Izinhlobo / i-myeloma / isiguli / i-myeloma-treatment-pdq
Okuqukethwe
- 1 Ukwelashwa kwe-Plasma Cell Neoplasms (Kubandakanya i-Multiple Myeloma) Treatment (®) –Patient Version
- 1.1 Imininingwane ejwayelekile Mayelana Ne-Plasma Cell Neoplasms
- 1.2 Izigaba zama-Plasma Cell Neoplasms
- 1.3 Uhlolojikelele lwenketho yokwelashwa
- 1.4 Ukwelashwa kwe-Monoclonal Gammopathy Yokubaluleka Okunganqunyelwe
- 1.5 Ukwelashwa kwe-Plasmacytoma ehlukanisiwe yamathambo
- 1.6 Ukwelashwa kwe-Extramedullary Plasmacytoma
- 1.7 Ukwelashwa kwe-Multiple Myeloma
- 1.8 Ukwelashwa kwe-Myeloma eminingi ebuyile noma ephikisayo
- 1.9 Ukuze ufunde kabanzi Mayelana Ne-Plasma Cell Neoplasms
Ukwelashwa kwe-Plasma Cell Neoplasms (Kubandakanya i-Multiple Myeloma) Treatment (®) –Patient Version
Imininingwane ejwayelekile Mayelana Ne-Plasma Cell Neoplasms
AMAPHUZU ASEMQOKA
- Ama-Plasma cell neoplasms yizifo lapho umzimba wenza amangqamuzana amaningi e-plasma.
- Ama-Plasma cell neoplasms angaba yingozi (hhayi umdlavuza) noma amabi (umdlavuza).
- Kunezinhlobo eziningana zama-plasma cell neoplasms.
- I-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS)
- I-Plasmacytoma
- I-myeloma eminingi
- I-myeloma eminingi namanye ama-neoplasms amangqamuzana e-plasma angadala isimo okuthiwa i-amyloidosis.
- Ubudala bungathinta ubungozi be-plasma cell neoplasms.
- Ukuhlolwa okuhlola igazi, umnkantsha, nomchamo kusetshenziselwa ukuxilonga ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma.
- Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.
Ama-Plasma cell neoplasms yizifo lapho umzimba wenza amangqamuzana amaningi e-plasma.
Amaseli e-Plasma akhula kusuka kuma-B lymphocyte (B cells), uhlobo lweseli elimhlophe elenziwa emnkantsheni wethambo. Ngokuvamile, lapho amabhaktheriya noma amagciwane engena emzimbeni, amanye amangqamuzana B azoshintsha abe amangqamuzana e-plasma. Amaseli e-plasma enza ama-antibody okulwa namagciwane namagciwane, ukunqanda ukutheleleka nezifo.
Ama-Plasma cell neoplasms yizifo lapho amangqamuzana e-plasma angajwayelekile noma amaseli e-myeloma akha izicubu emathanjeni noma izicubu ezithambile zomzimba. Amaseli e-plasma nawo enza iprotheni ye-antibody, ebizwa nge-M protein, engadingeki emzimbeni futhi engakusizi ukulwa nokutheleleka. Lawa maprotheni we-antibody akhela emnkantsheni wethambo futhi angadala igazi ukuthi likhuluphale noma alimaze izinso.
Ama-Plasma cell neoplasms angaba yingozi (hhayi umdlavuza) noma amabi (umdlavuza).
I-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS) ayiwona umdlavuza kepha ingaba ngumdlavuza. Izinhlobo ezilandelayo zama-plasma cell neoplasms umdlavuza:
- I-lymphoma ye-Lymphoplasmacytic. (Bheka i-Adult Non-Hodgkin Lymphoma Treatment ukuthola eminye imininingwane.)
- I-Plasmacytoma.
- I-myeloma eminingi.
Kunezinhlobo eziningana zama-plasma cell neoplasms.
Ama-Plasma cell neoplasms afaka okulandelayo:
I-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS)
Kulolu hlobo lwe-plasma cell neoplasm, ngaphansi kuka-10% womnkantsha wenziwe ngamaseli e-plasma angajwayelekile futhi awunawo umdlavuza. Amaseli e-plasma angajwayelekile enza amaprotheni e-M, kwesinye isikhathi atholakala ngesikhathi sokuhlolwa kwegazi noma umchamo ojwayelekile. Ezigulini eziningi, inani le-M protein lihlala lilingana futhi azikho izimpawu, izimpawu, noma izinkinga zempilo.
Kwezinye iziguli, i-MGUS kamuva ingaba yisimo esibi kakhulu, njenge-amyloidosis, noma ibangele izinkinga ngezinso, inhliziyo, noma izinzwa. I-MGUS ingaba ngumdlavuza, njenge-myeloma eminingi, i-lymphoplasmacytic lymphoma, noma i-leukemia engapheli ye-lymphocytic.
I-Plasmacytoma
Kulolu hlobo lwe-plasma cell neoplasm, amangqamuzana e-plasma angajwayelekile (amaseli we-myeloma) asendaweni eyodwa futhi akha isimila esisodwa, okuthiwa i-plasmacytoma. Kwesinye isikhathi i-plasmacytoma iyelapheka. Kunezinhlobo ezimbili zeplasmacytoma.
- Ku-plasmacytoma eyedwa, ithambo elilodwa le-plasma litholakala ethanjeni, ngaphansi kuka-10% womnkantsha wenziwe ngamaseli e-plasma, futhi azikho ezinye izimpawu zomdlavuza. I-Plasmacytoma yethambo ivame ukuba i-myeloma eminingi.
- Ku-extramedullary plasmacytoma, isimila esisodwa samangqamuzana e-plasma sitholakala ezicutshini ezithambile kepha hhayi ethanjeni noma emnkantsheni wethambo. Ama-extramedullary plasmacytomas ajwayele ukwakheka kwizicubu zomphimbo, i-tonsil nezono ze-paranasal.
Izimpawu nezimpawu zixhomeke lapho sikhona isimila.
- Ethanjeni, i-plasmacytoma ingadala ubuhlungu noma amathambo aphukile.
- Ezicubu ezithambile, isimila singacindezela ezindaweni eziseduze futhi sidale ubuhlungu noma ezinye izinkinga. Isibonelo, i-plasmacytoma esemphinjeni ingenza kube nzima ukugwinya.
I-myeloma eminingi
Ezingxenyeni eziningi ze-myeloma, amangqamuzana e-plasma angajwayelekile (amaseli we-myeloma) akha emnkantsheni wethambo futhi akha izicubu emathanjeni amaningi omzimba. Lezi zicubu zingavimbela umnkantsha wokwenza amaseli egazi anempilo anele. Imvamisa, umnkantsha wenza ama-stem cells (amaseli angavuthiwe) aba yizinhlobo ezintathu zamaseli egazi avuthiwe:
- Amaseli abomvu egazi athwala umoya-mpilo nezinye izinto aya kuzo zonke izicubu zomzimba.
- Amaseli egazi amhlophe alwa nokutheleleka nezifo.
- Ama-platelet akha amahlule egazi ukusiza ukuvimbela ukuphuma kwegazi.
Njengoba inani lamaseli e-myeloma landa, kwenziwa ambalwa amaseli abomvu egazi, amangqamuzana amhlophe egazi nama-platelets. Amaseli we-myeloma nawo ayalimaza futhi anciphise ithambo.
Kwesinye isikhathi i-myeloma eminingi ayibangeli zimpawu noma zimpawu. Lokhu kubizwa nge-smelering multiple myeloma. Ingatholwa lapho kwenziwa ukuhlolwa kwegazi noma umchamo ngesinye isimo. Izimpawu nezimpawu zingabangelwa i-myeloma eminingi noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:
- Ubuhlungu bamathambo, ikakhulukazi emhlane noma ezimbanjeni.
- Amathambo aphuka kalula.
- Umkhuhlane ngaphandle kwesizathu esaziwayo noma ukutheleleka njalo.
- Ukulinyazwa okulula noma ukopha.
- Ukuphefumula kanzima.
- Ubuthakathaka bezingalo noma bemilenze.
- Ukuzizwa ngikhathele kakhulu.
Isimila singalimaza ithambo futhi sidale i-hypercalcemia (i-calcium eningi egazini). Lokhu kungathinta izitho eziningi emzimbeni, kufaka phakathi izinso, izinzwa, inhliziyo, imisipha kanye nomgudu wokugaya ukudla, futhi kudale izinkinga ezinkulu zempilo.
I-Hypercalcemia ingadala lezi zimpawu nezimpawu ezilandelayo:
- Ukuphelelwa isifiso sokudla.
- Isicanucanu noma ukuhlanza.
- Ukuzizwa womile.
- Ukuchama njalo.
- Ukuqunjelwa.
- Ukuzizwa ngikhathele kakhulu.
- Ubuthakathaka bemisipha.
- Ukungahlaliseki.
- Ukudideka noma unenkinga yokucabanga.
I-myeloma eminingi namanye ama-neoplasms amangqamuzana e-plasma angadala isimo okuthiwa i-amyloidosis.
Ezimweni ezingavamile, i-myeloma eminingi ingadala izinzwa zomzimba (izinzwa ezingekho ebuchosheni noma intambo yomgogodla) nezitho zokuhluleka. Lokhu kungabangelwa yisimo esibizwa nge-amyloidosis. Amaprotheni we-antibody akha futhi anamathele ndawonye emithanjeni yezitho nezitho, ezinjengezinso nenhliziyo. Lokhu kungadala ukuthi izinzwa nezitho zomzimba ziqine futhi zingakwazi ukusebenza ngendlela okufanele zisebenze ngayo.
I-Amyloidosis ingadala lezi zimpawu nezimpawu ezilandelayo:
- Ukuzizwa ngikhathele kakhulu.
- Amabala ansomi esikhunjeni.
- Ulimi olukhulisiwe.
- Uhudo.
- Ukuvuvukala okubangelwa uketshezi lwezicubu zomzimba wakho.
- Ukuncipha noma ukuba ndikindiki emilenzeni nasezinyaweni zakho.
Ubudala bungathinta ubungozi be-plasma cell neoplasms.
Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini.
Ama-Plasma cell neoplasms ajwayelekile kakhulu kubantu abaneminyaka yobudala ephakathi noma ngaphezulu. Kwi-myeloma eminingi ne-plasmacytoma, ezinye izinto ezinobungozi zifaka okulandelayo:
- Ukuba mnyama.
- Ukuba owesilisa.
- Ukuba nomlando womuntu siqu we-MGUS noma i-plasmacytoma.
- Ukuvezwa yimisebe noma amakhemikhali athile.
Ukuhlolwa okuhlola igazi, umnkantsha, nomchamo kusetshenziselwa ukuxilonga ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma.
Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:
- Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
- Izifundo ze-immunoglobulin yegazi nomchamo: Inqubo lapho kuhlolwe khona isampula yegazi noma umchamo ukukala inani lama-antibodies athile (ama-immunoglobulins). Kuma-myeloma amaningi, i-beta-2-microglobulin, amaprotheni e-M, amaketanga wokukhanya wamahhala, namanye amaprotheni enziwe amaseli e-myeloma ayalinganiswa. Inani eliphakeme kakhulu kunokujwayelekile lalezi zinto kungaba uphawu lwesifo.
- Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha wethambo, igazi, nocezu oluncane lwethambo ngokufaka inaliti engenalutho ethangeni noma emathanjeni esifuba. Isazi sezifo sibheka umnkantsha, igazi, nethambo ngaphansi kwesibonakhulu ukubheka amaseli angajwayelekile.
Ukuhlolwa okulandelayo kungenziwa kusampula yezicubu ezisuswe ngesikhathi sokulangazelela umnkantsha kanye ne-biopsy:
- Ukuhlaziywa kwe-cytogenetic: Ukuhlolwa kwelabhorethri lapho ama-chromosomes amaseli esampula yomnkantsha abalwa khona futhi ahlolwe noma yiziphi izinguquko, njengama-chromosomes aphukile, alahlekile, ahlelwe kabusha, noma amanye. Izinguquko kuma-chromosomes athile kungaba luphawu lomdlavuza. Ukuhlaziywa kwe-cytogenetic kusetshenziselwa ukuxilonga umdlavuza, ukuhlela ukwelashwa, noma ukuthola ukuthi ukwelashwa kusebenza kahle kangakanani.
- I-FISH (i-fluorescence in situ hybridization): Ukuhlolwa kwaselebhu okusetshenziselwa ukubuka nokubala izakhi zofuzo noma ama-chromosomes kumaseli nezicubu. Izingcezu ze-DNA ezinodayi we-fluorescent zenziwa elabhoratri bese zengezwa kusampula yamaseli noma izicubu zesiguli. Lapho lezi zingcezu zeDNA ezidayiwe zinamathela kuzakhi zofuzo ezithile noma ezindaweni ezithile zama-chromosomes kusampula, ziyakhanya lapho zibhekwa ngaphansi kwesibonakhulu se-fluorescent. Ukuhlolwa kwe-FISH kusetshenziselwa ukusiza ukuthola umdlavuza nokusiza ukuhlela ukwelashwa.
- Flow cytometry: Isivivinyo selabhorethri esikala inani lamaseli esampula, iphesenti lamaseli aphilayo kusampula, nezici ezithile zamaseli, njengosayizi, umumo, nokuba khona komaka be-tumor (noma okunye) ubuso beseli. Amaseli avela kusampula lomnkantsha wesiguli agcotshwa udayi we-fluorescent, afakwa kuketshezi, bese edluliswa ngakunye ngogongolo lokukhanya. Imiphumela yokuhlolwa isuselwa ekutheni amangqamuzana abenebala lodayi we-fluorescent asabela kanjani oshalweni lokukhanya. Lokhu kuhlolwa kusetshenziselwa ukuxilonga nokuphatha izinhlobo ezithile zomdlavuza, njenge-leukemia ne-lymphoma.
- Ucwaningo lwamathambo lwamathambo: Kuhlolo lwamathambo lwamathambo, ama-x-ray awo wonke amathambo emzimbeni ayathathwa. Ama-x-ray asetshenziselwa ukuthola izindawo lapho konakele khona ithambo. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.
- Qedela ukubalwa kwegazi (i-CBC) ngokuhluka: Inqubo lapho kukhishwa khona isampula yegazi futhi ihlolwe lokhu okulandelayo:
- Inani lamaseli abomvu nama-platelets.
- Inombolo nohlobo lwamaseli amhlophe egazi.
- Inani le-hemoglobin (iprotheni ethwala umoya-mpilo) kumaseli abomvu egazi.
- Ingxenye yesampula yegazi eyenziwe ngamaseli abomvu egazi.
- Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-calcium noma i-albumin, ekhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.
- Ukuhlolwa komchamo wamahora angamashumi amabili nane: Isivivinyo lapho kuqoqwa khona umchamo amahora angama-24 ukukala inani lezinto ezithile. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Inani eliphakeme kunelejwayelekile lamaprotheni kungaba uphawu lwe-myeloma eminingi.
- I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI). I-MRI yomgogodla kanye ne-pelvis ingasetshenziswa ukuthola izindawo lapho ithambo lonakele khona.
- I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.
- I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengomgogodla, othathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.
- I-PET-CT scan: Inqubo ehlanganisa izithombe kusuka kuskena se-positron emission tomography (PET) kanye nokuskena kwe-computed tomography (CT). Izikena ze-PET ne-CT zenziwa ngasikhathi sinye ngomshini ofanayo. Izikena ezihlanganisiwe zinikeza izithombe ezinemininingwane eminingi yezindawo ezingaphakathi komzimba, njengomgogodla, kunalokho ukuskena okunikezayo ngokwakho.
Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.
Isibikezelo sincike kulokhu okulandelayo:
- Uhlobo lwe-plasma cell neoplasm.
- Isigaba sesifo.
- Noma ngabe kukhona i-immunoglobulin (antibody) ethile.
- Ukuthi kunezinguquko ezithile zofuzo.
- Ukuthi inso ilimele yini.
- Ukuthi umdlavuza uphendula ekwelashweni kokuqala noma uyaphinda (buyela emuva).
Izinketho zokwelashwa zincike kokulandelayo:
- Uhlobo lwe-plasma cell neoplasm.
- Iminyaka nempilo ejwayelekile yesiguli.
- Noma ngabe kukhona izimpawu, izimpawu, noma izinkinga zempilo, njengokuhluleka kwezinso noma ukutheleleka, okuhlobene nesifo.
- Ukuthi umdlavuza uphendula ekwelashweni kokuqala noma uyaphinda (buyela emuva).
Izigaba zama-Plasma Cell Neoplasms
AMAPHUZU ASEMQOKA
- Azikho izinhlelo ezijwayelekile zokuqalwa kwe-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS) ne-plasmacytoma.
- Ngemuva kokutholakala kwe-myeloma eminingi, kwenziwa ukuhlolwa ukuthola ukuthi ungakanani umdlavuza osemzimbeni.
- Isigaba se-myeloma eminingi sisekelwe emazingeni e-beta-2-microglobulin ne-albhamuin egazini.
- Lezi zigaba ezilandelayo zisetshenziselwa i-myeloma eminingi:
- Isigaba I myeloma amaningi
- Isigaba II i-myeloma eminingi
- Isigaba III i-myeloma eminingi
- Ama-Plasma cell neoplasms kungenzeka angaphenduli ekwelashweni noma angabuya emuva kokwelashwa.
Azikho izinhlelo ezijwayelekile zokuqalwa kwe-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS) ne-plasmacytoma.
Ngemuva kokutholakala kwe-myeloma eminingi, kwenziwa ukuhlolwa ukuthola ukuthi ungakanani umdlavuza osemzimbeni.
Inqubo esetshenzisiwe ukuthola inani lomdlavuza emzimbeni ibizwa ngokuthi isiteji. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa.
Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa ukuthola ukuthi ungakanani umdlavuza osemzimbeni:
- Ucwaningo lwamathambo lwamathambo: Kuhlolo lwamathambo lwamathambo, ama-x-ray awo wonke amathambo emzimbeni ayathathwa. Ama-x-ray asetshenziselwa ukuthola izindawo lapho konakele khona ithambo. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.
- I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezifana nomnkantsha. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
- I-Bone densitometry: Inqubo esebenzisa uhlobo olukhethekile lwe-x-ray ukukala ukuminyana kwethambo.
Isigaba se-myeloma eminingi sisekelwe emazingeni e-beta-2-microglobulin ne-albhamuin egazini.
I-Beta-2-microglobulin ne-albumin zitholakala egazini. I-Beta-2-microglobulin yiprotheni etholakala kumaseli e-plasma. I-albhamuin yakha ingxenye enkulu kakhulu ye-plasma yegazi. Kugcina uketshezi luphume emithanjeni yegazi. Iphinde ilethe izakhi zomzimba ezicutshini, futhi ithwala ama-hormone, amavithamini, izidakamizwa, nezinye izinto, njenge-calcium, emzimbeni wonke. Egazini leziguli ezine-myeloma eminingi, inani le-beta-2-microglobulin landa futhi inani le-albumin lehlile.
Lezi zigaba ezilandelayo zisetshenziselwa i-myeloma eminingi:
Isigaba I myeloma amaningi
Esigabeni ngine-myeloma eminingi, amazinga egazi ami kanjena:
- I-beta-2-microglobulin level ingaphansi kuka-3.5 mg / L; futhi
- Izinga le-albhamuin lingu-3.5 g / dL noma ngaphezulu.
Isigaba II i-myeloma eminingi
Esigabeni II i-myeloma eminingi, amazinga egazi aphakathi kwamazinga esigabeni I nesigaba III.
Isigaba III i-myeloma eminingi
Esigabeni III i-myeloma eminingi, izinga legazi le-beta-2-microglobulin lingu-5.5 mg / L noma ngaphezulu kanti isiguli sinokunye kwalokhu okulandelayo:
- amazinga aphezulu e-lactate dehydrogenase (LDH); noma
- izinguquko ezithile kuma-chromosomes.
Ama-Plasma cell neoplasms kungenzeka angaphenduli ekwelashweni noma angabuya emuva kokwelashwa.
Ama-Plasma cell neoplasms abizwa ngokuthi yi-refractory lapho inani lamaseli e-plasma liqhubeka nokukhuphuka yize kunikezwa ukwelashwa. Ama-Plasma cell neoplasms abizwa ngokuthi abuyiselwe emuva lapho ebuya emuva kokwelashwa.
Uhlolojikelele lwenketho yokwelashwa
AMAPHUZU ASEMQOKA
- Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-plasma cell neoplasms.
- Izinhlobo eziyisishiyagalombili zokwelashwa zisetshenzisiwe:
- Ukwelashwa ngamakhemikhali
- Olunye ukwelashwa kwezidakamizwa
- Ukwelashwa okuhlosiwe
- I-chemotherapy ephezulu ene-stem cell transplant
- I-Immunotherapy
- Ukwelashwa ngemisebe
- Ukuhlinzwa
- Ukulinda okulindile
- Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
- Inhlanganisela entsha yokwelashwa
- Ukwelashwa kwama-plasma cell neoplasms kungadala imiphumela emibi.
- Ukunakekelwa kokusekelwa kunikezwa ukunciphisa izinkinga ezibangelwa yisifo noma ukwelashwa kwaso.
- Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
- Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
- Ukuhlolwa kokulandelela kungadingeka.
Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-plasma cell neoplasms.
Izinhlobo ezahlukahlukene zokwelashwa ziyatholakala ezigulini ezine-plasma cell neoplasms. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.
Izinhlobo eziyisishiyagalombili zokwelashwa zisetshenzisiwe:
Ukwelashwa ngamakhemikhali
I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy).
Bheka Izidakamizwa Ezamukelwe i-Multiple Myeloma namanye ama-Plasma Cell Neoplasms ukuthola eminye imininingwane.
Olunye ukwelashwa kwezidakamizwa
AmaCorticosteroids angama-steroid anemiphumela yokuphikisa kuma-myeloma amaningi.
Ukwelashwa okuhlosiwe
Ukwelashwa okuhlosiwe ukwelashwa okusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amaseli womdlavuza athile. Ukwelashwa okuhlosiwe kungadala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe. Izinhlobo eziningi zokwelashwa okuqondisiwe zingasetshenziswa ukwelapha i-myeloma eminingi namanye ama-neoplasms weseli le-plasma. Kunezinhlobo ezahlukene zokwelashwa okuqondisiwe:
- Ukwelashwa kwe-Proteasome inhibitor: Lokhu kwelashwa kuvimbela isenzo sama-proteasomes kumaseli womdlavuza. Iproteasome yiprotheni esusa amanye amaprotheni angasadingeki yiseli. Lapho amaprotheni engasuswa esitokisini, ayakheka futhi angadala ukuthi iseli lomdlavuza life. I-Bortezomib, i-carfilzomib, ne-ixazomib ngama-proteasome inhibitors asetshenziswa ekwelapheni ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma.
- Ukwelashwa kwe-monoclonal antibody: Le ndlela yokwelapha isebenzisa amasosha omzimba enziwe elebhu, evela ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi noma okokusebenza okukhipha imisebe ngqo kumaseli womdlavuza. I-Daratumumab ne-elotuzumab ngama-antibody monoclonal asetshenziswa ekwelapheni ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma. I-Denosumab i-anti-monoclonal antibody esetshenziselwa ukunciphisa ukulahleka kwethambo nokunciphisa ubuhlungu bamathambo ezigulini ezine-myeloma eziningi.
- Ukwelashwa kwe-inhibitor ye-Histone deacetylase (HDAC): Lokhu kwelashwa kuvimba ama-enzyme adingekayo ekwahlukaneni kwamaseli futhi kungamisa ukukhula kwamangqamuzana omdlavuza. I-Panobinostat iyi-HDAC inhibitor esetshenziswa ekwelapheni ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma.
- Ukwelashwa kwe-BCL2 inhibitor: Lokhu kwelashwa kuvimba iprotheni ebizwa nge-BCL2. Ukuvimba le protein kungasiza ekubulaleni amangqamuzana omdlavuza futhi kungawenza azwele kakhulu emithini elwa nomdlavuza. IVenetoclax yi-BCL2 inhibitor efundwayo ekwelapheni i-myeloma ephindelela noma ephikisayo.
Bheka Izidakamizwa Ezamukelwe i-Multiple Myeloma namanye ama-Plasma Cell Neoplasms ukuthola eminye imininingwane.
I-chemotherapy ephezulu ene-stem cell transplant
Imithamo ephezulu yokwelashwa ngamakhemikhali inikezwa ukubulala amangqamuzana omdlavuza. Amaseli aphilile, kufaka phakathi amaseli akha igazi, nawo abhujiswa ukwelashwa komdlavuza. Ukufakelwa kwe-stem cell ukwelashwa ukufaka amaseli akha igazi. Ama-stem cell (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo lesiguli (i-autologous) noma i-donor (allogeneic) futhi afriziwe futhi agcinwe. Ngemuva kokuthi isiguli siqede i-chemotherapy, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.
I-Immunotherapy
I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.
- Ukwelashwa kwe-Immunomodulator: I-Thalidomide, i-lenalidomide, ne-pomalidomide ngama-immunomodulators asetshenziselwa ukwelapha ama-myeloma amaningi namanye ama-neoplasms weseli le-plasma.
- I-Interferon: Lokhu kwelashwa kuthinta ukuhlukaniswa kwamangqamuzana omdlavuza futhi kunganciphisa ukukhula kwesimila.
- Ukwelashwa kwe-CAR T-cell: Lokhu kwelashwa kuguqula ama-T cell wesiguli (uhlobo lweseli lomzimba) ngakho-ke azohlasela amaprotheni athile ebusweni bamangqamuzana omdlavuza. Amaseli we-T athathwa esigulini futhi ama-receptors akhethekile afakwa ebusweni bawo elabhoratri. Amaseli aguqukile abizwa ngamaseli we-chimeric antigen receptor (CAR) T. Amaseli e-CAR T akhuliswa elabhorethri futhi anikezwa isiguli ngokufakwa. Amaseli e-CAR T ayanda egazini lesiguli bese ehlasela amangqamuzana omdlavuza. Ukwelashwa kwe-CAR T-cell kuyacutshungulwa ekwelapheni i-myeloma eminingi ephindaphindekile (ebuyile).
Bheka Izidakamizwa Ezamukelwe i-Multiple Myeloma namanye ama-Plasma Cell Neoplasms ukuthola eminye imininingwane.
Ukwelashwa ngemisebe
Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza.
Ukuhlinzwa
Ukuhlinzwa okususa isimila kungenziwa. Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa ukwelashwa ngemisebe ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.
Ukulinda okulindile
Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu.
Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.
Inhlanganisela entsha yokwelashwa
Ukuhlolwa kwemitholampilo kutadisha izinhlanganisela ezahlukahlukene ze-immunotherapy, chemotherapy, therapy ye-steroid, nezidakamizwa. Izinhlobo ezintsha zokwelashwa ezisebenzisa i-selinexor nazo ziyafundwa.
Ukwelashwa kwama-plasma cell neoplasms kungadala imiphumela emibi.
Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.
Ukunakekelwa kokusekelwa kunikezwa ukunciphisa izinkinga ezibangelwa yisifo noma ukwelashwa kwaso.
Lokhu kwelashwa kulawula izinkinga noma imiphumela emibi ebangelwa yisifo noma ukwelashwa kwaso, futhi kuthuthukisa izinga lempilo. Ukunakekelwa kokusekelwa kunikezwa ukuphatha izinkinga ezibangelwa i-myeloma eminingi namanye ama-neoplasms weseli le-plasma.
Ukunakekelwa okusekelayo kungafaka okulandelayo:
- I-Plasmapheresis: Uma igazi liba likhulu ngamaprotheni e-antibody engeziwe futhi liphazamise ukusakazwa kwegazi, i-plasmapheresis yenziwa ukususa amaprotheni amaningi e-plasma kanye ne-antibody egazini. Kule nqubo igazi liyasuswa esigulini bese lithunyelwa ngomshini ohlukanisa i-plasma (ingxenye ewuketshezi yegazi) namaseli egazi. I-plasma yesiguli iqukethe amasosha omzimba angadingeki futhi ayibuyiselwa esigulini. Amaseli egazi ajwayelekile abuyiselwa egazini kanye ne-plasma enikelwe noma enye esikhundleni se-plasma. I-Plasmapheresis ayigcini ama-antibodies amasha ekwakhekeni.
- I-chemotherapy ephezulu ene-stem cell transplant: Uma kwenzeka i-amyloidosis, ukwelashwa kungafaka i-chemotherapy ephezulu elandelwa ukufakelwa kwe-stem cell kusetshenziswa amaseli we-stem wesiguli.
- I-Immunotherapy: I-Immunotherapy ene-thalidomide, i-lenalidomide, noma i-pomalidomide inikezwa ukwelapha i-amyloidosis.
- Ukwelashwa okuhlosiwe: Ukwelashwa okuhlosiwe ngama-proteasome inhibitors kunikezwa ukwehlisa ukuthi ingakanani i-immunoglobulin M esegazini futhi yelapha i-amyloidosis. Ukwelashwa okuhlosiwe nge-anti-monoclonal antibody kunikezwa ukunciphisa amathambo futhi kunciphise ubuhlungu bamathambo.
- Ukwelashwa ngemisebe: Ukwelashwa ngemisebe kunikezwa izilonda zamathambo zomgogodla.
- I-Chemotherapy: Ukwelashwa ngamakhemikhali kunikezwa ukunciphisa izinhlungu zangemuva ezivela e-osteoporosis noma ekucindezelweni kokuhlukana komgogodla.
- Ukwelashwa kwe-Bisphosphonate: Ukwelashwa kwe-Bisphosphonate kunikezwa ukunciphisa ukulahleka kwethambo nokunciphisa ubuhlungu bethambo. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane ngama-bisphosphonates nezinkinga ezihlobene nokusetshenziswa kwazo:
- Ubuhlungu Bomdlavuza
- Izinkinga zomlomo zeChemotherapy kanye neNhloko / Intamo Yemisebe
Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.
Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.
Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.
Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.
Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.
Ukuhlolwa kokulandelela kungadingeka.
Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.
Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.
Ukwelashwa kwe-Monoclonal Gammopathy Yokubaluleka Okunganqunyelwe
Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.
Ukwelashwa kwe-monoclonal gammopathy yokubaluleka okunganqunyelwe (MGUS) kuvame ukulinda ngokuqapha. Ukuhlolwa kwegazi njalo ukuhlola izinga le-M protein egazini nasezivivinyweni zomzimba ukubheka izimpawu noma izimpawu zomdlavuza kuzokwenziwa.
Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.
Ukwelashwa kwe-Plasmacytoma ehlukanisiwe yamathambo
Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.
Ukwelashwa kwe-plasmacytoma ehlukanisiwe yethambo imvamisa ukwelashwa ngemisebe kulonda lwethambo.
Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.
Ukwelashwa kwe-Extramedullary Plasmacytoma
Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.
Ukwelashwa kwe-extramedullary plasmacytoma kungafaka okulandelayo:
- Ukwelashwa kwemisebe ku-tumor kanye nama-lymph node aseduze.
- Ukuhlinzwa, ngokuvamile kulandelwa ukwelashwa ngemisebe.
- Ukulinda ngokuqapha ngemuva kokwelashwa kokuqala, kulandelwe ukwelashwa ngemisebe, ukuhlinzwa, noma i-chemotherapy uma isimila sikhula noma sidala izimpawu noma izimpawu.
Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.
Ukwelashwa kwe-Multiple Myeloma
Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.
Iziguli ezingenazo izimpawu noma izimpawu kungenzeka zingadingi ukwelashwa. Lezi ziguli zingaba nokulinda okulindile kuze kuvele izimpawu noma izimpawu.
Lapho kuvela izimpawu noma izimpawu, kunezigaba ezimbili zeziguli ezithola ukwelashwa:
- Iziguli ezisencane, ezilinganayo ezikulungele ukufakelwa i-stem cell.
- Iziguli ezindala, ezingafaneleki ezingakufanele ukufakelwa ama-stem cell.
Iziguli ezingaphansi kweminyaka engama-65 zivame ukubhekwa njengezincane futhi zilungile. Iziguli ezindala kuneminyaka engama-75 ngokuvamile azikufanele ukufakelwa ama-stem cell. Ezigulini eziphakathi kweminyaka engama-65 nengama-75 ubudala, ukuqina kunqunywa impilo yazo yonke nezinye izinto.
Ukwelashwa kwe-myeloma eminingi kuvame ukwenziwa ngezigaba:
- Ukwelashwa kokungeniswa: Lesi isigaba sokuqala sokwelapha. Inhloso yawo ukunciphisa inani lezifo, futhi kungafaka okukodwa noma ngaphezulu kokulandelayo:
- Ezigulini ezincane, ezilinganayo (ezifanele ukufakelwa):
- Ukwelashwa ngamakhemikhali.
- Ukwelashwa okuhlosiwe nge-proteasome inhibitor (bortezomib).
- I-Immunotherapy (lenalidomide).
- Ukwelashwa kwe-Corticosteroid.
- Ezigulini ezindala, ezingafanelekile (ezingafanele ukufakelwa):
- Ukwelashwa ngamakhemikhali.
- Ukwelashwa okuhlosiwe nge-proteasome inhibitor (i-bortezomib noma i-carfilzomib) noma i-antioclonal antibody (daratumumab).
- I-Immunotherapy (lenalidomide).
- Ukwelashwa kwe-Corticosteroid.
- I-Chemotherapy yokuhlanganisa: Lesi isigaba sesibili sokwelapha. Ukwelashwa esigabeni sokuhlanganiswa ukubulala noma yimaphi amangqamuzana omdlavuza asele. I-chemotherapy ephezulu kakhulu ilandelwa noma yikuphi:
- ukufakelwa kwesitokisi esisodwa se-autologous, lapho kusetshenziswa khona amaseli eziqu zesiguli asuka egazini noma emnkantsheni wethambo; noma
- ukufakelwa ama-stem cell amabili okuzenzekelayo kulandelwa ukufakelwa kwe-stem autologous noma i-allogeneic, lapho isiguli sithola khona ama-stem cells egazini noma emnkantsheni wethambo; noma
- ukufakelwa kwe-stem cell eyodwa kwe-allogeneic.
- Ukwelashwa kwesondlo : Ngemuva kokwelashwa kokuqala, ukwelashwa kwesondlo kuvame ukunikezwa ukusiza ukugcina isifo sixolelwe isikhathi eside. Izinhlobo eziningi zokwelashwa zifundelwa lokhu kusetshenziswa, kufaka phakathi okulandelayo:
- Ukwelashwa ngamakhemikhali.
- I-Immunotherapy (i-interferon noma i-lenalidomide).
- Ukwelashwa kwe-Corticosteroid.
- Ukwelashwa okuhlosiwe nge-proteasome inhibitor (bortezomib noma ixazomib).
Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.
Ukwelashwa kwe-Myeloma eminingi ebuyile noma ephikisayo
Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.
Ukwelashwa kwe-myeloma eminingi ebuyile noma ephikisayo kungabandakanya okulandelayo:
- Ukulinda okulindile kweziguli ezinesifo esizinzile.
- Ukwelashwa okuhlukile kunokwelashwa osekunikeziwe, kweziguli ezinesigaxa esilokhu sikhula ngenkathi selashwa. (Bheka izinketho zokwelashwa eziningi ze-Myeloma.)
- Izidakamizwa ezifanayo ezisetshenziswe ngaphambi kokubuyela emuva zingasetshenziswa uma ukubuyela emuva kwenzeka unyaka owodwa noma ngaphezulu ngemuva kokwelashwa kokuqala. (Bheka izinketho zokwelashwa eziningi ze-Myeloma.)
Izidakamizwa ezisetshenzisiwe zingafaka okulandelayo:
- Ukwelashwa okuhlosiwe ngama-antibody monoclonal (daratumumab noma elotuzumab).
- Ukwelashwa okuqondisiwe nge-proteasome inhibitors (bortezomib, carfilzomib, noma ixazomib).
- I-Immunotherapy (pomalidomide, lenalidomide, noma i-thalidomide).
- Ukwelashwa ngamakhemikhali.
- Ukwelashwa kwe-histone deacetylase inhibitor nge-panobinostat.
- Ukwelashwa kwe-Corticosteroid.
- Isivivinyo somtholampilo sokwelashwa kwe-CAR T-cell.
- Isivivinyo somtholampilo sokwelapha okuqondisiwe nge-molecule encane inhibitor (selinexor) kanye ne-corticosteroid therapy.
- Isivivinyo somtholampilo sokwelapha okuhlosiwe nge-BCL2 inhibitor (venetoclax).
Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.
Ukuze ufunde kabanzi Mayelana Ne-Plasma Cell Neoplasms
Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-myeloma eminingi namanye ama-neoplasms weseli le-plasma, bheka okulandelayo:
- I-Multiple Myeloma / Amanye ama-Plasma Cell Neoplasms Ikhasi Lasekhaya
- Izidakamizwa zivunyelwe i-Multiple Myeloma namanye ama-Plasma Cell Neoplasms
- Izindlela Zokwelapha Zomdlavuza
- Ukufakelwa Kwama-Stem Cell Stem
- I-Immunotherapy Yokwelapha Umdlavuza
Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:
- Mayelana Nomdlavuza
- Isiteji
- I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza
- Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza
- Ukubhekana Nomdlavuza
- Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza
- Kwabasindile Nabanakekeli
Nika amandla ukuvuselelwa okuzenzakalelayo kwamazwana