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

Ukwelashwa kwe-Myelodysplastic / Myeloproliferative Neoplasms (®) –Patient Version

Imininingwane ejwayelekile Mayelana Ne-Myelodysplastic / Myeloproliferative Neoplasms

AMAPHUZU ASEMQOKA

• Ama-neoplasms e-Myelodysplastic / myeloproliferative ayiqembu lezifo lapho umnkantsha wenza amangqamuzana amhlophe egazi amaningi kakhulu.

• Ama-neoplasms we-Myelodysplastic / myeloproliferative anezici zombili ze-myelodysplastic syndromes kanye ne-myeloproliferative neoplasms.

• Kunezinhlobo ezahlukahlukene zama-myelodysplastic / myeloproliferative neoplasms.

• Kusetshenziswa izivivinyo ezihlola umnkantsha wegazi nomnkantsha ukuthola (ukuthola) nokuxilonga izimila ze-myelodysplastic / myeloproliferative neoplasms.

Ama-neoplasms e-Myelodysplastic / myeloproliferative ayiqembu lezifo lapho umnkantsha wenza amangqamuzana amhlophe egazi amaningi kakhulu.

Ama-neoplasms we-Myelodysplastic / myeloproliferative yizifo zegazi nomnkantsha wamathambo.

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.

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

Ama-neoplasms we-Myelodysplastic / myeloproliferative anezici zombili ze-myelodysplastic syndromes kanye ne-myeloproliferative neoplasms.

Kwezifo ze-myelodysplastic, amangqamuzana egazi egazi awavuthwa abe ngamaseli abomvu anempilo, amaseli amhlophe egazi, noma ama-platelets. Amaseli egazi angavuthwa, abizwa ngokuthi ukuqhuma, awasebenzi ngendlela efanele futhi afela emnkantsheni wamathambo noma ngemuva nje kokungena egazini. Ngenxa yalokhu, kukhona amangqamuzana abomvu egazi abambalwa, amaseli amhlophe egazi, nama-platelets.

Ezifweni ze-myeloproliferative, inani elingaphezu kwelivamile lamangqamuzana egazi abe yinye noma ngaphezulu kwezinhlobo zamaseli egazi futhi inani eliphelele lamaseli egazi landa kancane.

Lesi sifinyezo simayelana nama-neoplasms anezici zombili zezifo ze-myelodysplastic kanye ne-myeloproliferative. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane ngezifo ezihlobene:

• Ukwelashwa kwe-Myelodysplastic Syndromes

• Ukwelashwa Okungapheli Kwe-Myeloproliferative Neoplasms

• Ukwelashwa Okungalapheki Kwe-Leukemia

Kunezinhlobo ezahlukahlukene zama-myelodysplastic / myeloproliferative neoplasms.

Izinhlobo ezintathu eziphambili ze-myelodysplastic / myeloproliferative neoplasms zifaka okulandelayo:

• I-myelomonocytic leukemia engapheli (CMML).

• I-juvenile myelomonocytic leukemia (JMML).

• I-atypical chronic myelogenous leukemia (CML).

Lapho i-myelodysplastic / myeloproliferative neoplasm ingafani nanoma iyiphi yalezi zinhlobo, ibizwa ngokuthi i-myelodysplastic / myeloproliferative neoplasm, engahlakazeki (MDS / MPN-UC).

Ama-neoplasms we-Myelodysplastic / myeloproliferative angaqhubekela phambili ku-leukemia enamandla.

Kusetshenziswa izivivinyo ezihlola umnkantsha wegazi nomnkantsha ukuthola (ukuthola) nokuxilonga izimila ze-myelodysplastic / myeloproliferative neoplasms.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo ezinjengobende obukhulisiwe nesibindi. 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 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 kuhlolwa khona isampula yegazi ukuthola amaseli wokuqhuma, inani nezinhlobo zamaseli amhlophe egazi, inani lama-platelets, kanye nezinguquko ekubunjweni kwamaseli egazi.

• 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 kocezu oluncane lwethambo nomnkantsha ngokufaka inaliti ethangeni noma emathanjeni esifuba. Isazi sezifo sibuka womabili amasampula omnkantsha namathambo ngaphansi kwesibonakhulu ukuze afune 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.

Ukuhlolwa okulandelayo kungenziwa kusampula lezicubu ezisusiwe:

• Ukuhlaziywa kwe-cytogenetic: Ukuhlolwa kwelabhorethri lapho ama-chromosomes amaseli 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. Amaseli womdlavuza kuma-myelodysplastic / myeloproliferative neoplasms aqukethe i-chromosome yaseFiladelphia ekhona kwi-leukemia engapheli.

• I-Immunocytochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen athile (omaka) kusampula lomnkantsha wesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen kusampula yomnkantsha wesiguli, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonwe ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokutshela umehluko phakathi kwe-myelodysplastic / myeloproliferative neoplasms, leukemia, nezinye izimo.

I-Myelomonocytic Leukemia Engapheli

AMAPHUZU ASEMQOKA

• I-myelomonocytic leukemia engapheli isifo lapho ama-myelocyte amaningi kanye nama-monocyte (amangqamuzana amhlophe egazi angavuthwa) enziwa emnkantsheni wethambo.

• Ukuguga nokuba ngowesilisa kwandisa ubungozi be-myelomonocytic leukemia engapheli.

• Izimpawu nezimpawu ze-myelomonocytic leukemia engapheli zibandakanya umkhuhlane, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

I-myelomonocytic leukemia engapheli isifo lapho ama-myelocyte amaningi kanye nama-monocyte (amangqamuzana amhlophe egazi angavuthwa) enziwa emnkantsheni wethambo.

Kwi-myelomonocytic leukemia engapheli (i-CMML), umzimba utshela amangqamuzana amaningi egazi ukuthi abe yizinhlobo ezimbili zamaseli amhlophe abizwa ngama-myelocytes nama-monocyte. Amanye ala maseli egazi egazi akaze abe ngamaseli amhlophe avuthiwe egazi. Lawa maseli egazi amhlophe angavuthiwe abizwa ngokuthi ukuqhuma. Ngokuhamba kwesikhathi, ama-myelocyte, ama-monocyte, nokuqhuma kugcwalisa amangqamuzana abomvu egazi nama-platelet emnkantsheni wethambo. Uma lokhu kwenzeka, ukutheleleka, i-anemia, noma ukuphuma kalula kwegazi kungenzeka.

Ukuguga nokuba ngowesilisa kwandisa ubungozi be-myelomonocytic leukemia engapheli.

Noma yini eyandisa amathuba akho okuthola isifo ibizwa ngokuthi ingozi. Izici ezinobungozi ezingaba khona ze-CMML zifaka okulandelayo:

• Ukuguga.
• Ukuba owesilisa.
• Ukuvezwa ezintweni ezithile emsebenzini noma emvelweni.
• Ukuvezwa yimisebe.
• Ukwelashwa kwangaphambilini ngemithi ethile yokulwa nomdlavuza.

Izimpawu nezimpawu ze-myelomonocytic leukemia engapheli zibandakanya umkhuhlane, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-CMML noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Umkhuhlane ngaphandle kwesizathu esaziwayo.
• Ukutheleleka.
• Ukuzizwa ngikhathele kakhulu.
• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.
• Ukulinyazwa okulula noma ukopha.
• Ubuhlungu noma umuzwa wokugcwala ngaphansi kwezimbambo.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa ze-CMML zincike kokulandelayo:

• Inani lamaseli amhlophe egazi noma amaplatelets egazini noma kumnkantsha wethambo.

• Ukuthi isiguli sinesifo segazi yini.

• Inani lokuqhuma egazini noma emnkantsheni wethambo.

• Inani le-hemoglobin kumaseli abomvu egazi.

• Ukuthi kunezinguquko ezithile yini kuma-chromosomes.

I-Juvenile Myelomonocytic Leukemia

AMAPHUZU ASEMQOKA

• I-juvenile myelomonocytic leukemia yisifo sobuntwana lapho kwenziwa khona ama-myelocyte amaningi kanye nama-monocyte (amaseli egazi amhlophe angavuthiwe) emnkantsheni wethambo.

• Izimpawu nezimpawu ze-juvenile myelomonocytic leukemia zibandakanya umkhuhlane, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

I-juvenile myelomonocytic leukemia yisifo sobuntwana lapho kwenziwa khona ama-myelocyte amaningi kanye nama-monocyte (amaseli egazi amhlophe angavuthiwe) emnkantsheni wethambo.

I-juvenile myelomonocytic leukemia (JMML) ngumdlavuza ongavamile wezingane owenzeka kaningi ezinganeni ezingaphansi kweminyaka emibili. Izingane ezine-neurofibromatosis yohlobo 1 nabesilisa zinobungozi obandayo be-juvenile myelomonocytic leukemia.

Ku-JMML, umzimba utshela amangqamuzana amaningi egazi ukuthi abe yizinhlobo ezimbili zamaseli amhlophe abizwa ngama-myelocyte nama-monocyte. Amanye ala maseli egazi egazi akaze abe ngamaseli amhlophe avuthiwe egazi. Lawa maseli egazi amhlophe angavuthiwe abizwa ngokuthi ukuqhuma. Ngokuhamba kwesikhathi, ama-myelocyte, ama-monocyte, nokuqhuma kugcwalisa amangqamuzana abomvu egazi nama-platelet emnkantsheni wethambo. Uma lokhu kwenzeka, ukutheleleka, i-anemia, noma ukuphuma kalula kwegazi kungenzeka.

Izimpawu nezimpawu ze-juvenile myelomonocytic leukemia zibandakanya umkhuhlane, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-JMML noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Ukuba nezifo, njenge-bronchitis noma i-tonsillitis.

• Ukuzizwa ngikhathele kakhulu.

• Ukulinyazwa okulula noma ukopha.

• Ukuqhuma kwesikhumba.

• Ukuvuvukala okungenasici kwama-lymph node entanyeni, ngaphansi kwekhwapha, esiswini noma emgodini.

• Ubuhlungu noma umuzwa wokugcwala ngaphansi kwezimbambo.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa ze-JMML zincike kokulandelayo:

• Iminyaka yengane etholwayo.

• Inani lamaplatelets egazini.

• Inani lohlobo oluthile lwe-hemoglobin kumaseli abomvu egazi.

I-Atypical Chronic Myelogenous Leukemia

AMAPHUZU ASEMQOKA

• I-atypical chronic myelogenous leukemia isifo lapho ama-granulocyte amaningi kakhulu (amangqamuzana amhlophe egazi angavuthiwe) enziwa emnkantsheni wethambo.

• Izimpawu nezimpawu ze-atypical chronic myelogenous leukemia zibandakanya ukulimaza noma ukopha kalula nokuzizwa ukhathele futhi ubuthakathaka.

• Izici ezithile zithinta ukubikezela (ithuba lokululama).

I-atypical chronic myelogenous leukemia isifo lapho ama-granulocyte amaningi kakhulu (amangqamuzana amhlophe egazi angavuthiwe) enziwa emnkantsheni wethambo.

E-atypical chronic myelogenous leukemia (CML), umzimba utshela amangqamuzana amaningi egazi ukuthi abe uhlobo lweseli elimhlophe elibizwa ngama-granulocytes. Amanye ala maseli egazi egazi akaze abe ngamaseli amhlophe avuthiwe egazi. Lawa maseli egazi amhlophe angavuthiwe abizwa ngokuthi ukuqhuma. Ngokuhamba kwesikhathi, ama-granulocyte nokuqhuma kugcwalisa amangqamuzana abomvu egazi nama-platelet emnkantsheni wethambo.

Amaseli we-leukemia ku-CML ye-atypical ne-CML abukeka ngokufana ngaphansi kwe-microscope. Kodwa-ke, ku-CML ye-atypical ushintsho oluthile lwe-chromosome, olubizwa nge- "Philadelphia chromosome" alukho lapho.

Izimpawu nezimpawu ze-atypical chronic myelogenous leukemia zibandakanya ukulimaza noma ukopha kalula nokuzizwa ukhathele futhi ubuthakathaka.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-CML engajwayelekile noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ukuphelelwa umoya.

• Isikhumba esiphaphathekile.

• Ukuzizwa ngikhathele futhi ngibuthakathaka.

• Ukulinyazwa okulula noma ukopha.

• I-Petechiae (izindawo ezicabalele, ezikhomba ngaphansi kwesikhumba ezibangelwa ukopha).

• Ubuhlungu noma umuzwa wokugcwala ngaphansi kwezimbambo ohlangothini lwesobunxele.

Izici ezithile zithinta ukubikezela (ithuba lokululama).

Isibikezelo (ithuba lokululama) le-CML engajwayelekile incike kwinani lamaseli abomvu egazi nama-platelet egazini.

I-Myelodysplastic / Myeloproliferative Neoplasm, engenakuchazeka

AMAPHUZU ASEMQOKA

• I-Myelodysplastic / myeloproliferative neoplasm, engenakuchazeka, isifo esinezici zombili zezifo ze-myelodysplastic kanye ne-myeloproliferative kodwa akusona isifo se-leukemia esingalapheki se-myelomonocytic, i-juvenile myelomonocytic leukemia, noma i-atypical chronic myelogenous leukemia.

• Izimpawu nezimpawu ze-myelodysplastic / myeloproliferative neoplasm, engahlakazeki, ifaka imfiva, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

I-Myelodysplastic / myeloproliferative neoplasm, engenakuchazeka, isifo esinezici zombili zezifo ze-myelodysplastic kanye ne-myeloproliferative kodwa akusona isifo se-leukemia esingalapheki se-myelomonocytic, i-juvenile myelomonocytic leukemia, noma i-atypical chronic myelogenous leukemia.

Ku-myelodysplastic / myeloproliferative neoplasm, engahlakazeki (MDS / MPD-UC), umzimba utshela amangqamuzana amaningi egazi ukuthi abe amaseli abomvu egazi, amangqamuzana amhlophe egazi, noma ama-platelets. Amanye ala maseli egazi egazi akaze abe ngamaseli egazi avuthiwe. Lawa maseli egazi angavuthwa abizwa ngokuthi ukuqhuma. Ngokuhamba kwesikhathi, amangqamuzana egazi angajwayelekile nokuqhuma emnkantsheni wamathambo kugcwalisa amangqamuzana abomvu egazi anempilo, amangqamuzana amhlophe egazi nama-platelets.

I-MDS / MPN-UC yisifo esingajwayelekile kakhulu. Ngoba akuvamile, izinto ezithinta ubungozi nokubikezela azaziwa.

Izimpawu nezimpawu ze-myelodysplastic / myeloproliferative neoplasm, engahlakazeki, ifaka imfiva, ukunciphisa umzimba, nokuzizwa ukhathele kakhulu.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-MDS / MPN-UC noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Umkhuhlane noma ukutheleleka okuvamile.

• Ukuphelelwa umoya.

• Ukuzizwa ngikhathele futhi ngibuthakathaka.

• Isikhumba esiphaphathekile.

• Ukulinyazwa okulula noma ukopha.

• I-Petechiae (izindawo ezicabalele, ezikhomba ngaphansi kwesikhumba ezibangelwa ukopha).

• Ubuhlungu noma umuzwa wokugcwala ngaphansi kwezimbambo.

Izigaba zeMyelodysplastic / Myeloproliferative Neoplasms

AMAPHUZU ASEMQOKA

• Alukho uhlelo olujwayelekile lokubeka izigaxa lwe-myelodysplastic / myeloproliferative neoplasms.

Alukho uhlelo olujwayelekile lokubeka izigaxa lwe-myelodysplastic / myeloproliferative neoplasms.

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

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-myelodysplastic / myeloproliferative neoplasms.

• Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa ngamakhemikhali

• Olunye ukwelashwa kwezidakamizwa

• Ukufakelwa kwe-stem cell

• Ukunakekelwa okusekelayo

• Ukwelashwa okuhlosiwe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwe-myelodysplastic / myeloproliferative neoplasms 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 ezahlukene zokwelashwa kweziguli ezine-myelodysplastic / myeloproliferative neoplasms.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-myelodysplastic / myeloproliferative 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 ezinhlanu zokwelashwa okujwayelekile 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). 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. Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa izidakamizwa ezingaphezu kwesisodwa ze-anticancer.

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

Olunye ukwelashwa kwezidakamizwa

I-13-cis retinoic acid isidakamizwa esifana nevithamini esinciphisa amandla omdlavuza wokwenza amangqamuzana omdlavuza amaningi futhi sishintshe indlela la maseli abukeka futhi enze ngayo.

Ukufakelwa kwe-stem cell

I-Chemotherapy inikezwa ukubulala amaseli angajwayelekile noma 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.

Ukunakekelwa okusekelayo

Ukunakekelwa kokusekelwa kunikezwa ukunciphisa izinkinga ezibangelwa yisifo noma ukwelashwa kwaso. Ukunakekelwa okusekelayo kungabandakanya ukwelashwa ngokumpontshelwa noma ukwelashwa ngezidakamizwa, njengama-antibiotics ukulwa nokutheleleka.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe ukwelashwa komdlavuza okusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza ngaphandle kokulimaza amaseli ajwayelekile. Imithi yokwelashwa ehlosiwe ebizwa nge-tyrosine kinase inhibitors (TKIs) isetshenziselwa ukwelapha i-myelodysplastic / myeloproliferative neoplasm, engahlakazeki. Ama-TKI avimba i-enzyme, i-tyrosine kinase, ebangela ukuthi ama-stem cells abe ngamaseli egazi (ukuqhuma) kunalokho okudingwa ngumzimba. I-Imatinib mesylate (Gleevec) iyi-TKI engasetshenziswa. Eminye imithi yokwelashwa ehlosiwe iyafundwa ekwelapheni i-JMML.

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

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa kwe-myelodysplastic / myeloproliferative neoplasms 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.

Izinketho Zokwelashwa ze-Myelodysplastic / Myeloproliferative Neoplasms

Kulesi Sigaba

• I-Myelomonocytic Leukemia Engapheli

• I-Juvenile Myelomonocytic Leukemia

• I-Atypical Chronic Myelogenous Leukemia

• I-Myelodysplastic / Myeloproliferative Neoplasm, engenakuchazeka

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

I-Myelomonocytic Leukemia Engapheli

Ukwelashwa kwe-myelomonocytic leukemia (CMML) kungafaka okulandelayo:

• Chemotherapy nge-ejenti eyodwa noma ngaphezulu.

• Ukufakelwa kwe-stem cell.

• 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-Juvenile Myelomonocytic Leukemia

Ukwelashwa kwe-juvenile myelomonocytic leukemia (JMML) kungafaka okulandelayo:

• Inhlanganisela chemotherapy.

• Ukufakelwa kwe-stem cell.

• Ukwelashwa kwe-acid ye-13-cis-retinoic.

• Isivivinyo somtholampilo sokwelapha okusha, njengokwelashwa okuhlosiwe.

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-Atypical Chronic Myelogenous Leukemia

Ukwelashwa kwe-atypical chronic myelogenous leukemia (CML) kungafaka i-chemotherapy.

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-Myelodysplastic / Myeloproliferative Neoplasm, engenakuchazeka

Ngoba i-myelodysplastic / myeloproliferative neoplasm, engahlakazeki (MDS / MPN-UC) isifo esingajwayelekile, kuncane okwaziwayo ngokwelashwa kwaso. Ukwelashwa kungafaka okulandelayo:

• Izindlela zokwelashwa ezisekelayo ukuphatha izinkinga ezibangelwa yilesi sifo njengokutheleleka, ukopha, nokushoda kwegazi.

• Ukwelashwa okuhlosiwe (imatinib mesylate).

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-Myelodysplastic / Myeloproliferative Neoplasms

Ngeminye imininingwane evela ku-National Cancer Institute mayelana ne-myelodysplastic / myeloproliferative neoplasms, bheka okulandelayo:

• Ikhasi lasekhaya le-Myeloproliferative Neoplasms

• Ukufakelwa Kwama-Stem Cell Stem

• Izidakamizwa zivunyelwe i-Myeloproliferative Neoplasms

• 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