Yini eyenza i-Graft vs Isifo Segciwane futhi ingabe ivinjelwe?
Iyini isifo se-graft versus host (GVHD), kungani kwenzeka, ukuthi siyaphathwa kanjani, futhi ingavinjelwa?
Ukuhlukunyezwa kweSifo seHlabathi (GVHD) - Incazelo
Isifo se-Graft versus host (GVHD) siwumphumela ovamile ohlangene we- allogeneic bone lomnkantsha noma ukuguqulwa kwesitembu se-stem . Yize amathuba okuthuthukisa i-GVHD ahlukahluka, abamukeli abangu-40% kuya kwabangu-80% bathatha i-GVHD ngenye indlela noma enye.
I-GVHD ivame ukuba mnene, kodwa ngezinye izikhathi ingaba nzima ngokwanele ukuba isongela ukuphila. Lesi sihloko sizokuthatha ngokusekelwe kuloluhlelo olubalulekile nolungabangela ukucindezeleka.
Izimbangela - Kungani i-Graft Versus Host Harm (GVHD) ivela?
Umnkantso noma amangqamuzana angama-stem asetshenziselwa esigulini aqukethe amaseli egazi omnikeli. Uhlobo olulodwa lwegazi elisekhona kumaseli egazi anikezwe yi-T cell (noma i-T lymphocyte.) Amaseli T awamaseli anonya emasosha omzimba afuna abahlaseli njengama-bacteria namagciwane namanye amaseli angaphandle nokuhlasela. Inkinga ngokufakelwa kabusha ukuthi lawo ma-cell donor T manje aqaphela amangqamuzana kumamukeli njengangaphandle. Ngakho-ke umnikeli (ama-graft cells) ahlasela umamukeli (umphathi wokufakelwa.)
Ngaphambi kokufakelwa, abanikeli kanye nokufakelwa kabusha abamukeli ba-HLA bafanelwe ukunciphisa amathuba okuhlaselwa, nakuba ngaphandle kokuba umdlalo ufanane (isibonelo, kusuka emaceleni afanayo) kukhona njalo ithuba lokuthuthukisa i-GVHD.
Ziyini izimpawu zeGraft Versus Host (GVHD)?
Izimpawu ezivame kakhulu ze-GVHDdepend kungakhathaliseki ukuthi kuyisenzo esiphuthumayo (sokuqala) noma esingapheliyo (siphelile) ukusabela.
- I-GVHD eqondile - I-GVHD elula kwenzeka ezinsukwini eziyi-100 zokufakelwa futhi ngokuvamile iyakuthinta isikhumba (ukuchohlazeka,) amathumbu, nesibindi. Abantu bangase bahlangane nemisipha ephezulu kakhulu ezandleni zabo nasemagcekeni, futhi izingxenye zesikhumba zingase zivele zivele. Ukubandakanywa kwamathumbu kungabangela izinambuzane, izimpungushe zesisu, nokuhuda, kanti ukubandakanya kwesibindi kuvame ukuphumela ku-jaundice - ukuchithwa okwesibhakabhaka kwesikhumba.
- I-GVHD engapheli - i-GVHD engapheli ivela ngemuva kwezinsuku eziyi-100 futhi ingahle ihlobene noma ingahambelani ne-GVHD enzima. Kwenzeka kaningi kakhulu kubantu abanobuchule obunzima. I-GVHD engapheli ivame ukuthinta izifunda eziningi zomzimba. Ngaphezu kokubandakanyeka kwesikhumba, amathumbu nesibindi njengokungathi usebenza kahle, i-GVHD engapheli ivame ukuhlanganisa ukuma kwamehlo noma izinguquko zombono, ubuhlungu nokuqina emalungeni, ukuqina kwesikhumba nokuqina kanye nokudumala, nokukhathala, ubuhlungu obunzima nobuhlungu obungapheli . Izimpawu ezingapheli zingaba nomthelela omubi wesikhathi eside kokubili impilo enhle kanye nekhwalithi yokuphila.
Ingabe i-Graft Versus Host (GVHD) ingabekelwa?
I-GVHD yisimo esingasikhathaza kakhulu, futhi impumelelo noma ukwehluleka kokufakelwa kuxhomeke kakhulu ekuvimbeleni noma ekunciphiseni imiphumela emibi yalesi simo. Kunezindlela eziningana ukuthi ithuba le-GVHD lingancishiswa. Lokhu kufaka phakathi i- HLA ehambisanayo , isebenzisa izidakamizwa ukunciphisa i-GVHD, nokususa amaseli T kusuka egazini lomnikezeli. Ngesizathu esithile, ukususa ama-T cells kungaba nomthelela omubi empumelelweni yokufakelwa kwezinye izindlela.
Ukuphatha ngokucophelela izimpawu zokuqala ze-GVHD kungasiza futhi, ikakhulukazi ngokucophelela ngokushisa kwelanga, njengoba lokhu kubonakala sengathi kuyisisusa sokudlula i-GVHD.
I-Graft Versus Host Disease (GVHD) iphathwa kanjani?
I-GVHD akulula ukuyiphatha. Kuhilela ukuhlolwa nokuguqulwa kwezidakamizwa ezivame ukuhlinzekwa ukuvimbela i-GVHD. Kuhlanganisa nokufaka izidakamizwa ezintsha, ikakhulukazi i-steroids, ukuvimbela umonakalo ezithombeni zomamukeli wokufakelwa. Ngezinye izikhathi, lapho i-steroids inganele ukulawula kahle isimo, ezinye izidakamizwa zingadinga ukungezwa.
Imithombo:
Bayraktar, U., noJ. Nates. Imiphumela yokunakekelwa okunamandla kumagciwane omdala we-hematopoietic stem cell transplantation. I-World Journal ye-Clinical Oncology . 2016. 7 (1): 98-105.
Chao, N. Ukubonakaliswa kwemitholampilo, ukuxilongwa, kanye nokufakwa kwesifo se-acute-versus-graft. Kubuyekezwe 05/04/15. http://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-grading-of-acute-graft-versus-host-disease