Zotsatira za Chemotherapy Zimakhudza Myelosuppression
Tanthauzo
Kugonjetsedwa kumatanthawuza kuti kuchepa kwa mphamvu ya mafupa kumapanga maselo a magazi. Amapezeka kawirikawiri ndi khansa monga zotsatira za mankhwala a chemotherapy , koma palinso zifukwa zina.
Maselo Amene Amakhudzidwa M'kugonjetseratu
Kugonjetsedwa kungachititse kuchepa kwa:
- Maselo ofiira a m'magazi (RBCs)
- Maselo oyera (WBCs)
- Platelets
Hematopoiesis, Bone Marrow, ndi Myelosuppression
Kuti mumvetsetse vutoli ndikuthandizira kulankhula za ntchito ya mafupa. M'mafupa, maselo onse a magazi-maselo ofiira ofiira, maselo oyera a magazi, ndi mapuloleteni-amayamba ndi mtundu umodzi wa selo: maselo amtundu wa hematopoietic .
Ma maselo amtundu wa Hematopoietic amatha kukhala mtundu uliwonse wa maselo a magazi. Maselowa amapita njira zosiyana posiyana ndi maselo ofiira a magazi, mapiritsi, ndi maselo oyera a m'magazi, kenaka nkukhala m'maselo ena apadera monga mitundu yosiyanasiyana ya maselo oyera. Koma zonse zimayambira ndi maselo ofunika. Myelosuppression amatanthauza njira yomwe imasokoneza maselo amenewa, komanso. Chifukwa chake, zimakhudza mitundu yonse ya maselo a magazi. Mawu akuti myeloablation amatanthauza kupwetekedwa mtima kwakukulu kumene palibe maselo a magazi opangidwa.
Zimayambitsa
Pali njira zambiri zomwe mafupa amatha kusokonezeka kuti asapangitse maselo a magazi.
- Kuwonongeka kwa maselo a tsinde - Chomwe chimayambitsa vuto la myelosuppression ndi chifukwa cha mankhwala omwe amachepetsa mphamvu za maselo otsika ndi ana opatsirana kuti apatule ndi kuchulukitsa. Maselo athu onse amagazi amapitirizabe kubwezeretsedwa. Mankhwala monga chemotherapy mankhwala amachititsa kumwa mankhwala osokoneza bongo.
- Kusintha kwa mafupa / kuphwanyidwa - Fupa la mafupa lingakhale "litathamanga" ndi zinthu monga khansa ya magazi kapena khansara ya metastatic kotero kuti palibe "malo" omwe amapanga maselo a magazi.
- Kufooka kwa mafuta a mitsempha - M'malo moponderezedwa ndi mankhwala, mafupa amatha kuwonongedwa ndi poizoni ndi mankhwala osiyanasiyana. Ngati zili choncho, kusiya mankhwalawo sikungachititse kuti fupa la fupa lichitenso ntchito yake yopanga maselo a magazi.
Zifukwa Zenizeni za Myelosuppression
Ndondomeko zomwe zingayambitse matendawa ndi awa:
- Kachitidwe kake ka mankhwala a Chemotherapy . Chemotherapy imapha maselo onse ofulumira kwambiri monga maselo a khansa, kuphatikizapo maselo omwe amakhala mitundu yonse ya maselo a magazi.
- Khansa ya mafupa monga mafupa, maimymphomas, myeloma, khansa ya metastatic mafupa amatha kuchititsa "kubisa" kotero kuti palibe malo oti hematopoiesis ayambe kuchitika.
- Myelosuppression / myeloablation - Mwa khansa yokhudzana ndi magazi yomwe ilipo m'mafupa, mankhwala amtundu wapamwamba kwambiri amagwiritsidwa ntchito pochotsa mafupa. Pamene mafupa "amamveka bwino" kupatsirana mafupa a pakhosi kapena kuwonongeka kwa magazi pamtengowo ndiyeno kumachitidwa kuti azibwezeretsa fupa la fupa ndi maselo osagawanika a magazi.
Zofooka za Maselo A Mwazi
Pamene maselo osabereka sakukula ndikugawidwa ndi maselo amagazi amodzi (pamene pali kuperewera kwa mafupa a mitsempha kapena myelosuppression) kufooka kwa mtundu wa maselo a magazi akutchedwa:
- Kutaya magazi m'thupi - Kutaya magazi m'thupi kumatanthawuza kusowa kwa maselo ofiira ofiira. Kuchepa kwa magazi kungayambitse kutopa, kufooka, kupsa mtima, kuthamanga kwa mtima mofulumira, kupuma pang'ono, ndi kupepuka. Matenda a Chemotherapy-omwe amachititsa kuti magazi asokonezeke ndi omwe amachititsa kuti munthu asatope pa mankhwala a chemotherapy.
- Leukopenia - Leukopenia imatanthauza kusowa kwa maselo oyera a magazi. Ndi anthu a leukopenia amakhala ndi chiopsezo chotenga matenda, kotero zizindikiro zikhoza kukhala zizindikiro za matenda monga fever, chifuwa, ndi ululu ndi kukodza. Ndi khansa, kawirikawiri anthu amamva za mankhwala a chemotherapy omwe amachititsa neutropenia . Mankhwalawa ndi mtundu wa selo loyera la magazi lomwe ndilo mzere woyamba wa chitetezo kachilombo ka mabakiteriya, mavairasi, ndi bowa (komanso motsutsana ndi maselo a khansa).
- Thrombocytopenia - Thrombocytopenia amatanthauza kusowa kwa mbale. Maselo ochepa a mapulogalamu angapangitse kuvulaza ndi kutaya magazi kwambiri. Matenda a Chemotherapy-omwe amachititsa thrombocytopeniya sangakhale ovuta nthawi zambiri monga kunena kwa neutropenia koma amatha kuyambitsa magazi ambiri mwa anthu ena.
Kodi Mlosuppression Is the same as Immunosuppression?
Mutha kudabwa ngati kusamalidwa ndi matendawa ndi chimodzimodzi. Poyambitsa matenda ozunguza bongo, kupanga maselo oyera a magazi kumachepetsedwa, kotero padzakhala kusamalidwa kwa thupi. Koma kuteteza thupi kumatanthawuza kusokoneza maganizo. Mwachitsanzo, mankhwala (kapena njira zina) akhoza kupewera maselo oyera a m'magazi kapena mbali zina za chitetezo cha mthupi, koma sichikhudza maselo ofiira a magazi kapena mapiritsi.
Chithandizo
Chithandizo cha myelosuppression chidzaphatikizapo kuthana ndi chilichonse chimene chimayambitsa matendawa. Ngati ikugwirizana ndi mankhwala kapena chemotherapy, mankhwala ayenera kuimitsidwa kapena kuchedwa. Ngati ndi chifukwa cholowera mafupa, ndipo kuwonjezereka kwakukulu, chithandizo cha khansa mu fupa la fupa ndilo sitepe yofunika kwambiri. Ngati ndi chifukwa cha kuperewera kwa mafuta m'thupi, zidzakhala zofunikira kuona ngati kuperewera kwa mafupa osasinthika kungasinthidwe, ndipo ngati ayi, mankhwala omwe amagwiritsidwa ntchito m'malo mwa maselo a magazi ndi kusakaniza mafupa a fupa amafunika kuganiziridwa.
Kwa zizindikiro zokhudzana ndi matenda a myelosuppression, mankhwala angapangidwe pa selo yeniyeni yomwe imayambitsa zizindikiro. Kuchulukitsa magazi, kupatsirana magazi, kupatsirana kwachitsulo, kapena kukula kwa zinthu zingaperekedwe. Chifukwa cha neutropenia yomwe imayambitsa matenda kapena kukhala ndi matenda, zizindikiro za kukula (monga Neulasta) zingagwiritsidwe ntchito ndipo matendawa amachititsa nkhanza ndi mankhwala osakaniza. Pamafunika mapepala apamwamba omwe amachititsa kuti pakhale kuika magazi magazi.
Zogwirizana pamwamba pa mankhwala a chemotherapy-omwe amachititsa kuchepa kwa magazi, neutropenia, ndi thrombocytopenia afotokozere mankhwalawa omwe angaganizidwe ngati myelosuppression ikugwirizana ndi chemotherapy.
Amadziwika kuti: Kuthamanga kwa mafupa a mafupa
Zitsanzo: Chifukwa cha kupweteka kwakukulu, Rick's oncologist adamuuza kuti ayime patangotha sabata asanayambe mankhwala enaake.
> Zotsatira:
> Coates, T., Drug-Induced Neutropenia ndi Agranulocytosis. Kupititsa patsogolo . Kusinthidwa 08/01/16.
> Weinzierl, E., ndi D. Arber. Kusiyanitsa kwa kusiyana kwake ndi Marrow a mafupa Kuwunika kwa New-Onset-Pancytopnia. American Journal of Clinical Pathology . 2013. 139 (1): 9-29.