I hoki mai anō te mate i muri i te maimoatanga matepukupuku? Me kōrero tātou mō te DLI (Donor Lymphocyte Infusion)

He aha ō whakaaro mēnā ka whiwhi koe i tētahi maimoatanga nui pērā i te whakawhitinga wheua wheua mō te mate pukupuku toto, ā, ka whakaaro koe, "Kei te pai ngā mea katoa inaianei," kātahi ka rongo koe kua hoki mai te mate pukupuku? He tino mamae te ngākau, he tino pouri hoki. Engari kaua e mutu te tumanako. I tēnei rā kei te kōrero tātou mō tētahi maimoatanga motuhake ka taea te āwhina i roto i ngā āhuatanga pēnei. Ko te ingoa ko DLI, ko te whakarāpopototanga mō te Donor Lymphocyte Infusion.

He aha te DLI?

Āe, me whakamāmā noa iho tēnei. He momo toto mā ngā lymphocytes i roto i ō toto. He rite rātou ki ngā hōia i roto i ō tātou tinana. He wāhanga nui rātou o tō tātou pūnaha ārai mate, e whawhai ana ki ngā iroriki tauhou, ngā mate urutā, me ngā pūtau matepukupuku.

Ināianei, ko te DLI (Donor Lymphocyte Infusion) he tikanga e tangohia ai ētahi o ēnei lymphocytes mai i te kaituku hauora kotahi i tuku i tō hinu wheua (ngā pūtau take) i mua, ā, ka werohia ki roto i tō tinana. Ka rapua e ēnei 'hōia' hou, hauora, kaha, ā, ka whakangaromia ngā pūtau matepukupuku e toe ana kei roto i tō tinana. Koinei te whāinga matua o tēnei maimoatanga.

I roto i ēhea ngā āhuatanga e taunakitia ana te maimoatanga DLI?

Tērā pea ka kōrero atu tō tākuta ki a koe mō tēnei maimoatanga mēnā ka hoki mai anō tō matepukupuku toto (ka hoki anō) i muri i te whakawhitinga wheua wheua.

Anei ētahi o ngā āhuatanga e whakamahia whānuitia ana te maimoatanga DLI:

• Te Mate Pūkahukahu Myeloid Koretake (AML)
• Te mate toto toto pūmau (CLL)
• Te Mate Pūkahukahu Myeloid Mau tonu (CML)
• Myeloma maha
• Te Myelodysplasia (MDS)
• Lymphoma Kore-Hodgkin

Me pēhea te whakarite mō tēnei maimoatanga?

I mua i te tīmatanga o te maimoatanga DLI, ka tirotirohia koe e tō tākuta, ka matapakihia ō tohumate, ā, ka whakaritea he maha o ngā whakamātautau.

• Kohikohi wheua wheua: Ka tangohia he tauira iti o te hinu wheua hei tirotiro i ngā pūtau matepukupuku e toe ana.
• Te Tatau Toto Katoa (CBC):Kei te tirohia te maha o ngā pūtau i roto i te toto.
• Ngā whakamātautau mahi a te whatukuhu me te ate.

Mena ka whakaatuhia e te koiora he tino teitei te taumata o ngā pūtau matepukupuku, ka whakatau pea tō tākuta ki te hoatu i te chemotherapy ki a koe i mua i te DLI. Hei whakaiti i te maha o ngā pūtau matepukupuku, hei whakanui ake hoki i te angitu o te maimoatanga DLI.

Me pēhea te whiwhi i ngā pūtau lymphocyte mai i tētahi kaituku?

He mea tino motuhake tēnei e tupu ana. Ko te kaituku i homai te ora ki a koe, arā, ko te kaituku i hoatu te hinu wheua ki a koe, ka āwhina anō hoki ki tēnei. Ka whakauruhia he ngongo iti (catheter) ki roto i tētahi uaua i roto i tōna ringa, ā, ka tangohia he toto. Ka haere tēnei toto mā roto i tētahi mīhini motuhake. Ko tā taua mīhini he wehe i ngā pūtau lymphocyte e hiahiatia ana e tātou, kātahi ka tukuna te toenga o te toto ki te tinana mā roto i tētahi uaua i roto i tētahi atu ringa o te kaituku. Ka kiia tēnei tukanga ko te apheresis . I ētahi wā, ina koha tuatahi koe i te hinu wheua, ka taea te tango i ētahi o ēnei pūtau lymphocyte ka whakatiohia mō te whakamahinga i muri mai.

Me pēhea te whiwhi maimoatanga mō te DLI?

He rite tonu tēnei ki te hoatutanga ki a koe he wai tote he ngāwari noa iho.

1. Ka whakaurua e te tākuta, e te nēhi rānei tētahi ngongo iti (catheter) ki roto i tētahi uaua i tō ringa, i tō uma rānei.

2. Kātahi ka honoa te kete kei roto ngā pūtau lymphocyte kua wehea mai i te kaituku ki taua ngongo ka werohia ki roto i tō toto.

3. E 30 meneti pea te roa o tēnei mahi.

4. Kia oti te mahi, ka tangohia te ngongo.

I ētahi wā ka taea e koe te hoatu i ētahi horopeta pēnei i roto i ētahi wiki, i ētahi marama rānei.

Ina whakaurua mai ngā pūtau hou ki roto i te tinana i tēnei ara, ko tētahi o ngā mea tino nui ko te pānga o te tārai me te pukupuku (GvT) . Ko te tikanga o tēnei ka rapua e ēnei pūtau hauora (tārai) mai i te kaituku ngā pūtau matepukupuku e toe ana (pukupuku) i roto i tō tinana, ka whakaekea, ka whakangaromia. Koinei te huarahi e ngaro katoa ai te matepukupuku.

He aha ngā painga me ngā mōrearea o te maimoatanga DLI?

Ko ngā painga matua o tēnei

I ngā wā o mua, mēnā ka hoki mai te mate pukupuku i muri i te whakawhitinga wheua wheua, ko te huarahi anake ko te whai i tētahi atu whakawhitinga wheua wheua. Engari he nui ake te mōrearea o ngā raruraru me te whakawhitinga tuarua. He huarahi pai, he iti te mōrearea o te DLI ki te whakaora i te mate pukupuku me te kore he rongoā ārai mate.

Ngā tūponotanga me ngā raruraru pea

Pērā i ngā maimoatanga katoa, he tūponotanga kei reira. Ka tirotirohia koe e tō rōpū hauora mō ēnei.

Me aha mēnā ka puta he raruraru?

Kaua e manukanuka. He maimoatanga kei reira mō ēnei mea katoa.

• Mena ka puta te GvHD: Ka tohua e tō tākuta ngā rongoā ārai mate .
• Mena he iti ō toto: He maha ngā wā ka memeha haere ngā toto ma. Ki te kore, he rongoā hei rongoā mō rātou. Ka taea te tuku toto mēnā e tika ana hei rongoā mō te iti o ngā toto whero me ngā pereti toto.

I muri i te maimoatanga me te angitu

Kōrero ki tō tākuta mō te roa o te wā e hoki ai koe ki te āhua noa i muri i te maimoatanga. Me whai tirotiro tonu koe me ngā whakamātautau toto.

Ka rerekē te angitu o tēnei maimoatanga i ia tangata, i ia tangata. He maha ngā āhuatanga e pā ana ki tēnei:

• Te wāhanga matepukupuku.
• Te hauora o tō pūnaha ārai mate.
• Te momo whakawhitinga i mahia i mua.
• Ahakoa i mahia te chemotherapy i mua i te DLI, kāore rānei.

He rongoā ārai mate te DLI?

Ae, he rongoā ārai mate te DLI.He momo maimoatanga tēnei. Nā te mea ko tāu mahi he hoatu i ngā pūtau-T hauora ki tō ake pūnaha ārai mate mai i waho hei āwhina i a ia ki te whawhai ki te mate pukupuku. He tino whai hua tēnā.