Iindidi / i-myeloma / isigulana / unyango lwe-myeloma-pdq

Unyango lwePlasma Cell Neoplasms (kubandakanywa nonyango lweMyeloma) (®) –uPawuent Version

Ulwazi ngokubanzi malunga neePlasma Cell Neoplasms

IINGONGOMA EZIPHAMBILI

• Iiplasma cell neoplasms zizifo apho umzimba wenza iiseli ezininzi zeplasma.

• Isilonda sePlasma neoplasms sinokuba nobungozi (hayi umhlaza) okanye isifo esibi (umhlaza).

• Kukho iintlobo ezahlukeneyo zeplasma yeseli.

• I-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS)

• Iplasmacytoma

• Uninzi lwe-myeloma

• I-myeloma eninzi kunye nezinye iiplasma zeeseli zingabangela imeko ebizwa ngokuba yi-amyloidosis.

• Ubudala bunokuchaphazela umngcipheko weeplasma zeeplasma.

• Uvavanyo oluvavanya igazi, umongo wethambo, kunye nomchamo zisetyenziselwa ukufumanisa isifo se-myeloma kunye nezinye iiplasma zeseli.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Iiplasma cell neoplasms zizifo apho umzimba wenza iiseli ezininzi zeplasma.

Iiseli zePlasma zikhula kwii-lymphocyte B (iiseli ze-B), uhlobo lweeseli ezimhlophe zegazi ezenziwe kumongo wethambo. Ngokwesiqhelo, xa intsholongwane ingena emzimbeni, ezinye zeeseli ze-B ziya kutshintsha zibe ziiseli zeplasma. Iiseli ze-plasma zenza ii-antibodies zokulwa neentsholongwane kunye neentsholongwane, ukunqanda usulelo kunye nezifo.

Uninzi lwe-myeloma. Iiseli ezininzi ze-myeloma ziiseli ezingaqhelekanga zeplasma (uhlobo lweseli emhlophe yegazi) ezakha kumongo wethambo kwaye zenze amathumba kumathambo amaninzi omzimba. Iiseli ze-plasma eziqhelekileyo zenza izilwa-buhlungu ukunceda umzimba ukulwa usulelo kunye nezifo. Njengoko inani leeseli ezininzi ze-myeloma landa, kwenziwa ii-antibodies ezininzi. Oku kunokubangela ukuba igazi lityebe kwaye ligcine umongo wethambo ekubeni wenze iiseli zegazi ezoneleyo. Iiseli ezininzi ze-myeloma zonakalisa kwaye zenze buthathaka ithambo.

Iiplasma cell neoplasms zizifo apho iiseli zeeplasma ezingaqhelekanga okanye iiseli ze-myeloma zenza amathumba emathanjeni okanye izicubu ezithambileyo zomzimba. Iiseli ze-plasma nazo zenza iprotheni ye-antibody, ebizwa ngokuba yi-M protein, engafunekiyo emzimbeni kwaye ayincedi ukulwa nosulelo. Ezi proteni ze-antibody ziyakha kumongo wethambo kwaye zinokubangela ukuba igazi lityebe okanye lonakalise izintso.

Isilonda sePlasma neoplasms sinokuba nobungozi (hayi umhlaza) okanye isifo esibi (umhlaza).

I-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS) ayisiwo umhlaza kodwa inokuba ngumhlaza. Ezi ndidi zilandelayo zeeplasma zeeseli ngumhlaza:

• I-Lymphoplasmacytic lymphoma. (Jonga uNyango lwe-Hodgkin Lymphoma yaBadala ngolwazi oluthe kratya.)

• Iplasmacytoma.

• Uninzi lwe-myeloma.

Kukho iintlobo ezahlukeneyo zeplasma yeseli.

Iiplasma cell neoplasms zibandakanya oku kulandelayo:

I-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS)

Kolu hlobo lweplasma cell neoplasm, ngaphantsi kwe-10% lomongo wethambo wenziwe ngeeseli zeeplasma ezingaqhelekanga kwaye akukho mhlaza. Iiseli ezingaqhelekanga zeplasma zenza iM protein, maxa wambi efumaneka ngexesha lovavanyo lwegazi okanye umchamo. Kwizigulana ezininzi, inani le-M protein lihlala ngokufanayo kwaye akukho zimpawu, zimpawu, okanye iingxaki zempilo.

Kwezinye izigulana, i-MGUS inokuthi kamva ibe yimeko enzulu, enje nge-amyloidosis, okanye ibangele iingxaki ngezintso, intliziyo, okanye imithambo-luvo. I-MGUS inokuba ngumhlaza, njenge-myeloma emininzi, i-lymphoplasmacytic lymphoma, okanye i-lempemia ye-lymphocytic leukemia.

Iplasmacytoma

Kolu hlobo lweplasma cell neoplasm, iiseli ezingaqhelekanga zeplasma (iiseli ze-myeloma) zikwindawo enye kwaye zenze ithumba elinye, elibizwa ngokuba yiplasmacytoma. Ngamanye amaxesha i-plasmacytoma iyanyangeka. Zimbini iintlobo zeplasmacytoma.

• Kwiplasmacytoma yethambo elizimeleyo, kufunyanwa ithumba elinye kwiseli yeplasma, ngaphantsi kwe-10% lomongo wethambo wenziwe ngeeseli ze-plasma, kwaye azikho ezinye iimpawu zomhlaza. Iplasmacytoma yethambo ihlala iba myeloma emininzi.

• Kwi-extramedullary plasmacytoma, ithumba elinye leseli leplasma lifumaneka kwithishu ethambileyo kodwa hayi kwithambo okanye kumongo wethambo. I-extramedullary plasmacytomas iqhele ukwenzeka kwizicubu zomqala, zetoni, kunye nezono zeparanasal.

Iimpawu kunye neempawu zixhomekeke apho likhona ithumba.

• Kwithambo, iplasmacytoma inokubangela iintlungu okanye amathambo aqhekekileyo.

• Kwizicubu ezithambileyo, ithumba linokucinezela kwiindawo ezikufuphi kwaye libangele iintlungu okanye ezinye iingxaki. Umzekelo, iplasmacytoma emqaleni inokwenza kube nzima ukuginya.

Uninzi lwe-myeloma

Kwii-myeloma ezininzi, iiseli ezingaqhelekanga zeplasma (iiseli ze-myeloma) zakha umongo wethambo kwaye zenze amathumba kumathambo amaninzi omzimba. Ezi tumors zinokugcina umongo wethambo ungenzi ngokwaneleyo iiseli zegazi. Ngokwesiqhelo, umongo wethambo wenza iiseli zeziqu (iiseli ezingafakwanga) eziba ziintlobo ezintathu zeeseli zegazi ezivuthiweyo

• Iiseli ezibomvu zegazi ezithwala ioksijini kunye nezinye izinto kuwo onke amalungu omzimba.

• Amaseli egazi amhlophe alwa nosulelo kunye nezifo.

• Iiplatelets ezenza amahlwili egazi ukunceda ukuthintela ukopha.

Njengoko inani leeseli ze-myeloma landa, iiseli ezibomvu zegazi ezimbalwa, iiseli ezimhlophe zegazi kunye neeplatelets zenziwa. Iiseli ze-myeloma zonakalisa kwaye zenze buthathaka ithambo.

Ngamanye amaxesha i-myeloma emininzi ayibangeli zimpawu okanye zimpawu. Oku kubizwa ngokuba ngumlilo omninzi we-myeloma. Inokufunyanwa xa uvavanyo lwegazi okanye umchamo lwenziwa kwenye imeko. Iimpawu kunye neempawu zinokubangelwa zii-myeloma ezininzi okanye ezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Intlungu yethambo, ngakumbi emqolo okanye kwiimbambo.

• Amathambo aphuka ngokulula.

• Umkhuhlane ngaphandle kwesizathu esaziwayo okanye usulelo oluqhelekileyo.

• Ukutyumza okulula okanye ukopha.

• Ingxaki yokuphefumla.

• Ubuthathaka beengalo okanye imilenze.

• Ndiziva ndidiniwe.

Ithumba linokonakalisa ithambo kwaye libangele i-hypercalcemia (i-calcium eninzi egazini). Oku kunokuchaphazela amalungu amaninzi emzimbeni, kubandakanya izintso, imithambo-luvo, intliziyo, izihlunu, kunye nokugaya ukutya, kwaye kunokubangela iingxaki zempilo.

I-Hypercalcemia inokubangela le miqondiso neempawu zilandelayo:

• Ukuphelelwa ngumdla wokutya.

• Isihlunu okanye ukugabha.

• Ndiziva ndinxaniwe.

• Ukuchama rhoqo.

• Ukuqunjelwa.

• Ndiziva ndidiniwe.

• Ubuthathaka bemisipha.

• Ukungazinzi.

• Ukudideka okanye ingxaki yokucinga.

I-myeloma eninzi kunye nezinye iiplasma zeeseli zingabangela imeko ebizwa ngokuba yi-amyloidosis.

Kwiimeko ezinqabileyo, i-myeloma eninzi inokubangela ukuba luvo lwe-peripheral (nerves ezingekho kwingqondo okanye intambo yomqolo) kunye namalungu asilele. Oku kunokubangelwa yimeko ebizwa ngokuba yi-amyloidosis. Iiproteni ze-antibody ziyakha kwaye zinamathele kunye kwimithambo yegazi kunye nakwizitho, ezinjengezintso nentliziyo. Oku kunokubangela ukuba imithambo-luvo kunye nezitho zomzimba ziqine kwaye zingakwazi ukusebenza ngendlela ebekufanele ukuba zisebenza ngayo.

I-Amyloidosis inokubangela le miqondiso neempawu zilandelayo:

• Ndiziva ndidiniwe.

• Amabala amfusa eluswini.

• Ulwimi olwandisiweyo.

• Urhudo.

• Ukudumba okubangelwa lulwelo kwizicwili zomzimba wakho.

• Ukudinwa okanye ukuba ndindisholo emilenzeni nasezinyaweni.

Ubudala bunokuchaphazela umngcipheko weeplasma zeeplasma.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini.

Iiplasma cell neoplasms zixhaphake kakhulu kubantu abaneminyaka ephakathi okanye ngaphezulu. Kwiimeloma ezininzi kunye neplasmacytoma, ezinye izinto ezinobungozi zibandakanya oku kulandelayo:

• Ukuba mnyama.

• Ukuba yindoda.

• Ukuba nembali yobuqu yeMGUS okanye iplasmacytoma.

• Ukuvezwa kwimitha okanye kwimichiza ethile.

Uvavanyo oluvavanya igazi, umongo wethambo, kunye nomchamo zisetyenziselwa ukufumanisa isifo se-myeloma kunye nezinye iiplasma zeseli.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo ze-immunoglobulin yegazi kunye nomchamo: Inkqubo apho kuvavanywa isampulu yegazi okanye umchamo ukulinganisa inani lezifo ezithile (ii-immunoglobulins). Kwii-myeloma ezininzi, i-beta-2-microglobulin, iiprotheyini ze-M, imixokelelwano yokukhanya yasimahla, kunye nezinye iiproteni ezenziwe ziiseli ze-myeloma ziyalinganiswa. Inani elingaphezulu kwesiqhelo kwezi zinto linokuba luphawu lwesifo.

• Umnqweno womongo wethambo kunye ne-biopsy: Ukususwa komongo wethambo, igazi, kunye nesiqwenga samathambo ngokufaka inaliti engenanto kumqolo okanye ithambo lesifuba. Ugqirha wezifo ujonga umongo wethambo, igazi kunye nethambo phantsi kwemicroscope ukukhangela iiseli ezingaqhelekanga.

Umnqweno wethambo lomnqweno kunye ne-biopsy. Emva kokuba indawo encinci yolusu iphonyiwe, inaliti yomongo wethambo ifakwa kwisithambo sethambo lesigulana. Iisampulu zegazi, ithambo, kunye nomongo wethambo ziyasuswa ukuze zihlolwe phantsi kwemicroscope.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esuswe ngexesha lomnqweno wethambo kunye ne-biopsy:

• Uhlalutyo lwe-cytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yomongo wethambo zibalwa kwaye zijongwa kulo naluphi na utshintsho, njengokuqhekeka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.
• I-FISH (i-fluorescence in situ hybridization): Uvavanyo lwaselebhu olusetyenziselwa ukujonga nokubala ii-genes okanye ii-chromosomes kwiiseli nakwizicubu. Amacandelo e-DNA aqukethe idayi ye-fluorescent yenziwa elebhu kwaye yongezwa kwisampulu yeeseli zomguli okanye izicwili. Xa ezi ziqwenga zeDNA zidayiweyo zinamathela kwimfuza ethile okanye kwiindawo zechromosomes kwisampulu, ziyakhanya xa zijongwa phantsi kwemicroscope ebengezelayo. Uvavanyo lwe-FISH lusetyenziselwa ukunceda ekuchongeni umhlaza kunye nokunceda ekucwangciseni unyango.
• Ukuhamba kwe-cytometry: Uvavanyo lwelebhu olulinganisa inani leeseli kwisampulu, ipesenti yeeseli eziphilayo kwisampulu, kunye neempawu ezithile zeeseli, ezinje ngobungakanani, imilo, kunye nobukho beempawu zethumba (okanye ezinye) umphezulu weseli. Iiseli ezivela kwisampulu yomongo wethambo lesigulana zihlanjwe ngedayi ye-fluorescent, ibekwe kulwelo, emva koko idlulise nganye nganye ngakwimitha yokukhanya. Iziphumo zovavanyo zisekwe kwindlela iiseli ezazinebala ledayi ye-fluorescent zisabela njani kwimbonakalo yokukhanya. Olu vavanyo lusetyenziselwa ukunceda ekuchongeni nasekulawuleni iintlobo ezithile zomhlaza, ezinje ngeleukemia kunye ne-lymphoma.

• Uvavanyo lwethambo lwamathambo: Kuphononongo lwamathambo, i-x-reyi yawo onke amathambo emzimbeni athathwa. I-ray-ray isetyenziselwa ukufumana iindawo apho ithambo lonakele khona. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.
• Gcwalisa ubalo lwegazi (CBC) ngokwahluka-hlukeneyo: Inkqubo apho isampulu yegazi itsalwa kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi kunye neeplatelets.
• Inani nohlobo lweeseli ezimhlophe zegazi.
• Isixa sehemoglobin (iprotein ethwala ioksijini) kwiiseli ezibomvu zegazi.
• Inxalenye yesampulu yegazi eyenziwe ziiseli ezibomvu zegazi.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngecalcium okanye ialbumin, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Uvavanyo lomchamo lweeyure ezingamashumi amabini anesine: Uvavanyo apho kuqokelelwa khona umchamo iiyure ezingama-24 ukulinganisa izixa zezinto ezithile. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lexabiso linokuba luphawu lwesifo kwilungu okanye kwithishu eyenzayo. Inani elingaphezulu kwesiqhelo leprotheni inokuba luphawu lwe-myeloma emininzi.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI). I-MRI yomqolo kunye ne-pelvis ingasetyenziselwa ukufumana indawo apho ithambo lonakele.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjenge-spine, ezithathwe kwii-angles ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Iskena se-PET-CT: Inkqubo edibanisa imifanekiso evela kwiskena se-positron emission tomography (PET) kunye nekhompyuter ye-tomography (CT). Ukuskena i-PET kunye ne-CT kwenziwa ngaxeshanye kumatshini omnye. Izikena ezidityanisiweyo zinika imifanekiso eneenkcukacha ngakumbi yeendawo ezingaphakathi emzimbeni, ezinje ngomqolo, kunokuba iskena sisodwa.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxelwa kwangaphambili kuxhomekeke koku kulandelayo:

• Uhlobo lweplasma yeseli yeplasma.

• Inqanaba lesi sifo.

• Nokuba kukho i-immunoglobulin (antibody) ethile.

• Nokuba kukho utshintsho oluthile kwimfuza.

• Nokuba sezintso na ezonakeleyo.

• Nokuba umhlaza uphendula kunyango lokuqala okanye ubuyela kwakhona (buyela emva).

Ukhetho lonyango luxhomekeke koku kulandelayo:

• Uhlobo lweplasma yeseli yeplasma.

• Ubudala kunye nempilo ngokubanzi yesigulana.

• Nokuba zikhona iimpawu, iimpawu, okanye iingxaki zempilo, ezinje ngokusilela kwezintso okanye usulelo, olunxulumene nesi sifo.

• Nokuba umhlaza uphendula kunyango lokuqala okanye ubuyela kwakhona (buyela emva).

Amanqanaba ePlasma Cell Neoplasms

IINGONGOMA EZIPHAMBILI

• Akukho ziinkqubo ziqhelekileyo zomgangatho we-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS) kunye neplasmacytoma.

• Emva kokuba i-myeloma ifunyenwe, kuvavanyo kuyenziwa ukufumana ukuba umhlaza ungakanani emzimbeni.

• Inqanaba le-myeloma emininzi isekwe kumanqanaba e-beta-2-microglobulin kunye nealbhamu egazini.

• Amanqanaba alandelayo asetyenziselwa i-myeloma ezininzi:

• Isigaba I myeloma ezininzi

• Isigaba II se-myeloma ezininzi

• Isigaba III se-myeloma ezininzi

• Iiplasma cell neoplasms ayinakuphendula kunyango okanye inokubuya emva konyango.

Akukho ziinkqubo ziqhelekileyo zomgangatho we-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS) kunye neplasmacytoma.

Emva kokuba i-myeloma ifunyenwe, kuvavanyo kuyenziwa ukufumana ukuba umhlaza ungakanani emzimbeni.

Inkqubo esetyenziselwa ukufumanisa isixa somhlaza emzimbeni ibizwa ngokuba yistage. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango.

Ezi mvavanyo zilandelayo kunye neenkqubo zingasetyenziselwa ukufumanisa ukuba ungakanani umhlaza osemzimbeni:

• Uvavanyo lwethambo lwamathambo: Kuphononongo lwamathambo, i-x-reyi yawo onke amathambo emzimbeni athathwa. I-ray-ray isetyenziselwa ukufumana iindawo apho ithambo lonakele khona. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngomongo wethambo. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• I-Bens densitometry: Inkqubo esebenzisa uhlobo oluthile lwe-x-ray ukulinganisa uxinano lwethambo.

Inqanaba le-myeloma emininzi isekwe kumanqanaba e-beta-2-microglobulin kunye nealbhamu egazini.

I-Beta-2-microglobulin kunye nealbumin zifumaneka egazini. I-Beta-2-microglobulin yiprotein efumaneka kwiiseli ze-plasma. Ialbumin yeyona nxalenye inkulu yegazi. Igcina ulwelo ekuphumeni kwimithambo yegazi. Izisa nezakha mzimba kwizicwili, kwaye ithwala iihomoni, iivithamini, iziyobisi, kunye nezinye izinto, ezinjengecalcium, kuwo wonke umzimba. Egazini lezigulana ezine-myeloma ezininzi, inani le-beta-2-microglobulin lonyukile kwaye inani le-albin liyancipha.

Amanqanaba alandelayo asetyenziselwa i-myeloma ezininzi:

Isigaba I myeloma ezininzi

Kwinqanaba le-myeloma emininzi, amanqanaba egazi ngolu hlobo lulandelayo:

• I-beta-2-microglobulin level ingaphantsi kwe-3.5 mg / L; kwaye

• Inqanaba le-albin yi-3.5 g / dL okanye ngaphezulu.

Isigaba II se-myeloma ezininzi

Kwinqanaba II i-myeloma emininzi, amanqanaba egazi aphakathi kwamanqanaba esigaba sokuqala kunye nesigaba III.

Isigaba III se-myeloma ezininzi

Kwinqanaba lesithathu le-myeloma, inqanaba legazi le-beta-2-microglobulin li-5.5 mg / L okanye ngaphezulu kwaye isiguli sinenye yezi zinto zilandelayo:

• amanqanaba aphezulu e-lactate dehydrogenase (LDH); okanye

• utshintsho oluthile kwii-chromosomes.

Iiplasma cell neoplasms ayinakuphendula kunyango okanye inokubuya emva konyango.

Iiplasma cell neoplasms ibizwa ngokuba yi-refractory xa inani leeseli ze-plasma liqhubeka linyuka nangona unyango lunikwa. Iiplasma cell neoplasms zibizwa ngokuba ziphinde zabuya xa zibuya emva konyango.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo seplasma neoplasms.

• Iindidi ezisibhozo zonyango zisetyenziswa:

• Unyango ngamayeza

• Olunye unyango lweziyobisi

• Unyango ekujoliswe kulo

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Unyango lwe-Immunotherapy

• Unyango ngemitha

• Ugqirha

• Ukulinda ulindile

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Umdibaniso omtsha wezonyango

• Unyango lwee-neoplasms zeseli ze-plasma kunokubangela iziphumo ebezingalindelekanga.

• Inkathalelo yenkxaso inikwa ukunciphisa iingxaki ezibangelwa sesi sifo okanye unyango lwaso.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo seplasma neoplasms.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinesifo seplasma neoplasms. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindidi ezisibhozo zonyango zisetyenziswa:

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy).

Jonga iziyobisi ezivunyiweyo kwi-Multiple Myeloma kunye nezinye iiPlasma Cell Neoplasms ngolwazi oluthe kratya.

Olunye unyango lweziyobisi

ICorticosteroids zii-steroids ezineziphumo ze-antitumor kwi-myeloma eninzi.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lunyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza. Unyango olujolisiweyo lunokubangela ingozi encinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango ngemitha. Iindidi ezininzi zonyango ekujoliswe kuzo zinokusetyenziselwa ukunyanga i-myeloma kunye nezinye iiplasma zeseli zeplasma. Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo:

• Unyango lweproteasome inhibitor: Olu nyango luthintela isenzo seproteasomes kwiiseli zomhlaza. Iproteasome yiprotein esusa ezinye iiproteni ezingasafunekiyo kwiseli. Xa iiproteni zingasuswanga kwiseli, ziyakha kwaye zinokubangela ukuba iseli yomhlaza ife. I-Bortezomib, i-carfilzomib, kunye ne-ixazomib ziyi-proteasome inhibitors ezisetyenziselwa unyango lwe-myeloma ezininzi kunye nezinye iiplasma zeseli zeplasma.

• Unyango lwe-monoclonal antibody: Olu nyango lusebenzisa ii-antibodies ezenziwe elebhu, ezivela kuhlobo olunye lweseli yomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Daratumumab kunye ne-elotuzumab zii-antibodies ze-monoclonal ezisetyenziswa kunyango lwe-myeloma kunye nezinye iiseli zeplasma. I-Denosumab yi-monoclonal antibody esetyenziselwa ukunciphisa ukuphulukana nethambo kunye nokunciphisa iintlungu zethambo kwizigulana ezine-myeloma ezininzi.

• Unyango lwe-inhibitorlase (i-HDAC) ye-inhibitor yonyango: Olu nyango luthintela ii-enzymes ezifunekayo ukwahlula iseli kwaye zinokumisa ukukhula kweeseli zomhlaza. I-Panobinostat yi-HDAC inhibitor esetyenziselwa unyango lwe-myeloma kunye nezinye iiplasma zeseli zeplasma.

• Unyango lwe-BCL2 inhibitor: Olu nyango luthintela iprotein ebizwa ngokuba yi-BCL2. Ukuthintela le protein kunokunceda ekubulaleni iiseli zomhlaza kwaye kunokubenza babe novakalelo ngakumbi kumachiza e-anticancer. IVenetoclax yi-BCL2 inhibitor efundwayo kunyango lwe-myeloma ebuyileyo okanye ephikisayo.

Jonga iziyobisi ezivunyiweyo kwi-Multiple Myeloma kunye nezinye iiPlasma Cell Neoplasms ngolwazi oluthe kratya.

I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

Amanqanaba aphezulu e-chemotherapy anikezelwa ukubulala iiseli zomhlaza. Iiseli ezisempilweni, kubandakanya iiseli ezenza igazi, nazo ziyatshatyalaliswa lunyango lomhlaza. Ukufakelwa kweseli kwistem kunyango endaweni yeeseli ezenza igazi. Iiseli zesinti (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana (i-autologous) okanye umnikeli (allogeneic) kwaye ziyabanda zigcinwe. Emva kokuba isiguli sigqibe i-chemotherapy, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Ukufakelwa kweseli. (Inyathelo 1): Igazi lithathwa emthanjeni engalweni yomnikeli. Isigulana okanye omnye umntu angangumnikeli. Igazi lihamba ngomatshini osusa iiseli zeziqu. Emva koko igazi libuyiselwa kulowo unikeleyo ngomthambo okwenye ingalo. (Inyathelo 2): Isigulana sifumana ichemotherapy yokubulala iiseli ezenza igazi. Isigulana sinokufumana unyango ngemitha (engaboniswanga). (Inyathelo 3): Isigulana sifumana iiseli zeziqu ngokusebenzisa ipayinti ebekwe kwisitya segazi esifubeni.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

• Unyango lwe-Immunomodulator: I-Thalidomide, i-lenalidomide, kunye ne-pomalidomide zii-immunomodulators ezisetyenziselwa ukunyanga i-myeloma ezininzi kunye nezinye iiseli zeplasma.

• I-Interferon: Olu nyango luchaphazela ukwahlulwa kweeseli zomhlaza kwaye lunokucothisa ukukhula kwethumba.

• Unyango lwe-CAR T-cell: Olu nyango lutshintsha iiseli ze-T zesigulana (uhlobo lweseli yomzimba yokuzikhusela) ukuze zihlasele iiproteni ezithile kubuso beeseli zomhlaza. Iiseli ze-T zithathwa kwisigulana kwaye ii-receptors ezizodwa zongezwa kumphezulu wazo kwilabhoratri. Iiseli eziguqulweyo zibizwa ngokuba ziiseli ze-chimeric antigen receptor (CAR) T. Iiseli ze-CAR T zikhula elebhu kwaye zinikwa isigulana ngokufakwa. Iiseli ze-CAR T ziphindaphindeka kwigazi lesigulana kwaye zihlasela iiseli zomhlaza. Unyango lwe-CAR T-cell lufundwa kunyango lwe-myeloma ephindaphindileyo (ebuyayo).

Unyango lwe-CAR T-cell. Uhlobo lonyango apho iiseli ze-T zesigulana (uhlobo lweseli yomzimba yokuzikhusela) ziguqulwa kwilabhoratri ukuze zibophelele kwiiseli zomhlaza kwaye zibabulale. Igazi eliphuma emthanjeni engalweni yesigulana lihamba lingena kwityhubhu lisiya kumatshini weapheresis (ongaboniswanga), osusa iiseli ezimhlophe zegazi, kubandakanya neeseli zeT, kwaye uthumele lonke igazi libuyele kwisigulana. Emva koko, i-gene ye-receptor ekhethekileyo ebizwa ngokuba yi-chimeric antigen receptor (CAR) ifakwe kwiiseli ze-T elebhu. Izigidi zeeseli ze-CAR T zikhuliswa elebhu zize zinikwe isigulana ngokufakwa. Iiseli ze-CAR T ziyakwazi ukubopha kwi-antigen kwiiseli zomhlaza kwaye zibabulale.

Jonga iziyobisi ezivunyiweyo kwi-Multiple Myeloma kunye nezinye iiPlasma Cell Neoplasms ngolwazi oluthe kratya.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

Ugqirha

Utyando lokususa ithumba lunokwenziwa. Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa unyango ngemitha emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Ukulinda ulindile

Ukuhlala ulindile kubeka esweni imeko yesigulana ngaphandle kokunikezela ngonyango de kuvele iimpawu okanye utshintsho.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Umdibaniso omtsha wezonyango

Uvavanyo lwezonyango lufunda indibaniselwano eyahlukeneyo ye-immunotherapy, chemotherapy, unyango lwe-steroid, kunye neziyobisi. Iirejimeni zonyango ezintsha ezisebenzisa i-selinexor nazo ziyafundwa.

Unyango lwee-neoplasms zeseli ze-plasma kunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Inkathalelo yenkxaso inikwa ukunciphisa iingxaki ezibangelwa sesi sifo okanye unyango lwaso.

Olu nyango lulawula iingxaki okanye iziphumo ebezingalindelekanga ezibangelwa sesi sifo okanye unyango lwaso, kwaye luphucula umgangatho wobomi. Unonophelo oluxhasayo lunikwa ukunyanga iingxaki ezibangelwa zii-myeloma ezininzi kunye nezinye iiplasma zeseli zeplasma.

Inkxaso yenkxaso inokubandakanya oku kulandelayo:

• I-Plasmapheresis: Ukuba igazi liyajiba ngeeproteni ze-antibody kwaye luphazamise ukujikeleza, iplasmapheresis yenziwa ukususa iplasma eyongezelelweyo kunye neeproteni zomzimba ezichasene negazi. Kule nkqubo igazi liyasuswa kwisigulana lize lithunyelwe ngomatshini ohlukanisa iplasma (inxalenye engamanzi yegazi) kwiiseli zegazi. Iplasma yesigulana inezinto zokulwa ezingafunekiyo kwaye ayibuyiswanga kwisigulana. Iiseli zegazi eziqhelekileyo zibuyiselwa egazini kunye neplasma enikelweyo okanye into ebuyiselweyo. I-Plasmapheresis ayigcini ii-antibodies ezintsha ekubeni zenziwe.

• Unyango oluphezulu lwe-chemotherapy kunye nokufakwa kweseli: Ukuba i-amyloidosis iyenzeka, unyango lunokubandakanya i-chemotherapy yedosi ephezulu elandelwa kukufakelwa kweseli ye-stem usebenzisa iiseli zesigulana.

• Immunotherapy: I-Immunotherapy ene-thalidomide, i-lenalidomide, okanye i-pomalidomide inikwa ukunyanga i-amyloidosis.

• Unyango ekujoliswe kulo: Unyango olujolisiweyo kunye neproteasome inhibitors lunikezelwa ukunciphisa ubuninzi be-immunoglobulin M esegazini kwaye inyange i-amyloidosis. Unyango ekujoliswe kulo kunye ne-anti-monoclonal antibody inikwa ukunciphisa amathambo kunye nokunciphisa iintlungu zethambo.

• Unyango ngemitha: Unyango ngemitha lunikezelwa kwizilonda zethambo lomqolo.

• I-Chemotherapy: I-Chemotherapy inikwe ukunciphisa iintlungu zangasemva ezivela kwi-osteoporosis okanye ukunyanzeliswa kwethambo lomqolo.

• Unyango lwe-Bisphosphonate: Unyango lwe-Bisphosphonate lunikezelwa ukunciphisa ukuphulukana nethambo kunye nokunciphisa iintlungu zethambo. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya kwi-bisphosphonates kunye neengxaki ezinxulumene nokusetyenziswa kwazo:

• Umhlaza Ubuhlungu

• Iingxaki zomlomo zeChemotherapy kunye neNtloko / iNtsholongwane yeNtsholongwane

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Unyango lwe-Monoclonal Gammopathy yokuBaluleka okungamiselwanga

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-monoclonal gammopathy yokubaluleka okungagqitywanga (MGUS) kuhlala kulindile. Uvavanyo lwegazi rhoqo ukujonga inqanaba le-M protein egazini kunye novavanyo lomzimba ukujonga iimpawu okanye iimpawu zomhlaza ziya kwenziwa.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lwePlasmacytoma eyahlukileyo yeBone

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-plasmacytoma yethambo eliqhelileyo luhlala lunyango lwe-radiation kwi-lesion bone.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lwe-Extramedullary Plasmacytoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-extramedullary plasmacytoma inokubandakanya oku kulandelayo:

• Ukunyanga ngemitha kwi-tumor nakwi-lymph node ezikufutshane.

• Utyando, oludla ngokulandela unyango ngemitha.

• Ukulinda ulindile emva konyango lokuqala, kulandele unyango lwe-radiation, utyando, okanye unyango ngamayeza ukuba ithumba liyakhula okanye libangela iimpawu okanye iimpawu.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lwe-Multiple Myeloma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Izigulana ezingenazo iimpawu okanye iimpawu zisenokungafuneki unyango. Ezi zigulana zinokulinda zilinde de kuvele iimpawu okanye iimpawu.

Xa iimpawu okanye iimpawu zivela, zimbini iindidi zezigulana ezifumana unyango:

• Izigulana ezisencinci, ezifanelekileyo ezifanele ukufakelwa iseli yesiqu.

• Izigulana ezindala, ezingafanelekanga ezingakulungelanga ukufakelwa iselfowuni.

Izigulana ezingaphantsi kweminyaka engama-65 zihlala zithathwa njengezincinci kwaye zilungile. Izigulana ezindala kuneminyaka engama-75 zihlala zingakulungelanga ukufakelwa iselfowuni. Kwizigulana eziphakathi kweminyaka engama-65 nama-75 yeminyaka, ukomelela komzimba kumiselwe yimpilo yabo iyonke kunye nezinye izinto.

Unyango lwe-myeloma ezininzi zihlala zenziwa ngezigaba:

• Unyango lokungenisa: Eli linqanaba lokuqala lonyango. Injongo yalo kukunciphisa inani lezifo, kwaye linokubandakanya enye okanye ezingaphezulu kwezi zilandelayo:

• Kwizigulana ezincinci, ezifanelekileyo (ezifanelekileyo ukufakelwa):

• Unyango ngamayeza.

• Unyango ekujoliswe kulo kunye neproteasome inhibitor (bortezomib).

• Unyango lwe-Immunotherapy (lenalidomide).

• Unyango lweCorticosteroid.

• Kubadala, abaguli abangakulungelanga (abafanelekanga ukufakelwa):

• Unyango ngamayeza.

• Unyango ekujoliswe kulo ngeproteasome inhibitor (bortezomib okanye carfilzomib) okanye i-monoclonal antibody (daratumumab).

• Unyango lwe-Immunotherapy (lenalidomide).

• Unyango lweCorticosteroid.

• Ukudityaniswa kwekhemotherapy: Eli linqanaba lesibini lonyango. Unyango kwinqanaba lokudibanisa kukubulala nayiphi na iseli yomhlaza eseleyo. I-dose ephezulu ye-chemotherapy ilandelwa nokuba:

• ukufakelwa kweseli enye ye-autologous, apho iiseli zesigulana esisuka egazini okanye kumongo wethambo; okanye

• ukufakelwa iiseli ezimbini ze-autologous stem kulandelwa ukufakelwa kweseli yeseli ye-autologous okanye yeallogeneic, apho isigulana sifumana iiseli zeziqu egazini okanye kumongo wethambo womnikeli; okanye

• ukufakelwa kweseli enye ye-allogeneic.

• Ulondolozo lonyango: Emva konyango lokuqala, unyango lwesondlo luhlala lunikezelwa ukunceda ukugcina isifo sixolelwe ixesha elide. Iindlela ezininzi zonyango zifundelwa olu setyenziso, kubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Immunotherapy (interferon okanye lenalidomide).

• Unyango lweCorticosteroid.

• Unyango ekujoliswe kulo kunye neproteasome inhibitor (bortezomib okanye ixazomib).

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lwe-Myeloma ebuyayo okanye ephikisayo

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-myeloma ebuyileyo okanye ephikisayo inokubandakanya oku kulandelayo:

• Ukujonga ukulinda abaguli abanesifo esizinzileyo.

• Unyango olwahlukileyo kunonyango esele lunikiwe, kwizigulana ezine-tumor eqhubeka ikhula ngexesha lonyango. (Jonga iindlela ezininzi zonyango lweMyeloma.)

• Amachiza afanayo asetyenzisiweyo ngaphambi kokubuyela umva anokusetyenziswa ukuba ukubuyela kwakhona kwenzeka kunyaka omnye okanye nangaphezulu emva konyango lokuqala. (Jonga iindlela ezininzi zonyango lweMyeloma.)

Iziyobisi ezisetyenzisiweyo zinokubandakanya oku kulandelayo:

• Unyango olujolise kwi-antibodies ye-monoclonal (daratumumab okanye elotuzumab).

• Unyango ekujoliswe kulo kunye neproteasome inhibitors (bortezomib, carfilzomib, okanye ixazomib).

• Immunotherapy (pomalidomide, lenalidomide, okanye thalidomide).

• Unyango ngamayeza.

• Imbali yonyango lwe-deacetylase inhibitor yonyango nge-panobinostat.

• Unyango lweCorticosteroid.

• Uvavanyo lweklinikhi yonyango lwe-CAR T-cell.

• Uvavanyo lweklinikhi yonyango ekujolise kulo kunye ne-molecule encinci inhibitor (selinexor) kunye nonyango lwe-corticosteroid.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo nge-BCL2 inhibitor (venetoclax).

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukuze ufunde ngakumbi malunga nePlasma Cell Neoplasms

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-myeloma kunye nezinye iiplasma zeseli zeplasma, jonga oku kulandelayo:

• I-Myeloma ezininzi / enye iPlasma Cell Neoplasms Ikhasi lasekhaya

• Iziyobisi ezivunyiweyo kwi-Multiple Myeloma kunye nezinye iiPlasma Cell Neoplasms

• Iithagethi zoMhlaza ezijolise kuko

• Utyando lweSeli oluQulunqwe ngegazi

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli

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