Isifo sokulwa kunye nokuchaphazeleka

Isifo esixhonyiweyo xa kuthelekiswa nomsingathi (i-GVHD) sisongelo esisongela ubomi esinokuthi senzeke emva kokudityaniswa kweseli okanye umongo wethambo.

I-GVHD inokwenzeka emva komongo wethambo, okanye iseli yesitshixo, ukufakelwa apho umntu efumana izicubu zomongo wethambo okanye iiseli kumxhasi. Olu hlobo lofakelo lubizwa ngokuba yiallogeneic. Iiseli ezintsha, ezifakelweyo zijonga umzimba wommkeli njengowangaphandle. Xa oku kusenzeka, iiseli zihlasela umzimba wommkeli.

I-GVHD ayenzeki xa abantu befumana iiseli zabo. Olu hlobo lofakelo lubizwa ngokuba yi-autologous.

Phambi kofakelo, izicwili kunye neeseli ezivela kubaboneleli abanokubakho ziyajongwa ukubona ukuba zihambelana kangakanani nomamkeli. I-GVHD ayinakufane yenzeke, okanye iimpawu ziya kuba nzima, xa umdlalo usondele. Ithuba le-GVHD yile:

• Malunga ne-35% ukuya kwi-45% xa umnikeli kunye nomamkeli bedibene
• Malunga ne-60% ukuya kwi-80% xa umnikeli kunye nomamkeli bengazalani

Zimbini iintlobo ze-GVHD: ezibukhali nezingapheliyo. Iimpawu kuzo zombini ii-GVHD ezibi kunye nezingapheliyo ukusuka kubunzulu ukuya kubunzima.

I-Acv GVHD ihlala isenzeka kwiintsuku okanye emva kweenyanga ezi-6 emva kokufakelwa. Amajoni omzimba, ulusu, isibindi kunye namathumbu achaphazeleka ikakhulu. Iimpawu eziqhelekileyo eziqhelekileyo zibandakanya:

• Intlungu zesisu okanye iicramps, isicaphucaphu, ukugabha kunye norhudo
• IJaundice (umbala omthubi kwesikhumba okanye amehlo) okanye ezinye iingxaki zesibindi
• Irhashalala, ukurhawuzelela, ukuba bomvu kwiindawo ulusu
• Ukwanda komngcipheko wosulelo

I-GVHD engapheliyo ihlala iqala ngaphezulu kweenyanga ezi-3 emva kokufakelwa, kwaye inokuhlala ubomi bonke. Iimpawu ezingapheliyo zinokubandakanya:

• Amehlo omileyo, ukutshisa, okanye utshintsho lombono
• Umlomo owomileyo, amabala amhlophe ngaphakathi emlonyeni, kunye novakalelo kukutya okunezipayisi
• Ukukhathala, ubuthathaka bemisipha, kunye nentlungu engapheliyo
• Intlungu edibeneyo okanye ukuqina
• Ukudumba kolusu kunye neendawo eziphakanyisiweyo, ezinombala, kunye nokuqina kolusu okanye ukuqina
• Ukuphefumla kancinci ngenxa yomonakalo wemiphunga
• Ukoma kwelungu lobufazi
• Ukuhla ukusinda
• Ukunciphisa ukuphuma kwenyongo esibindini
• Izinwele ezaphukileyo kunye nokungwevu kwangaphambi kwexesha
• Umonakalo wokubila amadlala
• ICytopenia (ukwehla kwenani leeseli zegazi esele zikhulile)
• I-Pericarditis (ukuvuvukala kwi-membrane ejikeleze intliziyo; kubangela intlungu yesifuba)

Iilabhoratri ezininzi kunye novavanyo lokucinga lunokwenziwa ukufumanisa kunye nokujonga iingxaki ezibangelwa yi-GVHD. Oku kunokubandakanya:

• Isisu seX-ray
• I-CT scan isisu kunye ne-CT esifubeni
• Uvavanyo lomsebenzi wesibindi
• Ukuskena iPET
• IMRI
• I-Capsule endoscopy
• Isibindi se-biopsy

I-biopsy yolusu, inwebu yangaphakathi emlonyeni, inokunceda ekuqinisekiseni isifo.

Emva kokufakelwa, ummkeli uhlala ethatha amayeza, njenge-prednisone (i-steroid), ethintela amajoni omzimba. Oku kunceda ukunciphisa amathuba (okanye ubukhali) be-GVHD.

Uya kuqhubeka nokuthatha amayeza de umboneleli wakho wezempilo acinge ukuba umngcipheko we-GVHD usezantsi. Uninzi lala mayeza aneziphumo ebezingalindelekanga, kubandakanya ukonzakala kwezintso kunye nesibindi. Uya kuba neemvavanyo rhoqo ukubukela ezi ngxaki.

Imbonakalo ixhomekeke kubukhali be-GVHD. Abantu abafumana izicwili zomongo wethambo kunye neeseli bahlala besenza ngcono.

Ezinye iimeko ze-GVHD zinokonakalisa isibindi, imiphunga, indlela yokugaya, okanye amanye amalungu omzimba. Kukwakho nomngcipheko wosulelo olukhulu.

Iimeko ezininzi ze-GVHD ebukhali okanye enganyangekiyo zinokunyangwa ngempumelelo. Kodwa oku akuqinisekisi ukuba ukufakelwa ngokwakho kuya kuphumelela kunyango lwesifo sokuqala.

Ukuba ufumene ugcino lomongo wethambo, tsalela umnikezeli wakho ngoko nangoko ukuba uphuhlisa naziphi na iimpawu ze-GVHD okanye ezinye iimpawu ezingaqhelekanga.

I-GVHD; Ukufakelwa komongo wethambo - isifo se-graft-versus-host host; Ukufakelwa kwe-cell stem - isifo se-graft-versus-host host; Ukufakelwa kweAllogeneic - GVHD

• Ukutsalwa komongo wethambo - ukukhupha

• Iintsholongwane

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Ndingu-A, uPavletic SZ. Ukufakelwa kweseli ye-hematopoietic stem. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahluko 28.

UReddy P, uFerrara JLM. Isifo sokulwa kunye nokuchaphazeleka kunye neempendulo ze-graft-versus-leukemia. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ii-eds. I-Hematology: Imigaqo esisiseko kunye nokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 108.