Unogara uchinzwa kuneta uye kuneta pasina chikonzero here? Une mavanga mumuviri wako wese here? Unonzwa kurema zvishoma kana kunzwa kuzara kuruboshwe rwedumbu rako here? Panogona kunge paine chikonzero chakakomba chiri shure kwezvinhu izvi chatisingafungi nezvacho. Idambudziko rinonzi myelofibrosis. Usatye kana ukanzwa zita iri. Tichataura nezvechii, nei chichiitika, zviratidzo zvacho, uye marapirwo acho nenzira iri nyore yaunogona kunzwisisa.
Zvichitaurwa zviri nyore, chii chinonzi myelofibrosis?
Funga nezvemapfupa makuru ari mukati memiviri yedu semafekitori ekugadzira ropa. Tinodaidza mafekitori aya kuti bone marrow . Ndimo mumongo uyu umo marudzi ese matatu emasero eropa akakosha kumiviri yedu anogadzirwa.
1. Masero Matsvuku Eropa: Anotakura okisijeni mumuviri wese.
2. Masero Machena Eropa: Anorwisa zvirwere nehutachiona.
3. Maplatelet: Anoumba magwamba eropa uye anomisa kubuda ropa.
Myelofibrosis igomarara reropa risingawanzoitiki umo mupfupa, fekitari inogadzira ropa, inozadzwa zvishoma nezvishoma nematishu emavanga. Kungofanana nemasora anotora zvishoma nezvishoma munda wakaorera, mavanga aya anodzivirira mupfupa kuti usagadzire masero eropa zvakanaka.
Nekuti basa iri hariitwe nemazvo, chiropa chedu, icho chiri chikamu chiri kumusoro kuruboshwe kwedumbu, chinoedza kubatsira nebasa iri. Kureva kuti, chiropa chinotanga kugadzira ropa. Asi harisi iro basa rayo guru. Nekuda kweizvi, chiropa chinozara, uye zvishoma nezvishoma chinotanga kukura nekuzvimba. Varwere vazhinji vanowana zviratidzo nekuzvimba uku kwechiropa.
Ichi chirwere chinowanzo gara kwenguva refu, chinowanzo enderera zvishoma nezvishoma. Zvisinei, dzimwe nguva chinogona kukura nekukurumidza, uye mune vamwe vanhu chinogona kukura kuita acute leukemia. Ndosaka chiremba wako achizokutarisa zvakanyanya mushure mekunge waonekwa kuti une chirwere ichi.
Pane mhando huru dze myelofibrosis here?
Ehe, kune mhando mbiri huru dzeizvi.
- Myelofibrosis Yekutanga: Iyi ndiyo mhando inonyanya kuwanikwa. Inoitika yoga, pasina kukanganiswa nechimwe chirwere.
- Myelofibrosis yechipiri:Izvi zvinoitika kana mamwe matambudziko ane chekuita neropa akanyanya kuipa. Semuenzaniso, munhu ane Essential Thrombocythemia kana Polycythemia Vera anogona kurwara nemyelofibrosis nekufamba kwenguva. Zvirwere izvi zvese zviri muboka rekenza yeropa rinonzi Myeloproliferative Neoplasms (MPNs). Zvichitaurwa zviri nyore, zvirwere izvi zvose zvinoita kuti mupfupa ugadzire mhando imwe chete kana kupfuura dzemasero eropa kupfuura zvazvinofanira kuita.
Ndezvipi zviratidzo zvechirwere ichi? Tinozviziva sei?
Kazhinji, chirwere ichi chinokura zvishoma nezvishoma. Saka, chinogona kupfuurira kwemakore pasina kuratidza zviratidzo. Kana zviratidzo zvatanga kuoneka, chinhu chekutanga chinouya mupfungwa kuneta kwakanyanya . Izvi zvinokonzerwa nekushaikwa kwemasero matsvuku eropa mumuviri, izvo zvinoreva anemia. Pamwe chete neizvi, nekuda kwekuwedzera kwepleen, unogona kunzwa kurema, kurwadziwa, kana kunzwa kuzara mudumbu rekumusoro kuruboshwe.
Ngationei zvimwe zviratidzo zviri patafura iri pazasi.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Kurwadziwa kwemapfupa nemajoini | Marwadzo anobva mukati memapfupa nekuda kwekuchinja kwemupfupa. |
| Kupwanya kana kubuda ropa zviri nyore | Nekuda kwekudzikira kwemaplatelet, kunyangwe bundu diki rinogona kukonzera mavanga uye kubuda ropa. |
| Chiropa Chakakura | Kufanana netsvina, chiropa chinogona kuzvimba pachinoedza kugadzira ropa. |
| Kupindwa nechando | Kunzwa kupisa pasina chikonzero. |
| Kutapukirwa kakawanda | Zvirwere zvinopararira zviri nyore nekuti masero machena eropa emuviri, ayo anoshanda semasero ekudzivirira emuviri, anodzikira. |
| Kunzwa kuguta kunyangwe mushure mekudya zvishoma | Nekuti chiropa chakazvimba uye dumbu rakazvimba, kunyangwe mushure mekudya mupunga mudiki, dumbu rinonzwa rakaguta. |
| Ganda rinokwenya | Panogona kuva nekukwenya kwakanyanya mumuviri wese. |
| Kudikitira zvakanyanya usiku | Kudikitira zvakanyanya husiku zvekuti machira anonyorova. |
| Kuderedza uremu pasina chikonzero | Kana ukaderedza uremu usingaedze. |
Sei izvi zvichiitika? Ndezvipi zvikonzero?
Vanachiremba havasati vaziva chikonzero chaicho che myelofibrosis yekutanga, asi vane kunzwisisa kwakanaka kwekuti zvinoitika sei.
Zvinotanga nekuchinja kwejini riri musero remuviri, iro rinova sero rekutanga rinogadzira ropa mumongo wemapfupa . Sero rine jini rine dambudziko rinova sero rekenza, richipatsanuka nekukurumidza uye richizvitevedzera. Masero aya ekenza anozadza mumongo wese wemapfupa.
Masero aya akaipa haangogari ipapo chete. Makemikari aanoburitsa anokuvadza mwongo wemapfupa uye mavanga anotanga kuumbwa. Izvi zvinonzi fibrosis.
Vanachiremba vakaona kuti vanhu vazhinji vane chirwere ichi vane zvimwe zvinhu zvakafanana mumajini avo. Chinonyanya kukosha ndechekuti:
- JAK2 (JACK-TWO)
- CALR (Cal-R)
- MPL
Kuchinja kwemajini uku ndiko kunokonzera chirwere ichi mumongo wemapfupa.
Ndiani ari panjodzi huru yekubatwa nechirwere ichi?
Kunyangwe munhu wese achigona kuwana chirwere ichi, vamwe vanhu vari panjodzi huru.
- Makore anopfuura makumi matanhatu ekuberekwa: Chirwere ichi chinowanzoonekwa nevanhu vakuru.
- Kuvapo kwezvimwe zvirwere zveropa:Kune avo vane zvirwere zvakaita se 'Essential Thrombocytosis' kana 'Polycythemia Vera', zvatakambotaura nezvazvo.
- Kusangana nemwaranzi inoisa maion: Kusangana nemwaranzi yakawanda. (Izvi hazviwanzoitiki).
- Kusangana nemamwe makemikari: Kusangana kwenguva refu nemakemikari anoshandiswa mumafekitori, akadai sebenzene (izvi hazviwanzoitikiwo).
Ndezvipi zvinetso zvinogona kuitika nekuda kwechirwere ichi?
Sezvo myelofibrosis ichienderera mberi, matambudziko akasiyana-siyana anogona kuitika.
Kuderera kwekugadzirwa kwemasero eropa
Kana mavanga aungana mumongo wemapfupa, haakwanise kugadzira masero eropa ane hutano. Izvi zvinogona kukonzera kudzikira kwemasero matsvuku eropa, zvichikonzera anemia , uye kudzikira kwemaplatelet, zvichiwedzera njodzi yekubuda ropa.
Kuumbwa kwemasero eropa ari kunze kwechiropa kubva mumwongo wemapfupa
Kana muromo wemapfupa usingakwanise kuita basa rawo, nhengo dzakadai sechiropa nechiropa dzinotanga kugadzira ropa. Izvi zvinogona kukonzera kuti nhengo idzodzo dzizvimbe uye zvikanganise mashandiro adzo.
Kumanikidzwa Kweropa Kwakakwira muPortal Vein
Mutsinga wepazasi ndiwo mutsinga mukuru weropa unotakura ropa kubva mutsinga kuenda kuchiropa. Chitsinga chakakura chinogona kuvharira kufamba kweropa kuburikidza netsinga iyi, zvichiwedzera kumanikidzwa mukati mayo. Izvi zvinogona kukonzera kubuda ropa kwakanyanya.
Kushanduka kuita acute leukemia
Mune vamwe varwere, myelofibrosis inogona kuzopedzisira yava mhando yeleukemia yakakomba uye inopararira nekukurumidza inonzi Acute Myeloid Leukemia (AML).
Chiremba anonyatsoongorora sei chirwere ichi?
Mushure mekuteerera zviratidzo zvako nekukuongorora, chiremba achakuraira bvunzo dzinoverengeka kuti asimbise chirwere chako.
1. Kuongororwa kweRopa: Izvi zvinoongorora kana huwandu hwemasero eropa rako (tsvuku, machena, maplatelet) hwakajairika kana kuti husina kujairika. Zvinoongororawo kana chimiro chemasero eropa chisina kujairika.
2. Kuongororwa kwemifananidzo: Kuongororwa kweCT kana ultrasound kunogona kuitwa kuti uone kana chiropa chako kana kuti pleen yako yakura. Kuongororwa kweMRI kunogonawo kubatsira kuona kana paine mavanga mumongo wemapfupa.
3. Kuongororwa kweBone Marrow Biopsy: Iyi ndiyo bvunzo inonyanya kukosha yekusimbisa chirwere. Muizvi, sampuli diki yemongo wemapfupa inotorwa, kazhinji kubva mubhonzo rehudyu kana rimwe bhonzo guru, pasi peanesthetic light. Inotumirwa kurabhoritari kuti ione kuti mavanga akawanda sei aripo, kana paine masero ekenza, uye kana paine majini akafanana ne`JAK2` yatakambotaura nezvayo.
Zvichibva pamhedzisiro yebvunzo idzi, chiremba wako achaona kana chirwere chako chiri mumatanho ekutanga (prefibrotic) kana kuti chiri padanho repamusoro (overt). Vachaongororawo huwandu hwenjodzi yako (yakaderera, yepakati, kana yenjodzi huru) zvichienderana nezviratidzo zvako uye rudzi rwekuchinja kwemajini. Kurapwa kunorongwa zvichienderana nehuwandu hwenjodzi iyi.
Ndezvipi zvinorapwa izvi?
Maitiro ekurapwa anoenderana nehuwandu hwenjodzi yechirwere chako, kuoma kwezviratidzo zvako, zera rako, uye hutano hwako hwese.
Chinhu chakakosha ndechekuti munhu asina zviratidzo zvechirwere ichi anogona kusapiwa mushonga pakutanga. Pane kudaro, chiremba acharamba achikutarisa (Waitingful Waiting).
Kune nzira dzakasiyana-siyana dzekurapa zvirwere zvine njodzi yepakati nepakati . Chinangwa chikuru chekurapa ndechekudzora zviratidzo uye kudzivirira kuti chirwere chisanyanya kuipa.
| Chiratidzo/mamiriro ezvinhu ari kurapwa | Nzira dzekurapa dzinoshandiswa |
|---|---|
| Kune zviratidzo zvechirwere uye chiropa chakakura | Mishonga yekurapa yakanangana inonzi JAK inhibitors. Mienzaniso: Ruxolitinib (Jakafi®), Fedratinib (Inrebic®), Pacritinib (Vonjo®), Momelotinib (Ojjaara®). Iyi mishonga inoderedza kukura kwepleen uye inodzora zviratidzo zvakaita sekuneta uye kudikitira husiku. |
| Kune Anemia | - Mishonga inobatsira kugadzira masero matsvuku eropa (semuenzaniso Erythropoietin) - Mimwe mishonga (Androgens, Immunomodulators, Corticosteroids) - Kuwedzerwa ropa kana zvichidikanwa |
| Kune chiropa chakakura (dzimwe nzira) | - Mishonga yekurapa nemakemikari - Kurapa chirwatata nemwaranzi - Izvi hazviwanzo shandiswa. - Kubviswa kwemasero eropa - Iyi inzira isingawanzoitiki uye ine njodzi. |
Kudyarwa kweStem Cell
Iyi ndiyo nzira chete yekurapa inogona kurapa myelofibrosis zvachose . Zvisinei, inzira ine njodzi huru ine migumisiro yakaipa. Saka, haina kukodzera varwere vese. Kazhinji, vanachiremba vanokurudzira nzira iyi yekurapa kune vane njodzi huru, vechidiki nevanhu vasina zvimwe zvirwere zvakakomba.
Izvi zvinosanganisira kuparadza zvachose mupfupa wemurwere une chirwere uye kupa masero emuviri wemurwere anowanikwa kubva kumupi ane hutano.
Mharidzo Yekuenda Nayo Kumba
- Myelofibrosis igomarara reropa rinokonzera mavanga nekukura kwemapfupa. Kunyangwe izvi zvichityisa, usavhunduke.
- Kana uine zviratidzo zvakaita sekuneta kwakanyanya kusingatsananguriki, kuremerwa mudumbu, kana mavanga ari nyore, usazviregeredza wobva waona chiremba nekukasika.
- Kuongororwa kweropa uye kuongororwa kwemapfupa nemapfupa zvakakosha kuti chirwere chiongororwe nemazvo.
- Kuti unoda kurapwa here kana kuti kwete, uye kuti rudzii rwekurapa rwakakodzera, zvinoenderana nehuwandu hwenjodzi yechirwere chako uye zviratidzo zvako.
- Taura nachiremba wako pachena. Bvunza zvese zvaunotya, kusava nechokwadi, uye mibvunzo. Ziva migumisiro yemishonga.
- Sezvo sainzi yezvekurapa ichifambira mberi, mishonga mitsva yekurapa chirwere ichi iri kuramba ichibuda. Saka, sangana nekurapwa uine tariro uye une tariro.
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