Ðewohĩ ɖɔkta aɖe ƒo nu kple ƒometɔ alo xɔlɔ̃ aɖe tso ‘lãmenugbagbevi siwo wodona ɖe lãme na ame’ ŋu. Alo ɖewohĩ wodo atike sia ƒe aɖaŋu na wò na atikewɔwɔ me dɔléle aɖe abe ʋumenugbagbeviɣidɔ ene. Enye nusi sɔ ŋutɔ be vɔvɔ̃ kple vɔvɔ̃ natsi vie ne èse ŋkɔ sia. Gake esia nye atikewɔwɔ vevi aɖe ŋutɔ si ate ŋu axɔ ame geɖe ɖe agbe. Eyata egbea, mina míaƒo nu bɔbɔe ŋutɔ eye eme nakɔ tso nusi ‘Allogeneic Stem Cell Transplant’ sia nye, alesi wowɔae, kple afɔku siwo le eme ŋu.
Kpuie ko la, nukae nye allogeneic stem cell transplant?
Esia gɔmesese le bɔbɔe ŋutɔ. Allogeneic stem cell transplant nye ne woɖe wò ŋutɔ wò stem cells siwo ŋu dɔléle le ɖa eye wotsɔ stem cells tso nunala si le lãmesẽ me, si sɔ gbɔ ɖɔ li wo. Lãmenugbagbevi siawo nye lãmenugbagbevi tɔxɛ aɖe si le míaƒe ƒumeŋuɖui me si ate ŋu atrɔ azu ʋumenugbagbevi ƒomevi ɖesiaɖe (ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, ʋumenugbagbevi dzĩwo).
Ne lãmenugbagbevi siawo siwo wotsɔ na wò le lãmesẽ me ge ɖe wò ŋutilã me la, wozɔa mɔ yia wò ƒumeŋuɖui me eye wodzea ʋumenugbagbevi yeye siwo le lãmesẽ me wɔwɔ gɔme. Esia nye atike sẽŋu aɖe si ate ŋu ada dɔléle sesẽ aɖewo gɔ̃ hã keŋkeŋ. Zi geɖe la, ɖɔktawo zãa atike sia ne dɔdamɔnu bubuwo do kpo nu alo ne dɔlélea gadze ake.
Nɔnɔme kawoe wozãa atikewɔwɔ sia na?
Wozãa allogeneic stem cell transplantation koŋ na dɔléle siwo do ƒome kple ʋu kple dɔlélenutsiŋutete.
| Nɔnɔme vevi siwo ŋu woda dɔ na |
|---|
| Ʋumenugbagbeviɣidɔ Sesẽ (ALL) . |
| Ʋumenugbagbeviɣidɔ (AML) . |
| Aplastic Anemia - Ƒumeŋuɖui ƒe dɔmawɔmawɔ nyuie |
| Lymphoma - kansa si le ʋukawo me |
| Myelodysplastic Dɔléle si woyɔna be Myelodysplastic Dɔléle |
| Lãmetsiŋusẽ ƒe Dɔdzẽ (MPN) . |
| Sickle Cell Dɔléle |
Aleke nèdzrana ɖo hafi wɔa atike nɛ?
Esi wònye be esia nye atikewɔwɔ vevi aɖe ta la, ɖɔktawo awɔ dodokpɔ geɖe atsɔ akpɔ wò ŋutilã ƒe kamedede hafi awɔ dɔa be woakpɔ egbɔ be yeate ŋu ado dzi le atikewɔwɔa ƒe nugbegblẽ le ame ŋu me.
Dodokpɔ vevi siwo wowɔ
Wò atikewɔlawo ƒe ƒuƒoƒoa awɔ dodokpɔ geɖe, abe:
- Ʋu Xexlẽme Blibo (CBC): Eléa ŋku ɖe wò ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ ŋu.
- Echocardiogram: Kpɔ alesi dzia le dɔ wɔm nyuie ɖa.
- Electrocardiogram (EKG): Eléa ŋku ɖe dzia ƒe dɔwɔwɔ ƒe tsɔtsɔme ŋu.
- Aklã kple ayiku ƒe dɔwɔwɔ dodokpɔ.
- Ƒumeŋuɖui Ŋuti Nusɔsrɔ̃: Ne kansa le ŋuwò la, woɖea wò ƒumeŋuɖui sue aɖe hedonɛ kpɔna. Esia kpena ɖe ame ŋu be woada tɔtrɔ siwo va le dɔlélea me kple afɔku si le dɔlélea me be wòagatrɔ ava le atikewɔwɔ vɔ megbe la kpɔ.
Do ŋgɔ na ame dodo na ame ƒe Nɔnɔmewɔwɔ
Le dodokpɔ siawo megbe la, woaxɔ wò ɖe kɔdzi eye woana atike si woyɔna be ‘conditioning’. Esia bia be woazã atike sesẽwo kple/alo ŋutilã bliboa ƒe keklẽŋusẽdɔdamɔnu . Taɖodzinu etɔ̃e le esia ŋu:
1. Kansa lãmenugbagbevi ɖesiaɖe si susɔ le wò ŋutilã me tsɔtsrɔ̃ .
2. Teƒe nana wò ƒumeŋuɖui be lãmenugbagbevi yeyewo natsi.
3. Wò dɔlélenutsiŋutete ƒe gbɔdzɔgbɔdzɔ . Esia ɖea wò ŋutilã ƒe ŋutete be wòadze lãmenugbagbevi yeyewo dzi (agbe) dzi kpɔtɔna.
Zi geɖe la, nɔnɔme sia wɔwɔ xɔa kwasiɖa ɖeka alo eve.
Nukae dzɔna le lãmenugbagbeviwo dodo na ame me?
Esia mevea ame ŋutɔŋutɔ o. Wò atikewɔlawo ade mɔ̃ sue aɖe si woyɔna be central venous catheter (CVC) ʋuka gã aɖe si le wò akɔta ƒe akpa si le etame la me. Woatsɔ lãmenugbagbevi yeyeawo ana wò ŋutilã to mɔ̃ sia dzi.
Enye nuwɔna bɔbɔe aɖe, abe ʋudodo ene. Wotsɔa lãmenugbagbevi siwo le lãmesẽ me siwo le dzekotoku me la dea wò ʋukawo me to CVC-mɔ̃ dzi. Wozɔa mɔ tso afima yia wò ƒumeŋuɖui gbɔ.
Dɔ sia wɔwɔ xɔa abe miniti 30 va ɖo 60 ene. Le ɣeyiɣi sia me la, atikewɔlawo ƒe ƒuƒoƒoa anɔ axawò alé ŋku ɖe wò dzesi veviwo ŋu. Woalé ŋku ɖe nugbegblẽ ɖesiaɖe hã ŋu nyuie. Ƒã hafi eƒe nugbegblẽ le ame ŋu mebɔ o eye zi geɖe la, womenɔa sue o. Le kpɔɖeŋu me, àte ŋu aʋuʋu vie, gbɔgbɔ nasesẽ na wò, alo asrã ate ŋu adze dziwò.
Nukae nye kuxi vevitɔ si dona tso atikewɔwɔ sia me?
Kuxi sesẽtɔ kple sesẽtɔ kekeake si dona tso allogeneic transplantation me enye graft-versus-host disease (GVHD) .
Kpuie ko la, esiae nye esime dɔlélenutsiŋutete ƒe lãmenugbagbevi yeye siwo le lãmesẽ me tso amesi tsɔe na (amesi wodoe) gbɔ dzea lãmenugbagbevi kple lãkusi siwo le lãmesẽ me le wò ŋutilã me (amesi xɔe) dzi dzedze gɔme. Ðeko wòle abe aʋakɔ yeye aɖe si le ame dzi dzem le wò ŋutɔ wò dukɔ me ene. Nɔnɔme sia ate ŋu agblẽ nu le ŋutigbalẽ, aklã, kple nuɖuɖumeŋusẽ ŋu. Gake mehiã be nàtsi dzi o, ɖɔktawo ate ŋu ana atike siwo hiã be nàtsɔ aɖu nɔnɔme sia dzi ahadae la wò.
Nukae dzɔna le atikewɔwɔ vɔ megbe? Ɣeyiɣi didi kae wòxɔna hafi wòhayana?
Le amedodo vɔ megbe la, ahiã be nànɔ kɔdzi kwasiɖa ʋɛ aɖewo. Le ɣeyiɣi ma me la, atikewɔlawo ƒe ƒuƒoƒoa alé be na wò nyuie. Àyi edzi anɔ dɔlélenutsiŋutete ƒe atikewo xɔm be wò ŋutilã nagagbe lãmenugbagbevi yeye siwo wodo na wò o. Ðewohĩ ahiã be woado ʋu na wò hã vaseɖe esime lãmenugbagbevi yeyeawo nate ŋu awɔ ʋumenugbagbevi yeyewo.
Woyɔa mɔnu si dzi lãmenugbagbevi yeyeawo tona gena ɖe ƒumeŋuɖui me eye wodzea ʋumenugbagbevi yeyewo wɔwɔ gɔme be ‘engraftment’ . Esia ate ŋu axɔ abe ŋkeke 10 va ɖo 14 ene. Gake ate ŋu axɔ ɣleti geɖe va ɖo ƒe ɖeka alo esi wu nenema hafi wò dɔlélenutsiŋutete nahaya keŋkeŋ. Le ɣeyiɣi sia me la, ele vevie ŋutɔ be nàkpɔ ɖokuiwò ta tso dɔlékuiwo me.
Ate ŋu axɔ ƒe eve alo esi wu nenema hafi wòahaya keŋkeŋ, eyata esia nye mɔzɔzɔ si bia dzigbɔɖi kple wò ɖɔkta ƒe mɔfiamewo dzi wɔwɔ.
Dzesi kawoe na wòhiã be nàyi ɖɔkta gbɔ enumake?
Ne èyi aƒeme le atikewɔwɔ vɔ megbe la, ele be nàlé ŋku ɖe wò ŋutilã ŋu nyuie. Ne èkpɔ dzesi siwo gbɔna dometɔ aɖe la, ƒo ka na wò atikewɔlawo enumake .
| Dzesiwo ƒe hatsotso | Features siwo ŋu wòle be woalé ŋku ɖo |
|---|---|
| Ate ŋu anye dɔléle si nye graft-versus-host disease (GVHD) ƒe dzesiwo . | |
| Nuɖuɖumeŋusẽ ƒe dɔwɔwɔ | Dɔgbo ƒe veve, aɖuɖɔtoe, ʋuʋudedi, kple ʋuʋudedi. |
| Ŋutilã kple ŋkuwo | Ŋutilã ƒe ʋuʋu kple eƒe ʋuʋu, ŋutigbalẽ kple/alo ŋku ƒe ɣie (jaundice). |
| Ate ŋu anye dɔlékuiwo ƒe dzesiwo | |
| Nɔnɔme siwo bɔ ɖe afisiafi | Dzoxɔxɔ si ƒe kɔkɔme nye Celsius 38 (Fahrenheit 100.4) alo esi wu nenema, vuvɔ, kɔdzi, aɖuɖɔtoe, ŋɔti me tsi si le dodom . |
| Nɔnɔme bubuwo | Taɖuame , gbɔgbɔ sesẽ, aɖuɖɔɖɔɖɔ enuenu, alo dzobibi ne wole aɖuɖɔ tom. |
Vovototo kae le allogeneic kple autologous transplants dome?
Vovototo vevitɔ si le wo ame evea domee nye afisi lãmenugbagbeviawo tso.
Allogeneic transplant: Woxɔa lãmenugbagbeviwo tso ame bubu (ame si naa nu) gbɔ.
Autologous transplant: Woxɔa lãmenugbagbeviwo le asiwò (woxɔa wò ŋutɔ wò lãmenugbagbeviwo hafi wowɔa atike sesẽ na wò, eye emegbe wogatsɔa wo dea wò ŋutilã me ake).
Allogeneic transplants ate ŋu ada dɔléle aɖewo siwo ate ŋu ade ame ƒe agbe afɔku me. Zi geɖe la, amedzrowo ƒe dɔmenyonyoe na esia te ŋu dzɔna. Ame siawoe naa lãmenugbagbeviwo. Ɣeaɖewoɣi la, nunalaawo nyea ƒomea me tɔwo. Afɔkuwo le lãmenugbagbevi siwo wotsɔ na amewo xɔxɔ me. Di ɣeyiɣi nàse viɖe kple afɔku siwo le dɔdamɔnu sia me gɔme. Wò ɖɔkta ate ŋu akpe ɖe ŋuwò nàda afɔku kple viɖe siwo le eme la akpɔ ale be kakaɖedzi nanɔ asiwò le wò nyametsotsoa ŋu.
Gbedasi si Wotsɔ Yi Aƒeme
- Allogeneic stem cell transplant nye mɔnu si dzi woato azã lãmenugbagbevi siwo le lãmesẽ me tso ame bubu gbɔ atsɔ ada ʋumenugbagbeviɣidɔ sesẽwo abe ʋumenugbagbeviɣidɔ ene.
- Hafi woawɔ atike la, wotsɔa atike sesẽwo abe atikewɔmɔnu ene dzraa ŋutilãa ɖo.
- Afɔku li be lãmenugbagbeviwo nadze dɔnɔa ƒe ŋutilã dzi (dɔléle si nye graft-versus-host disease), gake ɖɔktawo kpɔa nyuie le esia ŋu ŋutɔ.
- Exɔa ɣeyiɣi didi hafi wòhayana keŋkeŋ, eye atikewɔlawo ƒe aɖaŋuɖoɖowo dzi wɔwɔ kple dodokpɔ edziedzi le vevie le ɣeyiɣi sia me.
- Ðo dze kple wò ɖɔkta gaglãa tso nyabiase, vɔvɔ̃, alo nusiwo ŋu nètsi dzi ɖo ŋu. Emae nye teƒe nyuitɔ si nàkpɔ nyatakaka siwo de pɛpɛpɛ wu ahakpɔ gbɔdzɔe le.
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