Yog tias koj tau txais kev kho mob loj xws li kev hloov pob txha rau mob qog ntshav thiab xav tias, "Txhua yam zoo tam sim no," thiab tom qab ntawd koj hnov tias mob qog ntshav tau rov qab los? Nws yog qhov mob siab heev thiab tu siab heev. Tab sis tsis txhob tso tseg kev cia siab. Hnub no peb tab tom tham txog kev kho mob tshwj xeeb uas tuaj yeem pab tau rau hauv cov xwm txheej zoo li no. Nws hu ua DLI, uas sawv cev rau Donor Lymphocyte Infusion.
Hais yooj yim xwb, DLI yog dab tsi?
Zoo, cia peb hais yooj yim xwb. Lymphocytes yog ib hom qe ntshav dawb hauv koj cov ntshav. Lawv zoo li cov tub rog hauv peb lub cev. Lawv yog ib feem tseem ceeb ntawm peb lub cev tiv thaiv kab mob, tawm tsam cov kab mob txawv teb chaws, kev kis kab mob, thiab cov qe mob qog noj ntshav.
Tam sim no, DLI (Donor Lymphocyte Infusion) yog ib txoj kev kho mob uas qee cov lymphocytes no raug coj los ntawm tib tus neeg pub dawb noj qab haus huv uas tau pub koj cov pob txha (cov hlwb pob txha) thiab txhaj rau hauv koj lub cev. Cov 'tub rog' tshiab, noj qab haus huv thiab muaj zog no nrhiav thiab rhuav tshem cov hlwb qog nqaij hlav uas tseem nyob hauv koj lub cev. Qhov ntawd yog lub hom phiaj tseem ceeb ntawm kev kho mob no.
Hauv cov xwm txheej twg, kev kho mob DLI raug pom zoo?
Koj tus kws kho mob yuav qhia koj txog kev kho mob no yog tias koj tus mob qog ntshav rov qab los (rov qab los) tom qab hloov pob txha.
Nov yog qee yam mob uas kev kho mob DLI feem ntau siv rau:
- Kab mob ntshav dawb Acute Myeloid Leukemia (AML)
- Kab mob qog ntshav Lymphocytic ntev (CLL)
- Kab mob qog ntshav Myeloid ntev (CML)
- Ntau yam mob myeloma
- Myelodysplasia (MDS)
- Lymphoma uas tsis yog Hodgkin
Ib qho ntxiv yog, qee zaum tom qab hloov pob txha, koj lub cev yuav muaj cov qe ntshav dawb sib xyaw thiab koj cov qe ntshav qub. Peb hu qhov no (kev sib xyaw ua ke ntawm chimerism) . Qhov no kuj ua rau muaj kev pheej hmoo ntawm tus mob qog noj ntshav rov qab los. Yog li, DLI tuaj yeem ua tiav los hloov tag nrho cov qe ntshav hauv koj lub cev mus ua cov qe ntshav los ntawm tus neeg pub.
Koj npaj li cas rau qhov kev kho mob no?
Ua ntej pib kho mob DLI, koj tus kws kho mob yuav kuaj koj kom zoo zoo, tham txog koj cov tsos mob, thiab xaj ntau qhov kev kuaj mob.
- Kev kuaj cov pob txha hauv lub cev: Yuav muab ib qho qauv me me ntawm cov pob txha hauv lub cev coj mus kuaj seb puas muaj cov hlwb qog nqaij hlav uas tseem tshuav.
- Kev suav ntshav tag nrho (CBC):Tab tom kuaj xyuas tus naj npawb ntawm cov qe ntshav hauv cov ntshav.
- Kev kuaj mob raum thiab daim siab ua haujlwm.
Yog tias qhov kev kuaj mob qhia tau hais tias cov qe ntshav qog nqaij hlav siab heev, koj tus kws kho mob yuav txiav txim siab muab tshuaj chemotherapy rau koj ua ntej DLI. Qhov no yog kom txo cov qe ntshav qog nqaij hlav thiab ua kom kev kho mob DLI zoo dua.
Yuav ua li cas thiaj tau txais cov qe ntshav dawb los ntawm tus neeg pub dawb?
Qhov no yog ib qho tshwj xeeb heev uas tshwm sim. Tus neeg pub uas tau muab txoj sia rau koj, uas yog, tus neeg pub uas tau muab pob txha rau koj, kuj pab nrog qhov no. Ib lub raj me me (catheter) raug ntxig rau hauv cov leeg ntshav hauv nws txhais tes thiab qee cov ntshav raug coj mus. Cov ntshav no mus dhau lub tshuab tshwj xeeb. Lub tshuab ntawd ua yog cais cov hlwb lymphocyte uas peb xav tau, thiab xa cov ntshav seem rov qab mus rau lub cev los ntawm cov leeg ntshav hauv tus neeg pub lwm txhais tes. Cov txheej txheem no hu ua apheresis . Qee zaum, thaum koj thawj zaug pub cov pob txha, qee cov hlwb lymphocyte no tuaj yeem raug coj mus thiab khov rau kev siv tom qab.
Koj tau txais kev kho mob DLI li cas?
Qhov no zoo li ib yam yooj yim xws li muab cov kua ntsev rau koj.
1. Tus kws kho mob lossis tus nais maum yuav muab ib lub raj me me (catheter) ntxig rau hauv cov hlab ntsha hauv koj txhais caj npab lossis hauv siab.
2. Tom qab ntawd, lub pob uas muaj cov qe ntshav dawb uas tau cais tawm ntawm tus neeg pub dawb raug txuas nrog lub raj ntawd thiab txhaj rau hauv koj cov ntshav.
3. Txoj haujlwm no siv sijhawm li 30 feeb .
4. Thaum ua tiav txoj haujlwm, lub raj raug tshem tawm.
Qee zaum koj tuaj yeem muab ntau koob tshuaj zoo li no rau lub sijhawm ob peb lub lis piam lossis ob peb lub hlis.
Thaum cov hlwb tshiab raug coj mus rau hauv lub cev li no, ib qho tseem ceeb tshaj plaws yog hu ua qhov cuam tshuam ntawm kev hloov pauv ntawm cov qog nqaij hlav (GvT) . Qhov no txhais tau tias cov hlwb noj qab haus huv no (hloov pauv) los ntawm tus neeg pub dawb nrhiav cov hlwb qog nqaij hlav uas tseem tshuav (qog nqaij hlav) hauv koj lub cev, tawm tsam lawv, thiab rhuav tshem lawv. Qhov no yog li cas qog nqaij hlav ploj mus tag.
Cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob DLI yog dab tsi?
Cov txiaj ntsig tseem ceeb ntawm qhov no
Yav dhau los, yog tias tus mob qog noj ntshav rov qab los tom qab hloov pob txha, tib txoj kev xaiv yog hloov pob txha dua. Tab sis qhov kev pheej hmoo ntawm cov teeb meem yog siab dua nrog kev hloov zaum ob. DLI yog ib txoj hauv kev zoo, tsis muaj kev pheej hmoo los ua kom tus mob qog noj ntshav zoo yam tsis muaj cov tshuaj tiv thaiv kab mob.
Tej yam txaus ntshai thiab teeb meem uas yuav tshwm sim
Ib yam li txhua yam kev kho mob, muaj qee qhov kev pheej hmoo. Koj pab neeg kho mob yuav saib xyuas koj kom zoo rau cov no.
| Kev nyuaj siab | Kev piav qhia thiab cov tsos mob |
|---|---|
| Kab Mob Graft vs. Host Disease (GvHD) | Qhov no yog thaum cov qe ntshav ntawm tus neeg pub (hloov) pom koj lub cev noj qab haus huv (tus tswv tsev) ua yeeb ncuab thiab tawm tsam lawv. Cov tsos mob: raws plab, tawv nqaij daj (jaundice), xeev siab thiab ntuav, mob tawv nqaij lossis pob khaus. |
| Kev tiv thaiv kab mob myelosuppression | Qhov no yog ib qho kev txo qis ib ntus ntawm kev ua haujlwm ntawm cov pob txha, uas tuaj yeem ua rau cov qe ntshav tsawg zuj zus. - Cov qe ntshav liab tsawg (Anemia): qaug zog, ua pa luv luv. - Cov qe ntshav dawb txo qis (Leukopenia): Muaj kev pheej hmoo ntawm kev kis kab mob ntau ntxiv. - Cov ntshav platelets qis: Muaj kev pheej hmoo ntawm kev los ntshav. |
Yuav ua li cas yog tias muaj teeb meem tshwm sim?
Tsis txhob txhawj. Muaj kev kho rau txhua yam no.
- Yog tias muaj GvHD: Koj tus kws kho mob yuav sau ntawv kom noj cov tshuaj uas tiv thaiv kab mob .
- Yog tias koj cov qe ntshav qis: Cov qe ntshav dawb qis feem ntau ploj mus ntawm lawv tus kheej. Yog tias tsis yog, muaj cov tshuaj los kho lawv. Kev hloov ntshav tuaj yeem muab yog tias tsim nyog los kho cov qe ntshav liab thiab cov platelets qis.
Tom qab kev kho mob thiab txog kev vam meej
Tham nrog koj tus kws kho mob txog seb yuav siv sijhawm ntev npaum li cas thiaj rov qab zoo li qub tom qab kho tas. Koj yuav tsum tau mus ntsib kws kho mob thiab kuaj ntshav tas li.
Qhov kev vam meej ntawm kev kho mob no yuav txawv ntawm ib tus neeg mus rau ib tus neeg. Muaj ntau yam uas cuam tshuam rau nws:
- Theem mob qog noj ntshav.
- Kev noj qab haus huv ntawm koj lub cev tiv thaiv kab mob.
- Hom kev hloov pauv uas tau ua dhau los.
- Seb puas tau ua tshuaj chemotherapy ua ntej DLI los tsis tau.
Qhov tseem ceeb tshaj plaws: Yog tias koj muaj cov tsos mob ntawm GvHD xws li kub taub hau, los ntshav txawv txawv, ua pa nyuaj, raws plab, tawv nqaij tawm pob, lossis lwm yam tsos mob txawv txawv , qhia rau koj tus kws kho mob lossis tsev kho mob tam sim ntawd.
DLI puas yog kev kho mob tiv thaiv kab mob?
Yog, DLI yog kev kho mob tiv thaiv kab mob.Nws yog ib hom kev kho mob. Vim tias qhov koj ua yog muab rau koj lub cev tiv thaiv kab mob cov T-cells noj qab haus huv los ntawm sab nraud los pab nws tawm tsam mob qog noj ntshav. Qhov ntawd muaj kev cia siab tiag tiag.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- DLI yog ib txoj kev kho mob tshwj xeeb rau cov mob qog ntshav uas rov tshwm sim tom qab hloov pob txha.
- Qhov no siv cov hlwb hu ua lymphocytes los ntawm tib tus neeg pub dawb uas tau pub koj cov pob txha thawj zaug.
- Lub hom phiaj ntawm qhov no yog rau cov hlwb tshiab no los nrhiav thiab rhuav tshem cov hlwb qog nqaij hlav uas tseem tshuav hauv lub cev (GvT effect).
- Cov kev pheej hmoo tseem ceeb yog GvHD (Graft vs. Host Disease) thiab cov qe ntshav tsawg, tab sis cov no kho tau.
- Qhov no yog ib hom kev kho mob tiv thaiv kab mob uas muab kev cia siab yam tsis muaj kev pheej hmoo siab ntawm kev hloov pob txha zaum ob.
- Tham nrog koj tus kws kho mob tam sim ntawd txog tej yam tsos mob tshiab lossis teeb meem.
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