Ubungaziva njani ukuba ubunonyango olukhulu njengokufakelwa umongo wethambo lomhlaza wegazi uze ucinge, "Yonke into ilungile ngoku," uze uve ukuba umhlaza ubuyile? Kuyadabukisa ngokwenene kwaye kuyadabukisa kakhulu. Kodwa ungalahli ithemba. Namhlanje sithetha ngonyango olukhethekileyo olunokunceda kwiimeko ezinje. Lubizwa ngokuba yi-DLI, olumele i-Donor Lymphocyte Infusion.
Kalula nje, yintoni i-DLI?
Kulungile, masiyibeke ngokulula le nto. Ii-lymphocytes luhlobo lweeseli ezimhlophe zegazi egazini lakho. Zifana namajoni emizimbeni yethu. Ziyinxalenye enkulu yenkqubo yethu yokuzikhusela, zilwa neentsholongwane zangaphandle, usulelo, kunye neeseli zomhlaza.
Ngoku, i-DLI (Donor Lymphocyte Infusion) yinkqubo apho ezinye zezi lymphocytes zithathwa kumnikeli ofanayo ophilileyo owayenikele ngethambo lakho (iiseli ze-stem) waza wafakwa emzimbeni wakho. La 'majoni' amatsha, asempilweni nanamandla afuna aze atshabalalise naziphi na iiseli zomhlaza eziseleyo ezinokuba zifihlekile emzimbeni wakho. Leyo yeyona njongo iphambili yolu nyango.
Kukweziphi iimeko apho unyango lwe-DLI lucetyiswa khona?
Ugqirha wakho unokuthi akuxelele ngolu nyango ukuba umhlaza wegazi lakho ubuya (uphinda ubuye) emva kokufakelwa umongo wethambo.
Nazi ezinye zeemeko ezisetyenziswa kakhulu kunyango lwe-DLI:
- I-Acute Myeloid Leukemia (AML)
- I-Chronic Lymphocytic Leukemia (CLL)
- I-Chronic Myeloid Leukemia (CML)
- I-Multiple Myeloma
- I-Myelodysplasia (MDS)
- I-Non-Hodgkin Lymphoma
Enye into kukuba, ngamanye amaxesha emva kokufakelwa umongo wethambo, umzimba wakho unokuba nomxube weeseli zabanikeli kunye neeseli zakho ezindala. Oku sikubiza ngokuba yi-mixed chimerism . Oku kwandisa umngcipheko wokubuya komhlaza. Ngoko ke, i-DLI inokwenziwa ukuguqula zonke iiseli emzimbeni wakho zibe ziiseli ezivela kubanikeli.
Ulungiselela njani olu nyango?
Ngaphambi kokuba uqalise unyango lwe-DLI, ugqirha wakho uza kukuxilonga ngononophelo, axoxe ngeempawu zakho, aze acele iimvavanyo ezininzi.
- I-Bone marrow biopsy: Kuthathwa isampulu encinci yomongo ukuze kujongwe naziphi na iiseli zomhlaza eziseleyo.
- Ubalo lwegazi olupheleleyo (i-CBC):Inani leeseli egazini liyajongwa.
- Uvavanyo lokusebenza kwezintso kunye nesibindi.
Ukuba i-biopsy ibonisa ukuba inqanaba leeseli zomhlaza liphezulu kakhulu, ugqirha wakho unokugqiba ekubeni akunike i-chemotherapy ngaphambi kwe-DLI. Oku kwenzelwa ukunciphisa inani leeseli zomhlaza kunye nokunyusa impumelelo yonyango lwe-DLI.
Iiseli ze-lymphocyte zifunyanwa njani kumntu onikelayo?
Le yinto ekhethekileyo kakhulu eyenzekayo. Umnikeli owakunika ubomi, oko kukuthi, umnikeli owakunika umongo wethambo, naye uyanceda koku. Ityhubhu encinci (i-catheter) ifakwa kumthambo osengalweni yakhe kwaye kuthathwe igazi elithile. Eli gazi lidlula kumatshini okhethekileyo. Oko kwenziwa ngulo matshini kukwahlula iiseli ze-lymphocyte esizifunayo kuphela, kwaye uthumele lonke igazi emzimbeni ngomthambo osengalweni yomnye umnikeli. Le nkqubo ibizwa ngokuba yi-apheresis . Ngamanye amaxesha, xa unikela ngomongo wethambo okokuqala, ezinye zezi seli ze-lymphocyte zinokuthathwa zikhenkcezwe ukuze zisetyenziswe kamva.
Ufumana njani unyango lwe-DLI?
Oku kuvakala ngathi yinto elula njengokukunika isisombululo se-saline.
1. Ugqirha okanye umongikazi uza kufaka ityhubhu encinci (i-catheter) emthanjeni osengalweni okanye esifubeni sakho.
2. Emva koko, ipakethi equlethe iiseli ze-lymphocyte ezahlulwe kumxhasi iqhagamshelwe kuloo mbhobho ize ifakwe egazini lakho.
3. Lo msebenzi uthatha malunga nemizuzu engama-30 .
4. Xa umsebenzi ugqityiwe, ityhubhu iyasuswa.
Ngamanye amaxesha unganika iidosi ezininzi ezinje kangangexesha leeveki okanye iinyanga ezininzi.
Xa iiseli ezintsha zingeniswa emzimbeni ngale ndlela, enye yezona zinto zibalulekileyo ibizwa ngokuba yi-graft vs. tumor effect (GvT) . Oku kuthetha ukuba ezi seli ziphilileyo (graft) ezivela kumxhasi zifuna iiseli zomhlaza ezisele (tumor) emzimbeni wakho, zihlasele, kwaye zitshabalalise. Le yindlela umhlaza onyamalala ngayo ngokupheleleyo.
Zithini iingenelo kunye neengozi zonyango lwe-DLI?
Iingenelo eziphambili zale nto
Ngaphambili, ukuba umhlaza ubuya emva kokufakelwa umongo wethambo, ukhetho olulodwa yayikukwenza olunye utyando lomongo wethambo. Kodwa umngcipheko weengxaki wawuphezulu kakhulu ngokufakelwa okwesibini. I-DLI yindlela elungileyo, engenamngcipheko wokubeka umhlaza esichengeni ngaphandle kwezixhobo zokunciphisa amasosha omzimba.
Iingozi ezinokubakho kunye neengxaki
Njengakwezinye iindlela zonyango, kukho iingozi ezithile. Iqela lakho lezonyango liza kukubeka esweni ngokusondeleyo ezi ngxaki.
| Ingxaki | Inkcazo kunye neempawu |
|---|---|
| Isifo se-Graft vs. Host (GvHD) | Kulapho iiseli ezivela kumxhasi (i-graft) zibona iiseli zomzimba wakho eziphilileyo (umninimzi) njengotshaba zize zihlasele. Iimpawu: urhudo, ukutyheli kolusu (i-jaundice), isicaphucaphu nokuhlanza, izilonda zolusu okanye irhashalala. |
| Uxinzelelo lweMyelosuppression | Oku kukuncipha okwethutyana komsebenzi womongo wethambo, okunokukhokelela ekunciphiseni inani leeseli zegazi. - Iiseli ezibomvu zegazi ezisezantsi (i-Anemia): ukudinwa, ukuphefumla kancinci. - Ukuncipha kweeseli ezimhlophe zegazi (iLeukopenia): Umngcipheko okhulayo wosulelo. - Iiplatelets ezisezantsi: Umngcipheko ophezulu wokopha. |
Yintoni omawuyenze xa kuvela iingxaki?
Ungakhathazeki. Kukho unyango lwazo zonke ezi zinto.
- Ukuba i-GvHD iyenzeka: Ugqirha wakho uza kukunika amayeza okunciphisa umzimba .
- Ukuba iiseli zakho zegazi ziphantsi: Iiseli ezimhlophe zegazi ezisezantsi zihlala ziziphelela zodwa. Ukuba akunjalo, kukho amayeza okuzinyanga. Utofelo-gazi lunokunikwa ukuba kuyimfuneko ukunyanga iiseli ezibomvu zegazi kunye neeplatelets ezisezantsi.
Emva konyango kunye nempumelelo
Thetha nogqirha wakho malunga nokuba kuza kuthatha ixesha elingakanani ukubuyela esiqhelweni emva konyango. Kuya kufuneka ulandelelwe rhoqo kwaye uhlolwe igazi.
Impumelelo yolu nyango inokwahluka kumntu nomntu. Kukho izinto ezininzi ezichaphazela olu nyango:
- Inqanaba lomhlaza.
- Impilo yenkqubo yakho yomzimba yokuzikhusela.
- Uhlobo lokufakelwa kwesisu olwenziwe ngaphambili.
- Nokuba i-chemotherapy yenziwe ngaphambi kwe-DLI okanye akunjalo.
Okubaluleke kakhulu: Ukuba ufumana naziphi na iimpawu ze-GvHD ezinje ngomkhuhlane, ukopha okungaqhelekanga, ubunzima bokuphefumla, urhudo, ukurhawuzelela kolusu, okanye naziphi na ezinye iimpawu ezingaqhelekanga , yazisa ugqirha wakho okanye isibhedlele esinyangayo ngoko nangoko.
Ngaba i-DLI yi-immunotherapy?
Ewe, i-DLI yi -immunotherapy.Luhlobo lonyango. Kuba into oyenzayo kukunika amajoni akho omzimba asempilweni ii-T-cells ezivela ngaphandle ukuze zincede ekulweni nomhlaza. Oko kuyathembisa ngokwenene.
Umyalezo Wokuya Ekhaya
- I-DLI lunyango olukhethekileyo lomhlaza wegazi oluphinda luvele emva kokufakelwa umongo wethambo.
- Oku kusebenzisa iiseli ezibizwa ngokuba zii-lymphocytes ezivela kulowo unikela ngegazi eliphilileyo owanikela ngethambo lakho kwasekuqaleni.
- Injongo yoku kukuba ezi seli zintsha zifune kwaye zitshabalalise iiseli zomhlaza eziseleyo emzimbeni (isiphumo seGvT).
- Iingozi eziphambili yi-GvHD (iGraft vs. iSifo soMphathi) kunye nokubalwa kweeseli zegazi eziphantsi, kodwa ezi ziyanyangeka.
- Olu luhlobo lonyango lwe-immunotherapy olunika ithemba ngaphandle kweengozi eziphezulu zokufakelwa umongo wesibini.
- Thetha nogqirha wakho ngoko nangoko malunga naziphi na iimpawu okanye iingxaki ezintsha.
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