Ngaba ukhe wafakelwa i-stem cell ngumntu othile? Masiqaphele oku (Graft vs. Host Disease)!

Mhlawumbi ukhe weva ngokufakelwa kweeseli ze-stem. Ziyindlela ebaluleke kakhulu yonyango kwezinye izifo. Nangona kunjalo, namhlanje siza kuthetha ngengxaki enokwenzeka emva kokufakelwa okunjalo. Oku kubizwa ngokuba yi-`(Graft vs. Host Disease)` okanye `(GvHD)` ngamafutshane. Ungakhathazeki, masithethe ngale nto ngokulula.

Yintoni `(iGraft vs. iSifo esinguMphathi - iGvHD)`? Icacisiwe nje...

Khawucinge ukuba ufumene utyando lwe-stem cell komnye umntu, umnikeli . Oku sikubiza ngokuba yi-allogeneic transplant. Ezi stem cells zifana neeseli ezingavuthwanga kwifektri yomzimba wakho yokwenza igazi, okanye ii-hematopoietic stem cells. Ezi ziiseli eziya kuba ziiseli ezibomvu zegazi kunye neeseli ezimhlophe zegazi ezifunekayo emzimbeni wakho.

Ngoku, ungadinga nini ii-stem cells kumntu onikela ngolu hlobo? Ukuba unomhlaza ofana ne-leukemia okanye i-lymphoma, okanye esinye isifo apho umongo wakho wethambo ungasebenzi kakuhle njenge-aplastic anemia, ungadinga olu hlobo lokufakelwa.

Kulungile, ngoku yintoni le `(GvHD)`? Kwi `(GvHD)`, okwenzekayo kukuba iiseli zomnikeli ozifumeneyo (i-graft) zibona iiseli emzimbeni wakho (umnikeli) njengento engaqhelekanga, engaqhelekanga. Kufana nokuba umzimba wakho yindawo entsha kuzo. Ngoko ke, ezi seli zomnikeli ziqala ukuhlasela iiseli zomzimba wakho. Yiyo loo nto ibizwa ngokuba yi `(Graft vs. Host Disease)`, oko kuthetha ukuthi "i-graft nxamnye nomnikeli." Uyaqonda?

Ziziphi iintlobo eziphambili ze-GvHD?

Kukho iintlobo ezimbini eziphambili ze-GvHD. Ngaphambili, oogqirha babeyihlela ngokwexesha elithathiweyo ukuqala kweempawu. Kodwa ngoku, bajonga iimpawu kunye neziphumo zovavanyo ukuze babone uhlobo oluchanekileyo.

1. I-Acute GvHD (aGvHD)

Oku kwenzeka emva nje kokufakelwa i-stem cell yakho, rhoqo kwiintsuku ezili-100 zokuqala . Nangona kunjalo, ngamanye amaxesha iimpawu ziqala kamva. I-Acute GvHD idla ngokuchaphazela ulusu lwakho, inkqubo yokugaya ukutya (i-GI tract), okanye isibindi.

2. I-GvHD engapheliyo (cGvHD)

I-Chronic GvHD inokwenzeka nangaliphi na ixesha emva kokufakelwa i-allogeneic. Nangona kunjalo, idla ngokuqala kwiminyaka emibini . I-Chronic GvHD inokuchaphazela ulusu lwakho, umlomo, isibindi, imiphunga, indlela yokugaya ukutya, izihlunu, amalungu, okanye amalungu esini.

Kubalulekile: Ungenza olunye, zombini, okanye akukho nanye kwezi ntlobo ze-GvHD. Iyahluka kumntu nomntu.

Zithini iimpawu ze-`(GvHD)`? Ziqaphele ezi!

Iimpawu ze-GvHD ziyahluka kumntu nomntu. Abanye abantu banokuba neempawu ezingephi , abanye banokuba neempawu eziphakathi , kwaye abanye banokuba neempawu eziqatha.Inokuba yingozi kakhulu (ide ibeke ubomi esichengeni).

Iimpawu ze-acute `(GvHD)`

Sele sitshilo ukuba i-acute GvHD idla ngokuchaphazela ulusu, indlela yokugaya ukutya, kunye nesibindi.

• Ulusu (aGvHD): Uphawu oluqhelekileyo kukuqhambuka kwesikhumba okanye ukuba bomvu (njengokutshiswa lilanga). Kunokubakho iintlungu nokurhawuzelelwa. Ukuqhambuka kudla ngokuqala entanyeni, emagxeni, ezindlebeni, ezintendeni zezandla, nasezinyaweni zeenyawo. Emva koko kunokusasazeka kwezinye iindawo zomzimba.
• Indlela yesisu (i-GI) (aGvHD): Iimpawu eziqhelekileyo sisicaphucaphu, ukuhlanza, kunye norhudo (ukudumba). Ezi mpawu zinokuba buthathaka okanye zibe nzima ngokwaneleyo ukuba zifune ukulaliswa esibhedlele.

Iimpawu eziqhelekileyo ze-GvHD ebukhali ziquka:

• Ukurhawuzelela kwesikhumba kunye/okanye ukurhawuzelela.
• Urhudo.
• Isicaphucaphu nokuhlanza.
• Intlungu yesisu, ukuqhwalela.
• I-Jaundice (ukutyheli kolusu kunye/okanye amehlo).

Iimpawu ze-GvHD engapheliyo

I-GvHD engapheliyo idla ngokuchaphazela ulusu lwakho, isibindi, indlela yokugaya ukutya, kunye nemiphunga. Nangona kunjalo, inokuchaphazela naliphi na ilungu lomzimba wakho.

Iimpawu zingabandakanya:

• Ukurhawuzelela kwesikhumba kunye/okanye ukurhawuzelela.
• Ukuqina kolusu kunye nokudumba.
• Ukulahlekelwa ziinwele entloko nasemzimbeni.
• Umlomo owomileyo.
• Izilonda zomlomo.
• Isifo seentsini.
• Amehlo omileyo, ukuziva ngathi kukho intlama yesanti enamathele ngaphakathi.
• Utshintsho kwimbono.
• Urhudo.
• Isicaphucaphu nokuhlanza.
• Ukutyheli kolusu kunye/okanye amehlo (i-jaundice).
• Ubunzima bokuphefumla (ukuphelelwa ngamandla).
• Ukukhohlela okomileyo nokungapheliyo.
• Ukudinwa.
• Ubuthathaka bemisipha, ukuqhwalela, okanye intlungu.
• Ukungakwazi ukugoba nokwandisa amalungu ngokufanelekileyo.
• Abafazi banokuba nokoma kwelungu lobufazi, ukurhawuzelelwa, okanye iintlungu ngexesha lokwabelana ngesondo.
• Amadoda anokufumana ukurhawuzelelwa yipenis okanye amasende, okanye iintlungu ngexesha lokwabelana ngesondo.

Kutheni le nto `(GvHD)` isenzeka? Yintoni unobangela?

Ngamafutshane, i-GvHD yenzeka xa iiseli ze-stem ezivela kumxhasi ofumene utyando zibona iiseli zomzimba wakho "njengezangaphandle" zize ziqale ukuzihlasela.

Oku kuqhele ukwenzeka: Iiseli zakho zomzimba (iiseli ezisegazini lakho) zikukhusela kwizifo. Zilwa nezinto zangaphandle, ezifana neentsholongwane kunye neebhaktheriya. Nangona kunjalo, ezi seli azihlaseli iiseli zakho. Oku kungenxa yokuba iiseli zakho zineproteni ekhethekileyo ebizwa ngokuba yi-``Human Leukocyte Antigens'', okanye ``HLA''. Oku kufana nethegi enegama kuyo. Le ``HLA'' yiyo exelela iiseli zakho zomzimba ukuba, "Hee, le yenye yethu."

Eyona nto ibalulekileyo kukuba, ngaphandle kwamawele afanayo, wonke umntu wahlukile komnye nomnye.

Emva kokuba ufumene utyando lwe-stem cell komnye umntu, iiseli zegazi ezintsha emzimbeni wakho azinazo i-`(HLA)` yakho, kodwa i -`(HLA)` yomxhasi . Ngoko ke, ukuba i-`(HLA)` yalo mxhasi yahlukile kakhulu kwi-`(HLA)` emzimbeni wakho, ezo seli zegazi zintsha ziqala ukuhlasela iiseli zomzimba wakho. Kulapho ke i-`(GvHD)` iyenzeka khona.

Yingakho oogqirha bejonga ngononophelo i-HLA yomnikeli ukuqinisekisa ukuba ikufutshane kangangoko kunokwenzeka neyakho ngaphambi kokuba benze utyando lwe-stem cell. Ukufumana into efana naleyo kunciphisa umngcipheko wokufumana i-GvHD. Nangona kunjalo, ukuba awufumani iiseli ezivela kwiwele elifanayo, kusekho ithuba lokuba uza kufumana i-GvHD, nokuba zingaphi na ii-matches ozizamayo.

Ngubani osengozini enkulu yokufumana i-GvHD?

Eyona nto ibalulekileyo kumngcipheko kukuba i-HLA yomnikeli wakho ifana kangakanani neyakho. Usemngciphekweni omkhulu wokufumana i-GvHD ukuba:

• Ufumene ii-stem cells kwisalamane sakho, kodwa azifani ngqo ne-HLA match .
• Ufumene ii-stem cells kumntu ongengomntu ozalana nawe, kodwa ofana no-`(HLA)` .

Ezinye izinto ezinobungozi zezi:

• Umnikeli kufuneka abe ngumfazi okhe wakhulelwa ngaphambili.
• Ukukhula kweminyaka yomnikeli okanye wena.
• Ukungangqinelani ngokwesini phakathi komnikeli kunye nawe (umz. ukufumana iiseli ezivela kumnini-mali oyindoda ukuya kowesifazane, okanye ezivela kumnini-mali ongumfazi ukuya kowesilisa).
• Ukuba ii-stem cells zomnikeli zithathwa kwimithambo yegazi (egazini) endaweni yokuba zithathwe kumongo wethambo (apho kuveliswa khona ii-blood cells).

Ukuba sele unayo i-acute `(aGvHD)`, usemngciphekweni omkhulu wokuba ne-`(cGvHD)` engapheliyo.

Ifunyaniswa njani i-GvHD?

Ugqirha wakho unokuxilonga i-GvHD ngokukuxilonga, ukujonga iimpawu zakho, nokujonga iimvavanyo zelebhu kunye neziphumo ze-biopsy. I-biopsy ibandakanya ukuthatha isampuli encinci yezicubu okanye iiseli zakho uze uyithumele kwilebhu ukuze ivavanywe.

Kwi-GvHD engapheliyo (cGvHD), ezinye zeempawu zinokufana nezinye izifo. Ke ngoko, ugqirha uya kuzisusa zonke ezinye izizathu ngaphambi kokuba enze uxilongo oluchanekileyo lwe-cGvHD.

Ziziphi iindlela zonyango ze-GvHD?

Emva kokuba ufumene utyando lwe-stem cell, uza kunikwa amayeza okuthintela amasosha omzimba njengendlela yokuthintela ukunciphisa amandla eeseli ezinikelayo okuhlasela izicubu zakho.

Ukuba la mayeza awayithinteli i-GvHD, ugqirha wakho uya kukunika unyango olusekelwe kubukhali bemeko yakho kunye nohlobo lwe-GvHD.

Unyango lwe-GvHD ebukhali

Oogqirha badla ngokunyanga ngempumelelo abantu abane-GvHD ebukhali ngokunyusa umthamo wamayeza acinezela inkqubo yomzimba yokuzikhusela. La mayeza akwiqela lamayeza abizwa ngokuba yi-corticosteroids. Anganikwa ngomlomo, ngemithambo yegazi, okanye ngethamo. Ukuba ii-steroids azisebenzi, ugqirha wakho unokukunika iyeza elifana neRuxolitinib (Jakafi®). ​​Unokufumana ithuba lokuthatha inxaxheba kuvavanyo lweklinikhi oluvavanya unyango olutsha.

Unyango lwe-GvHD engapheliyo

I-GvHD engapheliyo idla ngokuphathwa ngamayeza okunciphisa amasosha omzimba ixesha elide. Ukuba la mayeza awancedi, ugqirha wakho unokukunika amayeza anjengala:

• `Ruxolitinib (Jakafi®)`
• `Belumosudil (Rezurock™)`
• `Ibrutinib (Imbruvica®)`
• I-Photopheresis (Le yindlela ekhethekileyo yonyango)

Usenokufanelekela `(izilingo zeklinikhi)`. Ugqirha uza kukuxelela ngaloo nto.

Zithini iingxaki/iziphumo ebezingalindelekanga zonyango?

Ngenxa yokuba la mayeza okunciphisa amasosha omzimba ewenza buthathaka amasosha omzimba wakho, unamathuba amaninzi okufumana usulelo lwefungus, iintsholongwane kunye neentsholongwane . Ngoko ke, ugqirha wakho uza kukunika amanye amayeza amaninzi okukhusela kwezi zifo ziyingozi.

Ngaba i-GvHD ingathintelwa?

Iilabhoratri zokubhala izicubu zihlala ziphuhliswa kwaye zisebenzisa uvavanyo olutsha noluchanekileyo olusekelwe kwi-DNA. Oku kuvumela iqela lakho lezonyango ukuba likhethe umxhasi onomlinganiso we-HLA ofanelekileyo kuwe. Okukhona umlinganiso ungcono, kokukhona amathuba okuthintela i-GvHD angcono.

Kwakhona, ugqirha wakho uza kukunika amayeza okuthintela i-GvHD emva kokufakelwa i-stem cell yakho.

Ngaba i-GvHD inganyangeka ngokupheleleyo?

Kwiimeko ezininzi, oogqirha banokukwazi ukulawula imeko ngempumelelo (GvHD). Oko kukuthi, banokulawula iimpawu baze bakuncede uphile ubomi obuqhelekileyo.

Okwangoku, abaphandi bafunda iindlela ezintsha zokuthintela i-GvHD ngokusebenzisa iimvavanyo zeklinikhi. Umzekelo, baphanda amayeza ahlukeneyo okunciphisa umzimba kunye namayeza amatsha okuthintela isifo.

Ngaba i-GvHD ingasongela ubomi?

Ewe, i-GvHD ngamanye amaxesha inokuba yingozi ebomini. I-GvHD engapheliyo yeyona nto iphambili ebangela ukufa phakathi kwabantu abafumana utyando lwe-allogeneic stem cell, ngaphandle kwesifo sabo sokuqala.

Ngoko ke, ngaphambi kokuba ufumane naluphi na unyango - nokuba kukufakelwa i-stem cell - kubaluleke kakhulu ukuxoxa ngemingcipheko nogqirha wakho. Angachaza iingozi kuwe aze akuncede ulinganisele izinto ezilungileyo nezingalunganga zonyango.

Ngaba ngamanye amaxesha kukho inzuzo kwi-`(GvHD)`?

Musa ukumangaliswa, nangona i-GvHD inokuba nefuthe elibi kumgangatho wobomi bakho, ikwanazo neenzuzo ezithile. Impendulo efanayo yomzimba yokuzikhusela ehlasela iiseli zakho eziqhelekileyo ikwafuna kwaye itshabalalise naziphi na iiseli zomhlaza ezinokushiyeka emzimbeni wakho. Oku kubizwa ngokuba yi-graft-versus-tumor effect. Abantu abafumana i-GvHD bafunyenwe bengenawo amathuba okuba isifo sabo esiphambili (ingakumbi umhlaza) sibuye.

Ndingazinyamekela njani? Landela la macebiso!

Ugqirha wakho uza kukuchazela indlela omele uzinyamekele ngayo emva kokufakelwa i-stem cell yakho. Umzekelo, zeziphi iimpawu omele uziqaphele kunye neempawu omele uzibize iqela lakho lezonyango ngoko nangoko ukuba uyavela. Ukuba usemngciphekweni wokufumana i-GvHD, banokukunika nemiyalelo eyongezelelweyo yokhathalelo. Le miyalelo ibandakanya:

• Khusela ulusu lwakho elangeni. Nxiba iihempe ezinemikhono emide kunye neebhulukhwe ezinde. Sebenzisa i-sunscreen ene-SPF 50 ubuncinane. (Ukukhanya kwelanga kunokubangela ukuba kube mandundu okanye kubangele i-GvHD.)
• Gcina umlomo wakho usempilweni. Oku kuya kunciphisa umngcipheko wokuba nesifo seentsini.
• Kuphephe ukutya okuneziqholo okunokubangela izilonda emlonyeni.
• Thatha amanyathelo okuzikhusela kwiintsholongwane. (Ugqirha wakho uza kukuxelela okungakumbi ngale nto.)

Ndifanele ndimbone nini ugqirha?

Kubalulekile ukwazisa ugqirha wakho ngokukhawuleza ukuba kukho naluphi na utshintsho emzimbeni wakho, ingakumbi iimpawu zosulelo kunye nomkhuhlane (100.4 Fahrenheit / 38 Celsius nangaphezulu). Xa uthatha amayeza okunciphisa umzimba, usengozini enkulu yokufumana usulelo olunokuba yingozi ebomini.

Emva kokufakelwa i-allogeneic stem cell, ugqirha wakho uza kukujonga ngokusondeleyo ukuze afumane iingxaki ezifana neGraft vs. Host Disease (GvHD). Ukuba ubonakalisa iimpawu ze-GvHD ebukhali okanye engapheliyo, ugqirha wakho unokutshintsha amayeza akho okanye akunike amayeza amatsha. Thatha onke amayeza njengoko kuyalelwe. Landela imiyalelo kagqirha wakho malunga nendlela yokuzinyamekela, ngakumbi malunga nendlela yokuzikhusela kwiintsholongwane.

Izinto ezibalulekileyo ekufuneka uzikhumbule ngokufutshane!

Kulungile, ngoko ke iGraft vs. Host Disease, okanye iGvHD, yingxaki enokwenzeka emva kokufakelwa i-stem cell komnye umntu. Ngamafutshane, kuxa iiseli ezinikelayo zihlasela iiseli zakho.

Khumbula, kukho unyango lwe-GvHD, kwaye imeko inokulawulwa. Eyona nto ibalulekileyo kukulandela imiyalelo yeqela lakho lezonyango ngononophelo kwaye ubazise ngazo naziphi na iimpawu ezintsha ngokukhawuleza.

Ukuba uneminye imibuzo malunga noku, ungoyiki ukubuza ugqirha wakho. Ngabo banokukunceda ngcono.

I- GvHD, ukufakelwa kweeseli zesiqu, ukufakelwa kwe-allogeneic, inkqubo yomzimba yokuzikhusela, i-HLA, iiseli zomnikelo, iimpawu