Uke wafakelwa i-stem cell ngomuntu othile? Ake siqaphele lokhu (Isifo Sokufakelwa Kwezicubu vs. Isifo Sokubamba)!

Cishe uke wezwa ngokufakelwa kwamaseli e-stem. Kuyindlela yokwelapha ebaluleke kakhulu kwezinye izifo. Kodwa-ke, namuhla sizokhuluma ngenkinga engenzeka ngemva kokufakelwa okunjalo. Lokhu kubizwa ngokuthi `(Graft vs. Host Disease)` noma `(GvHD)` ngamafuphi. Ungakhathazeki, ake sixoxe ngalokhu kalula.

Kuyini `(Isifo Sokuxhuzula vs. Isifo Somsingathi - GvHD)`? Kuchazwe kalula...

Ake sithi uthole ukufakelwa kweseli le-stem kusuka komunye umuntu, umnikeli . Lokhu sikubiza ngokuthi ukufakelwa kwe-allogeneic. Lawa maseli e-stem afana namaseli angavuthiwe efektri yomzimba wakho yokwenza igazi, noma amaseli e-hematopoietic stem. Lawa amaseli azoba amaseli egazi abomvu namaseli egazi amhlophe kamuva umzimba wakho owadingayo.

Manje, ungawadinga nini ama-stem cell avela kumuntu onikela ngale ndlela? Uma unomdlavuza ofana ne-leukemia noma i-lymphoma, noma esinye isifo lapho umongo wakho wethambo ungasebenzi kahle njenge-aplastic anemia, ungase udinge lolu hlobo lokufakelwa.

Kulungile, manje kuyini lokhu `(GvHD)`? Ku-`(GvHD)`, okwenzekayo ukuthi amaseli anikelayo owatholile (i-graft) abona amaseli emzimbeni wakho (umphathi) njengento engavamile, engajwayelekile. Kufana nokuthi umzimba wakho uyindawo entsha kuwo. Ngakho-ke, la maseli anikelayo aqala ukuhlasela amaseli omzimba wakho. Yingakho ibizwa ngokuthi `(i-Graft vs. Isifo Somphathi)`, okusho ukuthi "i-graft ngokumelene nomphathi." Uyaqonda?

Yiziphi izinhlobo eziyinhloko ze-GvHD?

Kunezinhlobo ezimbili eziyinhloko ze-GvHD. Esikhathini esidlule, odokotela babeyihlukanisa ngokwesikhathi okwathatha ngaso ukuqala kwezimpawu. Kodwa manje, babheka izimpawu nemiphumela yokuhlola ukuze bathole uhlobo oluqondile.

1. I-Acute GvHD (aGvHD)

Lokhu kuvame ukwenzeka ngokushesha ngemva kokufakelwa i-stem cell yakho, ngokuvamile phakathi nezinsuku zokuqala eziyi-100 . Kodwa-ke, ngezinye izikhathi izimpawu zingaqala kamuva. I-Acute GvHD ivame ukuthinta isikhumba sakho, uhlelo lokugaya ukudla (i-GI tract), noma isibindi.

2. I-GvHD Engapheli (cGvHD)

I-GvHD Engapheli ingenzeka nganoma yisiphi isikhathi ngemva kokufakelwa i-allogeneic. Kodwa-ke, ivame ukuqala phakathi neminyaka emibili . I-GvHD Engapheli ingathinta isikhumba sakho, umlomo, isibindi, amaphaphu, indlela yokugaya ukudla, imisipha, amalunga, noma izitho zangasese.

Okubalulekile: Ungakha uhlobo olulodwa, kokubili, noma akukho nhlobo yalolu hlobo lwe-GvHD. Luyahlukahluka kumuntu nomuntu.

Ziyini izimpawu ze-`(GvHD)`? Qaphela lezi!

Izimpawu ze-GvHD ziyahlukahluka kumuntu nomuntu. Abanye abantu bangase babe nezimpawu ezincane , abanye bangase babe nezimpawu ezimaphakathi , kanti abanye bangase babe nezimpawu ezinzima.Kungaba nzima kakhulu (kuze kube yingozi ngisho nasekufeni).

Izimpawu ze-acute `(GvHD)`

Sesishilo kakade ukuthi i-acute GvHD ivame ukuthinta isikhumba, indlela yokugaya ukudla, kanye nesibindi.

• Isikhumba (aGvHD): Uphawu oluvame kakhulu ukuqubuka kwesikhumba noma ukubomvu (njengokushiswa yilanga). Kungase kube nobuhlungu nokulunywa. Ukuqubuka kuvame ukuqala entanyeni, emahlombe, ezindlebeni, ezintendeni zezandla, nasematheni ezinyawo. Kungabe sekusakazekela kwezinye izingxenye zomzimba.
• Umgudu Wesisu (i-GI) (aGvHD): Izimpawu ezivame kakhulu isicanucanu, ukuhlanza, kanye nesifo sohudo (ukuqunjelwa). Lezi zimpawu zingaba zincane noma zibe zimbi ngokwanele ukuthi zidinge ukulaliswa esibhedlela.

Izimpawu ezivamile ze-GvHD ebukhali zifaka:

• Ukuqubuka kwesikhumba kanye/noma ukulunywa.
• Uhudo.
• Isicanucanu nokuhlanza.
• Ubuhlungu besisu, ukuxhuga.
• I-jaundice (ukuphuzi kwesikhumba kanye/noma amehlo).

Izimpawu ze-GvHD engapheli

I-GvHD Engapheli ivame ukuthinta isikhumba sakho, isibindi, indlela yokugaya ukudla kanye namaphaphu. Kodwa-ke, ingathinta noma iyiphi ingxenye yomzimba wakho.

Izimpawu zingafaka:

• Ukuqubuka kwesikhumba kanye/noma ukulunywa.
• Ukuqina kwesikhumba nokuvuvukala.
• Ukulahlekelwa izinwele ekhanda nasemzimbeni.
• Umlomo owomile.
• Izilonda zomlomo.
• Isifo sezinsini.
• Amehlo omile, uzizwa sengathi uhlamvu lwesihlabathi lunamathele ngaphakathi.
• Izinguquko embonweni.
• Uhudo.
• Isicanucanu nokuhlanza.
• Ukuphuzi kwesikhumba kanye/noma amehlo (i-jaundice).
• Ubunzima bokuphefumula (ukuphelelwa umoya).
• Ukukhwehlela okomile nokungapheli.
• Ukukhathala.
• Ubuthakathaka bemisipha, ukuxhuga, noma ubuhlungu.
• Ukungakwazi ukugoba nokwelula amalunga kahle.
• Abesifazane bangase babe nokoma kwesitho sangasese sowesifazane, ukulunywa, noma ubuhlungu ngesikhathi socansi.
• Amadoda angase azwe ukulunywa kwepenis noma amasende, noma ubuhlungu ngesikhathi socansi.

Kungani lokhu `(GvHD)` kwenzeka? Iyini imbangela?

Kalula nje, i-GvHD yenzeka lapho amaseli okuqala avela kumuntu onikele ngokufakelwa ebona amangqamuzana omzimba wakho "njengawangaphandle" bese eqala ukuwahlasela.

Yilokhu okuvame ukwenzeka: Amaseli akho omzimba (amaseli egazini lakho) akuvikela ezifweni. Alwa nezinto zakwamanye amazwe, njengegciwane namagciwane. Kodwa-ke, lawa maseli awahlaseli amaseli akho. Lokhu kungenxa yokuthi amaseli akho aneprotheni ekhethekile ebizwa ngokuthi ``Human Leukocyte Antigens'', noma ``HLA''. Lokhu kufana nethegi enegama kuyo. Le ``HLA'' yiyo etshela amaseli akho omzimba ukuthi, "Hei, lena ingenye yethu."

Into ebaluleke kakhulu ukuthi, ngaphandle kwamawele afanayo, i-`(HLA)` yawo wonke umuntu ihlukile komunye nomunye.

Ngemva kokuthola ukufakelwa kweseli lesitho esivela komunye umuntu, amangqamuzana egazi amasha emzimbeni wakho awanawo i-`(HLA)` yakho, kodwa i -`(HLA)` yomnikeli . Ngakho-ke, uma i-`(HLA)` yalo mnikeli ihluke kakhulu ku-`(HLA)` emzimbeni wakho, lawo maseli egazi amasha aqala ukuhlasela amangqamuzana omzimba wakho. Yilapho-ke i-`(GvHD)` iqala khona.

Yingakho odokotela behlola ngokucophelela i-HLA yomnikeli ukuqinisekisa ukuthi iseduze kakhulu neyakho ngangokunokwenzeka ngaphambi kokwenza ukufakelwa kwe-stem cell. Ukuthola okufanayo okunjalo kunciphisa ingozi yokuthola i-GvHD. Kodwa-ke, uma ungawatholi amaseli avela kumawele afanayo, kusenethuba lokuthi uzothola i-GvHD, kungakhathaliseki ukuthi uzama okufana okungakanani.

Ubani osengozini enkulu yokuthola i-GvHD?

Isici esibaluleke kakhulu sengozi ukuthi i-HLA yomnikeli wakho ifana kangakanani neyakho. Usengozini enkulu yokuthola i-GvHD uma:

• Uthole ama-stem cell esihlotsheni, kodwa hhayi i-HLA match eqondile .
• Uthole ama-stem cell kumuntu ongeyena isihlobo sakho, kodwa ofana no-`(HLA)` .

Ezinye izinto eziyingozi yilezi:

• Umnikeli kumele kube ngowesifazane oke wakhulelwa ngaphambilini.
• Ukukhula kweminyaka yomnikeli noma wena ngokwakho.
• Ukungalingani kobulili phakathi komnikeli nawe (isib. ukwamukela amaseli avela kumnikeli wesilisa kuya kowesifazane, noma avela kumnikeli wesifazane kuya kowesilisa).
• Uma amaseli okuqala omnikeli ethathwa emithanjeni yegazi (egazini) esikhundleni sokuthathwa emnkantsheni wamathambo (lapho kukhiqizwa khona amaseli egazi).

Uma usuvele une-`(aGvHD)` ebukhali, usengozini enkulu yokuthola i-`(cGvHD)` engamahlalakhona.

Itholakala kanjani i-GvHD?

Udokotela wakho angakuxilonga i-GvHD ngokukuhlola, ukubheka izimpawu zakho, nokubheka izivivinyo zelebhu kanye nemiphumela ye-biopsy. I-biopsy ihilela ukuthatha isampula encane yezicubu noma amaseli akho bese uyithumela elebhu ukuze ihlolwe.

Ku-GvHD engamahlalakhona (cGvHD), ezinye zezimpawu zingafana nezinye izifo. Ngakho-ke, udokotela uzokhipha zonke ezinye izimbangela ngaphambi kokuthola ukuthi i-cGvHD iyatholakala yini.

Yiziphi izindlela zokwelapha i-GvHD?

Ngemva kokufakelwa i-stem cell, uzonikezwa imithi yokucindezela amasosha omzimba njengesinyathelo sokuvimbela ukunciphisa ikhono lamaseli anikelayo lokuhlasela izicubu zakho.

Uma le mithi ingavimbeli ukukhula kwe-GvHD, udokotela wakho uzokunikeza ukwelashwa ngokusekelwe ebunzimeni besimo sakho kanye nohlobo lwe-GvHD.

Ukwelashwa kwe-GvHD ebukhali

Odokotela bavame ukwelapha ngempumelelo abantu abane-GvHD ebukhali ngokwandisa umthamo wemithi ecindezela amasosha omzimba. Lokhu kungokwesigaba semithi ebizwa ngokuthi i-corticosteroids. Inganikezwa ngomlomo, ngemithambo yegazi, noma ngokufakwa phezulu. Uma ama-steroid engasebenzi, udokotela wakho angase akunikeze umuthi ofana ne-Ruxolitinib (Jakafi®). ​​​​Ungase futhi ube nethuba lokubamba iqhaza ezivivinyweni zemitholampilo ezihlola ukwelashwa okusha.

Ukwelashwa kwe-GvHD engamahlalakhona

I-GvHD Engapheli ivame ukwelashwa ngemithi yokucindezela amasosha omzimba isikhathi eside. Uma le mithi ingasizi, udokotela wakho angase akunike imithi efana nalokhu:

• `I-Ruxolitinib (Jakafi®)`
• `Belumosudil (Rezurock™)`
• `Ibrutinib (Imbruvica®)`
• I-Photopheresis (Lena indlela yokwelapha ekhethekile)

Ungase futhi ufanelekele "izivivinyo zemitholampilo." Udokotela uzokutshela ngalokho.

Yiziphi izinkinga/imiphumela emibi yokwelashwa?

Ngenxa yokuthi le mithi yokucindezela amasosha omzimba yenza buthaka amasosha omzimba wakho, kungenzeka kakhulu ukuthi ube nokutheleleka ngefungus, amagciwane kanye namagciwane . Ngakho-ke, udokotela wakho uzokunikeza eminye imithi eminingana ukuze akuvikele kulezi zifo eziyingozi.

Ingabe i-GvHD ingavinjelwa?

Amalebhu okuthayipha izicubu ahlala ethuthuka futhi asebenzisa izivivinyo ezintsha nezinembile ezisekelwe ku-DNA. Lokhu kuvumela ithimba lakho lezokwelapha ukuthi likhethe umnikeli ofanelana ne-HLA kakhulu kuwe. Uma ifanelana ingcono, kulapho amathuba okuvimbela i-GvHD eba ngcono khona.

Futhi, udokotela wakho uzokunikeza imithi yokucindezela amasosha omzimba ukuvimbela i-GvHD ngemuva kokufakelwa iseli lakho le-stem.

Ingabe i-GvHD ingelapheka ngokuphelele?

Ezimweni eziningi, odokotela bangakwazi ukuphatha lesi simo ngempumelelo (GvHD). Okusho ukuthi, bangakwazi ukulawula izimpawu futhi bakusize uphile impilo evamile.

Okwamanje, abacwaningi bafunda izindlela ezintsha zokuvimbela i-GvHD ngokusebenzisa izivivinyo zemitholampilo. Isibonelo, baphenya ngemithi ehlukahlukene yokucindezela amasosha omzimba kanye nemithi emisha yokuvimbela.

Ingabe i-GvHD ingaba yingozi empilweni?

Yebo, i-GvHD ngezinye izikhathi ingaba yingozi empilweni. I-GvHD engapheli iyimbangela ehamba phambili yokufa phakathi kwabantu abathola ukufakelwa iseli le-allogeneic stem, ngaphandle kwesifo sabo esiyinhloko.

Ngakho-ke, ngaphambi kokuthola noma yikuphi ukwelashwa - ngisho nokufakelwa i-stem cell - kubaluleke kakhulu ukuxoxa ngezingozi nodokotela wakho. Angakuchazela izingozi futhi akusize uhlole izinzuzo nezingozi zokwelashwa.

Ingabe ngezinye izikhathi kukhona inzuzo ku-`(GvHD)`?

Ungamangali, yize i-GvHD ingaba nomthelela omubi ezingeni lempilo yakho, futhi inezinzuzo ezithile. Impendulo efanayo yokuzivikela komzimba ehlasela amangqamuzana akho ajwayelekile ifuna futhi ibhubhise noma yimaphi amangqamuzana omdlavuza angase ashiywe emzimbeni wakho. Lokhu kubizwa ngokuthi umphumela we-graft-versus-tumor. Abantu abathola i-GvHD kutholakale ukuthi abanawo amathuba amaningi okubuya kwesifo sabo esiyinhloko (ikakhulukazi umdlavuza).

Ngizinakekela kanjani? Landela lawa macebiso!

Udokotela wakho uzochaza ukuthi kufanele uzinakekele kanjani ngemva kokufakelwa i-stem cell yakho. Isibonelo, yiziphi izimpawu okufanele uziqaphele nokuthi yiziphi izimpawu okufanele uzibize ithimba lakho lezokwelapha ngokushesha uma uthuthuka. Uma usengozini yokuthola i-GvHD, bangakunikeza nemiyalelo eyengeziwe yokunakekelwa. Le miyalelo ihlanganisa:

• Vikela isikhumba sakho elangeni. Gqoka amahembe anemikhono emide namabhulukwe amade. Sebenzisa isithako sokuvikela ilanga okungenani esine-SPF 50. (Ukuchayeka elangeni kungaba kubi kakhulu noma kubangele i-GvHD.)
• Gcina impilo yomlomo iphilile. Lokhu kuzonciphisa ingozi yokuthola isifo sezinsini.
• Gwema ukudla okunongwe okungabangela ukucasuka esiswini sakho futhi kubangele izilonda emlonyeni.
• Thatha izinyathelo zokuzivikela emagciwaneni. (Udokotela wakho uzokutshela okwengeziwe ngalokhu.)

Kufanele ngimbone nini udokotela?

Kubalulekile ukwazisa udokotela wakho ngokushesha uma unezinguquko emzimbeni, ikakhulukazi izimpawu zokutheleleka kanye nomkhuhlane (100.4 Fahrenheit / 38 Celsius noma ngaphezulu). Uma uthatha imithi yokucindezela amasosha omzimba, usengozini enkulu yokuthola izifo ezingasongela ukuphila.

Ngemva kokufakelwa i-allogeneic stem cell, udokotela wakho uzokuqapha eduze ukuze athole izinkinga ezifana ne-Graft vs. Host Disease (GvHD). Uma uba nezimpawu ze-GvHD ebukhali noma engamahlalakhona, udokotela wakho angashintsha imithi yakho noma akunike imithi emisha. Thatha yonke imithi njengoba uyalelwe. Landela imiyalelo kadokotela wakho mayelana nendlela yokunakekela, ikakhulukazi mayelana nendlela yokuzivikela ezifweni.

Izinto ezibaluleke kakhulu okufanele uzikhumbule ngamafuphi!

Kulungile, ngakho-ke i-Graft vs. Host Disease, noma i-GvHD, iyinkinga engenzeka ngemva kokufakelwa i-stem cell komunye umuntu. Kalula nje, yilapho amaseli anikelayo ehlasela amaseli akho.

Khumbula, kunezindlela zokwelapha i-GvHD, futhi lesi simo singalawulwa. Into ebaluleke kakhulu ukulandela imiyalelo yethimba lakho lezokwelapha ngokucophelela nokubazisa nganoma yiziphi izimpawu ezintsha ngokushesha okukhulu.

Uma uneminye imibuzo mayelana nalokhu, ungesabi ukubuza udokotela wakho. Yibo abangakusiza kangcono.

I- GvHD, ukufakelwa kweseli le-stem, ukufakelwa kwe-allogeneic, isimiso somzimba sokuzivikela, i-HLA, amaseli anikelayo, izimpawu