Ke ne lãmenugbagbevi yeyeawo va zu ŋutilãa ƒe futɔ ya ɖe? Graft vs. Host Disease (GvHD) ƒe numeɖeɖe bɔbɔe aɖe le ame dodo vɔ megbe

Tsɔe be wotsɔ lãmenugbagbeviwo ƒe ʋumenugbagbeviɣidɔ na wò tso ame si le lãmesẽ me gbɔ be wòanye dɔléle aɖe abe ʋumenugbagbeviɣidɔ ene dada. Wokpɔ mɔ be esia ada wò nɔnɔmea. Gake ƒã ŋutɔ la, lãmenugbagbevi yeye siawo siwo va kpe ɖe ŋuwò la, wò ŋutilã bua wo vodadatɔe be "futɔ" eye wòdzea wò ŋutɔ wò lãmenugbagbeviwo dzi dzedze gɔme. Emae nye nɔnɔme sesẽ si míeyɔna be "Graft versus Host Disease" alo GvHD kpuie.

Nukae nye GvHD le nya bɔbɔewo me?

Be míase esia gɔme la, ele be míanya nya eve. "Graft" fia nusi wodo, si nye lãmenugbagbevi siwo le lãmesẽ me siwo wona wò tso egodo. "Amedzroxɔla" fia amedzroa, si fia be wò ŋutilã si xɔa lãmenugbagbevi mawo. Eyata "Graft versus Host" gɔmee nye "graft versus host."

Zi geɖe la, wowɔa lãmenugbagbeviwo dodo na ame sia ƒomevi, si woyɔna be allogeneic transplant, tsɔ daa kansa abe ʋumenugbagbeviɣidɔ kple ʋumenugbagbeviɣidɔ ene, alo ƒumeŋuɖui ƒe dɔmawɔmawɔ nyuie abe aplastic anemia ene . Lãmenugbagbevi siawo siwo wodo na ame bubuwoe dzea wò ŋutilã gɔme be wòawɔ ʋumenugbagbevi yeyewo.

Gake, ɣeaɖewoɣi la, lãmenugbagbevi yeye siawo medea dzesi wò ŋutɔ wò lãmenugbagbeviwo o. Wosusuna be dutatɔwo ƒe amedzidzelawoe yewonye. Eyata, wodzea wò ŋutinu siwo le lãmesẽ me, abe wò ŋutigbalẽ, aklã, kple dɔgbowo ene dzi dzedze gɔme. Emae nye nusi GvHD nye.

GvHD ƒomevi vevi eve li:

Woate ŋu ama GvHD ɖe hatsotso vevi eve me. Tsã la, womaa esia ɖe ɣeyiɣi si me dzesiawo dze egɔme nu. Gake fifia, ɖɔktawo dea dzesi dɔlélea ƒe ƒomevi tututu to ŋkuléle ɖe dɔlélea ƒe dzesiwo, dodokpɔa me tsonu, kple ɣeyiɣi si me dzesiawo dzea egɔme me.

• Acute GvHD (aGvHD): Zi geɖe la, esia dzɔna le ŋkeke 100 gbãtɔ siwo le ame dodo vɔ megbe me. Gake ate ŋu adzɔ emegbe ɣeaɖewoɣi. Esia ƒomevi gblẽa nu le wò ŋutigbalẽ, dɔgbo ƒe dɔwɔwɔ (dɔgbowo), kple aklã koŋ ŋu.
• GvHD si nɔa anyi didi (cGvHD): Esia ƒomevi ate ŋu adzɔ ɣesiaɣi le amedodo vɔ megbe, gake ebɔ wu le ƒe eve gbãtɔwo me . Ate ŋu adze ŋutilã ƒe akpa ɖesiaɖe, si ƒe ɖewoe nye ŋutigbalẽ, nu, aklã, lãkusi, dɔgbo, lãmeka, ƒunukpeƒewo, kple vidzinuwo.

Ame si wodo ʋu na la ate ŋu axɔ ƒomevi eve siawo dometɔ ɖeka, wo ame evea siaa, alo woate ŋu anɔ lãmesẽ me wo dometɔ aɖeke manɔmee.

Nukae nye GvHD ƒe dzesiwo?

GvHD ƒe dzesiwo ate ŋu atso esiwo nu mesẽ ŋutɔ dzi, va ɖo esiwo mesẽ o dzi, va ɖo esiwo nu sẽ, eye woate ŋu ade ame ƒe agbe afɔku me gɔ̃ hã. Mina míalé ŋku ɖe dzesi siwo do ƒome kple ƒomevi eve siawo ŋu.

Nukatae GvHD sia dzɔna?

Esia nye dzɔdzɔmeŋutinunya vie, gake maɖe eme bɔbɔe.

Zi geɖe la, míaƒe dɔlélenutsiŋutete ƒe lãmenugbagbeviwo kpɔa mía ta tso dɔléle me to avuwɔwɔ kple amedzro siwo va dzea mía dzi abe dɔlékuiwo kple dɔlékuiwo ene me. Gake lãmenugbagbevi mawo dzea mía ŋutɔwo ƒe lãmenugbagbeviwo dzi gbeɖe o. Nusitae nye be protein tɔxɛ aɖe le míaƒe lãmenugbagbeviwo katã ƒe anyime. Woyɔa esia be Amegbetɔ ƒe Ʋumenugbagbeviɣidɔlékuiwutike (HLA) .

Negbe venɔvi siwo ɖi wo nɔewo ko la, amesiame ƒe HLA to vovo.

Ne wodo lãmenugbagbeviwo na wò la, ʋumenugbagbevi yeye siwo wotsɔ lãmenugbagbevi mawo wɔe la ƒe HLA le amesi tsɔ lãmenugbagbeviawo na wò la si. Ne HLA ma to vovo akpa tso wò HLA gbɔ la, lãmenugbagbevi yeye mawo léa ŋku ɖe lãmenugbagbevi siwo le wò ŋutilã me ŋu hesusuna be, "Amedzidzelae nye esia, eƒe ID mesɔ kple mía tɔ o." Ɣemaɣie lãmenugbagbevi mawo dzea wò ŋutilã dzi dzedze gɔme.

Le susu sia ta la, ɖɔktawo léa ŋku ɖe amesi nae kple amesi xɔe ƒe HLA ŋu nyuie be woakpɔ egbɔ be yewote ɖe wo nɔewo ŋu alesi yewoate ŋui hafi doa ame bubu na amea. Gake negbe ɖe woɖe lãmenugbagbeviwo tso venɔvi aɖe gbɔ ko la, afɔku aɖe nɔa GvHD ŋu ɣesiaɣi.

Amekawoe le afɔku gã me be woaxɔ GvHD?

Afɔku vevitɔ kekeakee nye HLA ƒe masɔmasɔ, gake nu bubu geɖewo hã ate ŋu awɔ akpa aɖe.

Azɔ hã, ne Acute GvHD (aGvHD) nɔ ŋuwò xoxo la, ke èle afɔku gã aɖe me be nàxɔ Chronic GvHD (cGvHD).

Aleke wokpɔa dɔléle sia dzea sii hedaae?

Dɔlélea didi

Wò ɖɔkta akpɔ GvHD to ŋutilãmedɔdada, ŋkuléle ɖe wò dzesiwo ŋu, kple ʋudodokpɔ kple ŋutilã ƒe akpa aɖewo ɖeɖeɖa me. Biopsy bia be woaɖe ŋutigbalẽ sue aɖe alo lãkusi si ŋu dɔlélea le eye woadoe kpɔ le nusuekpɔmɔ̃ me. Esi wònye be GvHD si nɔa anyi didi ƒe dzesi aɖewo sɔ kple nɔnɔme bubuwo ta la, wò ɖɔkta agbe nɔnɔme bubuwo hafi akpɔ GvHD.

Dᴐyᴐyᴐ

Be woaxe mɔ ɖe GvHD nu le ame bubu dodo vɔ megbe la, woana dɔlélenutsiŋutete ƒe atike siwo tea wò dɔlélenutsiŋutete ɖe to la wò. Atike siawo wɔa dɔ to lãmenugbagbeviwo ƒe ŋutete be woadze wò ŋutilã dzi dzi ɖeɖe kpɔtɔ me.

• Le GvHD sesẽ (aGvHD) gome: Zi geɖe la, wonaa corticosteroids abe atikekuiwo, atikewo, alo abe atike si wotsɔ sisi ɖe ŋutigbalẽa ŋu ene. Ne esiawo mete ŋu ɖu dɔlélea dzi o la, woate ŋu abu atike bubuwo abe Ruxolitinib (Jakafi®) alo dɔdamɔnu dodokpɔwo ŋu.
• Le GvHD si nɔa anyi didi (cGvHD) gome: Wonaa dɔlélenutsiŋutete ƒe atike siwo nɔa anyi didi hã ɖe esia ta. Ne esiawo mete ŋu ɖu nɔnɔmea dzi o la, woate ŋu ahiã atikewo abe Ruxolitinib (Jakafi®), Belumosudil (RezurockTM), Ibrutinib (Imbruvica®) alo atike tɔxɛwo abe photopheresis ene.

Atikewɔwɔ ƒe nugbegblẽ le ame ŋu

Dɔdamɔnu siawo tea wò dɔlélenutsiŋutete ɖe to, si wɔnɛ be wò ŋutilã ƒe ŋutete be wòawɔ avu kple dɔlékuiwo dzi ɖena kpɔtɔna. Esia nana be fungi, dɔlékui, kple dɔlékuiwo ƒe dɔlékuiwo xɔxɔ ƒe afɔkua dzina ɖe edzi. Wò ɖɔkta aŋlɔ atikewo hã na wò be wòakpe ɖe ŋuwò nàxe mɔ ɖe dɔlékui siawo siwo ate ŋu ade wò agbe afɔku me nu.

Nu bubu siwo ate ŋu adzɔ le GvHD ta

Ðe GvHD ate ŋu ade ame ƒe agbe afɔku mea?

Ẽ, GvHD ate ŋu ade ame ƒe agbe afɔku me. GvHD si nɔa anyi didi koŋue nye nusi koŋ wua ame le lãmenugbagbeviwo dodo na ame megbe, ne menye dɔléle vevitɔ o. Esia tae wòle vevie be nàdzro afɔku siwo le eme la me kple wò ɖɔkta hafi awɔ atike aɖeke nɛ.

Ðe viɖe aɖe le GvHD ŋua?

Nukutɔe la, ẽ. Viɖe aɖewo le GvHD ŋu. Dɔlélenutsiŋutete ƒe lãmenugbagbevi yeye siawo siwo dzea wò lãmenugbagbevi siwo le lãmesẽ me dzi hã dia kansa lãmenugbagbevi ɖesiaɖe si ate ŋu agblẽ ɖe wò ŋutilã me eye wogblẽa wo dome. Woyɔa esia be "graft-versus-tumor effect." Eyata numekukuwo ɖee fia be dɔnɔ siwo ŋu GvHD le la megate ŋu gaxɔa woƒe kansa o.

Nusiwo nàte ŋu awɔ hena wò dedienɔnɔ

Wò ɖɔkta aɖe alesi wòle be nàlé be na ɖokuiwò le lãmeka dodo vɔ megbe la me. Kpɔ nyuie le nu siawo ŋu vevietɔ ne èle afɔku me be yeaxɔ GvHD.

• Takpɔ ɖokuiwò ta tso ɣea si me: Ɣe ƒe keklẽ ate ŋu ana GvHD nagblẽ ɖe edzi. Eyata do awudziwui siwo ƒe abɔ legbe kple pantalon legbe ne èle gota. Zã ɣe ƒe keklẽŋusẽtike si ƒe SPF 50 ya teti.
• Dzadzɛnyenye le nu me: Klɔ aɖuwo nyuie be nàɖe aɖudɔléle ƒe afɔkua dzi akpɔtɔ.
• Nuɖuɖu Kple Nunono: Ƒo asa na nuɖuɖu siwo me nu ʋeʋĩwo le, siwo me ami le, kple esiwo ate ŋu ana nu me naxɔ abi.
• Takpɔ ɖokuiwò ta tso dɔlékuiwo si me: Esi wò dɔlélenutsiŋutete gbɔdzɔ ta la, ƒo asa na teƒe siwo dɔlélewo kaka ɖo kple teƒe siwo amewo sɔ gbɔ ɖo. Na wò asiwo nanɔ dzadzɛ ɣesiaɣi.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ele vevie be nàna wò ɖɔkta nanya enumake ne ède dzesi tɔtrɔ aɖewo le wò ŋutilã me, vevietɔ dɔléle ƒe dzesiwo alo dzoxɔxɔ si ƒe dzoxɔxɔ nye Celsius 38 (100.4 Fahrenheit) alo esi wu nenema. Dɔlékuiwo ate ŋu asẽ ɖe edzi kabakaba ne èle atike siwo tea dɔlélenutsiŋutete ɖe to zãm.

Wò ɖɔkta alé ŋku ɖe ŋuwò edziedzi le wò ʋudodo vɔ megbe be yealé ŋku ɖe kuxiwo abe GvHD ene ŋu. Ne dzesiawo do mo ɖa la, woatrɔ wò atikewo alo aŋlɔ yeyewo na wò. Ele vevie ŋutɔ be nàno atike siwo katã woŋlɔ na wò abe alesi wogblɔe ene eye nàwɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi.