Khawucinge ukuba unikwe utyando lwe-stem cell kumntu ophilileyo njengonyango lwesifo esifana ne-leukemia. Oku kulindeleke ukuba kunyange imeko yakho. Kodwa kunqabile kakhulu, ezi seli zintsha ezize kukunceda, umzimba wakho uziphambanisa "njengotshaba" kwaye ziqale ukuhlasela iiseli zakho. Leyo yimeko enzima esiyibiza ngokuba yi-"Graft versus Host Disease" okanye i-GvHD ngamafutshane.
Iyintoni i-GvHD ngokulula?
Ukuze sikuqonde oku, kufuneka sazi amagama amabini. Igama elithi "graft" libhekisa kwinto etyaliweyo, oko kukuthi, iiseli ze-stem eziphilileyo ezinikwa wena zivela ngaphandle. Igama elithi "Host" libhekisa kumninimzi, oko kukuthi, umzimba wakho owamkela ezo seli. Ngoko ke igama elithi "Graft versus Host" lithetha "graft versus host."
Ngokwesiqhelo, olu hlobo lokufakelwa kweeseli ze-stem, olubizwa ngokuba yi-allogeneic transplant, lwenzelwa ukunyanga umhlaza ofana ne-leukemia kunye ne-lymphoma, okanye iimeko zokungaphumeleli komongo wethambo ezifana ne-aplastic anemia . Ezi seli zifakwe kwenye indawo zezona ziqala umzimba wakho ukwenza iiseli ezintsha zegazi.
Kodwa, ngamanye amaxesha ezi seli zintsha azizazi iiseli zakho. Zicinga ukuba ziintsali zangaphandle. Ngoko ke, ziqala ukuhlasela amalungu akho asempilweni, njengolusu lwakho, isibindi, namathumbu. Yiyo loo nto i-GvHD iyiyo.
Kukho iintlobo ezimbini eziphambili ze-GvHD:
I-GvHD inokwahlulwahlulwa ibe ziintlobo ezimbini eziphambili. Ngaphambili, oku kwahlulwahlulwa ngokwexesha lokuqalisa kweempawu. Kodwa ngoku, oogqirha bamisela uhlobo oluchanekileyo ngokujonga iimpawu, iziphumo zovavanyo, kunye nexesha lokuqalisa kweempawu.
- I-Acute GvHD (aGvHD): Oku kudla ngokuvela kwiintsuku ezili-100 zokuqala emva kokufakelwa isidoda. Kodwa ngamanye amaxesha kuyenzeka kamva. Olu hlobo luchaphazela kakhulu ulusu lwakho, inkqubo yesisu (amathumbu), kunye nesibindi.
- I-GvHD engapheliyo (cGvHD): Olu hlobo lunokwenzeka nangaliphi na ixesha emva kokufakelwa isidoda, kodwa luxhaphake kakhulu kwiminyaka emibini yokuqala . Lunokuchaphazela naliphi na ilungu lomzimba, kuquka ulusu, umlomo, isibindi, imiphunga, amathumbu, izihlunu, amalungu kunye namalungu esini.
Umntu okhe wafakelwa isibeleko unokuba nolunye lwezi ntlobo zimbini, zombini, okanye aphile ubomi obusempilweni ngaphandle kwaso nasinye kuzo.
Zithini iimpawu ze-GvHD?
Iimpawu ze-GvHD zingaqala kwezincinci kakhulu, ukuya kweziphakathi, ukuya kwezinzima, kwaye zisongela ubomi. Makhe sijonge iimpawu ezinxulumene nezi ntlobo zimbini.
| Uhlobo lwe-GvHD | Iimpawu eziqhelekileyo |
|---|---|
| I-Acute GvHD (aGvHD) (Ichaphazela kakhulu ulusu, amathumbu, isibindi) |
|
| I-GvHD engapheliyo (cGvHD) (Ingachaphazela naliphi na ilungu lomzimba) |
Kutheni le nto i-GvHD yenzeka?
Oku kungokwesayensi kancinci, kodwa ndiza kukuchaza ngokulula.
Ngokwesiqhelo, iiseli zenkqubo yethu yokuzikhusela komzimba zisikhusela kwizifo ngokulwa nabahlaseli bamanye amazwe njengeentsholongwane kunye neebhaktheriya. Kodwa ezo seli azize zihlasele iiseli zethu. Isizathu soku kukuba kukho iproteni ekhethekileyo kumphezulu wazo zonke iiseli zethu. Oku kubizwa ngokuba yiHuman Leukocyte Antigens (HLA) .
Cinga ngale HLA njengento efana nekhadi lesazisi. Iiseli zethu zomzimba zijonga eli khadi lesazisi zize zithi, "Owu... lo ngomnye wethu."
Ngaphandle kwamawele afanayo, i-HLA yomntu wonke yahlukile.
Xa ufumana utyando lweeseli ze-stem, iiseli zegazi ezintsha ezenziwe ngezo seli zine-HLA yomntu owakunika iiseli. Ukuba loo HLA yahlukile kakhulu kwi-HLA yakho, ezo seli zintsha zijonga iiseli emzimbeni wakho zize zicinge, "Lo ngumhlaseli, isazisi sakhe asifani nesethu." Kulapho ezo seli ziqala khona ukuhlasela umzimba wakho.
Ngenxa yesi sizathu, oogqirha bajonga ngononophelo i-HLA yomnikeli kunye nommkeli ukuqinisekisa ukuba basondelelene kangangoko kunokwenzeka ngaphambi kokuba benze utyando. Kodwa ngaphandle kokuba iiseli zithathwe kwiwele, kusoloko kukho umngcipheko othile we-GvHD.
Ngubani osengozini enkulu yokufumana i-GvHD?
Eyona nto ibalulekileyo kukungahambelani kwe-HLA, kodwa nezinye izinto ezininzi zinokudlala indima.
| Into enobungozi | Inkcazo |
|---|---|
| Ukungafani kwe-HLA | - Ukufakelwa kweeseli ezingafanelaniyo ne-HLA, nokuba zithathwe kwisalamane. - Nokuba ivela kumntu ongazalaniyo, kwaye i-HLA ihambelana kakuhle, kusekho umngcipheko othile. |
| Ezinye izinto |
|
Kwakhona, ukuba sele unayo i-Acute GvHD (aGvHD), usemngciphekweni omkhulu wokufumana i-Chronic GvHD (cGvHD).
Ifunyanwa njani le meko kwaye inyangwa njani?
Uxilongo
Ugqirha wakho uza kuxilonga i-GvHD ngokwenza uvavanyo lomzimba, ukujonga iimpawu zakho, nokwenza uvavanyo lwegazi kunye ne-biopsy. I-biopsy ibandakanya ukuthatha iqhekeza elincinci lolusu okanye izicubu ezichaphazelekileyo uze ulihlolisise phantsi kwe-microscope. Ngenxa yokuba ezinye zeempawu ze-GvHD engapheliyo zifana nezinye iimeko, ugqirha wakho uza kuzisusa ezinye iimeko ngaphambi kokuba axilonge i-GvHD.
Unyango
Ukuthintela i-GvHD emva kokufakelwa, uza kunikwa amayeza okunciphisa amasosha omzimba acinezela inkqubo yakho yokuzikhusela komzimba. La mayeza asebenza ngokunciphisa amandla eeseli zangaphandle okuhlasela umzimba wakho.
Ukuba i-GvHD iyenzeka nangona usele la mayeza, ugqirha wakho uya kugqiba ngonyango olusekelwe kubukhali bemeko yakho kunye nohlobo lwe-GvHD.
- Kwi-acute GvHD (aGvHD): Amaxesha amaninzi, ii-corticosteroids zinikwa njengeepilisi, iinaliti, okanye njengekhrimu esetyenziswa eluswini. Ukuba ezi azilawuli isifo, ezinye iziyobisi ezifana neRuxolitinib (Jakafi®) okanye iimvavanyo zeklinikhi zinokuqwalaselwa.
- Kwi-Chronic GvHD (cGvHD): Amayeza okunciphisa amasosha omzimba ahlala ixesha elide nawo ayanikwa oku. Ukuba imeko ayilawulwa zezi, amayeza anjengeRuxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) okanye unyango olukhethekileyo olufana ne -photopheresis lunokufuneka.
Iziphumo ebezingalindelekanga zonyango
Olu nyango lucinezela amajoni omzimba wakho, nto leyo enciphisa amandla omzimba wakho okulwa nosulelo. Oku kwandisa umngcipheko wakho wokufumana usulelo lwefungus, bacterial, kunye neviral. Ugqirha wakho uya kukunika amayeza okunceda ukuthintela olu sulelo lunokuba yingozi ebomini.
Ezinye iziphumo ezinokubakho ngenxa ye-GvHD
Ngaba i-GvHD iyingozi ebomini?
Ewe, i-GvHD inokuba yingozi ebomini. I-GvHD engapheliyo, ngakumbi, yeyona nto ibangela ukufa emva kokufakelwa i-stem cell, ngaphandle kwesifo esiyintloko. Yiyo loo nto kubalulekile ukuxoxa ngemingcipheko nogqirha wakho ngaphambi kokuba ufumane naluphi na unyango.
Ngaba kukho inzuzo evela kwi-GvHD?
Okumangalisayo kukuba, ewe. I-GvHD ineengenelo ezithile. Ezi seli zintsha zomzimba ezihlasela iiseli zakho eziphilileyo zikwafuna kwaye zitshabalalise naziphi na iiseli zomhlaza ezinokuthi zishiyeke emzimbeni wakho. Oku kubizwa ngokuba yi-"graft-versus-tumor effect." Ke ngoko, uphando lubonise ukuba izigulana ezine-GvHD azinawo amathuba amaninzi okubuya komhlaza wazo.
Izinto onokuzenza ukuze ukhuseleke
Ugqirha wakho uza kukuchazela indlela omele uzinyamekele ngayo emva kokufakelwa isidoda. Lumka ngakumbi ngezi zinto ukuba usengozini yokufumana i-GvHD.
- Zikhusele elangeni: Ukuvezwa lilanga kungenza i-GvHD ibe mandundu ngakumbi. Ngoko ke nxiba iihempe ezinemikhono emide kunye neebhulukhwe ezinde xa uphuma ngaphandle. Sebenzisa i-sunscreen ene-SPF 50 ubuncinane.
- Ucoceko lomlomo: Hlamba amazinyo akho kakuhle ukuze unciphise umngcipheko wesifo seentsini.
- Ukutya Neziselo: Kuphephe ukutya okuneziqholo, okunamafutha, kunye nokutya okunokubangela izilonda emlonyeni.
- Zikhusele kwiintsholongwane: Ekubeni inkqubo yakho yokuzikhusela yomzimba ibuthathaka, ziphephe iindawo apho izifo zisasazeka khona neendawo ezixineneyo. Hlala ugcina izandla zakho zicocekile.
Ndifanele ndimbone nini ugqirha?
Kubalulekile ukwazisa ugqirha wakho ngokukhawuleza ukuba ubona naluphi na utshintsho emzimbeni wakho, ingakumbi iimpawu zosulelo okanye umkhuhlane ongama-38 degrees Celsius (100.4 Fahrenheit) okanye ngaphezulu. Usulelo lunokuba yingozi kakhulu ngokukhawuleza xa usela amayeza acinezela inkqubo yomzimba yokuzikhusela.
Ugqirha wakho uza kukujonga rhoqo emva kokufakelwa kwakho ukuze ajonge iingxaki ezifana ne-GvHD. Ukuba iimpawu ziyavela, ziya kutshintsha amayeza akho okanye zinike amatsha. Kubaluleke kakhulu ukuthatha onke amayeza amiselweyo njengoko kuyalelwe kwaye ulandele imiyalelo kagqirha wakho.
Umyalezo Wokuya Ekhaya
- Isifo se-Graft vs. Host (GvHD) yingxaki eyenzeka emva kokufakelwa i-stem cell, xa umzimba womntu ofumana le ntsholongwane uhlasela iiseli ezinikelweyo.
- Kukho iintlobo ezimbini eziphambili zesi sifo, esibukhali nesingapheliyo. Iimpawu ziyahluka ngokufanelekileyo.
- Eyona ndlela ilungileyo yokuthintela i-GvHD kukuqinisekisa ukuba umnikeli kunye nommkeli bane-HLA efanelekileyo.
- Ngenxa yokuba amayeza acinezela inkqubo yomzimba yokuzikhusela asetyenziswa kunyango, umngcipheko wokosuleleka uphezulu kakhulu.
- Yazisa ugqirha wakho ngoko nangoko xa kukho naziphi na iimpawu ezintsha, ingakumbi umkhuhlane.
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