Wake wezwa nge-"Waldenström Macroglobulinemia"? Mhlawumbe akunjalo. Yigama elide, okunzima ukulibiza, akunjalo? Kodwa ungakhathazeki. Luhlobo lomdlavuza wegazi olungavamile kakhulu, kodwa oluvame kakhulu. Namuhla, sizoxoxa ngalesi simo ngolimi olulula ongaluqonda, njengokukhuluma nomngane. Ake sibone ukuthi siyini ngempela, ukuthi ziyini izimpawu, nokuthi selashwa kanjani.
Iyini ngempela i-Waldenström Macroglobulinemia (WM)?
Kalula nje, lo mdlavuza uthinta igazi lakho. Uma sikhuluma iqiniso, ungoweqembu lomdlavuza elibizwa ngokuthi i-Lymphoma, futhi uwuhlobo lwe-non-Hodgkin lymphoma. Ubizwa nangokuthi i-lymphoplasmacytic lymphoma. Akuvamile kakhulu. Ngisho nasezweni elifana neMelika, uthinta abantu abathathu kuya kwabane kuphela kwabayisigidi. Ngakho ungacabanga ukuthi kungavamile kangakanani.
Manje ake sibone ukuthi lokhu kwakheka kanjani ngaphakathi emzimbeni.
Olunye uhlobo olubaluleke kakhulu lwamaseli ohlelweni lwethu lokuzivikela komzimba lubizwa ngokuthi "amaseli e-B." Lawa akhiqizwa emnkantsheni wethu wamathambo. Uyazi ukuthi umnkantshe uyindawo engaphakathi kwamathambo ethu efana nefektri ekhiqiza amaseli egazi.
Ngakho-ke, ku-WM, la maseli e-B aphilile aphenduka amangqamuzana omdlavuza bese eqala ukuhlukana nokwanda ngokungalawuleki. Lapho la maseli omdlavuza egcwalisa umongo wamathambo, acindezela amangqamuzana ethu egazi aphilile.
Ngakho-ke, izinhlobo ezintathu eziyinhloko zamaseli egazi zingancishiswa:
- Amaseli Abomvu Egazi Anciphile: Lokhu kubizwa ngokuthi "i-anemia". Yilokhu okwenza uzizwe ukhathele kakhulu futhi ungenampilo .
- Ukwehla Kwamaseli Amhlophe Egazi: Lokhu kubizwa ngokuthi "i-neutropenia." Amaseli amhlophe egazi afana namasosha emzimbeni wethu. Lawa maseli asivikela ezifweni. Ngakho-ke uma lawa maseli ehla , ukutheleleka kungavela njalo .
- Ama-platelet anciphile: Lokhu kubizwa ngokuthi `(thrombocytopenia).` Lawa yiwo asiza ekuqhekekeni kwegazi. Yiwo avimba ukopha ngisho nasenxebeni elincane. Ngakho-ke uma ama-platelet ephansi, ngisho nenxebeni elincane alikwazi ukuyeka ukopha, futhi ungase ube nemihuzuko emzimbeni wakho .
Ngaphezu kwalokho, la maseli omdlavuza akhiqiza inani elikhulu leprotheyini engajwayelekile ebizwa ngokuthi `(immunoglobulin M)` noma `(IgM)`. Lapho le phrotheyini `(IgM)` iqoqana egazini, igazi lethu liyaqina. Cabanga ukuthi igazi, okufanele libe njengamanzi, liyaqina njengesiraphu. Lokhu kubizwa ngokuthi `(hyperviscosity syndrome)` kwisayensi yezokwelapha.
Uma igazi liqina kanje, kuba nzima ukuhamba ngemithambo yegazi emincane kakhulu emizimbeni yethu. Lokhu kungabangela izimpawu ezinkulu njengokuzungeza kanye nokopha ekhaleni.
Akukho ukwelashwa kwe-WM okwamanje. Kodwa-ke, ngenxa yokuthi kuvame kakhulu, ngokwelashwa okuhle, izimpawu zingalawulwa, futhi ngezinye izikhathi ziqedwe ngokuphelele, futhi abantu bangaphila kahle iminyaka eminingi.
Yiziphi izimpawu ezingaba khona zesifo se-WM?
Into emangalisayo ukuthi cishe umuntu oyedwa kwabane abanalesi sifo akabonisi zimpawu. Batholakala ngengozi ngesikhathi sokuhlolwa lapho beya kudokotela ngenxa yesinye isifo. Uma kuvela izimpawu, zivela kancane kancane.
Ake sibheke izimpawu ezivamile ezinjengalezi.
| Isibonakaliso | Kalula nje... |
|---|---|
| Ubuthakathaka nokukhathala okukhulu | Ukuzizwa ukhathele kungakhathaliseki ukuthi ulala kangakanani, okubangelwa ukuntuleka kwamaseli abomvu egazi (i-anemia). |
| Umkhuhlane ngaphandle kwesizathu | Umkhuhlane ongenalo ukutheleleka. |
| Ukulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo | Ukwehlisa isisindo ngaphandle komzamo, ngaphandle kokuqaphela. |
| Ukujuluka ngokweqile ebusuku | Ujuluka kakhulu kangangokuthi awukwazi ukulala, amashidi amanzi kakhulu. |
| Ukuphazamiseka kwenkumbulo kanye nokuqonda (Ukudideka) | Ukuhlaselwa yisifo sohlangothi kungenzeka ngenxa yokuphazamiseka kokugeleza kwegazi ebuchosheni ngenxa yokujiya kwegazi. |
| Ukuvuvukala kwesibindi, i-spleen, noma ama-lymph node | Amangqamuzana omdlavuza aqoqana kulezi zitho, okubangela ukuba akhule. |
| Ukukhubazeka kwamalungu omzimba (i-Peripheral Neuropathy) | Umuzwa wokuthuthumela ezinzwaneni nasezinzwaneni, njengokungathi izintuthwane ziyagijima. |
| Izimpawu zokujiya kwegazi | Ukopha ekhaleni, ukopha kwezinsini lapho uxubha amazinyo, isiyezi, ikhanda elibuhlungu njalo, ukubona okufiphele. |
Kungani lolu hlobo lwesifo luvela?
Isizathu esiyinhloko salokhu ukushintshashintsha kwezakhi zofuzo. Okungukuthi, izinguquko ezakhiweni zethu zofuzo. Abantu abayisishiyagalolunye kwabayi-10 abane-WM banokuguquguquka kwezakhi zofuzo okuthiwa ``MYD88``. Futhi cishe abantu abane kwabayi-10 banoshintsho ezakhiweni zofuzo okuthiwa ``CXCR4``. Izinguquko kuzo zombili lezi zakhi zofuzo zisiza amangqamuzana omdlavuza angajwayelekile ukuba ahlukane futhi akhule ngokushesha.
Kodwa into ebaluleke kakhulu neqinisekisayo lapha ukuthi lezi zinguquko zofuzo azizuzwa njengefa.
Lokho kusho ukuthi, lokhu akuyona into oyithole kumama wakho noma kuyihlo. Futhi akuyona into oyidlulisela ezinganeni zakho. Lezi izinguquko ezintsha ezenzeka emzimbeni ngesikhathi sokuphila.
Kodwa abacwaningi abakakwazi ukuthola isizathu esithile sokuthi kungani lokhu kuguquka kwezakhi zofuzo kwenzeka.
Yiziphi izinto ezibangela lesi sifo?
Kunezici ezithile ezikhulisa kancane amathuba okuthola lesi sifo. Kodwa-ke, ukuba khona kwalesi sici akusho ukuthi lesi sifo sizokhula.
| Isici sengozi | Incazelo |
|---|---|
| Ubudala | Lesi sifo sivame ukutholakala kubantu abaneminyaka engaphezu kwengu-65. |
| Isizwe | Kuvame ukubonakala phakathi kwabantu abamhlophe. |
| Ubulili | Amadoda anamathuba amaningi okuba nayo kunabesifazane. |
| Ezinye izimo zezokwelapha | Abantu abanezifo ezifana ne-Hepatitis C, i-AIDS, kanye ne-Sjögren's Syndrome basengozini enkulu. Isimo esibizwa ngokuthi ``(MGUS)`` singaba yimbangela ye-WM. Kodwa-ke, akuwona wonke umuntu one-MGUS ozoba ne-WM. |
| Umlando wezokwelapha womndeni | Ingozi inganda kancane uma isihlobo segazi sibe ne-WM noma olunye uhlobo lwe-lymphoma. |
Udokotela usithola kanjani lesi sifo?
Uma unezimpawu, udokotela wakho uzokwenza izivivinyo eziningana ukuqinisekisa ukuthi unalesi sifo. Izivivinyo eziyinhloko ukubheka amangqamuzana omdlavuza kanye nephrotheni "(IgM)" engavamile egazini lakho.
- Ukuhlolwa kwegazi nomchamo: Lokhu kuhlola inani eliphansi lamaseli egazi (amangqamuzana abomvu, amangqamuzana amhlophe, ama-platelet) kanye namazinga aphezulu kakhulu eprotheyini ``(IgM)''.
- Ukuhlolwa kwezithombe: Ukuhlolwa okufana ne-"CT scan" noma i-"PET scan" kungasetshenziswa ukuhlola ama-lymph node avuvukele kanye nezitho ezikhulisiwe njengesibindi kanye ne-spleen.
- Ukuhlolwa kwamehlo: Ngezinye izikhathi, ukuphuma kwegazi okuncane kungenzeka ngaphakathi kweso, ngemuva kwebhola leso, ngenxa yokujiya kwegazi. Udokotela wamehlo angakuhlola lokhu.
- I-Bone Marrow Biopsy: Lolu vivinyo olubaluleke kakhulu lokuqinisekisa lesi sifo. Kulokhu, kuthathwa isampula encane kakhulu yomnkantsha endaweni efana nethambo le-hip bese ihlolwa ngaphansi kwe-microscope. Lokhu kungasetshenziswa ukuthola ukuthi kukhona yini amangqamuzana omdlavuza kuwo.
Yiziphi izindlela zokwelapha i-WM?
Njengoba sishilo ngaphambili, nakuba lesi sifo singelapheki ngokuphelele, kunezindlela zokwelapha ezisebenza kahle kakhulu zokulawula izimpawu. Udokotela wakho uzohlola isimo sakho futhi athuthukise uhlelo lokwelashwa olufanele wena futhi olunemiphumela emibi embalwa kakhulu.
| Indlela yokwelapha | Kwenzekani kuyo? |
|---|---|
| Ukulinda Okuqaphile | Uma ungenazo izimpawu, udokotela wakho cishe uzovele akubheke ngaphandle kokuqala noma yimiphi imithi. Abanye abantu baphila kahle iminyaka eminingi ngaphandle kokwelashwa. |
| I-Plasmapheresis (ukushintshana kwe-plasma) | Lokhu kwenziwa uma unezimpawu zokujiya kwegazi. Umshini uhlukanisa ingxenye ewuketshezi ebizwa ngokuthi i-plasma egazini lakho, ususa iphrotheni ye-IgM eyingozi, bese ubuyisela i-plasma ehlanziwe emzimbeni wakho. |
| Ukwelashwa nge-immunotherapy | Lokhu kuhilela ukusebenzisa amasosha omzimba wakho ukubhubhisa amangqamuzana omdlavuza. Umuthi othi ``Rituximab`` uvame ukusetshenziswa kulokhu. |
| Ukwelashwa ngamakhemikhali | Ukunikeza imithi ebulala amangqamuzana omdlavuza. Ngezinye izikhathi lokhu kuhlanganiswa nokwelashwa nge-immunotherapy. |
| Ukwelashwa Okuqondiwe | Lolu uhlobo olusha lokwelapha. Le mithi ihlose amaprotheni athile asiza amangqamuzana omdlavuza ukuthi ahlukane futhi akhule, amise ukusebenza kwawo. `(Ibrutinib)` kanye `(Zanubrutinib)` yimithi enjalo. |
| Ukufakelwa Kweseli Lesiqu | Lokhu kuyindlela yokwelapha engavamile kakhulu, eyenziwa kuphela ezigulini ezikhethiwe. Kulokhu, umongo wamathambo owonakele ngenxa yomdlavuza ushintshwa umongo wamathambo ophilile. |
Impilo izoba njani ngalesi sifo?
Ngenxa yokuthi yisifo esiqhubeka kakhulu, akubona bonke abantu abafanayo. Ucwaningo lukhombisile ukuthi abantu abangu-66 kwabayi-100 (okungaphezu kwababili kwabathathu) basaphila eminyakeni eyi-10 ngemva kokuxilongwa. Kodwa-ke, lokhu kuyahlukahluka ngokweminyaka. Ezimweni eziningi, abantu abatholakala benesifo ngemuva kweminyaka engu-65 abafi ngenxa ye-WM, kodwa ngenxa yezinye izimo ezikhula njengoba bekhula.
Indlela oqhubeka ngayo incike ezintweni eziningana:
- iminyaka yakho
- Imiphumela yemibiko yokuhlolwa kwegazi lakho
- Uhlobo lokuguqulwa kwezakhi zofuzo onalo
Uma unemibuzo ngalokhu, khuluma nodokotela wakho. Uyakwazi wena nakho konke okuthinta impilo yakho kangcono.
Yini ongayenza ukuze uhlale uphilile?
Ukuphila nesifo sesikhathi eside njenge-WM kungasho ukwenza izinguquko ezinkulu empilweni yakho, kodwa kunezinto eziningi ongazenza ukuze usize.
- Buza udokotela wakho: Yikuphi ukudla neziphuzo ezifanele wena, yikuphi ukuzivocavoca okuhle kuwe, nokuthi yini okudingeka uyenze ukuze uhlale uphilile engqondweni.
- Xhumana nabanye: Uma unesifo esingavamile njengalesi, ungazizwa unesizungu, njengokuthi "Ngingedwa emhlabeni onalesi sifo." Kodwa awuwedwa. Kunezinhlangano zokusekela abantu abanalesi simo. Cela udokotela wakho ukuthi akuxhumanise nesinye. Ukukhuluma nabantu abaye badlula ezintweni ezifanayo nawe kungaba umthombo omkhulu wamandla.
Umlayezo Wokuya Nawe Ekhaya
- I-Waldenström Macroglobulinemia (WM) umdlavuza wegazi ovame kakhulu futhi olawulekayo.
- Abantu abaningi abatholakale benalesi sifo ekuqaleni abanazo izimpawu, ngakho bangaphila kahle iminyaka eminingi ngaphandle kokwelashwa.
- Lesi akusona isifo esizuzwa njengefa, ngakho ungakhathazeki ngokusidlulisela ezinganeni zakho.
- Umgomo oyinhloko wokwelashwa akukhona ukwelapha lesi sifo, kodwa ukulawula izimpawu nokugcina ikhwalithi yempilo yakho.
- Khuluma ngokukhululekile nodokotela wakho okwelaphayo nganoma yimiphi imibuzo, ukwesaba, noma ukungabaza ongase ube nakho. Uzokusiza.
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