Ese hari umuntu wigeze guterwa uturemangingo tw’umubiri? Reka tumenye ibi (Graft vs. Host Disease)!

Ushobora kuba warumvise iby’iterwa ry’uturemangingo tw’ingirabuzimafatizo. Ni uburyo bw’ingenzi cyane bwo kuvura indwara zimwe na zimwe. Ariko, uyu munsi tugiye kuvuga ku kibazo gishobora kubaho nyuma yo guterwa nk’uko. Ibi byitwa `(Graft vs. Host Disease)` cyangwa `(GvHD)` mu magambo ahinnye. Ntugahangayike, reka tubiganireho mu buryo bworoshye.

`(Graft vs. Host Disease - GvHD)` ni iki? Byasobanuwe mu buryo bworoshye...

Tekereza ko wahawe uturemangingo tw’amaraso dukomoka ku wundi muntu, umutanga . Ibi tubyita guterwa mu buryo bwa allogeneic. Utu turemangingo tw’amaraso dusa n’uturemangingo tudakuze mu ruganda rw’umubiri wawe rukora amaraso, cyangwa uturemangingo tw’amaraso dukomoka ku maraso. Utu ni uturemangingo tuzaba uturemangingo tw’amaraso dutukura n’uturemangingo tw’amaraso twera umubiri wawe ukeneye.

None se, ni ryari wakenera uturemangingo tw’umubiri kuva ku muntu nk’uyu? Niba ufite kanseri nka kanseri y’amaraso cyangwa lymphoma, cyangwa indi ndwara aho umwongo w’amagufwa yawe udakora neza nka aplastic anemia, ushobora gukenera ubwoko bw’iyi miti.

None se, iyi `(GvHD)` ni iki? Muri `(GvHD)`, ikibaho ni uko uturemangingo twahawe (graft) tubona uturemangingo mu mubiri wawe (host) nk'ikintu kidasanzwe, kitamenyerewe. Ni nk'aho umubiri wawe ari ahantu hashya kuri bo. Rero, utwo turemangingo dutangira kwibasira uturemangingo tw'umubiri wawe. Niyo mpamvu byitwa `(Graft vs. Host Disease)`, bivuze "graft against host." Urabyumva?

Ni ubuhe bwoko bw'ingenzi bwa GvHD?

Hari ubwoko bubiri bw'ingenzi bwa GvHD. Mu bihe byashize, abaganga bayishyiraga mu byiciro bakurikije igihe byafashe kugira ngo ibimenyetso bitangire. Ariko ubu, bareba ibimenyetso n'ibisubizo by'ibizamini kugira ngo bamenye ubwoko nyabwo.

1. Gukira indwara ya GvHD mu buryo butunguranye (aGvHD)

Ibi bikunze kubaho nyuma gato yo guterwa uturemangingo tw’umubiri, akenshi mu minsi 100 ya mbere . Ariko, hari igihe ibimenyetso bishobora gutangira nyuma. Indwara ya GvHD ikunze kugira ingaruka ku ruhu rwawe, ku igogora (inzira y’igifu), cyangwa ku mwijima.

2. GvHD idakira (cGvHD)

GvHD idakira ishobora kubaho igihe icyo ari cyo cyose nyuma yo guterwa allogeneic. Ariko, akenshi itangira mu myaka ibiri . GvHD idakira ishobora kugira ingaruka ku ruhu rwawe, mu kanwa, mu mwijima, mu bihaha, mu nzira y'igifu, mu mitsi, mu ngingo, cyangwa mu myanya ndangagitsina.

Icy'ingenzi: Ushobora gukora ubwoko bumwe muri ubu bwa GvHD, haba ubwombi cyangwa nta na bumwe muri ubwo. Buratandukanye bitewe n'umuntu ku wundi.

Ni ibihe bimenyetso bya `(GvHD)`? Menya ibi!

Ibimenyetso bya GvHD biratandukanye bitewe n'umuntu ku giti cye. Hari abantu bashobora kugira ibimenyetso byoroheje , abandi bashobora kugira ibimenyetso biri hagati , abandi bashobora kugira ibimenyetso bikomeye.Bishobora kuba bikomeye cyane (ndetse bikabangamira ubuzima).

Ibimenyetso bya `acute` (GvHD)`

Twavuze ko GvHD ikabije ikunze kugira ingaruka ku ruhu, inzira y'imbere mu nda, no ku mwijima.

• Uruhu (aGvHD): Ikimenyetso gikunze kugaragara ni uduheri ku ruhu cyangwa gutukura (nk'izuba ritwitswe). Hashobora kubaho ububabare no kwishimagura. Ubusanzwe uduheri dutangirira ku ijosi, ku bitugu, ku matwi, ku biganza no ku birenge. Hanyuma dushobora gukwirakwira mu bindi bice by'umubiri.
• Uburyo bwo mu gifu (aGvHD): Ibimenyetso bikunze kugaragara ni isesemi, kuruka, no kubyimba . Ibi bimenyetso bishobora kuba byoroheje cyangwa bikomeye ku buryo bisaba kujya mu bitaro.

Ibimenyetso bisanzwe bya GvHD ikabije birimo:

• Uruhu rushyushye cyangwa uburyaryate.
• Impiswi.
• Isesemi no kuruka.
• Kubabara mu nda, gucumbagira.
• Jaundice (umuhondo w'uruhu cyangwa amaso).

Ibimenyetso bya GvHD idakira

Indwara ya GvHD idakira ikunze kugira ingaruka ku ruhu rwawe, umwijima, inzira y'igifu n'ibihaha. Ariko, ishobora kugira ingaruka ku gice icyo ari cyo cyose cy'umubiri wawe.

Ibimenyetso bishobora kuba birimo:

• Uruhu rushyushye cyangwa uburyaryate.
• Uruhu rurakomera kandi rukabyimba.
• Gutakaza umusatsi ku mutwe no ku mubiri.
• Umunwa wumye.
• Ibisebe byo mu kanwa.
• Indwara y'ishinya.
• Amaso yumye, yumva nk'aho agace k'umucanga karimo karambitse imbere.
• Impinduka mu iyerekwa.
• Impiswi.
• Isesemi no kuruka.
• Ibara ry'umuhondo ry'uruhu n'amaso (jaundice).
• Kugorwa no guhumeka (dyspnea).
• Inkorora yumye kandi idashira.
• Umunaniro.
• Ubunebwe bw'imitsi, gucumbagira, cyangwa ububabare.
• Kudashobora kunama no kwagura ingingo neza.
• Abagore bashobora kugira ubwumye mu gitsina, uburyaryate, cyangwa ububabare mu gihe cy'imibonano mpuzabitsina.
• Abagabo bashobora kugira uburyaryate mu gitsina cyangwa mu mabya, cyangwa bakababara mu gihe cy'imibonano mpuzabitsina.

Kuki ibi `(GvHD)` bibaho? Ni iyihe mpamvu?

Mu magambo make, GvHD ibaho iyo uturemangingo tw’umubiri w’umuntu waguteye tumwe tubona uturemangingo tw’umubiri wawe nk’ “utw’abanyamahanga” tugatangira kutwibasira.

Ibi ni byo bikunze kubaho: Uturemangingo tw’ubudahangarwa bw’umubiri wawe (uturemangingo turi mu maraso yawe) tukurinda indwara. Turwanya ibintu by’amahanga, nka virusi na bagiteri. Ariko, utwo turemangingo ntitwibasira uturemangingo twawe bwite. Ibi biterwa nuko uturemangingo twawe dufite poroteyine yihariye yitwa ``Human Leukocyte Antigens'', cyangwa ``HLA''. Ibi ni nk'agapapuro kanditseho izina. Iyi ``HLA'' ni yo ibwira uturemangingo tw’ubudahangarwa bwawe tuti : "Hey, iyi ni imwe muri twe."

Igikuru ni uko, uretse impanga zisa, `(HLA)` ya buri wese itandukanye.

Nyuma yo guhabwa uturemangingo tw’umubiri dukomoka ku wundi muntu, uturemangingo dushya tw’amaraso mu mubiri wawe ntabwo tuba dufite `(HLA)` yawe, ahubwo tuba dufite `(HLA)` y’uwatanze . Rero, niba `(HLA)` y’uyu watanze itandukanye cyane na `(HLA)` mu mubiri wawe, utwo turemangingo dushya tw’amaraso dutangira kwibasira uturemangingo tw’umubiri wawe. Icyo gihe ni bwo `(GvHD)` ibaho.

Niyo mpamvu abaganga basuzuma witonze HLA y'uwatanze kugira ngo barebe neza ko yegereye uwawe uko bishoboka kose mbere yo gutera uturemangingo fatizo. Kubona uturemangingo nk'utwo bigabanya ibyago byo kurwara GvHD. Ariko, niba udahawe uturemangingo tumwe n'utw'impanga imwe, haracyari amahirwe ko uzarwara GvHD, uko wagerageza kose.

Ni nde uri mu kaga gakomeye ko kwandura GvHD?

Ikintu cy'ingenzi mu byago ni uburyo HLA y'umuterankunga wawe ihuye cyane n'iyawe. Ufite ibyago byinshi byo kurwara GvHD niba:

• Wahawe uturemangingo tw’umubiri duturutse ku muvandimwe wawe, ariko ntabwo ari HLA ihuye neza neza .
• Wahawe uturemangingo tw’umubiri n’umuntu utari mwene wanyu, ariko uhuye na `(HLA)` .

Izindi mpamvu zishobora gutera ibyago ni izi:

• Utanga iyo nkunga agomba kuba ari umugore wigeze gutwita mbere.
• Imyaka y'uwatanze cyangwa wowe ubwawe yiyongera.
• Kutahuza igitsina hagati y'uwatanze nawe (urugero: kwakira uturemangingo tw'amaraso tuvuye ku mugabo utanga utwo turemangingo tujya ku mugore, cyangwa utwo ku mugore utanga utwo turemangingo tujya ku mugabo).
• Iyo uturemangingo tw’umuterankunga dufashwe mu mitsi y’amaraso (amaraso) aho gukurwa mu musokoro w’amagufwa (aho uturemangingo tw’amaraso dukorerwa).

Niba waramaze kugira `(aGvHD)` ikabije, uri mu kaga gakomeye ko kurwara `(cGvHD)` idakira.

Ni gute GvHD ipimwa?

Muganga wawe ashobora gusuzuma GvHD agusuzuma, akareba ibimenyetso byawe, akareba ibizamini byo muri laboratwari n'ibyavuye muri biopsy. Biopsy ikubiyemo gufata icyitegererezo gito cy'uturemangingo twawe cyangwa uturemangingo hanyuma ukacyohereza muri laboratwari kugira ngo gipimwe.

Mu ndwara ya GvHD idakira (cGvHD), zimwe mu bimenyetso zishobora gusa n'izindi ndwara. Kubwibyo, muganga azasuzuma izindi mpamvu zose mbere yo gusuzuma cGvHD burundu.

Ni ubuhe buryo bwo kuvura GvHD?

Nyuma yo guterwa uturemangingo fatizo, uzahabwa imiti igabanya ubudahangarwa bw'umubiri nk'uburyo bwo kwirinda kugira ngo ugabanye ubushobozi bw'uturemangingo tw'utanga udukoko bwo kwibasira ingirabuzimafatizo zawe.

Iyo iyi miti idahagaritse iterambere rya GvHD, muganga wawe azaguha uburyo bwo kuvura hashingiwe ku buremere bw'indwara yawe n'ubwoko bwa GvHD.

Kuvura GvHD ikabije

Abaganga bakunze kuvura neza abantu bafite GvHD ikabije bongera urugero rw'imiti igabanya ubudahangarwa bw'umubiri. Iyi miti iri mu bwoko bw'imiti yitwa corticosteroids. Ishobora gutangwa mu kanwa, mu mitsi, cyangwa mu mazuru. Iyo steroid idakora, muganga wawe ashobora kukwandikira umuti nka Ruxolitinib (Jakafi®). ​​Ushobora kandi kugira amahirwe yo kwitabira igeragezwa ry'ubuvuzi rigerageza uburyo bushya bwo kuvura.

Kuvura GvHD idakira

Indwara ya GvHD idakira ikunze kuvurwa n'imiti igabanya ubudahangarwa bw'umubiri igihe kirekire. Iyo iyi miti idafashije, muganga wawe ashobora kukwandikira imiti nk'iyi:

• `Ruxolitinib (Jakafi®)`
• `Belumosudil (Rezurock™)`
• `Ibrutinib (Imbruvica®)`
• Photopheresis (Ubu ni uburyo bwihariye bwo kuvura)

Ushobora kandi kuba wemerewe `(ibizamini by'ubuvuzi)`. Muganga azabikubwira.

Ni izihe ngorane/ingaruka mbi zo kuvurwa?

Kubera ko iyi miti igabanya ubudahangarwa bw'umubiri igabanya imbaraga z'ubudahangarwa bw'umubiri wawe, uba ufite amahirwe menshi yo kurwara indwara z'ibihumyo, bagiteri na virusi . Kubwibyo, muganga wawe azaguha indi miti myinshi yo kukurinda izo ndwara zikomeye.

Ese GvHD ishobora kwirindwa?

Laboratwari zo kwandika ingirabuzimafatizo zihora zitera imbere kandi zikoresha ibizamini bishya kandi byuzuyemo ADN. Ibi bituma itsinda ry’abaganga rihitamo utanga inkunga ihuye na HLA ikwiye. Uko ihuye neza, niko amahirwe yo kwirinda GvHD aba menshi.

Nanone, muganga wawe azakwandikira imiti igabanya ubudahangarwa bw'umubiri kugira ngo wirinde GvHD nyuma yo guterwa uturemangingo tw'umubiri.

Ese GvHD ishobora gukira burundu?

Kenshi na kenshi, abaganga bashobora kuvura iyo ndwara neza (GvHD). Ni ukuvuga ko bashobora kugenzura ibimenyetso no kugufasha kubaho ubuzima busanzwe.

Hagati aho, abashakashatsi barimo kwiga uburyo bushya bwo kwirinda GvHD binyuze mu igeragezwa ry’ubuvuzi. Urugero, barimo gukora ubushakashatsi ku miti itandukanye igabanya ubudahangarwa bw’umubiri ndetse n’imiti mishya yo kwirinda.

Ese GvHD ishobora gushyira ubuzima mu kaga?

Yego, GvHD rimwe na rimwe ishobora gushyira ubuzima mu kaga. GvHD idakira ni yo mpamvu ikomeye itera urupfu mu bantu baterwa uturemangingo tw’umubiri two mu bwoko bwa allogeneic, usibye indwara yabo y’ibanze.

Kubwibyo, mbere yo kuvurwa – ndetse no guterwa uturemangingo fatizo – ni ngombwa cyane kuganira na muganga wawe ku ngaruka zishobora kubaho. Ashobora kugusobanurira ingaruka mbi no kugufasha gusuzuma ibyiza n'ibibi by'ubuvuzi.

Ese rimwe na rimwe hari inyungu kuri `(GvHD)`?

Ntutangare, nubwo GvHD ishobora kugira ingaruka mbi ku mibereho yawe, ifite n'inyungu zimwe na zimwe. Uburyo bumwe bw'ubudahangarwa bw'umubiri bwibasira uturemangingo twawe busanzwe bushakisha kandi bukangiza uturemangingo twa kanseri dushobora gusigara mu mubiri wawe. Ibi byitwa ingaruka ya graft-versus-tumor. Abantu barwaye GvHD byagaragaye ko badakunze kugaruka ku ndwara yabo y'ibanze (cyane cyane kanseri).

Nitwara nte? Kurikiza izi nama!

Muganga wawe azagusobanurira uburyo ukwiye kwiyitaho nyuma yo guterwa uturemangingo tw’umubiri. Urugero, ibimenyetso ugomba kwitondera n’ibimenyetso ugomba guhamagara itsinda ry’abaganga bawe vuba uramutse ugize ikibazo. Niba ufite ibyago byo kurwara GvHD, bashobora no kuguha andi mabwiriza yo kwita ku buzima bwawe. Aya mabwiriza arimo:

• Rinda uruhu rwawe izuba. Ambara ishati y'amaboko maremare n'ipantaro ndende. Koresha amavuta yo kwisiga afite nibura SPF 50. (Kugera ku zuba bishobora kongera cyangwa bigatera GvHD.)
• Guma uhorana ubuzima bwiza bw'amenyo. Ibi bizagabanya ibyago byo kurwara indwara y'ishinya.
• Irinde ibintu nk'ibiryo biryoshye bishobora kubangamira igifu no gutera ibisebe mu kanwa.
• Fata ingamba zo kwirinda mikorobe. (Muganga wawe azakubwira byinshi kuri ibi.)

Ni ryari ngomba kubonana na muganga?

Ni ngombwa kumenyesha muganga wawe vuba niba ufite impinduka ku mubiri, cyane cyane ibimenyetso by'ubwandu n'umuriro (100.4 Fahrenheit / 38 Selisiyusi cyangwa irenga). Iyo ufashe imiti igabanya ubudahangarwa bw'umubiri, uba ufite ibyago byinshi byo kwandura indwara zishobora gushyira ubuzima mu kaga.

Nyuma yo guterwa ingirabuzimafatizo z’umubiri zigizwe n’ibinini bya allogeneic, muganga wawe azagukurikiranira hafi kugira ngo arebe ko hari ingorane nka Graft vs. Host Disease (GvHD). Iyo ugaragaje ibimenyetso bya GvHD ikabije cyangwa idakira, muganga wawe ashobora guhindura imiti yawe cyangwa akakwandikira indi miti. Fata imiti yose uko byategetswe. Kurikiza amabwiriza ya muganga wawe ku bijyanye n’uburyo bwo kwiyitaho, cyane cyane uburyo bwo kwirinda indwara zandura.

Ibintu by'ingenzi cyane ugomba kwibuka muri make!

Yego, indwara ya Graft vs. Host Disease, cyangwa GvHD, ni ikibazo gishobora kubaho nyuma yo guterwa uturemangingo tw’umubiri n’undi muntu. Mu magambo make, ni igihe uturemangingo tw’umuterankunga twibasira uturemangingo twawe bwite.

Wibuke ko hari uburyo bwo kuvura GvHD, kandi iyo ndwara ishobora gukemurwa. Icy'ingenzi ni ugukurikiza amabwiriza y'itsinda ry'abaganga witonze no kubamenyesha ibimenyetso bishya vuba bishoboka.

Niba ufite ikindi kibazo kuri ibi, ntutinye kubaza muganga wawe. Nibo bashobora kugufasha neza.

GvHD , gutera uturemangingo fatizo, gutera allogene, ubudahangarwa bw'umubiri, HLA, uturemangingo tw'abatanga, ibimenyetso