Myeloma ndi myeloma ambiri amatanthauza matenda omwewo. Pali mitundu yosiyanasiyana ya myeloma, ndipo mapangidwe amapangidwa ndi ntchito ya matendawa, komanso mitundu ya ma antibodies, kapena mapuloteni a immunoglobulin, omwe amapangidwa molakwika.
Munthu amene amapezeka ndi myeloma amayamba kapena alibe zizindikiro. Milandu imatha kuchoka ku zizindikiro zosavuta kuti zikhale zovuta zomwe zimafuna chithandizo cham'tsogolo.
Mitundu ina ya myeloma - monoclonal gammopathy yapadera kwambiri (MGUS) - imapanga ma antibodies owonjezera pamagulu ochepa, koma amatero popanda mavuto ambiri m'ziwalo. Ikhoza kukhala myeloma yogwira ntchito, koma ikadzachitika, nthawi zambiri imachita pang'onopang'ono. Sikuti aliyense amene ali ndi MGUS adzapitirizabe kupanga myeloma, koma ena akhoza, chifukwa chake kufufuza chaka ndi chaka n'kofunika. MGUS, ngakhale kuti ili ndi vuto lachilombo, imayambitsa chiwonongeko kukhala myeloma yambiri pamtunda wa ~ 1.5 peresenti pachaka.
MGUS
Pali kusiyana kwakukulu pakati pa MGUS ndi myeloma:
1. Pamene khansara kapena matenda ena amachititsa kuti mapuloteni apangidwe asapangidwe, mapuloteniwa amatchedwa paraprotein. Mtengo wa paraprotein uwu ndi wosachepera 30 g / L (<3g / dL) mu MGUS.
2. Maselo a plasma ali oposa 10 peresenti ya chiwerengero chonse cha mayeso a mafupa a MGUS.
Smoldering Myeloma
Myeloma kawirikawiri amapezedwa kudzera mu ntchito yamagazi nthawi zonse pamene odwala akuyesedwa kwa chinachake chosagwirizana.
Kusungunuka kapena kusungika kwa myeloma ndiko kupititsa patsogolo, matenda oyambirira. Ngakhale kuti maselo a plasma opanga mankhwala opatsirana m'magazi ndi / kapena mapuloteni apamwamba a M angakhale alipo, pakadalibe vuto lalikulu kwa mafupa kapena impso.
Mukutentha, asymptomatic myeloma:
1. Kuchuluka kwa paraprotein ndiposa 30 g / L (<3g / dL).
2. Maselo a plasma ndi opitirira 10 peresenti pa kufufuza kwa minofu.
Kusiyana kwakukulu pakati pa smoldering myeloma ndi yambiri myeloma ndikutaya kwa chiwalo chogwirizana ndi myeloma kapena kuwonongeka kwa minofu.
Myeloma yambiri
Symptomatic, kapena active myeloma ali ndi kuchuluka kwa maselo a plasma mu fupa, M-protein amadziwika m'magazi kapena mkodzo - komanso kuwonongeka kwa thupi. Myeloma zambiri zimafuna chithandizo. Nthaŵi zina ma myeloma angapo, maselo a khansa amasonkhanitsa pfupa limodzi ndikupanga chotupa chotchedwa plasmacytoma .
Zizindikilo za myeloma zingapo zimasiyana ndipo zingaphatikizepo:
- Kupweteka kwa mafupa, makamaka msana kapena chifuwa
- Kusokonezeka, kudzimbidwa, kusala kudya, kulemera
- Kusokonezeka maganizo, kusokonezeka, kutopa
- Matenda ndifupipafupi
- Kufooka kapena kupweteka m'milingo
- Kumva ludzu, kumangokhalira kukodza
Myelomas amadziwika kwambiri ndi mapuloteni a immunoglobulin omwe amapezeka m'magazi. Mankhwala a Immunoglobulins ali ndi mbali zosiyana - amatchedwa unyolo wolemera ndi unyolo wofewa. Ma antibodies amatchulidwa ndi mtundu wolemetsa womwe amapezeka nawo (G, A, M, D, kapena E).
- M-mapuloteni omwe amapezeka kwambiri mu myeloma ndi mtundu wa IgG.
- Zosagwirizana ndi IgA myelomas.
- Myelomas a IgD ndi IgE ndi osazolowereka kwambiri.
- Kuchulukitsidwa kwa IgM ndi chinthu chosowa chotchedwa Waldenstrom's macroglobulinemia .
Mitundu ina ya myelomas imapanga immunoglobulin yosakwanira ya mitsempha yowongoka. Izi zimatchedwa chain chain myelomas. Mapuloteni amtundu wowala amatchedwanso mapuloteni a Bence-Jones . Pamene mapuloteni a Bence-Jones ali mu mkodzo, amadziunjikitsa impso ndikuwononga.
Palinso matenda ena omwe amapezeka kuti maselo a khansa amalephera kupanga mitsempha yolemera. Izi zimatchedwa matenda olemera kwambiri ndipo akhoza kapena sagwirizana nawo ndi myeloma.
Pafupifupi 1 peresenti ya myelomas amatchedwa non-secretory myeloma . Odwalawa, kupangidwa kwa M-mapuloteni kapena mitsempha yosalekeza sikokwanira kupezeka m'magazi kapena mkodzo. Kuyezetsa kwapadera n'kofunikira kuti mudziwe matenda omwe akudwalawa.
Zotsatira
Sonneveld P, A. A. Kuchiza kwa kubwereranso ndi kutsutsa multiple myeloma. Haematologica. 2016; 101 (4): 396-406.
Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011; 364 (11): 1046-1060.
Kyle, Robert ndi Rajkumar, S. Vincent "Multiple Myeloma" Magazi 15 March 2008 111: 2962-2972.
Lin, Pei "Plasma Cell Myeloma" Maofesi a Hematology / Oncology a North America 2009 23: 709-727.
Nau, Konrad ndi Lewis, William "Multiel Myeloma: Kuzindikira ndi Chithandizo" American Family Physician 1 Oktoba 2008 78: 853-859.