Xav txog tias koj tau txais kev hloov noob hlwb los ntawm ib tus neeg noj qab haus huv los kho tus kab mob xws li mob ntshav dawb (leukemia). Qhov no yuav kho tau koj tus mob. Tab sis tsis tshua muaj cov hlwb tshiab no uas tuaj pab koj, koj lub cev yuam kev tias lawv yog "yeeb ncuab" thiab pib tawm tsam koj cov hlwb. Qhov ntawd yog qhov teeb meem nyuaj uas peb hu ua "Graft versus Host Disease" lossis luv luv GvHD .
GvHD yog dab tsi hauv cov lus yooj yim?
Yuav kom nkag siab qhov no, peb yuav tsum paub ob lo lus. "Graft" txhais tau tias yam khoom uas tau cog rau hauv av, uas yog, cov hlwb noob uas noj qab nyob zoo uas tau muab rau koj los ntawm sab nraud. "Host" txhais tau tias tus tswv tsev, uas yog, koj lub cev uas tau txais cov hlwb ntawd. Yog li "Graft versus Host" txhais tau tias "graft versus host."
Feem ntau, hom kev hloov hlwb no, hu ua allogeneic transplant, yog ua los kho cov mob qog noj ntshav xws li leukemia thiab lymphoma, lossis cov mob pob txha tsis ua haujlwm zoo li aplastic anemia . Cov hlwb uas tau hloov no yog cov uas pib koj lub cev tsim cov hlwb ntshav tshiab.
Tiam sis, qee zaum cov hlwb tshiab no tsis paub koj cov hlwb. Lawv xav tias lawv yog cov neeg txawv teb chaws tuaj txeeb koj lub cev. Yog li, lawv pib tawm tsam koj cov kab mob zoo, xws li koj daim tawv nqaij, lub siab, thiab txoj hnyuv. Qhov ntawd yog qhov GvHD yog.
Muaj ob hom GvHD tseem ceeb:
GvHD muaj ob hom loj. Yav tas los, qhov no tau muab faib raws li lub sijhawm pib muaj cov tsos mob. Tab sis tam sim no, cov kws kho mob txiav txim siab hom tseeb los ntawm kev saib cov tsos mob, cov txiaj ntsig ntawm kev kuaj mob, thiab lub sijhawm pib muaj cov tsos mob.
- Mob GvHD Loj (aGvHD): Feem ntau qhov no tshwm sim hauv 100 hnub tom qab hloov pauv. Tab sis qee zaum nws tuaj yeem tshwm sim tom qab. Hom no feem ntau cuam tshuam rau koj daim tawv nqaij, lub plab zom mov (cov hnyuv), thiab lub siab.
- Mob GvHD Ntev (cGvHD): Hom no tuaj yeem tshwm sim txhua lub sijhawm tom qab hloov pauv, tab sis feem ntau tshwm sim hauv ob xyoos thawj zaug . Nws tuaj yeem cuam tshuam rau txhua qhov ntawm lub cev, suav nrog daim tawv nqaij, qhov ncauj, siab, ntsws, plab hnyuv, cov leeg, pob qij txha, thiab qhov chaw mos.
Ib tug neeg uas tau hloov pauv lub cev lawm ces yuav muaj ib hom ntawm ob hom no, ob hom, lossis lawv yuav noj qab nyob zoo yam tsis muaj ib hom ntawm cov no.
Cov tsos mob ntawm GvHD yog dab tsi?
Cov tsos mob ntawm GvHD muaj txij li me me xwb, nruab nrab xwb, mus txog rau hnyav heev, thiab tej zaum yuav ua rau tuag taus. Cia peb saib cov tsos mob uas cuam tshuam nrog ob hom no.
| Hom GvHD | Cov tsos mob feem ntau |
|---|---|
| Kab mob GvHD mob hnyav (aGvHD) (Feem ntau cuam tshuam rau daim tawv nqaij, txoj hnyuv, siab) |
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| Kab mob GvHD ntev (cGvHD) (Yuav cuam tshuam rau txhua qhov ntawm lub cev) |
Vim li cas GvHD no thiaj tshwm sim?
Qhov no yog ib qho kev tshawb fawb me ntsis, tab sis kuv yuav piav qhia yooj yim.
Feem ntau, cov hlwb ntawm peb lub cev tiv thaiv kab mob tiv thaiv peb ntawm kab mob los ntawm kev tawm tsam cov neeg txawv teb chaws xws li cov kab mob thiab cov kab mob me me. Tab sis cov hlwb ntawd yeej tsis tawm tsam peb cov hlwb. Qhov laj thawj rau qhov no yog vim muaj ib qho protein tshwj xeeb nyob rau ntawm qhov chaw ntawm peb cov hlwb. Qhov no hu ua Human Leukocyte Antigens (HLA) .
Xav txog HLA no zoo li daim npav ID. Peb cov qe ntshav dawb tiv thaiv kab mob saib daim npav ID no thiab hais tias, "Auj ... qhov no yog ib tug ntawm peb."
Tsuas yog cov menyuam ntxaib zoo sib xws xwb, txhua tus neeg lub HLA txawv.
Thaum koj tau txais kev hloov noob hlwb (stem cell transplant), cov qe ntshav tshiab uas tsim los ntawm cov qe ntshav ntawd muaj HLA ntawm tus neeg uas pub cov qe ntshav rau koj. Yog tias HLA ntawd txawv ntawm koj cov HLA, cov qe ntshav tshiab ntawd yuav saib cov qe ntshav hauv koj lub cev thiab xav tias, "Qhov no yog tus neeg tawm tsam, nws tus ID tsis phim peb li." Thaum ntawd cov qe ntshav ntawd pib tawm tsam koj lub cev.
Vim li no, cov kws kho mob ua tib zoo xyuas tus neeg pub thiab tus neeg txais HLA kom paub tseeb tias lawv nyob ze li ze tau ua ntej hloov pauv. Tab sis tshwj tsis yog tias cov hlwb raug rho tawm ntawm tus menyuam ntxaib, yeej ib txwm muaj qee qhov kev pheej hmoo ntawm GvHD.
Leej twg muaj feem yuav mob GvHD ntau dua?
Qhov tseem ceeb tshaj plaws uas ua rau muaj kev pheej hmoo yog HLA tsis sib xws, tab sis muaj ntau lwm yam uas ua rau muaj kev pheej hmoo no.
| Qhov ua rau muaj kev pheej hmoo | Kev piav qhia |
|---|---|
| HLA tsis sib xws | - Kev hloov cov qe ntshav uas tsis sib phim HLA, txawm tias yog coj los ntawm ib tug txheeb ze los xij. - Txawm yog los ntawm ib tus neeg uas tsis muaj txheeb ze, thiab HLA sib phim zoo los xij, tseem muaj qee qhov kev pheej hmoo. |
| Lwm yam tseem ceeb |
|
Tsis tas li ntawd xwb, yog tias koj twb muaj tus kab mob Acute GvHD (aGvHD) lawm, koj muaj feem yuav mob Chronic GvHD (cGvHD) ntau dua.
Yuav kuaj mob thiab kho tus mob no li cas?
Kev kuaj mob
Koj tus kws kho mob yuav kuaj mob GvHD los ntawm kev kuaj koj lub cev, saib koj cov tsos mob, thiab kuaj ntshav thiab kuaj ib daim nqaij me me. Kev kuaj nqaij me me yog kev siv ib daim tawv nqaij me me lossis cov nqaij mos uas raug mob thiab kuaj nws hauv lub tshuab tsom iav. Vim tias qee cov tsos mob ntawm GvHD ntev zoo ib yam li lwm yam mob, koj tus kws kho mob yuav tshem tawm lwm yam mob ua ntej kuaj mob GvHD.
Kev Kho Mob
Yuav kom tiv thaiv tau GvHD tom qab hloov cev, koj yuav tau txais cov tshuaj uas tiv thaiv koj lub cev tiv thaiv kab mob. Cov tshuaj no ua haujlwm los ntawm kev txo cov hlwb txawv teb chaws kom tawm tsam koj lub cev.
Yog tias muaj GvHD txawm tias noj cov tshuaj no los xij, koj tus kws kho mob yuav txiav txim siab kho raws li qhov hnyav ntawm koj tus mob thiab hom GvHD.
- Rau tus kab mob GvHD mob hnyav (aGvHD): Feem ntau, cov tshuaj corticosteroids raug muab ua cov tshuaj ntsiav, tshuaj txhaj, lossis ua tshuaj pleev rau ntawm daim tawv nqaij. Yog tias cov no tswj tsis tau tus kab mob, lwm yam tshuaj xws li Ruxolitinib (Jakafi®) lossis kev sim tshuaj kho mob yuav raug xav txog.
- Rau Mob GvHD Ntev (cGvHD): Cov tshuaj tiv thaiv kab mob mus sij hawm ntev kuj raug muab rau qhov no. Yog tias tus mob tsis raug tswj los ntawm cov no, cov tshuaj xws li Ruxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) lossis kev kho mob tshwj xeeb xws li photopheresis yuav tsum tau ua.
Cov kev mob tshwm sim ntawm kev kho mob
Cov kev kho mob no ua rau koj lub cev tiv thaiv kab mob tsis muaj zog, uas ua rau koj lub cev tsis muaj peev xwm tiv thaiv kab mob. Qhov no ua rau koj muaj feem yuav kis tau kab mob fungal, kab mob bacterial, thiab kab mob viral ntau ntxiv. Koj tus kws kho mob kuj tseem yuav sau tshuaj los pab tiv thaiv cov kab mob no uas yuav ua rau tuag taus.
Lwm yam teebmeem uas yuav tshwm sim vim yog GvHD
Puas yog GvHD ua rau neeg tuag taus?
Yog, GvHD tuaj yeem ua rau tuag taus. Tshwj xeeb tshaj yog GvHD ntev ntev yog qhov ua rau tuag ntau tshaj plaws tom qab hloov cov noob hlwb, tsis suav nrog tus kab mob tseem ceeb. Yog vim li ntawd nws thiaj li tseem ceeb uas yuav tsum tham txog cov kev pheej hmoo nrog koj tus kws kho mob ua ntej yuav kho mob.
Puas muaj txiaj ntsig dab tsi los ntawm GvHD?
Qhov xav tsis thoob, yog lawm. GvHD muaj qee qhov txiaj ntsig. Cov hlwb tiv thaiv kab mob tshiab no uas tawm tsam koj cov hlwb noj qab haus huv kuj nrhiav thiab rhuav tshem cov hlwb mob qog noj ntshav uas yuav tseem nyob hauv koj lub cev. Qhov no hu ua "graft-versus-tumor effect." Yog li ntawd, kev tshawb fawb tau qhia tias cov neeg mob uas muaj GvHD yuav tsis tshua muaj mob qog noj ntshav rov qab los.
Tej yam koj ua tau rau koj txoj kev nyab xeeb
Koj tus kws kho mob yuav piav qhia koj yuav ua li cas saib xyuas koj tus kheej tom qab hloov pauv lub raum. Ceev faj tshwj xeeb txog cov no yog tias koj muaj feem yuav kis tau GvHD.
- Tiv thaiv koj tus kheej ntawm lub hnub: Kev raug lub hnub tuaj yeem ua rau GvHD hnyav dua. Yog li ntawd, hnav tsho ntev thiab ris ntev thaum mus sab nraum zoov. Siv tshuaj pleev thaiv hnub uas muaj tsawg kawg SPF 50.
- Kev tu cev qhov ncauj: Txhuam koj cov hniav kom huv si kom txo tau qhov kev pheej hmoo ntawm kab mob pos hniav.
- Khoom Noj thiab Dej Haus: Tsis txhob noj cov khoom noj uas muaj roj ntau, thiab cov khoom noj uas ua rau mob qhov ncauj.
- Tiv thaiv koj tus kheej ntawm cov kab mob: Vim tias koj lub cev tiv thaiv kab mob tsis muaj zog, zam cov chaw uas muaj kab mob sib kis thiab cov chaw muaj neeg coob coob. Ib txwm ntxuav koj txhais tes kom huv si.
Kuv yuav tsum mus ntsib kws kho mob thaum twg?
Nws yog ib qho tseem ceeb uas yuav tsum qhia rau koj tus kws kho mob tam sim ntawd yog tias koj pom muaj kev hloov pauv hauv koj lub cev, tshwj xeeb tshaj yog cov cim qhia txog kev kis kab mob lossis kub taub hau txog 38 degrees Celsius (100.4 Fahrenheit) lossis siab dua. Kev kis kab mob tuaj yeem ua rau hnyav dua sai dua thaum koj noj cov tshuaj uas ua rau lub cev tiv thaiv kab mob tsis muaj zog.
Koj tus kws kho mob yuav saib xyuas koj tsis tu ncua tom qab koj hloov koj lub cev kom paub txog cov teeb meem xws li GvHD. Yog tias cov tsos mob tshwm sim, lawv yuav hloov koj cov tshuaj lossis sau ntawv rau cov tshuaj tshiab. Nws yog ib qho tseem ceeb heev uas yuav tsum noj tag nrho cov tshuaj raws li tau qhia thiab ua raws li koj tus kws kho mob cov lus qhia.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob Graft vs. Host Disease (GvHD) yog ib qho teeb meem uas tshwm sim tom qab kev hloov stem cell, thaum lub cev ntawm tus neeg txais kev pab tawm tsam cov cell pub dawb.
- Muaj ob hom mob no, mob hnyav thiab mob ntev. Cov tsos mob sib txawv raws li ntawd.
- Txoj kev zoo tshaj plaws los tiv thaiv GvHD yog xyuas kom tus neeg pub thiab tus neeg txais muaj HLA sib phim zoo tshaj plaws.
- Vim tias cov tshuaj uas tswj lub cev tiv thaiv kab mob raug siv rau kev kho mob, qhov kev pheej hmoo ntawm kev kis kab mob yog siab heev.
- Qhia rau koj tus kws kho mob tam sim ntawd yog tias muaj cov tsos mob tshiab, tshwj xeeb tshaj yog kub taub hau.
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Ntxiv koj cov lus