Matenda olimbana nawo

Matenda a Graft-versus-host (GVHD) ndi vuto lowopsa lomwe limatha kuchitika pambuyo poti tsinde kapena mafupa asintha.

GVHD itha kuchitika pambuyo poti mafupa, kapena tsinde la cell, kumuika momwe wina amalandila mafupa am'mafupa kapena maselo kuchokera kwa woperekayo. Kuika kotereku kumatchedwa allogeneic. Maselo atsopano, osanjidwa amaona thupi la wolandirayo kukhala lachilendo. Izi zikachitika, maselowa amalimbana ndi thupi la wolandirayo.

GVHD sichimachitika anthu akamalandira maselo awo. Kuika kotereku kumatchedwa autologous.

Pamaso pomuika, minofu ndi maselo ochokera kwa omwe angakupatseni ndalama amawunika kuti awone momwe akufananira ndi wolandirayo. GVHD sichitha kuchitika, kapena zizindikilo zimakhala zochepa, masewera atayandikira. Mpata wa GVHD ndi:

• Pafupifupi 35% mpaka 45% pomwe woperekayo ndi wolandila ali ofanana
• Pafupifupi 60% mpaka 80% pomwe wopereka ndi wolandila sali pachibale

Pali mitundu iwiri ya GVHD: yovuta komanso yovuta. Zizindikiro mu GVHD yovuta komanso yanthawi yayitali kuyambira poyambira mpaka povuta.

Pachimake GVHD nthawi zambiri imachitika m'masiku ochepa kapena kumapeto kwa miyezi sikisi mutangoika. Chitetezo chamthupi, khungu, chiwindi, ndi matumbo zimakhudzidwa makamaka. Zizindikiro zoyipa zimaphatikizapo:

• Kupweteka m'mimba kapena kukokana, nseru, kusanza, ndi kutsegula m'mimba
• Jaundice (khungu lachikopa kapena maso) kapena mavuto ena a chiwindi
• Kutupa pakhungu, kuyabwa, kufiira m'malo akhungu
• Kuchulukitsa chiwopsezo cha matenda

Matenda a GVHD nthawi zambiri amayamba miyezi yopitilira 3 mutakhazikika, ndipo amatha kukhala moyo wonse. Zizindikiro zanthawi yayitali zimaphatikizapo:

• Maso owuma, zotengeka, kapena masomphenya amasintha
• Pakamwa pouma, zigamba zoyera mkamwa, komanso kuzindikira zakudya zokometsera
• Kutopa, kufooka kwa minofu, ndi ululu wopweteka
• Ululu wophatikizana kapena kuuma
• Kutupa pakhungu ndi malo omwe akwezedwa, otumbululuka, komanso kulimbitsa khungu kapena kukulimba
• Kupuma pang'ono chifukwa cha kuwonongeka kwamapapu
• Kuuma kwa nyini
• Kuchepetsa thupi
• Kuchepetsa kutuluka kwa ndulu kuchokera pachiwindi
• Tsitsi lofooka komanso kumera msanga msanga
• Kuwonongeka kwa thukuta
• Cytopenia (kuchepa kwa maselo okhwima m'magazi)
• Pericarditis (kutupa mu nembanemba yozungulira mtima; imayambitsa kupweteka pachifuwa)

Mayeso angapo a labu ndi kujambula atha kuchitidwa kuti muwone ndikuwunika zovuta zomwe zimayambitsidwa ndi GVHD. Izi zingaphatikizepo:

• X-ray pamimba
• CT scan pamimba ndi CT chifuwa
• Kuyesa kwa chiwindi
• Kujambula PET
• MRI
• Kapisozi endoscopy
• Chiwindi

Chikopa cha khungu, mamina am'mimbamo mkamwa, chingathandizenso kutsimikizira matendawa.

Pambuyo pakuika, wolandirayo nthawi zambiri amatenga mankhwala, monga prednisone (steroid), yomwe imalepheretsa chitetezo cha mthupi. Izi zimathandiza kuchepetsa mwayi (kapena kuuma) kwa GVHD.

Mupitiliza kumwa mankhwalawa mpaka wothandizira zaumoyo wanu akuganiza kuti chiwopsezo cha GVHD ndi chochepa. Ambiri mwa mankhwalawa amakhala ndi zovuta zina, kuphatikizapo kuwonongeka kwa impso ndi chiwindi. Mudzakhala ndi mayesero pafupipafupi kuti muwone zovuta izi.

Maonekedwe amatengera kuuma kwa GVHD. Anthu omwe amalandila minyewa yamafupa yofanana kwambiri ndimaselo nthawi zambiri amachita bwino.

Mavuto ena a GVHD amatha kuwononga chiwindi, mapapo, gawo logaya chakudya, kapena ziwalo zina za thupi. Palinso chiopsezo cha matenda opatsirana kwambiri.

Matenda ambiri a GVHD ovuta kapena osachiritsika amatha kuchiritsidwa bwino. Koma izi sizikutsimikizira kuti kudzichotsa komweko kudzakwanitsa kuchiza matenda oyambawo.

Ngati mwakhala ndikudyetsa mafuta m'mafupa, itanani ndi omwe amakupatsani nthawi yomweyo mukakhala ndi zizindikilo za GVHD kapena zizindikilo zina zachilendo.

GVHD; Kuika mafuta m'mafupa - matenda olumikizidwa ndi otsutsana; Kuika tsinde la khungu - matenda olumikiza motsutsana ndi omwe amakhala nawo; Kukhazikitsa kwa allogeneic - GVHD

• Kuika mafuta m'mafupa - kutulutsa

• Ma antibodies

Bishopu MR, Keating A. Kuika ma cell a hematopoietic. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 168.

Ndine A, Pavletic SZ. Kuika hematopoietic stem cell. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: mutu 28.

Reddy P, Ferrara JLM. Matenda olumikizidwa motsutsana ndi omwe ali nawo komanso mayankho olimbana ndi leukemia. Mu: Hoffman R, Benz EJ, Silberstein LE, et al, olemba. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 108.