Ake sithi unikezwe ukufakelwa kwe-stem cell kumuntu ophilile njengokwelashwa kwesifo esifana ne-leukemia. Lokhu kulindeleke ukuthi kwelaphe isimo sakho. Kodwa akuvamile kakhulu, la maseli amasha azele ukuzokusiza, umzimba wakho uwaphambanisa ngokuthi “isitha” bese eqala ukuhlasela amangqamuzana akho. Leso yisimo esiyinkimbinkimbi esisibiza ngokuthi “i-Graft versus Host Disease” noma i-GvHD ngamafuphi.
Kuyini i-GvHD ngamagama alula?
Ukuze siqonde lokhu, sidinga ukwazi amagama amabili. Igama elithi "graft" libhekisela entweni etshalwa kabusha, okungukuthi, amaseli okuqala aphilile anikezwa kuwe evela ngaphandle. Igama elithi "Host" libhekisela kumnikazi, okungukuthi, umzimba wakho owamukela lawo maseli. Ngakho-ke elithi "Graft versus Host" lisho "graft versus host."
Ngokuvamile, lolu hlobo lokufakelwa kwamaseli e-stem, olubizwa ngokuthi i-allogeneic transplant, lwenzelwa ukwelapha umdlavuza ofana ne-leukemia kanye ne-lymphoma, noma izimo zokwehluleka komnkantsha wamathambo njenge-aplastic anemia . Lawa maseli afakwe kabusha yiwo aqala umzimba wakho ukwenza amaseli egazi amasha.
Kodwa, ngezinye izikhathi la maseli amasha awawaboni amaseli akho. Acabanga ukuthi angabahlaseli bakwamanye amazwe. Ngakho-ke, aqala ukuhlasela izitho zakho ezinempilo, njengesikhumba sakho, isibindi, namathumbu. Yilokho i-GvHD eyikho.
Kunezinhlobo ezimbili eziyinhloko ze-GvHD:
I-GvHD ingahlukaniswa ngezinhlobo ezimbili eziyinhloko. Esikhathini esidlule, lokhu kwahlukaniswa ngokwesikhathi sokuqala kwezimpawu. Kodwa manje, odokotela banquma uhlobo oluqondile ngokubheka izimpawu, imiphumela yokuhlolwa, kanye nesikhathi sokuqala kwezimpawu.
- I-Acute GvHD (aGvHD): Lokhu kuvame ukwenzeka ezinsukwini zokuqala eziyi-100 ngemva kokufakelwa. Kodwa ngezinye izikhathi kungase kwenzeke kamuva. Lolu hlobo luthinta kakhulu isikhumba sakho, uhlelo lokugaya ukudla (amathumbu), kanye nesibindi.
- I-GvHD Engapheli (cGvHD): Lolu hlobo lungavela nganoma yisiphi isikhathi ngemva kokufakelwa, kodwa luvame kakhulu eminyakeni emibili yokuqala . Lungathinta noma iyiphi ingxenye yomzimba, okuhlanganisa isikhumba, umlomo, isibindi, amaphaphu, amathumbu, imisipha, amalunga, kanye nezitho zangasese.
Umuntu oke wafakelwa isitho angathuthuka ngenye yalezi zinhlobo ezimbili, zombili, noma angaba nempilo enhle ngaphandle kwanoma iyiphi yazo.
Ziyini izimpawu ze-GvHD?
Izimpawu ze-GvHD zingasukela kwezincane kakhulu, kuya kweziphakathi, kuya kwezinzima, ngisho nezisongela impilo. Ake sibheke izimpawu ezihlobene nalezi zinhlobo ezimbili.
| Uhlobo lwe-GvHD | Izimpawu ezivamile |
|---|---|
| I-Acute GvHD (aGvHD) (Kuthinta kakhulu isikhumba, amathumbu, isibindi) |
|
| I-GvHD Engapheli (cGvHD) (Kungathinta noma iyiphi ingxenye yomzimba) |
Kungani le GvHD yenzeka?
Lokhu kungokwesayensi kancane, kodwa ngizokuchaza kalula.
Ngokuvamile, amangqamuzana omzimba wethu asivikela ezifweni ngokulwa nabahlaseli bakwamanye amazwe njengama-virus namabhaktheriya. Kodwa lawo maseli awalokothi ahlasele amangqamuzana ethu. Isizathu salokhu ukuthi kukhona iphrotheni ekhethekile ebusweni bawo wonke amangqamuzana ethu. Lokhu kubizwa ngokuthi i-Human Leukocyte Antigens (HLA) .
Cabanga ngale HLA njengento efana nekhadi le-ID. Amaseli ethu omzimba abheka leli khadi le-ID bese ethi, "O... lona ungomunye wethu."
Ngaphandle kwamawele afanayo, i-HLA yawo wonke umuntu ihlukile.
Uma uthola ukufakelwa i-stem cell, amangqamuzana egazi amasha enziwe ngalawo maseli ane-HLA yomuntu owanikela ngamaseli kuwe. Uma leyo HLA ihluke kakhulu kune-HLA yakho, lawo maseli amasha abheka amangqamuzana emzimbeni wakho bese ecabanga ukuthi, "Lona ungumhlaseli, umazisi wakhe awufani nowethu." Yilapho lawo maseli eqala khona ukuhlasela umzimba wakho.
Ngenxa yalesi sizathu, odokotela bahlola ngokucophelela i-HLA yomnikeli kanye neyomuntu otholayo ukuqinisekisa ukuthi basondelene ngangokunokwenzeka ngaphambi kokwenza ukufakelwa. Kodwa ngaphandle kokuthi amaseli athathwe kumawele, kuhlale kunengozi ethile ye-GvHD.
Ubani osengozini enkulu yokuthola i-GvHD?
Isici esibaluleke kakhulu sengozi ukungahambelani kwe-HLA, kodwa ezinye izici eziningana nazo zingadlala indima.
| Isici sengozi | Incazelo |
|---|---|
| Ukungafani kwe-HLA | - Ukufakelwa kwamaseli angafanelani kahle ne-HLA, noma ngabe athathwe esihlotsheni. - Noma ngabe kuvela kumuntu ongahlobene naye, futhi i-HLA ifana kahle, kusenengozi ethile. |
| Ezinye izinto |
|
Futhi, uma usuvele unayo i-Acute GvHD (aGvHD), usengozini enkulu yokuthola i-Chronic GvHD (cGvHD).
Lesi simo sitholakala futhi selashwa kanjani?
Ukuxilongwa
Udokotela wakho uzoxilonga i-GvHD ngokwenza ukuhlolwa ngokomzimba, ukubheka izimpawu zakho, nokwenza ukuhlolwa kwegazi kanye ne-biopsy. I-biopsy ihilela ukuthatha ucezu oluncane lwesikhumba noma izicubu ezithintekile bese uluhlola ngaphansi kwe-microscope. Ngenxa yokuthi ezinye zezimpawu ze-GvHD engapheli zifana nezinye izimo, udokotela wakho uzokhipha ezinye izimo ngaphambi kokuxilongwa kwe-GvHD.
Ukwelashwa
Ukuze uvimbele i-GvHD ngemva kokufakelwa, uzonikezwa imithi yokucindezela amasosha omzimba ecindezela amasosha omzimba wakho. Le mithi isebenza ngokunciphisa ikhono lamaseli angaphandle lokuhlasela umzimba wakho.
Uma i-GvHD ivele naphezu kokuthatha lo muthi, udokotela wakho uzonquma ukwelashwa ngokusekelwe ebunzimeni besimo sakho kanye nohlobo lwe-GvHD.
- Nge-GvHD ebukhali (aGvHD): Ngokuvamile, ama-corticosteroids anikezwa njengamaphilisi, imijovo, noma njengokhilimu osetshenziswa esikhumbeni. Uma lokhu kungalawuli lesi sifo, eminye imithi efana ne-Ruxolitinib (Jakafi®) noma izivivinyo zemitholampilo ingacatshangelwa.
- Nge-GvHD Engapheli (cGvHD): Imithi yokucindezela amasosha omzimba yesikhathi eside nayo inikezwa ngalokhu. Uma lesi simo singalawulwa yilezi, kungadingeka imithi efana neRuxolitinib (Jakafi®), Belumosudil (Rezurock™), Ibrutinib (Imbruvica®) noma ukwelashwa okukhethekile okufana ne -photopheresis .
Imiphumela emibi yokwelashwa
Lezi zindlela zokwelapha zicindezela amasosha omzimba wakho, okunciphisa ikhono lomzimba wakho lokulwa nezifo. Lokhu kwandisa ingozi yakho yokuthola izifo ezibangelwa yisikhunta, amagciwane kanye namagciwane. Udokotela wakho uzokunikeza nemithi yokusiza ukuvimbela lezi zifo ezingaba yingozi empilweni.
Eminye imiphumela engase ivele ngenxa ye-GvHD
Ingabe i-GvHD isongela impilo?
Yebo, i-GvHD ingaba yingozi empilweni. I-GvHD engapheli, ikakhulukazi, iyimbangela ehamba phambili yokufa ngemva kokufakelwa iseli le-stem, ngaphandle kwesifo esiyinhloko. Yingakho kubalulekile ukuxoxa ngezingozi nodokotela wakho ngaphambi kokuthola noma yikuphi ukwelashwa.
Ingabe ikhona inzuzo evela ku-GvHD?
Ngokumangalisayo, yebo. I-GvHD inezinzuzo ezithile. Lawa maseli amasha omzimba ahlasela amaseli akho aphilile nawo afuna futhi abhubhise noma yimaphi amaseli omdlavuza angase ashiywe emzimbeni wakho. Lokhu kubizwa ngokuthi "umphumela we-graft-versus-tumor." Ngakho-ke, izifundo zikhombisile ukuthi iziguli ezithola i-GvHD azinamathuba amaningi okubuya komdlavuza wazo.
Izinto ongazenzela ukuphepha kwakho
Udokotela wakho uzochaza ukuthi kufanele uzinakekele kanjani ngemva kokufakelwa isitho. Qaphela kakhulu ngalezi zinto uma usengozini yokuthola i-GvHD.
- Zivikele elangeni: Ukuchayeka elangeni kungenza i-GvHD ibe yimbi kakhulu. Ngakho-ke gqoka amahembe anemikhono emide kanye namabhulukwe amade uma uphuma ngaphandle. Sebenzisa isivikelo selanga okungenani esine-SPF 50.
- Ukuhlanzeka komlomo: Hlanza amazinyo akho kahle ukuze unciphise ingozi yesifo sezinsini.
- Ukudla Nokuphuza: Gwema ukudla okubabayo, okunamafutha, kanye nokudla okungabangela izilonda emlonyeni.
- Zivikele emagciwaneni: Njengoba amasosha omzimba wakho ebuthaka, gwema izindawo lapho izifo zisakazeka khona nezindawo ezinabantu abaningi. Hlala ugcina izandla zakho zihlanzekile.
Kufanele ngimbone nini udokotela?
Kubalulekile ukwazisa udokotela wakho ngokushesha uma ubona noma yiziphi izinguquko emzimbeni wakho, ikakhulukazi izimpawu zokutheleleka noma umkhuhlane ongama-degree Celsius angu-38 (100.4 Fahrenheit) noma ngaphezulu. Ukutheleleka kungaba kubi kakhulu ngokushesha uma uthatha imithi ecindezela amasosha omzimba.
Udokotela wakho uzokuqapha njalo ngemva kokufakelwa kwakho ukuze aqaphele izinkinga ezifana ne-GvHD. Uma kuvela izimpawu, zizoshintsha imithi yakho noma zikunike emisha. Kubaluleke kakhulu ukuthatha yonke imithi oyinikezwe njengoba kuyalelwe futhi ulandele imiyalelo kadokotela wakho.
Umlayezo Wokuya Nawe Ekhaya
- Isifo se-Graft vs. Host (GvHD) siyinkinga eyenzeka ngemva kokufakelwa iseli le-stem, lapho umzimba womamukeli uhlasela amangqamuzana anikelwe.
- Kunezinhlobo ezimbili eziyinhloko zalokhu, okubukhali kanye nokungalapheki. Izimpawu ziyahlukahluka ngokufanele.
- Indlela engcono kakhulu yokuvimbela i-GvHD ukuqinisekisa ukuthi umnikeli kanye nomamukeli bafanelana kahle kakhulu ne-HLA.
- Ngenxa yokuthi imithi ecindezela amasosha omzimba isetshenziselwa ukwelapha, ingozi yokutheleleka iphezulu kakhulu.
- Yazisa udokotela wakho ngokushesha nganoma yiziphi izimpawu ezintsha, ikakhulukazi umkhuhlane.
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