Kodi mukufunanso kudziwa za matenda osowa magazi awa? Tiyeni tikambirane za Waldenström Macroglobulinemia mwachidule!

Kodi munamvapo za Waldenström Macroglobulinemia? Ndi dzina lalitali, lovuta kulitchula, sichoncho? Ndi mtundu wa khansa womwe umakula pang'onopang'ono m'magazi. Mwina simunamvepo za izi, chifukwa ndi vuto losowa. Koma palibe vuto, lero tikambirana za izi mosavuta, mwanjira yomwe mungamvetse.

Kodi Waldenstrom macroglobulinemia (WM) ndi chiyani?

Mwachidule, Waldenstrom macroglobulinemia, kapena WM mwachidule, ndi khansa ya m'magazi . Ndi mtundu wa khansa wotchedwa non-Hodgkin lymphoma, womwe umadziwikanso kuti lymphoplasmacytic lymphoma. Ndi wosowa kwambiri. Tangoganizani, ngakhale m'dziko ngati America, anthu atatu kapena anayi okha mwa miliyoni imodzi amadwala matendawa.

Ndiye, kodi `(WM)` iyi imayamba bwanji? Tili ndi mafuta a m'mafupa m'thupi lathu, ndipo ndi komwe maselo athu a m'magazi amapangidwa. Matendawa amayamba pamene maselo ena otchedwa `(maselo a B)` (awa ndi mtundu wa selo m'thupi lathu, ndiko kuti, maselo omwe amatiteteza ku matenda) m'mafupa awa amakhala maselo a khansa.

Maselo a khansa awa, m'malo mosiyidwa okha, amayamba kupanga maselo ambiri ofanana nawo. Monga udzu m'nkhalango. Nanga chimachitika ndi chiyani? Maselo athanzi amagazi omwe thupi lathu limafunikira alibe malo, ndipo amayamba kuchepa.

• Maselo ofiira a m'magazi akachepa, magazi m'thupi amayamba kuchepa. Izi zimakupangitsani kumva kutopa komanso kuyera.
• Maselo oyera a m'magazi akachepa, matenda otchedwa ``neutropenia'' amapezeka, zomwe zimapangitsa kuti mukhale ndi matenda mosavuta.
• Pamene ma platelet (maselo omwe amathandiza kuundana kwa magazi) ali otsika (thrombocytopenia), kutuluka magazi sikungasiye mosavuta.

Si zokhazo, maselo a khansa amenewa amapanga puloteni yosazolowereka yotchedwa `(immunoglobulin M)` kapena `(IgM)`. Puloteni iyi ya `(IgM)` ikakwera kwambiri m'magazi, magazi athu amakhala okhuthala, ngati uchi . Izi zimatchedwa `(hyperviscosity syndrome).` Magazi akamakhuthala motere, zimakhala zovuta kuti magazi ayende m'mitsempha yaying'ono yamagazi m'thupi lonse. Kenako, zizindikiro zoopsa zingapo zimatha kuwoneka.

Chofunika ndichakuti palibe mankhwala a WM pakadali pano. Koma musadandaule. Pali mankhwala omwe angathandize kuchepetsa zizindikiro, nthawi zina kuzichotsa, ndikukuthandizani kukhala ndi thanzi labwino. WM nthawi zambiri ndi matenda omwe amakula pang'onopang'ono, kotero mutha kukhala nawo bwino kwa zaka zambiri.

Kodi zizindikiro za matenda a `(WM)` awa ndi ziti?

Tangoganizirani, pafupifupi munthu m'modzi mwa anayi aliwonse omwe ali ndi matendawa sasonyeza zizindikiro zilizonse . Amadziwa za matendawa akapita kwa dokotala pazifukwa zina. Koma, zizindikiro zikaonekera, nthawi zambiri zimabwera pang'onopang'ono . Tiyeni tiwone zizindikiro izi:

• Kufooka ndi kutopa kosalekeza:Zikumveka ngati batire yatha.
• Malungo: Thupi limamva kutentha popanda chifukwa.
• Kusowa chilakolako cha kudya: Kusafuna kudya.
• Thukuta la usiku: Kutuluka thukuta kwambiri ukugona.
• Kuchepetsa thupi: Umakhala woonda popanda chifukwa chenicheni.
• Kusokonezeka: Kuvutika kuganizira, kusokonezeka pang'ono.
• Kutupa kwa chiwindi, ndulu, kapena ma lymph nodes: Dokotala yekha ndi amene angakuuzeni motsimikiza.
• Zizindikiro za matenda a mitsempha ya m'mitsempha, monga dzanzi m'zala ndi zala zakumapazi : Zimamveka ngati kumva kuwawa, kapena kutaya kumva.
• Zizindikiro za magazi kuundana: kutuluka magazi m'mphuno, kutuluka magazi m'kamwa mukamatsuka mano, chizungulire, mutu, komanso kusawona bwino.

Kungoti muli ndi chimodzi kapena ziwiri mwa zizindikirozi sizikutanthauza kuti muli ndi WM. Koma ngati zizindikirozi zikupitirira, ndi bwino kufunafuna upangiri wa dokotala.

Kodi zifukwa za kupangika kwa `(WM)` ndi ziti?

Chifukwa chachikulu cha matenda a Waldenstrom's macroglobulinemia ndi kusintha kwa majini . Anthu opitilira 90% omwe ali ndi matendawa, kapena anthu asanu ndi anayi mwa khumi, ali ndi kusintha kwa majini otchedwa MYD88. Pafupifupi 40% ya anthu alinso ndi kusintha kwa majini otchedwa CXCR4. Kusintha kwa majini onsewa kumathandiza maselo osazolowereka mu WM kugawikana mwachangu.

Chofunika kwambiri ndichakuti kusintha kwa majini kumeneku sikobadwa nako . Izi zikutanthauza kuti, si chinthu chomwe mumalandira kuchokera kwa makolo anu, komanso si chinthu chomwe mumapatsa ana anu. Chimachitika moyo wonse. Komabe, ofufuza sakudziwabe chomwe chimayambitsa kusintha kwa majini kumeneku.

Ndani ali pachiwopsezo chachikulu chotenga matendawa? (Zinthu zomwe zingakubweretsereni chiopsezo)

Pali zinthu zina zomwe zimawonjezera mwayi wokhala ndi `(WM)`. Tiyeni tiwone zomwe zili:

• Zaka: Matendawa nthawi zambiri amapezeka mwa anthu azaka 65 kapena kuposerapo.
• Mtundu: Matendawa amapezeka kwambiri pakati pa anthu oyera.
• Jenda: Amuna ali ndi mwayi waukulu wopeza matendawa.
• Matenda ena: Mungakhale pachiwopsezo chachikulu ngati muli ndi matenda monga `(Hepatitis C)`, `(AIDS)`, `(Sjögren's Syndrome)`, kapena matenda otchedwa `(MGUS - Monoclonal Gammopathy of Undetermined Significance)` (izi ndi zotsatira za `(WM)`). Komabe, ndikofunikira kukumbukira kuti si aliyense amene ali ndi `(MGUS)` amene adzadwala `(WM)`.
• Mbiri ya banja: Ngati achibale anu a m'magazi adadwala matenda a WM kapena mitundu ina ya lymphoma, inunso mungakhale pachiwopsezo.

Kodi ndi mavuto otani omwe angayambitse matendawa?

Muzochitika zina zoopsa, WM ingayambitse mavuto ena.

• Amyloidosis: Izi zimachitika pamene mapuloteni olakwika amaikidwa m'ziwalo monga mtima, mapapo, ndi impso.
• Cryoglobulinemia: Pa vutoli, mapuloteni ena a m'magazi omwe amayankha kuzizira amasonkhana m'miyendo ndikuphatikizana. Izi zingayambitse kupweteka komanso kusintha mtundu wa buluu/woyera (cyanosis).

Kodi madokotala amazindikira bwanji matendawa? (Kuzindikira)

Dokotala wanu angagwiritse ntchito mayeso angapo kuti adziwe ngati muli ndi WM. Amayang'ana makamaka maselo a khansa ndi puloteni ya IgM yomwe tidakambirana kale.

• Kuyezetsa magazi ndi mkodzo: Mayeso a magazi ndi mkodzo amatengedwa kuti awone ngati pali zizindikiro za WM. Amafufuza zinthu monga kuchuluka kwa maselo m'magazi ndi mapuloteni a IgM osakwanira.
• Mayeso ojambulira: Kujambula kwa CT kapena CT-PET, komwe ndi kuphatikiza kwa CT ndi PET scan, kumagwiritsidwa ntchito pofufuza zizindikiro za WM mkati mwa thupi. Mayesowa amafufuza zinthu monga ziwalo zotupa ndi ma lymph nodes.
• Kuyezetsa maso: Kuyezetsa ngati magazi akutuluka kumbuyo kwa diso. Ichi ndi chizindikiro cha magazi kuundana.
• Kufufuza za mafupa: Izi zimaphatikizapo kutenga chitsanzo cha mafupa ndikuyang'ana pansi pa maikulosikopu kuti muwone ngati pali maselo a khansa.

Kodi `(WM)` imachiritsidwa bwanji?

Monga tanenera kale, palibe mankhwala a matendawa pakadali pano. Chifukwa chake, chithandizo chabwino kwambiri ndikuchepetsa zizindikiro popanda zotsatirapo zoyipa zambiri . Dokotala wanu adzakulankhulani ndikupanga dongosolo la chithandizo lomwe lili loyenera kwa inu. Nazi zina mwa njira zochizira `(WM)`:

• Kudikira Mosamala: Ngati mulibe zizindikiro, dokotala wanu sangayambe kulandira chithandizo. Anthu ena omwe ali ndi WM sangafunike chithandizo kwa zaka zambiri.
• Plasmapheresis / kusinthana kwa plasma: Izi zimaphatikizapo kugwiritsa ntchito makina kuti asefe puloteni ya IgM yosazolowereka kuchokera ku plasma, gawo lamadzimadzi la magazi anu. Kenako plasma yoyeretsedwayo imabwezeretsedwa m'magazi anu. Mankhwalawa amagwiritsidwa ntchito kuchepetsa zizindikiro za magazi kuundana.
• Chithandizo cha Immunotherapy: Chithandizochi chimagwiritsa ntchito chitetezo chanu cha mthupi kuwononga kapena kuchepetsa kukula kwa maselo a WM. Mankhwala a Rituximab (Rituxan®) nthawi zambiri amaperekedwa okha kapena ndi chemotherapy.
• Mankhwala Oletsa Khansa: Mankhwala opha maselo a khansa angaperekedwe okha kapena pamodzi ndi mankhwala oteteza thupi ku matenda.
• Corticosteroids: Mtundu wa steroid, monga dexamethasone, ukhoza kuperekedwa limodzi ndi chithandizo cha immunosuppressive ndi chemotherapy. Zimathandiza kulimbana ndi khansa komanso kuchepetsa zotsatirapo zoyipa za chithandizo.
• Chithandizo cholunjika:Mankhwalawa amagwira ntchito poletsa mapuloteni omwe maselo a khansa amagwiritsa ntchito kuti akule. Ibrutinib (Imbruvica®) ndi zanubrutinib (Brukinsa®) ndi mankhwala awiri omwe amavomerezedwa ndi U.S. Food and Drug Administration (FDA) kuti athetse WM.
• Kusamutsa maselo oyambira: Izi zimaphatikizapo kusintha mafuta a m'mafupa omwe akhudzidwa ndi maselo osazolowereka ndi mafuta a m'mafupa abwino. Izi sizimachitika kawirikawiri, ndipo zimachitika kwa odwala osankhidwa okha.

Kodi ndiyenera kupeza upangiri wa dokotala liti?

Ngati mwapezeka ndi WM, lankhulani ndi dokotala wanu nthawi yomweyo ngati muli ndi zizindikiro zatsopano kapena ngati mukuda nkhawa ndi zizindikiro zilizonse zomwe zilipo. Mukapezeka ndi WM, ndikofunikira kufunsa mafunso kuti mudziwe zomwe mungayembekezere. Nazi mafunso ena omwe mungafunse dokotala wanu:

• Kodi `(WM)` ndi nkhani yaikulu bwanji? Kodi izi zidzakhudza bwanji moyo wanga?
• Kodi ndiyenera kuyembekezera chiyani nthawi yochepa komanso yayitali?
• Kodi ndiyenera kuyamba kulandira chithandizo nthawi yomweyo?
• Kodi mumalimbikitsa chithandizo chamtundu wanji?
• Kodi ndi zotsatirapo ziti zomwe zingayembekezeredwe kuchokera ku chithandizochi?

Kodi ndingayembekezere chiyani ngati ndili ndi vutoli?

Si aliyense amene ali ndi matenda omwe akupita patsogolo pang'onopang'ono monga Waldenstrom's macroglobulinemia amene ali chimodzimodzi. Kafukufuku akusonyeza kuti 66%, kapena anthu oposa awiri mwa atatu, amakhalabe ndi moyo zaka 10 atapezeka ndi matendawa. Komabe, nthawi yopulumuka imatha kusiyana ndi zaka . Anthu ambiri opitirira zaka 65 (gulu la zaka lomwe nthawi zambiri limapezeka ndi matendawa) amafa chifukwa cha zifukwa zosagwirizana ndi WM.

Zinthu zambiri zimakhudza momwe matenda anu angayambire. Mwachitsanzo:

• zaka zanu
• Zotsatira za mayeso a magazi
• Mtundu wa kusintha kwa majini (nthawi zina kusakhalapo kwa kusintha kwa `(MYD88)` kungasonyeze zotsatira zoyipa)

Ngati muli ndi mafunso okhudza matenda anu, lankhulani ndi dokotala wanu . Iye amakudziwani bwino komanso zinthu zomwe zingakhudze thanzi lanu.

Kodi pali chilichonse chomwe ndingachite kuti ndimve bwino?

Kukhala ndi matenda a lymphoma monga a Waldenstrom's macroglobulinemia kungatanthauze kusintha kwakukulu pa moyo wanu. Ndikofunikira kugwiritsa ntchito zinthu zonse zomwe muli nazo. Lankhulani ndi dokotala wanu za zakudya zomwe mungadye komanso njira zodzisamalira .

Kuti mupewe kusungulumwa, lumikizanani ndi ena omwe ali ndi matenda osowawa. Ngakhale mutamva choncho poyamba mutazindikira kuti muli ndi matendawa, simuli nokha paulendowu . Funsani dokotala wanu ndipo lowani nawo magulu othandizira.

Pomaliza, kumbukirani izi.

Ofufuza sanapezebe mankhwala a Waldenstrom macroglobulinemia (WM). Komabe, apeza njira zingapo zochiritsira zomwe zimapangitsa kuti moyo ndi matendawa ukhale wosavuta . Anthu ambiri amakhala ndi matendawa kwa zaka zambiri popanda zizindikiro zilizonse. Mankhwala atsopano akulola anthu omwe ali ndi WM kukhala ndi moyo wautali kuposa kale lonse, popanda kutaya moyo wawo.

Ngati mwalandira matendawa, musachite mantha ndikufunsa dokotala wanu za chiyembekezo cha nthawi yochepa komanso yayitali. Adzakuthandizani kusankha njira yabwino kwambiri yothandizira. Kumbukirani, ndi upangiri ndi chithandizo choyenera chamankhwala, mutha kukhala bwino ndi vutoli.

Waldenstrom macroglobulinemia, WM, khansa ya m'magazi, mapuloteni a IgM, hyperviscosity syndrome, bone morrow, lymphoma