Types/myeloproliferative/patient/mds-mpd-treatment-pdq

Unyango lwe-Myelodysplastic / Myeloproliferative Neoplasms (®) -Patient Version

Ulwazi ngokubanzi malunga neMyelodysplastic / Myeloproliferative Neoplasms

IINGONGOMA EZIPHAMBILI

• I-Myelodysplastic / myeloproliferative neoplasms liqela lezifo apho umongo wethambo wenza iiseli ezimhlophe zegazi ezininzi.

• I-Myelodysplastic / i-myeloproliferative neoplasms ineempawu zombini ze-myelodysplastic syndromes kunye ne-myeloproliferative neoplasms.

• Kukho iintlobo ezahlukeneyo ze-myelodysplastic / myeloproliferative neoplasms.

• Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa isifo se-myelodysplastic / myeloproliferative neoplasms.

I-Myelodysplastic / myeloproliferative neoplasms liqela lezifo apho umongo wethambo wenza iiseli ezimhlophe zegazi ezininzi.

I-Myelodysplastic / i-myeloproliferative neoplasms zizifo zegazi kunye nomongo wethambo.

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.

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

I-Myelodysplastic / i-myeloproliferative neoplasms ineempawu zombini ze-myelodysplastic syndromes kunye ne-myeloproliferative neoplasms.

Kwizifo ze-myelodysplastic, iiseli zeziqu zegazi azikhuli zibe ziiseli ezibomvu ezisempilweni, iiseli ezimhlophe zegazi, okanye iiplatelets. Iiseli zegazi ezingakhulanga, ezibizwa ngokuba zii-blast, azisebenzi ngendlela ebekufanele ukuba zife ngayo kwaye ziyafa kumongo wethambo okanye kungekudala emva kokuba zingene egazini. Ngenxa yoko, zimbalwa iiseli ezibomvu ezisempilweni, iiseli ezimhlophe zegazi kunye neeplatelets.

Kwizifo ze-myeloproliferative, inani elikhulu kuneliqhelekileyo leeseli zegazi ziye zibe lunye okanye nangaphezulu iintlobo zeeseli zegazi kwaye inani elipheleleyo leeseli zegazi lonyuka kancinci.

Esi sishwankathelo malunga ne-neoplasms eneempawu zezifo zombini ze-myelodysplastic kunye ne-myeloproliferative. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga nezifo ezinxulumene noko:

• Unyango lwe-Myelodysplastic Syndromes

• Unyango olungapheliyo lwe-Myeloproliferative Neoplasms

• Unyango lwe-Myelogenous Leukemia enganyangekiyo

Kukho iintlobo ezahlukeneyo ze-myelodysplastic / myeloproliferative neoplasms.

Iintlobo ezintathu eziphambili ze-myelodysplastic / myeloproliferative neoplasms zibandakanya oku kulandelayo:

• I-leukemia engapheliyo ye-myelomonocytic (CMML).

• Ulutsha lwe-myelomonocytic leukemia (JMML).

• I-atypical chronic myelogenous leukemia (CML).

Xa i-myelodysplastic / myeloproliferative neoplasm ingahambelani nayo nayiphi na kwezi ntlobo, ibizwa ngokuba yi-myelodysplastic / myeloproliferative neoplasm, engenakulungiseka (MDS / MPN-UC).

I-Myelodysplastic / myeloproliferative neoplasms inokuqhubela phambili kwi-leukemia ebukhali.

Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa isifo se-myelodysplastic / myeloproliferative neoplasms.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga imiqondiso yezifo ezinje ngepeni eyandisiweyo kunye nesibindi. 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 eyenziwe ngeeseli 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 ukuqhuma kweeseli, inani kunye neentlobo zeeseli ezimhlophe zegazi, inani leeplatelets, kunye nokutshintsha kwimo yeeseli zegazi.

• 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 wethambo kunye ne-biopsy: Ukususwa kwesiqwenga esincinci sethambo kunye nomongo wethambo ngokufaka inaliti kwisifuba okanye ithambo lesifuba. Ugqirha wezifo ujonga zombini iisampulu zomongo wethambo 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 esusiweyo:

• 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. Amaseli omhlaza kwi-myelodysplastic / myeloproliferative neoplasms ayinayo i-chromosome yaseFiladelphia ekhoyo kwi-leukemia engapheliyo.

• I-Immunocytochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yomongo wethambo lesigulana. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen kwisampulu yomongo wethambo lesigulana, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukufumanisa isifo somhlaza kunye nokuchaza umahluko phakathi kwe-myelodysplastic / myeloproliferative neoplasms, leukemia, kunye nezinye iimeko.

Isifo seeleukemia esinganyangekiyo seMyelomonocytic

IINGONGOMA EZIPHAMBILI

• Isifo segazi esingapheliyo se-myelomonocytic leukemia sisifo apho i-myelocytes ezininzi kunye ne-monocytes (iiseli ezimhlophe zegazi ezimhlophe) zenziwe kumongo wethambo.

• Ukwaluphala kunye nokuba yindoda kwandisa umngcipheko we-leukemia engapheliyo ye-myelomonocytic.

• Iimpawu kunye neempawu ze-myelomonocytic leukemia engapheliyo zibandakanya umkhuhlane, ukwehla kobunzima, kunye nokuziva udiniwe kakhulu.

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

Isifo segazi esingapheliyo se-myelomonocytic leukemia sisifo apho i-myelocytes ezininzi kunye ne-monocytes (iiseli ezimhlophe zegazi ezimhlophe) zenziwe kumongo wethambo.

Kwi-myelomonocytic leukemia (CMML) engapheliyo, umzimba uxelela iiseli ezininzi zegazi ukuba zibe ziindidi ezimbini zeeseli ezimhlophe ezibizwa ngokuba zii-myelocytes kunye ne-monocytes. Ezinye zezi seli zegazi azikaze zibe ziiseli ezimhlophe zegazi. Ezi seli zegazi zimhlophe zingakhulanga zibizwa ngokuba zii-blast. Ixesha elingaphezulu, ii-myelocyte, i-monocytes, kunye noqhushumbo baxinanisa iiseli ezibomvu zegazi kunye neeplatelet kumongo wethambo. Xa oku kusenzeka, usulelo, i-anemia, okanye ukopha ngokulula kunokwenzeka.

Ukwaluphala kunye nokuba yindoda kwandisa umngcipheko we-leukemia engapheliyo ye-myelomonocytic.

Nantoni na eyandisa amathuba akho okufumana isifo ibizwa ngokuba yingozi. Izinto ezinokubangela umngcipheko kwi-CMML zibandakanya oku kulandelayo:

• Ukwaluphala.
• Ukuba yindoda.
• Ukuvezwa kwezinto ezithile emsebenzini okanye kwindalo esingqongileyo.
• Ukuvezwa kwimitha.
• Unyango oludlulileyo kunye neziyobisi ezithile.

Iimpawu kunye neempawu ze-myelomonocytic leukemia engapheliyo zibandakanya umkhuhlane, ukwehla kobunzima, kunye nokuziva udiniwe kakhulu.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yi-CMML okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Umkhuhlane ngaphandle kwesizathu esaziwayo.
• Usulelo.
• Ndiziva ndidiniwe.
• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.
• Ukutyumza okulula okanye ukopha.
• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo.

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

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho kunyango lwe-CMML luxhomekeke koku kulandelayo:

• Inani leeseli ezimhlophe zegazi okanye iiplatelets egazini okanye kumongo wethambo.

• Nokuba isigulana sinesifo segazi.

• Isixa sokuqhuma egazini okanye kumongo wethambo.

• Isixa sehemoglobin kwiiseli ezibomvu zegazi.

• Nokuba kukho utshintsho oluthile kwii-chromosomes.

Ulutsha lweMyelomonocytic Leukemia

IINGONGOMA EZIPHAMBILI

• I-juvenile myelomonocytic leukemia sisifo sobuntwana apho ii-myelocyte ezininzi kunye ne-monocytes (iiseli ezimhlophe zegazi ezimhlophe) ezenziwe kumongo wethambo.

• Iimpawu kunye neempawu zentsha ye-myelomonocytic leukemia zibandakanya umkhuhlane, ukunciphisa umzimba kunye nokuziva udinwe kakhulu.

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

I-juvenile myelomonocytic leukemia sisifo sobuntwana apho ii-myelocyte ezininzi kunye ne-monocytes (iiseli ezimhlophe zegazi ezimhlophe) ezenziwe kumongo wethambo.

I-juvenile myelomonocytic leukemia (JMML) ngumhlaza onqabileyo wobuntwana owenzeka rhoqo kubantwana abangaphantsi kweminyaka emi-2. Abantwana abane-neurofibromatosis yohlobo loku-1 kunye nabesilisa banomngcipheko okhulayo we-leukemia yolutsha.

Kwi-JMML, umzimba uxelela iiseli ezininzi zegazi ukuba zibe ziindidi ezimbini zeeseli ezimhlophe ezibizwa ngokuba zii-myelocytes kunye ne-monocytes. Ezinye zezi seli zegazi azikaze zibe ziiseli ezimhlophe zegazi. Ezi seli zegazi zimhlophe zingakhulanga zibizwa ngokuba zii-blast. Ixesha elingaphezulu, ii-myelocyte, i-monocytes, kunye noqhushumbo baxinanisa iiseli ezibomvu zegazi kunye neeplatelet kumongo wethambo. Xa oku kusenzeka, usulelo, i-anemia, okanye ukopha ngokulula kunokwenzeka.

Iimpawu kunye neempawu zentsha ye-myelomonocytic leukemia zibandakanya umkhuhlane, ukunciphisa umzimba kunye nokuziva udinwe kakhulu.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa yiJMML okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Ukuba nosulelo, njenge-bronchitis okanye i-tonsillitis.

• Ndiziva ndidiniwe.

• Ukutyumza okulula okanye ukopha.

• Ukudumba kolusu.

• Ukudumba okungenasiphelo kwee-lymph node entanyeni, phantsi kwekhwapha, esiswini, okanye emhlubulweni.

• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo.

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

Ukuxela kwangaphambili (ithuba lokuphinda ubuye) kunye nokhetho lweJMML luxhomekeke koku kulandelayo:

• Iminyaka yomntwana ekuchongeni isifo.

• Inani leeplatelets egazini.

• Ubungakanani bohlobo oluthile lwehemoglobin kwiiseli ezibomvu zegazi.

I-Atypical Chronic Meelogenous Leukemia

IINGONGOMA EZIPHAMBILI

• I-atypical chronic myelogenous leukemia sisifo apho ii-granulocytes ezininzi kakhulu (iiseli ezimhlophe zegazi ezingafakwanga) zenziwe kumongo wethambo.

• Iimpawu kunye neempawu ze-atypical chronic myelogenous leukemia zibandakanya ukulunywa ngokulula okanye ukopha kunye nokuziva udiniwe kwaye ubuthathaka.

• Izinto ezithile zichaphazela isifo (ithuba lokuchacha kwakhona).

I-atypical chronic myelogenous leukemia sisifo apho ii-granulocytes ezininzi kakhulu (iiseli ezimhlophe zegazi ezingafakwanga) zenziwe kumongo wethambo.

Kwi-atypical chronic myelogenous leukemia (CML), umzimba uxelela iiseli ezininzi zegazi ukuba zibe luhlobo lweeseli ezimhlophe ezibizwa ngokuba zii-granulocytes. Ezinye zezi seli zegazi azikaze zibe ziiseli ezimhlophe zegazi. Ezi seli zegazi zimhlophe zingakhulanga zibizwa ngokuba zii-blast. Ixesha elingaphezulu, ii-granulocytes kunye nokuqhushumba kugxotha iiseli ezibomvu zegazi kunye neeplatelet kumongo wethambo.

Iiseli ze-leukemia kwi-CML ye-atypical kunye ne-CML ijongeka ngokufanayo phantsi kwemicroscope. Nangona kunjalo, kwi-atypical CML utshintsho oluthile lwe-chromosome, olubizwa ngokuba yi "Philadelphia chromosome" alukho.

Iimpawu kunye neempawu ze-atypical chronic myelogenous leukemia zibandakanya ukulunywa ngokulula okanye ukopha kunye nokuziva udiniwe kwaye ubuthathaka.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yi-atypical CML okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukuqhawukelwa ngumphefumlo.

• Ulusu oluthuthu.

• Ndiziva ndidiniwe kwaye ndibuthathaka.

• Ukutyumza okulula okanye ukopha.

• I-Petechiae (tyaba, khomba amabala phantsi kolusu okubangelwa kukopha).

• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo kwicala lasekhohlo.

Izinto ezithile zichaphazela isifo (ithuba lokuchacha kwakhona).

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kwi-CML ye-atypical kuxhomekeke kwinani leeseli ezibomvu zegazi kunye neeplatelets egazini.

I-Myelodysplastic / iMyeloproliferative Neoplasm, engenakuchazeka

IINGONGOMA EZIPHAMBILI

• I-Myelodysplastic / myeloproliferative neoplasm, engenakuchazwa, sisifo esinezinto zombini ze-myelodysplastic kunye nezifo ze-myeloproliferative kodwa ayisosifo se-myelomonocytic leukemia, ulutsha lwe-myelomonocytic leukemia, okanye i-leypemia enganyangekiyo ye-myelogenous leukemia.

• Iimpawu kunye neempawu ze-myelodysplastic / myeloproliferative neoplasm, engenakuchazeka, ibandakanya umkhuhlane, ukunciphisa umzimba, kunye nokuziva udiniwe kakhulu.

I-Myelodysplastic / myeloproliferative neoplasm, engenakuchazwa, sisifo esinezinto zombini ze-myelodysplastic kunye nezifo ze-myeloproliferative kodwa ayisosifo se-myelomonocytic leukemia, ulutsha lwe-myelomonocytic leukemia, okanye i-leypemia enganyangekiyo ye-myelogenous leukemia.

Kwi-myelodysplastic / myeloproliferative neoplasm, engenakuchazeka (MDS / MPD-UC), umzimba uxelela iiseli ezininzi zegazi ukuba zibe ziiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets. Ezinye zezi seli zegazi azikaze zibe ziiseli zegazi ezivuthiweyo. Ezi seli zegazi zingakhulanga zibizwa ngokuba zii-blast. Ixesha elingaphezulu, iiseli zegazi ezingaqhelekanga kunye nokuqhushumba kumongo wethambo kugxotha iiseli ezibomvu ezisempilweni, iiseli ezimhlophe zegazi kunye neeplatelets.

I-MDS / MPN-UC sisifo esinqabileyo. Ngenxa yokuba kunqabile, izinto ezichaphazela umngcipheko kunye nokuxelwa kwangaphambili azaziwa.

Iimpawu kunye neempawu ze-myelodysplastic / myeloproliferative neoplasm, engenakuchazeka, ibandakanya umkhuhlane, ukunciphisa umzimba, kunye nokuziva udiniwe kakhulu.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yi-MDS / MPN-UC okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Umkhuhlane okanye usulelo oluqhelekileyo.

• Ukuqhawukelwa ngumphefumlo.

• Ndiziva ndidiniwe kwaye ndibuthathaka.

• Ulusu oluthuthu.

• Ukutyumza okulula okanye ukopha.

• I-Petechiae (tyaba, khomba amabala phantsi kolusu okubangelwa kukopha).

• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo.

Amanqanaba eMyelodysplastic / iMyeloproliferative Neoplasms

IINGONGOMA EZIPHAMBILI

• Akukho nkqubo yokubeka emgangathweni ye-myelodysplastic / myeloproliferative neoplasms.

Akukho nkqubo yokubeka emgangathweni ye-myelodysplastic / myeloproliferative neoplasms.

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

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-myelodysplastic / myeloproliferative neoplasms.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Unyango ngamayeza

• Olunye unyango lweziyobisi

• Ukufakelwa kweseli

• Inkxaso yenkxaso

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-myelodysplastic / myeloproliferative neoplasms lunokubangela 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 ezine-myelodysplastic / myeloproliferative neoplasms.

Iindlela ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-myelodysplastic / myeloproliferative 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 ezintlanu zonyango olusetyenziswayo 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). 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. Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza.

Jonga iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms ngolwazi oluthe kratya.

Olunye unyango lweziyobisi

I-13-cis retinoic acid sisiyobisi esifana ne-vithamini esinciphisa amandla omhlaza okwenza iiseli zomhlaza ngakumbi kwaye sitshintshe indlela ezi jonga ngayo kunye nokwenza kwazo.

Ukufakelwa kweseli

I-Chemotherapy inikezelwa ukubulala iiseli ezingaqhelekanga okanye 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.

Inkxaso yenkxaso

Inkathalelo yenkxaso inikwa ukunciphisa iingxaki ezibangelwa sesi sifo okanye unyango lwaso. Unonophelo oluxhasayo lunokubandakanya unyango lotofelo-gazi okanye unyango lweziyobisi, ezinje ngeyeza lokulwa usulelo

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lunyango lomhlaza olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Amachiza ojolise ekunyangeni abizwa ngokuba yi-tyrosine kinase inhibitors (TKIs) asetyenziselwa ukunyanga i-myelodysplastic / myeloproliferative neoplasm, engenakuchazeka. Ii-TKIs zivimba i-enzyme, i-tyrosine kinase, ebangela ukuba iiseli ezi-stem zibe ziiseli zegazi ezingakumbi (kuqhume) kunoko kufunwa ngumzimba. I-Imatinib mesylate (Gleevec) yi-TKI enokusetyenziswa. Ezinye iziyobisi zonyango ekujoliswe kuzo ziyafundwa kunyango lwe-JMML.

Jonga iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms ngolwazi oluthe kratya.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-myelodysplastic / myeloproliferative neoplasms lunokubangela 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.

Izinketho zonyango kwi-Myelodysplastic / Myeloproliferative Neoplasms

Kweli Candelo

• Isifo seeleukemia esinganyangekiyo seMyelomonocytic

• Ulutsha lweMyelomonocytic Leukemia

• I-Atypical Chronic Meelogenous Leukemia

• I-Myelodysplastic / iMyeloproliferative Neoplasm, engenakuchazeka

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

Isifo seeleukemia esinganyangekiyo seMyelomonocytic

Unyango lwe-myelomonocytic leukemia (CMML) inokubandakanya oku kulandelayo:

• I-Chemotherapy nge-arhente enye okanye nangaphezulu.

• Ukufakelwa kweseli.

• 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.

Ulutsha lweMyelomonocytic Leukemia

Unyango lwe-juelile myelomonocytic leukemia (JMML) lunokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Ukufakelwa kweseli.

• Unyango lwe-asidi ye-13-cis-retinoic.

• Uvavanyo lweklinikhi yonyango olutsha, njengonyango ekujoliswe kulo.

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-Atypical Chronic Meelogenous Leukemia

Unyango lwe-atypical chronic myelogenous leukemia (CML) inokubandakanya ichemotherapy.

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-Myelodysplastic / iMyeloproliferative Neoplasm, engenakuchazeka

Ngenxa yokuba i-myelodysplastic / myeloproliferative neoplasm, engenakuchazeka (MDS / MPN-UC) sisifo esinqabileyo, kuncinci okwaziwayo malunga nonyango lwaso. Unyango lunokubandakanya oku kulandelayo:

• Unyango oluxhasayo lokulawula iingxaki ezibangelwa sisifo esifana nosulelo, ukopha, kunye negazi

• Unyango ekujoliswe kulo (imatinib mesylate).

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 ngeMyelodysplastic / Myeloproliferative Neoplasms

Ngolwazi oluthe kratya kwiNational Cancer Institute malunga ne-myelodysplastic / myeloproliferative neoplasms, bona oku kulandelayo:

• Iphepha lasekhaya leMyeloproliferative Neoplasms

• Utyando lweSeli oluQulunqwe ngegazi

• Iziyobisi ezivunyiweyo zeMyeloproliferative Neoplasms

• 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