Koj puas tau muaj ib tug neeg tau txais kev hloov noob hlwb los ntawm koj tus kheej? Cia peb paub txog qhov no '(Graft vs. Host Disease)'!

Tej zaum koj twb tau hnov ​​txog kev hloov noob hlwb (stem cell transplants). Lawv yog ib qho kev kho mob tseem ceeb heev rau qee yam kab mob. Txawm li cas los xij, hnub no peb yuav tham txog qhov teeb meem uas tuaj yeem tshwm sim tom qab kev hloov noob hlwb. Qhov no hu ua '(Graft vs. Host Disease)' lossis '(GvHD)' luv. Tsis txhob txhawj, cia peb tham txog qhov no yooj yim.

`(Kab Mob Sib Kis vs. Kab Mob Host - GvHD)` yog dab tsi? Piav qhia yooj yim...

Xav txog tias koj tau txais kev hloov pauv ntawm cov hlwb los ntawm lwm tus, tus neeg pub dawb . Peb hu qhov no ua kev hloov pauv allogeneic. Cov hlwb no zoo li cov hlwb tsis tau loj hlob hauv koj lub cev lub Hoobkas tsim cov ntshav, lossis cov hlwb hematopoietic. Cov no yog cov hlwb uas tom qab ntawd yuav dhau los ua cov hlwb ntshav liab thiab cov hlwb ntshav dawb uas koj lub cev xav tau.

Tam sim no, thaum twg koj yuav xav tau cov hlwb ntawm tus neeg pub dawb zoo li no? Yog tias koj muaj mob qog noj ntshav xws li leukemia lossis lymphoma, lossis lwm yam kab mob uas koj cov pob txha tsis ua haujlwm zoo xws li aplastic anemia, koj yuav xav tau hom kev hloov hlwb no.

Zoo, tam sim no qhov no yog dab tsi '(GvHD)'? Hauv '(GvHD)', qhov tshwm sim yog tias cov qe ntshav dawb uas koj tau txais (graft) pom cov qe ntshav hauv koj lub cev (tus tswv tsev) ua ib yam dab tsi txawv txawv, tsis paub. Nws zoo li koj lub cev yog qhov chaw tshiab rau lawv. Yog li, cov qe ntshav dawb no pib tawm tsam koj lub cev cov qe ntshav. Yog vim li cas nws thiaj hu ua '(Graft vs. Host Disease)', uas txhais tau tias "graft tawm tsam tus tswv tsev." Koj puas nkag siab?

Cov hom kab mob GvHD tseem ceeb yog dab tsi?

Muaj ob hom kab mob GvHD tseem ceeb. Yav dhau los, cov kws kho mob faib nws raws li lub sijhawm siv rau cov tsos mob pib. Tab sis tam sim no, lawv saib cov tsos mob thiab cov txiaj ntsig ntawm kev kuaj mob kom paub meej tias yog hom twg.

1. Kab mob GvHD mob hnyav (aGvHD)

Qhov no feem ntau tshwm sim tsis ntev tom qab koj hloov cov noob hlwb, feem ntau yog nyob rau hauv 100 hnub thawj zaug . Txawm li cas los xij, qee zaum cov tsos mob tuaj yeem pib tom qab. Mob GvHD mob hnyav feem ntau cuam tshuam rau koj daim tawv nqaij, lub plab zom mov (GI tract), lossis siab.

2. Kab mob GvHD ntev (cGvHD)

Kab mob GvHD ntev tuaj yeem tshwm sim txhua lub sijhawm tom qab hloov pauv allogeneic. Txawm li cas los xij, feem ntau nws pib tsis pub dhau ob xyoos . Kab mob GvHD ntev tuaj yeem cuam tshuam rau koj daim tawv nqaij, qhov ncauj, siab, ntsws, txoj hnyuv plab, cov leeg, pob qij txha, lossis qhov chaw mos.

Tseem Ceeb: Koj yuav muaj ib hom mob GvHD no, ob hom, lossis ob hom tsis muaj. Nws txawv ntawm ib tus neeg mus rau ib tus neeg.

Cov tsos mob ntawm `(GvHD)` yog dab tsi? Ceev faj txog cov no!

Cov tsos mob ntawm GvHD txawv ntawm ib tus neeg mus rau ib tus neeg. Ib txhia neeg yuav muaj cov tsos mob me me , ib txhia yuav muaj cov tsos mob nruab nrab , thiab lwm tus yuav muaj cov tsos mob hnyav.Nws tuaj yeem ua rau mob hnyav heev (txawm tias ua rau tuag taus).

Cov tsos mob ntawm tus mob '(GvHD)'

Peb twb hais lawm tias tus kab mob GvHD mob hnyav feem ntau cuam tshuam rau daim tawv nqaij, txoj hnyuv GI, thiab lub siab.

• Tawv Nqaij (aGvHD): Cov tsos mob feem ntau yog tawv nqaij ua pob liab los yog liab (zoo li kub hnyiab). Tej zaum yuav mob thiab khaus. Cov pob liab feem ntau pib ntawm caj dab, xub pwg nyom, pob ntseg, xib teg, thiab hauv qab taw. Tom qab ntawd nws tuaj yeem kis mus rau lwm qhov ntawm lub cev.
• Kab mob plab hnyuv (GI) (aGvHD): Cov tsos mob feem ntau yog xeev siab, ntuav, thiab raws plab (o). Cov tsos mob no yuav tsis hnyav heev lossis yuav tsum tau mus pw hauv tsev kho mob.

Cov tsos mob ntawm GvHD mob hnyav muaj xws li:

• Tawv nqaij ua pob khaus thiab/lossis khaus.
• Mob raws plab.
• Xeev siab thiab ntuav.
• Mob plab, ceg tawv.
• Jaundice (daj ntawm daim tawv nqaij thiab/lossis qhov muag).

Cov tsos mob ntawm tus kab mob GvHD ntev

Kab mob GvHD uas kav ntev feem ntau cuam tshuam rau koj daim tawv nqaij, daim siab, txoj hnyuv plab, thiab lub ntsws. Txawm li cas los xij, nws tuaj yeem cuam tshuam rau txhua qhov ntawm koj lub cev.

Cov tsos mob yuav muaj xws li:

• Tawv nqaij ua pob khaus thiab/lossis khaus.
• Tawv nqaij nruj thiab o.
• Plaub hau poob ntawm lub taub hau thiab lub cev.
• Qhov ncauj qhuav.
• Mob qhov ncauj.
• Kab mob ntawm cov pos hniav.
• Qhov muag qhuav, zoo li ib lub xuab zeb lo rau sab hauv.
• Kev hloov pauv ntawm kev pom kev.
• Mob raws plab.
• Xeev siab thiab ntuav.
• Tawv nqaij thiab/lossis qhov muag daj (jaundice).
• Ua pa nyuaj (ua tsis taus pa).
• Hnoos qhuav, tsis tu ncua.
• Qaug zog.
• Cov leeg tsis muaj zog, ceg tawv, lossis mob.
• Tsis muaj peev xwm khoov thiab ncab cov pob qij txha kom raug.
• Cov poj niam yuav muaj qhov chaw mos qhuav, khaus, lossis mob thaum sib deev.
• Cov txiv neej yuav khaus qhov chaw mos lossis noob qes, lossis mob thaum sib deev.

Vim li cas qhov "(GvHD)" no thiaj tshwm sim? Dab tsi yog qhov ua rau?

Hais yooj yim xwb, GvHD tshwm sim thaum cov hlwb ntawm tus neeg pub koj tau txais kev hloov pauv pom koj cov hlwb hauv lub cev ua "txawv teb chaws" thiab pib tawm tsam lawv.

Qhov no yog qhov feem ntau tshwm sim: Koj cov hlwb tiv thaiv kab mob (cov hlwb hauv koj cov ntshav) tiv thaiv koj ntawm kab mob. Lawv tawm tsam cov khoom txawv teb chaws, xws li cov kab mob thiab cov kab mob me me. Txawm li cas los xij, cov hlwb no tsis tawm tsam koj cov hlwb. Qhov no yog vim koj cov hlwb muaj cov protein tshwj xeeb hu ua "Human Leukocyte Antigens", lossis "HLA". Qhov no zoo li daim ntawv lo nrog lub npe rau ntawm nws. Qhov "HLA" no yog qhov qhia rau koj cov hlwb tiv thaiv kab mob, "Auj, qhov no yog ib qho ntawm peb li."

Qhov tseem ceeb tshaj plaws yog tias, tshwj tsis yog cov menyuam ntxaib zoo sib xws, txhua tus '(HLA)' txawv ntawm ib leeg.

Tom qab koj tau txais kev hloov noob hlwb los ntawm lwm tus, cov qe ntshav tshiab hauv koj lub cev tsis muaj koj li '(HLA)', tab sis '(HLA)' ntawm tus neeg pub . Yog li, yog tias '(HLA)' ntawm tus neeg pub no txawv ntawm '(HLA)' hauv koj lub cev, cov qe ntshav tshiab ntawd pib tawm tsam koj lub cev cov qe ntshav. Thaum ntawd '(GvHD)' tshwm sim.

Qhov no yog vim li cas cov kws kho mob thiaj li ua tib zoo xyuas cov HLA ntawm tus neeg pub kom paub tseeb tias nws nyob ze rau koj li sai tau ua ntej hloov cov noob hlwb. Kev nrhiav cov noob hlwb zoo li ntawd yuav txo qhov kev pheej hmoo ntawm kev mob GvHD. Txawm li cas los xij, yog tias koj tsis tau txais cov noob hlwb los ntawm ib tug menyuam ntxaib zoo sib xws, tseem muaj feem yuav mob GvHD, txawm tias koj sim ntau npaum li cas los xij.

Leej twg muaj feem yuav mob GvHD tshaj?

Qhov tseem ceeb tshaj plaws uas ua rau muaj kev pheej hmoo yog seb koj tus neeg pub dawb lub HLA sib xws li cas rau koj li. Koj muaj feem yuav muaj GvHD ntau dua yog tias:

• Koj tau txais cov hlwb noob los ntawm ib tug txheeb ze, tab sis tsis yog HLA sib phim .
• Koj tau txais cov noob hlwb los ntawm ib tus neeg uas tsis yog koj txheeb ze, tab sis yog tus sib phim '(HLA)' .

Lwm yam uas ua rau muaj kev pheej hmoo yog:

• Tus neeg pub nyiaj yuav tsum yog ib tug poj niam uas tau cev xeeb tub ua ntej lawm.
• Lub hnub nyoog ntawm tus neeg pub dawb lossis koj tus kheej nce ntxiv.
• Kev tsis sib haum xeeb ntawm tus neeg pub thiab koj yog poj niam los yog txiv neej (piv txwv li, tau txais cov qe ntshav los ntawm tus txiv neej pub rau tus poj niam, lossis los ntawm tus poj niam pub rau tus txiv neej).
• Yog tias tus neeg pub cov noob hlwb raug coj los ntawm cov hlab ntsha (ntshav) es tsis yog los ntawm cov pob txha (qhov chaw tsim cov qe ntshav).

Yog tias koj twb muaj tus kab mob '(aGvHD)' sai lawm, koj muaj feem yuav mob 'cGvHD' ntev ntxiv.

Yuav kuaj mob GvHD li cas?

Koj tus kws kho mob tuaj yeem kuaj mob GvHD los ntawm kev kuaj koj, saib koj cov tsos mob, thiab saib cov kev kuaj hauv chaw kuaj mob thiab cov txiaj ntsig ntawm kev kuaj nqaij. Kev kuaj nqaij yog kev coj me me ntawm koj cov nqaij lossis cov qe ntshav thiab xa mus rau chaw kuaj mob kom kuaj.

Hauv cov mob GvHD ntev (cGvHD), qee cov tsos mob yuav zoo ib yam li lwm yam kab mob. Yog li ntawd, tus kws kho mob yuav txiav txim siab seb puas muaj lwm yam ua rau mob ua ntej kuaj mob cGvHD.

Cov kev kho mob rau GvHD yog dab tsi?

Tom qab koj tau txais kev hloov noob hlwb (stem cell transplant), koj yuav tau txais cov tshuaj uas tiv thaiv kab mob kom txo tau qhov muaj peev xwm ntawm cov noob hlwb pub dawb los tawm tsam koj cov nqaij.

Yog tias cov tshuaj no tsis tiv thaiv kev loj hlob ntawm GvHD, koj tus kws kho mob yuav sau ntawv kho mob raws li qhov hnyav ntawm koj tus mob thiab hom GvHD.

Kev kho mob GvHD mob hnyav

Cov kws kho mob feem ntau kho cov neeg uas muaj tus kab mob GvHD sai sai los ntawm kev nce cov tshuaj uas ua rau lub cev tiv thaiv kab mob tsis muaj zog. Cov no yog cov tshuaj hu ua corticosteroids. Lawv tuaj yeem muab los ntawm qhov ncauj, txhaj rau hauv cov hlab ntsha, lossis txhaj rau sab nraud. Yog tias cov tshuaj steroids tsis ua haujlwm, koj tus kws kho mob yuav sau ntawv kom muab cov tshuaj xws li Ruxolitinib (Jakafi®). ​​Koj kuj tseem yuav muaj lub sijhawm los koom nrog kev sim tshuaj uas sim cov kev kho mob tshiab.

Kev kho mob GvHD mob ntev

Feem ntau cov tshuaj uas pab tiv thaiv kab mob GvHD ntev kho tau. Yog tias cov tshuaj no tsis pab, koj tus kws kho mob yuav sau ntawv kom noj cov tshuaj xws li:

• Ruxolitinib (Jakafi®)
• `Belumosudil (Rezurock™)`
• Ibrutinib (Imbruvica®)
• Photopheresis (Qhov no yog txoj kev kho mob tshwj xeeb)

Tej zaum koj kuj tsim nyog tau txais "kev sim tshuaj." Tus kws kho mob yuav qhia koj txog qhov ntawd.

Cov teeb meem/cov kev mob tshwm sim ntawm kev kho mob yog dab tsi?

Vim tias cov tshuaj no ua rau koj lub cev tiv thaiv kab mob tsis muaj zog, koj yuav muaj feem ntau dua los kis kab mob fungal, bacterial, thiab viral . Yog li ntawd, koj tus kws kho mob yuav sau ntawv rau ntau yam tshuaj los tiv thaiv koj ntawm cov kab mob txaus ntshai no.

Puas tiv thaiv tau GvHD?

Cov chaw kuaj mob uas ntsuas cov ntaub so ntswg yeej ib txwm tsim thiab siv cov kev kuaj DNA tshiab thiab raug dua. Qhov no ua rau koj pab neeg kho mob xaiv tau tus neeg pub uas muaj HLA phim koj tshaj plaws. Yog tias phim zoo dua, ces yuav muaj feem ntau dua los tiv thaiv GvHD.

Tsis tas li ntawd xwb, koj tus kws kho mob yuav sau ntawv kom noj cov tshuaj uas tiv thaiv kab mob kom tiv thaiv tau GvHD tom qab koj hloov hlwb hlwb lawm.

Puas kho tau GvHD kom zoo tag nrho?

Feem ntau, cov kws kho mob tuaj yeem tswj tau tus mob (GvHD). Qhov ntawd yog, lawv tuaj yeem tswj cov tsos mob thiab pab koj ua neej nyob li qub.

Lub sijhawm no, cov kws tshawb fawb tab tom kawm txog txoj hauv kev tshiab los tiv thaiv GvHD los ntawm kev sim tshuaj. Piv txwv li, lawv tab tom tshawb nrhiav ntau yam tshuaj tiv thaiv kab mob thiab cov tshuaj tiv thaiv tshiab.

Kab mob GvHD puas tuaj yeem ua rau tuag taus?

Yog, GvHD qee zaum tuaj yeem ua rau tuag taus. GvHD ntev yog qhov ua rau tuag ntau tshaj plaws ntawm cov neeg uas tau txais kev hloov pauv hlwb allogeneic, tsis suav nrog lawv tus kab mob tseem ceeb.

Yog li ntawd, ua ntej yuav kho mob - txawm tias yog kev hloov noob hlwb - nws yog ib qho tseem ceeb heev uas yuav tsum tham txog cov kev pheej hmoo nrog koj tus kws kho mob. Nws tuaj yeem piav qhia txog cov kev pheej hmoo rau koj thiab pab koj ntsuas qhov zoo thiab qhov tsis zoo ntawm kev kho mob.

Puas muaj qee zaum qhov zoo dua rau `(GvHD)`?

Tsis txhob xav tsis thoob, txawm hais tias GvHD tuaj yeem muaj qhov cuam tshuam tsis zoo rau koj lub neej zoo, nws kuj muaj qee qhov txiaj ntsig. Tib yam kev tiv thaiv kab mob uas tawm tsam koj cov hlwb ib txwm muaj kuj nrhiav thiab rhuav tshem cov hlwb mob qog noj ntshav uas yuav tshuav nyob hauv koj lub cev. Qhov no hu ua qhov cuam tshuam ntawm graft-versus-tumor. Cov neeg uas muaj GvHD tau pom tias muaj feem tsawg dua uas lawv tus kab mob thawj zaug (tshwj xeeb tshaj yog mob qog noj ntshav) rov qab los.

Kuv yuav saib xyuas kuv tus kheej li cas? Ua raws li cov lus qhia no!

Koj tus kws kho mob yuav piav qhia rau koj seb koj yuav tsum saib xyuas koj tus kheej li cas tom qab koj hloov cov noob hlwb. Piv txwv li, cov tsos mob twg yuav tsum tau saib xyuas thiab cov tsos mob twg yuav tsum tau hu rau koj pab neeg kho mob tam sim ntawd yog tias koj muaj mob. Yog tias koj muaj feem yuav mob GvHD, lawv kuj tseem yuav muab cov lus qhia ntxiv rau koj saib xyuas. Cov lus qhia no suav nrog:

• Tiv thaiv koj daim tawv nqaij ntawm lub hnub. Hnav cov tsho tes ntev thiab ris ntev. Siv cov tshuaj pleev thaiv hnub uas muaj tsawg kawg yog SPF 50. (Kev raug tshav ntuj tuaj yeem ua rau mob GvHD hnyav dua lossis ua rau mob hnyav dua.)
• Tswj kom muaj kev noj qab haus huv ntawm qhov ncauj. Qhov no yuav txo qhov kev pheej hmoo ntawm kev mob ntawm cov pos hniav.
• Tsis txhob noj cov khoom noj ntsim uas yuav ua rau koj lub plab mob thiab ua rau mob qhov ncauj.
• Ua cov kauj ruam los tiv thaiv koj tus kheej ntawm cov kab mob. (Koj tus kws kho mob yuav qhia koj ntxiv txog qhov no.)

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj muaj kev hloov pauv ntawm lub cev, tshwj xeeb yog qhia rau koj tus kws kho mob tam sim ntawd , tshwj xeeb yog cov cim qhia tias koj muaj kab mob thiab kub taub hau (100.4 Fahrenheit / 38 Celsius lossis siab dua). Thaum koj noj cov tshuaj tiv thaiv kab mob, koj yuav muaj feem ntau dua ntawm kev kis kab mob uas tuaj yeem ua rau tuag taus.

Tom qab koj hloov cov noob hlwb allogeneic stem cell lawm, koj tus kws kho mob yuav saib xyuas koj kom zoo rau cov teeb meem xws li Graft vs. Host Disease (GvHD). Yog tias koj muaj cov tsos mob ntawm GvHD mob hnyav lossis mob ntev, koj tus kws kho mob yuav hloov koj cov tshuaj lossis sau ntawv rau koj noj tshuaj tshiab. Noj tag nrho cov tshuaj raws li tau sau tseg. Ua raws li koj tus kws kho mob cov lus qhia txog kev saib xyuas koj tus kheej, tshwj xeeb tshaj yog txog kev tiv thaiv koj tus kheej ntawm kev kis kab mob.

Cov yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov luv luv!

Zoo, yog li Graft vs. Host Disease, lossis GvHD, yog ib qho teeb meem uas tuaj yeem tshwm sim tom qab tau txais stem cell transplant los ntawm lwm tus. Hais yooj yim, nws yog thaum cov donor cell tawm tsam koj cov cell.

Nco ntsoov tias, muaj kev kho mob rau GvHD, thiab tus mob no tuaj yeem tswj tau. Qhov tseem ceeb tshaj plaws yog ua raws li koj pab neeg kho mob cov lus qhia kom zoo thiab qhia rau lawv paub txog cov tsos mob tshiab sai li sai tau.

Yog koj muaj lus nug ntxiv txog qhov no, tsis txhob ntshai nug koj tus kws kho mob. Lawv yog cov uas yuav pab tau koj zoo tshaj plaws.

GvHD , kev hloov noob hlwb, kev hloov allogeneic, lub cev tiv thaiv kab mob, HLA, cov hlwb pub dawb, cov tsos mob