{"id":8491,"date":"2020-05-21T09:14:38","date_gmt":"2020-05-21T02:14:38","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/benh-ghep-chong-chu-do-truyen-mau\/"},"modified":"2020-05-21T09:14:38","modified_gmt":"2020-05-21T02:14:38","slug":"benh-ghep-chong-chu-do-truyen-mau","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/benh-ghep-chong-chu-do-truyen-mau\/","title":{"rendered":"B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 do truy\u1ec1n m\u00e1u"},"content":{"rendered":"<p style=\"text-align: right\"><strong><em>Ng\u01b0\u1eddi d\u1ecbch: Bs Ph\u1ea1m V\u00f5 Ph\u01b0\u01a1ng Th\u1ea3o<\/em><\/strong><\/p>\n<p style=\"text-align: right\"><strong><em>Ng\u01b0\u1eddi hi\u1ec7u \u0111\u00ednh: ThS.BS. Nguy\u1ec5n V\u0103n Tuy<\/em><\/strong><\/p>\n<h2>B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 do truy\u1ec1n m\u00e1u l\u00e0 g\u00ec?<\/h2>\n<p>B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 (GVHD) do truy\u1ec1n m\u00e1u l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng, \u0111\u00f4i khi \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n khi gh\u00e9p t\u1ebf b\u00e0o t\u1ea1o m\u00e1u (th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 gh\u00e9p t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c).<\/p>\n<p>GVHD c\u00f3 th\u1ec3 x\u1ea3y ra sau khi gh\u00e9p d\u1ecb th\u00e2n. C\u00f3 2 lo\u1ea1i gh\u00e9p d\u1ef1a tr\u00ean ngu\u1ed3n t\u1ebf b\u00e0o t\u1ea1o m\u00e1u: d\u1ecb th\u00e2n v\u00e0 t\u1ef1 th\u00e2n. Gh\u00e9p d\u1ecb th\u00e2n khi gh\u00e9p c\u00e1c t\u1ebf b\u00e0o t\u1eeb m\u1ed9t ng\u01b0\u1eddi kh\u00e1c. Gh\u00e9p t\u1ef1 th\u00e2n khi c\u00e1c t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c l\u1ea5y t\u1eeb b\u1ec7nh nh\u00e2n.<\/p>\n<p>GVHD x\u1ea3y ra khi c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch t\u1eeb ng\u01b0\u1eddi hi\u1ebfn t\u1eb7ng (m\u1ea3nh gh\u00e9p) nh\u1eadn ra b\u1ec7nh nh\u00e2n, c\u00e1c t\u1ebf b\u00e0o v\u00e0 m\u00f4 b\u00ecnh th\u01b0\u1eddng (v\u1eadt ch\u1ee7) l\u00e0 ngo\u1ea1i lai v\u00e0 t\u1ea5n c\u00f4ng ch\u00fang. C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch ph\u1ee5 thu\u1ed9c v\u00e0o ph\u1ea7n n\u00e0o c\u1ee7a c\u01a1 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>GVHD x\u1ea3y ra \u1edf kho\u1ea3ng 20-50% b\u1ec7nh nh\u00e2n sau gh\u00e9p. N\u00f3 c\u00f3 th\u1ec3 ph\u00e1t sinh b\u1ea5t c\u1ee9 l\u00fac n\u00e0o sau khi c\u1ea5y gh\u00e9p. M\u1ed9t khi n\u00f3 x\u1ea3y ra, b\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 c\u00f3 th\u1ec3 kh\u00f3 \u0111i\u1ec1u tr\u1ecb v\u00e0 trong tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/p>\n<p>GVHD c\u00f3 2 lo\u1ea1i:<\/p>\n<ul>\n<li><strong><em>C\u1ea5p t\u00ednh<\/em><\/strong>:\u00a0GVHD c\u1ea5p t\u00ednh khi b\u1ec7nh x\u1ea3y ra trong 100 ng\u00e0y \u0111\u1ea7u sau khi gh\u00e9p. Nh\u01b0ng n\u00f3 c\u00f3 th\u1ec3 x\u1ea3y ra b\u1ea5t c\u1ee9 l\u00fac n\u00e0o. C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn da, \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (GI) v\u00e0 gan. C\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch li\u00ean quan ch\u1ee7 y\u1ebfu l\u00e0 c\u00e1c t\u1ebf b\u00e0o T.<\/li>\n<li><em><strong>M\u1ea1n t\u00ednh<\/strong><\/em>:\u00a0GVHD m\u1ea1n t\u00ednh khi b\u1ec7nh x\u1ea3y ra h\u01a1n 100 ng\u00e0y sau khi gh\u00e9p. Nh\u01b0ng n\u00f3 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n s\u1edbm h\u01a1n. N\u00f3 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 m\u1ed9t b\u1ec7nh t\u1ef1 mi\u1ec5n v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nhi\u1ec1u c\u01a1 quan ho\u1eb7c h\u1ec7 c\u01a1 quan. Ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn li\u00ean quan \u0111\u1ebfn ch\u1ee7 y\u1ebfu l\u00e0 t\u1ebf b\u00e0o T v\u00e0 t\u1ebf b\u00e0o B.<\/li>\n<\/ul>\n<h3><strong>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a GVHD c\u1ea5p t\u00ednh<\/strong><\/h3>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 t\u1eeb nh\u1eb9 \u0111\u1ebfn n\u1eb7ng. Ch\u00fang c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n<ul>\n<li><em>Da<\/em>: Ph\u00e1t ban, \u0111\u1ecf, r\u1ed9p, lo\u00e9t.<\/li>\n<li><em>\u0110\u01b0\u1eddng ti\u00eau h\u00f3a<\/em>: Bu\u1ed3n n\u00f4n, n\u00f4n, \u0103n m\u1ea5t ngon, ti\u00eau ch\u1ea3y ho\u1eb7c \u0111i c\u1ea7u ph\u00e2n m\u00e1u, \u0111au b\u1ee5ng, n\u1ed3ng \u0111\u1ed9 albumin th\u1ea5p, v\u00e0ng da.<\/li>\n<li><em>Gan<\/em>: T\u0103ng n\u1ed3ng \u0111\u1ed9 bilirubin, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 gan.<\/li>\n<\/ul>\n<h3><strong>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh GVHD m\u1ea1n t\u00ednh<\/strong><\/h3>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 t\u1eeb nh\u1eb9 \u0111\u1ebfn n\u1eb7ng. Ch\u00fang c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n<ul>\n<li>C\u00e1c tri\u1ec7u ch\u1ee9ng v\u1ec1 da: ph\u00e1t ban v\u00e0 ng\u1ee9a, da bong v\u1ea3y, m\u1ea5t c\u00e1c m\u1ea3ng da, s\u1ea1m da, c\u1ee9ng k\u1ebft c\u1ea5u da, s\u1eb9o c\u00f3 th\u1ec3 khi\u1ebfn chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a c\u00e1c kh\u1edbp g\u1ea7n \u0111\u00f3 nh\u01b0 ng\u00f3n tay b\u1ecb h\u1ea1n ch\u1ebf.<\/li>\n<li>H\u1ecfng m\u00f3ng ho\u1eb7c ti\u00eau m\u00f3ng<\/li>\n<li>R\u1ee5ng t\u00f3c<\/li>\n<li>C\u1ee9ng kh\u1edbp<\/li>\n<li>Kh\u00f4 v\u00e0 l\u1edf lo\u00e9t trong mi\u1ec7ng v\u00e0 th\u1ef1c qu\u1ea3n<\/li>\n<li>Kh\u00f4 m\u1eaft v\u00e0 \u0111\u1ecf m\u1eaft<\/li>\n<li>N\u1eef: kh\u00f4 \u00e2m \u0111\u1ea1o v\u00e0 c\u00e1c ni\u00eam m\u1ea1c kh\u00e1c<\/li>\n<li>Nam: thay \u0111\u1ed5i k\u00edch th\u01b0\u1edbc d\u01b0\u01a1ng v\u1eadt<\/li>\n<li>Ho, kh\u00f3 th\u1edf, th\u1edf kh\u00f2 kh\u00e8<\/li>\n<li>Vi\u00eam v\u00e0 s\u1eb9o ph\u1ed5i<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng gan ho\u1eb7c suy gan<\/li>\n<li>V\u00e0ng da<\/li>\n<\/ul>\n<h2><strong>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/strong><\/h2>\n<p>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed1i v\u1edbi b\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 bao g\u1ed3m:<\/p>\n<ul>\n<li>M\u1ee9c \u0111\u1ed9 ph\u00f9 h\u1ee3p gi\u1eefa ng\u01b0\u1eddi cho v\u00e0 b\u1ec7nh nh\u00e2n (ph\u1ee9c h\u1ec7 HLA)<\/li>\n<li>Tu\u1ed5i c\u1ee7a ng\u01b0\u1eddi cho v\u00e0 ng\u01b0\u1eddi nh\u1eadn<\/li>\n<li>Ngu\u1ed3n t\u1ebf b\u00e0o t\u1ea1o m\u00e1u<\/li>\n<li>M\u1ee9c \u0111\u1ed9 nh\u1ea1y c\u1ea3m c\u1ee7a c\u00e1 th\u1ec3<\/li>\n<\/ul>\n<h2><strong>Ph\u00f2ng b\u1ec7nh<\/strong><\/h2>\n<p>B\u00e1c s\u0129 s\u1ebd th\u1ef1c hi\u1ec7n c\u00e1c b\u01b0\u1edbc \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba GVHD:<\/p>\n<ul>\n<li><em>L\u1ef1a ch\u1ecdn ng\u01b0\u1eddi cho<\/em>: Ch\u1ecdn ng\u01b0\u1eddi cho ph\u00f9 h\u1ee3p v\u1edbi HLA ng\u01b0\u1eddi nh\u1eadn.<\/li>\n<li><em>L\u00e0m s\u1ea1ch t\u1ebf b\u00e0o c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn<\/em>: C\u00e1c t\u1ebf b\u00e0o c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u00e0m s\u1ea1ch \u0111\u1ec3 l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o T, trong n\u1ed7 l\u1ef1c ng\u0103n ch\u1eb7n ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn g\u00e2y ra GVHD. Thao t\u00e1c n\u00e0y c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc khi chuy\u1ec3n cho b\u1ec7nh nh\u00e2n ho\u1eb7c b\u1eb1ng c\u00e1ch cho b\u1ec7nh nh\u00e2n d\u00f9ng m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c sau khi gh\u00e9p.<\/li>\n<li><em>Thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch<\/em>: B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c \u0111\u1ec3 gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn. C\u00e1c lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng bao g\u1ed3m: cyclosporine, tacrolimus, sirolimus, methotrexate, mycophenolate mofetil, cyclophosphamide, ch\u1ed1ng thymocyte globulin (ATG) v\u00e0 alemtuzumab.<\/li>\n<\/ul>\n<h2><strong>B\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh c\u00f3 th\u1ec3 l\u00e0m g\u00ec?<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u00f3ng vai tr\u00f2 t\u00edch c\u1ef1c trong vi\u1ec7c gi\u00fap ng\u0103n ng\u1eeba GVHD:<\/p>\n<ul>\n<li>Th\u1ef1c hi\u1ec7n d\u00f9ng thu\u1ed1c theo ch\u1ec9 d\u1eabn. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c ch\u00ednh x\u00e1c theo quy \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129.<\/li>\n<li>Theo d\u00f5i c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng s\u1edbm. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 th\u1ec3 g\u1ee3i \u00fd GVHD. Nh\u00ecn chung, GVHD c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c trong giai \u0111o\u1ea1n \u0111\u1ea7u. Ch\u1ea9n \u0111o\u00e1n nhanh ch\u00f3ng c\u00f3 th\u1ec3 cho ti\u00ean l\u01b0\u1ee3ng t\u1ed1t.<\/li>\n<li>B\u1ea3o v\u1ec7 da ch\u1ed1ng l\u1ea1i \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi. Ph\u01a1i n\u1eafng c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t GVHD ho\u1eb7c l\u00e0m cho n\u00f3 t\u1ed3i t\u1ec7 h\u01a1n. Khi b\u1ec7nh nh\u00e2n ra ngo\u00e0i, h\u1ecd \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u1ed9i m\u0169, \u00e1o d\u00e0i tay, qu\u1ea7n d\u00e0i v\u00e0 kem ch\u1ed1ng n\u1eafng c\u00f3 SPF t\u1eeb 30 tr\u1edf l\u00ean. B\u1ea3o v\u1ec7 t\u1ed1t nh\u1ea5t l\u00e0 tr\u00e1nh ra ngo\u00e0i n\u1eafng.<\/li>\n<\/ul>\n<h2><strong>Ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i GVHD<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n s\u1ebd \u0111\u01b0\u1ee3c theo d\u00f5i r\u1ea5t ch\u1eb7t ch\u1ebd c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a GVHD. Qu\u00e1 tr\u00ecnh n\u00e0y c\u00f3 th\u1ec3 bao g\u1ed3m kh\u00e1m th\u1ef1c th\u1ec3, h\u1ecfi b\u1ec7nh s\u1eed, x\u00e9t nghi\u1ec7m sinh h\u00f3a v\u00e0 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh.<\/p>\n<p>X\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u h\u01a1n ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c lo\u1ea1i tri\u1ec7u ch\u1ee9ng. C\u00e1c x\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 th\u1ec3 bao g\u1ed3m l\u1ea5y m\u1ed9t m\u1eabu m\u00f4 th\u00f4ng qua sinh thi\u1ebft, n\u1ed9i soi, x\u00e9t nghi\u1ec7m sinh h\u00f3a v\u00e0 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh.<\/p>\n<h2><strong>\u0110i\u1ec1u tr\u1ecb GVHD<\/strong><\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb nh\u1eb1m m\u1ee5c \u0111\u00edch ng\u0103n ch\u1eb7n ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c c\u1ee7a ng\u01b0\u1eddi hi\u1ebfn v\u00e0 \u0111i\u1ec1u ch\u1ec9nh h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch ng\u01b0\u1eddi nh\u1eadn \u0111\u1ec3 kh\u00f4ng t\u1ea5n c\u00f4ng c\u00e1c m\u00f4 ch\u1ee7 b\u00ecnh th\u01b0\u1eddng. \u0110i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 kh\u00e1c nhau gi\u1eefa c\u00e1c b\u1ec7nh nh\u00e2n d\u1ef1a tr\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ecd.<\/p>\n<h3><strong>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n<p>Corticosteroid nh\u01b0 methylprednisolone, dexamethasone v\u00e0 prednison l\u00e0 c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh cho GVHD. Thu\u1ed1c c\u00f3 th\u1ec3 d\u00f9ng qua \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, \u0111\u01b0\u1eddng u\u1ed1ng, b\u00f4i kem ho\u1eb7c thu\u1ed1c m\u1ee1, thu\u1ed1c nh\u1ecf m\u1eaft ho\u1eb7c n\u01b0\u1edbc s\u00fac mi\u1ec7ng.<\/p>\n<p>C\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 bao g\u1ed3m thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch (nh\u01b0 nh\u1eefng thu\u1ed1c \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea \u1edf tr\u00ean trong ph\u1ea7n Ph\u00f2ng ng\u1eeba), li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch v\u00e0 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00edch.<\/p>\n<h3><strong>Li\u1ec7u ph\u00e1p \u00e1nh s\u00e1ng<\/strong><\/h3>\n<p>Ph\u01b0\u01a1ng ph\u00e1p tr\u1ecb li\u1ec7u b\u1eb1ng tia c\u1ef1c t\u00edm (UV) v\u00e0 \u0111i\u1ec1u tr\u1ecb quang ngo\u1ea1i b\u00e0o (ECP) l\u00e0 2 li\u1ec7u ph\u00e1p m\u00e0 c\u1ea3 hai \u0111\u1ec1u s\u1eed d\u1ee5ng \u00e1nh s\u00e1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb GVHD.<\/p>\n<p>Quang tr\u1ecb li\u1ec7u b\u1eb1ng tia c\u1ef1c t\u00edm s\u1eed d\u1ee5ng b\u1ee9c x\u1ea1 UVB \u0111\u1ec3 ch\u1eefa l\u00e0nh c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 da do GVHD g\u00e2y ra.<\/p>\n<p>ECP li\u00ean quan \u0111\u1ebfn vi\u1ec7c thu th\u1eadp m\u00e1u v\u00e0 t\u00e1ch n\u00f3 th\u00e0nh c\u00e1c t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u, b\u1ea1ch c\u1ea7u v\u00e0 ti\u1ec3u c\u1ea7u. C\u00e1c t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c v\u00e0 ti\u1ebfp x\u00fac v\u1edbi tia c\u1ef1c t\u00edm (UV). Sau \u0111\u00f3, c\u00e1c t\u1ebf b\u00e0o n\u00e0y, c\u00f9ng v\u1edbi c\u00e1c t\u1ebf b\u00e0o m\u00e1u kh\u00e1c, \u0111\u01b0\u1ee3c \u0111\u01b0a tr\u1edf l\u1ea1i c\u01a1 th\u1ec3. C\u00e1c t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u00e0y c\u00f3 th\u1ec3 k\u00edch th\u00edch h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u0111\u1ec3 gi\u00fap ch\u1ed1ng l\u1ea1i GVHD.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p><a href=\"https:\/\/together.stjude.org\/en-us\/diagnosis-treatment\/side-effects\/graft-versus-host-disease-gvhd.html\" target=\"_blank\" rel=\"noopener\">https:\/\/together.stjude.org\/en-us\/diagnosis-treatment\/side-effects\/graft-versus-host-disease-gvhd.html<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 (GVHD) do truy\u1ec1n m\u00e1u l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng, \u0111\u00f4i khi \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n khi gh\u00e9p t\u1ebf b\u00e0o t\u1ea1o m\u00e1u (g\u1ecdi l\u00e0 gh\u00e9p t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c).<\/p>\n","protected":false},"author":469,"featured_media":8492,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3239],"tags":[3243,3244,3245,2489],"series":[2108],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 do truy\u1ec1n m\u00e1u - D\u1ef1 \u00e1n Ung Th\u01b0<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh gh\u00e9p ch\u1ed1ng ch\u1ee7 (GVHD) do truy\u1ec1n m\u00e1u l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng, \u0111\u00f4i khi \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n khi gh\u00e9p t\u1ebf b\u00e0o t\u1ea1o m\u00e1u (g\u1ecdi l\u00e0 gh\u00e9p t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c).\" \/>\n<meta name=\"robots\" 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