Ukuthi yini i-Myelodysplastic Syndrome? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Myelodysplastic syndrome (MDS) iyiqembu lemithi yokungasebenzi kahle kwegazi lapho u-marrow wakho wamathambo ungenzi khona amaseli egazi aphilile ngendlela efanele. Cabanga nge-marrow yakho yamathambo njengefektri okufanele ikhiqize amaseli egazi abomvu avamile, amaseli egazi amhlophe, nama-platelets, kodwa ku-MDS, le fekthri iqala ukwenza amaseli abonakala engaqondakali futhi angasebenzi kahle.

Lokhu kusimo kubathinta ikakhulu abadala, abantu abaningi bacutshungulwa ngemuva kweminyaka engama-65. Nakuba i-MDS ingase izizwe icindezelayo uma uyizwa okokuqala, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza ukusebenzisana neqembu lakho lokunakekelwa kwezempilo ukuze uliphathe ngokuphumelelayo.

Ukuthi yini i-Myelodysplastic Syndrome?

I-Myelodysplastic syndrome ivela lapho amaseli estem cell ku-marrow yakho yamathambo elimazeka futhi angakwazi ukuthuthukela kumaseli egazi aphilile, avuthiwe. Esikhundleni sokukhiqiza amaseli avamile, i-marrow yakho yamathambo idala amaseli egazi angaqondakali, angasebenzi kahle, futhi ngokuvamile afa ngaphambi kokuba akwazi ukwenza umsebenzi wawo emzimbeni wakho.

Lokhu kuholela ekutheni inani legazi liphansi, okuthi odokotela balibize ngokuthi i-cytopenias. Ungase ungabi namaseli egazi abomvu anele (anemia), amaseli egazi amhlophe (neutropenia), noma ama-platelets (thrombocytopenia). Ngamunye walawa mafutha angabangela izimpawu ezahlukene nezinkinga zezempilo.

I-MDS ngezinye izikhathi ibizwa ngokuthi isimo "esingaphambi kwe-leukemia" ngoba ingase ithuthukele ku-leukemia ebukhali kubantu abathile. Noma kunjalo, abantu abaningi abane-MDS abayithuthukisi i-leukemia futhi bangaphila iminyaka eminingi ngokuphathwa kahle nokwelashwa.

Ziyini Izimpawu ze-Myelodysplastic Syndrome?

Izimpawu ze-MDS zithuthuka kancane kancane futhi zihambisana ngokuqondile nokuthi inani legazi liphansi. Abantu abaningi abaziboni izimpawu ngokushesha, futhi lesi simo ngezinye izikhathi sitholakala ngesikhathi sokuhlolwa kwegazi okuvamile ngezizathu ezingezona lezo.

Nazi izimpawu ezivame kakhulu ongazihlangabezana nazo:

• Ukukhathala okuqhubekayo nobuthakathaka obungaphuli ngokuphumula
• Ukuphefumula okufushane ngesikhathi semisebenzi evamile noma lapho ulele phansi
• Ukukhanya kwesikhumba, okubonakala kakhulu ebusweni, emakhaleni angaphakathi, noma ezindaweni zezinzipho
• Ukubulala okulula ngezigubhu ezincane noma ukulimala
• Ukuphuza okungavamile, njengokuphuza igazi emakhaleni, ukuphuza igazi emazinyweni, noma izikhathi zenyanga ezisindayo
• Ukutheleleka okuvamile okuthatha isikhathi eside kunokujwayelekile ukuphulukisa
• Ukukhungatheka noma ukukhanya ekhanda lapho ukuma
• Ukushona kwenhliziyo noma ukushaywa kwenhliziyo okusheshayo

Abanye abantu nabo bahlangabezana nezimpawu ezingavamile njengokuhlunguluka kwamathambo, ukulahlekelwa ukudla, noma ukulahlekelwa isisindo okungathandeki. Uma ubona ezinye zalezi zimpawu ziqhubeka amasonto amaningi, kufanele ukuxoxe nazo nodokotela wakho, ngisho noma zingabangelwa ezinye izimo eziningi kakhulu.

Ziyini Izinhlobo ze-Myelodysplastic Syndrome?

Odokotela bahlukanisa i-MDS ngezinhlobo eziningi ngokusekelwe ekutheni amaseli angaqondakali abonakala kanjani ngaphansi komkhiqizo kanye namaseli egazi athonya. Uhlelo lwe-World Health Organization (WHO) luyindlela evamile yokwahlukanisa.

Izinhlobo eziyinhloko zihlanganisa i-MDS enesifo esisodwa (esithinta uhlobo olulodwa lweselula legazi), i-MDS enesifo esiningi (esithinta izinhlobo eziningi zamaseli), ne-MDS enama-blasts amaningi (enamaseli amaningi angavuthiwe). Kukhona futhi i-MDS enokuqothulwa kwe-chromosome 5q okuhlukile, enesiguquko esithile se-genetic futhi ngokuvamile iphendula kahle ezinye izindlela zokwelapha.

Udokotela wakho uzothola futhi amazinga wakho ngosizo lwezinhlelo zokubala ezisiza ukubikezela ukuthi isifo singathuthuka kanjani. Lolu lwazi lusiza ukuqondisa izinqumo zokwelapha futhi lukunikeze ukuqonda okungcono kokulindele ukwenzekani kusuka.

Yini ebangela i-Myelodysplastic Syndrome?

Ezimweni eziningi, odokotela abakwazi ukubona ngqo ukuthi yini ebangela i-MDS. Lokhu kubizwa ngokuthi i-primary noma i-de novo MDS, futhi kubonakala sengathi kwenzeka lapho izinguquko ze-genetic zenzeka kumaseli estem cell ku-marrow yamathambo ngokuhamba kwesikhathi, ngokuvamile njengengxenye yendlela yokuguga evamile.

Kodwa-ke, izinto eziningi zingandisa ingozi yakho yokuthuthukisa i-MDS:

• Ukuphathwa kwesifo samanje nge-chemotherapy noma i-radiation therapy
• Ukuvezwa ezintweni ezithile ezikhemikhali njenge-benzene noma i-formaldehyde
• Ukubhema okukhulu eminyakeni eminingi
• Izifo ezithile ze-genetic ezikhona kusukela ekuzalweni
• Izifo zegazi ezedlule noma izifo ze-marrow yamathambo

Lapho i-MDS ithuthuka ngemuva kokwelashwa kwesifo samanje, kubizwa ngokuthi i-therapy-related noma i-secondary MDS. Lokhu ngokuvamile kwenzeka eminyakeni embalwa ngemuva kokwelashwa futhi kuvamise ukuba nzima kune-primary MDS. Izindaba ezinhle ukuthi abantu abaningi abamukela ukwelashwa kwesifo samanje abayithuthukisi i-MDS.

Ubudala buyimbangela enkulu yegozi, ngokulinganiselwe ubudala besikhathi sokutholakala cishe eminyakeni engama-70. Amadoda avame kakhulu ukuthuthukisa i-MDS kunabesifazane, nakuba umehluko ungakhulu.

Nini Okufanele Ubone Udokotela nge-Myelodysplastic Syndrome?

Kufanele uhlele i-aphoyintimenti nodokotela wakho uma uhlangabezana nokukhathala okuqhubekayo, ubuthakathaka, noma ukuphefumula okufushane okuphazamisa imisebenzi yakho yansuku zonke. Lezi zimpawu zingabonisa ukuthi inani lamaseli egazi abomvu liphansi, okudinga ukuhlolwa kwezokwelapha.

Funani ukunakekelwa kwezokwelapha ngokushesha uma ubona ukuphuza okungavamile noma ukubulala, ukutheleleka okuvamile, noma uma uzizwa ukhungathekile futhi ukhaliphile njalo. Nakuba lezi zimpawu zingaba nezizathu eziningi, zidinga ukuhlolwa ukuze kuvinjwe izifo zegazi njenge-MDS.

Uma unomlando wokwelashwa kwesifo samanje, kubalulekile ukubika noma yiziphi izimpawu ezintsha noma eziqhubekayo eqenjini lakho lokunakekelwa kwezempilo. Bayazi umlando wakho wezokwelapha futhi bangakwazi ukuthola ukuthi ukuhlolwa okuqhubekayo kuyadingeka yini.

Ziyini Izimbangela Zegozi ze-Myelodysplastic Syndrome?

Ukuqonda izimbangela zegozi kungakusiza ukuba ube nezingxoxo ezicacile nodokotela wakho, nakuba ukuba nezimbangela zegozi akusho ukuthi uzokuthuthukisa ngokuqinisekile i-MDS. Ubudala buhlala buyimbangela enkulu yegozi, ngalesi simo singavamile kubantu abangaphansi kweminyaka engama-50.

Izimbangela eziyinhloko zegozi zihlanganisa:

• Ubudala obukhulu, ikakhulukazi ukuba ngaphezu kweminyaka engama-65
• Ubulili besilisa (ingozi encane kuneabesifazane)
• Ukuphathwa ngaphambili nge-alkylating agents noma i-topoisomerase II inhibitors
• Ukuvezwa kwe-radiation kusuka ekwelapheni kwezokwelapha noma imithombo yemisebenzi
• Ukubhema, okungalimaza amaseli e-marrow yamathambo ngokuhamba kwesikhathi
• Izifo ezithile ze-genetic ezifuywe njenge-Fanconi anemia
• Umlando womndeni wezifo zamanyala noma i-MDS

Ukuba nenye noma ngaphezulu kwezimbangela zegozi akusho ukuthi uzokuthuthukisa i-MDS. Abantu abaningi abanezinto eziningi zegozi abayithuthukisi lesi simo, kanti abanye abangenazo izimbangela zegozi ezaziwayo bayenza. Ukusebenzisana kwe-genetics, imvelo, nokuthuthuka kuyinkimbinkimbi futhi akuqondakali ngokuphelele.

Ziyini Izingozi Ezingaba khona ze-Myelodysplastic Syndrome?

I-MDS ingabangela izinkinga eziningi, ikakhulukazi ngoba i-marrow yakho yamathambo ayikhiqizi amaseli egazi aphilile anele. Ukuqonda lezi zingozi ezingaba khona kukusiza ukwazi izimpawu okufanele uzibheke futhi nini okufanele ufune ukunakekelwa kwezokwelapha.

Izingozi ezivamile zihlanganisa:

• I-anemia eqinile edinga ukuthuthukiswa kwegazi
• Ukutheleleka okuqine kakhulu ngenxa yokuthi inani lamaseli egazi amhlophe liphansi
• Ukuphuza okuyingozi ngenxa yokuthi inani lama-platelets liphansi
• Ukugcwala kwesinyithi ngenxa yokuthuthukiswa kwegazi okuphindaphindayo
• Izinkinga zenhliziyo ezivela ku-anemia eqinile
• Ukuthuthukela ku-acute myeloid leukemia (AML)

Cishe u-30% wabantu abane-MDS ekugcineni bathuthukisa i-leukemia ebukhali, nakuba lokhu kuhluka kakhulu ngokusekelwe ohlotsheni lwakho oluthile lwe-MDS kanye nezinto zegozi. Udokotela wakho angakunika ukubikezela okuningi oluqondene nesimo sakho ngokusekelwe esimweni sakho siqu.

Ukugcwala kwesinyithi kungaba ukukhathazeka uma udinga ukuthuthukiswa kwegazi okuvamile. I-iron engaphezulu ingalimaza inhliziyo yakho, isibindi, namanye amalungu ngokuhamba kwesikhathi, kodwa lokhu kungaphathwa ngemithi ebizwa ngokuthi yi-iron chelators uma kudingeka.

I-Myelodysplastic Syndrome Ihlonishwa Kanjani?

Ukuhlonishwa kwe-MDS kudinga ukuhlolwa okuningi ngoba izimpawu zingafana nezinye izifo zegazi noma ngisho nezimo ezivamile njenge-iron deficiency anemia. Udokotela wakho uzoqala ngokubala igazi eliphelele (CBC) ukuhlola amaseli akho egazi abomvu, amaseli egazi amhlophe, nama-platelets.

Uma inani legazi lakho lingaqondakali, isinyathelo esilandelayo ngokuvamile yi-bone marrow biopsy. Ngalesi senzo, udokotela wakho ususa isampula encane ye-marrow yamathambo, ngokuvamile emathanjeni akho, ukuhlola amaseli ngaphansi komkhiqizo. Lokhu kubonisa ukuthi i-marrow yakho yamathambo ikhiqiza yini amaseli angaqondakali aphawuleka ku-MDS.

Ukuhlolwa okuqhubekayo kungase kuhlanganise ukuhlaziywa kwe-cytogenetic ukuze kubhekwe izinguquko ze-chromosome, i-flow cytometry ukuhlaziya izici zamaseli, kanye nokuhlolwa kwe-molecular ngezinguquko ezithile ze-genetic. Lokhu kuhlolwa kusiza ukuthola uhlobo lwakho oluqondile lwe-MDS futhi kuqondise izinqumo zokwelapha.

Yini Ukwelashwa kwe-Myelodysplastic Syndrome?

Ukuphathwa kwe-MDS kuncike ezintweni eziningi, kufaka phakathi ubudala bakho, impilo yakho yonke, uhlobo oluqondile lwe-MDS onalo, kanye nezinga lakho legozi. Umgomo ukulungisa inani legazi lakho, ukunciphisa izimpawu, nokunciphisa ukuthuthuka kwesifo.

Izinketho zokwelapha zingase zihlanganise:

• Ukukhathalela okusekayo ngokuthuthukiswa kwegazi kanye nemithi yokuvimbela ukutheleleka
• I-hypomethylating agents njenge-azacitidine noma i-decitabine
• I-Lenalidomide, ikakhulukazi isebenza kahle kwezinye izinhlobo ze-genetic
• Ukuthuthukiswa kweselula yestem cell kubantu abasebasha, abaphilile
• I-Iron chelation therapy uma ukugcwala kwesinyithi kuthuthuka
• I-Growth factors ukuvuselela ukukhiqizwa kwamaseli egazi

Abantu abaningi baqala ngokunakekelwa okusekayo, okugxile ekulawuleni izimpawu nokuvimbela izinkinga. Lokhu kungase kuhlanganise ukuthuthukiswa kwegazi okuvamile, ama-antibiotics ukuvimbela ukutheleleka, noma imithi yokwandisa inani legazi lakho.

Kwabanye abantu, ikakhulukazi labo abane-MDS engozi enkulu, ukwelashwa okuqine kakhulu njenge-hypomethylating agents kungasiza ekuthuthukiseni inani legazi kanye nekhwalithi yempilo. Ukuthuthukiswa kweselula yestem cell kunikeza ithuba elihle kakhulu lokuphulukisa kodwa ngokuvamile kugcinelwe abantu abasebasha abangakhuthazelela le nqubo eqinile.

Ukuthi Ungawuthatha Kanjani Ukwelashwa Ekhaya Ngesikhathi Se-Myelodysplastic Syndrome?

Ukuphatha i-MDS ekhaya kuhilela ukuthatha izinyathelo zokuzivimbela ekuthelelekeni, ukuvimbela ukulimala okungabangela ukuphuza, nokugcina impilo yakho yonke. Iqembu lakho lokunakekelwa kwezempilo lizokunika imiyalo ethile ngokusekelwe emaninini akho egazi kanye nelenqubo yokwelapha.

Nazi izindlela ezibalulekile zokunakekelwa ekhaya:

• Geza izandla zakho njalo futhi gwema abantu abagulayo
• Sebenzisa ibrashi yoboya oluthambile futhi gwema ukusebenzisa i-floss uma inani lama-platelets lakho liphansi
• Gqoka iziqhwaga lapho ulima noma uhlanza
• Gwema imidlalo yomzimba noma imisebenzi engozi enkulu
• Dle ukudla okulinganiselayo okuneprotheni eningi ukuze usekele i-immune system yakho
• Thola ukuphumula okwanele futhi ulawule ukucindezeleka
• Thatha imithi ngokuqondile njengoba kulotshiwe

Gcina i-thermometer eseduze futhi hlola ubushushu bakho uma uzizwa ungaphili kahle. Ukuthuthumela okungaphezu kuka-100.4°F (38°C) kudinga ukunakekelwa kwezokwelapha ngokushesha uma une-low white blood cell counts. Ngokufanayo, noma yikuphi ukuphuza okungavamile noma ukukhathala okukhulu kufanele kukhuthaze ukubiza iqembu lakho lokunakekelwa kwezempilo.

Kufanele Uzilungiselele Kanjani I-Aphoyintimenti Yakho Nodokotela?

Ukulungiselela i-aphoyintimenti yakho kungakusiza ukuba wenze okuningi ngesikhathi sakho neqembu lakho lokunakekelwa kwezempilo futhi kuqinisekise ukuthi uthola ulwazi oludingayo. Qala ngokubhala izimpawu zakho, kufaka phakathi ukuthi zaqala nini nokuthi zikuthinta kanjani impilo yakho yansuku zonke.

Letha uhlu oluphelele lwemithi yonke, izithasiselo, namavithamini owaqabula. Faka noma iyiphi imithi yokuthengwa ngaphandle kwelayisensi, njengoba ezinye zingathinta inani legazi lakho noma zisebenzisane nokuphathwa kwe-MDS. Futhi, buthana ulwazi ngomlando wakho wezokwelapha, kufaka phakathi noma yikuphi ukwelashwa kwesifo samanje okwedlule noma ukuvezwa ezintweni ezikhemikhali.

Lungiselela imibuzo kusengaphambili futhi cabanga ukuletha ilungu lomndeni noma umngani ukuze akusize ukukhumbula ulwazi olubalulekile. Buza ngohlobo lwakho oluqondile lwe-MDS, izinketho zokwelapha, imiphumela emibi okulindelekile, nokuthi yini okulindelekile kusuka. Unganqikazi ukucela incazelo uma ungakuqondi okuthile.

Yini Iphuzu Eliyinhloko Mayelana ne-Myelodysplastic Syndrome?

I-MDS isimo esilawuleka, ngisho noma singase sizizwe sicindezela ekuqaleni. Abantu abaningi baphila iminyaka eminingi ngekhwalithi enhle yempilo ngokwelashwa okufanele nokunakekelwa okusekayo. Ikhona ukusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo ukuze uqaphe isimo sakho futhi ulungise ukwelashwa njengoba kudingeka.

Khumbula ukuthi i-MDS ibathinta bonke ngendlela ehlukile. Isipiliyoni sakho singase sihluke kakhulu kunesomunye umuntu, ngisho noma unehlobo elifanayo. Gxila ekuthatheni izinto usuku ngosuku futhi unganqikazi ukucela ukwesekwa eqenjini lakho lokunakekelwa kwezempilo, umndeni, nabangane.

Ukuba nolwazi ngesimo sakho kukusiza ukuba wenze izinqumo ezinhle ngokunakekelwa kwakho, kodwa zama ukungacindezeleki ngolwazi. Themba iqembu lakho lokunakekelwa kwezempilo ukuba likukhokhele kule nqubo futhi khumbula ukuthi ukwelashwa kwe-MDS kuqhubeka nokuthuthuka, kunikeza ithemba lemiphumela emihle esikhathini esizayo.

Imibuzo Evamile Mayelana ne-Myelodysplastic Syndrome

Q1. Ingabe i-myelodysplastic syndrome ifana ne-leukemia?

I-MDS ayifani ne-leukemia, nakuba kuyizimo ezihlobene. I-MDS iyisifo lapho i-marrow yakho yamathambo yenza khona amaseli egazi angaqondakali angasebenzi kahle. I-Leukemia ihilela amaseli omdlavuza ahlanganisa ngokushesha futhi agcwalisa amaseli egazi avamile. Kodwa-ke, cishe u-30% wabantu abane-MDS bangase ekugcineni bathuthukise i-leukemia ebukhali, kungakho odokotela beqapha iziguli eduze.

Q2. Isikhathi esingakanani umuntu angaphila nge-myelodysplastic syndrome?

Isikhathi sokuphila nge-MDS sihluka kakhulu ngokusekelwe ebudaleni bakho, impilo yakho yonke, kanye nohlobo oluqondile kanye nezinga legozi le-MDS yakho. Abanye abantu baphila iminyaka eminingi ngalesi simo, kanti abanye bangase babe nenqubo eqinile. Udokotela wakho angakunikeza umbono oluqondene nesimo sakho ngokusekelwe esimweni sakho siqu kanye nendlela oqaphela ngayo ukwelashwa.

Q3. Ingabe i-myelodysplastic syndrome ingaphulileka?

Okwamanje, ukuthuthukiswa kweselula yestem cell yiyona kuphela indlela yokwelapha enikeza ithuba lokuphulukisa, kodwa ayifanele bonke ngenxa yokucabangela ubudala nempilo. Kwabantu abaningi, i-MDS iwelashwa njengesimo esiqhubekayo esingaphathwa ngezindlela ezahlukene zokwelapha ukuthuthukisa ikhwalithi yempilo nokunciphisa ukuthuthuka.

Q4. Ingabe ngizodinga ukuthuthukiswa kwegazi nge-MDS?

Abantu abaningi abane-MDS bayadinga ukuthuthukiswa kwegazi, ikakhulukazi ukuthuthukiswa kwamaseli egazi abomvu ngenxa ye-anemia. Ukuvamile kuncike emaninini akho egazi kanye nezimpawu. Abanye abantu badinga ukuthuthukiswa kwegazi masonto onke, kanti abanye bangase badinge kancane noma konke, ikakhulukazi uma ezinye izindlela zokwelapha zisiza ekuqondiseni amanani abo egazi.

Q5. Ingabe ukudla noma ukushintsha indlela yempilo kungasiza nge-MDS?

Nakuba ukudla nokushintsha indlela yempilo kungakwazi ukwelapha i-MDS, kungakusiza uzizwe ukhulu futhi kunciphisa ingozi yezinkinga. Ukudla ukudla okulinganiselayo okuneprotheni eningi kusekela i-immune system yakho, ukuhlala uqinisile kusiza ekukhathaleni, nokungagwema abantu abagulayo kunciphisa ingozi yokutheleleka. Ukuzivocavoca okuthambile okuvamile, uma uzizwa ukhulu, kungasiza futhi ekuqondiseni amandla akho kanye nomoya wakho.