So wopɛ sɛ wuhu mogya mu yare a wɔntaa nhu yi ho asɛm nso? Momma yɛnka Waldenström Macroglobulinemia ho asɛm wɔ nsɛm a ɛnyɛ den mu!

So woate Waldenström Macroglobulinemia ho asɛm pɛn? Ɛyɛ edin tenten a ɛyɛ den sɛ wɔbɛbɔ, ɛnte saa? Nokwarem no, ɛyɛ kokoram bi a enyin nkakrankakra wɔ mogya no mu. Ebia woante ho asɛm, efisɛ ɛyɛ tebea a ɛntaa nsi. Nanso ɛnyɛ hwee, ɛnnɛ yɛbɛka ho asɛm tiawa, wɔ ɔkwan a wobɛtumi ate aseɛ so.

Dɛn ne Waldenstrom macroglobulinemia (WM)?

Sɛ yɛbɛka no tiawa a, Waldenstrom macroglobulinemia, anaa WM tiawa no yɛ mogya mu kokoram . Ɛyɛ kokoram bi a wɔfrɛ no non-Hodgkin lymphoma, a wɔsan frɛ no lymphoplasmacytic lymphoma. Nokwarem no, ɛntaa nsi koraa. Susuw ho hwɛ, wɔ ɔman te sɛ Amerika mpo mu no, nnipa ɔpepem biako mu baasa kosi baanan pɛ na wonya saa yare yi.

Enti, ɔkwan bɛn so na saa `(WM)` yi nya nkɔso? Yɛwɔ nnompe mu ntini wɔ yɛn nipadua mu, na ɛhɔ na wɔyɛ yɛn mogya mu nkwammoaa. Saa yare yi fi ase bere a nkwammoaa a wɔfrɛ no `(B cells)` (eyinom yɛ nkwammoaa bi a ɛwɔ yɛn nipadua mu tumi a ɛko tia nyarewa mu, kyerɛ sɛ, nkwammoaa a ɛbɔ yɛn ho ban fi nyarewa ho) a ɛwɔ saa nnompe mu ntini yi mu no bi bɛyɛ kokoram nkwammoaa.

Saa kokoram nkwammoaa yi, sɛ́ anka wobegyaw wɔn nkutoo no, wofi ase yɛ nkwammoaa pii te sɛ wɔn ankasa. Te sɛ nwura a ɛwɔ kwae mu no ara pɛ. Dɛn na ɛba saa bere no? Mogya mu nkwammoaa a ɛte apɔw a yɛn nipadua hia no nni baabi, na efi ase so tew.

• Sɛ mogya mu nkwammoaa kɔkɔɔ no so tew a, mogya a ɛtɔ kɔ nipadua no mu ba. Eyi ma wote nka sɛ woabrɛ na wo ho ayɛ wo hyew.
• Sɛ mogya mu nkwammoaa fitaa sua a, tebea bi a wɔfrɛ no ``neutropenia'' ba, na ɛma wo ho yɛ den sɛ wobɛyare.
• Sɛ mogya nkwammoaa (nkwaboaa a ɛboa ma mogya tu) sua (thrombocytopenia) a, ebia mogya a ɛretu no rennyae ntɛm.

Ɛnyɛ ɛno nko, saa kokoram nkwammoaa yi yɛ protein bi a ɛnyɛ ne kwan so a wɔfrɛ no `(immunoglobulin M)` anaa `(IgM)`. Sɛ saa `(IgM)` protein yi dɔɔso dodo wɔ mogya no mu a, yɛn mogya no yɛ den, te sɛ ɛwo . Wɔfrɛ eyi `(hyperviscosity syndrome).` Sɛ mogya no yɛ den saa a, ɛbɛyɛ den sɛ mogya no bɛfa mogya ntini nketewa no mu akɔ nipadua no nyinaa mu. Afei, sɛnkyerɛnne ahorow a anibere wom a ɛtoatoa so betumi ada adi.

Nea ɛho hia ne sɛ wonnya nnyaa WM aduru biara. Nanso mma ɛnhaw wo. Ayaresa ahorow bi wɔ hɔ a ebetumi aboa ma woadi yare no ho sɛnkyerɛnne ahorow so, ɛtɔ mmere bi mpo a wɔayi afi hɔ, na aboa wo ma woanya apɔwmuden. WM taa yɛ yare a enyin nkakrankakra, enti wubetumi ne no atra ase yiye mfe pii.

Dɛn ne saa `(WM)` yareɛ yi ho sɛnkyerɛnne?

Fa no sɛ, nnipa baanan biara a wɔwɔ saa yare yi mu bɛyɛ biako nkyerɛ yare no ho sɛnkyerɛnne biara . Wohu yare yi ho asɛm bere a wɔkɔ oduruyɛfo nkyɛn esiane biribi foforo bi nti nkutoo. Nanso, sɛ sɛnkyerɛnne ahorow da adi ampa a, ɛtaa ba nkakrankakra . Momma yɛnhwɛ nea ɛyɛ sɛnkyerɛnne ahorow yi:

• Mmerewa ne ɔbrɛ a ɛba bere nyinaa:Ɛte sɛ nea batere no awu.
• Atiridii: Nipadua no yɛ hyew a ntease biara nnim.
• Anorexia: Ɔnte nka sɛ ɔpɛ sɛ odidi.
• Anadwo fifiri: Fifiri pii bere a woada.
• Wo mu duru a ɛso tew: Wobɛyɛ teateaa a ntease pɔtee biara nni ho.
• Adwene a ɛyɛ basaa: Ɛyɛ den sɛ wode w’adwene besi biribi so, n’adwene tu fra kakra.
• Mmɛn, akyi berɛmo, anaa ntini a ɛma mogya tu a ɛho ahonhon: Oduruyɛfo nkutoo na obetumi aka akyerɛ wo yiye.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ ntini mu yare a ɛwɔ akyi, te sɛ nsateaa ne nansoaa a ɛyɛ mmerɛw : Ɛte sɛ nea ɛyɛ wo yaw, anaasɛ wo ho yɛ wo hyew.
• Mogya a ɛtwetwe ho sɛnkyerɛnne: mogya a ɛba hwene mu, mogya a ɛba wo hwene mu bere a worehohoro wo sẽ, adwenemhaw, tiyɛ, ne aniwa a ɛyɛ mmerɛw.

Esiane sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa abien nti, ɛnkyerɛ sɛ wowɔ WM. Nanso sɛ saa sɛnkyerɛnne ahorow yi kɔ so a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu.

Dɛn ne nea enti a wɔhyehyɛɛ `(WM)`?

Nea ɛde Waldenstrom macroglobulinemia ba titiriw ne awosu mu nsakrae . Nnipa a wɔwɔ yare no mu bɛboro 90%, anaa nnipa du biara mu nkron, wɔ awosu mu nkwaadɔm a wɔfrɛ no MYD88 no mu nsakrae. Nnipa bɛyɛ 40% nso wɔ mutation wɔ gene a wɔfrɛ no CXCR4 mu. Saa awosu mu nsakrae abien yi nyinaa boa nkwammoaa a ɛnteɛ a ɛwɔ WM mu no ma wɔkyekyɛ ntɛmntɛm.

Nea ɛho hia ne sɛ saa awosu mu nsakrae yi mfi awosu mu . Ɛne sɛ, ɛnyɛ biribi a wunya fi w’awofo hɔ, na saa ara nso na ɛnyɛ biribi a wode ma wo mma. Wɔba wɔ nkwa nna nyinaa mu. Nanso, nhwehwɛmufo da so ara nnim nea ɛde awosu mu nsakrae yi ba wɔ nea edi kan no mu.

Henanom na wɔwɔ asiane kɛse mu sɛ wobenya saa yare yi? (Nneɛma a ɛde asiane ba) .

Nneɛma bi wɔ hɔ a ɛma hokwan a ɛwɔ hɔ sɛ wobenya `(WM)` no yɛ kɛse. Ma yɛnhwɛ nea wɔyɛ:

• Mfe a wɔadi: Nnipa a wɔadi mfe 65 anaa nea ɛboro saa na wɔtaa hu saa yare yi.
• Abusuakuw: Saa yare yi abu so wɔ aborɔfo mu.
• Bɔbeasu: Mmarima na wɔtaa nya saa yare yi.
• Ayaresa tebea afoforo: Ebia wobɛkɔ asiane mu kɛse sɛ wowɔ nyarewa te sɛ `(Hepatitis C)`, `(AIDS)`, `(Sjögren's Syndrome)`, anaa tebea bi a wɔfrɛ no `(MGUS - Monoclonal Gammopathy of Undetermined Significance)` (eyi yɛ nea edi `(WM)` anim). Nanso, ɛho hia sɛ yɛkae sɛ ɛnyɛ obiara a ɔwɔ `(MGUS)` na obenya `(WM)`.
• Abusua abakɔsɛm: Sɛ w’abusuafo a wɔwɔ mogya mu no anya WM anaa lymphoma ahorow afoforo a, ebia wo nso wobɛkɔ asiane mu.

Dɛn ne nsɛnnennen a ebetumi afi yare yi mu aba?

Wɔ tebea horow bi a emu yɛ den mu no, WM betumi de nsɛnnennen afoforo aba.

• Amyloidosis: Eyi ne bere a protein ahorow a asɛe kɔ akwaa te sɛ koma, ahurututu, ne asaabo mu.
• Cryoglobulinemia: Wɔ tebea yi mu no, mogya mu protein ahorow bi a ɛyɛ awɔw ho dwuma no boaboa ano wɔ akwaa no mu na ɛboaboa ano. Eyi betumi ama obi ate ɛyaw na ne kɔla ayɛ bruu/fitaa (cyanosis).

Ɔkwan bɛn so na nnuruyɛfo hu yare yi? (Nyare a Wɔahu) .

Wo duruyɛfo betumi de nhwehwɛmu pii adi dwuma de ahu sɛ ebia wowɔ WM anaa. Wɔhwehwɛ kokoram nkwammoaa ne IgM protein a yɛadi kan aka ho asɛm no titiriw.

• Mogya ne nsu mu nhwehwɛmu: Wɔfa mogya ne nsu mu nhwehwɛmu de hwɛ sɛ ebia WM ho sɛnkyerɛnne bi wɔ hɔ anaa. Wɔhwehwɛ nneɛma te sɛ mogya mu nkwammoaa dodow a ɛba fam ne IgM protein ahorow a ɛnteɛ.
• Mfoniniyɛ mu nhwehwɛmu: Wɔde CT scan anaa CT-PET scan a ɛyɛ CT ne PET scan a wɔaka abom di dwuma de hwehwɛ WM ho sɛnkyerɛnne wɔ nipadua no mu. Saa nhwehwɛmu ahorow yi hwehwɛ nneɛma te sɛ akwaa a ahonhon ne ntini a ɛma mogya tu.
• Aniwa mu nhwehwɛmu: Ɛhwɛ sɛ mogya retu wɔ aniwa no akyi anaa. Eyi yɛ sɛnkyerɛnne a ɛkyerɛ sɛ mogya atɔ.
• Nnompe mu ntini mu nhwehwɛmu: Eyi hwehwɛ sɛ wɔfa nnompe mu ntini ketewaa bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwɛ mu hwɛ sɛ kokoram nkwammoaa bi wɔ hɔ anaa.

Ɔkwan bɛn so na wɔyɛ `(WM)`?

Sɛnea yɛadi kan aka no, wonnya nnyaa saa yare yi ano aduru. Enti, ayaresa a eye sen biara ne sɛ wobeyi yare no ho sɛnkyerɛnne ahorow no afi hɔ a nsunsuanso bɔne kakraa bi na ɛbɛba . Wo duruyɛfoɔ ne wo bɛkasa na wayɛ ayaresa nhyehyɛeɛ a ɛfata wo. Ayaresa a wobetumi apaw ama `(WM)` no bi ni:

• Twɛn a wobɛwɛn: Sɛ wunni yare no ho sɛnkyerɛnne biara a, ebia wo duruyɛfo no renfi ayaresa ase. Ebia nnipa binom a wɔwɔ WM renhia ayaresa mfe pii.
• Plasmapheresis / plasma exchange: Eyi hwehwɛ sɛ wode afiri bi yi IgM protein a ɛnteɛ no fi plasma, wo mogya no fã a ɛyɛ nsu no mu. Afei wɔsan de plasma a wɔahohoro no gu wo mogya mu. Wɔde saa ayaresa yi di dwuma de tew mogya a ɛbɛtɔ ho sɛnkyerɛnne so.
• Nkwammoaa a ɛko tia nyarewa no ayaresa: Saa ayaresa yi de w’ankasa nipadua mu tumi a ɛko tia nyarewa no sɛe anaasɛ ɛma WM nkwammoaa nyin brɛoo. Wɔtaa de aduru Rituximab (Rituxan®) no nkutoo ma anaasɛ wɔde nnuru a wɔde sa yare ka ho.
• Nnuru a wɔde sa yare: Wobetumi de nnuru a ekum kokoram nkwammoaa nkutoo ama anaasɛ wɔde aka nipadua no mu tumi a ɛko tia nyarewa ho.
• Corticosteroids: Wobetumi de steroid bi te sɛ dexamethasone aka aduru a ɛma nipadua no tumi ko tia nyarewa ne nnuru a wɔde sa yare ho. Wɔboa ma wɔko tia kokoram bere a wɔtew ayaresa mu nsunsuanso bɔne so nso.
• Ayaresa a wɔde asi wɔn ani so:Saa ayaresa yi yɛ adwuma denam protein ahorow a kokoram nkwammoaa de nyin a esiw ano no so. Ibrutinib (Imbruvica®) ne zanubrutinib (Brukinsa®) yɛ ayaresa abien a wɔde wɔn ani asi so a U.S. Aduan ne Nnuru Dwumadibea (FDA) apene so sɛ wɔmfa nsa WM.
• Stem cell transplant: Wɔ eyi mu no, wɔde nnompe mu ntini a ɛte apɔw si ananmu de si nnompe mu ntini a nkwammoaa a ɛnteɛ aka no ananmu. Wɔntaa nyɛ eyi, na wɔyɛ wɔ ayarefo a wɔapaw wɔn nkutoo mu.

Bere bɛn na ɛsɛ sɛ mehwehwɛ aduruyɛ mu afotu?

Sɛ wɔahu sɛ wowɔ WM a, sɛ wowɔ sɛnkyerɛnne foforo bi anaasɛ wohaw wo ho wɔ sɛnkyerɛnne biara a ɛwɔ hɔ dedaw ho a , wo ne wo duruyɛfo nkasa ntɛm ara . Sɛ wohu sɛ wowɔ WM wie a, ɛho hia sɛ wubisa nsɛm de hu nea wobɛhwɛ kwan. Nsɛmmisa bi a wubetumi abisa wo duruyɛfo ni:

• `(WM)` yɛ aniberesɛm dɛn? Eyi bɛka m’asetra dɛn?
• Dɛn na ɛsɛ sɛ mehwɛ kwan wɔ bere tiaa ne bere tenten mu?
• So ɛsɛ sɛ mifi ayaresa ase ntɛm ara?
• Ayaresa bɛn na wokamfo kyerɛ?
• Nsunsuanso bɔne bɛn na yebetumi ahwɛ kwan afi ayaresa no mu?

Sɛ mewɔ saa tebea yi a, dɛn na metumi ahwɛ kwan?

Ɛnyɛ obiara a ɔwɔ yare a ɛkɔ so nkakrankakra te sɛ Waldenstrom macroglobulinemia no na ɔyɛ pɛ. Nhwehwɛmu kyerɛ sɛ 66%, anaasɛ bɛboro nnipa baasa biara mu baanu da so te ase wɔ mfe 10 akyi wɔ bere a wɔahu sɛ wɔwɔ yare no akyi. Nanso, mmere a wɔde tra ase no betumi ayɛ soronko wɔ mfe a obi adi mu . Nnipa dodow no ara a wɔadi boro mfe 65 (mfe kuw a wɔtaa hu sɛ wɔwɔ yare no) wuwu esiane nneɛma a ɛne WM nni abusuabɔ nti.

Nneɛma pii ka wo yare no ho nkɔmhyɛ. Nhwɛsoɔ:

• wo mfe a woadi
• Nea efii mogya mu nhwehwɛmu mu bae
• Awosu mu nsakrae no su (ɛtɔ mmere bi a `(MYD88)` mutation a enni hɔ no betumi akyerɛ sɛ nea efi mu ba bɔne)

Sɛ wowɔ nsɛmmisa bi fa wo tebea no ho a, wo ne wo duruyɛfo nkasa . Onim wo yiye ne nneɛma a ebetumi aka w’akwahosan.

So biribi wɔ hɔ a metumi ayɛ na ama me ho atɔ me?

Sɛ wo ne lymphoma te sɛ Waldenstrom macroglobulinemia bɛtra ase a, ebetumi akyerɛ sɛ wobɛyɛ nsakrae akɛse bi wɔ w’asetra mu. Ɛho hia sɛ wode nneɛma a wowɔ nyinaa di dwuma. Wo ne wo duruyɛfo nkasa mfa nnuan a ɛsɛ sɛ wudi ne nneɛma a ɛsɛ sɛ woyɛ de hwɛ wo ho so .

Nea ɛbɛyɛ na worente nka sɛ woayɛ ankonam no, wo ne afoforo a wɔwɔ yare a wɔntaa nhu yi nni nkitaho. Sɛ mpo wote nka saa mfiase no bere a wuhu sɛ wowɔ saa yare yi a, ɛnyɛ wo nkutoo na wowɔ akwantu yi mu . Bisa wo duruyɛfo na kɔka mmoa akuw ho.

Nea etwa to no, kae eyi.

Nhwehwɛmufo nnya nhuu Waldenstrom macroglobulinemia (WM) aduru. Nanso, wɔahu ayaresa ahorow pii a ɛma ɛyɛ mmerɛw sɛ wo ne yare no bɛtra ase . Nnipa pii de yare no tra ase mfe pii a wonni sɛnkyerɛnne biara. Ayaresa foforo rema nnipa a wɔwɔ WM atra ase akyɛ sen bere biara, a wɔmfa wɔn asetra pa mmɔ afɔre.

Sɛ wo nsa ka saa yare yi a, mma wo ho nnyɛ wo hu na bisa wo duruyɛfo no bere tiaa ne bere tenten mu anidaso ho asɛm. Wɔbɛboa wo ma woasi ayaresa nhyehyɛe a eye sen biara ama wo ho gyinae. Kae sɛ, sɛ wunya aduruyɛ mu afotu ne mmoa a ɛfata a, wubetumi ne tebea yi atra ase yiye.

` Waldenstrom macroglobulinemia, WM, mogya mu kokoram, IgM protein, hyperviscosity syndrome, nnompe mu ntini, lymphoma