Types/myeloproliferative/patient/chronic-treatment-pdq

Unyango lwe-Myeloproliferative Neoplasms enganyangekiyo (®) -Patient Version

Ulwazi ngokubanzi malunga ne-Myeloproliferative Neoplasms engapheliyo

IINGONGOMA EZIPHAMBILI

• I-Myeloproliferative neoplasms liqela lezifo apho umongo wethambo wenza iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets.

• Kukho iintlobo ezi-6 zeeplosms ezingapheliyo ze-myeloproliferative.

• Iimvavanyo ezivavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa isifo se-myeloproliferative neoplasms.

I-Myeloproliferative neoplasms liqela lezifo apho umongo wethambo wenza iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets.

Ngokwesiqhelo, umongo wethambo wenza iiseli zegazi (ezingafakwanga iiseli) eziba ziiseli zegazi ezivuthiweyo ngokuhamba kwexesha.

Umzimba wethambo. Ithambo lenziwe ngethambo elidibeneyo, ithambo lesiponji kunye nomongo wethambo. Ithambo elidityanisiweyo lenza umaleko wangaphandle wethambo. Ithambo lesiponji lifumaneka ikakhulu kwiziphelo zamathambo kwaye liqukethe umongo obomvu. Umongo wethambo ufumaneka embindini wamathambo kwaye unemithambo yegazi emininzi. Zimbini iintlobo zomongo wethambo: obomvu nomthubi. Umongo obomvu uqukethe iiseli zegazi ezinokuthi zibe ziiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets. Umongo omthubi wenziwe ikakhulu ngamafutha.

Iseli yegazi inokuba siseli se-myeloid okanye iseli ye-lymphoid stem. Iseli ye-lymphoid stem iyiseli yegazi emhlophe. Iseli yeseli ye-myeloid iba yenye yeentlobo 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 ayeke ukopha.

Ukuphuhliswa kweseli yegazi. Iseli yegazi ihamba ngamanqanaba aliqela ukuze ibe yiseli ebomvu yegazi, iplatelet, okanye iseli yegazi emhlophe.

Kwii-neoplasms ze-myeloproliferative, iiseli ezininzi zegazi ziba lunye okanye nangaphezulu iintlobo zeeseli zegazi. Iimpawu ezandayo zihlala zisiba kancinci njengoko inani leeseli zegazi landa.

Kukho iintlobo ezi-6 zeeplosms ezingapheliyo ze-myeloproliferative.

Uhlobo lwe-myeloproliferative neoplasm lusekwe ekubeni zininzi kakhulu iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets. Ngamanye amaxesha umzimba uya kwenza okuninzi kakhulu kunodidi olunye lweseli yegazi, kodwa kuhlala kukho uhlobo lweseli yegazi oluchaphazeleka ngakumbi kunolunye. Iimpawu ezingapheliyo ze-myeloproliferative zibandakanya ezi ntlobo zilandelayo:

• Leukemia enganyangekiyo engapheliyo.

• IPolycythemia vera.

• I-myelofibrosis yaseprayimari (ekwabizwa ngokuba yi-idiopathic myelofibrosis engapheliyo).

• I-thrombocythemia ebalulekileyo.

• I-leukemia engapheliyo ye-neutrophilic.

• I-leosemia engapheliyo ye-eosinophilic.

Ezi ntlobo zichazwe apha ngezantsi. Iimpawu ezingapheliyo ze-myeloproliferative ngamanye amaxesha ziba yi-leukemia ebukhali, apho kwenziwa khona iiseli ezimhlophe zegazi ezimhlophe ezininzi kakhulu.

Iimvavanyo ezivavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa isifo se-myeloproliferative neoplasms.

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.

• 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.

Gcwalisa ubalo lwegazi (CBC). Igazi liqokelelwa ngokufaka inaliti emthanjeni kwaye livumele igazi ukuba lingene kumbhobho. Isampulu yegazi ithunyelwa elebhu kwaye iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets kubalwa. I-CBC isetyenziselwa ukuvavanya, ukufumanisa isifo, kunye nokubeka iliso kwiimeko ezininzi ezahlukeneyo.

• I-peripheral blood smear: Inkqubo apho isampuli yegazi ihlolwe khona ngoku kulandelayo:

• Nokuba kukho iiseli ezibomvu zegazi ezimile okweenyembezi.

• Inani kunye neentlobo zeeseli ezimhlophe zegazi.

• Inani leeplatelets.

• Nokuba kukho iiseli zokudubula.

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

• 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.

• Uhlalutyo lwe-cytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yomongo wethambo okanye igazi zibalwa kwaye zijongwa kulo naluphi na utshintsho, njengokwaphuka, 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.

• Uvavanyo lokutshintsha komzimba: Uvavanyo lwelebhu olwenziwe kumongo wethambo okanye kwisampulu yegazi ukukhangela utshintsho kwiJAK2, MPL, okanye kwiical genes. I-JAK2 gene mutation ihlala ifunyanwa kwizigulana ezine-polycythemia vera, i-thrombocythemia ebalulekileyo, okanye i-myelofibrosis ephambili. I-MPL okanye i-CALR iinguqu zofuzo zifumaneka kwizigulana ezine-thrombocythemia ebalulekileyo okanye i-myelofibrosis ephambili.

Ileukemia enganyangekiyo engapheliyo

I-leukemia enganyangekiyo sisifo apho iiseli ezimhlophe ezininzi zegazi zenziwe kumongo wethambo. Jonga isishwankathelo se- kunyango lwe-Myelogenous Leukemia enganyangekiyo ngolwazi malunga nokuchongwa, ukubekwa kwinqanaba, kunye nonyango.

IPolycythemia Vera

IINGONGOMA EZIPHAMBILI

• I-Polycythemia vera sisifo apho iiseli ezibomvu zegazi zenziwa kakhulu kumongo wethambo.

• Iimpawu zepolycythemia vera zibandakanya iintloko kunye nemvakalelo yokugcwala ngaphantsi kweembambo kwicala lasekhohlo.

• Uvavanyo lwegazi olukhethekileyo lusetyenziselwa ukufumanisa i-polycythemia vera.

I-Polycythemia vera sisifo apho iiseli ezibomvu zegazi zenziwa kakhulu kumongo wethambo.

Kwi-polycythemia vera, igazi liyajiya ngeeseli ezibomvu ezininzi kakhulu. Inani leeseli ezimhlophe zegazi kunye neeplatelet zinokunyuka. Ezi seli zegazi zongezelelekileyo zinokuqokelela kudaka kwaye zibangele ukudumba. Inani elonyukayo leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets egazini zinokubangela iingxaki zokopha kwaye zenze amahlwili kwifom yegazi. Oku kunokunyusa umngcipheko wokubetha okanye ukuhlaselwa yintliziyo. Kwizigulana ezindala kuneminyaka engama-65 okanye ezinembali yamahlwili egazi, umngcipheko wokubetha okanye wokuhlaselwa sisifo sentliziyo uphezulu. Izigulana zikwanomngcipheko okhulayo we-myeloid leukemia okanye i-myelofibrosis ephambili.

Iimpawu zepolycythemia vera zibandakanya iintloko kunye nemvakalelo yokugcwala ngaphantsi kweembambo kwicala lasekhohlo.

I-Polycythemia vera kaninzi ayibangeli zimpawu zokuqala okanye iimpawu. Inokufumaneka ngexesha lovavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokwenzeka xa inani leeseli zegazi landa. Ezinye iimeko zinokubangela iimpawu kunye neempawu ezifanayo. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Imvakalelo yoxinzelelo okanye ukugcwala ngaphantsi kweembambo kwicala lasekhohlo.

• Intloko ebuhlungu.

• Umbono ophindwe kabini okanye ukubona iindawo ezimnyama okanye ezingaboniyo eziza zihambe.

• Ukurhawuzelela umzimba wonke, ngakumbi emva kokuba ukufudumele okanye amanzi ashushu.

• Ubuso obubomvu obubonakala ngathi bubomvu okanye ukutshiswa lilanga.

• Ubuthathaka.

• Ukuba nesiyezi.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Uvavanyo lwegazi olukhethekileyo lusetyenziselwa ukufumanisa i-polycythemia vera.

Ukongeza kubalo olupheleleyo lwegazi, umnqweno wethambo kunye ne-biopsy, kunye nohlalutyo lwe-cytogenetic, uvavanyo lwe-serum erythropoietin lusetyenziselwa ukufumanisa i-polycythemia vera. Kolu vavanyo, isampulu yegazi ihlolwe inqanaba le-erythropoietin (ihomoni evuselela iiseli ezibomvu zegazi). Kwi-polycythemia vera, inqanaba le-erythropoietin liya kuba sezantsi kunesiqhelo kuba umzimba awudingi ukwenza iiseli ezibomvu zegazi.

I-Myelofibrosis yaseprayimari

IINGONGOMA EZIPHAMBILI

• I-myelofibrosis yaseprayimari sisifo apho iiseli zegazi ezingaqhelekanga kunye nefayibha zakha ngaphakathi komongo wethambo.

• Iimpawu ze-myelofibrosis ephambili zibandakanya iintlungu ezantsi kweembambo kwicala lasekhohlo kunye nokuziva udiniwe kakhulu.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho kunyango lwe-myelofibrosis ephambili.

I-myelofibrosis yaseprayimari sisifo apho iiseli zegazi ezingaqhelekanga kunye nefayibha zakha ngaphakathi komongo wethambo.

Umongo wethambo wenziwe ngamathishu enza iiseli zegazi (iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets) kunye newebhu yemicu exhasa izicwili ezenza igazi. Kwiprayimari ye-myelofibrosis (ekwabizwa ngokuba yi-myelofibrosis engapheliyo), inani elikhulu leeseli zegazi ziba ziiseli zegazi ezingakhuli kakuhle (kuqhuma). Iwebhu yeentsinga ngaphakathi komongo wethambo nayo iyaqina kakhulu (njengezicwili ezibomvu) kwaye icothise amandla okwenza izicwili zegazi ukwenza iiseli zegazi. Oku kubangela ukuba izicwili ezenza igazi zenze iiseli zegazi ezimbalwa kunye nezimbalwa. Ukwenza inani eliphantsi leeseli ezenziwe kumongo wethambo, isibindi kunye ne-spleen ziqala ukwenza iiseli zegazi.

Iimpawu ze-myelofibrosis ephambili zibandakanya iintlungu ezantsi kweembambo kwicala lasekhohlo kunye nokuziva udiniwe kakhulu.

I-myelofibrosis yaseprayimari kaninzi ayibangeli zimpawu zokuqala okanye iimpawu. Inokufumaneka ngexesha lovavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokubangelwa yi-myelofibrosis ephambili okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukuziva iintlungu okanye ukugcwala ngaphantsi kweembambo kwicala lasekhohlo.

• Ukuziva ugcwele msinyane kunesiqhelo xa usitya.

• Ndiziva ndidiniwe.

• Ukuqhawukelwa ngumphefumlo.

• Ukutyumza okulula okanye ukopha.

• I-Petechiae (icwecwe, ibomvu, ikhomba amabala phantsi kolusu okubangelwa kukopha).

• Ifiva.

• Ukumanzisa ukubila ebusuku.

• Ukuhla ukusinda.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho kunyango lwe-myelofibrosis ephambili.

Ukuxela kwangaphambili kuxhomekeke koku kulandelayo:

• Ubudala besigulana.

• Inani leeseli ezibomvu ezingaqhelekanga kunye neeseli ezimhlophe zegazi.

• Inani lokuqhuma egazini.

• Nokuba kukho utshintsho oluthile kwii-chromosomes.

• Nokuba isigulana sineempawu ezinje ngomkhuhlane, ukubila ebusuku, okanye ukunciphisa umzimba.

I-Thrombocythemia ebalulekileyo

IINGONGOMA EZIPHAMBILI

• I-thrombocythemia ebalulekileyo sisifo apho iiplatelets ezininzi zenziwe kumongo wethambo.

• Izigulana ezine-thrombocythemia ebalulekileyo ayinakuba nazimpawu okanye zimpawu.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokuchacha) kunye nokhetho kunyango lwe-thrombocythemia ebalulekileyo.

I-thrombocythemia ebalulekileyo sisifo apho iiplatelets ezininzi zenziwe kumongo wethambo.

I-thrombocythemia ebalulekileyo ibangela ukonyuka okungaqhelekanga kwinani leeplatelets ezenziwe kwigazi kunye nomongo wethambo.

Izigulana ezine-thrombocythemia ebalulekileyo ayinakuba nazimpawu okanye zimpawu.

I-thrombocythemia ebalulekileyo ihlala ingabangeli zimpawu okanye iimpawu zokuqala. Inokufumaneka ngexesha lovavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokubangelwa yi-thrombocytopenia ebalulekileyo okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Intloko ebuhlungu.

• Ukutshisa okanye ukubetha ezandleni okanye ezinyaweni.

• Ubomvu kunye nobushushu bezandla okanye iinyawo.

• Umbono okanye iingxaki zokuva.

Iiplatelets zincangathi. Xa zininzi kakhulu iiplatelets, zinokudibana zenze nzima ukuba igazi liphume. Amahlwili angenza kwimithambo yegazi kwaye kusenokonyuka nokopha. Oku kunokubangela iingxaki zempilo ezinje ngestrowuku okanye isifo sentliziyo.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokuchacha) kunye nokhetho kunyango lwe-thrombocythemia ebalulekileyo.

Ukuqikelela kunye nokukhetha unyango kuxhomekeke koku kulandelayo:

• Ubudala besigulana.

• Nokuba isigulana sineempawu okanye iimpawu okanye ezinye iingxaki ezinxulumene ne-thrombocythemia ebalulekileyo.

Isifo seleukemia esinganyangekiyo se-Neutrophilic

I-leukemia engapheliyo sisifo apho iiseli ezininzi zegazi ziba luhlobo lweeseli ezimhlophe ezibizwa ngokuba zii-neutrophils. I-Neutrophils sisifo esilwa neeseli zegazi ezijikeleze kwaye zitshabalalise iiseli ezifileyo kunye nezinto zangaphandle (ezinjengebhaktheriya). I-spleen kunye nesibindi kunokuvuvukala ngenxa yee-neutrophils ezongezelelweyo. I-leukemia engapheliyo ye-neutrophilic inokuhlala injalo okanye iqhubeke ngokukhawuleza iye kwi-leukemia ebukhali.

I-Eosinophilic Leukemia engapheliyo

IINGONGOMA EZIPHAMBILI

• I-eosinophilic leukemia engapheliyo sisifo apho iiseli ezimhlophe zegazi ezininzi (ii-eosinophils) zenziwe kumongo wethambo.

• Iimpawu kunye neempawu ze-leosemia engapheliyo ye-eosinophilic zibandakanya umkhuhlane kunye nokuziva udiniwe kakhulu.

I-eosinophilic leukemia engapheliyo sisifo apho iiseli ezimhlophe zegazi ezininzi (ii-eosinophils) zenziwe kumongo wethambo.

I-Eosinophil ziiseli ezimhlophe zegazi ezisabela kwizigulo (izinto ezibangela impendulo eyaliwa) kunye nokunceda ukulwa izifo ezenziwa zii-parasites ezithile. Kwi-leosemia engapheliyo ye-eosinophilic, zininzi kakhulu ii-eosinophil egazini, umongo wethambo, kunye nezinye izicwili. I-leosemia engapheliyo ye-eosinophilic inokuhlala injalo kangangeminyaka emininzi okanye inokuthi iqhubeke ngokukhawuleza iye kwi-leukemia ebukhali.

Iimpawu kunye neempawu ze-leosemia engapheliyo ye-eosinophilic zibandakanya umkhuhlane kunye nokuziva udiniwe kakhulu.

Isifo se-eosinophilic leukemia esingapheliyo sinokubangela iimpawu okanye iimpawu zokuqala. Inokufumaneka ngexesha lovavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokubangelwa yi-eosinophilic leukemia okanye ezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ifiva.

• Ndiziva ndidiniwe.

• Khohlela.

• Ukudumba phantsi kolusu olujikeleze amehlo nemilebe, emqaleni, okanye ezandleni nasezinyaweni.

• Intlungu yezihlunu.

• Ukurhawuzelela.

• Urhudo.

Amanqanaba ee-Myeloproliferative Neoplasms ezingapheliyo

IINGONGOMA EZIPHAMBILI

• Akukho nkqubo yokubeka emgangathweni yeempawu ezingapheliyo ze-myeloproliferative neoplasms.

Akukho nkqubo yokubeka emgangathweni yeempawu ezingapheliyo ze-myeloproliferative neoplasms.

Inqanaba yinkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazeke kangakanani. Akukho nkqubo yokubeka emgangathweni yeempawu ezingapheliyo ze-myeloproliferative neoplasms. Unyango lusekwe kuhlobo lwe-myeloproliferative neoplasm enesigulana. Kubalulekile ukwazi uhlobo ukuze ucwangcise unyango.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinee -oplasms ezingapheliyo ze-myeloproliferative.

• Iindidi ezilishumi elinanye zonyango olusetyenziswayo:

• Ukulinda ulindile

• Phlebotomy

• Iplatelet apheresis

• Unyango lotofelo-gazi

• Unyango ngamayeza

• Unyango ngemitha

• Olunye unyango lweziyobisi

• Ugqirha

• Unyango lwebhayoloji

• Unyango ekujoliswe kulo

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-myeloproliferative neoplasms engapheliyo inokubangela iziphumo ebezingalindelekanga.

• 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 ezinee -oplasms ezingapheliyo ze-myeloproliferative.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-neelphroliferative neoplasms ezingapheliyo. 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. 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 ezilishumi elinanye zonyango olusetyenziswayo:

Ukulinda ulindile

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

Phlebotomy

I-Phlebotomy yinkqubo apho igazi lithathwa khona emthanjeni. Isampulu yegazi ingathathwa kuvavanyo olunjengeCBC okanye ikhemistri yegazi. Ngamanye amaxesha iphlebotomy isetyenziswa njengonyango kwaye igazi lithathwa emzimbeni ukususa iiseli ezibomvu zegazi. I-Phlebotomy isetyenziswa ngale ndlela ukunyanga ezinye ze-myeloproliferative neoplasms ezingapheliyo.

Iplatelet apheresis

Iplatelet apheresis lunyango olusebenzisa umatshini okhethekileyo ukususa iiplatelets egazini. Igazi lithathwa kwisigulana kwaye lifakwe kwisahluli seseli yegazi apho kususwa khona iiplatelets. Elinye igazi lize libuyiselwe kwigazi lomguli.

Unyango lotofelo-gazi

Unyango lotofelo-gazi (utofelo-gazi) yindlela yokunika iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets ukubuyisela iiseli zegazi ezonakaliswe sisifo okanye unyango lomhlaza.

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). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Jonga iziyobisi ezivunyiweyo zeMyeloproliferative 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.

Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga ii-neoplasms ezingapheliyo ze-myeloproliferative, kwaye zihlala zijolise kudakada.

Olunye unyango lweziyobisi

I-Prednisone kunye ne-danazol ngamachiza anokusetyenziselwa ukunyanga i-anemia kwizigulana ezine-myelofibrosis ephambili.

Unyango lwe-Anagrelide lusetyenziselwa ukunciphisa umngcipheko wamahlwili egazi kwizigulana ezineeplatelets ezininzi egazini lazo. I-aspirin yedosi ephantsi inokusetyenziselwa ukunciphisa umngcipheko wamahlwili egazi.

I-Thalidomide, i-lenalidomide, kunye ne-pomalidomide ngamachiza athintela imithambo yegazi ukuba ingakhuli kwiindawo zeeseli zethumba.

Jonga iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms ngolwazi oluthe kratya.

Ugqirha

I-Splenectomy (utyando lokususa ipeni) inokwenziwa ukuba udakada luyandisiwe.

Unyango lwebhayoloji

Unyango lwe-Biologic lunyango olusebenzisa amajoni omzimba wesigulana ukulwa nomhlaza okanye ezinye izifo. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo kwizifo. Olu hlobo lonyango lukwabizwa ngokuba yi-biotherapy okanye i-immunotherapy. I-interferon alfa kunye ne-peferlated interferon alpha zii-biologic agents ezisetyenziselwa ukunyanga ezinye ze-myeloproliferative neoplasms ezingapheliyo.

Ukukhula kwe-Erythropoietic kukwangumsebenzi we-biologic agents. Zisetyenziselwa ukukhuthaza umongo wethambo ukwenza iiseli ezibomvu zegazi.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. I-Tyrosine kinase inhibitors ijolise kunyango lweziyobisi ezithintela imiqondiso efunekayo ekukhuleni kwamathumba.

I-Ruxolitinib yi-tyrosine kinase inhibitor esetyenziselwa ukunyanga i-polycythemia vera kunye neentlobo ezithile ze-myelofibrosis.

Jonga iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms ngolwazi oluthe kratya.

Ezinye iintlobo zonyango ekujoliswe kuzo ziyafundwa kuvavanyo lweklinikhi.

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 zeziqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana okanye somnikeli kwaye zibandisiwe kwaye 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.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-myeloproliferative neoplasms engapheliyo inokubangela iziphumo ebezingalindelekanga.

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

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 lweeMiphunga zeMyeloproliferative ezingapheliyo

Kweli Candelo

• Ileukemia enganyangekiyo engapheliyo

• IPolycythemia Vera

• I-Myelofibrosis yaseprayimari

• I-Thrombocythemia ebalulekileyo

• Isifo seleukemia esinganyangekiyo se-Neutrophilic

• I-Eosinophilic Leukemia engapheliyo

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

Ileukemia enganyangekiyo engapheliyo

Jonga isishwankathelo se- malunga nonyango lwe-Leukemia enganyangekiyo engapheliyo.

IPolycythemia Vera

Injongo yonyango lwe-polycythemia vera kukunciphisa inani leeseli zegazi ezongezelelweyo. Unyango lwe-polycythemia vera inokubandakanya oku kulandelayo:

• Phlebotomy.

• I-Chemotherapy kunye okanye ngaphandle kwe-phlebotomy. Ukuba ichemotherapy ayisebenzi, unyango ekujoliswe kulo (i-ruxolitinib) lunokunikwa.

• Unyango lwe-Biologic usebenzisa i-interferon alfa okanye i-peferlated interferon alpha.

• I-aspirin yedosi ephantsi.

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.

I-Myelofibrosis yaseprayimari

Unyango lwe-myelofibrosis ephambili kwizigulana ngaphandle kweempawu okanye iimpawu zihlala zilindile.

Izigulana ezine-myelofibrosis zaseprayimari zinokuba neempawu okanye iimpawu ze-anemia. I-anemia ihlala inyangwa ngokufakwa iiseli ezibomvu zegazi ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi. Ukongeza, i-anemia inokunyangwa nge:

• Ukukhula kwe-Erythropoietic.

• IPrednisone.

• IDanazol.

• I-Thalidomide, i-lenalidomide, okanye i-pomalidomide, kunye okanye ngaphandle kwe-prednisone.

Unyango lwe-myelofibrosis ephambili kwizigulana ezineempawu okanye iimpawu zinokubandakanya oku kulandelayo:

• Unyango olujolise kwi-ruxolitinib.

• Unyango ngamayeza.

• Ukufakelwa kweseli yesiqu.

• Thalidomide, lenalidomide, okanye pomalidomide.

• Splenectomy.

• Unyango lwe-radiation kwipeni, i-lymph node, okanye ezinye iindawo ezingaphandle komongo wethambo apho iiseli zegazi zakha khona.

• Unyango lwe-Biologic usebenzisa i-interferon alfa okanye ukukhula kwe-erythropoietic.

• Uvavanyo lweklinikhi lwamanye amayeza onyango ekujolise kuwo.

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.

I-Thrombocythemia ebalulekileyo

Unyango lwe-thrombocythemia ebalulekileyo kwizigulana ezingaphantsi kweminyaka engama-60 ezingenazo iimpawu kunye neempawu ezamkelekileyo zeplatelet zihlala zilindile. Unyango lwezinye izigulana lunokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Unyango lwe-Anagrelide.

• Unyango lwe-Biologic usebenzisa i-interferon alfa okanye i-peferlated interferon alpha.

• Iplatelet apheresis.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

Isifo seleukemia esinganyangekiyo se-Neutrophilic

Unyango lwe-neutrophilic leukemia lungabandakanya oku kulandelayo:

• Ukufakelwa komongo wethambo.

• Unyango ngamayeza.

• Unyango lwe-Biologic usebenzisa i-interferon alfa.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

I-Eosinophilic Leukemia engapheliyo

Unyango lwe-eosinophilic leukemia inokubandakanya oku kulandelayo:

• Ukutsalwa komongo wethambo.

• Unyango lwe-Biologic usebenzisa i-interferon alfa.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

Ukufunda ngakumbi malunga ne-Myeloproliferative Neoplasms ezingapheliyo

Ngolwazi oluthe kratya kwiZiko leSizwe leCancer malunga ne-myeloproliferative neoplasms, bona oku kulandelayo:

• Iphepha lasekhaya leMyeloproliferative Neoplasms

• Iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

• Utyando lweSeli oluQulunqwe ngegazi

• Iithagethi zoMhlaza ezijolise kuko

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