Kumvetsetsa Myelofibrosis

Zamkati

• Zizindikiro zake ndi ziti?
• Zimayambitsa chiyani?
• Kodi pali zoopsa zilizonse?
• Kodi amapezeka bwanji?
• Amachizidwa bwanji?
• Kuchiza kuchepa kwa magazi m'thupi
• Kuchiza nthenda yotakasa
• Kuchiza majini osinthika
• Mankhwala oyesera
• Kodi pali zovuta zina?
• Kukhala ndi myelofibrosis

Kodi myelofibrosis ndi chiyani?

Myelofibrosis (MF) ndi mtundu wa khansa ya m'mafupa yomwe imakhudza kuthekera kwa thupi lanu kutulutsa maselo amwazi. Ndi gawo limodzi lazikhalidwe zotchedwa myeloproliferative neoplasms (MPNs). Izi zimapangitsa kuti mafupa anu am'mafupa asiye kugwira ntchito momwe akuyenera kuchitira, zomwe zimapangitsa minofu yoluma.

MF ikhoza kukhala yoyamba, kutanthauza kuti imachitika yokha, kapena yachiwiri, kutanthauza kuti imachokera ku chikhalidwe china - nthawi zambiri chimakhudza mafupa anu. Ma MPN ena amathanso kupita ku MF. Ngakhale kuti anthu ena amatha zaka zambiri osakhala ndi zizindikilo, ena amakhala ndi zizindikilo zomwe zimakulirakulira chifukwa cha zipsera m'mafupa.

Zizindikiro zake ndi ziti?

Myelofibrosis imayamba kubwera pang'onopang'ono, ndipo anthu ambiri sazindikira zizindikiro poyamba. Komabe, pamene ikupita ndikuyamba kusokoneza kapangidwe ka maselo amwazi, zizindikilo zake zimatha kuphatikizira izi:

• kutopa
• kupuma movutikira
• kuvulaza kapena kutuluka magazi mosavuta
• kumva kupweteka kapena kukhuta kumanzere kwako, pansi pa nthiti zako
• thukuta usiku
• malungo
• kupweteka kwa mafupa
• kuchepa kwa njala ndi kuonda
• Mphuno kapena magazi m'kamwa

Zimayambitsa chiyani?

Myelofibrosis imagwirizanitsidwa ndi kusintha kwa majini m'maselo am'magazi. Komabe, ofufuza sakudziwa chomwe chimayambitsa kusintha kumeneku.

Maselo osinthika akamadzichulukitsa ndikugawana, amapatsira kusintha kuma cell amwazi. Potsirizira pake, maselo osinthika amaposa mphamvu ya m'mafupa yopanga maselo athanzi lamagazi. Izi nthawi zambiri zimabweretsa maselo ofiira ochepa komanso maselo oyera oyera ambiri. Zimayambitsanso mabala ndi kuuma kwa mafupa anu, omwe nthawi zambiri amakhala ofewa komanso siponji.

Kodi pali zoopsa zilizonse?

Myelofibrosis ndi yosowa, yomwe imachitika pafupifupi 1.5 mwa anthu 100,000 ku United States. Komabe, zinthu zingapo zingakulitse chiopsezo chanu chokhala nacho, kuphatikiza:

• Zaka. Ngakhale kuti anthu azaka zilizonse amatha kukhala ndi myelofibrosis, nthawi zambiri amapezeka kwa omwe ali ndi zaka zopitilira 50.
• Matenda ena amwazi. Anthu ena omwe ali ndi MF amakhala ndi vuto lina, monga thrombocythemia kapena polycythemia vera.
• Kuwonetsedwa ndi mankhwala. MF yakhala ikugwirizanitsidwa ndi kupezeka kwa mankhwala ena ogulitsa mafakitale, kuphatikizapo toluene ndi benzene.
• Chiwonetsero cha radiation. Anthu omwe adakumana ndi zinthu zowononga ma radio atha kukhala ndi chiopsezo chowonjezeka chokhala ndi MF.

Kodi amapezeka bwanji?

MF nthawi zambiri imawonetsa kuwerengera kwathunthu kwa magazi (CBC). Anthu omwe ali ndi MF amakonda kukhala ndi maselo ofiira ofiira kwambiri komanso kuchuluka kwa maselo oyera am'magazi ndi ma platelet.

Kutengera zotsatira za mayeso anu a CBC, adotolo atha kupanganso mafupa. Izi zimaphatikizapo kutenga kachidutswa kakang'ono ka mafupa anu ndikuyang'anitsitsa kwambiri zizindikiro za MF, monga zipsera.

Mwinanso mungafunike kujambulidwa ndi X-ray kapena MRI kuti muchepetse zina zomwe zingayambitse matenda anu kapena zotsatira za CBC.

Amachizidwa bwanji?

Chithandizo cha MF nthawi zambiri chimatengera mitundu yazizindikiro zomwe muli nazo. Zizindikiro zambiri za MF zimakhudzana ndi vuto lomwe limayambitsidwa ndi MF, monga kuchepa kwa magazi m'thupi kapena nthenda yotakasa.

Kuchiza kuchepa kwa magazi m'thupi

Ngati MF ikuyambitsa kuchepa kwa magazi m'thupi, mungafunike:

• Kuikidwa magazi. Kuikidwa magazi nthawi zonse kumatha kukulitsa kuchuluka kwanu kwama cell ofiira ndikuchepetsa kuchepa kwa magazi m'thupi, monga kutopa ndi kufooka.
• Thandizo la mahomoni. Mtundu wopanga mahomoni amphongo a androgen ungalimbikitse kupanga maselo ofiira m'magazi mwa anthu ena.
• Corticosteroids. Izi zitha kugwiritsidwa ntchito ndi androgens kulimbikitsa kupanga maselo ofiira a magazi kapena kuchepetsa kuwonongeka kwawo.
• Mankhwala akuchipatala. Mankhwala a immunomodulatory, monga thalidomide (Thalomid), ndi lenalidomide (Revlimid), amatha kusintha kuchuluka kwama cell. Angathandizenso ndi zizindikilo za nthenda yotakasa.

Kuchiza nthenda yotakasa

Ngati muli ndi nthenda yotambalala yokhudzana ndi MF yomwe imayambitsa mavuto, dokotala akhoza kukulangizani kuti:

• Thandizo la radiation. Thandizo la radiation limagwiritsa ntchito matabwa olowera kupha maselo ndikuchepetsa kukula kwa ndulu.
• Chemotherapy. Mankhwala ena a chemotherapy amatha kuchepetsa kukula kwa ntchentche yanu.
• Opaleshoni. Splenectomy ndi njira yochitira opaleshoni yomwe imachotsa nthenda yanu. Dokotala wanu angakulimbikitseni izi ngati simukuyankha bwino mankhwala ena.

Kuchiza majini osinthika

Mankhwala atsopano otchedwa ruxolitinib (Jakafi) adavomerezedwa ndi US Food and Drug Administration mu 2011 kuti athetse zizindikiro zomwe zimakhudzana ndi MF. Ruxolitinib amayang'ana kusintha kwamitundu ina komwe kungakhale chifukwa cha MF. Mu, adawonetsedwa kuti amachepetsa kukula kwa ndulu zokulitsa, kuchepetsa zizindikilo za MF, ndikuwongolera malingaliro.

Mankhwala oyesera

Ofufuzawo akugwira ntchito yopanga chithandizo chatsopano cha MF. Ngakhale zambiri mwa izi zimafunikira maphunziro owonjezerapo kuti atsimikizire kuti ali otetezeka, madokotala ayamba kugwiritsa ntchito mankhwala awiri atsopano nthawi zina:

• Kupanga khungu la tsinde. Kusintha kwa maselo am'mimba kumatha kuchiritsa MF ndikubwezeretsanso mafuta m'mafupa. Komabe, njirayi imatha kubweretsa zovuta zowononga moyo, choncho nthawi zambiri zimangochitika pokhapokha palibenso china chogwira ntchito.
• Interferon-alpha. Interferon-alfa yachedwetsa kupangika kwa minofu mu mafupa a anthu omwe amalandila chithandizo koyambirira, koma kafukufuku wina amafunika kuti adziwe chitetezo chake cha nthawi yayitali.

Kodi pali zovuta zina?

Popita nthawi, myelofibrosis imatha kubweretsa zovuta zingapo, kuphatikiza:

• Kuchuluka kwa magazi m'chiwindi. Kuwonjezeka kwa magazi kuchokera pakatambo kakakulidwe kumatha kukweza kupsinjika kwazitseko zamitsempha m'chiwindi, ndikupangitsa vuto lotchedwa portal hypertension. Izi zitha kupanikiza kwambiri mitsempha yaying'ono m'mimba mwanu ndi m'mimba, zomwe zingayambitse magazi ochulukirapo kapena mtsempha wophulika.
• Zotupa. Maselo amwazi amatha kupangika kunja kwa mafupa, ndikupangitsa zotupa kumera m'malo ena amthupi lanu. Kutengera komwe zotupazi zimapezeka, zimatha kuyambitsa mavuto osiyanasiyana, kuphatikiza kukomoka, kutuluka magazi m'mimba, kapena kupindika kwa msana.
• Khansa ya m'magazi. Pafupifupi 15 mpaka 20 peresenti ya anthu omwe ali ndi MF amapitilizabe kudwala khansa yayikulu yamtundu wa khansa.

Kukhala ndi myelofibrosis

Ngakhale kuti MF nthawi zambiri siyimayambitsa zizindikilo kumayambiliro, imatha kubweretsa zovuta zazikulu, kuphatikiza mitundu yambiri ya khansa. Gwiritsani ntchito ndi dokotala wanu kuti mudziwe njira yabwino kwambiri yothandizira inu ndi momwe mungathetsere matenda anu. Kukhala ndi MF kumatha kukhala kopanikiza, chifukwa chake mutha kupeza zothandiza kufunafuna chithandizo kuchokera ku bungwe monga Leukemia ndi Lymphoma Society kapena Myeloproliferative Neoplasm Research Foundation. Mabungwe onsewa atha kukuthandizani kupeza magulu othandizira am'deralo, magulu a pa intaneti, komanso ndalama zothandizira.