Graft-khahlanong le-host disease

Boloetse ba Graft-versus-host (GVHD) ke bothata bo sokelang bophelo bo ka hlahang kamora ho fetoha hoa sele kapa bakoang moko oa masapo.

GVHD e kanna ea hlaha kamora 'moko oa masapo, kapa stem cell, ho kenella moo motho e mong a fumanang lisele tsa masapo kapa lisele ho mofani. Mofuta ona oa ho kenyelletsa o bitsoa allogeneic. Lisele tse ncha, tse jetsoeng hape li nka 'mele oa moamoheli e le kantle ho naha. Ha sena se etsahala, lisele li hlasela 'mele oa motho ea li amohelang.

GVHD ha e etsahale ha batho ba amohela lisele tsa bona. Mofuta ona oa ho kenyelletsa o bitsoa autologous.

Pele ho kenyelletsoa, ​​lisele le lisele tse tsoang ho bao e ka bang bafani li ea hlahlojoa ho bona hore na li tsamaellana joang le moamoheli. GVHD ha e na monyetla oa ho etsahala, kapa matšoao a tla ba bobebe, ha papali e se e le haufi. Monyetla oa GVHD ke:

• Hoo e ka bang 35% ho isa ho 45% ha mofani le moamoheli ba amana
• Hoo e ka bang 60% ho isa ho 80% ha mofani le moamoheli ba sa amane

Hona le mefuta e 'meli ea GVHD: e hlobaetsang le e sa foleng. Matšoao a GVHD a hlobaetsang le a sa foleng a fapana ho tloha bonyenyaneng ho ea bohlokong.

Hangata GVHD e etsahala matsatsing a seng makae kapa kamora likhoeli tse 6 kamora ho kenella. Tsamaiso ea 'mele ea ho itšireletsa mafung, letlalo, sebete le mala lia ameha haholo. Matšoao a tloaelehileng a matla a kenyelletsa:

• Mahlaba a ka mpeng kapa cramps, ho nyekeloa ke pelo, ho hlatsa le letshollo
• Jaundice ('mala o mosehla oa letlalo kapa mahlo) kapa mathata a mang a sebete
• Ho phatloha ha letlalo, ho hlohlona, ​​bofubelu libakeng tsa letlalo
• Kotsi e eketsehileng ea tšoaetso

GVHD e sa foleng hangata e qala ho feta likhoeli tse 3 kamora ho kenella, 'me e ka nka bophelo bohle. Matšoao a sa foleng a ka kenyelletsa:

• Mahlo a omileng, maikutlo a tukang, kapa pono ea fetoha
• Molomo o omileng, matheba a masoeu kahare ho molomo, le kutlo ho lijo tse nokiloeng ka linoko
• Mokhathala, bofokoli ba mesifa le bohloko bo sa foleng
• Ho opeloa kapa ho satalla
• Ho phatloha ha letlalo ka libaka tse phahamisitsoeng, tse 'mala, hammoho le ho tiisa letlalo kapa ho tenya
• Phefumoloho e khutšoanyane ka lebaka la tšenyo ea matšoafo
• Ho omella ha botshehadi
• Ho fokotsa boima ba 'mele
• Phokotso ea phallo ea bile e tsoang sebeteng
• Moriri o mosesane le ho putsoa pele ho nako
• Tšenyo ea litšoelesa tsa mofufutso
• Cytopenia (fokotseha ka palo ea lisele tse holileng tsebong tsa mali)
• Pericarditis (ho ruruha ka lera le potileng pelo; ho baka bohloko ba sefubeng)

Ho ka etsoa liteko tse 'maloa tsa lab le litšoantšo ho fumana le ho lekola mathata a bakoang ke GVHD. Tsena li ka kenyelletsa:

• Mpeng ea X-ray
• CT scan mpa le sefuba sa CT
• Liteko tsa ts'ebetso ea sebete
• Scan ea PET
• MRI
• Capsule endoscopy
• Biopsy ea sebete

Biopsy ea letlalo, mamina a molomo, e kanna ea thusa ho netefatsa tlhahlobo.

Kamora 'ho kenya' mele, moamoheli hangata o noa meriana, joalo ka prednisone (steroid), e hatellang sesole sa 'mele. Sena se thusa ho fokotsa menyetla (kapa ho tiea) ha GVHD.

U tla tsoelapele ho noa meriana ho fihlela mofani oa tlhokomelo ea bophelo a nahana hore kotsi ea GVHD e tlase. Bongata ba meriana ena e na le litla-morao, ho kenyelletsa le ts'enyo ea liphio le sebete. U tla ba le liteko tse tloaelehileng ho shebella mathata ana.

Ponahalo e latela boima ba GVHD. Batho ba fumanang lisele tsa 'moko oa masapo tse tšoanang hantle le lisele hangata ba sebetsa hantle.

Maemo a mang a GVHD a ka senya sebete, matšoafo, tšilo ea lijo kapa litho tse ling tsa 'mele. Hape ho na le kotsi ea tšoaetso e matla.

Maemo a mangata a GVHD a hlobaetsang kapa a sa foleng a ka phekoloa ka katleho. Empa sena ha se fane ka tiiso ea hore ho ikatisa ka boeona ho tla atleha ho phekola lefu la mantlha.

Haeba u kile ua fetisetsoa mokoallo oa masapo, letsetsa mofani oa litšebeletso hang-hang haeba u ka ba le matšoao a GVHD kapa matšoao a mang a sa tloaelehang.

GVHD; Ho kenyelletsa 'moko oa masapo - lefu la ho hlomathisa khahlanong le lefu lena; Ho fetisetsa lisele tsa stem - lefu la ho hlomathisa khahlanong le motsamaisi; Phetoho ea allogeneic - GVHD

• Ho kenyelletsa 'mele oa masapo - ho tsoa

• Masole a mmele

Mobishopo MR, Keating A. Hematopoietic stem cell transplant. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 168.

Ke A, ​​Pavletic SZ. Phetisetso ea hematopoietic stem cell. Ka: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, bahlophisi. Abeloff's Clinical Oncology. La 6th. Philadelphia, PA: Elsevier; 2020: khaolo ea 28.

Reddy P, Ferrara JLM. Graft-vs-host host le likarabo-khahlanong le-leukemia likarabo. Ka: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Melao-motheo le Tloaelo ea Motheo. La 7th. Philadelphia, PA: Elsevier; 2018: khaolo ea 108.