Wali okyusiddwa obutoffaali obusibuka mu mubiri okuva eri omuntu? Tumanye kino (Obulwadde bwa Graft vs. Host)!

Oboolyawo owulidde ku kusimbuliza obutoffaali obusibuka mu mubiri. Zino ddagala ddene nnyo erijjanjaba endwadde ezimu. Wabula leero tugenda kwogera ku kizibu ekiyinza okubaawo oluvannyuma lw’okusimbuliza omuntu ng’ekyo. Kino kiyitibwa `(Graft vs. Host Disease)` oba `(GvHD)` mu bufunze. Tofaayo, ka twogere ku nsonga eno mu ngeri ennyangu.

`(Obulwadde bwa Graft vs. Host - GvHD)` kye ki? Mu ngeri ennyangu okunnyonnyolwa...

Teebereza nti okyusiddwa obutoffaali obusibuka mu mubiri okuva eri omuntu omulala, omugabi . Kino tukiyita okusimbuliza kwa allogeneic. Obutoffaali buno obusibuka mu mubiri bulinga obutoffaali obutakuze mu kkolero ly’omubiri gwo erikola omusaayi, oba obutoffaali obusibuka omusaayi. Buno bwe butoffaali oluvannyuma obujja okufuuka obutoffaali obumyufu n’obutoffaali obweru omubiri gwo bwe gwetaaga.

Kati, ddi lwe wandyetaaga obutoffaali obusibuka okuva eri omugabi nga ono? Bw’oba ​​olina kookolo nga leukemia oba lymphoma, oba obulwadde obulala ng’obusigo bw’amagumba tebukola bulungi nga aplastic anemia, oyinza okwetaaga okusimbuliza ekika kino.

Okay, kati kino `(GvHD)` kye ki? Mu `(GvHD)`, ekibaawo nti obutoffaali obugaba bwe wafuna (graft) bulaba obutoffaali mu mubiri gwo (host) ng’ekintu ekyewuunyisa, ky’otomanyi. Kiringa omubiri gwo kifo kipya gye bali. Kale, obutoffaali buno obugaba butandika okulumba obutoffaali bw’omubiri gwo. Eno y'ensonga lwaki kiyitibwa `(Graft vs. Host Disease)`, ekitegeeza "graft against host." Otegedde?

Bika ki ebikulu ebya GvHD?

Waliwo ebika bya GvHD bibiri ebikulu. Edda abasawo baagugabanyaamu okusinziira ku budde bwe bwatwala obubonero okutandika. Wabula kati, batunuulira obubonero n’ebyava mu kukeberebwa okuzuula ekika ekituufu.

1. GvHD ey’amaanyi (aGvHD) .

Kino kitera okubaawo nga wayiseewo akaseera katono ng’omaze okusimbibwa obutoffaali obusibuka mu mubiri, emirundi mingi mu nnaku 100 ezisooka . Kyokka oluusi obubonero buyinza okutandika oluvannyuma. Acute GvHD esinga kukosa lususu lwo, enkola y’okugaaya emmere (GI tract), oba ekibumba.

2. GvHD etali ya bulijjo (cGvHD) .

GvHD etawona esobola okubaawo ekiseera kyonna oluvannyuma lw’okusimbuliza allogeneic. Kyokka, kisinga kutandika mu myaka ebiri . GvHD etawona esobola okukosa olususu lwo, akamwa, ekibumba, amawuggwe, GI tract, ebinywa, ennyondo oba ebitundu by’ekyama.

Ekikulu: Oyinza okukola ekimu, byombi, oba tewali kimu ku bika bya GvHD bino. Kyawukana okusinziira ku muntu.

Bubonero ki obwa `(GvHD)`? Bino bibeere mwegendereza!

Obubonero bwa GvHD bwawukana okusinziira ku muntu. Abantu abamu bayinza okuba n’obubonero obutono , abamu bayinza okuba n’obubonero obw’ekigero , ate abalala bayinza okuba n’obubonero obw’amaanyi.Kiyinza okuba eky’amaanyi ennyo (ne bwe kiba nga kiyinza okutta omuntu).

Obubonero bwa acute `(GvHD)`

Twagamba dda nti acute GvHD esinga kukosa lususu, GI tract, n’ekibumba.

• Olususu (aGvHD): Akabonero akasinga okulabika kwe kuzimba olususu oba okumyuuka (nga okwokya omusana). Wayinza okubaawo obulumi n’okusiiyibwa. Ebiseera ebisinga okusiiyibwa kutandikira ku bulago, ebibegabega, mu matu, engalo n’engalo z’ebigere. Olwo kiyinza okusaasaana mu bitundu by’omubiri ebirala.
• Enkola y’omu lubuto (GI) (aGvHD): Obubonero obusinga okulabika kwe kuziyira, okusiiyibwa, n’ekiddukano (okuzimba). Obubonero buno buyinza okuba obutono oba obw’amaanyi ekimala nga kyetaagisa okuweebwa ekitanda mu ddwaaliro.

Obubonero obutera okulabika obw’obulwadde bwa GvHD obw’amaanyi mulimu:

• Okusiiyibwa kw’olususu ne/oba okusiiwa.
• Embiro.
• Okuziyira n’okusiiyibwa.
• Olubuto oluluma, okulemagana.
• Jaundice (okufuuka kwa kyenvu kw’olususu ne/oba amaaso).

Obubonero bwa GvHD etali ya bulijjo

GvHD etawona esinga kukosa lususu lwo, ekibumba, GI tract, n’amawuggwe. Kyokka, kiyinza okukosa ekitundu kyonna eky’omubiri gwo.

Obubonero buyinza okuli:

• Okusiiyibwa kw’olususu ne/oba okusiiwa.
• Okunyweza olususu n’okuzimba.
• Enviiri okugwa ku mutwe n’omubiri.
• Akamwa akalu.
• Amabwa mu kamwa.
• Obulwadde bw’ennyindo.
• Amaaso amakalu, ng’owulira ng’empeke y’omusenyu esimbye munda.
• Enkyukakyuka mu kulaba.
• Embiro.
• Okuziyira n’okusiiyibwa.
• Okufuuka okwa kyenvu kw’olususu ne/oba amaaso (jaundice).
• Obuzibu mu kussa (dyspnea).
• Okusesema okukalu, okutambula obutasalako.
• Obukoowu.
• Okunafuwa kw’ebinywa, okulemererwa oba okulumwa.
• Obutasobola kufukamira n’okugaziya ennyondo obulungi.
• Abakyala bayinza okufuna obukyala okukala, okusiiwa oba okulumwa nga beegatta.
• Abasajja bayinza okusiiwa obusajja oba ensigo, oba okulumwa nga beegatta.

Lwaki kino `(GvHD)` kibaawo? Kiki ekivaako?

Mu ngeri ennyangu, GvHD ebaawo ng'obutoffaali obusibuka okuva mu muntu gwe wafuna okusimbibwa bulaba obutoffaali bw'omubiri gwo nga "obw'ebweru" ne butandika okubulumba.

Kino kye kitera okubaawo: Obutoffaali bw’abaserikale b’omubiri (obutoffaali mu musaayi gwo) bukukuuma obutakwatibwa bulwadde. Zirwanyisa ebintu ebigwira, gamba nga akawuka ne bakitiriya. Kyokka obutoffaali buno tebulumba butoffaali bwo. Kino kiri bwe kityo kubanga obutoffaali bwo bulina puloteyina ey'enjawulo eyitibwa ``Human Leukocyte Antigens'', oba ``HLA''. Kino kiringa tag eriko erinnya. ``HLA'' eno y'egamba obutoffaali bwo obw'abaserikale b'omubiri nti, "Hey, eno y'emu ku zaffe."

Ekisinga obukulu kiri nti, okuggyako abalongo abafaanagana, `(HLA)` ya buli muntu ya njawulo ku munne.

Oluvannyuma lw’okusimbuliza obutoffaali obusibuka okuva eri omuntu omulala, obutoffaali obupya mu mubiri gwo tebulina `(HLA)` yo, wabula `(HLA)` y’oyo agaba . Kale, singa `(HLA)` y'omugabi ono eba ya njawulo nnyo ku `(HLA)` mu mubiri gwo, obutoffaali obwo obupya obw'omusaayi butandika okulumba obutoffaali bw'omubiri gwo. Awo we wabeera `(GvHD)`.

Eno y’ensonga lwaki abasawo bakebera n’obwegendereza HLA y’oyo agiwaddeyo okukakasa nti eri kumpi n’eyo nga bwe kisoboka nga tebannaba kukyusa butoffaali busibuka. Okuzuula omuntu akwatagana ng’oyo kikendeeza ku bulabe bw’okufuna GvHD. Wabula bw’oba ​​tofuna butoffaali okuva mu balongo abafaanagana, wakyaliwo omukisa nti ojja kukola GvHD, ne bw’ogezaako emipiira emeka.

Ani asinga okubeera mu bulabe bw’okulwala GvHD?

Ensonga esinga obukulu ey’akabi y’engeri HLA y’omugabi wo gy’ekwataganamu n’eyo. Oli mu bulabe bwa maanyi obw’okukwatibwa GvHD singa:

• Wafuna obutoffaali obusibuka okuva mu b’oluganda, naye si bukwatagana bulungi bwa HLA .
• Wafuna obutoffaali obusibuka okuva ku muntu atali wa luganda lwo, naye nga `(HLA)` match .

Ebirala ebiyinza okuleeta akabi bye bino:

• Omugabi alina okuba ng’abadde mukyala eyali amaze okufuna olubuto.
• Okwongera emyaka gy’oyo agaba oba ggwe kennyini.
• Obutakwatagana mu kikula ky’omuntu wakati w’oyo agaba naawe (e.g. okufuna obutoffaali okuva ku musajja agaba okudda ku mukazi, oba okuva ku mukazi agaba okudda ku musajja).
• Singa obutoffaali obusibuka bw’omugabi buggyibwa mu misuwa (omusaayi) mu kifo ky’okuggyibwa mu busimu bw’amagumba (awali obutoffaali bw’omusaayi).

Bwoba nga wali dda okufuna acute `(aGvHD)`, oli mu bulabe bwa maanyi okulwala chronic `(cGvHD)`.

GvHD ezuulibwa etya?

Omusawo asobola okuzuula GvHD ng’akukebera, ng’atunuulira obubonero bwo, n’okutunuulira ebikeberebwa mu laabu n’ebyava mu kukebera omubiri. Okukebera ebitundu by’omubiri (biopsy) kizingiramu okutwala akatundu akatono ak’ebitundu byo oba obutoffaali n’okasindika mu laabu okukeberebwa.

Mu GvHD etali ya bulijjo (cGvHD), obubonero obumu buyinza okufaananako n’endwadde endala. N’olwekyo, omusawo ajja kuggyawo ebivaako ebirala byonna nga tannazuula bulungi cGvHD.

Bujjanjabi ki obuweebwa GvHD?

Oluvannyuma lw’okusimbuliza obutoffaali obusibuka mu mubiri, ojja kuweebwa eddagala eriziyiza obusimu bw’omubiri ng’ekipimo eky’okuziyiza okukendeeza ku busobozi bw’obutoffaali obugaba okulumba ebitundu byo.

Singa eddagala lino terikomya kukula kwa GvHD, omusawo ajja kukuwa obujjanjabi okusinziira ku buzibu bw’embeera yo n’ekika kya GvHD.

Obujjanjabi bw’obulwadde bwa GvHD obw’amaanyi

Abasawo batera okujjanjaba obulungi abantu abalina acute GvHD nga bongera ku ddoozi y’eddagala eriziyiza abaserikale b’omubiri. Zino ziri mu kibinja ky’eddagala eriyitibwa corticosteroids. Ziyinza okuweebwa mu kamwa, mu misuwa oba ku mubiri. Singa eddagala lya steroids tebikola, omusawo ayinza okukuwa eddagala nga Ruxolitinib (Jakafi®). Oyinza n’okufuna omukisa okwetaba mu kugezesebwa okw’obujjanjabi okugezesa obujjanjabi obupya.

Obujjanjabi bw’obulwadde bwa GvHD obutawona

GvHD etali ya bulijjo etera okujjanjabibwa n’eddagala eriziyiza obusimu obuziyiza endwadde okumala ebbanga eddene. Singa eddagala lino teriyamba, omusawo ayinza okukuwa eddagala nga:

• `Ruxolitinib (Jakafi®)`
• `Belomosudil (RezurockTM)`
• `Ibrutinib (Imbruvica®)`
• Photopheresis (Eno nkola ya njawulo ey’obujjanjabi) .

Oyinza n'okuba n'ebisaanyizo okugezesebwa ``clinical trials.'' Omusawo ajja kukubuulira ku ekyo.

Bizibu ki/ebizibu ebiva mu bujjanjabi bye biruwa?

Olw’okuba eddagala lino eriweweeza ku busimu obuziyiza endwadde linafuya abaserikale b’omubiri gwo, otera okufuna yinfekisoni za ffene, bakitiriya, n’akawuka . N’olwekyo, omusawo ajja kukuwa eddagala eddala eriwerako okukukuuma okuva ku yinfekisoni zino ez’obulabe.

GvHD esobola okuziyizibwa?

Laabu z’okuwandiika ebitundu by’omubiri zikola buli kiseera era nga zikozesa ebigezo ebipya ebituufu ebisinziira ku DNA. Kino kisobozesa ttiimu yo ey’abasawo okulonda omugabi asinga omupiira gwa HLA gy’oli. Omupiira gye gukoma okuba omulungi, omukisa gw’okuziyiza GvHD gye gukoma okuba omulungi.

Ekirala, omusawo ajja kukuwa eddagala eriweweeza ku busimu bw’omubiri okuziyiza GvHD oluvannyuma lw’okusimbuliza obutoffaali obusibuka mu mubiri.

GvHD esobola okuwona ddala?

Emirundi egisinga, abasawo basobola bulungi okuddukanya embeera eno (GvHD). Kwe kugamba, zisobola okufuga obubonero ne zikuyamba okubeera mu bulamu obwa bulijjo.

Mu kiseera kino, abanoonyereza banoonyereza ku ngeri empya ez’okuziyiza GvHD nga bayita mu kugezesebwa mu malwaliro. Okugeza, banoonyereza ku ddagala ery’enjawulo eriziyiza obusimu bw’omubiri n’eddagala eppya eriziyiza obulwadde.

GvHD eyinza okuba ey’obulabe eri obulamu?

Yee, GvHD oluusi eyinza okuteeka obulamu mu matigga. GvHD etali ya bulijjo y’esinga okutta abantu abafuna okukyusa obutoffaali obusibuka mu mubiri (allogeneic stem cell transplant), ng’oggyeeko obulwadde bwabwe obusookerwako.

N’olwekyo, nga tonnafuna bujjanjabi bwonna – wadde okusimbuliza obutoffaali obusibuka mu mubiri – kikulu nnyo okukubaganya ebirowoozo n’omusawo wo akabi akali mu mbeera. Asobola okukunnyonnyola akabi akali mu bujjanjabi n’okukuyamba okupima ebirungi n’ebibi ebiri mu bujjanjabi obwo.

Oluusi waliwo enkizo eri `(GvHD)`?

Tokyewuunya wadde nga GvHD esobola okukosa omutindo gw’obulamu bwo, naye era erina emigaso egimu. Enkola y’emu ey’abaserikale b’omubiri elumba obutoffaali bwo obwa bulijjo era enoonya n’okusaanyaawo obutoffaali bwa kookolo bwonna obuyinza okulekebwa mu mubiri gwo. Kino kiyitibwa enkola ya graft-versus-tumor effect. Abantu abafuna GvHD kizuuliddwa nti tebatera kuddamu kufuna bulwadde bwabwe obusookerwako (naddala kookolo).

Nze nneerabirira ntya? Goberera amagezi gano!

Omusawo ajja kukunnyonnyola engeri gy’osaanidde okwerabirira ng’omaze okusimbuliza obutoffaali obusibuka mu mubiri. Okugeza, bubonero ki bw’olina okwegendereza n’obubonero bw’olina okuyita ttiimu yo ey’abasawo amangu ddala singa ofuna. Bw’oba ​​oli mu bulabe bw’okulwala GvHD, bayinza n’okukuwa ebiragiro ebirala eby’okulabirira. Ebiragiro bino mulimu:

• Kuuma olususu lwo okuva ku musana. Yambala essaati ez’emikono emiwanvu n’empale empanvu. Kozesa eddagala eriziyiza omusana nga lirina waakiri SPF 50. (Okubeera mu musana kiyinza okwonooneka oba okuleeta GvHD.)
• Kuuma obulamu obulungi mu kamwa. Kino kijja kukendeeza ku bulabe bw’okufuna obulwadde bw’ennyindo.
• Weewale emmere erimu ebirungo ebiyinza okutabula olubuto n’okukuleetera amabwa mu kamwa.
• Kola emitendera okwekuuma obuwuka. (Omusawo wo ajja kukubuulira ebisingawo ku nsonga eno.)

Ddi lwe nnina okulaba omusawo?

Kikulu okutegeeza omusawo mu bwangu bw’oba ​​olina enkyukakyuka yonna mu mubiri naddala obubonero obulaga nti olina yinfekisoni n’omusujja (100.4 Fahrenheit / 38 Celsius oba okusingawo). Bw’omira eddagala eriweweeza ku busimu bw’omubiri, oba mu bulabe obw’okufuna yinfekisoni eziyinza okutta omuntu.

Oluvannyuma lw’okusimbuliza obutoffaali obusibuka mu mubiri (allogeneic stem cell transplant), omusawo wo ajja kukulondoola nnyo ebizibu nga Graft vs. Host Disease (GvHD). Singa ofuna obubonero bwa GvHD ey’amaanyi oba etali ya bulijjo, omusawo ayinza okukyusa eddagala lyo oba okukuwa eddagala eppya. Eddagala lyonna limira ddala nga bwe likulagiddwa. Goberera ebiragiro by’omusawo ku ngeri y’okwerabirira naddala ku ngeri y’okwekuumamu yinfekisoni.

Ebintu ebikulu by’olina okujjukira mu bufunze!

Okay, kale Graft vs. Host Disease, oba GvHD, kizibu ekiyinza okubaawo oluvannyuma lw’okusimbuliza obutoffaali obusibuka okuva eri omuntu omulala. Mu ngeri ennyangu, obutoffaali obugaba bwe bulumbye obutoffaali bwo.

Jjukira nti waliwo obujjanjabi bwa GvHD, era embeera eno esobola okuddukanyizibwa. Ekisinga obukulu kwe kugoberera obulungi ebiragiro bya ttiimu yo ey’abasawo n’okubategeeza ku bubonero bwonna obupya mu bwangu.

Bw’oba ​​olina ekibuuzo ekirala kyonna ku nsonga eno, totya kubuuza musawo wo. Bano be basobola okukuyamba obulungi.

` GvHD, okukyusa obutoffaali obusibuka, okukyusa allogeneic, abaserikale b’omubiri, HLA, obutoffaali obugaba, obubonero