So wo nnompe mu ntini no ntumi nyɛ adwuma yiye? Momma yɛnka myelosuppression ho asɛm!

So wote nka nso sɛ wo ho nyɛ wo den kɛkɛ, woreyare bere nyinaa, anaasɛ mogya retu wo wɔ nea wɔatwa ketewaa bi mpo mu, sɛ́ ebia woreyɛ kokoram ayaresa anaa yare foforo bi? Ebia myelosuppression , tebea bi a nnompe mu ntini no ntumi nyɛ adwuma yiye wɔ saa nneɛma yi akyi . Mma ɛnhaw wo, momma yɛnka eyi ho asɛm tiawa.

Dɛn ne myelosuppression? Sɛ yɛbɛka no pɛpɛɛpɛ a, so ɛyɛ nnompe mu ntini a ɛyɛ mmerɛw?

Sɛ yɛbɛka no tiawa a, yiw! Nnompe mu ntini yɛ ntini a ɛyɛ mmerɛw na ɛte sɛ sponge a ɛwɔ wo nnompe mu. Fa no sɛ ɛte sɛ yɛn nipadua adwumayɛbea a wɔyɛ mogya . Saa adwumayɛbea yi yɛ mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, ne mogya mu nkwammoaa a ɛho hia ma yɛn nkwa, ɔpepepem pii, na ɛde ka yɛn mogya ho. Ɛsono sɛnea nkwammoaa biara yɛ adwuma ma yɛn nipadua. Nnompe mu ntini no ma saa nneɛma yi yɛ kɛse anaasɛ ɛtew so a egyina yɛn nipadua no ahiade so.

Mprempren, wɔ tebea bi a wɔfrɛ no myelosuppression , mu no, nnompe mu ntini adwumayɛbea yi adwuma asɛe esiane biribi nti. Afei, mogya mu nkwammoaa ne mogya mu nkwammoaa a ɛma mogya tu no ntumi nyɛ yiye. Ade titiriw nti a wɔyɛ eyi ne nnuru a wɔde sa kokoram. Nanso, mogya mu kokoram ahorow bi ne mmoawa bi nso betumi ama nnompe mu ntini asɛe.

Dɛn ne myelosuppression ho sɛnkyerɛnne ahorow?

Nsɛnkyerɛnne no betumi ayɛ soronko wɔ onipa biara ho, a egyina sɛ ebia wo nnompe mu ntini no ma mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, anaa mogya mu nkwammoaa kɔkɔɔ ba.

Sɛ mogya mu nkwammoaa kɔkɔɔ so tew a - Anemia

Mogya mu nkwammoaa kɔkɔɔ de mframa pa kɔ wo nipadua nyinaa mu. Sɛ wɔn dodow nnɔɔso a , mogya a ɛtɔ kɔ nipadua no mu ba. Nsɛnkyerɛnne no betumi ayɛ:

• Ɔbrɛ
• Ɔhome a ɛyɛ tiaa / ahome a ɛyɛ den
• Adwene a ɛyɛ basaa
• Koma a ɛbɔ ntɛmntɛm anaasɛ ɛnteɛ / arrhythmia
• Nnyigyei a ɛrebɔ wɔ aso mu a wɔte nka, ɛtɔ mmere bi a "thumping" nnyigyei ne koma bɔ (Pulsatile tinnitus) ka ho .
• Tipaeɛ
• Honam ani kɔla a ɛyɛ mmerɛw
• Koko mu yaw

Neutropenia - mogya mu nkwammoaa fitaa (titiriw neutrophils) a ɛso tew .

Mogya mu nkwammoaa fitaa ko tia mmoawa a wɔhyɛn yɛn nipadua mu na wɔbɔ yɛn ho ban fi ɔyare mmoawa ho . Wɔfrɛ mogya mu nkwammoaa fitaa biako neutrophils . Sɛ nnompe mu ntini no mma neutrophils kakraa bi na ɛba esiane myelosuppression nti a, wɔfrɛ tebea no neutropenia . Neutropenia nni sɛnkyerɛnne pɔtee biara, na mmom esiane eyi ntiNyarewa a wɔtaa nya no betumi aba, na ɛno ne bere a yare no ho sɛnkyerɛnne ahorow no da adi.

• Atiridiinini (ɛtɔ mmere bi a wɔfrɛ no febrile neutropenia ) .
• Ɔbrɛ
• Menewa mu yaw/yare mmoawa (Menewa mu yaw/pharyngitis) .
• Ntini a ɛma mogya tu a ahonhon
• Akuru a ɛwɔ ano anaa akyi berɛmo no ho
• Ayamtuo
• Ɔhyew bere a woretow, wote nka sɛ ɛsɛ sɛ wototo wo ho ntɛmntɛm, wotaa tow wo ho

Sɛ mogya nkwammoaa so tew a - Thrombocytopenia

Nkwammoaa a ɛma mogya tu boa ma wotumi siw mogya a ɛba no so . Sɛ saa dodow yi so tew a, tebea bi a wɔfrɛ no thrombocytopenia ba. Eyi betumi ama:

• Mogya a ɛtra hɔ kyɛ, mpo efi kuru ketewaa bi mu, anaasɛ ɛyɛ den sɛ wobegyae hwene mu mogya.
• Akuru no pue ntɛmntɛm sen sɛnea ɛtaa ba.
• Ntini kɔkɔɔ nketewa (te sɛ akisikuru) a ɛda adi wɔ nan ase - wɔfrɛ eyi petechiae .
• Nsonsonoe kɔkɔɔ, kɔkɔɔ, anaa bruu a ɛwɔ honam ani - wɔfrɛ eyi purpura .

Sɛ mogya mu nkwammoaa ahorow nyinaa so tew a - Pancytopenia

Ɛtɔ mmere bi a, mogya mu nkwammoaa abiɛsa yi nyinaa—mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, ne mogya mu nkwammoaa kɔkɔɔ—tumi sua bere koro mu . Wɔfrɛ saa tebea yi pancytopenia . Te sɛ neutropenia no, eyi ankasa nyɛ yare, nanso ebetumi ayɛ aduruyɛ mu tebea bi a ɛda adi ho sɛnkyerɛnne.

Dɛn nti na myelosuppression ba? Dɛn na ɛde ba?

Sɛnea yɛadi kan aka no, nnuru a wɔde sa yare na ɛtaa de ba . Nanso, nneɛma afoforo nso wɔ hɔ a ɛde ba.

Nnuru a wɔde sa yare, nipadua no mu tumi a ɛko tia nyarewa, ne myelosuppression

Nnuru ahorow pii a wɔde sa yare a wɔde sa yare betumi de eyi aba. Nea wɔtaa yɛ no bi ne:

• Fluorouracil a wɔde yɛ aduru
• Oxaliplatin a wɔde di dwuma
• Irinotecan a ɛyɛ aduru a wɔfrɛ no Irinotecan
• Capecitabine a wɔde di dwuma

Bio nso, CAR T-cell ayaresa, a ɛyɛ immunotherapy bi , nso betumi asɛe nnompe mu ntini no dwumadi na ama mogya mu nkwammoaa ne mogya mu nkwammoaa a wɔyɛ no so atew.

Mogya mu Kokoram ne Myelosuppression

Mogya mu kokoram ahorow bi nso betumi asiw mogya mu nkwammoaa a wɔyɛ no sɛnea ɛsɛ. Sɛ nhwɛso no, wɔ kokoram ahorow te sɛ mogya mu kokoram, lymphoma, ne myeloma , mu no, kokoram nkwammoaa a ɛnteɛ nyin dodo wɔ nnompe mu ntini mu na egyae mogya mu nkwammoaa ne mogya mu nkwammoaa a ɛte apɔw a wɔyɛ no.

Mmoawa ne myelosuppression

Mmoawa bi nso betumi asɛe mogya a ɛba nnompe mu ntini mu no. Fa no sɛ, sɛ mmoawa bi hyɛn nipadua no mu a, yɛn nipadua no ahobammɔ, a ɛne mogya mu nkwammoaa fitaa no ko tia mmoawa no. Wɔ ɔko yi mu no, nnompe mu ntini no betumi ama mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa kakraa bi aba. Nhwehwɛmu ahorow bi kyerɛ sɛ mmoawa bi ka nkwammoaa a ɛyɛ mogya wɔ nnompe mu ntini mu no tẽẽ, na ɛma mogya mu nkwammoaa dodow so tew. Mmoawa bi a wɔahu sɛ ɛne myelosuppression tebea yi wɔ abusuabɔ ne:

• Epstein-Barr mmoawa (EBV) .
• Hepatitis C mmoawa
• Parvovirus B19 a ɛyɛ ɔyare mmoawa
• Nkwammoaa a wɔfrɛ no Cytomegalovirus (CMV) .
• Mmoawa a ɛde akokɔsrade ba (Akisikuru / varicella zoster) .
• Nnipa a nipadua no tumi ko tia nyarewa (HIV) .
• Dengue atiridiinini

So myelosuppression betumi de nsɛnnennen a emu yɛ den aba?

Yiw, ɛtɔ mmere bi a eyi betumi de nsɛnnennen a ɛde nkwa to asiane mu aba . Sɛ nhwɛso no, mogya mu nkwammoaa kɔkɔɔ a ɛso tew mpofirim (mogya a ɛtɔ kɔ nipadua mu a emu yɛ den) anaasɛ mogya mu nkwammoaa a ɛso tew (mogya a wontumi nni so) .

Nea ɛho hia: Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi, titiriw sɛ woreyɛ kokoram ayaresa a, ɛho hia yiye sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.

Ɔkwan bɛn so na nnuruyɛfo hu saa tebea yi pɛpɛɛpɛ?

Wɔnam mogya mu nhwehwɛmu so titiriw na ɛkyerɛ eyi . Saa mogya mu nhwehwɛmu ahorow yi hwɛ sɛ wo nnompe mu ntini no reyɛ mogya mu nkwammoaa ne mogya mu nkwammoaa kɔkɔɔ sɛnea ɛsɛ anaa.

Wobetumi ayɛ mogya mu nhwehwɛmu te sɛ eyinom:

• Mogya dodow a wɔde ma a edi mũ (CBC) .
• MCV sɔhwɛ (Mean corpuscular volume / MCV sɔhwɛ) .
• RDW sɔhwɛ (Red cell kyekyɛ trɛw / RDW sɔhwɛ) .
• Reticulocyte dodow a ɛwɔ nipadua no mu
• Mogya a wɔde srasra nipadua no akyi
• MPV sɔhwɛ (Mpam nkwammoaa dodow a ɛkyerɛ / MPV sɔhwɛ) .

Dɛn ne ayaresa ahorow a wɔde sa myelosuppression?

Nnuruyɛfo de akwan yi sa eyi:

• Sɛ nea ɛde myelosuppression ba ne nnuru a wɔde sa yare a, ɛsɛ sɛ wɔtew nnuru dodow a wɔde sa yare no so anaasɛ wogyae bere tiaa bi .
• Mogya a wɔde ma na ama mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa dodow akɔ soro.
• Nnuru a ɛboa ma wo nnompe mu ntini ma mogya mu nkwammoaa ne mogya mu nkwammoaa kɔkɔɔ pii a wɔbɛma wo.

So wobetumi asiw tebea yi ano na amma?

Mpɛn pii no, myelosuppression ba sɛ nea efi kokoram ayaresa mu ba. Enti, nnuruyɛfo hwɛ nneɛma bɔne yi bere nyinaa bere a wɔsa kokoram no. Wɔbɛhwɛ wo mogya mu nhwehwɛmu daa na sɛ ɛho hia a, wɔbɛyɛ nsakrae wɔ wo ayaresa nhyehyɛe no mu.

Sɛ mewɔ myelosuppression a, dɛn na metumi ahwɛ kwan?

Nnipa pii nya saa tebea yi esiane sɛ wɔreyɛ nnuru a wɔde sa wɔn yare nti. Sɛ saa a, wo duruyɛfo no bɛhwɛ sɛnea nnuru a wɔde sa wo no renya wo nnompe mu ntini no so yiye . Ebia ebehia sɛ wugye w’ahome bere tiaa bi fi kokoram ayaresa mu na ama wo nnompe mu ntini no asan akyekye ne mogya mu nkwammoaa dodow.

Mɛyɛ dɛn ahwɛ me ho?

Myelosuppression betumi ama asiane a ɛwɔ hɔ sɛ wubenya nyarewa ne mogya a ɛbɛtɔ wo no ayɛ kɛse . Wubetumi ayɛ saa nneɛma yi de atew asiane yi so:

• Nya nnuru a wɔde bɔ wo ho ban fi mmoawa a wɔtaa nya ho.
• Ahotew ho su pa a wode bedi dwuma , te sɛ wo nsa a wobɛhohoro mpɛn pii ne nnipa a wɔyare a wobɛtwe wo ho afi ho.
• Bɔ wo ho ban fi tebea horow a wubetumi apira anaasɛ woatwitwa wo ho . Sɛ nhwɛso no, hwɛ yiye bere a wode akode a ano yɛ nnam redi dwuma no.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Wubetumi abisa oduruyɛfo no nsɛm te sɛ:

• Dɛn nti na mewɔ saa myelosuppression tebea yi?
• Ɔkwan bɛn so na saa tebea yi ka me nipadua?
• Ayaresa ahorow bɛn na mewɔ?
• So ayaresa bɛsa me myelosuppression no koraa?

Nsɛm a Wɔaboaboa Ano: Nea ɛsɛ sɛ wokae (Take-Home Message) .

Wo nnompe mu ntini yɛ wo nipadua no fã titiriw. Mogya mu nkwammoaa kɔkɔɔ a ɛde oxygen kɔ, mogya mu nkwammoaa fitaa a ɛko tia ɔyare mmoawa, mogya nkwammoaa a ɛboa ma wo mogya tu – wɔyɛɛ ne nyinaa wɔ hɔ. Myelosuppression yɛ bere a wo nnompe mu ntini gyae adwumayɛ esiane biribi nti. Nea ɛtaa de ba ne nnuru a wɔde sa kokoram, nanso mogya mu kokoram ne mmoawa bi nso betumi de aba. Nha wo ho. Nnuruyɛfo behu nea ɛde ba no na wɔasa no sɛnea ɛfata. Ade a ɛho hia sen biara ne sɛ sɛ wowɔ sɛnkyerɛnne ahorow bi a ɛyɛ soronko a, wobɛkɔ aduruyɛ mu na woadi wɔn afotu akyi yiye. Ɛnyɛ wo nko ara, na nnuruyɛfo bi wɔ hɔ a wobetumi aboa wo wɔ akwantu yi mu.

` Myelosuppression, Nnompe mu ntini a wɔde siw ano, Nnompe mu ntini, Mogya mu nkwammoaa kɔkɔɔ, Mogya mu nkwammoaa fitaa, mogya mu nkwammoaa, Nnuru a wɔde sa yare, Kokoram, mogya a ɛtɔ kɔ nipadua mu, Neutropenia, Thrombocytopenia, Nyarewa