Ukuthi yini i-Waldenstrom macroglobulinemia? Izimpawu, Izimbangela, & Ukwelashwa

I-Waldenstrom macroglobulinemia uhlobo oluyimfihlo lomdlavuza wegazi oluthinta ikhono lesistimu yakho yokulwa nezifo zokulwa nezifo. Kwenzeka lapho amaseli amhlophe egazi athile abizwa ngama-B-lymphocytes ekhula ngokungapheli futhi akhiqize iprotheni eningi kakhulu ebizwa nge-IgM antibody.

Lesi simo sihamba kancane uma kuqhathaniswa namanye ama-cancer egazi, okusho ukuthi abantu abaningi bangaphila naso iminyaka ngenkathi baphatha izimpawu zabo. Nakuba kuzwakala kukhulu ekuqaleni, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza uzizwe ulawula kangcono uhambo lwakho lokuphila impilo.

Ukuthi yini i-Waldenstrom Macroglobulinemia?

I-Waldenstrom macroglobulinemia, evame ukubizwa nge-WM, umdlavuza oqala e-bone marrow lapho amaseli egazi enziwa khona. Amaseli omdlavuza uhlobo oluthile lweselula elibomvu legazi elikuvikela ngokujwayelekile ekuthelelekeni.

La maseli angajwayelekile akhiqiza inani elikhulu leprotheni ebizwa nge-immunoglobulin M noma i-IgM. Uma i-IgM eningi kakhulu iqokelela egazini lakho, yenza igazi lakho libe nzima kunokujwayelekile, njengoba uju kunokuba yimanzi. Le nhlanzi ingabangela izinkinga ngokuhamba kwegazi kulo lonke umzimba wakho.

I-WM ibhekwa njengohlobo lwe-lymphoma, ikakhulukazi uhlobo oluthile lwe-non-Hodgkin lymphoma. Ihlukaniswe njenge-lymphoplasmacytic lymphoma ngoba amaseli omdlavuza abukeka njengokuhlanganiswa kwama-lymphocytes namaseli e-plasma ngaphansi komkhiqizo.

Zithini izimpawu ze-Waldenstrom Macroglobulinemia?

Abantu abaningi abane-WM abanazo izimpawu ekuqaleni, futhi lesi simo sivame ukutholakala ngesikhathi sokuhlolwa kwegazi okujwayelekile. Uma izimpawu zivele, zithuthuka kancane kancane futhi zingazizwa njengokukhathala okujwayelekile noma izinkinga zempilo ezincane.

Izimpawu ezivame kakhulu ongazibona zihlanganisa:

• Ukhathazwa ubuthakathaka obungapheli obungaphuli ngisho noma ukhuluphuke
• Ubuthakathaka obukhulu obenza imisebenzi yansuku zonke ibe nzima
• Ukuqhuma kalula noma ukuphuza igazi, ngisho nasekuqotsheni okuncane
• Ukuphuza igazi ekhaleni noma emazinyweni njalo
• Ama-lymph nodes amakhulu entanyeni, ezikhaleni, noma emadolweni
• Ukuhlanza ubusuku obukhulu obukhulu obunamakhambi noma amashati
• Ukulahlekelwa isisindo ngaphandle kokuhlose ezinyangeni eziningi
• Ukutheleleka okuphindaphindayo okuthetha isikhathi eside ukuphulukisa

Abanye abantu baphuthuma futhi izimpawu ezihlobene negazi elikhulu, abaguli ababiza ngokuthi i-hyperviscosity syndrome. Lezi zimpawu zenzeka ngoba igazi elikhulu lihlupheka ukugeleza ngezitsha ezincane emzimbeni wakho.

Izimpawu zegazi elikhulu zifaka:

• Ukubona okungacaci noma ukushintsha emehlweni
• Izinhlungu zikhanda ezihluke kakhulu kunokujwayelekile
• Ukukhungatheka noma ukuzizwa ukhanya
• Ukudideka noma ukuhluleka ukugxila
• Ukuphefumula kancane ngesikhathi semisebenzi evamile

Ngokungavamile, ungase uqaphele ukuthamba noma ukungabi namandla ezandleni nasezinzwani. Lokhu kwenzeka uma i-IgM protein eyengeziwe ithonya imizwa yakho, isimo esibizwa ngokuthi i-peripheral neuropathy.

Yini ebangela i-Waldenstrom Macroglobulinemia?

Imbangela eqondile ye-WM ayiqondakali ngokuphelele, kodwa abacwaningi bakholelwa ukuthi iqala lapho izinguquko ze-DNA zenzeka ku-B-lymphocytes. Lezi zinguquko ze-genetic zitshela amaseli ukuba akhule futhi ahlukanise lapho kungafanele, okuholela ekwakhekeni kwamaseli angajwayelekile.

Izigameko eziningi ze-WM zenzeka ngokungahleliwe ngaphandle kwesizathu esicacile. Izinguquko ze-DNA ebangela i-WM ngokuvamile zenzeka phakathi nokuphila komuntu kunokuba zidluliselwe kubazali.

Kodwa-ke, ososayensi baye baqaphela izici ezithile ezingase zikhulise amathuba okukhula kwe-WM. Cishe u-20% wabantu abane-WM banamalungu omndeni abane-WM noma izifo zegazi ezihlobene, okubonisa ukuthi i-genetics ingase ibe nomthelela kwezinye izimo.

Ubudala yingxenyekazi enkulu kakhulu yengozi esiyaziyo. I-WM ikhungathekisa ikakhulu abadala, abantu abaningi baqaphela ebudaleni babo bama-60 noma ama-70. Amadoda nawo amancane amathuba okuba athole i-WM kunabesifazane.

Nini Okufanele Ubone Udokotela NgeWaldenstrom Macroglobulinemia?

Kufanele uxhumane nodokotela wakho uma ubhekene nezimpawu eziqhubekayo ezingaphuli ngemuva kwamasonto ambalwa. Nakuba lezi zimpawu zingaba nezizathu eziningi, kubalulekile ukuzihlola, ikakhulu uma unezimpawu eziningi ndawonye.

Hlela i-aphoyintimenti uma uqaphela ukukhathala okuqhubekayo okuhlupha impilo yakho yansuku zonke, ukwehla kwesisindo okungachazeki, noma ukutheleleka okuvamile. Lezi zimpawu zifanele ukunakekelwa kwezokwelapha kungakhathaliseki isizathu sazo.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uthola ukushintsha kokubona okungazelelwe, izinhlungu ezinzima zikhanda, ukudideka, noma ukuphefumula okuphansi okukhulu. Lokhu kungaba izimpawu zokuthi igazi elikhulu liyathinta amandla abalulekile futhi lidinga ukwelashwa ngokushesha.

Ungakhathazeki ngokubonakala uqapha kakhulu. Udokotela wakho angathanda ukulinganisa izimpawu eziphuma into encane kunokushiya into edinga ukunakekelwa.

Ziyini Izici Zengozi ZeWaldenstrom Macroglobulinemia?

Izici eziningi zingandisa amathuba akho okuba ne-WM, nakuba ukuba nezici zengozi akusho ukuthi uzoba naleli simo. Abantu abaningi abanezici zengozi abazitholi i-WM, futhi abanye abantu abangenazo izici zengozi ezaziwayo bayayithola.

Izici eziyinhloko zengozi zihlanganisa:

• Ubudala obungaphezu kweminyaka engama-60, engozi ikhuphuka njengoba ukhula
• Ukuba yindoda, njengoba amadoda ethola i-WM kancane kancane kunabesifazane
• Ukuba nomlando womndeni we-WM noma umdlavuza wegazi ohlobene
• Ukuba nesimo esibizwa ngokuthi i-monoclonal gammopathy of undetermined significance (MGUS)
• Ukudluliselwa kwangaphambili kwe-hepatitis C virus
• Izimo ezithile zokuzimela komzimba

I-MGUS yisimo lapho umzimba wakho ukhulisa khona amaprotheni angavamile afana nawo ku-WM, kodwa ngobuningi obuncane. Abantu abaningi abane-MGUS abazange bafune umdlavuza, kodwa kukhuphula kancane ingozi ye-WM namanye ama-cancer egazi.

Izici zemvelo njengokubekwa ezingozini zezinto ezithile noma ukukhanya kuye kwafundwa, kodwa azikho izixhumanisi ezicacile ne-WM eziye zamiswa. Izindaba ezinhle ukuthi izinhlangothi eziningi zezingozi ze-WM yizinto ongenakuzilawula, okusho ukuthi akukho lutho oluye lwabangela lesi simo.

Ziyini Izingozi Ezingase Zenzeke Ze-Waldenstrom Macroglobulinemia?

I-WM ingabangela ubunzima obuningi, ikakhulu ngenxa yegazi elikhulu kakhulu nemiphumela yeseli lomdlavuza ohlelweni lwakho lokuphepha. Ukuqonda lezi zinto ezingase zenzeke kungakusiza ukuthi uqaphele nini kufanele ufuna ukunakekelwa kwezokwelapha.

Ingozi enkulu kunazo zonke yi-hyperviscosity syndrome, lapho igazi liba khulu kakhulu ukuba ligeleze kahle. Lokhu kuchaphazela cishe i-10-30% yabantu abane-WM futhi kungabangela izinkinga zobuso, ukuphuza igazi, futhi ezimweni ezingavamile, isifo sobuchopho noma izinkinga zenhliziyo.

Ubunzima obuvamile buhlanganisa:

• Ukungena engcupheni enkulu yokutheleleka ngenxa yesistimu yokuphepha ebuthakathaka
• I-Anemia, ebangela ukukhathala nokuqina komoya
• Izinkinga zokopha ngenxa yebali le-platelet eliphansi
• I-spleen enkulu engabangela ukungakhululeki esiswini
• Izinkinga zezinso ezivela ekwakhekeni kwamaprotheni
• Ukonakala kwama-nerve okubangela ukungathinti noma ukukhahlela

Abanye abantu bathuthukisa isimo esibizwa nge-cryoglobulinemia, lapho amaprotheni egazi ehlangana ndawonye ezimweni ezibandayo. Lokhu kungabangela ubuhlungu bezingxenye zomzimba, isikhumba esiqhumayo, noma izinkinga zokujikeleza kwegazi ezimweni ezibandayo.

Ngokungavamile, i-WM ingaguquka ibe uhlobo olukhulu lwe-lymphoma oluthiwa yi-diffuse large B-cell lymphoma. Lokhu kwenzeka ngaphansi kwe-10% yezimo futhi ngokuvamile kwenzeka eminyakeni eminingi ngemuva kokuxilongwa kwe-WM yokuqala.

Izindaba ezinhle ukuthi ukwelashwa kwamanje kungavimbela noma kuphathe kahle izinhlanganisela eziningi zalezi. Ukulandelela njalo kusiza ekutholeni izinkinga ekuqaleni lapho kulula khona ukwelapha.

UWaldenstrom Macroglobulinemia Utholakala Kanjani?

Ukuxilongwa kwe-WM kuhilela ukuhlolwa okuningi ukuqinisekisa ukuba khona kwamaseli e-cancer nokulinganisa amazinga e-IgM protein egazini lakho. Udokotela wakho uzoqala ngezivivinyo zegazi futhi angadinga izinqubo ezengeziwe ukuze athole isithombe esiphelele.

Inqubo yokuxilongwa iqala ngokuvamile ngomsebenzi wegazi obonisa amazinga e-protein angavamile noma ukubalwa kwamaseli egazi. Udokotela wakho uzoyala ukuhlolwa okuqondile ukuze alinganise amazinga e-IgM futhi abukele iphethini ye-protein ephawuleka ye-WM.

Ukuhlolwa okubalulekile kokuxilongwa kufaka phakathi:

1. Ukubalwa kwamaseli egazi aphelele ukuhlola zonke izinhlobo zamaseli egazi
2. Iphaneli ephelele yemithombo ukuhlola umsebenzi we-organ
3. I-serum protein electrophoresis ukuhlonza ama-protein angavamile
4. I-Immunofixation ukuqinisekisa uhlobo lwe-protein engavamile
5. I-Bone marrow biopsy ukuhlola amaseli e-cancer ngokuqondile
6. I-Flow cytometry ukuhlonza amamaki athile amaseli

I-bone marrow biopsy ivame ukwenziwa njengesiqondiso sokuphuma ngaphandle kokwelashwa kwendawo. Udokotela wakho uzothatha isampula encane ye-bone marrow emathanjeni akho ukuze ahlole ngaphansi komkhiqizo.

Ukuhlolwa okwengeziwe kungafaka i-CT scans ukuhlola ama-lymph nodes amakhulu noma ama-organ, futhi ngezinye izikhathi ukuhlolwa kwe-genetic kwamaseli e-cancer ukuqondisa izinqumo zokwelapha. Udokotela wakho angase futhi ahlole ubukhulu begazi lakho uma unezimpawu ze-hyperviscosity syndrome.

Iyini Ukwelashwa kweWaldenstrom Macroglobulinemia?

Ukuphathwa kwe-WM kuncike ezimpawu zakho, emiphumeleni yokuhlolwa kwegazi, nokuphulukela kwakho konke. Abantu abaningi abane-WM abadingi ukwelashwa ngokushesha futhi bangalandelelwa ngokuhlangana okuvamile, indlela ebizwa ngokuthi "ukubuka nokulinda."

Udokotela wakho uzokuncoma ukwelashwa uma uthola izimpawu, uma izinombolo zegazi zakho ziya phansi kakhulu, noma uma amazinga akho e-IgM ekhuphuka kakhulu. Umgomo ukubhekana nesifo, ukunciphisa izimpawu, nokugcina ikhwalithi yokuphila kwakho.

Izindlela zokwelapha ezivamile zihlanganisa:

• Imithi ye-chemotherapy efana ne-bendamustine noma i-fludarabine
• Imithi yokwelapha ehloselwe njenge-ibrutinib noma i-rituximab
• Imihlanganiso ye-immunotherapy esebenza nezimbongolo zakho zokulwa nezifo
• I-Plasmapheresis ukususa amaprotheni angaphezulu egazini
• Ukuhlinzwa kwamaseli esiqalo kubantu abancane abakhethiwe

I-Rituximab ivame ukusetshenziswa ngoba ihlose ngokuqondile uhlobo lwamaseli ahilelekile ku-WM. Ivamise ukunikezwa njengokufakwa esibhedlela futhi ivame ukuhlanganiswa nemithi ye-chemotherapy ukuze kuzuzwe imiphumela emihle.

I-Plasmapheresis inqubo ehlanza igazi lakho ukususa iprotheni e-IgM engaphezulu. Ivamise ukusetshenziswa njengendlela esheshayo yokunciphisa ubukhulu begazi ngenkathi ezinye izindlela zokwelapha zisebenza.

Ukwelashwa kuvame ukunikezwa ngezigaba ngezikhathi zokuphumula phakathi ukuze umzimba wakho uthole ithuba lokuphulukana. Abantu abaningi bangaqhubeka nemisebenzi yabo evamile ngesikhathi sokwelashwa, yize ungase uzizwe ukhathele kakhulu kunokujwayelekile.

Ungayiphatha Kanjani I-Waldenstrom Macroglobulinemia Ekhaya?

Ukuphila ne-WM kuhilela ukunakekela impilo yakho yonke ngenkathi ubhekana nazo zonke izimpawu onazo. Ukulungiswa okulula kokuphila kungakusiza uzizwe kangcono futhi kunciphisa ingozi yezinkinga.

Gxila ekugcineni amandla akho ngokuphumula ngokwanele nokudla ukudla okunomsoco. Umzimba wakho udinga amandla engeziwe ukubhekana nesimo, ngakho ungazizwa unecala ngokudinga ukulala okuningi kunangaphambili.

Izinyathelo ezibalulekile zokunakekela uqobo zihlanganisa:

• Ukudla ukudla okulinganiselayo okugcwele izithelo, imifino, neprotheni
• Ukugcina umzimba uthambile ngokusela amanzi amaningi
• Ukuzivocavoca njalo, kancane kancane njengoba amandla akho evuma
• Ukugwema izixuku ngesikhathi sesizini yempilo ne-influenza
• Ukugeza izandla njalo ukuvimbela ukutheleleka
• Ukuthatha imithi ebekiwe ngokuqondile njengoba kuqondiswe

Qapha izimpawu zakho futhi ugcine ulandelela noma yikuphi ukushintsha. Abanye abantu bayithola ikusiza ukugcina idayari elula yokuthi bazizwa kanjani, okungaba ulwazi oluwusizo eqenjini lakho lokuphatha impilo.

Hlala usesikhathini ngokugoma, kodwa qala uqale ukhulumisane nodokotela wakho ngoba amanye amavaksini angase angafaneleki ngesikhathi sokwelashwa. Isistimu yakho yokuthola amandla ingase ingaphenduli kumavaksini njengoba nje, kodwa ukuvikelwa okuthile kungcono kunalutho.

Unganqikazi ukucela usizo emisebenzini yansuku zonke uma uzizwa ukhathele noma ungaphili kahle. Ukwamukela ukwesekwa komndeni nabangane kuyiyingxenye ebalulekile yokunakekela wena.

Kufanele Uzilungiselele Kanjani Ukuya Edokotela?

Ukulungiselela iziqukatho zakho kungakusiza ukwenza okuningi ngesikhathi sakho neqembu lakho lokuphatha impilo. Bhala phansi imibuzo yakho nezinkathazo ngaphambi kwesikhathi ukuze ungakhohlwa ukuxoxa ngezihloko ezibalulekile.

Letha uhlu oluphelele lwemithi yonke, amavithamini, kanye nezithasiselo ozithathayo, kufaka phakathi imithamo nokuthi ubathatha kangaki. Lokhu kusiza udokotela wakho ukugwema noma yikuphi ukusebenzisana okungase kube yingozi.

Ngaphambi kokubonisana kwakho, lungiselela:

• Uhlu lwezimpawu zakho zonke nokuthi zaqala nini
• Umbhalo wakho wezokwelapha, kufaka phakathi ezinye izimo kanye nokuphathwa
• Umbhalo womndeni wezifo zegazi noma umdlavuza
• Imibuzo mayelana nokuxilongwa kwakho, izinketho zokwelashwa, kanye neprognosis
• Umngane othembekile noma ilungu lomndeni ukuthi liye nawe

Cabanga ukuthi ulethe umuntu emihlanganweni yakho, ikakhulukazi uma uxoxa ngezinketho zokwelashwa noma uthola imiphumela yokuhlolwa. Bangakusiza ukuba ukhumbule ulwazi olubalulekile futhi banikeze ukwesekwa ngokomzwelo.

Ungesabi ukubuza udokotela wakho ukuthi achaze noma yini ongeyiqondi. Kuvamile ukudinga ukuthi amagama ezokwelapha achazwe ngolimi oluqondile, futhi odokotela abahle bayabazisa iziguli ezifuna ukuqonda isimo sazo.

Iyini iphuzu eliyinhloko mayelana neWaldenstrom Macroglobulinemia?

I-WM iyisimo esilawuleka kalula esivame ukuqhubeka kancane, sikunika wena neqembu lakho lokunakekelwa kwezempilo isikhathi sokulungiselela indlela engcono kakhulu yesimo sakho. Abantu abaningi abane-WM baphila impilo egcwele, esebenzayo iminyaka eminingi.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi i-WM ibathinta ngokwahlukile bonke abantu. Abanye abantu badinga ukwelashwa ngokushesha, kanti abanye bangase bahambe iminyaka ngaphandle kokudinga noma yiluphi ukwelashwa. Udokotela wakho uzosebenza nawe ukuze unqume isikhathi esifanele nendlela yesimo sakho esithile.

Izindlela zokwelapha zanamuhla ziye zaqhubekisa kakhulu imiphumela kubantu abane-WM. Imithi emisha ihlale ithuthukiswa, futhi abantu abaningi bafinyelela ezikhathini ezinde lapho isifo sabo silawulwa kahle.

Gxila kulokho ongakulawula: ukuhlala uphilile, ukulandela uhlelo lwakho lokwelashwa, ukugcina iziqukatho zakho, nokugcina ukuxhumana okuvulekile neqembu lakho lokunakekelwa kwezempilo. Ngokunakekelwa okulungile nokubhekwa, abantu abaningi abane-WM bangqhubeka bejabulela impilo yabo nemisebenzi abayithandayo.

Imibuzo Evame Ukubuzwa Mayelana neWaldenstrom Macroglobulinemia

Ingabe i-Waldenstrom macroglobulinemia iyefa?

Nakuba izimo eziningi ze-WM zenzeka ngokungahleliwe, cishe u-20% wabantu abane-WM banamalungu omndeni anesimo esifanayo noma izifo zegazi ezihlobene. Lokhu kusikisela ukuthi i-genetics ingase ibe nomthelela emindenini ethile, kodwa ukuba nelungu lomndeni eline-WM akusho ukuthi uzoyithola ngokuqinisekile.

Uma unemlando womndeni ka-WM, xoxa nalokho nodokotela wakho. Bangase bacebise ukuhlolwa kwegazi okuvamile ukuqapha izimpawu zokuqala, kodwa ayikho i-screening test ethile ye-WM kubantu abangenazo izimpawu.

Ukuthi umuntu angaphila isikhathi esingakanani eneWaldenstrom macroglobulinemia?

I-WM ngokuvamile iyisifo somdlavuza esikhula kancane, futhi abantu abaningi baphila iminyaka eminingi ngemva kokuxilongwa. Ukuphila okuphakathi kwesikhathi kuvame ukulinganiswa ngeminyaka eminingi kunokuba ngeminyaka, ikakhulukazi ngezinqubo zanamuhla.

Umbono wakho siqu uqondene nezinto ezinjengobudala bakho, impilo yakho yonke, izimpawu ngesikhathi sokutholwa, nokuthi uphendula kangcono kanjani ekwelapheni. Udokotela wakho angakunika ulwazi oluqondile olusekelwe esimweni sakho esithile.

Ingabuyekeza yini iWaldenstrom macroglobulinemia?

Okwamanje, ayikho impilo ye-WM, kodwa kubhekwa njengesimo esiphatheka kalula. Abantu abaningi bafinyelela ekuphumuleni isikhathi eside lapho isifo singabonakali khona noma silawulwa iminyaka eminingi.

Umgomo wokwelapha ukulawula izimpawu, ukuvimbela izinkinga, nokugcina ikhwalithi yokuphila. Ngokwelashwa okufanele, abantu abaningi abane-WM bangaphila isikhathi eside sokuphila futhi baqhubeke nemisebenzi yabo evamile.

Uyini umehluko phakathi kwe-WM ne-multiple myeloma?

Bobabili i-WM ne-multiple myeloma yizifo zomdlavuza wegazi ezihlasela amaseli e-plasma, kodwa yizifo ezahlukene. I-WM ikhiqiza ikakhulukazi ama-antibodies e-IgM futhi ayithinti amathambo, kuyilapho i-multiple myeloma ivame ukukhiqiza ama-antibodies ahlukene futhi ivame ukubangela ukonakala kwamathambo.

Izindlela zokwelapha lezi zimo zihlukile, kungakho kubaluleke kakhulu ukuthola ukuxilongwa okuqondile. Udokotela wakho uzosebenzisa izivivinyo ezithile ukuhlukanisa phakathi kwalezi nezinye izimo ezihlobene.

Ngizokwazi yini ukuqhubeka ngisebenza ngineWaldenstrom macroglobulinemia?

Abantu abaningi abane-WM baqhubeka besebenza, ikakhulukazi uma bengenawo ubuhlungu noma uma ubuhlungu babo bulawulwa kahle ngokwelashwa. Uthinta kulokho okwenzekayo empilweni yakho yomsebenzi kuncike ezimpahleni zakho ezithile, imiphumela emibi yokwelashwa, nohlobo lomsebenzi owenzayo.

Abanye abantu kudingeka benze izinguquko, njengokusebenza ekhaya ngesikhathi sokwelashwa noma ukuthatha isikhathi sokuya emakhonweni. Khuluma ngokukhululekile nodokotela wakho ngesimo sakho somsebenzi ukuze bakusize ukuhlela indlela engcono kakhulu yokugcina umsebenzi wakho ngenkathi uphatha impilo yakho.