Bite ho iyo uturemangingo dushya tubaye umwanzi w'umubiri? Ibisobanuro byoroshye ku ndwara ya Graft vs. Host (GvHD) nyuma yo guterwa

Tekereza ko wahawe ingirabuzimafatizo z’umubiri ziturutse ku muntu muzima nk'umuti w’indwara nka kanseri y’amaraso. Ibi byitezwe ko bizakiza indwara yawe. Ariko ni gake cyane, izi ngirabuzimafatizo nshya zaje kugufasha, umubiri wawe uzibeshya ko ari "umwanzi" maze ugatangira kwibasira uturemangingo twawe. Iyo ni yo mimerere ikomeye twita "Graft versus Host Disease" cyangwa GvHD mu magambo ahinnye.

Mu magambo make, GvHD ni iki?

Kugira ngo tubisobanukirwe, tugomba kumenya amagambo abiri. "Graft" yerekeza ku kintu giterwa, ni ukuvuga uturemangingo tw’umubiri tuzima duhabwa uturutse hanze. "Host" yerekeza ku mubiri wawe, ni ukuvuga umubiri wawe wakira utwo turemangingo. Rero "Graft versus Host" bivuze "graft versus host."

Ubusanzwe, ubu bwoko bwo gutera uturemangingo tw’umubiri, bwitwa allogeneic transplant, bukorerwa kuvura kanseri nka leukemia na lymphoma, cyangwa indwara zo kunanirwa k’umusemburo w’amagufwa nka aplastic anemia . Izi selile zatewe nizo zitangira umubiri wawe gukora uturemangingo dushya tw’amaraso.

Ariko, hari igihe izi selile nshya zitamenya selile zawe bwite. Zitekereza ko ari abajura b'abanyamahanga. Bityo, zitangira kwibasira ingingo zawe nzima, nk'uruhu rwawe, umwijima, n'amara. Ni cyo GvHD ari cyo.

Hari ubwoko bubiri bw'ingenzi bwa GvHD:

GvHD ishobora kugabanywamo ubwoko bubiri bw'ingenzi. Mu bihe byashize, ibi byagabanyijwemo ibice bitewe n'igihe ibimenyetso byatangiriye. Ariko ubu, abaganga bagena ubwoko nyabwo bareba ibimenyetso, ibisubizo by'ibizamini, n'igihe ibimenyetso byatangiriye.

• GvHD ikabije (aGvHD): Ibi bikunze kubaho mu minsi 100 ya mbere nyuma yo guterwa inshinge. Ariko rimwe na rimwe bishobora kubaho nyuma. Ubu bwoko bw'indwara zigira ingaruka cyane ku ruhu rwawe, mu mara (amara), no ku mwijima.
• GvHD idakira (cGvHD): Ubu bwoko bushobora kubaho igihe icyo ari cyo cyose nyuma yo guterwa inshinge, ariko bukunze kugaragara cyane mu myaka ibiri ya mbere . Bushobora kwibasira igice icyo ari cyo cyose cy'umubiri, harimo uruhu, umunwa, umwijima, ibihaha, amara, imitsi, ingingo n'imyanya ndangagitsina.

Umuntu watewe inshinge ashobora kugira bumwe muri ubu bwoko bubiri, byombi, cyangwa akaba afite ubuzima bwiza nta na bumwe muri bwo.

Ni ibihe bimenyetso by'indwara ya GvHD?

Ibimenyetso bya GvHD bishobora kuva ku byoroheje cyane, kugeza ku biri hagati, kugeza ku bikomeye, ndetse no mu kaga. Reka turebe ibimenyetso bifitanye isano n'ubu bwoko bubiri.

Kuki iyi GvHD ibaho?

Ibi ni ibintu bya siyansi gato, ariko ndabisobanura mu buryo bworoshye.

Ubusanzwe, uturemangingo tw’ubudahangarwa bw’umubiri wacu tuturinda indwara mu kurwanya abaduteye b’abanyamahanga nka virusi na bagiteri. Ariko utwo turemangingo ntitwigera twibasira uturemangingo twacu. Impamvu ni uko hari poroteyine yihariye ku buso bw’uturemangingo twacu twose. Iyi yitwa Human Leukocyte Antigens (HLA) .

Uretse impanga zisa, HLA ya buri wese iratandukanye.

Iyo utewe uturemangingo tw’amaraso, uturemangingo dushya tw’amaraso dukozwe muri utwo turemangingo tuba dufite HLA y’umuntu waguhaye uturemangingo. Iyo iyo HLA itandukanye cyane na HLA yawe, utwo turemangingo dushya tureba uturemangingo mu mubiri wawe tugatekereza tuti: "Uyu ni umujura, indangamuntu ye ntabwo ihuye n’iyacu." Ni bwo utwo turemangingo dutangira kwibasira umubiri wawe.

Kubera iyo mpamvu, abaganga basuzuma witonze HLA y'uwatanze n'uwahawe iyi ndwara mbere yo kuyitera. Ariko keretse iyo uturemangingo twakuwe ku mpanga, hari ibyago bimwe na bimwe byo kwandura GvHD.

Ni nde uri mu kaga gakomeye ko kwandura GvHD?

Ikintu cy’ingenzi gishobora gutera ibyago ni ukudahuza kwa HLA, ariko hari n’ibindi bintu byinshi bishobora kugira uruhare muri ibyo.

Nanone, niba waramaze kugira indwara ya Acute GvHD (aGvHD), uba uri mu kaga gakomeye ko kurwara GvHD idakira (cGvHD).

Iyi ndwara ipimwa ikanavurwa ite?

Isuzuma

Muganga wawe azasuzuma GvHD agukorera isuzuma ry’umubiri, akareba ibimenyetso byawe, kandi agukorere ibizamini by’amaraso na biopsy. Biopsy ikubiyemo gufata agace gato k’uruhu cyangwa ingingo zangiritse no kubisuzuma ukoresheje mikorosikopi. Kubera ko bimwe mu bimenyetso bya GvHD idakira bisa n’ibindi, muganga wawe azakuraho izindi ndwara mbere yo gusuzuma GvHD.

Ubuvuzi

Kugira ngo wirinde GvHD nyuma yo guterwa inshinge, uzahabwa imiti igabanya ubudahangarwa bw'umubiri igabanya ubudahangarwa bw'umubiri wawe. Iyi miti ikora mu kugabanya ubushobozi bw'uturemangingo tw'amahanga bwo kwibasira umubiri wawe.

• Ku ndwara ya GvHD ikabije (aGvHD): Akenshi, imiti ya corticosteroids itangwa nk'ibinini, inshinge, cyangwa nk'amavuta yo kwisiga ku ruhu. Iyo ibi bidashoboye kurwanya indwara, indi miti nka Ruxolitinib (Jakafi®) cyangwa ibizamini byo kwa muganga ishobora gusuzumwa.
• Ku ndwara ya GvHD idakira (cGvHD): Imiti igabanya ubudahangarwa bw'umubiri itangwa igihe kirekire kuri ibi. Iyo iyi ndwara idagenzurwa na yo, imiti nka Ruxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) cyangwa ubuvuzi bwihariye nka photopheresis ishobora gukenerwa.

Ingaruka mbi zo kuvurwa

Ubu buryo bwo kuvura bugabanya ubudahangarwa bw'umubiri wawe, ibyo bikaba bigabanya ubushobozi bw'umubiri wawe bwo kurwanya indwara zandura. Ibi byongera ibyago byo kwandura indwara z'ibihumyo, bagiteri na virusi. Muganga wawe azaguha kandi imiti igufasha kwirinda izo ndwara zishobora gushyira ubuzima bwawe mu kaga.

Izindi ngaruka zishobora guterwa na GvHD

Ese GvHD irashyira ubuzima mu kaga?

Yego, GvHD ishobora gushyira ubuzima mu kaga. By’umwihariko, GvHD idakira ni yo mpamvu ikomeye itera urupfu nyuma yo guterwa uturemangingo tw’umubiri, uretse indwara nyamukuru. Niyo mpamvu ari ngombwa kuganira na muganga wawe ku ngaruka zishobora kubaho mbere yo kuvurwa.

Ese hari inyungu GvHD ifite?

Igitangaje ni uko yego. GvHD ifite ibyiza bimwe na bimwe. Izi selile nshya z’ubudahangarwa bw’umubiri zitera uturemangingo twawe tuzima zishakisha kandi zikarimbura uturemangingo twa kanseri dushobora kuba dusigaye mu mubiri wawe. Ibi byitwa "ingaruka za graft-versus-tumor." Kubwibyo, ubushakashatsi bwagaragaje ko abarwayi barwaye GvHD badakunze kugaruka ku barwayi babo.

Ibintu ushobora gukora ku bw'umutekano wawe

Muganga wawe azagusobanurira uburyo ukwiye kwiyitaho nyuma yo guterwa inshinge. Witondere cyane ibi bintu niba uri mu kaga ko kwandura GvHD.

• Irinde izuba: Kurwanywa n'izuba bishobora gutuma GvHD irushaho kuba mbi. Ambara amashati y'amaboko maremare n'ipantaro ndende iyo ugiye hanze. Koresha amavuta yo kwisiga afite nibura SPF 50.
• Isuku yo mu kanwa: Koza amenyo yawe neza kugira ngo ugabanye ibyago byo kurwara ishinya.
• Ibiryo n'ibinyobwa: Irinde ibirungo, amavuta, n'ibiribwa bishobora gutera ibisebe mu kanwa.
• Irinde mikorobe: Kubera ko ubudahangarwa bw'umubiri bwawe bufite intege nke, irinde ahantu indwara zikwirakwira n'ahantu hahurira abantu benshi. Buri gihe komeza ugire intoki zawe zisukuye.

Ni ryari ngomba kubonana na muganga?

Ni ngombwa kumenyesha muganga wawe vuba niba ubonye impinduka mu mubiri wawe, cyane cyane ibimenyetso by'ubwandu cyangwa umuriro wa dogere selisiyusi 38 (100.4 Fahrenheit) cyangwa urenga. Kwandura bishobora gukomera vuba iyo ufata imiti igabanya ubudahangarwa bw'umubiri.

Muganga wawe azagukurikirana buri gihe nyuma yo guterwa inshinge kugira ngo arebe niba hari ingorane nka GvHD. Iyo ibimenyetso bigaragaye, azahindura imiti yawe cyangwa akwandikire indi mishya. Ni ngombwa cyane gufata imiti yose wanditswe na muganga nk'uko wabitegetswe no gukurikiza amabwiriza ya muganga wawe.