Kodi munasamutsidwa maselo oyambira kuchokera kwa winawake? Tiyeni tidziwe izi ((Graft vs. Host Disease)!

Mwina mwamvapo za kusamutsa maselo oyambira. Ndi mankhwala ofunikira kwambiri pa matenda ena. Komabe, lero tikambirana za vuto lomwe lingachitike mutasamutsa maselo otere. Izi zimatchedwa `(Graft vs. Host Disease)` kapena `(GvHD)` mwachidule. Musadandaule, tiyeni tikambirane za izi mosavuta.

Kodi `(Graft vs. Host Disease - GvHD)` ndi chiyani? Mwachidule tafotokoza...

Tangoganizani kuti mwalandira chithandizo cha maselo oyambira kuchokera kwa munthu wina, wopereka . Timatcha izi kuti ndi chithandizo cha allogeneic. Maselo oyambira awa ali ngati maselo osakhwima omwe ali mu fakitale yopanga magazi m'thupi lanu, kapena maselo oyambira a hematopoietic. Awa ndi maselo omwe pambuyo pake adzakhala maselo ofiira a magazi ndi maselo oyera a magazi omwe thupi lanu limafunikira.

Tsopano, ndi liti pamene mungafunike maselo oyambira kuchokera kwa wopereka ngati uyu? Ngati muli ndi khansa monga khansa ya m'magazi kapena lymphoma, kapena matenda ena omwe mafupa anu sagwira ntchito bwino monga aplastic anemia, mungafunike mtundu uwu wa opaleshoni.

Chabwino, tsopano ichi ndi chiyani `(GvHD)`? Mu `(GvHD)`, chomwe chimachitika ndichakuti maselo opereka omwe mudalandira (graft) amawona maselo m'thupi lanu (host) ngati chinthu chachilendo, chosazolowereka. Zili ngati thupi lanu ndi malo atsopano kwa iwo. Chifukwa chake, maselo opereka awa amayamba kuukira maselo a thupi lanu. Ndicho chifukwa chake amatchedwa `(Graft vs. Host Disease)`, zomwe zikutanthauza "graft motsutsana ndi host." Kodi mukumvetsa?

Kodi mitundu ikuluikulu ya GvHD ndi iti?

Pali mitundu iwiri ikuluikulu ya GvHD. Kale, madokotala ankaika chizindikirochi m'magulu potengera nthawi yomwe zizindikirozo zinayamba. Koma tsopano, akuyang'ana zizindikirozo ndi zotsatira za mayeso kuti adziwe mtundu weniweni.

1. Acute GvHD (aGvHD)

Izi nthawi zambiri zimachitika nthawi yochepa mutangoika maselo oyamba, nthawi zambiri mkati mwa masiku 100 oyambirira . Komabe, nthawi zina zizindikiro zimatha kuyamba pambuyo pake. GvHD yoopsa nthawi zambiri imakhudza khungu lanu, kugaya chakudya (GI tract), kapena chiwindi.

2. Matenda a GvHD Osatha (cGvHD)

Matenda a GvHD osatha amatha kuchitika nthawi iliyonse mutapatsidwa chithandizo cha allogeneic. Komabe, nthawi zambiri amayamba mkati mwa zaka ziwiri . Matenda a GvHD osatha amatha kukhudza khungu lanu, pakamwa, pachiwindi, mapapo, m'mimba, minofu, mafupa, kapena ziwalo zoberekera.

Chofunika: Mungathe kupanga mtundu umodzi, zonse ziwiri, kapena palibe mtundu uliwonse wa GvHD. Zimasiyana malinga ndi munthu.

Kodi zizindikiro za `(GvHD)` ndi ziti? Dziwani izi!

Zizindikiro za GvHD zimasiyana malinga ndi munthu. Anthu ena akhoza kukhala ndi zizindikiro zochepa , ena akhoza kukhala ndi zizindikiro zochepa , ndipo ena akhoza kukhala ndi zizindikiro zoopsa.Zingakhale zoopsa kwambiri (ngakhale zoopsa kwa moyo).

Zizindikiro za `(GvHD)` yoopsa

Tanena kale kuti matenda a shuga otchedwa acute GvHD nthawi zambiri amakhudza khungu, njira ya m'mimba, ndi chiwindi.

• Khungu (aGvHD): Chizindikiro chodziwika bwino ndi kutupa pakhungu kapena kufiira (monga kutentha kwa dzuwa). Pakhoza kukhala ululu ndi kuyabwa. Kutupa nthawi zambiri kumayambira pakhosi, mapewa, makutu, zikhatho, ndi mapazi. Kenako kumatha kufalikira ku ziwalo zina za thupi.
• Matenda a m'mimba (GI) tract (aGvHD): Zizindikiro zodziwika bwino ndi nseru, kusanza, ndi kutsegula m'mimba (kudzimbidwa). Zizindikirozi zimatha kukhala zochepa kapena zazikulu kwambiri moti zimafuna kuti munthu agonekedwe kuchipatala.

Zizindikiro zodziwika bwino za GvHD yoopsa ndi izi:

• Kutupa pakhungu ndi/kapena kuyabwa.
• Kutsegula m'mimba.
• Kusanza ndi kusanza.
• Kupweteka m'mimba, kupunduka.
• Jaundice (kuoneka kwachikasu kwa khungu ndi/kapena maso).

Zizindikiro za GvHD yosatha

Matenda a GvHD osatha nthawi zambiri amakhudza khungu lanu, chiwindi, njira ya m'mimba, ndi mapapo. Komabe, amatha kukhudza gawo lililonse la thupi lanu.

Zizindikiro zake zingakhale izi:

• Kutupa pakhungu ndi/kapena kuyabwa.
• Kulimba kwa khungu ndi kutupa.
• Kutaya tsitsi pamutu ndi m'thupi.
• Pakamwa pouma.
• Zilonda pakamwa.
• Matenda a chiseyeye.
• Maso ouma, kumva ngati mchenga walowa mkati.
• Kusintha kwa masomphenya.
• Kutsegula m'mimba.
• Kusanza ndi kusanza.
• Kuoneka kwachikasu pakhungu ndi/kapena m'maso (jaundice).
• Kuvuta kupuma (kupuma movutikira).
• Chifuwa chouma komanso chosatha.
• Kutopa.
• Kufooka kwa minofu, kupunduka, kapena kupweteka.
• Kulephera kupindika ndi kukulitsa malo olumikizirana mafupa bwino.
• Azimayi amatha kumva kuuma kwa nyini, kuyabwa, kapena kupweteka panthawi yogonana.
• Amuna amatha kuyabwa mbolo kapena machende, kapena kupweteka panthawi yogonana.

N’chifukwa chiyani `(GvHD)` imeneyi imachitika? Kodi chifukwa chake n’chiyani?

Mwachidule, GvHD imachitika pamene maselo oyambira kuchokera kwa woperekayo amene mudalandira chithandizocho amaona maselo anu a thupi ngati "achilendo" ndikuyamba kuwaukira.

Izi ndi zomwe zimachitika nthawi zambiri: Maselo anu a chitetezo chamthupi (maselo m'magazi mwanu) amakutetezani ku matenda. Amalimbana ndi zinthu zakunja, monga mavairasi ndi mabakiteriya. Komabe, maselo awa saukira maselo anu. Izi zili choncho chifukwa maselo anu ali ndi puloteni yapadera yotchedwa ``Human Leukocyte Antigens'', kapena ``HLA''. Izi zili ngati chizindikiro chokhala ndi dzina. ``HLA'' iyi ndi yomwe imauza maselo anu a chitetezo chamthupi kuti, "Hei, iyi ndi imodzi mwa zathu."

Chofunika kwambiri ndichakuti, kupatula mapasa ofanana, `(HLA)` ya aliyense ndi yosiyana.

Mukalandira chithandizo cha maselo oyambira kuchokera kwa wina, maselo atsopano a magazi m'thupi lanu sali ndi `(HLA)` yanu, koma `(HLA)` ya wopereka . Chifukwa chake, ngati `(HLA)` ya wopereka uyu ndi yosiyana kwambiri ndi `(HLA)` m'thupi lanu, maselo atsopano a magaziwo amayamba kuukira maselo a thupi lanu. Pamenepo ndi pomwe `(GvHD)` imachitika.

Ichi ndichifukwa chake madokotala amafufuza mosamala HLA ya woperekayo kuti atsimikizire kuti ili pafupi ndi yanu momwe angathere asanachite opaleshoni yoika maselo oyambira. Kupeza ofanana ndi amenewo kumachepetsa chiopsezo chokhala ndi GvHD. Komabe, ngati simulandira maselo ochokera kwa mapasa ofanana, pali mwayi woti mudzakhala ndi GvHD, ngakhale mutayesa mafananidwe angati.

Ndani amene ali pachiwopsezo chachikulu chotenga matenda a GvHD?

Chofunika kwambiri pa chiopsezo ndi momwe HLA ya wopereka wanu ikugwirizanirana ndi yanu. Muli pachiwopsezo chachikulu chotenga GvHD ngati:

• Munalandira maselo oyambira kuchokera kwa wachibale, koma osati ofanana ndi HLA .
• Munalandira maselo oyambira kuchokera kwa munthu amene si wachibale wanu, koma ndi ofanana ndi `(HLA)` .

Zina mwa zinthu zomwe zingakubweretsereni chiopsezo ndi izi:

• Wopereka ayenera kukhala mkazi amene anakhalapo ndi pakati kale.
• Kuwonjezeka kwa zaka za wopereka kapena iwe mwini.
• Kusagwirizana pakati pa wopereka ndi inu (monga kulandira maselo kuchokera kwa wopereka wamwamuna kupita kwa mkazi, kapena kuchokera kwa wopereka wamkazi kupita kwa mwamuna).
• Ngati maselo oyambira a woperekayo atengedwa kuchokera m'mitsempha yamagazi (magazi) m'malo mwa kuchokera ku mafupa (kumene maselo amagazi amapangidwa).

Ngati mwakhala kale ndi matenda a `(aGvHD)`, muli pachiwopsezo chachikulu chotenga matenda a `(cGvHD)` osatha.

Kodi GvHD imapezedwa bwanji?

Dokotala wanu akhoza kuzindikira GvHD mwa kukuyang'anani, kuyang'ana zizindikiro zanu, ndikuyang'ana mayeso a labu ndi zotsatira za biopsy. Biopsy imaphatikizapo kutenga chitsanzo chaching'ono cha minofu kapena maselo anu ndikutumiza ku labu kuti akayesedwe.

Mu matenda a GvHD osatha (cGvHD), zizindikiro zina zimatha kufanana ndi matenda ena. Chifukwa chake, dokotala adzachotsa zifukwa zina zonse asanapeze matenda a cGvHD.

Kodi mankhwala a GvHD ndi ati?

Mukalandira chithandizo cha stem cell, mudzapatsidwa mankhwala oletsa chitetezo chamthupi ngati njira yopewera kuti maselo opereka chithandizo achepetse mphamvu ya maselo anu kuukira minofu yanu.

Ngati mankhwala awa saletsa kukula kwa GvHD, dokotala wanu adzakupatsani chithandizo kutengera kuopsa kwa vuto lanu komanso mtundu wa GvHD.

Chithandizo cha GvHD yoopsa

Madokotala nthawi zambiri amachiritsa bwino anthu omwe ali ndi GvHD yoopsa mwa kuwonjezera mlingo wa mankhwala omwe amaletsa chitetezo cha mthupi. Mankhwalawa ndi a gulu la mankhwala otchedwa corticosteroids. Angaperekedwe pakamwa, kudzera m'mitsempha, kapena pakhungu. Ngati ma steroids sagwira ntchito, dokotala wanu angakulembereni mankhwala monga Ruxolitinib (Jakafi®). ​​Mungakhalenso ndi mwayi wochita nawo mayeso azachipatala omwe amayesa mankhwala atsopano.

Chithandizo cha matenda a GvHD osatha

Matenda a GvHD osatha nthawi zambiri amachiritsidwa ndi mankhwala oletsa chitetezo chamthupi kwa nthawi yayitali. Ngati mankhwala awa sathandiza, dokotala wanu angakulembereni mankhwala monga:

• `Ruxolitinib (Jakafi®)`
• `Belumosudil (Rezurock™)`
• `Ibrutinib (Imbruvica®)`
• Photopheresis (Iyi ndi njira yapadera yochizira)

Mungakhalenso oyenerera `(mayesero azachipatala)`. Dokotala adzakuuzani za zimenezo.

Kodi mavuto/zotsatira zake za chithandizo ndi ziti?

Popeza mankhwala oletsa chitetezo chamthupi awa amafooketsa chitetezo chamthupi chanu, mumakhala ndi mwayi waukulu wopeza matenda a bowa, bakiteriya, ndi mavairasi . Chifukwa chake, dokotala wanu adzakupatsani mankhwala ena angapo kuti akutetezeni ku matenda oopsawa.

Kodi GvHD ingapewedwe?

Ma labotale olembera minofu nthawi zonse akupanga ndipo amagwiritsa ntchito mayeso atsopano komanso olondola ochokera ku DNA. Izi zimathandiza gulu lanu lachipatala kusankha wopereka mankhwala omwe ali ndi HLA yoyenera kwa inu. Ngati ali ndi HLA yoyenera, mwayi wopewera GvHD umakhala wabwino.

Komanso, dokotala wanu adzakupatsani mankhwala oletsa chitetezo chamthupi kuti mupewe GvHD mutaika maselo oyambira.

Kodi GvHD ingachiritsidwe kwathunthu?

Nthawi zambiri, madokotala amatha kuthana ndi vutoli (GvHD). Izi zikutanthauza kuti, amatha kulamulira zizindikiro ndikukuthandizani kukhala ndi moyo wabwinobwino.

Pakadali pano, ofufuza akufufuza njira zatsopano zopewera GvHD kudzera mu mayeso azachipatala. Mwachitsanzo, akufufuza mankhwala osiyanasiyana oletsa chitetezo chamthupi komanso mankhwala atsopano oletsa matenda.

Kodi GvHD ingakhale yoopsa pa moyo?

Inde, nthawi zina GvHD ikhoza kukhala yoopsa. Matenda a GvHD osatha ndi omwe amachititsa imfa kwambiri pakati pa anthu omwe amalandira chithandizo cha allogeneic stem cell, kupatula matenda awo oyamba.

Choncho, musanalandire chithandizo chilichonse - ngakhale kungoika maselo oyambira - ndikofunikira kwambiri kukambirana zoopsazo ndi dokotala wanu. Iye angakufotokozereni zoopsazo ndikukuthandizani kuwunika zabwino ndi zoyipa za chithandizocho.

Kodi nthawi zina pamakhala ubwino wa `(GvHD)`?

Musadabwe, ngakhale kuti GvHD ikhoza kusokoneza moyo wanu, ilinso ndi ubwino wina. Chitetezo cha mthupi chomwe chimaukira maselo anu abwinobwino chimafunafuna ndikuwononga maselo aliwonse a khansa omwe angatsale m'thupi lanu. Izi zimatchedwa zotsatira za graft-versus-tumor. Anthu omwe ali ndi GvHD apezeka kuti ali ndi mwayi wochepa woti matenda awo oyamba (makamaka khansa) abwererenso.

Kodi ndimadzisamalira bwanji? Tsatirani malangizo awa!

Dokotala wanu adzakufotokozerani momwe muyenera kudzisamalira mukangoika maselo oyambira. Mwachitsanzo, zizindikiro zomwe muyenera kusamala nazo komanso zizindikiro zomwe muyenera kuyimbira gulu lanu lachipatala nthawi yomweyo ngati mutayamba. Ngati muli pachiwopsezo chotenga matenda a GvHD, angakupatseninso malangizo ena osamalira. Malangizo awa akuphatikizapo:

• Tetezani khungu lanu ku dzuwa. Valani malaya a manja aatali ndi mathalauza aatali. Gwiritsani ntchito mafuta oteteza ku dzuwa omwe ali ndi SPF 50 osachepera. (Kutentha ndi dzuwa kungayambitse GvHD.)
• Khalani ndi thanzi labwino la mkamwa. Izi zichepetsa chiopsezo chotenga matenda a mkamwa.
• Pewani zakudya zokometsera zomwe zingakhumudwitse m'mimba mwanu ndikuyambitsa zilonda mkamwa.
• Chitani zinthu zodzitetezera ku majeremusi. (Dokotala wanu adzakuuzani zambiri za izi.)

Ndiyenera kupita kwa dokotala liti?

Ndikofunikira kudziwitsa dokotala wanu nthawi yomweyo ngati muli ndi kusintha kulikonse kwa thupi, makamaka zizindikiro za matenda ndi malungo (100.4 Fahrenheit / 38 Celsius kapena kupitirira apo). Mukatenga mankhwala oletsa chitetezo chamthupi, mumakhala pachiwopsezo chachikulu chotenga matenda omwe angakhale oopsa ku moyo.

Pambuyo poika maselo oyambira a allogeneic, dokotala wanu adzakuyang'anirani mosamala kuti aone ngati pali zovuta monga Graft vs. Host Disease (GvHD). Ngati mukupeza zizindikiro za GvHD yoopsa kapena yosatha, dokotala wanu angasinthe mankhwala anu kapena kukupatsani mankhwala atsopano. Imwani mankhwala onse monga momwe mwalangizidwira. Tsatirani malangizo a dokotala wanu okhudza momwe mungadzisamalire nokha, makamaka momwe mungadzitetezere ku matenda.

Zinthu zofunika kwambiri kuzikumbukira mwachidule!

Chabwino, kotero Graft vs. Host Disease, kapena GvHD, ndi vuto lomwe lingachitike munthu wina akapatsidwa selo loyambira. Mwachidule, ndi pamene maselo opereka chithandizo akuukira maselo anu.

Kumbukirani kuti pali mankhwala a GvHD, ndipo vutoli lingathe kuthetsedwa. Chofunika kwambiri ndikutsatira malangizo a gulu lanu lachipatala mosamala ndikuwauza za zizindikiro zatsopano mwamsanga.

Ngati muli ndi mafunso ena okhudza izi, musaope kufunsa dokotala wanu. Iwo ndi omwe angakuthandizeni bwino kwambiri.

GvHD , kusamutsa maselo oyambira, kusamutsa maselo a allogeneic, chitetezo chamthupi, HLA, maselo opereka, zizindikiro