Organ transplant hnuah PTLD (Post-Transplant Lymphoproliferative Disorders) hi kan hriat tur em ni?

Nangmah emaw, i hriat mi emaw chuan nunna chhanhim thei operation lian tak, taksa peng dang thlak ang chi chu i nei tawh ngei ang. A nih loh leh stem cell thlak danglam a ni. Heng thilte hnuah hian harsatna awm lo, beisei loh tak tak a awm thin. Chutiang harsatna pakhat chu PTLD, a nih loh leh Post-Transplant Lymphoproliferative Disorders a ni. Hei hi a pawi deuh thei a nih avangin i hriatthiam theih tur awlsam takin i sawi dawn nia.

PTLD hi eng nge ni tak tak?

A awlsam zawngin sawi ila, PTLD hi nunna atana hlauhawm, organ transplant emaw allogeneic stem cell transplant emaw hnua lo awm thei a ni. Heta thil thleng hi kan taksaa thisen var chi khat, lymphocyte an tih chu a inthen darh chak a, thunun theih lohvin a pung a ni.

He PTLD an tih hi a takah chuan lymphoma chi khat a ni . Lymphoma hi cancer chi khat, kan lymphatic system-a lo awm thin a ni. Hetiang dinhmun hi thisen var (white blood cells) cancer a nih a, thi lovin a thang chak lutuk hian a lo awm thin.

PTLD hi Epstein-Barr Virus (EBV) vang a ni fo thin. Hei hi kan taksaa virus kan neih vek a ni. PTLD hi chi hrang hrang a awm a, mi pakhat a nghawng dan pawh a inang lo thei. Thu lawmawm tak chu Doctor ten an enkawl thei tih hi a ni. Mahse, a chang chuan a dinhmun chu a lo let leh thei a ni.

PTLD chi hrang hrangte chu engte nge ni?

Doctor-te chuan microscope hmanga lymphoma cell-te an lan dan a\angin PTLD hi chi hrang hrang paliah an ṭhen a:

• Early Lesion: Heng mite hian Epstein-Barr virus (EBV) nena hmuh ang chi symptoms an nei thin.
• Polymorphic PTLD: Hetah hian lymphoma cells te hi thisen var chi dang, normal lymphocyte leh plasma cell te nen an inzawm khawm a.
• Monomorphic PTLD: Hei hi PTLD chi khat zingah chuan a tam ber a ni . Heta lymphoma cells hi lymphoma chi dang, ``Non-Hodgkin Lymphomas''-a hmuh theih nen a inang a ni. Entirnan, ``Diffuse Large B-cell Lymphoma'' emaw ``Burkitt Lymphoma'' emaw te hi a ni.
• Classic Hodgkin Lymphoma - PTLD type: Hei hi PTLD chi khat zingah chuan a awm lo ber a ni .

He natna hi engtiang chiahin nge PTLD tia koh a nih?

Sawi tawh ang khan PTLD hi thil awm lo tak a ni . Chu chu mi zawng zawngah a thleng lo tihna a ni. A tlangpuiin sawi ila, stem cell transplant nei tawh mi 100 zinga 2 vel (`(2%)`) chuan PTLD an nei ang. Organ transplant nei tawhte chu PTLD vei an tam deuh hlek a ni. Mahse chu pawh chu organ transplanted a zirin a danglam thei bawk.

Hetiang hian han ngaihtuah teh, kal thlak tawh mi 100 zinga pathum vel (`(3%)`) chuan he natna hi an vei laiin, mithiamte chuan lung thlak tawh mi 100 zinga sawm vel (`(10%)`) chuan he natna hi an nei thei niin an sawi. Chuvangin, ngaihtuah tur a awm lo, hei hi mi tam zawkah chuan a thleng lo.

PTLD natna lan chhuahna awm thei te chu engte nge ni?

Mi thenkhat chuan a tir lamah symptom an nei lo mai thei. PTLD symptoms hi engtik lai pawhin a lang thei a, thla engemaw zat atanga kum engemaw zat atanga transplant atanga kum engemaw zat thlengin. Symptoms a lo lang tak tak a nih chuan:

• Chau lutuk (`Fatigue`) : Nunna nei lo anga inhriatna mai mai.
• Chhan awm lovin khawsik .
• Chaw ei chu a thlum lo .
• Beisei loh takin taksa rihna tlahniam .
• Zan lama thawk hah lutuk (`Zan lama thawkrim`) .
• Swollen lymph nodes : Kawr leh kawrfual-ah lump ang maiin an hria.

Engvangin nge he PTLD hi a lo awm? A chhante chu engte nge ni?

Hei hi hriatthiam tur chuan a stretch deuh. PTLD hi virus tlanglawn tak pakhatin kan immune system chak lohna a hman tangkai vang a ni .

Stem cell transplant tur i inbuatsaih niin han mitthla teh. Chumi hma chuan i ruhro chhunga cancer cell awmte tihlum turin chemotherapy pek i ni ang. Hei hi conditioning an ti a. Hei hian i immune system-in natna laka a humhim theihna chu a tichak lo hle. A bik takin, conditioning hian EBV kai tawh leh inactive leh tawh T cells (T-cells) te hnathawh a ti tlem a ni.

Tichuan, stem cell emaw organ emaw an thlak hnuah i taksa chu thil thar a hnawl loh nan immunosuppressant damdawi pek a ni. Heng damdawite hian taksa peng thar emaw, cell thar emaw a humhim rualin, keimahni taksa chakna (immune system) pawh a tichak lo a, virus ang chi ramdang mi rawn lutte lakah a hlauhawm zawk a ni.

PTLD-ah chuan virus agent ber chu Epstein-Barr virus (EBV) a ni. EBV hi stem cell emaw organ transplant atanga kum khat emaw kum hnih emaw chhunga lo awm PTLD nen a inzawm tih an sawi. Mahse, transplant hnu kum tam takah PTLD lo awm chhan dik tak chu hriat a la ni lo. Mithiamte pawhin virus, cytomegalovirus (CMV) emaw adenovirus (Adenovirus) te hian chanvo an nei thei em tih an zirchiang mek bawk.

Mithiamte sawi dan chuan kan mipui 90% vel chu an naupan lai emaw, an tleirawl lai emaw khan EBV hi an vei tawh a ni. He virus hi symptoms nei lovin i nei thei a, i hre lo pawh a ni thei. EBV virus hian kan B cells te chu a kai a, taksa chhungah "muhil" rengin, chu chu ``Latent'' state-ah a awm reng a, harsatna a siam lo. (Donor hnen atangin virus hi i dawng tawh pawh a ni thei.)

Chutiang immunosuppressive damdawi i ei avangin i immune system chuan chu EBV muhil chu a thunun thei lo. Tichuan, EBV kai B cell te chu an inthen darh a, an pung chak hle bawk. Chu chu PTLD thlentu a ni.

Tute nge PTLD vei theihna chance sang zawk?

PTLD vei theihna i neih theihna chu a hnuaia thilte avang hian a sang thei a ni:

• I taksaah emaw, organ/cells petu che (`(Donor)`) taksaah Epstein-Barr virus (EBV) awm .
• Transplant hmaa i T cells hnathawh dan pangngai tihtlem thei enkawlna (`Pre-transplant conditioning') dawng tawh.
• I taksain taksa peng thar emaw cell thar emaw a hnawl loh nan immunosuppressant damdawi ei.
• PTLD vei theihna tipungtu gene thenkhat (`(Genes)`)-a danglamna neih.

Engtin nge doctor-te chuan he PTLD an tih hi an hriat chhuah?

Doctor-te chuan taksa enfiahna an nei hmasa ang a, i medical history uluk takin an en ang. Chu bakah, a tlangpuiin a hnuaia test te hi an ti ang:

• Thisen chhiar kim (`Thisen chhiar kim - CBC`) .
• Metabolic Panel kimchang tak a awm .
• Lactate dehydrogenase (LDH) level a ni.
• Urinalysis , uric acid level pawh a tel.
• EBV virus laka taksaa antibody siam chhuah hmuhchhuahna test .
• CT scan (`Computed Tomography - CT scan`) hmanga tih a ni .
• MRI scan (Magnetic Resonance Imaging - MRI) hmanga tihchhuah a ni .
• PET scan (`Positron Emission Tomography - PET scan`) hmanga tihchhuah a ni .
• Bone marrow biopsy hmanga enfiah a ni .

Heng test te hi doctor-te tan PTLD a awm leh awm loh chiang taka hriat theihna a ni a, a awm a nih chuan eng ang nge a nih tih hriat theihna a ni bawk.

PTLD enkawl dan tur chu engte nge ni?

Doctor te chuan immunosuppressant damdawi an ei zat tihtlem atanga tan a ni tlangpui . A châng chuan hei hian danglamna nasa tak a thlen thei a ni. Tin, enkawlna dang pawh a awm a, chungte chu:

• Chemotherapy : Cancer cell thattu damdawi.
• Radiation therapy : Energy sang tak nei rays hmanga cancer cell tihchhiat.
• Monoclonal antibodies hmanga immunotherapy : Hei hi cancer cells beih nan protein bik (monoclonal antibodies) hman a ni.
• Surgery : Hei hi tih a tlem hle. PTLD hi localized a nih a, him taka lakchhuah theih a nih chauhvin surgery ngaihtuah a ni. Entirnan, tonsils te hi PTLD in a nghawng a nih chuan tonsils te hi lakchhuah theih a ni.

PTLD a lo awm loh nan kan tih theih tur a awm em?

PTLD hi direct-a venna tur hian kan tih theih a awm lo tak zet a ni. Mahse, doctor leh zirchiangtute chuan PTLD vei theihna tihziaawmna turin damdawi thenkhat, transplant hma leh/ emaw transplant hnua hman theih tur an ngaihtuah mek a ni . Chuvangin, nakin lawkah he thil hi chinfel dan tha zawk a awm ngei beiseina a awm.

PTLD i neih chuan eng nge thleng? Dam theih a ni em?

PTLD i chhan dan tur chu mi hrang hrangah a inang lo thei. Thil tam takah a innghat a ni.

Entirnan, a châng chuan doctor-te’n immunosuppressant an tihtlem mai pawhin PTLD hi a ṭha chho ṭhin.

Tun hnaia zirchianna hrang hrangah chuan organ transplant hnua lymphoma vei leh immunotherapy leh chemotherapy hmanga enkawl zinga 60% leh 70% inkar chuan symptoms (remission) a tlahniam emaw, a bo emaw a ni tih hmuhchhuah a ni.

PTLD hi tihdam theih a ni em? Ni e, PTLD hi `Immunotherapy` hmang chauh emaw, `Chemotherapy` nena hman dun emaw hmangin tihdam theih a ni. Zirna hrang hrangah he enkawlna dawngtu zinga 50% leh 60% inkar chu an dam vek tih hmuhchhuah a ni . Chuvangin, hei hi beisei tur thil a ni.

Doctor ka zawh tur zawhna pawimawh ber berte chu engte nge ni?

PTLD i neih chuan doctor hnenah hetiang zawhna hi zawh a tha ang:

• Engvangin nge hetiang hian ka chungah a lo thlen?
• PTLD hi engtin nge enkawl a nih?
• Immunosuppressant damdawi ka tihtlem chuan ka taksain organ/cell thar a hnawl theihna chance chu engzat nge ni ang?
• Ka enkawlna hi a hlawhtling a nih chuan he natna hi a lo let leh theihna chance engzat nge awm?

Heng zawhnate bakah hian i rilrua i thil neih zawng zawng doctor hnenah zawh hreh suh.

Engtikah nge Doctor ka hmuh ang?

PTLD i neih chuan i doctor chuan i hriselna zawng zawng chu uluk takin a enfiah ang . I dinhmun a chhe zual zel tih chhinchhiahna an zawng ang. PTLD enkawl i nih chuan i doctor chuan eng inthlak danglamna nge i tawn emaw, i natna lan chhuah dan a na zual em tih emaw a hrilhfiah ang che. Hetiang a nih chuan doctor hrilh nghal a pawimawh.

A tawp berah chuan thil hriat reng tur

Organ transplant leh stem cell transplant hian a chang chuan nunna a chhanhim thei emaw nunna a ti rei thei bawk . Mahse, hengte hi damdawi lam thil lian tak tak a nih avangin hlauhawmna a keng tel thei a ni. PTLD hi chutiang harsatna awm lo, mahse na tak thei tak zinga mi a ni.

Organ emaw stem cell transplant atana candidate i nih chuan i healthcare team chuan PTLD i vei theihna tur te , chubakah risk factor dang tam tak chungchang te an sawipui ang che. Doctor leh zirchiangtute chuan PTLD vei theihna tihziaawm dan tur an zawng mek a ni. A pawimawh ber chu hei hi hriat chian a, zawhna i neih apiang i healthcare team te zawh hi a ni.

`PTLD, Post-Transplant Lymphoproliferative Disorders, Organ Transplant, Lymphoma, Epstein-Barr Virus, Immunology, Cancer te a ni