He aha inā lilo nā pūnaewele hou i ʻenemi o ke kino? He wehewehe maʻalahi no ka Graft vs. Host Disease (GvHD) ma hope o ke kāpili ʻana

E noʻonoʻo ua hāʻawi ʻia ʻoe i kahi hoʻoili cell kumu mai kahi kanaka olakino ma ke ʻano he lāʻau lapaʻau no kahi maʻi e like me ka leukemia. Manaʻo ʻia kēia e ho'ōla i kou kūlana. Akā, he mea kākaʻikahi loa, ʻo kēia mau cell hou i hele mai e kōkua iā ʻoe, kuhihewa kou kino iā lākou no ka "ʻenemi" a hoʻomaka e hoʻouka i kāu mau cell ponoʻī. ʻO ia ke kūlana paʻakikī a mākou e kapa nei ʻo "Graft versus Host Disease" a i ʻole GvHD no ka pōkole.

He aha ka GvHD ma nā huaʻōlelo maʻalahi?

I mea e maopopo ai kēia, pono kākou e ʻike i ʻelua mau huaʻōlelo. ʻO "Graft" ke ʻano o ka mea i hoʻoili ʻia, ʻo ia hoʻi, nā hunaola kumu olakino i hāʻawi ʻia iā ʻoe mai waho. ʻO "Host" ke ʻano o ka kikowaena, ʻo ia hoʻi kou kino e loaʻa ana kēlā mau hunaola. No laila, ʻo "Graft versus Host" ke ʻano o "graft versus host."

ʻO ka maʻamau, ʻo kēia ʻano hoʻoili cell kumu, i kapa ʻia he allogeneic transplant, hana ʻia e mālama i nā maʻi kanesa e like me ka leukemia a me ka lymphoma, a i ʻole nā ​​​​​​kūlana hāʻule ʻana o ka iwi e like me ka anemia aplastic. ʻO kēia mau cell i hoʻoili ʻia ka mea e hoʻomaka ai kou kino e hana i nā cell koko hou.

Akā, i kekahi manawa, ʻaʻole ʻike kēia mau pūnaewele hou i kāu mau pūnaewele ponoʻī. Manaʻo lākou he poʻe komo hewa lākou. No laila, hoʻomaka lākou e hoʻouka i kou mau kino olakino, e like me kou ʻili, akepaʻa, a me nā ʻōpū. ʻO ia ka GvHD.

ʻElua ʻano nui o GvHD:

Hiki ke hoʻokaʻawale ʻia ʻo GvHD i ʻelua ʻano nui. I ka wā ma mua, ua hoʻokaʻawale ʻia kēia e like me ka manawa o ka hoʻomaka ʻana o nā hōʻailona. Akā i kēia manawa, hoʻoholo nā kauka i ke ʻano pololei ma ka nānā ʻana i nā hōʻailona, ​​​​nā hopena hoʻāʻo, a me ka manawa o ka hoʻomaka ʻana o nā hōʻailona.

• ʻO ka GvHD ʻoi (aGvHD): Hana pinepine kēia i loko o nā lā 100 mua ma hope o ke kāpili ʻana. Akā hiki ke hana ʻia ma hope. Hoʻopilikia nui kēia ʻano i kou ʻili, ka ʻōnaehana gastrointestinal (nā ʻōpū), a me ke ake.
• ʻO ka GvHD Mau Loa (cGvHD): Hiki ke ʻike ʻia kēia ʻano i kēlā me kēia manawa ma hope o kahi hoʻoili ʻana, akā ʻoi aku ka maʻamau i loko o nā makahiki ʻelua mua . Hiki iā ia ke hoʻopilikia i kekahi ʻāpana o ke kino, me ka ʻili, ka waha, ke akepaʻa, nā māmā, nā ʻōpū, nā ʻiʻo, nā hono, a me nā ʻāpana wahine.

Hiki i ke kanaka i hana ʻia kahi hoʻoili lāʻau ke loaʻa i kekahi o kēia mau ʻano ʻelua, ʻo nā mea ʻelua, a i ʻole hiki iā lākou ke olakino me ka ʻole o kekahi o lākou.

He aha nā hōʻailona o GvHD?

Hiki i nā hōʻailona GvHD ke ʻano like ʻole mai ka ʻoluʻolu loa, a i ka waena, a i ka koʻikoʻi, a hiki i ka hoʻoweliweli ʻana i ke ola. E nānā kākou i nā hōʻailona e pili ana i kēia mau ʻano ʻelua.

No ke aha i hana ʻia ai kēia GvHD?

He ʻano ʻepekema iki kēia, akā e wehewehe maʻalahi wau.

ʻO ka maʻamau, pale nā ​​​​​​pūnaewele o kā mākou ʻōnaehana pale iā mākou mai nā maʻi ma ke kaua ʻana i nā mea komo hewa mai nā ʻāina ʻē e like me nā virus a me nā bacteria. Akā, ʻaʻole loa e hoʻouka kēlā mau pūnaewele i kā mākou mau pūnaewele ponoʻī. ʻO ke kumu o kēia, aia kahi protein kūikawā ma luna o ka ʻili o kā mākou mau pūnaewele āpau. Ua kapa ʻia kēia ʻo Human Leukocyte Antigens (HLA) .

ʻOkoʻa nā māhoe like, ʻokoʻa ka HLA o kēlā me kēia kanaka.

Ke loaʻa iā ʻoe kahi hoʻoili ʻana o nā cell kumu, loaʻa i nā cell koko hou i hana ʻia mai kēlā mau cell ka HLA o ka mea nāna i hāʻawi i nā cell iā ʻoe. Inā ʻokoʻa loa kēlā HLA mai kāu HLA, nānā kēlā mau cell hou i nā cell i loko o kou kino a noʻonoʻo, "He mea hoʻouka kaua kēia, ʻaʻole kūlike kāna ID me kā mākou." ʻO ia ka manawa e hoʻomaka ai kēlā mau cell e hoʻouka i kou kino.

No kēia kumu, nānā pono nā kauka i ka HLA o ka mea hāʻawi a me ka mea loaʻa e hōʻoia i ko lāua kokoke loa kekahi i kekahi ma mua o ka hana ʻana i kahi hoʻoili. Akā inā ʻaʻole i lawe ʻia nā pūnaewele mai kahi māhoe, aia mau kekahi pilikia o GvHD.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka GvHD?

ʻO ka mea pilikia nui loa ka HLA incompatibility, akā hiki i kekahi mau kumu ʻē aʻe ke pāʻani i kekahi kuleana.

Eia kekahi, inā ua loaʻa iā ʻoe ka Acute GvHD (aGvHD), ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka Chronic GvHD (cGvHD).

Pehea e ʻike ʻia ai a mālama ʻia ai kēia maʻi?

ʻIkepili

E ʻike kāu kauka i ka GvHD ma ka hana ʻana i kahi hoʻokolokolo kino, ka nānā ʻana i kāu mau hōʻailona, ​​a me ka hana ʻana i nā hoʻokolohua koko a me kahi biopsy. ʻO ka biopsy e pili ana i ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻili a i ʻole nā ​​​​ʻiʻo i hoʻopilikia ʻia a nānā iā ia ma lalo o kahi microscope. No ka mea ua like kekahi o nā hōʻailona o ka GvHD mau loa me nā kūlana ʻē aʻe, e kāpae kāu kauka i nā kūlana ʻē aʻe ma mua o ka ʻike ʻana iā GvHD.

Lapaʻau

I mea e pale aku ai iā GvHD ma hope o kahi hoʻoili ʻana, e hāʻawi ʻia ʻoe i nā lāʻau lapaʻau immunosuppressive e kāohi ana i kāu ʻōnaehana pale. Hana kēia mau lāʻau lapaʻau ma ka hōʻemi ʻana i ka hiki o nā ʻāpana haole ke hoʻouka i kou kino.

• No ka GvHD koʻikoʻi (aGvHD): I ka manawa pinepine, hāʻawi ʻia nā corticosteroids ma ke ʻano he mau pila, nā inikini, a i ʻole he kirīmi i kau ʻia ma ka ʻili. Inā ʻaʻole kēia mau mea e kāohi i ka maʻi, hiki ke noʻonoʻo ʻia nā lāʻau ʻē aʻe e like me Ruxolitinib (Jakafi®) a i ʻole nā ​​hoʻokolohua lapaʻau.
• No ka GvHD Mau Loa (cGvHD): Hāʻawi ʻia nā lāʻau pale pale lōʻihi no kēia. Inā ʻaʻole i kāohi ʻia ke kūlana e kēia mau mea, pono paha nā lāʻau e like me Ruxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) a i ʻole nā ​​​​lāʻau lapaʻau kūikawā e like me ka photopheresis .

Nā hopena ʻaoʻao o ka lāʻau lapaʻau

Hoʻopau kēia mau lāʻau lapaʻau i kāu ʻōnaehana pale, kahi e hōʻemi ai i ka hiki o kou kino ke hakakā i nā maʻi. Hoʻonui kēia i kou pilikia o ka loaʻa ʻana o nā maʻi fungal, bacteria, a me viral. E kuhikuhi pū kāu kauka i nā lāʻau lapaʻau e kōkua i ka pale ʻana i kēia mau maʻi e hoʻoweliweli nei i ke ola.

Nā hopena ʻē aʻe e hiki ke kū mai ma muli o GvHD

He mea hoʻoweliweli anei ke ola o GvHD?

ʻAe, hiki i ka GvHD ke hoʻoweliweli i ke ola. ʻO ka GvHD mau loa, ʻo ia hoʻi, ke kumu nui o ka make ma hope o kahi hoʻoili cell kumu, koe wale nō ka maʻi mua. No laila he mea nui e kūkākūkā i nā pilikia me kāu kauka ma mua o ka hana ʻana i kekahi lāʻau lapaʻau.

Aia kekahi pōmaikaʻi mai GvHD?

ʻO ka mea kupanaha, ʻae. Loaʻa iā GvHD kekahi mau pono. ʻO kēia mau pūnaewele pale kino hou e hoʻouka i kāu mau pūnaewele olakino e ʻimi a luku i nā pūnaewele maʻi kanesa i waiho ʻia i loko o kou kino. Ua kapa ʻia kēia ʻo "graft-versus-tumor effect." No laila, ua hōʻike nā haʻawina ʻaʻole hiki i nā poʻe maʻi e loaʻa iā GvHD ke hoʻi hou mai kā lākou maʻi kanesa.

Nā mea hiki iā ʻoe ke hana no kou palekana

E wehewehe kāu kauka pehea ʻoe e mālama ai iā ʻoe iho ma hope o ke kāpili ʻana. E makaʻala loa i kēia mau mea inā ʻoe e pilikia ana no GvHD.

• E pale iā ʻoe iho mai ka lā: Hiki i ka lā ke hoʻonui i ka GvHD. No laila, e ʻaʻahu i nā pālule lima lōʻihi a me nā lole lōʻihi i ka wā e hele ai i waho. E hoʻohana i kahi sunscreen me ka liʻiliʻi o SPF 50.
• Hoʻomaʻemaʻe waha: E palaki pono i kou mau niho e hōʻemi i ka pilikia o ka maʻi ʻāʻī.
• Mea ʻAi a me Mea Inu: E hōʻalo i ka mea ʻala, ka ʻaila, a me nā meaʻai e hiki ai ke hoʻoulu i nā ʻeha waha.
• E pale iā ʻoe iho mai nā germs: ʻOiai ua nāwaliwali kou ʻōnaehana pale, e pale i nā wahi i laha ai nā maʻi a me nā wahi i piha ai nā kānaka. E mālama mau i kou mau lima i ka maʻemaʻe.

Āhea wau e ʻike ai i ke kauka?

He mea nui e hoʻomaopopo koke i kāu kauka inā ʻike ʻoe i kekahi mau loli i kou kino, ʻoiai nā hōʻailona o ka maʻi a i ʻole ke kuni o 38 degere Celsius (100.4 Fahrenheit) a ʻoi aku paha. Hiki i nā maʻi ke lilo i mea koʻikoʻi koke ke lawe ʻoe i nā lāʻau lapaʻau e kāohi ana i ka ʻōnaehana pale.

E nānā mau kāu kauka iā ʻoe ma hope o kāu hoʻoili ʻana e nānā i nā pilikia e like me GvHD. Inā kū mai nā hōʻailona, ​​e hoʻololi lākou i kāu mau lāʻau lapaʻau a kuhikuhi paha i nā mea hou. He mea nui loa e lawe i nā lāʻau lapaʻau āpau i kuhikuhi ʻia e like me ke kuhikuhi ʻana a hahai i nā ʻōlelo a kāu kauka.