Types/myeloproliferative/patient/chronic-treatment-pdq

Ukwelashwa kwe-Chronic Myeloproliferative Neoplasms Treatment (®) –Patient Version

Imininingwane ejwayelekile mayelana Neoplasms engapheli ye-Myeloproliferative

AMAPHUZU ASEMQOKA

• Ama-neoplasms we-Myeloproliferative yiqembu lezifo lapho umnkantsha wenza amangqamuzana egazi abomvu amaningi kakhulu, amaseli amhlophe egazi, noma ama-platelets.

• Kunezinhlobo ezingama-6 zama-neoplasms ezingapheli ze-myeloproliferative.

• Ukuhlolwa okuhlola igazi nomnkantsha kusetshenziselwa ukuxilonga izimila ezingapheli ze-myeloproliferative neoplasms.

Ama-neoplasms we-Myeloproliferative yiqembu lezifo lapho umnkantsha wenza amangqamuzana egazi abomvu amaningi kakhulu, amaseli amhlophe egazi, noma ama-platelets.

Imvamisa, umnkantsha wenza amangqamuzana egazi (amaseli angavuthiwe) abe ngamaseli egazi avuthiwe ngokuhamba kwesikhathi.

I-anatomy yethambo. Ithambo lakhiwa ithambo elihlangene, ithambo lesiponji nomnkantsha. Ithambo elihlangene lenza ungqimba lwangaphandle lwethambo. Ithambo le-Spongy litholakala kakhulu emaphethelweni amathambo futhi liqukethe umnkantsha obomvu. Umnkantsha wethambo utholakala maphakathi namathambo amaningi futhi unemithambo yegazi eminingi. Kunezinhlobo ezimbili zomnkantsha wethambo: obomvu nophuzi. Umnkantsha obomvu uqukethe amangqamuzana egazi angaba amaseli abomvu egazi, amangqamuzana amhlophe egazi, noma ama-platelets. Umnkantsha ophuzi wenziwa kakhulu ngamafutha.

Iseli lesiqu segazi lingahle libe iseli le-myeloid noma iseli le-lymphoid stem. Iseli lesiqu le-lymphoid liba yiseli legazi elimhlophe. Iseli le-myeloid stem liba ngolunye lwezinhlobo 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 ukumisa ukopha.

Ukuthuthukiswa kwamangqamuzana egazi. Iseli lesiqu segazi lidlula ezinyathelweni eziningana ukuze libe yiseli elibomvu, iplatelet, noma iseli elimhlophe.

Ezingxenyeni ze-myeloproliferative neoplasms, amangqamuzana amaningi egazi aba yizinhlobo zamangqamuzana egazi. Ama-neoplasms ajwayele ukuba mabi kancane njengoba inani lamaseli egazi landa.

Kunezinhlobo ezingama-6 zama-neoplasms ezingapheli ze-myeloproliferative.

Uhlobo lwe-myeloproliferative neoplasm lususelwa ekutheni kwenziwa amangqamuzana amaningi abomvu egazi, amaseli amhlophe egazi, noma ama-platelets. Kwesinye isikhathi umzimba uzokwakha izinhlobo eziningi zamangqamuzana egazi amaningi, kepha imvamisa uhlobo olulodwa lweseli lwegazi luthinteka kakhulu kunezinye. Izilonda ezingama-myeloproliferative ezingamahlalakhona zifaka phakathi izinhlobo ezi-6 ezilandelayo:

• I-leukemia engapheli yomzimba.

• I-Polycythemia vera.

• I-myelofibrosis eyinhloko (ebizwa nangokuthi i-myelofibrosis engapheli).

• I-thrombocythemia ebalulekile.

• I-leukemia engapheli ye-neutrophilic.

• I-leukemia engapheli ye-eosinophilic.

Lezi zinhlobo zichazwe ngezansi. Ama-neoplasms angapheli we-myeloproliferative kwesinye isikhathi aba yi-leukemia enamandla, lapho kwenziwa khona amangqamuzana amhlophe egazi amaningi angajwayelekile.

Ukuhlolwa okuhlola igazi nomnkantsha kusetshenziselwa ukuxilonga izimila ezingapheli ze-myeloproliferative neoplasms.

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.

• 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.

Qedela ukubalwa kwegazi (CBC). Igazi liqoqwa ngokufaka inaliti emthanjeni bese livumela igazi ukuba ligelezele kushubhu. Isampuli yegazi ithunyelwa elabhorethri bese kubalwa amaseli abomvu egazi, amaseli amhlophe egazi, nama-platelets. I-CBC isetshenziselwa ukuhlola, ukuxilonga, nokuqapha izimo eziningi ezahlukahlukene.

• I-peripheral blood smear: Inqubo lapho kuhlolwe khona isampula legazi ngokulandelayo:

• Noma ngabe kunamaseli abomvu egazi abunjwe njengezinyembezi.

• Inombolo nezinhlobo zamaseli amhlophe egazi.

• Inani lama-platelet.

• Ukuthi kunamaseli wokuqhuma.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto 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.

Ukufiswa komnkantsha we-Bone kanye ne-biopsy. Ngemuva kokuba indawo encane yesikhumba ibanjiwe, kufakwa inaliti yomnkantsha ethanjeni lesinqe lesiguli. Amasampula egazi, amathambo, nomnkantsha uyasuswa ukuze kuhlolwe ngaphansi kwesibonakhulu.

• Ukuhlaziywa kwe-cytogenetic: Ukuhlolwa kwelabhoratri lapho ama-chromosomes wamaseli esampula yomnkantsha noma wegazi abalwa 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.

• Ukuhlolwa kokuguquka kwezakhi zofuzo: Ukuhlolwa kwelabhorethri okwenziwe emnkantsheni wethambo noma kusampula yegazi ukuhlola ukuguquka kwezakhi zofuzo ku-JAK2, MPL, noma ku-CALR genes. Ukuguqulwa kofuzo lweJAK2 kuvame ukutholakala ezigulini ezine-polycythemia vera, i-thrombocythemia ebalulekile, noma i-myelofibrosis eyinhloko. Izinguquko ze-MPL noma ze-CALR zitholakala ezigulini ezine-thrombocythemia ebalulekile noma i-myelofibrosis eyinhloko.

Umdlavuza Wegazi Ongamahlalakhona

I-chronic myelogenous leukemia yisifo lapho kwenziwa khona amangqamuzana amhlophe egazi amaningi kakhulu emnkantsheni wethambo. Bona isifinyezo se- ku-Chronic Myelogenous Leukemia Treatment ukuze uthole imininingwane ngokuxilongwa, isiteji, nokwelashwa.

I-Polycythemia Vera

AMAPHUZU ASEMQOKA

• I-Polycythemia vera yisifo lapho kwenziwa khona amangqamuzana abomvu egazi amaningi emnkantsheni wethambo.

• Izimpawu ze-polycythemia vera zifaka phakathi ikhanda nokuzizwa kugcwele ngaphansi kwezimbambo ohlangothini lwesobunxele.

• Ukuhlolwa kwegazi okukhethekile kusetshenziselwa ukuxilonga i-polycythemia vera.

I-Polycythemia vera yisifo lapho kwenziwa khona amangqamuzana abomvu egazi amaningi emnkantsheni wethambo.

Ku-polycythemia vera, igazi liyajiya ngamaseli abomvu amaningi kakhulu. Inani lamaseli amhlophe egazi nama-platelet nalo lingakhuphuka. Lawa maseli egazi angeziwe angaqoqa ku-spleen futhi abangele ukuvuvukala. Inani elandisiwe lamaseli abomvu egazi, amaseli amhlophe egazi, noma ama-platelets egazini angadala izinkinga zokopha futhi enze amahlule abe semithanjeni yegazi. Lokhu kungakhuphula ubungozi bokushaywa unhlangothi noma isifo senhliziyo. Ezigulini ezindala kuneminyaka engama-65 noma ezinomlando wamahlule egazi, ingozi yokushaywa unhlangothi noma isifo senhliziyo iphezulu. Iziguli zibuye zibe nengozi eyengeziwe ye-acute myeloid leukemia noma i-myelofibrosis eyinhloko.

Izimpawu ze-polycythemia vera zifaka phakathi ikhanda nokuzizwa kugcwele ngaphansi kwezimbambo ohlangothini lwesobunxele.

I-Polycythemia vera kaningi ayibangeli zimpawu zokuqala noma izimpawu. Ingatholakala ngesikhathi sokuhlolwa kwegazi okujwayelekile. Izimpawu nezimpawu zingavela njengoba inani lamaseli egazi landa. Ezinye izimo zingadala izimpawu nezimpawu ezifanayo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Umuzwa wengcindezi noma ukugcwala ngaphansi kwezimbambo ohlangothini lwesobunxele.

• Ukuphathwa ikhanda.

• Ukubona kabili noma ukubona izindawo ezimnyama noma eziyimpumputhe eza futhi zihambe.

• Ukulunywa umzimba wonke, ikakhulukazi ngemuva kokuba semanzini afudumele noma ashisayo.

• Ubuso obubomvu obufana nokusha noma ukushiswa yilanga.

• Ubuthakathaka.

• Isiyezi.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Ukuhlolwa kwegazi okukhethekile kusetshenziselwa ukuxilonga i-polycythemia vera.

Ngaphezu kokubalwa kwegazi okuphelele, ukufisa umnkantsha kanye ne-biopsy, kanye nokuhlaziywa kwe-cytogenetic, ukuhlolwa kwe-serum erythropoietin kusetshenziselwa ukuxilonga i-polycythemia vera. Kulesi sivivinyo, kuhlolwe isampula segazi ukuthi alikho yini izinga le-erythropoietin (i-hormone evuselela ukwenziwa kwamangqamuzana abomvu egazi amasha). Ku-polycythemia vera, izinga le-erythropoietin lizobe liphansi kunokujwayelekile ngoba umzimba awudingi ukwenza amangqamuzana egazi abomvu amaningi.

I-Myelofibrosis eyinhloko

AMAPHUZU ASEMQOKA

• I-myelofibrosis eyinhloko yisifo lapho amangqamuzana egazi angajwayelekile nemicu yakha ngaphakathi komnkantsha wethambo.

• Izimpawu ze-myelofibrosis eyinhloko zibandakanya ubuhlungu obungezansi kwezimbambo ohlangothini lwesobunxele nokuzizwa ukhathele kakhulu.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa ze-myelofibrosis eyinhloko.

I-myelofibrosis eyinhloko yisifo lapho amangqamuzana egazi angajwayelekile nemicu yakha ngaphakathi komnkantsha wethambo.

Umnkantsha wethambo wenziwa izicubu ezakha amangqamuzana egazi (amaseli abomvu egazi, amangqamuzana amhlophe egazi, nama-platelets) kanye newebhu yezintambo ezisekela izicubu ezakha igazi. Ku-myelofibrosis eyinhloko (ebizwa nangokuthi i-idiopathic myelofibrosis engapheli), amanani amakhulu amangqamuzana egazi egazi aba ngamaseli egazi angavuthwa kahle (ukuqhuma). Iwebhu yezintambo ngaphakathi kukomnkantsha wamathambo nayo iyajiya (njengezicubu ezibomvu) futhi inciphisa ikhono lezicubu ezakha igazi lokwenza amangqamuzana egazi. Lokhu kubangela ukuthi izicubu ezakha igazi zenze amangqamuzana egazi ambalwa futhi abe mbalwa. Ukuze kwenzelwe inani eliphansi lamaseli egazi enziwe emnkantsheni wethambo, isibindi nobende buqala ukwenza amangqamuzana egazi.

Izimpawu ze-myelofibrosis eyinhloko zibandakanya ubuhlungu obungezansi kwezimbambo ohlangothini lwesobunxele nokuzizwa ukhathele kakhulu.

I-myelofibrosis eyinhloko kaningi ayibangeli izimpawu noma izimpawu zakuqala. Ingatholakala ngesikhathi sokuhlolwa kwegazi okujwayelekile. Izimpawu nezimpawu zingabangelwa i-myelofibrosis eyinhloko noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ukuzwa ubuhlungu noma ukugcwala ngaphansi kwezimbambo ohlangothini lwesobunxele.

• Uzizwa ugcwele ngokushesha kunokujwayelekile lapho udla.

• Ukuzizwa ngikhathele kakhulu.

• Ukuphelelwa umoya.

• Ukulinyazwa okulula noma ukopha.

• I-Petechiae (amabala acabalekile, abomvu, akhombayo ngaphansi kwesikhumba abangelwa ukopha).

• Imfiva.

• Kumanzisa ukujuluka ebusuku.

• Ukwehla kwesisindo.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa ze-myelofibrosis eyinhloko.

Isibikezelo sincike kulokhu okulandelayo:

• Iminyaka yesiguli.

• Inani lamaseli abomvu angajwayelekile namaseli amhlophe egazi.

• Inani lokuqhuma egazini.

• Ukuthi kunezinguquko ezithile yini kuma-chromosomes.

• Ukuthi isiguli sinezimpawu ezinjengomkhuhlane, ukujuluka kwamanzi ebusuku, noma ukwehla kwesisindo.

I-Thrombocythemia ebalulekile

AMAPHUZU ASEMQOKA

• I-thrombocythemia ebalulekile yisifo lapho kwenziwa khona amaplatelet amaningi emnkantsheni wethambo.

• Iziguli ezine-thrombocythemia ebalulekile kungenzeka zingabi nazo izimpawu noma izimpawu.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa ze-thrombocythemia ebalulekile.

I-thrombocythemia ebalulekile yisifo lapho kwenziwa khona amaplatelet amaningi emnkantsheni wethambo.

I-thrombocythemia ebalulekile ibangela ukwanda okungavamile kwenani lama-platelet enziwe egazini nasemnkantsheni wethambo.

Iziguli ezine-thrombocythemia ebalulekile kungenzeka zingabi nazo izimpawu noma izimpawu.

I-thrombocythemia ebalulekile imvamisa ayibangeli zimpawu noma izimpawu zakuqala. Ingatholakala ngesikhathi sokuhlolwa kwegazi okujwayelekile. Izimpawu nezimpawu zingabangelwa i-thrombocytopenia ebalulekile noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ubuhlungu bekhanda.

• Ukuvutha noma ukuncinza ezandleni noma ezinyaweni.

• Ububomvu nokufudumala kwezandla noma kwezinyawo.

• Izinkinga zokubona noma zokuzwa.

Amaplatelets anamathele. Lapho kunama-platelet amaningi kakhulu, angahlangana futhi enze kube nzima ukuthi igazi ligeleze. Amahlule angahle abe khona emithanjeni yegazi futhi kungahle futhi kube nokopha okwengeziwe. Lokhu kungadala izinkinga ezinkulu zempilo njengokushaywa unhlangothi noma isifo senhliziyo.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa ze-thrombocythemia ebalulekile.

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

• Iminyaka yesiguli.

• Ukuthi isiguli sinezimpawu noma izimpawu noma ezinye izinkinga ezihlobene ne-thrombocythemia ebalulekile.

I-Neutrophilic Leukemia Engapheli

I-chronic neutrophilic leukemia yisifo lapho amangqamuzana amaningi egazi eba uhlobo lweseli elimhlophe elibizwa nge-neutrophils. Ama-neutrophils amangqamuzana egazi alwa nokutheleleka azungeze futhi abhubhise amaseli afile nezinto zangaphandle (njengamagciwane). Ubende nesibindi kungakhukhumala ngenxa yama-neutrophil ongeziwe. I-leukemia engapheli ye-neutrophilic ingahlala ifana noma ingahle iqhubekele phambili ngokushesha ibe yi-leukemia enamandla.

I-Eosinophilic Leukemia Engapheli

AMAPHUZU ASEMQOKA

• I-leukemia e-eosinophilic engapheli yisifo lapho kwenziwa khona amangqamuzana amhlophe egazi amaningi (ama-eosinophils) emnkantsheni wethambo.

• Izimpawu nezimpawu ze-leosemia engapheli ye-eosinophilic zibandakanya umkhuhlane nokuzizwa ukhathele kakhulu.

I-leukemia e-eosinophilic engapheli yisifo lapho kwenziwa khona amangqamuzana amhlophe egazi amaningi (ama-eosinophils) emnkantsheni wethambo.

Ama-eosinophil amangqamuzana amhlophe egazi asabela kwizilwelwe (izinto ezibangela impendulo yokungezwani) futhi asize ukulwa nezifo ezibangelwa ezinye izimuncagazi. Ku-leukemia engapheli ye-eosinophilic, kunama-eosinophil amaningi kakhulu egazini, umnkantsha, nezinye izicubu. I-leukemia engapheli ye-eosinophilic ingahlala ifana iminyaka eminingi noma ingaqhubeka ngokushesha iye ku-leukemia enamandla.

Izimpawu nezimpawu ze-leosemia engapheli ye-eosinophilic zibandakanya umkhuhlane nokuzizwa ukhathele kakhulu.

I-leukemia engapheli ye-eosinophilic kungenzeka ingabangeli izimpawu noma izimpawu zakuqala. Ingatholakala ngesikhathi sokuhlolwa kwegazi okujwayelekile. Izimpawu nezimpawu zingabangelwa yi-leukemia engapheli ye-eosinophilic noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Imfiva.

• Ukuzizwa ngikhathele kakhulu.

• Khwehlela.

• Ukuvuvukala ngaphansi kwesikhumba nxazonke zamehlo nezindebe, emphinjeni, noma ezandleni nasezinyaweni.

• Ubuhlungu bemisipha.

• Ukulunywa.

• Uhudo.

Izigaba zama-Neoplasms ezingapheli ze-Myeloproliferative

AMAPHUZU ASEMQOKA

• Alukho uhlelo olujwayelekile lokubeka izigaxa ezingapheli ze-myeloproliferative neoplasms.

Alukho uhlelo olujwayelekile lokubeka izigaxa ezingapheli ze-myeloproliferative neoplasms.

Isiteji inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalale kangakanani. Alukho uhlelo olujwayelekile lokubeka izigaxa ezingapheli ze-myeloproliferative neoplasms. Ukwelashwa kusekelwe ohlotsheni lwe-myeloproliferative neoplasm isiguli esinayo. Kubalulekile ukwazi uhlobo ukuze uhlele ukwelashwa.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinezilonda ezingapheliyo ze-myeloproliferative neoplasms.

• Izinhlobo eziyishumi nanye zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukulinda okulindile

• I-Phlebotomy

• Iplatelet apheresis

• Ukwelashwa kokumpontshelwa

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• Olunye ukwelashwa kwezidakamizwa

• Ukuhlinzwa

• Ukwelashwa kwe-Biologic

• Ukwelashwa okuhlosiwe

• I-chemotherapy ephezulu ene-stem cell transplant

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwama-neoplasms angapheli we-myeloproliferative kungadala imiphumela emibi.

• 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 ezinezilonda ezingapheliyo ze-myeloproliferative neoplasms.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinama-neoplasms ezingapheli ze-myeloproliferative. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo sokwelashwa isifundo socwaningo esenzelwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela ezintsha zokwelapha. 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 eziyishumi nanye zokwelashwa okujwayelekile zisetshenzisiwe:

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu.

I-Phlebotomy

I-Phlebotomy inqubo lapho igazi lithathwa emthanjeni. Isampula yegazi ingathathwa ukuhlolwa njenge-CBC noma i-chemistry yegazi. Kwesinye isikhathi i-phlebotomy isetshenziswa njengokwelashwa futhi igazi liyathathwa emzimbeni ukususa amaseli abomvu angeziwe. I-Phlebotomy isetshenziswa ngale ndlela ukwelapha ezinye izimila ezingapheli ze-myeloproliferative neoplasms.

Iplatelet apheresis

I-Platelet apheresis yindlela yokwelapha esebenzisa umshini okhethekile ukususa ama-platelet egazini. Igazi lithathwa esigulini bese lifakwa kusihlukanisi samaseli egazi lapho kususwa khona amaplatelets. Lonke elinye igazi liyabuyiselwa egazini lesiguli.

Ukwelashwa kokumpontshelwa

Ukwelashwa kokumpontshelwa (ukumpontshelwa igazi) kuyindlela yokunikeza amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, noma ama-platelets ukufaka amaseli egazi abhujiswe izifo noma ukwelashwa komdlavuza.

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). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa Ezamukelwe Ama-Neoplasms E-Myeloproliferative 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.

Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha izimila ezingapheli ze-myeloproliferative, futhi kuvame ukuqondiswa ebuchosheni.

Olunye ukwelashwa kwezidakamizwa

I-Prednisone ne-danazol yizidakamizwa ezingasetshenziswa ukwelapha i-anemia ezigulini ezine-myelofibrosis eyinhloko.

Ukwelashwa kwe-Anagrelide kusetshenziselwa ukunciphisa ubungozi bamahlule egazini ezigulini ezinama-platelet amaningi egazini lazo. I-aspirin yedosi ephansi ingasetshenziselwa ukunciphisa ubungozi bamahlule egazi.

I-Thalidomide, i-lenalidomide, ne-pomalidomide yizidakamizwa ezivimbela imithambo yegazi ukuthi ingakhuli ibe yizingxenye zamangqamuzana wesimila.

Bheka Izidakamizwa Ezamukelwe Ama-Neoplasms E-Myeloproliferative ukuthola eminye imininingwane.

Ukuhlinzwa

I-Splenectomy (ukuhlinzekwa ukukhipha ubende) kungenziwa uma ubende lukhulisiwe.

Ukwelashwa kwe-Biologic

Ukwelashwa nge-Biologic ukwelashwa okusebenzisa amasosha omzimba esiguli ukulwa nomdlavuza noma ezinye izifo. Izinto ezenziwe ngumzimba noma ezenziwe elabhorethri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba ezifweni. Lolu hlobo lwezokwelapha lubizwa nangokuthi i-biotherapy noma i-immunotherapy. I-Interferon alfa kanye ne-pegylated interferon alpha zingama-biologic agents ajwayele ukusetshenziselwa ukwelapha ezinye izimila ezingama-myeloproliferative ezingapheli.

Izici zokukhula kwe-erythropoietic nazo zingama-biologic agents. Zisetshenziselwa ukuvuselela umnkantsha wokwenza amangqamuzana abomvu egazi.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. I-Tyrosine kinase inhibitors yimithi yokwelashwa ebhekiswe kuyo evimba amasiginali adingekayo ukuze izicubu zikhule.

I-Ruxolitinib iyi-tyrosine kinase inhibitor esetshenziselwa ukwelapha i-polycythemia vera nezinhlobo ezithile ze-myelofibrosis.

Bheka Izidakamizwa Ezamukelwe Ama-Neoplasms E-Myeloproliferative ukuthola eminye imininingwane.

Ezinye izinhlobo zokwelashwa ezihlosiwe ziyafundwa ezivivinyweni zokwelashwa.

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 cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo wesiguli noma womnikeli 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.

Ukufakelwa kwe-stem cell. (Isinyathelo 1): Igazi lithathwa emthanjeni osengalweni yomnikeli. Isiguli noma omunye umuntu kungaba umnikeli. Igazi ligeleza ngomshini osusa ama-stem cells. Ngemuva kwalokho igazi libuyiselwa kumnikeli ngomthambo okwenye ingalo. (Isinyathelo 2): Isiguli sithola i-chemotherapy yokubulala amaseli akha igazi. Isiguli singathola ukwelashwa ngemisebe (okungakhonjisiwe). (Isinyathelo 3): Isiguli sithola ama-stem cells nge-catheter efakwa emthanjeni wegazi esifubeni.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa kwama-neoplasms angapheli we-myeloproliferative kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

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 kwama-Neoplasms ama-Myeloproliferative Chronic

Kulesi Sigaba

• Umdlavuza Wegazi Ongamahlalakhona

• I-Polycythemia Vera

• I-Myelofibrosis eyinhloko

• I-Thrombocythemia ebalulekile

• I-Neutrophilic Leukemia Engapheli

• I-Eosinophilic Leukemia Engapheli

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Umdlavuza Wegazi Ongamahlalakhona

Bona isifinyezo se- mayelana ne-Chronic Myelogenous Leukemia Treatment for information.

I-Polycythemia Vera

Inhloso yokwelashwa kwe-polycythemia vera ukunciphisa inani lamaseli egazi angeziwe. Ukwelashwa kwe-polycythemia vera kungafaka okulandelayo:

• I-Phlebotomy.

• I-Chemotherapy nge-phlebotomy noma ngaphandle kwayo. Uma i-chemotherapy ingasebenzi, ukwelashwa okuqondisiwe (i-ruxolitinib) kunganikezwa.

• Ukwelashwa kwe-Biologic usebenzisa i-interferon alfa noma i-pegylated interferon alpha.

• I-aspirin yomthamo ophansi.

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.

I-Myelofibrosis eyinhloko

Ukwelashwa kwe-myelofibrosis eyinhloko ezigulini ezingenazo izimpawu noma izimpawu kuvame ukulinda ngokuqapha.

Iziguli ezine-myelofibrosis eyinhloko zingaba nezimpawu noma izimpawu ze-anemia. I-anemia ivame ukwelashwa ngokumpontshelwa amaseli abomvu egazi ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo. Ngaphezu kwalokho, i-anemia ingaphathwa nge:

• Izici zokukhula kwe-erythropoietic.

• Prednisone.

• IDanazol.

• I-Thalidomide, lenalidomide, noma i-pomalidomide, ene-prednisone noma ngaphandle kwayo.

Ukwelashwa kwe-myelofibrosis eyinhloko ezigulini ezinezinye izimpawu noma izimpawu kungafaka okulandelayo:

• Ukwelashwa okubhekiswe ku-ruxolitinib.

• Ukwelashwa ngamakhemikhali.

• Ukufakelwa kabusha kweseli lomnikeli.

• I-Thalidomide, lenalidomide, noma i-pomalidomide.

• I-Splenectomy.

• Ukwelashwa ngemisebe ebuchosheni, kuma-lymph node, noma kwezinye izindawo ezingaphandle komnkantsha wamathambo lapho kwakhiwa khona amaseli egazi.

• Ukwelashwa kwe-Biologic usebenzisa i-interferon alfa noma izici zokukhula kwe-erythropoietic.

• Isivivinyo somtholampilo seminye imithi yokwelashwa ehlosiwe.

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.

I-Thrombocythemia ebalulekile

Ukwelashwa kwe-thrombocythemia ebalulekile ezigulini ezingaphansi kweminyaka engama-60 ezingenazo izimpawu noma izimpawu futhi isibalo seplatelet esamukelekayo kuvame ukulinda ngokuqapha. Ukwelashwa kwezinye iziguli kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa kwe-Anagrelide.

• Ukwelashwa kwe-Biologic usebenzisa i-interferon alfa noma i-pegylated interferon alpha.

• Iplatelet apheresis.

• Isivivinyo somtholampilo sokwelapha okusha.

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.

I-Neutrophilic Leukemia Engapheli

Ukwelashwa kwe-leukemia engapheli kungafaka okulandelayo:

• Ukufakelwa komnkantsha womnikeli.

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa kwe-Biologic usebenzisa i-interferon alfa.

• Isivivinyo somtholampilo sokwelapha okusha.

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.

I-Eosinophilic Leukemia Engapheli

Ukwelashwa kwe-leukemia engapheli ye-eosinophilic kungafaka okulandelayo:

• Ukufakelwa komnkantsha wethambo.

• Ukwelashwa kwe-Biologic usebenzisa i-interferon alfa.

• Isivivinyo somtholampilo sokwelapha okusha.

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 Neoplasms engapheli ye-Myeloproliferative

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nezimila ezingamahlalakhona ezingama-myeloproliferative, bheka okulandelayo:

• Ikhasi lasekhaya le-Myeloproliferative Neoplasms

• Izidakamizwa zivunyelwe i-Myeloproliferative Neoplasms

• I-Immunotherapy Yokwelapha Umdlavuza

• Ukufakelwa Kwama-Stem Cell Stem

• Izindlela Zokwelapha Zomdlavuza

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