Graft versus host disease (GvHD), sakamako ne na gefe wanda zai iya faruwa bayan an allogeneic dashi.
Menene grafts da cutar mai masauki (GvHD)?
Graft versus host disease (GvHD) cuta ce ta gama gari ta dashen kwayar halitta ta allogeneic. Yana faruwa ne lokacin da ƙwayoyin T-sel na sabon tsarin rigakafi, sun gane ƙwayoyin mai karɓa a matsayin na waje, kuma suka kai musu hari. Wannan yana haifar da yaƙi tsakanin 'dama' da 'mai masaukin'.
Ana kiransa graft versus host, saboda 'graft' shine tsarin rigakafi da aka ba da gudummawa, kuma 'mai masaukin' shine majinyacin da ke karbar kyautar kwayoyin.
GvHD wani rikitarwa ne wanda kawai zai iya faruwa a ciki allogenic transplants. Dashen allogenic ya haɗa da ƙananan ƙwayoyin da aka ba da kyauta don majiyyaci ya karɓa.
Lokacin da aka dasa mutum a inda ya karbi nasu kwayoyin halitta, ana kiran wannan dasawa ta atomatik. GvHD ba rikitarwa ba ne da zai iya faruwa a cikin mutanen da ke karɓar sake jiko na ƙwayoyin nasu.
Likitan zai tantance marasa lafiya don GvHD akai-akai a matsayin wani ɓangare na kulawar kulawa bayan an allogenic transplants. Ga kowane bangare na jikin da GvHD na yau da kullun ya shafa, ana ba da maki tsakanin 0 (babu tasiri) da 3 (tasiri mai tsanani). Sakamakon ya dogara ne akan tasirin alamun da ke tattare da rayuwar yau da kullum kuma wannan yana taimaka wa likitoci su yanke shawara akan mafi kyawun magani ga mai haƙuri.
Nau'o'in graft tare da cutar mai masauki (GvHD)
GvHD an lasafta shi azaman 'm' ko' na yau da kullun' ya danganta da lokacin da majiyyaci ya dandana shi da alamu da alamun GvHD.
M graft da cuta mai gida
- Yana farawa a cikin kwanaki 100 na farko bayan dasawa
- Fiye da 50% na marasa lafiya waɗanda ke da dashen allogenic, sun fuskanci wannan
- Mafi yawan lokuta yana faruwa kusan makonni 2 zuwa 3 bayan dasawa. Wannan alamar mako na 2 - 3 shine lokacin da sababbin kwayoyin halitta suka fara daukar nauyin aikin tsarin rigakafi da kuma yin sababbin kwayoyin jini.
- Mummunan GvHD na iya faruwa a waje da kwanaki 100, wannan shine al'amarin kawai a cikin marasa lafiya waɗanda suka sami raguwar tsarin yanayin sanyi kafin a dasa.
- A cikin m GvHD, dasa yana kin mai masaukin sa, ba mai watsa shiri ya ƙi dasa ba. Duk da yake wannan ka'ida iri ɗaya ce a cikin GvHD mai ƙarfi da na yau da kullun, fasalin GvHD mai girma ya bambanta da na na yau da kullun.
An ƙididdige tsananin tsananin GvHD daga mataki na I (mai laushi sosai) zuwa mataki IV (mai tsanani), wannan tsarin ƙididdigewa yana taimaka wa likitoci su yanke shawara kan jiyya. Shafukan da aka fi sani da GvHD mai girma sune:
Gastrointestinal tract: haifar da gudawa wanda zai iya zama mai ruwa ko jini. Tashin zuciya da amai tare da ciwon ciki, raguwar nauyi da raguwar ci.
Fata: yana haifar da kurji mai ciwo da ƙaiƙayi. Sau da yawa yana farawa a hannaye, ƙafafu, kunnuwa da ƙirji amma yana iya yaduwa a jikin duka.
Hanta: yana haifar da jaundice wanda ke tattare da 'bilirubin' (wani abu ne da ke aiki a cikin aikin hanta na yau da kullun) wanda ke juya fararen idanuwa launin rawaya kuma fata.
Ƙungiyar masu jinyar ya kamata ta tantance majiyyaci don GvHD akai-akai a matsayin wani ɓangare na kulawar biyo baya.
Chronic graft da cuta mai gida
- Chronic GvHD yana faruwa fiye da kwanaki 100 bayan dasawa.
- Duk da yake yana iya faruwa a kowane wuri bayan dasawa, an fi ganin shi a cikin shekara ta farko.
- Marasa lafiya waɗanda suka sami GvHD mai tsanani suna cikin haɗarin haɓaka GvHD na yau da kullun.
- Kusan kashi 50% na marasa lafiya da suka sami GvHD mai tsanani za su ci gaba da fuskantar GvHD na yau da kullun.
- Zai iya yin tasiri ga kowa ya aika da dashen kwayar halitta.
GvHD na yau da kullun yana shafar:
- Baki: yana haifar da bushewar baki da ciwon baki
- Fatar: kurjin fata, fata ta yi laushi da ƙaiƙayi, tana matse fata kuma ta canza zuwa launi da sautin sa.
- Gastrointestinal: rashin narkewar abinci, zawo, tashin zuciya, amai da asarar nauyi da ba a bayyana ba.
- Hanta: sau da yawa yana nunawa tare da alamun da ke kama da ciwon hanta
GvHD na yau da kullun na iya shafar wasu wurare, kamar idanu, gaɓoɓi, huhu da al'aura.
Alamomi da alamun cutar da aka yi da cutar mai masauki (GvHD)
- Rash, gami da konewa da jajayen fata. Wannan kurji sau da yawa yana bayyana akan tafin hannu da tafin ƙafafu. Zai iya haɗawa da akwati da sauran extremities.
- Tashin zuciya, amai, gudawa, ciwon ciki da rashin ci na iya zama waƙar GvHD na ciki.
- Yellowing na fata da idanu (wannan ake kira jaundice) na iya zama alamar GvHD na hanta. Hakanan ana iya ganin tabarbarewar hanta akan wasu gwaje-gwajen jini.
- Bakin:
- Dry bakinka
- Haɓaka hankali na baka (zafi, sanyi, fizz, abinci mai yaji da sauransu)
- Wahalar cin abinci
- Ciwon danko da rubewar hakori
- Skin:
- Rash
- Bushewa, matsatsi, fata mai raɗaɗi
- Kauri da ƙulla fata wanda zai iya haifar da ƙuntatawa na motsi
- Kalar fata ta canza
- Rashin haƙuri ga canjin yanayin zafi, saboda lalacewar gland
- Ƙusa:
- Canje-canje a cikin rubutun ƙusa
- ƙusoshi masu ƙarfi, masu karyewa
- Asarar farce
- Gastrointestinal:
- Rashin ci
- Baceccen asarar rashin lafiya
- Vomiting
- cutar gudawa
- Abun ciki na ciki
- Huhu:
- Rawancin numfashi
- Tari wanda baya gushewa
- Wheezing
- Hanta:
- Ƙarar ciki
- Rawar launin fata/ido (jaundice)
- Rashin aikin hanta
- tsoka da haɗin gwiwa:
- Rauni na tsoka da kumburi
- Ƙunƙarar haɗin gwiwa, matsewa da wahalar faɗawa
- Al'aura:
- Mace:
- Rashin bushewar farji, ƙaiƙayi da zafi
- Ciwon farji da tabo
- Karkatar da farji
- Jima'i mai wahala/mai raɗaɗi
- Namiji:
- kunkuntar da tabo daga urethra
- Ƙunƙasa da tabo akan maƙogwaro da azzakari
- Haushin azzakari
- Mace:
Jiyya don grafts da cututtukan gida (GvHD)
- Ƙara yawan rigakafi
- Gudanar da corticosteroids kamar Prednisolone da Dexamethasone
- Ga wasu ƙananan fata GvHD, ana iya amfani da kirim na steroid
Don maganin GvHD wanda baya amsawa ga corticosteroids:
- Ibrutinib
- Ruxolitinib
- Mycophenolate mofetil
- Sirolimus
- Tacrolimus da Cyclosporin
- Monoclonal antibodies
- Antithymocyte Globulin (ATG)
