Types/myeloproliferative/patient/myelodysplastic-treatment-pdq

Unyango lweMyelodysplastic Syndromes (®) –Ugulo lwePatient

Ulwazi ngokubanzi malunga neMyelodysplastic Syndromes

IINGONGOMA EZIPHAMBILI

• I-Myelodysplastic syndromes liqela lomhlaza apho iiseli zegazi ezingafakwanga kumongo wethambo zingakhuli okanye zibe ziiseli zegazi ezisempilweni.

• Iindidi ezahlukeneyo ze-myelodysplastic syndromes zifunyaniswa ngokusekwe kutshintsho oluthile kwiiseli zegazi kunye nomongo wethambo.

• Ubudala kunye nonyango lwangaphambili ngekhemotherapy okanye unyango ngemitha luchaphazela umngcipheko wesifo se-myelodysplastic.

• Iimpawu kunye neempawu zesifo se-myelodysplastic syndrome zibandakanya ukuphefumla kancinci kunye nokudinwa.

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

• Izinto ezithile zichaphazela isifo kunye nokukhethwa kunyango.

I-Myelodysplastic syndromes liqela lomhlaza apho iiseli zegazi ezingafakwanga kumongo wethambo zingakhuli okanye zibe ziiseli zegazi ezisempilweni.

Kumntu osempilweni, 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-lymphoid okanye iseli ye-myeloid. 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.

• Iiplatelets ezenza amahlwili egazi ayeke ukopha.

• Amaseli egazi amhlophe alwa nosulelo kunye nezifo.

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

Kwisigulana esine-myelodysplastic syndrome, iiseli ze-stem zegazi (iiseli ezingakhulanga) azibi ziiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets kumongo wethambo. Ezi seli zegazi zingakhulanga, zibizwa ngokuba ziqhushumbo, azisebenzi ngendlela ebekufanele ukuba ziyafa ngayo kwaye ziyafa kumongo wethambo okanye kungekudala emva kokuba ziye egazini. Oku kushiya igumbi elincinci leeseli ezimhlophe eziphilileyo, iiseli ezibomvu zegazi, kunye neeplatelets ukuba zenziwe kumongo wethambo. Xa kukho iiseli zegazi ezisempilweni ezimbalwa, usulelo, i-anemia, okanye ukopha ngokulula kunokwenzeka.

Iindidi ezahlukeneyo ze-myelodysplastic syndromes zifunyaniswa ngokusekwe kutshintsho oluthile kwiiseli zegazi kunye nomongo wethambo.

• I-anemia enganyangekiyo: Zimbalwa kakhulu iiseli ezibomvu zegazi egazini kwaye isigulana sine-anemia. Inani leeseli ezimhlophe zegazi kunye neeplatelets ziqhelekile.

• I-anemia ephikisayo eneeringi zesideroblasts: Zimbalwa kakhulu iiseli ezibomvu zegazi egazini kwaye isigulana sine-anemia. Iiseli ezibomvu zegazi zinentsimbi eninzi ngaphakathi kwiseli. Inani leeseli ezimhlophe zegazi kunye neeplatelets ziqhelekile.

• I-anemia ephikisayo eneziqhushumbisi ezigqithisileyo: Zimbalwa kakhulu iiseli ezibomvu zegazi egazini kwaye isigulana sine-anemia. Iipesenti ezintlanu ukuya kwi-19% yeeseli kumongo wethambo ziqhume. Kukho kwakhona kukho utshintsho kwiiseli ezimhlophe zegazi kunye neeplatelets. I-anemia ephikisayo enefutha engaphezulu inokuqhubela phambili kwi-leukemia ye-myeloid (AML). Jonga isishwankathelo soNyango lwe-Myeloid Leukemia yaBadala ngolwazi olungakumbi.

• I-cytopenia enqabileyo ene-multilineage dysplasia: Zimbalwa kakhulu ubuncinci iintlobo ezimbini zeeseli zegazi (iiseli ezibomvu zegazi, iiplatelets, okanye iiseli ezimhlophe zegazi). Ngaphantsi kwe-5% yeeseli kumongo wethambo kuqhume kwaye zingaphantsi kwe-1% yeeseli ezisegazini kuqhuma. Ukuba iiseli ezibomvu zegazi zichaphazelekayo, zinokuba nentsimbi eyongezelelweyo. I-cytopenia ekhanyayo inokuqhubela phambili kwi-leukemia ye-myeloid (AML).

• I-cytopenia enqabileyo ene-unilineage dysplasia: Zimbalwa kakhulu kuhlobo olunye lweeseli zegazi (iiseli ezibomvu zegazi, iiplatelets, okanye iiseli ezimhlophe zegazi). Kukho utshintsho kwi-10% okanye ngaphezulu kwezinye iintlobo ezimbini zeeseli zegazi. Ngaphantsi kwe-5% yeeseli kumongo wethambo kuqhume kwaye zingaphantsi kwe-1% yeeseli ezisegazini kuqhuma.

• Isifo se-myelodysplastic syndrome esingachazekiyo: Inani lokuqhuma kumongo wethambo kunye negazi liqhelekile, kwaye esi sifo asiyoyenye ye-myelodysplastic syndromes.

• I-Myelodysplastic syndrome enxulunyaniswa ne-del (5q) engaqhelekanga ye-chromosome engaqhelekanga: Zimbalwa kakhulu iiseli ezibomvu zegazi egazini kwaye isigulana sine-anemia. Ngaphantsi kwe-5% yeeseli kumongo wethambo kunye nokuqhuma kwegazi. Kukho utshintsho oluthile kwi-chromosome.

• I-myelomonocytic leukemia engapheliyo (i-CMML): Jonga isishwankathelo se- kwi-Myelodysplastic / Myeloproliferative Neoplasms Treatment ngolwazi oluthe kratya.

Ubudala kunye nonyango lwangaphambili ngekhemotherapy okanye unyango ngemitha luchaphazela umngcipheko wesifo se-myelodysplastic.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kufumana isifo; ukungabinabungozi akuthethi ukuba awuzukufumana sifo. Thetha nogqirha wakho ukuba ucinga ukuba usengozini. Imiba yomngcipheko we-myelodysplastic syndromes ibandakanya oku kulandelayo:

• Unyango lwangaphambili ngekhemotherapy okanye unyango ngemitha yomhlaza.

• Ukuvezwa kwimichiza ethile, kubandakanya umsi wecuba, iyeza lokubulala izitshabalalisi, izichumisi kunye nezinyibilikisi ezifana ne-benzene.

• Ukuvezwa kwizinyithi ezinzima, ezinje nge-mercury okanye lead.

Isizathu se-myelodysplastic syndromes kwizigulana ezininzi asaziwa.

Iimpawu kunye neempawu zesifo se-myelodysplastic syndrome zibandakanya ukuphefumla kancinci kunye nokudinwa.

I-Myelodysplastic syndromes kaninzi ayibangeli zimpawu zokuqala okanye iimpawu. Banokufumaneka ngexesha lovavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokubangelwa zii-myelodysplastic syndromes okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukuqhawukelwa ngumphefumlo.

• Ubuthathaka okanye uziva udiniwe.

• Ukuba nesikhumba esiqaqambileyo kunesiqhelo.

• Ukutyumza okulula okanye ukopha.

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

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

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: 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 isampulu yegazi ihlolwe khona kutshintsho kwinani, uhlobo, imilo, kunye nobungakanani beeseli zegazi kunye nentsimbi eninzi kwiiseli ezibomvu zegazi.

• 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.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinjengevithamini B12 kunye nefolate, ekhutshelwa 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.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esusiweyo:

• 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 yeeseli zesigulana, 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 syndromes, leukemia, kunye nezinye iimeko.

• Immunophenotyping: Uvavanyo lwaselabhoratri olusebenzisa izilwa-buhlungu ukufumanisa iiseli zomhlaza ngokusekwe kwiindidi zeantigens okanye iimpawu zokumakisha phezu kweeseli. Olu vavanyo lusetyenziselwa ukufumanisa iintlobo ezithile ze-leukemia kunye nokunye ukuphazamiseka kwegazi.

• 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 yegazi lesigulana, umongo wethambo, okanye ezinye izicwili zinamabala edayi ye-fluorescent, ibekwe kulwelo, emva koko idlulise nganye nganye kwitampu 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.

• 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.

Izinto ezithile zichaphazela isifo kunye nokukhethwa kunyango.

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Inani lokuqhuma kweeseli kumongo wethambo.

• Nokuba ngaba olunye okanye ngaphezulu iintlobo zeeseli zegazi zichaphazelekayo.

• Nokuba isigulana sineempawu okanye iimpawu ze-anemia, ukopha, okanye usulelo.

• Nokuba isigulana sinomngcipheko ophantsi okanye ophezulu weleukemia.

• Utshintsho oluthile kwii-chromosomes.

• Nokuba isifo se-myelodysplastic senzeke emva kwekhemotherapy okanye unyango ngemitha yomhlaza.

• Ubudala kunye nempilo ngokubanzi yesigulana.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-syndromes ze-myelodysplastic.

• Unyango lwe-myelodysplastic syndromes lubandakanya ukhathalelo oluxhasayo, unyango lweziyobisi, kunye nokufakelwa kweseli.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Inkxaso yenkxaso

• Unyango lweziyobisi

• I-Chemotherapy kunye nokufakelwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-myelodysplastic syndromes lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

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

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-syndromes ze-myelodysplastic.

Iindlela ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-myelodysplastic syndromes. 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.

Unyango lwe-myelodysplastic syndromes lubandakanya ukhathalelo oluxhasayo, unyango lweziyobisi, kunye nokufakelwa kweseli.

Izigulana ezine-myelodysplastic syndrome ezineempawu ezibangelwa kukuphantsi kwegazi zinikwa ukhathalelo lokuxhasa iimpawu kunye nokuphucula umgangatho wobomi. Unyango lweziyobisi lunokusetyenziselwa ukunciphisa ukuqhubela phambili kwesi sifo. Ezinye izigulana zinokunyangeka ngonyango olunobukrakra kunye ne-chemotherapy elandelwa kukufakelwa kweseli ye-stem usebenzisa iiseli ezi-stem ezivela kulowo unikelayo.

Zintathu iintlobo zonyango olusetyenziswayo:

Inkxaso yenkxaso

Inkathalelo yenkxaso inikwa ukunciphisa iingxaki ezibangelwa sesi sifo okanye unyango lwaso. Inkxaso yenkxaso inokubandakanya oku kulandelayo:

• 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. Ukongezwa kwegazi elibomvu kunikezelwa xa inani elibomvu leeseli liphantsi kwaye iimpawu okanye iimpawu ze-anemia, ezinje ngokuphefumla kancinci okanye ukuziva udiniwe kakhulu, zenzeka. Ukufakwa kwegazi kwiplatelet kuhlala kunikwa xa isiguli sisopha, sinenkqubo enokubangela ukopha, okanye xa inani leplatelet liphantsi kakhulu.

Izigulana ezifumana uninzi lotofelo lweeseli zegazi zinokuba nomonakalo wethishu kunye nowomzimba obangelwa kukukhula kwentsimbi eyongezelelweyo. Ezi zigulana zinokunyangwa ngonyango lwe-iron chelation ukususa i-iron eyongezelelweyo egazini.

• Iiarhente ezivuselela i-Erythropoiesis

Iiarhente ze-Erythropoiesis-stimulating agents (ESAs) zinokunikwa ukwandisa inani leeseli ezibomvu zegazi ezenziwe ngumzimba kunye nokunciphisa iziphumo ze-anemia. Ngamanye amaxesha i-granulocyte colony-stimulating factor (G-CSF) inikwa nee-ESA ukunceda unyango lusebenze ngcono.

• Unyango lwe-Antibiotic

Amayeza okubulala iintsholongwane anokunikwa ukulwa usulelo.

Unyango lweziyobisi

• Igama Lenidomide

Izigulana ezine-myelodysplastic syndrome ezinxulunyaniswa ne-del (5q) engaqhelekanga ye-chromosome engaqhelekanga efuna utofelo-gazi lweeseli ezibomvu rhoqo zinokunyangwa nge-lenalidomide. I-Lenalidomide isetyenziselwa ukunciphisa isidingo sotofelo-gazi olubomvu.

• Unyango lwe-Immunosuppressive

I-Antithymocyte globulin (ATG) isebenza ukucinezela okanye ukwenza buthathaka amajoni omzimba. Isetyenziselwa ukunciphisa isidingo sotofelo lwegazi.

• I-Azacitidine kunye ne-decitabine

I-Azacitidine kunye ne-decitabine zisetyenziselwa ukunyanga i-myelodysplastic syndromes ngokubulala iiseli ezahlula ngokukhawuleza. Zikwanceda imizila yemfuza ebandakanyekayo ekukhuleni kweseli ukuze isebenze ngendlela efaneleke ngayo. Unyango nge-azacitidine kunye ne-decitabine lunokucothisa ukuqhubela phambili kwe-myelodysplastic syndromes ukuya kwi-leukemia ye-myeloid.

• I-Chemotherapy esetyenziswa kwi-acute myeloid leukemia (AML)

Izigulana ezine-myelodysplastic syndrome kunye nenani eliphezulu lokuqhuma kumongo wethambo labo banomngcipheko omkhulu we-leukemia ebukhali. Banokunyangwa ngerejimeni efanayo ye-chemotherapy esetyenziswa kwizigulana ezine-acute myeloid leukemia.

I-Chemotherapy kunye nokufakelwa kweseli

I-Chemotherapy inikezelwa 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.

Olu nyango lusenokungasebenzi nakwizigulana ezinesifo se-myelodysplastic syndrome esabangelwa lunyango lwangaphambili lomhlaza.

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-myelodysplastic syndromes 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.

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.

Ukhetho kunyango lweMyelodysplastic Syndromes

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

Unyango oluMiselweyo lweMyelodysplastic Syndromes

Izinketho zonyango oluqhelekileyo lwe-myelodysplastic syndromes zibandakanya:

• Inkxaso ngenkxaso enye okanye ezingaphezulu kwezi zilandelayo:

• Unyango lotofelo-gazi.

• Iiarhente ezivuselela i-Erythropoiesis.

• Unyango lwe-Antibiotic.

• Unyango kunyango olucothayo ukuya kwi-acute myeloid leukemia (AML):

• Igama Lenidomide.

• Unyango lwe-Immunosuppressive.

• I-Azacitidine kunye ne-decitabine.

• I-Chemotherapy isetyenziswe kwi-leukemia ye-myeloid.

• I-Chemotherapy kunye nokufakelwa kweseli.

Unyango lwee-Myeloid Neoplasms ezinxulumene nonyango

Izigulana ezanyangwa ngaphambili ngekhemotherapy okanye unyango ngemitha zinokuphuhlisa i-myeloid neoplasms ezinxulumene nonyango. Ukhetho lonyango luyafana nolunye uhlobo lwe-myelodysplastic syndromes.

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.

Ukhetho kunyango lwe-Syndromes ye-Myelodysplastic ebuyileyo okanye ephikisayo

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

Akukho lunyango lusezantsi lwe-myelodysplastic syndromes. Izigulana ezinomhlaza ongaphenduliyo kunyango okanye obuyileyo emva konyango banokufuna ukuthatha inxaxheba kuvavanyo lweklinikhi.

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 okungakumbi malunga neMyelodysplastic Syndromes

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-myelodysplastic syndromes, jonga oku kulandelayo:

• Utyando lweSeli oluQulunqwe ngegazi

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

• Malunga nesi Shwankathelo se