Types/myeloproliferative/patient/myelodysplastic-treatment-pdq

Ukwelashwa kwe-Myelodysplastic Syndromes (®) –Patient Version

Imininingwane ejwayelekile Mayelana neMyelodysplastic Syndromes

AMAPHUZU ASEMQOKA

• Ama-syndromes ama-Myelodysplastic ayiqembu lomdlavuza lapho amangqamuzana egazi angavuthiwe emnkantsheni wethambo engakhuli noma abe ngamaseli egazi aphilile.

• Izinhlobo ezahlukahlukene zama-myelodysplastic syndromes zitholwa ngokususelwa kuzinguquko ezithile kumaseli egazi nomnkantsha wethambo.

• Ukwelashwa kweminyaka kanye nokwedlule nge-chemotherapy noma i-radiation therapy kuthinta ubungozi be-myelodysplastic syndrome.

• Izimpawu nezimpawu zesifo se-myelodysplastic syndrome zibandakanya ukuphefumula okuncane nokuzizwa ukhathele.

• Ukuhlolwa okuhlola igazi nomnkantsha kusetshenziselwa ukuthola (ukuthola) nokuxilonga ama-syndromes we-myelodysplastic.

• Izici ezithile zithinta izinketho zokubikezela kanye nokwelashwa.

Ama-syndromes ama-Myelodysplastic ayiqembu lomdlavuza lapho amangqamuzana egazi angavuthiwe emnkantsheni wethambo engakhuli noma abe ngamaseli egazi aphilile.

Kumuntu onempilo, umnkantsha wenza amangqamuzana egazi (amangqamuzana angavuthiwe) aphenduka amaseli 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 yiseli lesiqu se-lymphoid noma iseli le-myeloid 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.

• Ama-platelet akha amahlule egazi ukumisa ukopha.

• Amaseli egazi amhlophe alwa nokutheleleka nezifo.

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

Esigulini esine-myelodysplastic syndrome, amangqamuzana egazi egazi (amangqamuzana angavuthiwe) awabi ngamaseli abomvu avuthiwe egazi, amangqamuzana amhlophe egazi, noma ama-platelet emnkantsheni wethambo. Lawa maseli egazi angavuthiwe, abizwa ngokuthi ukuqhuma, awasebenzi ngendlela okufanele enze ngayo futhi angafa emnkantsheni wamathambo noma ngemuva nje kokungena egazini. Lokhu kushiya indawo encane yamangqamuzana amhlophe egazi anempilo, amangqamuzana abomvu egazi, nama-platelet akha emnkantsheni wethambo. Lapho kunamaseli egazi anempilo ambalwa, ukutheleleka, i-anemia, noma ukuphuma kalula kwegazi kungenzeka.

Izinhlobo ezahlukahlukene zama-myelodysplastic syndromes zitholwa ngokususelwa kuzinguquko ezithile kumaseli egazi nomnkantsha wethambo.

• I-anemia ekhanyayo: Ambalwa kakhulu amaseli egazi abomvu egazini kanti isiguli sine-anemia. Inani lamaseli amhlophe egazi namaplatelets lijwayelekile.

• I-anemia ekhanyayo ene-ring sideroblasts: Kunamaseli abomvu ambalwa kakhulu egazini kanti isiguli sine-anemia. Amaseli abomvu ane-iron eningi kakhulu ngaphakathi kweseli. Inani lamaseli amhlophe egazi namaplatelets lijwayelekile.

• I-anemia ekhombayo enokuqhuma okweqile: Ambalwa kakhulu amaseli egazi abomvu egazini kanti isiguli sine-anemia. Amaphesenti amahlanu kuya ku-19% wamaseli emnkantsheni wethambo ukuqhuma. Kungabuye kube nezinguquko kumaseli amhlophe egazi nama-platelets. I-anemia ephikisayo enokuqhuma ngokweqile ingaqhubekela phambili ibe yi-acute myeloid leukemia (AML). Bona isifinyezo se- Adult Acute Myeloid Leukemia Treatment ukuthola eminye imininingwane.

• I-cytopenia ephikisayo ene-multilineage dysplasia: Zimbalwa kakhulu okungenani izinhlobo ezimbili zamaseli egazi (amaseli abomvu egazi, ama-platelets, noma amaseli amhlophe egazi). Ngaphansi kuka-5% wamaseli emnkantsheni wethambo ukuqhuma kanti ngaphansi kwamaphesenti ayisishiyagalolunye egazini kuqhuma. Uma amaseli abomvu egazi ethintekile, angaba nensimbi eyengeziwe. I-cytopenia ephikisayo ingaqhubekela phambili ku-acute myeloid leukemia (AML).

• I-cytopenia ephikisayo ene-unilineage dysplasia: Zimbalwa kakhulu izinhlobo zohlobo olulodwa lweseli (amaseli abomvu egazi, ama-platelets, noma amaseli amhlophe egazi). Kukhona izinguquko ku-10% noma ngaphezulu kwezinye izinhlobo ezimbili zamaseli egazi. Ngaphansi kuka-5% wamaseli emnkantsheni wethambo ukuqhuma kanti ngaphansi kwamaphesenti ayisishiyagalolunye egazini kuqhuma.

• I-myelodysplastic syndrome engahlakazeki: Izinombolo zokuqhuma emnkantsheni nasegazini zijwayelekile, kanti lesi sifo asiyona enye yama-syndromes we-myelodysplastic.

• I-Myelodysplastic syndrome ehlotshaniswa nokungajwayelekile kwe-chromosome del (5q): Kunamaseli abomvu ambalwa kakhulu egazini kanti isiguli sine-anemia. Ngaphansi kuka-5% wamaseli emnkantsheni wethambo nasegazini kuqhuma. Kukhona ushintsho oluthile ku-chromosome.

• I-chronic myelomonocytic leukemia (CMML): Bona isifinyezo se- ku-Myelodysplastic / Myeloproliferative Neoplasms Treatment ukuthola eminye imininingwane.

Ukwelashwa kweminyaka kanye nokwedlule nge-chemotherapy noma i-radiation therapy kuthinta ubungozi be-myelodysplastic syndrome.

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola isifo; ukungabi nezici zobungozi akusho ukuthi ngeke usithole isifo. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini. Izici zobungozi kuma-syndromes we-myelodysplastic zifaka okulandelayo:

• Ukwelashwa kwangaphambilini ngamakhemikhali noma ngemisebe yokwelapha umdlavuza.

• Ukuchayeka kumakhemikhali athile, kufaka phakathi intuthu kagwayi, izibulala-zinambuzane, umanyolo namakhemikhali awuketshezi afana ne-benzene.

• Ukuvezwa kuzinsimbi ezisindayo, njenge-mercury noma umthofu.

Isizathu se-myelodysplastic syndromes ezigulini eziningi asaziwa.

Izimpawu nezimpawu zesifo se-myelodysplastic syndrome zibandakanya ukuphefumula okuncane nokuzizwa ukhathele.

Ama-syndromes ama-Myelodysplastic kaningi awabangeli izimpawu noma izimpawu zakuqala. Zingatholwa ngesikhathi sokuhlolwa kwegazi okujwayelekile. Izimpawu nezimpawu zingabangelwa ama-myelodysplastic syndromes noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ukuphelelwa umoya.

• Ubuthakathaka noma ukuzizwa ukhathele.

• Ukuba nesikhumba esincanyana kunokujwayelekile.

• Ukulinyazwa okulula noma ukopha.

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

Ukuhlolwa okuhlola igazi nomnkantsha kusetshenziselwa ukuthola (ukuthola) nokuxilonga ama-syndromes we-myelodysplastic.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: 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 yegazi ukuze kubonakale ushintsho enombolweni, uhlobo, ukwakheka, nosayizi wamaseli egazi kanye nensimbi eningi kakhulu kumaseli abomvu egazi.

• 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.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njengevithamini B12 ne-folate, ekhishwe 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.

Ukuhlolwa okulandelayo kungenziwa kusampula lezicubu ezisusiwe:

• 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 yamaseli wesiguli, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokwazisa umehluko phakathi kwe-myelodysplastic syndromes, i-leukemia, nezinye izimo.

• I-Immunophenotyping: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukukhomba amangqamuzana omdlavuza asuselwa ezinhlotsheni zama-antigen noma omaka ebusweni bamaseli. Lokhu kuhlolwa kusetshenziselwa ukuxilonga izinhlobo ezithile ze-leukemia nezinye izifo zegazi.

• 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 yegazi lesiguli, umnkantsha, noma ezinye izicubu anamabala ombala we-fluorescent, afakwa kuketshezi, abese edluliswa ngalinye ngesikhathi emgqeni wokukhanya. 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.

• 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.

Izici ezithile zithinta izinketho zokubikezela kanye nokwelashwa.

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Inani lamaseli wokuqhuma emnkantsheni wethambo.

• Ukuthi ngabe kuthinteka yini uhlobo olulodwa noma ngaphezulu lwamaseli egazi.

• Ukuthi isiguli sinezimpawu noma izimpawu zokushoda kwegazi, ukopha noma ukutheleleka.

• Ukuthi isiguli sinengozi ephansi noma ephezulu ye-leukemia.

• Izinguquko ezithile kuma-chromosomes.

• Ukuthi i-myelodysplastic syndrome yenzeke ngemuva kokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe yomdlavuza.

• Iminyaka nempilo ejwayelekile yesiguli.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-myelodysplastic syndromes.

• Ukwelashwa kwama-syndromes e-myelodysplastic kufaka ukunakekelwa okusekelayo, ukwelashwa kwezidakamizwa, nokufakelwa kwe-stem cell.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukunakekelwa okusekelayo

• Ukwelashwa kwezidakamizwa

• I-Chemotherapy ngokufakelwa kwe-stem cell

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwama-syndromes e-myelodysplastic kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-myelodysplastic syndromes.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-myelodysplastic syndromes. 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.

Ukwelashwa kwama-syndromes e-myelodysplastic kufaka ukunakekelwa okusekelayo, ukwelashwa kwezidakamizwa, nokufakelwa kwe-stem cell.

Iziguli ezine-myelodysplastic syndrome ezinezimpawu ezibangelwa ukubalwa kwegazi okuphansi zinikezwa ukunakekelwa okusekelayo ukunciphisa izimpawu nokwenza ngcono impilo. Ukwelashwa kwezidakamizwa kungasetshenziselwa ukunciphisa ukukhula kwesifo. Ezinye iziguli zingelashwa ngokwelashwa okunamandla nge-chemotherapy elandelwa ukufakelwa kwe-stem cell kusetshenziswa ama-stem cell avela kumnikeli.

Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukunakekelwa okusekelayo

Ukunakekelwa kokusekelwa kunikezwa ukunciphisa izinkinga ezibangelwa yisifo noma ukwelashwa kwaso. Ukunakekelwa okusekelayo kungafaka okulandelayo:

• Ukwelashwa kokumpontshelwa

Ukwelashwa kokumpontshelwa (ukumpontshelwa igazi) kuyindlela yokunikeza amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, noma ama-platelets okuzothatha indawo yamaseli egazi abhujiswe izifo noma ukwelashwa. Ukufakwa kwegazi elibomvu kunikezwa lapho isibalo segazi elibomvu siphansi futhi izimpawu noma izimpawu ze-anemia, njengokuphefumula okuncane noma ukuzizwa ukhathele kakhulu, kwenzeka. Ukumpontshelwa kweplatelet kuvame ukunikezwa lapho isiguli sopha, sinenqubo engadala ukopha, noma lapho inani leplatelet liphansi kakhulu.

Iziguli ezithola ukumpontshelwa amangqamuzana egazi amaningi zingase zibe nokulimala kwezicubu nezitho zomzimba okubangelwe yinsimbi eyengeziwe. Lezi ziguli zingelashwa nge-iron chelation therapy ukususa insimbi eyengeziwe egazini.

• Ama-ejenti e-Erythropoiesis-ashukumisayo

Ama-Erythropoiesis-stimulating agents (ESAs) anganikezwa ukwandisa inani lamaseli abomvu avuthiwe enziwe ngumzimba nokunciphisa imiphumela yokushoda kwegazi. Kwesinye isikhathi i-granulocyte colony-stimulating factor (G-CSF) inikezwa nama-ESA ukusiza ukuthi ukwelashwa kusebenze kangcono.

• Imithi elwa namagciwane

Ama-antibiotic anganikezwa ukulwa nokutheleleka.

Ukwelashwa kwezidakamizwa

• Lenalidomide

Iziguli ezine-myelodysplastic syndrome ezihambisana nokungajwayelekile kwe-ch (5q) chromosome engavamile edinga ukumpontshelwa njalo kwamangqamuzana egazi abomvu zingelashwa nge-lenalidomide. ILenalidomide isetshenziselwa ukunciphisa isidingo sokumpontshelwa amangqamuzana egazi abomvu.

• Ukwelashwa kwama-immunosuppressive

I-Antithymocyte globulin (ATG) isebenza ukucindezela noma ukwenza buthaka amasosha omzimba. Isetshenziselwa ukunciphisa isidingo sokumpontshelwa amangqamuzana egazi abomvu.

• I-Azacitidine ne-decitabine

I-Azacitidine ne-decitabine kusetshenziselwa ukwelapha ama-syndromes e-myelodysplastic ngokubulala amaseli ahlukana ngokushesha. Zisiza nezakhi zofuzo ezibandakanyeka ekukhuleni kwamaseli ukuze zisebenze ngendlela efanele. Ukwelashwa nge-azacitidine ne-decitabine kunganciphisa ukukhula kwama-myelodysplastic syndromes kuya ku-acute myeloid leukemia.

• I-Chemotherapy esetshenziswa ku-acute myeloid leukemia (AML)

Iziguli ezine-myelodysplastic syndrome kanye nenani eliphakeme lokuqhuma emnkantsheni wazo zinengozi enkulu yokuba ne-leukemia ebukhali. Bangase baphathwe ngemithi efanayo yokwelashwa ngamakhemikhali esetshenziswa ezigulini ezine-acute myeloid leukemia.

I-Chemotherapy ngokufakelwa kwe-stem cell

I-Chemotherapy 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.

Lokhu kwelashwa kungahle kungasebenzi kahle ezigulini ezinesifo i-myelodysplastic syndrome esibangelwe ukwelashwa komdlavuza okwedlule.

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-syndromes e-myelodysplastic 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.

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 zama-Myelodysplastic Syndromes

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

Izinketho Ezijwayelekile Zokwelashwa Zama-Myelodysplastic Syndromes

Izinketho zokwelashwa ezijwayelekile ze-myelodysplastic syndromes zifaka:

• Ukunakekelwa kokusekelwa kokukodwa noma okuningi kokulandelayo:

• Ukwelashwa kokumpontshelwa.

• Ama-erythropoiesis-ashukumisayo.

• Imithi elwa namagciwane.

• Ukwelashwa kokunciphisa kancane kancane ku-acute myeloid leukemia (AML):

• Lenalidomide.

• Ukwelashwa kwama-immunosuppressive.

• I-Azacitidine ne-decitabine.

• I-Chemotherapy esetshenziswa ku-acute myeloid leukemia.

• I-Chemotherapy ngokufakelwa kwe-stem cell.

Ukwelashwa kwama-Myeloid Neoplasms Ahlobene Nokwelapha

Iziguli ezelashwa esikhathini esidlule ngamakhemikhali noma ngemisebe yokwelapha ngemisebe zingathuthukisa ama-myeloid neoplasms ahlobene nalolo lwazi. Izinketho zokwelashwa ziyefana namanye ama-syndromes we-myelodysplastic.

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.

Izinketho zokwelashwa zama-Syndromes abuyiselwe emuva noma aphikisayo e-Myelodysplastic Syndromes

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

Akukho ukwelashwa okujwayelekile kwama-syndromes we-myelodysplastic aphikisayo noma abuyele emuva. Iziguli ezinomdlavuza ongaphenduli ekwelashweni noma ezibuyile ngemuva kokwelashwa zingafuna ukubamba iqhaza esivivinyweni somtholampilo.

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.

Ukufunda Kabanzi Nge-Myelodysplastic Syndromes

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-myelodysplastic syndromes, bheka okulandelayo:

• Ukufakelwa Kwama-Stem Cell Stem

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

• Mayelana Nesi Sifinyezo se-