Aleke nàse le ɖokuiwò me ne wowɔ atike vevi aɖe abe ƒumeŋuɖui dodo na ʋumekansa ene eye nèsusu be, "Nusianu nyo fifia," eye emegbe nèse be kansa la trɔ gbɔ? Egbãa dzi na ame ŋutɔŋutɔ eye wòwɔa nublanui ŋutɔ. Gake mègana mɔkpɔkpɔ o. Egbea míele nu ƒom tso atikewɔwɔ tɔxɛ aɖe si ate ŋu akpe ɖe ame ŋu le nɔnɔme siawo tɔgbe me ŋu. Woyɔe be DLI, si gɔmee nye Donor Lymphocyte Infusion.
Kpuie ko la, nukae nye DLI?
Enyo, mina míagblɔ nya sia kpuie. Lãmenugbagbevi ɣiwo nye ʋumenugbagbevi ɣi ƒomevi aɖe si le wò ʋu me. Wole abe asrafo siwo le míaƒe ŋutilã me ene. Wonye míaƒe dɔlélenutsiŋutete ƒe akpa vevi aɖe, wowɔa avu kple duta dɔlékuiwo, dɔlékuiwo, kple kansa lãmenugbagbeviwo.
Fifia, DLI (Donor Lymphocyte Infusion) nye dɔdamɔnu si me woxɔa ʋumenugbagbevi siawo dometɔ aɖewo tso nunala si le lãmesẽ me si tsɔ wò ƒumeŋuɖui (lãmenugbagbeviwo) na va yi la gbɔ eye wodoa wo ɖe wò ŋutilã me. ‘Asrafo’ yeye siawo siwo le lãmesẽ me eye ŋusẽ le wo ŋu la dia kansa lãmenugbagbevi ɖesiaɖe si susɔ siwo ate ŋu aɣla ɖe wò ŋutilã me eye wogblẽa wo dome. Emae nye dɔdamɔnu sia ƒe taɖodzinu vevitɔ.
Nɔnɔme kawo mee wokafu DLI zazã le?
Anɔ eme be wò ɖɔkta agblɔ atikewɔwɔ sia na wò wu ne wò ʋumenugbagbeviɣidɔ gatrɔ (egadze egɔme ake) le ƒumeŋuɖui dodo vɔ megbe.
Nɔnɔme siwo ŋu wozãa DLI dɔdamɔnu na zi geɖe la dometɔ aɖewoe nye esi:
- Ʋumenugbagbeviɣidɔ (AML) .
- Ʋumenugbagbeviɣidɔ si Nɔa Anyi Didi (CLL) .
- Ʋumenugbagbeviɣidɔ si Nɔa Anyi Didi (CML) .
- Multiple Myeloma ƒe dɔléle
- Lãmetsiŋusẽ ƒe dɔléle (MDS) .
- Lãmetsiŋusẽdɔléle si menye Hodgkin o
Nu bubue nye be, ɣeaɖewoɣi le ƒumeŋuɖui dodo vɔ megbe la, lãmenugbagbevi siwo naa wò kple wò ŋutɔ wò lãmenugbagbevi xoxowo ate ŋu atsaka le wò ŋutilã me. Míeyɔa esia be (mixed chimerism) . Esia hã dzia afɔku si li be kansa la nagatrɔ ava. Eyata woate ŋu awɔ DLI atsɔ atrɔ lãmenugbagbevi siwo katã le wò ŋutilã me woazu lãmenugbagbevi siwo tso nunala la gbɔ.
Aleke nèdzrana ɖo ɖe atikewɔwɔ sia ŋu?
Hafi nàdze DLI dada gɔme la, wò ɖɔkta ado wò kpɔ nyuie, adzro wò dzesiwo me, eye wòaɖe gbe be woado wò kpɔ zi geɖe.
- Ƒumeŋuɖui ƒe lãmenugbagbeviwo ɖeɖe: Woɖea ƒumeŋuɖui sue aɖe tsɔ léa ŋku ɖe kansa lãmenugbagbevi siwo susɔ ŋu.
- Ʋu Xexlẽme Blibo (CBC):Wole lãmenugbagbevi siwo le ʋua me ƒe xexlẽme me dzrom.
- Ayiku kple aklã ƒe dɔwɔwɔ dodokpɔ.
Ne lãmenugbagbeviwo ƒe dɔwɔwɔ ɖee fia be kansa lãmenugbagbeviwo ƒe agbɔsɔsɔ sɔ gbɔ ŋutɔ la, wò ɖɔkta ate ŋu atso nya me be yeado atike na wò hafi DLI. Esia nye be woaɖe kansa lãmenugbagbeviwo ƒe xexlẽme dzi akpɔtɔ eye woadzi DLI dɔdamɔnua ƒe dzidzedzekpɔkpɔ ɖe edzi.
Aleke wokpɔa ʋumenugbagbevi dzĩwo tso nunala gbɔe?
Esia nye nu tɔxɛ aɖe ŋutɔ si dzɔna. Nunala si na agbe wò, si fia be nunala si na ƒumeŋuɖui wò hã kpena ɖe esia ŋu. Wotsɔa mɔ̃ sue aɖe (catheter) dea ʋuka aɖe si le eƒe alɔnu me eye woɖea ʋu aɖe. Ʋu sia toa mɔ̃ tɔxɛ aɖe me. Nusi mɔ̃ ma wɔnae nye be eɖea ʋumenugbagbevi siwo míehiã la ɖeɖeko ɖa, eye wògbugbɔa ʋu susɔea ɖona ɖe ŋutilãa me to ʋuka aɖe si le amesi na ʋua ƒe alɔ kemɛa me. Woyɔa nuwɔna sia be apheresis . Ɣeaɖewoɣi ne ètsɔ ƒumeŋuɖui na zi gbãtɔ la, woate ŋu axɔ ʋumenugbagbevi dzĩ siawo dometɔ aɖewo ahatsɔ wo ade tsikpe me be woazã wo emegbe.
Aleke nèwɔna xɔa DLI dɔdamɔnu?
Esia se le eɖokui me abe nu bɔbɔe aɖe ene abe dzetsi si me wodea dzee nana wò ene.
1. Ðɔkta alo dɔnɔdzikpɔla ade mɔ̃ sue aɖe (catheter) ʋuka aɖe si le wò alɔnu alo akɔta me.
2. Emegbe, wotsɔa agbalẽvi si me ʋumenugbagbevi dzĩ siwo woɖe ɖe vovo tso amesi tsɔ ʋua na gbɔ la doa ka kple mɔ̃ ma eye wodonɛ ɖe wò ʋu me.
3. Dɔ sia xɔa abe miniti 30 ene .
4. Ne wowu dɔa nu la, woɖea mɔ̃a ɖa.
Ɣeaɖewoɣi la, àte ŋu ana atike vovovowo abe esia ene le kwasiɖa alo ɣleti geɖe me.
Ne wotsɔ lãmenugbagbevi yeyewo va ŋutilãa me alea la, woyɔa nu vevitɔwo dometɔ ɖeka be graft vs. tumor effect (GvT) . Esia fia be lãmenugbagbevi siawo siwo le lãmesẽ me (graft) siwo tso nunala la gbɔ dia kansa lãmenugbagbevi (tumor) susɔe siwo le wò ŋutilã me, dzea wo dzi, eye wotsrɔ̃a wo. Aleae kansa la nu yina keŋkeŋ.
Viɖe kple afɔku kawoe le DLI dada me?
Viɖe vevi siwo le esia me
Tsã la, ne kansa la gatrɔ va le ƒumeŋuɖui dodo vɔ megbe la, tiatia ɖeka koe nye be wogado ƒumeŋuɖui bubu. Gake kuxi siwo ate ŋu ado mo ɖa ƒe afɔkua lolo wu sã ne wodoe na ame zi evelia. DLI nye mɔnu nyui aɖe si me afɔku mele o si dzi woato ana kansa la nagbɔdzɔ dɔlélenutsiŋutete ƒe atikewo manɔmee.
Afɔku kple kuxi siwo ate ŋu ado tso eme
Abe alesi wòle le atikewɔwɔwo katã gome ene la, afɔku aɖewo li. Wò atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe ŋuwò nyuie le nusiawo ŋu.
| Kuxi si dona tso eme | Numeɖeɖe kple dzesiwo |
|---|---|
| Dɔléle si nye Graft vs. Amedzroxɔla (GvHD) . | Esia nye ne lãmenugbagbevi siwo tso nunala (graft) gbɔ kpɔ wò ŋutilã me lãmenugbagbevi siwo le lãmesẽ me (amedzro) be wonye futɔ eye wodze wo dzi. Dzesiwo: aɖuɖɔtoe, ŋutigbalẽ ƒe ɣie (jaundice), ʋuʋudedi kple ʋuʋudedi, ŋutigbalẽ ƒe abi alo ʋuʋudedi. |
| Lãmetsiŋusẽ ƒe dɔwɔwɔ | Esia nye ƒumeŋuɖui ƒe dɔwɔwɔ dzi ɖeɖe kpɔtɔ hena ɣeyiɣi aɖe, si ate ŋu ana ʋumenugbagbeviwo ƒe xexlẽme dzi naɖe akpɔtɔ. - Ʋumenugbagbevi dzĩwo ƒe agbɔsɔsɔ si bɔbɔ (Anemia): ɖeɖiteameŋu, gbɔgbɔtsixetsixe. - Ʋumenugbagbevi ɣiwo dzi ɖe kpɔtɔ (Leukopenia): Dɔlékuiwo xɔxɔ ƒe afɔku dzina ɖe edzi. - Ʋumenugbagbeviɣidɔ si mebɔ o: Ʋu ƒe dodo ƒe afɔku dzina ɖe edzi. |
Nukae woawɔ ne kuxiwo do mo ɖa?
Mega tsi dzi o. Atikewɔmɔnu aɖewo li na nusiawo katã.
- Ne GvHD dzɔ: Wò ɖɔkta aŋlɔ dɔlélenutsiŋutete ƒe atikewo na wò .
- Ne wò ʋumenugbagbeviɣiwo mesɔ gbɔ o: Zi geɖe la, ʋumenugbagbevi ɣi siwo mesɔ gbɔ o la nu yina le wo ɖokui si. Ne menye nenema o la, atikewo li woatsɔ ada woe. Woate ŋu ado ʋu na ame ne ehiã be woatsɔ ada ʋumenugbagbevi dzĩwo kple ʋumenugbagbevi dzĩ siwo mebɔ o.
Le atikewɔwɔ vɔ megbe kple dzidzedzekpɔkpɔ ŋu
Ƒo nu kple wò ɖɔkta tso ɣeyiɣi didi si wòaxɔ hafi nàgaɖo nɔnɔme nyui me le atikewɔwɔ vɔ megbe ŋu. Ahiã be woakplɔ wò ɖo edziedzi ahado ʋu kpɔ.
Dɔdamɔnu sia ƒe dzidzedzekpɔkpɔ ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Nu geɖe li siwo kpɔa ŋusẽ ɖe edzi:
- Kansa ƒe afɔɖeɖe.
- Wò dɔlélenutsiŋutete ƒe lãmesẽ.
- Dodokpɔ ƒomevi si wowɔ va yi.
- Ne wowɔ atikewɔmɔnu do ŋgɔ na DLI alo womewɔe o.
Vevietɔ wu: Ne GvHD ƒe dzesi aɖewo abe dzoxɔxɔ, ʋu si mebɔ o, gbɔgbɔ sesẽ, aɖuɖɔtoe, ŋutigbalẽ ƒe ʋuʋu, alo dzesi bubu ɖesiaɖe si mebɔ o dze le ŋuwò , na wò ɖɔkta alo kɔdzi si le atike dam na wò enumake.
Ðe DLI nye dɔlélenutsiŋutete ƒe dɔdamɔnua?
Ẽ, DLI nye dɔlélenutsiŋutete ƒe atikewɔwɔ.Enye atikewɔwɔ ƒomevi aɖe. Elabena nusi wɔm nèle enye be nàna wò ŋutɔ wò dɔlélenutsiŋutete ƒe T-lãmenugbagbevi siwo le lãmesẽ me tso egodo be wòakpe ɖe eŋu wòawɔ avu kple kansa. Ema nye ŋugbedodo ŋutɔŋutɔ.
Gbedasi si Wotsɔ Yi Aƒeme
- DLI nye ʋumenugbagbeviɣidɔ siwo gbugbɔna dzɔna le ƒumeŋuɖui dodo vɔ megbe ƒe atike tɔxɛ aɖe.
- Esia zãa lãmenugbagbevi siwo woyɔna be lymphocytes tso nunala si le lãmesẽ me ma ke si tsɔ wò ƒumeŋuɖui na le gɔmedzedzea me la gbɔ.
- Taɖodzinu si le esia ŋue nye be lãmenugbagbevi yeye siawo nadi kansa lãmenugbagbevi siwo susɔ le ŋutilãa me (GvT effect) ahatsrɔ̃ wo.
- Afɔku vevitɔwoe nye GvHD (Graft vs. Host Disease) kple ʋumenugbagbeviɣidɔ, gake woate ŋu ada esiawo.
- Esia nye dɔlélenutsiŋutete ƒe atikewɔwɔ ƒomevi aɖe si naa mɔkpɔkpɔ afɔku gã siwo le ƒumeŋuɖui dodo evelia me manɔmee.
- Ðo dze kple wò ɖɔkta enumake tso dzesi alo kuxi yeye ɖesiaɖe ŋu.
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