Ama-syndromes we-Myelodysplastic

Iyini i-myelodysplastic syndrome?

I-Myelodysplastic syndromes, eyaziwa nangokuthi i-myelodysplasia, iyiqembu lomdlavuza ovimbela amangqamuzana egazi lakho ukuthi akhule abe amaseli egazi anempilo. I-Myelodysplasia elinye igama le-myelodysplastic syndromes. I-Myelodysplastic syndromes yiqembu lokuphazamiseka okungaholela ezimweni ezimbi kakhulu ezifana ne-anemia, izifo ezivamile, nokopha okunganqamuki. Iziguli ze-MDS zinengozi eyengeziwe yokuthuthukiswa i-acute myeloid leukemia. Uma une-MDS, abahlinzeki bakho bezempilo bazogxila ekwelashweni ekunciphiseni ubunzima bezimpawu zakho, ukwelapha izimo ezibangelwa i-MDS, nokunciphisa ukuqhubeka kwesifo.

Izimpawu nezimpawu

Ezimweni eziningi, i-myelodysplastic syndromes ayikhiqizi izimpawu noma izimpawu eziyisixwayiso zakuqala. Ukuhlolwa kwegazi okulula kungase kuveze ubufakazi bokuba khona kwazo. I-Myelodysplastic syndromes nezinye izimo kungaba kokubili imbangela yezimpawu nezimpawu. Xhumana nodokotela wakho wokunakekela oyinhloko uma uneminye yale mibandela elandelayo:

• Ukukhathala
• Ukuphelelwa umoya
• Ukuphaphatheka okungavamile (i-pallor), okwenzeka ngenxa yokubala okuphansi kwamangqamuzana egazi abomvu (i-anemia)
• Ukulimala okulula noma okungajwayelekile noma ukopha, okwenzeka ngenxa yokubala kweplatelet ephansi yegazi (thrombocytopenia)
• Khomba amachashaza abomvu anosayizi ngaphansi nje kwesikhumba abangelwa ukopha (petechiae)
• Ukutheleleka okuvamisile, okwenzeka ngenxa yokubala okuphansi kwamaseli amhlophe egazi (i-leukopenia)

Izinkinga ze-myelodysplastic syndromes

Lapho umuntu engumqemane, umnkantsha wabo ukhiqiza amangqamuzana egazi amasha, angavuthiwe, azogcina ekhule abe amangqamuzana egazi avuthiwe. I-Myelodysplastic syndromes ilethwa yinoma yini ephazamisa le nqubo futhi ivimbele ukuvuthwa kwamangqamuzana egazi.

Amangqamuzana egazi, kunokuba akhule ngendlela evamile, abhubha emnkantsheni noma ngemva nje kokungena egazini. Ngokuhamba kwesikhathi, kunamangqamuzana angakakhuli nakhubazekile kunalawo anempilo, okuholela ezinkingeni ezinjengokukhathala okubangelwa amangqamuzana egazi abomvu ambalwa anempilo (i-anemia), izifo ezibangelwa amangqamuzana egazi amhlophe ambalwa anempilo (i-leukopenia), nokopha okubangelwa amaplatelet ambalwa avala igazi. Lezi zinkinga zivezwa ngenxa yokuthi kunamangqamuzana angakakhuli futhi anesici kunalawo anempilo (i-thrombocytopenia).

Iningi le-myelodysplastic syndromes alinayo imbangela echazwe ngokucacile. Ezinye zilethwa ukuphathwa kwemithi yokwelapha umdlavuza njenge-chemotherapy nemisebe, kanti ezinye zilethwa ngokuthintana namakhemikhali anobuthi njenge-benzene.

izinhlobo

I-World Health Organization ihlukanisa i-myelodysplastic syndromes ibe yizinhlobo ezincane ngokusekelwe ohlotsheni lwamangqamuzana egazi - amangqamuzana abomvu, amangqamuzana amhlophe namaplatelet - ahilelekile.

I-Myelodysplastic syndrome subtypes ihlanganisa:

• I-Myelodysplastic syndromes ene-dysplasia yomugqa owodwa. Ingqamuzana elilodwa legazi - amangqamuzana amhlophe egazi, amangqamuzana egazi abomvu noma ama-platelet - anenani eliphansi futhi abonakala engavamile ngaphansi kwesibonakhulu.
• I-Myelodysplastic syndromes ene-multilineage dysplasia. Kulolu hlobo oluncane, izinhlobo ezimbili noma ezintathu zamangqamuzana egazi azijwayelekile.
• I-Myelodysplastic syndromes ene-sideroblasts eyindandatho. Lolu hlobo oluncane lubandakanya inombolo ephansi yohlobo lweseli elilodwa noma ngaphezulu. Isici esiphawulekayo ukuthi amangqamuzana egazi abomvu akhona emnkantsheni aqukethe izindandatho zensimbi eyeqile.
• I-Myelodysplastic syndromes ene-del(5q) ehlukile ye-chromosome engavamile. Abantu abanalolu hlobo oluncane banezinombolo eziphansi zamangqamuzana abomvu egazi, futhi amangqamuzana anoshintsho oluthile ku-DNA yawo.
• I-Myelodysplastic syndromes enokuqhuma okweqile. Kulolu hlobo oluncane, noma yiziphi izinhlobo ezintathu zamangqamuzana egazi - amangqamuzana egazi abomvu, amangqamuzana egazi amhlophe noma ama-platelet - angase abe phansi futhi abonakale engavamile ngaphansi kwesibonakhulu. Amangqamuzana egazi angavuthiwe kakhulu (ukuqhuma) atholakala egazini nomnkantsha wamathambo.
• I-Myelodysplastic syndromes, engabonakali. Kulolu hlobo oluncane, kunezinombolo ezincishisiwe zohlobo olulodwa noma eziningi zamangqamuzana egazi avuthiwe futhi amaseli angase abukeke engajwayelekile ngaphansi kwesibonakhulu. Ngezinye izikhathi amangqamuzana egazi abonakala evamile, kodwa ukuhlaziya kungase kuthole ukuthi amaseli anezinguquko ze-DNA ezihlotshaniswa ne-myelodysplastic syndromes.

Izici zengozi

Izinto ezingandisa ingozi ye-myelodysplastic syndromes zihlanganisa:

• Ukuguga. Iningi labantu abane-myelodysplastic syndromes badala kuneminyaka engama-60.
• Ukwelashwa kwangaphambilini nge-chemotherapy noma ngemisebe. I-Chemotherapy noma ukwelashwa ngemisebe, kokubili okuvame ukusetshenziselwa ukwelapha umdlavuza, kungandisa ingozi ye-myelodysplastic syndromes.
• Ukuchayeka kumakhemikhali athile. Amakhemikhali, kuhlanganise ne-benzene, axhunyaniswe ne-myelodysplastic syndromes.

Sifo

Abahlinzeki bathatha izinyathelo ezimbalwa zokuxilonga i-myelodysplastic syndromes, kuqala ngokuhlolwa kwegazi nomnkantsha. Nazi ezinye izivivinyo abangazenza:

• Isibalo segazi esiphelele (CBC) esinomehluko. Umhlinzeki wakho uzokhipha amasampula egazi ukuze ahlaziye amangqamuzana akho egazi abomvu namhlophe, okuhlanganisa nokubala inombolo yohlobo lweseli elimhlophe legazi ngalinye.
• I-peripheral blood smear. Bazohlola isampula yegazi lakho ukuze babone izinguquko enanini, uhlobo, ukuma, nosayizi wamangqamuzana egazi futhi uma unensimbi eningi kumaseli akho abomvu egazi.
• Ukuhlaziywa kwe-Cytogenetic. Umhlinzeki wakho angase abuke isampula yegazi lakho ngaphansi kwesibonakhulu, efuna izinguquko kuma-chromosome eseli lakho legazi. Ama-Chromosome yizingxenye zamangqamuzana ethu aqukethe izakhi zofuzo. Izakhi zofuzo zenziwe nge-DNA. Ama-chromosome angajwayelekile angase asho okuthile okuthinte i-DNA yakho, okubangela izinguquko kuma-chromosome engqamuzana lakho legazi.
• I-Bone marrow aspiration kanye ne-biopsy. Ukuze wenze le nqubo, umhlinzeki wakho ufaka inaliti engenalutho ku-hipbone yakho ukuze akhiphe umnkantsha wethambo, igazi, kanye nocezu oluncane lwethambo ukuze luhlolwe ngaphansi kwesibonakhulu.

Ukwelashwa kwe-myelodysplastic syndromes

Inhloso yokwelashwa kwe-myelodysplastic syndromes ngokuvamile ukunciphisa ukuqhubeka kwesifo, ukuthuthukisa izimpawu, nokuvikela ezinkingeni. Okwamanje akukho ukwelashwa okungahlehlisa imiphumela ye-myelodysplastic syndromes, kodwa imithi ethile ingasiza ekubambezeleni ukuqhubeka kwesifo.

Kungenzeka ukuthi ukwelashwa akudingeki ngokushesha uma zingekho izimpawu ezikhona. Esikhundleni salokho, udokotela wakho angase asikisele ukuhlela ukuhlolwa okujwayelekile nokuhlolwa kwelebhu ukuze alandelele isimo sakho futhi anqume ukuthi isifo siyaqhubeka noma cha.

Uphenyo oluqhubekayo lwe-myelodysplastic syndromes luyenziwa. Khuluma nodokotela wakho oyinhloko mayelana nokubamba iqhaza kunoma iyiphi izivivinyo zokwelashwa lokho kungase kukufanele.

Abahlinzeki bezempilo bangasebenzisa i-chemotherapy, i-immunosuppressive therapy noma i-stem cell transplants ukubulala amangqamuzana egazi angenampilo. Nalu ulwazi ngalezo zindlela zokwelapha:

• I-Chemotherapy: Abahlinzeki bezempilo bangasebenzisa i-chemotherapy efanayo esetshenziselwa ukwelapha i-AML.
• Ukwelashwa kwe-Immunosuppressive: Abahlinzeki bangasebenzisa lokhu kwelashwa kwezinye izinhlobo ezincane ze-MDS. Ukwelashwa kwe-immunosuppressive kucindezela amasosha omzimba asebenza ngokweqile futhi kungase kusize ekunciphiseni isidingo sokumpontshelwa.
• Ukufakelwa kwe-stem cell: I-Myelodysplastic syndromes yelapheka kuphela ngenqubo ebizwa ngokuthi i-bone marrow transplant, ebizwa nangokuthi ukufakelwa kwe-stem cell. Lena ukuphela kwendlela yokwelapha ekwazi ukwelapha lesi sifo. Kodwa-ke, ngenxa yamathuba aphezulu okuba nemiphumela engemihle engathi sína, lokhu kwelashwa ngokuvamile kugcinelwe iziguli eziphile kahle ngokwanele ukumelana nemiphumela yako. Imithamo ephezulu yemithi yokwelapha ngamakhemikhali ivame ukunikezwa iziguli ezifakelwa umnkantsha ukuze kuqedwe. noma imaphi amangqamuzana egazi angajwayelekile angase abe khona emnkantsheni wawo. Amaseli e-stem awonakele emnkantsheni abe eseshintshelwa amaseli anempilo anikelwe (ukufakelwa kwe-allogeneic) .Kungenzeka, ezimweni ezithile, ukusebenzisa izidakamizwa ze-chemotherapy zomfutho ophansi ukuze kwehliswe izingozi ezihlobene nokufakelwa komnkantsha. ezigulini esezikhulile kanye nezinye iziguli ngokuvamile ebezingeke zicatshangelwe lokhu kwelashwa.

Lezi zindlela zokwelapha zinemiphumela emibi ehlukene kanye nezinkinga. Njengoba ucabanga ngezinketho zokwelapha, buza umhlinzeki wakho wokunakekelwa kwezempilo mayelana nemiphumela emibi yenketho ngayinye kanye nezinkinga.

• Amazwana Avaliwe
• Julayi 14th, i-2022