze wò ŋutilã dzi o.
- Ʋudodo: Exɔa ɣeyiɣi aɖe hafi lãmenugbagbevi yeyeawo te ŋu dzea dɔwɔwɔ gɔme hewɔa lãmenugbagbevi dzĩwo kple ʋumenugbagbevi dzĩ yeyewo. Le ɣeyiɣi ma me la, ɖewohĩ ahiã be woado ʋu na wò.
- Takpɔkpɔ tso dɔlékuiwo me: Wò dɔlélenutsiŋutete gbɔdzɔna ŋutɔ le ɣeyiɣi sia me, eyata woléa ŋku ɖe ɖokuiwò takpɔkpɔ tso dɔlékuiwo kple dɔlékuiwo ƒe dɔlékuiwo me ŋu etɔxɛe.
Woyɔa mɔnu si dzi lãmenugbagbevi yeyeawo tona yia ƒumeŋuɖui me, nɔa afima, eye wodzea ʋumenugbagbevi yeyewo wɔwɔ gɔme be "engraftment." Esia ate ŋu axɔ abe ŋkeke 10 va ɖo 14 ene.
Ɣeyiɣi didi kae wòxɔna hafi wòhayana keŋkeŋ?
Esia nye nusi yia edzi didi. Ate ŋu axɔ ƒe eve alo esi wu nenema hafi wòahaya keŋkeŋ. Ate ŋu axɔ abe ƒe ɖeka ene hafi wò dɔlélenutsiŋutete nahaya.
Afɔku tɔxɛ si wòle be nànya: Dɔléle si nye Graft vs. Host Disease (GVHD) .
Esiae nye kuxi si bɔ wu le allogeneic transplant me. Kpuie ko la, edzɔna ne dɔlélenutsiŋutete ƒe lãmenugbagbevi yeye siwo tso nunala (si wodo) gbɔ dze wò ŋutɔ wò ŋutilã ƒe lãmenugbagbeviwo kple lãkusiwo (amesi xɔe) dzi . Ele abe "amedzro aɖe si dze amedzroxɔla dzi ene."
Esia ate ŋu anɔ bɔbɔe alo nu sesẽ. Esia tae wonaa dɔlélenutsiŋutete ƒe atikewo ɣesiaɣi ɖo. Ele be nànya nɔnɔme sia ƒe dzesiwo nyuie.
Dzesi siwo wòle be nàgblɔ na wò ɖɔkta enumake
Ne èyi aƒeme le atikewɔwɔ vɔ megbe la, ele be nàɖɔ ŋu ɖo vevie le dzesi aɖewo ŋu. Ne amesiawo dometɔ aɖe do la, yɔ wò atikewɔlawo ƒe ƒuƒoƒoa enumake.
| Dzesiwo ƒe hatsotso | Features siwo ŋu wòle be woalé ŋku ɖo |
|---|---|
| Dɔléle si nye Graft vs. Host (GVHD) ƒe dzesiwo ate ŋu anye: | |
| Ƒodo me | Dɔgbo ƒe vevesese, ʋuʋudedi kple ʋuʋudedi, aɖuɖɔtoe (ʋuʋudedi) . |
| Ŋutilã kple ŋkuwo | Ŋutilã ƒe ʋuʋu, ŋutigbalẽ kple/alo ŋku ƒe ɣie (jaundice) . |
| Ate ŋu anye dɔlékui aɖe ƒe dzesiwo | |
| Nɔnɔme siwo bɔ ɖe afisiafi | Asrã si ƒe dzoxɔxɔ nye Celsius 38 (Fahrenheit 100.4) alo esi wu nenema, vuvɔ wɔna |
| Yagbɔgbɔ ƒe ɖoɖo | Kɔdzi, aɖuɖɔtoe, ŋɔti me sisi, gbɔgbɔ sesẽ |
| Nɔnɔme bubuwo | Taɖuame, aɖuɖɔtoe enuenu, alo dzobibi ne ele aɖuɖɔ tom |
Vovototo si le "allogeneic" kple "autologous" dodoɖeŋgɔ dome
Ðewohĩ èse nu tso autologous stem cell transplant hã ŋu kpɔ. Vovototo vevitɔ si le wo ame evea domee nye afisi lãmenugbagbeviawo tso.
- Allogeneic: Woxɔa lãmenugbagbeviwo tso ame bubu (ame si naa lãmenugbagbeviwo) gbɔ.
- Autologous: Woxɔa lãmenugbagbeviawo le dɔnɔa si . Esia fia be woƒoa dɔnɔa ŋutɔ ƒe lãmenugbagbevi siwo le lãmesẽ me nu ƒu gbã eye emegbe wogbugbɔa wo naa wo le atike gbogbowo zazã vɔ megbe.
Allogeneic transplant ate ŋu ada dɔléle aɖewo siwo ate ŋu ade ame ƒe agbe afɔku me keŋkeŋ. Zi geɖe la, nunala siwo míenya o siwo míedo goe kpɔ o ye wɔa dɔ siawo siwo xɔa ame ɖe agbe. Ɣeaɖewoɣi la, ƒomea me tɔwo va zua nunala. Togbɔ be afɔkuwo le atikewɔwɔ sia me hã la, viɖe siwo le eŋu hã lolo ŋutɔ. Wò ɖɔkta aɖe nusiawo katã me na wò eye wòakpe ɖe ŋuwò nàwɔ nyametsotso si anyo na wò.
Gbedasi si Wotsɔ Yi Aƒeme
- Allogeneic stem cell transplant nye ƒumeŋuɖui si ŋu dɔléle le ɖɔliɖɔli kple stem cells tso nunala si le lãmesẽ me gbɔ.
- Esia nye atike sẽŋu aɖe si wozãna na ʋumenugbagbeviɣidɔ sesẽwo abe ʋumenugbagbeviɣidɔ, ʋumenugbagbeviɣidɔ, kple ʋusɔgbɔdɔ si woyɔna be aplastic anemia ene.
- Ele vevie be woadzra ŋutilãa ɖo kple atikewɔmɔnu alo keklẽŋusẽdɔdamɔnu si ƒe agbɔsɔsɔme sɔ gbɔ hafi woawɔ atike nɛ.
- Kuxi vevitɔ si ate ŋu ado mo ɖa le atikewɔwɔ vɔ megbe enye Graft vs. Host Disease (GVHD), eye ele vevie be nànya esia kple dɔlékui ƒe dzesiwo ɣesiaɣi.
- Esia nye dɔyɔyɔ ɣeyiɣi didi aɖe, eye ele vevie ŋutɔ be nàna wò ɖɔkta alo atikewɔha nanya tso kuxi ɖesiaɖe ŋu enumake.
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