Wandiwulidde otya singa olina obujjanjabi obw'amaanyi ng'okusimbuliza obusigo bw'amagumba ku kookolo w'omusaayi n'olowooza nti, "Buli kimu kirungi kati," ate n'owulira nti kookolo akomyewo? Ddala kimenya omutima era kya nnaku nnyo. Naye toggwaamu ssuubi. Leero twogera ku bujjanjabi obw'enjawulo obuyinza okuyamba mu mbeera nga eno. Kiyitibwa DLI ekitegeeza Donor Lymphocyte Infusion.
Mu ngeri ennyangu, DLI kye ki?
Okay, kino ka tukiteeke mu ngeri ennyangu. Lymphocytes kika kya butoffaali obweru mu musaayi gwo. Balinga abajaasi abali mu mibiri gyaffe. Zino kitundu kinene ku baserikale baffe abaserikale b’omubiri, okulwanyisa obuwuka obugwira, yinfekisoni, n’obutoffaali bwa kookolo.
Kati, DLI (Donor Lymphocyte Infusion) nkola ng’ezimu ku lymphocytes zino ziggyibwa ku mugabi y’omu omulamu eyasooka okuwaayo obusigo bwo obw’amagumba (stem cells) n’ekuba empiso mu mubiri gwo. ‘Abajaasi’ bano abapya, abalamu era ab’amaanyi banoonya era ne basaanyaawo obutoffaali bwa kookolo bwonna obusigaddewo obuyinza okuba nga bwekwese mu mubiri gwo. Ekyo kye kigendererwa ekikulu eky’obujjanjabi buno.
Mu mbeera ki obujjanjabi bwa DLI bwe busemba?
Omusawo wo asinga kukubuulira ku bujjanjabi buno singa kookolo wo akomawo (addamu) oluvannyuma lw’okusimbuliza obusigo bw’amagumba.
Wano waliwo embeera obujjanjabi bwa DLI gye butera okukozesebwa:
- Obulwadde bw’omusaayi obuyitibwa Acute Myeloid Leukemia (AML) .
- Obulwadde bwa Leukemia obutawona (CLL) .
- Obulwadde bw’omusaayi obutawona (CML) .
- Obulwadde bwa Myeloma obuyitibwa Multiple Myeloma
- Obulwadde bw’okuzimba omubiri (MDS) .
- Obulwadde bwa Lymphoma obutali bwa Hodgkin
Ekirala, oluusi oluvannyuma lw’okusimbuliza obusigo bw’amagumba, omubiri gwo guyinza okuba n’obutoffaali obugaba n’obutoffaali bwo obukadde. Kino tukiyita (mixed chimerism) . Kino nakyo kyongera obulabe bwa kookolo okudda. Kale, DLI esobola okukolebwa okufuula obutoffaali bwonna mu mubiri gwo obutoffaali okuva eri oyo agaba.
Okwetegekera otya obujjanjabi buno?
Nga tonnatandika bujjanjabi bwa DLI, omusawo wo ajja kukukebera n’obwegendereza, ateese ku bubonero bwo, era alagire okukeberebwa okuwerako.
- Okukebera obusigo bw’amagumba: Baggyibwako akatundu akatono ak’obusimu bw’amagumba okukebera oba obutoffaali bwa kookolo bwonna obusigaddewo.
- Omuwendo gw’omusaayi mu bujjuvu (CBC):Batunuulira omuwendo gw’obutoffaali mu musaayi.
- Okukebera enkola y’ekibumba n’ekibumba.
Singa okukebera omubiri (biopsy) kulaga nti omuwendo gw’obutoffaali bwa kookolo guli waggulu nnyo, omusawo wo ayinza okusalawo okukuwa eddagala eriweweeza ku bulwadde nga DLI tennabaawo. Kino kikolebwa okukendeeza ku butoffaali bwa kookolo n’okwongera ku buwanguzi bw’obujjanjabi bwa DLI.
Obutoffaali bwa lymphocyte bufunibwa butya okuva mu muntu agaba?
Kino kintu kya njawulo nnyo ekibaawo. Omugabi eyakuwa obulamu, kwe kugamba, omugabi eyakuwa obusigo bw’amagumba naye ayamba ku kino. Akatundu akatono (catheter) kamuyingiza mu musuwa mu mukono gwe ne bamuggyamu omusaayi. Omusaayi guno guyita mu kyuma eky’enjawulo. Ekyuma ekyo kye kikola kwe kwawula obutoffaali bwa lymphocyte bwokka bwe twetaaga, ne tusindika omusaayi ogusigaddewo okudda mu mubiri nga guyita mu musuwa oguli mu mukono omulala ogw’oyo agugaba. Enkola eno eyitibwa apheresis . Oluusi, bw’osooka okugaba obusigo bw’amagumba, obumu ku butoffaali buno obw’obutoffaali obuyitibwa lymphocyte osobola okutwalibwa ne buteekebwa mu bbugumu okukozesebwa oluvannyuma.
Ofuna otya obujjanjabi bwa DLI?
Kino owulira ng’ekintu eky’angu ng’okukuwa eddagala ly’omunnyo.
1. Omusawo oba nnansi ajja kuyingiza akatuli akatono (catheter) mu musuwa mu mukono gwo oba mu kifuba kyo.
2. Olwo, ekipapula ekirimu obutoffaali bw’obutoffaali obuyitibwa lymphocyte obwawuddwa ku muntu akigaba kiyungibwa ku ttanka eyo ne kifukibwa mu musaayi gwo.
3. Omulimu guno gutwala eddakiika nga 30 .
4. Omulimu bwe guggwa, ttanka eggyibwamu.
Oluusi osobola okuwa ddoozi eziwerako nga zino mu bbanga lya wiiki oba emyezi egiwerako.
Obutoffaali obupya bwe buyingizibwa mu mubiri mu ngeri eno, ekimu ku bintu ebikulu kiyitibwa graft vs. tumor effect (GvT) . Kino kitegeeza nti obutoffaali buno obulamu (graft) okuva ku muntu abuwaddeyo bunoonya obutoffaali bwa kookolo (tumor) obusigadde mu mubiri gwo, ne bubulumba, ne bubusaanyaawo. Eno y’engeri kookolo gy’abulawo ddala.
Migaso ki n’akabi akali mu bujjanjabi bwa DLI?
Emigaso emikulu egiri mu kino
Edda singa kookolo akomawo oluvannyuma lw’okusimbuliza obusigo bw’amagumba, eky’okukola kyali kya kusimbuliza magumba amalala. Naye obulabe bw’ebizibu bwali bungi nnyo nga bakyusiddwa omulundi ogw’okubiri. DLI ngeri nnungi, etali ya bulabe nnyo ey’okuteeka kookolo mu kusonyiyibwa awatali ddagala eriweweeza ku busimu obuziyiza endwadde.
Obulabe n‟ebizibu ebiyinza okuvaamu
Nga bwe kiri ku bujjanjabi bwonna, waliwo akabi akayinza okuvaamu. Ttiimu yo ey’abasawo ejja kukulondoola nnyo bino.
| Okuzibuwalirwa | Ennyonnyola n’obubonero |
|---|---|
| Obulwadde bwa Graft vs. Obulwadde bw’omugenyi (GvHD) . | Kino obutoffaali okuva mu mugabi (graft) bwe bulaba obutoffaali bw’omubiri gwo obulamu (host) ng’omulabe ne bubulumba. Obubonero: ekiddukano, olususu okufuuka ekya kyenvu (jaundice), okuziyira n’okusiiyibwa, ebiwundu ku lususu oba okusiiyibwa. |
| Okuziyiza obuwuka obuleeta endwadde (myelosuppression). | Kino kikendeera okumala akaseera mu nkola y’obusimu bw’amagumba, ekiyinza okuvaako omuwendo gw’obutoffaali bw’omusaayi okukendeera. - Obutoffaali obumyufu obutono (Anemia): obukoowu, okussa obubi. - Okukendeera kw’obutoffaali obweru (Leukopenia): Okwongera ku bulabe bw’okukwatibwa yinfekisoni. - Obulwadde bwa platelets obutono: Okwongera ku bulabe bw’okuvaamu omusaayi. |
Kiki eky’okukola singa wabaawo ebizibu?
Tofaayo. Bino byonna waliwo obujjanjabi.
- Singa GvHD ebaawo: Omusawo wo ajja kukuwa eddagala eriweweeza ku busimu bw’omubiri .
- Singa obutoffaali bwo buba butono: Obutoffaali obweru obutono butera okugenda ku bwabwo. Bwe kitaba bwe kityo, waliwo eddagala erizijjanjaba. Omusaayi guyinza okuguweebwa bwe kiba kyetaagisa okujjanjaba obutoffaali obumyufu obutono n’obutoffaali obuyitibwa platelets.
Oluvannyuma lw’okujjanjabwa n’okukwata ku buwanguzi
Yogerako n’omusawo wo ku bbanga lye kinaatwala okudda mu mbeera eya bulijjo oluvannyuma lw’okujjanjabibwa. Ojja kwetaaga okugoberera buli kiseera n’okukeberebwa omusaayi.
Obuwanguzi bw’obujjanjabi buno buyinza okwawukana okusinziira ku muntu. Waliwo ebintu ebiwerako ebigikwatako:
- Omutendera gwa kookolo.
- Obulamu bw’abaserikale b’omubiri gwo.
- Ekika ky’okukyusa omubiri ekyakolebwa emabegako.
- Oba eddagala lya kemiko lyakolebwa oba nedda nga DLI tennabaawo.
Ekisinga obukulu: Bw’ofuna obubonero bwonna obwa GvHD ng’omusujja, okuvaamu omusaayi ogutali gwa bulijjo, okukaluubirirwa okussa, ekiddukano, okusiiyibwa ku lususu, oba obubonero obulala bwonna obutali bwa bulijjo , tegeeza omusawo wo oba eddwaaliro erijjanjaba amangu ddala.
DLI ddagala lya busimu obuziyiza endwadde?
Yee, DLI bujjanjabi bwa busimu obuziyiza endwadde.Kika kya bujjanjabi. Kubanga ky’okola kwe kuwa abaserikale bo bennyini obutoffaali bwa T obulamu okuva ebweru okubuyamba okulwanyisa kookolo. Ekyo ddala kisuubiza.
Obubaka Obutwala Awaka
- DLI bujjanjabi bwa njawulo eri kookolo w’omusaayi addamu oluvannyuma lw’okusimbuliza obusigo bw’amagumba.
- Kino kikozesa obutoffaali obuyitibwa lymphocytes okuva mu mugabi y’omu omulamu eyawaayo obusigo bwo obw’amagumba mu kusooka.
- Ekigendererwa kya kino kwe kuba nti obutoffaali buno obupya bunoonya n’okusaanyaawo obutoffaali bwa kookolo obusigadde mu mubiri (GvT effect).
- Obulabe obukulu bwe GvHD (Graft vs. Host Disease) n’obutoffaali bw’omusaayi obutono, naye bino bijjanjabibwa.
- Eno ngeri ya bujjanjabi bwa busimu obuziyiza endwadde obuwa essuubi awatali bulabe bwa maanyi obw’okusimbuliza obusigo bw’amagumba omulundi ogw’okubiri.
- Yogerako amangu ddala n’omusawo wo ku bubonero oba ebizibu byonna ebipya.
💬 Comments (0)
Tewali bigambo biwandiikiddwa n'okutuusa kati. Yongera wano comment yo omulundi ogusoose.
Yongera ku comment yo