Tinofanira kuziva nezve PTLD (Post-Transplant Lymphoproliferative Disorders) mushure mekuisirwa nhengo yemuviri here?

Iwe kana mumwe munhu waunoziva pamwe wakambovhiyiwa zvakanyanya zvinoponesa hupenyu, zvakaita sekuisirwa nhengo. Kana kuisirwa stem cell. Mushure mezvinhu izvi, pane matambudziko asingawanzoitika, asingatarisirwi. Rimwe dambudziko rakadaro iPTLD, kana kuti Post-Transplant Lymphoproliferative Disorders. Sezvo izvi zvichigona kunge zvakakomba, ngatitaurei nezvazvo nenzira iri nyore yaunogona kunzwisisa.

Chii chaizvo chinonzi PTLD?

Zvichitaurwa zviri nyore, PTLD idambudziko rinouraya rinogona kuitika mushure mekuisirwa nhengo kana kuisirwa allogeneic stem cell. Chinoitika pano ndechekuti rudzi rwemasero machena eropa mumuviri wedu, anonzi lymphocytes, anopatsanuka nekukurumidza uye anowedzera zvisingadzoreki.

Chirwere ichi chinonzi PTLD chaizvoizvo rudzi rwe lymphoma . Lymphoma rudzi rwekenza inokura mu lymphatic system yedu. Chirwere ichi chinoitika kana masero machena eropa akava kenza uye achikura nekukurumidza asingafe.

PTLD inowanzo kukonzerwa neEpstein -Barr Virus (EBV) . Urwu hutachiona hwatinahwo tese mumiviri yedu. Kune mhando dzakasiyana dzePTLD, uye nzira yainobata nayo munhu inogona kusiyana. Mashoko akanaka ndeekuti vanachiremba vanogona kuirapa. Zvisinei, dzimwe nguva chirwere ichi chinogona kudzoka.

Ndeapi marudzi makuru ePTLD?

Vanachiremba vanopatsanura PTLD kuita mhando ina huru zvichienderana nekuti masero elymphoma anotaridzika sei pasi pemaikorosikopu:

• Maronda Ekutanga: Vanhu ava vanowana zviratidzo zvakafanana nezvinoonekwa nehutachiona hweEpstein-Barr (EBV).
• Polymorphic PTLD: Pano, masero elymphoma anosanganiswa nemamwe marudzi emasero machena eropa, akadai semalymphocytes akajairwa nemasero eplasma.
• Monomorphic PTLD: Iyi ndiyo mhando yePTLD inonyanya kuwanikwa . Masero elymphoma pano akafanana neaya anowanikwa mune mamwe marudzi elymphoma, akadai se "Non-Hodgkin Lymphomas". Semuenzaniso, "Diffuse Large B-cell Lymphoma" kana kuti "Burkitt Lymphoma".
• Classic Hodgkin Lymphoma - PTLD type: Iyi ndiyo mhando yePTLD isinganyanyi kuwanikwa .

Chirwere ichi chinonzi PTLD chakajairika zvakadii?

Sezvambotaurwa, PTLD chirwere chisingawanzoitiki . Izvi zvinoreva kuti hazviitiki kune wese munhu. Zvichitaurwa, vanhu vaviri pavanhu 100 vakamboisirwa stem cell (`(2%)`) vachazobatwa nePTLD. Vanhu vakamboisirwa nhengo vane mukana wekuti vabatwe nePTLD. Asi izvozvo zvinosiyanawo zvichienderana nenhengo yakaisirwa.

Funga nezvazvo nenzira iyi, nepo vanhu vatatu pavanhu zana vakaisirwa itsvo (`(3%)`) vachiva nechirwere ichi, nyanzvi dzinoti vanhu gumi pavanhu zana vakaisirwa mapapu (`(10%)`) vanogona kuva nechirwere ichi. Saka, hapana chekunetseka nacho, ichi hachisi chinhu chinoitika kuvanhu vazhinji.

Ndezvipi zviratidzo zvinogona kuitika zvePTLD?

Vamwe vanhu vanogona kunge vasina zviratidzo pakutanga. Zviratidzo zvePTLD zvinogona kuoneka chero nguva, kubva pamwedzi mishoma kusvika makore akati wandei mushure mekuisirwa chibereko. Kana zviratidzo zvikaonekwa, zvinogona kusanganisira:

• Kunzwa kuneta zvakanyanya ('Kuneta') : Kungonzwa sekuti hauna hupenyu.
• Fivha pasina chikonzero .
• Chikafu hachina kunaka .
• Kudzikira kwehuremu kusingatarisirwi .
• Kudikitira zvakanyanya usiku (`Kudikitira husiku`) .
• Ma lymph nodes akazvimba : Anonzwa semapundu mumutsipa nemuhapwa.

Sei chirwere ichi chePTLD chichiitika? Ndezvipi zvinokonzera?

Izvi zvakaoma kunzwisisa. PTLD inoitika nekuti hutachiona hunowanzo shandiswa nekushaya simba kwemuviri wedu .

Fungidzira kuti uri kugadzirira kuiswa stem cell. Usati waita izvozvo, uchapihwa chemotherapy yekuuraya masero egomarara ari mubhonzo rako. Izvi zvinonzi conditioning. Izvi zvinoderedza simba remasoja emuviri wako rekudzivirira kubva kuzvirwere. Kunyanya, conditioning inoderedza mashandiro emasero eT (T-cells) akange abatwa neEBV uye asingachashande zvakare.

Zvadaro, mushure mekunge masero emuviri kana nhengo yadyarwa, muviri wako unopihwa mushonga unodzvinyirira immune system kuti usarambe chinhu chitsva. Kunyange zvazvo mishonga iyi ichidzivirira nhengo itsva kana masero, inoshayisawo simba masoja edu ekudzivirira muviri, zvichiita kuti ive nyore kubatwa nezvirwere zvekunze zvakaita semavhairasi.

MuPTLD, chirwere chikuru chinokonzerwa nehutachiona iEpstein-Barr virus (EBV) . EBV yakabatana nePTLD inokura mukati megore rimwe kana maviri mushure mekuisirwa stem cell kana nhengo. Zvisinei, chikonzero chaicho chePTLD chinokura makore mushure mekuisirwa hutachiona hachisati chazivikanwa. Nyanzvi dziri kuferefetawo kana mavhairasi akadai se cytomegalovirus (CMV) kana adenovirus (Adenovirus) angave aine chekuita nazvo.

Sekureva kwenyanzvi, vanhu vanosvika 90% vevanhu vedu vakambobatwa neEBV panguva yehudiki hwavo kana kuyaruka. Ungave uine hutachiona uhu usina zviratidzo, uye ungasatombozviziva. Utachiona hweEBV hunopinda mumasero edu eB uye hunoramba "hwakarara" mumuviri, kureva kuti, huri mumamiriro ekuti "hwakavanda", pasina kukonzera matambudziko. (Unogona kunge wakawanawo hutachiona kubva kune anopa.)

Nekuti uri kutora mishonga iyoyo inodzvinyirira masoja emuviri, masoja emuviri wako haakwanise kudzora EBV iyoyo isina kurara. Zvadaro, masero eB ane utachiona hweEBV anotanga kupatsanuka nekuwanda nekukurumidza. Ndizvo zvinoita kuti pave nePTLD.

Ndiani ari panjodzi huru yekubatwa nePTLD?

Ngozi yako yekuva nePTLD inogona kuwedzera nekuda kwezvikonzero zvinotevera:

• Kuva nehutachiona hweEpstein-Barr (EBV) mumuviri wako kana mumuviri wemunhu akakupa nhengo/masero (`(Donor)`).
• Kana wagamuchira kurapwa (`Pre-transplant conditioning') kunoderedza mashandiro emasero eT ako usati waiswa.
• Kutora mishonga inodzvinyirira masoja emuviri kudzivirira muviri wako kuti usarambe nhengo itsva kana masero.
• Kuva nekuchinja-chinja kwemajini mamwe (`(Majini)`) kunowedzera njodzi yekubatwa nePTLD.

Vanachiremba vanoongorora sei chirwere ichi chinonzi PTLD?

Vanachiremba vanotanga vaita ongororo yemuviri uye vonyatsoongorora nhoroondo yezveutano hwako. Pamusoro pezvo, vanowanzoita bvunzo dzinotevera:

• Kuverengwa Kweropa Rakazara (`Kuverengwa Kweropa Rakazara - CBC`) .
• Paneri Yemetabolism Yakakwana .
• Nhamba yeLactate dehydrogenase (LDH) .
• Kuongororwa kweweti , kusanganisira huwandu hweuric acid.
• Kuongororwa kwekuona ma antibodies anowanikwa mumuviri anodzivirira hutachiona hweEBV .
• Kuongororwa kweCT (`Computed Tomography - CT scan`) .
• Kuongororwa kweMRI (Magnetic Resonance Imaging - MRI) .
• Kuongororwa kwePET (`Positron Emission Tomography - Kuongororwa kwePET`) .
• Kuongororwa kwemapfupa emumongo .

Miedzo iyi ndiyo inobvumira vanachiremba kuona kana PTLD iripo kana kuti kwete, uye kana zvakadaro, kuti yakaita sei.

Ndeapi marapirwo ePTLD?

Vanachiremba vanowanzotanga nekuderedza huwandu hwemishonga inodzvinyirira immune system yavanotora . Dzimwe nguva izvi zvinogona kuita mutsauko mukuru. Pamusoro pezvo, kune mamwe marapirwo akadai se:

• Chemotherapy : Mushonga unouraya masero ekenza.
• Kurapa nemwaranzi : Kuparadza masero ekenza uchishandisa mwaranzi ine simba rakawanda.
• Kurapa nekudzivirira muviri ne monoclonal antibodies : Izvi zvinosanganisira kushandisa mapuroteni chaiwo (monoclonal antibodies) kurwisa masero ekenza.
• Kuvhiya : Izvi hazviwanzoitwa. Kuvhiya kunongoonekwa chete kana PTLD iri panzvimbo yayo uye ichigona kubviswa zvakachengeteka. Semuenzaniso, kana matoni akakanganiswa nePTLD, matoni anogona kubviswa.

Pane chatingaita here kudzivirira kukura kwePTLD?

Hapana chatingaita kudzivirira zvakananga PTLD. Zvisinei, vanachiremba nevatsvagurudzi vari kutsvaga mimwe mishonga inogona kushandiswa vasati vaisa uye/kana mushure mekuisirwa PTLD kuderedza njodzi yePTLD. Saka, pane tariro yekuti pachava nemhinduro dziri nani dzeizvi mune ramangwana.

Chii chinoitika kana ukava nePTLD? Inogona kurapwa here?

Maitiro auchaita kuPTLD anogona kusiyana kubva pamunhu nemunhu. Zvinoenderana nezvinhu zvakawanda.

Semuenzaniso, dzimwe nguva PTLD inovandudzika kunyangwe vanachiremba vakangoderedza mishonga inodzvinyirira masoja emuviri.

Ongororo dzichangobva kuitwa dzakaratidza kuti pakati pe60% ne70% yevanhu vanowana lymphoma mushure mekuisirwa nhengo uye vanorapwa ne immunotherapy uye chemotherapy vakasangana nekudzikira kana kunyangarika kwezviratidzo (remission) .

PTLD inogona kurapwa here? Ehe, PTLD inogona kurapwa ne 'Immunotherapy' chete kana pamwe chete ne 'Chemotherapy'. Zvidzidzo zvakaratidza kuti pakati pe50% ne60% yevanhu vanorapwa uku vanopora zvachose . Saka, ichi chinhu chekutarisira.

Ndeipi mibvunzo inonyanya kukosha yandinofanira kubvunza chiremba wangu?

Kana uine PTLD, zvakanaka kubvunza chiremba wako mibvunzo yakaita seiyi:

• Sei izvi zvakaitika kwandiri?
• PTLD inorapwa sei?
• Kana ndikaderedza mishonga yangu inodzvinyirira masoja emuviri, mukana wekuti muviri wangu urambe nhengo/masero matsva ndeupi?
• Kana kurapwa kwangu kukabudirira, mikana yekuti chirwere ichi chidzoke ndeyei?

Pamusoro pemibvunzo iyi, usatya kubvunza chiremba chero chauri kufunga nezvacho.

Ndinofanira kuona chiremba rini?

Kana uine PTLD, chiremba wako achanyatsoongorora hutano hwako . Vachatsvaga zviratidzo zvekuti mamiriro ako ari kuipa. Kana uri kurapwa PTLD, chiremba wako achakutsanangurira shanduko dziri kuitika kwauri kana kuti zviratidzo zvako zviri kuipa. Zvakakosha kuudza chiremba wako nekukurumidza kana izvi zvikaitika.

Pakupedzisira, zvinhu zvekurangarira

Kuisirwa nhengo dzemuviri uye kuisirwa masero emuviri dzimwe nguva zvinogona kuponesa hupenyu kana kuwedzera hupenyu . Zvisinei, nekuti idzi inzira huru dzekurapa, dzinogona kuuya nenjodzi. PTLD ndeimwe yezvinetso zvisingawanzoitiki, asi zvinogona kunge zvakakomba.

Kana uri kuda kuiswa nhengo kana kuti stem cell, timu yako yehutano ichataura newe nezvenjodzi yako yePTLD , pamwe nezvimwe zvinhu zvakawanda zvinogona kukonzera njodzi. Vanachiremba nevatsvagiri vari kutsvaga nzira dzekuderedza njodzi yePTLD. Chinhu chakakosha kuziva izvi uye kubvunza timu yako yehutano chero mibvunzo yaungave nayo.

'PTLD, Matambudziko eLymphoproliferative Mushure mekuisirwa, Kuisirwa Nhengo, Lymphoma, Epstein-Barr Virus, Immunology, Kenza