Matenda a Myelodysplastic syndromes (MDS) ndi magulu a mafupa a mafupa omwe ali ndi chiopsezo chowonjezereka chokhala ndi mitsempha yambiri ya m'magazi (AML) . Ngakhale kuti matendawa ali ndi zizindikiro zosiyana ndi mankhwala, chinthu chimodzi chomwe ali nacho ndi chomwe chimakhudza kuchuluka kwa momwe mafupa amatha kukhalira maselo abwino.
Pafupifupi anthu 10,000 amapanga MDS ku United States chaka chilichonse.
Mawu ena omwe amagwiritsidwa ntchito pofotokoza MDS ndi matenda a preleukemia, hematopoietic dysplasia, subacute myeloid leukemia, oligoblastic khansa ya m'magazi, kapena kutentha kwa khansa ya m'magazi.
Kodi MDS Yakula Bwanji?
MDS imayamba ndi kuwonongeka kwa DNA kapena kusinthika mu maselo amodzi (hematopoietic) . Chifukwa cha kuwonongeka kumeneku, mafupa amayamba kuwonjezereka maselo a magazi ndipo amadzazidwa ndi maselo osakhwimitsa kapena "ophulika".
Mu MDS, palinso kuwonjezereka kwa imfa ya maselo (apoptosis), zomwe zimabweretsa chisokonezo chosangalatsa. Ngakhale kuti pangakhale kuchulukidwe kwa maselo mumtambo, sakhala moyo wokwanira kuti amasulidwe mwazi. Choncho, anthu omwe ali ndi MDS nthawi zambiri amavutika ndi kuchepa kwa magazi m'thupi (tsamba lochepa la maselo ofiira magazi), thrombocytopenia (chiwerengero chochepa cha platelet,) ndi neutropenia (chiwerengero choyera cha maselo oyera).
Zowopsa
Sindikudziwika chomwe chimachititsa kusintha kwa thupi komwe kumayambitsa myelodysplastic syndromes, ndipo 90% nthawiyo palibe chifukwa chodziwika cha matendawa.
Zina mwazidziwitso zomwe zingakhale zovuta zomwe zikuwonjezeka ndizo:
- Zaka: Msinkhu wa zaka zapakati pa matendawa ndi 70, ngakhale MDS yawonetsedwa ngakhale kwa ana aang'ono.
- Mavitamini odziwitsira - Anthu amene adalandira mankhwala opatsirana pogwiritsa ntchito mankhwala a khansa, komanso kuwonetseredwa kwa ma radiation ochokera ku mabomu a atomiki ndi ngozi za nyukiliya ali pangozi yaikulu.
- Zomwe zimayambitsa mankhwala: Kuwonetsa mankhwala enaake, zitsulo zolemera, feteleza, mankhwala ophera tizilombo, ndi herbicides zimabweretsa chiopsezo cha matendawa.
- Kusuta fodya
- Dizeli imatha
Kodi Ndili Pachirepa Choyamba?
Kuyeza kwa chiwerengero cha kuphulika kwa maselo mumtambo kumasonyeza momwe matendawa alili - kwambiri maselo ambiri, omwe amakhala ovuta kwambiri. Pamene mchere umasonyeza kuti chiŵerengero chake chimapangidwa ndi opitirira 20% kuphulika maselo, chikhalidwecho chimatengedwa kukhala AML.
Pafupifupi 30% za MDS zimapita ku AML. Komabe, nkofunika kuzindikira kuti ngakhale kusinthaku sikungatheke, kuchepa kwa magazi, thrombocytopenia, ndi neutropenia zomwe zimagwirizanitsidwa ndi MDS akadali moyo wowopsya.
Zotsatira
Kuzindikira kwa MDS kumaphatikizapo matenda osiyanasiyana a mafupa, pali zifukwa zingapo mkati mwa zinthu izi zomwe zimatsimikizira khalidwe ndi kufalikira kwa matendawa. Chotsatira chake, asayansi akhala akuyesetsa kuti athe kupeza dongosolo la magawo lomwe limaganizira zosiyana zonsezi.
Yoyamba ya machitidwewa ndi chikhalidwe cha French-American-British (FAB). Amathyola MDS mpaka 5 subtypes pogwiritsa ntchito momwe mafupa amawonekera ndi zotsatira za chiwerengero cha magazi chokwanira (CBC) :
- Nthenda yotaya magazi (RA)
- Nthenda yotaya magazi yowonongeka ndi mitsempha yozungulira (RARS)
- RAIM)
- Kuperewera kwa magazi m'thupi mwa kusintha kwapadera (RAEB-T)
- Matenda a monomyelocytic a m'magazi (CMML)
Kuyambira pamene chitukuko cha FAB chinayambika mu 1982, asayansi aphunzira zambiri zokhudza zovuta zomwe zimayambitsa MDS komanso ntchito yomwe kusinthaku kumachitika m'kati mwa matendawa. Zotsatira zake, mu 2001, World Health Organization (WHO) inasindikiza kusintha kwa FAB. Anapanganso zinthu zina - ma 5q-syndrome, MDS osadziwika (MDS-U), ndi refractory cytopenia ndi multilineage dysplasia (RCMD) - ndipo anagawa ena monga RAEB ndi CMML potsatira kuchulukana kwa mafupa m'thupi.
Awonetsanso kuti chilichonse choposa 20% cha kuphulika m'mafuta chinapanga AML, kupanga ma RAW-T kuti asagwirizane ndi MDS.
Njira yachitatu yosankhira MDS ikugwiritsa ntchito International Prognostic Scoring System (IPSS). Njirayi imagwiritsa ntchito njira zitatu zowonetsera momwe MDS idzasinthire: chiwerengero cha maselo m'magazi ozungulira odwala, chiwerengero cha maselo omwe amachiza mafupa, ndi cytogenetics (mtundu wa zovuta zomwe zimayambitsa MDS).
Pogwiritsa ntchito izi, IPSS imagawanitsa odwala m'magulu anayi omwe amasonyeza "ngozi" ya MDS-low, pakati-1, pakati-2, ndi pamwamba. IPSS imapereka njira yabwino yofotokozeratu zotsatira za MDS, kudziwa momwe angagwirire ntchito, ndikukonza chithandizo.
Mitu ya Primary vs MDS
Kwa odwala ambiri, MDS ikuwoneka kuti ikuyamba chifukwa chosadziwika, kunja kwa buluu. Izi zimatchedwa MDS oyambirira kapena de novo . Monga momwe zilili ndi khansa ya m'magazi ndi matenda ena a mafupa, asayansi sadziwa kwenikweni chomwe chimayambitsa MDS.
MDS yachiwiri imatanthawuza momwe zimakhalira poyambitsanso chithandizo cham'mbuyomu ndi chemotherapy kapena mankhwala ochizira.
Kudziwa
MDS imapezeka kuti ikugwiritsidwa ntchito pogwiritsa ntchito njira zomwe zimagwiritsidwa ntchito poyeza matenda a khansa ya m'magazi .
Njira yoyamba ndiyo kuyesa magazi ozungulira magazi kuti awononge magazi (CBC). Mayesowa amayang'ana maselo ofiira a magazi ofiira, maselo oyera a magazi, ndi mapulogalamu m'magazi kuti amvetse bwino zomwe zikuchitika mumtambo. Kawirikawiri, munthu yemwe ali ndi MDS angasonyeze kuchuluka kwa maselo ofiira a magazi (anemia), mwinamwake mapulaneti otsika (thrombocytopenia) ndi neutrophils (neutropenia).
Ngati palibe chifukwa china chimene wodwala angapeze kuti ali ndi magazi m'thupi, madokotala adzachita aspirate ndi mafupa . Mu wodwala ndi MDS, mafuta amatha kusonyeza mawonekedwe osalimba komanso kuchuluka kwa maselo kapena "kuphulika" maselo. Ma maselo akafufuzidwa pamtundu wa majini, amasonyeza kusintha kwa thupi kapena kusintha kwa ma chromosomes.
Zizindikiro ndi Zizindikiro
Odwala omwe ali ndi MDS angathe kuona zizindikiro za kuchepa kwa magazi monga:
- Kupuma pang'ono ndi kuchitapo kanthu pang'ono
- Khungu lenileni
- Kumva kutopa
- Kupweteka pachifuwa
- Chizungulire
Odwala angapo adzakhala ndi zizindikiro za neutropenia ndi thrombocytopenia komanso kuphatikizapo mavuto otha magazi komanso kuvutika kulimbana ndi matenda.
Ndikofunika kuzindikira kuti pali zinthu zina zambiri zochepa zomwe zingayambitse zizindikirozi. Ngati mukudandaula za zaumoyo zilizonse zomwe mukukumana nazo, ndibwino kuti mukambirane ndi adokotala kapena ena azachipatala.
Kuwongolera Iwo
MDS si matenda amodzi, koma gulu la zikhalidwe zomwe zimayambitsa momwe mafupa amagwirira ntchito.
Monga sayansi ikuphunziranso zambiri zokhudza chibadwa ndi gawo lomwe iwo amasewera pakukula kwa matenda amtundu uwu, tikuphunziranso zambiri zomwe zimapanga zomwe adzatenge ndi zotsatira zake. M'tsogolomu, ochita kafukufuku adzagwiritsa ntchito chidziwitso ichi kuti apange mankhwala atsopano komanso othandiza a MDS.
Zotsatira:
Goldberg, S., Chen, E., Corral, M., et al. "Kuchulukira ndi Mavuto Ochipatala a Myelodysplastic Syndromes Pakati pa United States Medicare Bene benefary" Journal of Clinical Oncology June 2010. 28: 2847-2852.
Bowen, D. "Utsogoleri wa Odwala ndi Myelodysplastic Syndromes: Mfundo Zoyambira" ku Deeg, H., Bowen, D., Gore, S., Haferlach, T., Beau, M., Niemeyer, C. (eds) (2006 ) Chikhalidwe Chachilengedwe Malignancies: Myelodylasticlastic Syndromes. Springer: New York. (pp. 89-94).
Haferlach, T., Kern, W. "Kulongosola ndi Kuyika Masitepe a Myelodysplastic Syndromes" ku Deeg, H., Bowen, D., Gore, S., Haferlach, T., Beau, M., Niemeyer, C. (eds) (2006) Chikhalidwe Chachilengedwe Malignancies: Myelodylasticlastic Syndromes. Springer: New York. (pp.40- 51).
National Cancer Institute. Mfundo zapakati pa khansa ya PDQ. Myelodysplastic Syndromes Chithandizo. Health Professional Version. 04/02/15. http://www.ncbi.nlm.nih.gov/books/NBK66015/#CDR0000062929__1
Nimer, S. "Myelodysplastic Syndromes" Magazi May 2008. 111: 4841- 4851.
Scott, B., Deeg, J. "Myelodysplastic Syndromes" Kukambitsirana Kwachidule kwa Mankhwala 2010. 61: 345-358.