I-Myeloma ne-myeloma eminingi ibhekisela kwisifo esifanayo. Kunezinhlobo ezahlukene ze-myeloma, futhi ukuhlukaniswa kwenziwa ngezenzo zesifo, kanye nezinhlobo zama-antibodies, noma amaprotheni e-immunoglobulin, akhiqizwa ngendlela engavamile.
Umuntu otholwa ngecala lokuqala nge-myeloma kungenzeka noma angenayo izimpawu. Amacala angahle avela kumabonakaliso angenazo izimpawu ezinzima ezinezinkinga ezidinga ukwelashwa okuphuthumayo.
Olunye uhlobo oluthile lwe-myeloma - monoclonal gammopathy lokubaluleka okungakahleleki (MGUS) - lwenza ama-antibodies engeziwe emazingeni aphansi, kodwa akwenza ngaphandle kwezinkinga ezinkulu ezingxenyeni. Kungaba yi-myeloma esebenzayo, kodwa lapho ikwenza, ivame ukuyenza kancane kancane. Akuwona wonke umuntu onenhlangano ye-MGUS oyoqhubeka nokuthuthukisa i-myeloma, kodwa amanye angase, yingakho ukuqapha kwansuku zonke kuyadingeka. I-MGUS, nakuba isimo esibucayi, ibeka ingozi yokuguqulwa ibe yi-myeloma eminingi ngesilinganiso sama- ~ 1.5% ngonyaka.
I-MGUS
Kukhona umehluko omkhulu phakathi kweMGUS ne-myeloma:
1. Uma umdlavuza noma esinye isifo kubangelwa amazinga angavamile we-antibody amaprotheni, leyo protheyini ibizwa ngokuthi i-paraprotein. Inani le paraprotein lingaphansi kuka-30 g / L (<3g / dL) ku-MGUS.
2. Amangqamuzana e-plasma angama- 10 engamaphesenti angu-10 ephelele ematheni emnothweni wokuhlolwa e-MGUS.
Smoldering Myeloma
I-Myeloma ivame ukutholakala ngokusebenzisa umsebenzi wegazi njalo lapho iziguli zihlolwa ngento engathandeki.
I-myeloma yokubhema noma i-indolent ihamba phambili kancane, ifomu lokuqala lesifo. Nakuba amazinga amangqamuzana e- plasma akhiqiza ama-anti- mma emnothweni wamathambo kanye / noma amazinga aphakeme we- M-amaprotheni angase abe khona, akusekho umonakalo omkhulu emathanjeni noma ezinso.
Ekukhenizeni, i-myeloma engabonakali:
1. Inani le-paraprotein lingaphezu kuka-30 g / L (<3g / dL).
2. Amangqamuzana e-plasma angaphezu kwamaphesenti angu-10 ekuhlolweni komthambo wamathambo.
Umehluko omkhulu phakathi kwe-myeloma ne-myeloma eningi egcwele i-myeloma yikho ukungabi khona kwegciwane elihlobene ne-myeloma noma ukukhubazeka kwamathambo.
I-Myeloma eminingi
I-myeloma, noma i-activeel ye-myeloma inenombolo ekhuphukile yamangqamuzana e-plasma emnothweni wamathambo, i-M-protein etholakele egazini noma emcimbini - kanye nokulimala komzimba. I-myeloma eminingi idinga ukwelashwa. Kwezinye izimo ze-myeloma, amangqamuzana omdlavuza ayoqoqa ngethambo elilodwa bese enza isisu esibizwa nge- plasmacytoma .
Izimpawu nezimpawu ze-myeloma eziningi zingahluka futhi zingabandakanya:
- Ubuhlungu be-Bone, ikakhulukazi emgodleni noma esifubeni
- Ukudabuka, ukuqothulwa, ukulahlekelwa ukudla, ukulahlekelwa isisindo
- Intukuthelo yengqondo, ukudideka, ukukhathala
- Ukutheleleka njalo kanye nemifudu
- Ukubuthakathaka noma ukungafihli emilenzeni
- Ukoma ngokweqile, ukuvuthwa njalo
Ama-myelomas angokomfanekiso aphinde ahlukaniswe nezinhlobo zama-protein a-immunoglobulin atholakala egazini. I-immunoglobulins iqukethe izingxenye ezihlukene - ezibizwa ngamaketanga amakhulu nezinketho ezilula. Ama-antibodies abizwa ngokuthi uhlobo lwezinsimbi ezinzima okuqukethe (G, A, M, D, noma E).
- I-protein ejwayelekile kakhulu e-myeloma iyinhlobo ye-IgG.
- Okungavamile yi-IgA myelomas.
- I-myelomas ye-IgD ne-IgE ayinhle kakhulu.
- Ukwanda ngokweqile kwe-IgM yisimo esingavamile esibizwa nge- Waldenstrom's macroglobulinemia .
Ezinye izinhlobo ze-myelomas ziveza i-immunoglobulin engaphelele yamaketanga alula kuphela. Lezi zibizwa ngokuthi i-myelomas ye-light chain. Amaprotheni okukhanya amancane nawo abizwa ngokuthi amaprotheni aseBence-Jones . Lapho amaprotheni e-Bence-Jones e-urine, aqoqa ezinso bese enza umonakalo.
Kukhona nezinye izifo ezingavamile lapho amangqamuzana omdlavuza adala khona iminyango eqinile kuphela. Lezi zibizwa ngokuthi izifo ezinezinkathazo ezinzima futhi kungenzeka noma zingahlanganyeli izici ne-myeloma.
Cishe amaphesenti angu-1 ama-myelomas abizwa ngokuthi i -myeloma engeyona eyimfihlo . Kulezi ziguli, ukukhiqizwa kwe-M-amaprotheni noma amaketanga amancane akwanele ukuthola igazi noma umchamo. Ukuhlolwa okukhethekile kuyadingeka ukukhomba isifo kulaba baguli.
Imithombo
Sonneveld P, Broijl A. Ukwelashwa kwe-myeloma eminingi ephindaphindiwe futhi ephikisayo. Haematologica. 2016; 101 (4): 396-406.
UPalumbo A, Anderson K. I-myeloma eminingi. N Engl J Med. 2011; 364 (11): 1046-1060.
UKyle, uRobert no Rajkumar, S. Vincent "I-Myeloma eminingi" Igazi 15 Mashi 2008 111: 2962-2972.
Lin, Pei "I-Plasma Cell Myeloma" Imitholampilo ye-Hematology / Oncology yaseNyakatho Melika 2009 23: 709-727.
Nau, Konrad no Lewis, uWilliam "I-Myeloma eminingi: Ukuxilongwa Nezokwelapha" I- American Family Physician 1 Okthoba 2008 78: 853-859.