Uhlolojikelele lweTherapy for Essential Thrombocythemia
I-Essential Thrombocythemia (ET) ingenye yezinkinga zegazi ezibizwa ngokuthi i-myeloproliferative neoplasms. Ezinye izinhlobo ze-myelofliferative neoplasms zihlanganisa i- myelofibrosis eyinhloko ne- polycythemia vera .
Ukuguqulwa kwesisu ku-thrombocythemia ebalulekile kuholela ekubalweni okuphakeme kakhulu kweplatelet (thrombocytosis). Abantu abaningi bangenazo izimpawu ngesikhathi sokuxilongwa futhi bazoba nokuphila okuvamile.
Izinkinga zihlanganisa ukwakheka kwe-clot (okuholela ekushayweni, ukuhlaselwa yinhliziyo, i-clot emaphashini, noma i-thrombosis ejulile ye-vein), ukuthuthukiswa kwe- myelofibrosis , noma ukuguqulwa kwesifo se-myeloid leukemia (AML). Enye inkinga engavamile ye-thrombocythemia ebalulekile ukuthuthukiswa kwe- von Willebrand Disease , i-bleeding disorder.
Iningi labantu lizodinga ukwelashwa ngandlela-thile ukuvimbela izinkinga. Kodwa-ke, ukuhlala okujwayelekile okuvamile kuyinto engavamile.
Izinketho zokwelapha
Uma uthola ukuthi une-thrombocythemia ebalulekile umbuzo olandelayo wemvelo uwukuthi, "yiziphi izinketho zami zokwelapha?" Kunezinketho eziningi okumele udokotela wakho akhulume nawe. Imithi yokwelapha udokotela wakho ayincoma kungenzeka ukuthi isekelwe ezintweni eziningana: izimpawu zakho, iminyaka yakho, kanye namanani akho laboratory. Iningi labantu lizohamba iminyaka eminingana ngaphandle kokudinga ukwelashwa, okuvame ukuqala uma uthuthukisa i-clot.
- I-aspirin: I-aspirin ephansi yansuku zonke ijwayele ukuphatha abantu abanezimpawu ze-vasomotor. Izimpawu ze-Vasomotor zihlanganisa ikhanda, isizungu, ubuhlungu besifuba, ukushiswa kwezandla nezinyawo, nezinguquko ezibukwayo. Akuvamile ukuthi ukwelashwa kwe-aspirin kusetshenziswe nezinye izifo. I-aspirin ye-dose ephakeme kakhulu ihlotshaniswe nengozi yokuphuma kwegazi futhi ayikhuthazwa.
- I-Hydroxyurea: I-chemotherapy agent e-hydroxyurea yomlomo iyancipha ingozi ye-thrombosis ekuthandweni kwe-thromobcytosis ebalulekile ngokunciphisa inani leplatelet. U-Hydroxyurea uqaliswa ngomthamo ophansi futhi ukhula kuze kube yilapho isibalo seplatelet siseduze (evamile 100,000 - 400,000 amaseli ngayinye nge-microliter). I-hydroxyurea ivame ukubekezelela kahle ngaphandle kwemiphumela emibi kakhulu. Imiphumela emibi ihlanganisa ukuguqulwa kwesibindi (isikhanyiso) sesikhumba, izinguquko ze-nail (ngokuvamile imigqa emnyama ngaphansi kwesipikili), ukuqhuma isikhumba, nezilonda zomlomo. I-Hydroxyurea iyanciphisa inani legazi elimhlophe (ikakhulukazi isibalo se-neutrophil) kanye ne-hemoglobin efuna ukuqapha okusheshayo ngokubala okuphelele kwegazi (i-CBC).
- I-Anagrelide: I- Anagrelide iyi-medication yomlomo ehlisa inani leplatelet ngokuvimbela ukukhiqizwa kwamaplatele emnothweni wethambo. Kuvame ukusetshenziswa lapho i-hydroxyurea ingasebenzi. Ngokufanayo ne-hydroxyurea, i-anagrelide iqalwa ngomthamo ophansi futhi yanda kuze kube nomphumela oyifunayo. Imiphumela emibi ihlanganisa ikhanda, izintambo (ukushaya kwenhliziyo okusheshayo), ukugcinwa kwamanzi kagesi kanye nokuhuda. Lemiphumela emibi ixazulula ngokuphathwa okuqhubekayo.
- I-Alpha interferon: I- Alpha interferon ingasetshenziswa ukulawula inani leplatelet ku-thrombocythemia ebalulekile, i-polycythemia vera, ne-myelofibrosis eyinhloko. Kunganciphisa ubukhulu besipen. I-interferon ye-Alpha ilawulwa ngaphansi komzimba (ngaphansi kwesikhumba) nsuku zonke. I-alpha interferon iyatholakala futhi kwifomu elide elibizwa ngokuthi i-pegylated interferon enganikezwa kanye ngesonto. I-interferon therapy ngokuvamile igcinelwe abesifazane abakhulelwe noma abantu abangaphenduli ekwelashweni kwe-hydroxyurea.
- I-Plateletpheresis: I- Plateletpheresis yinkqubo esusa ama-platelet ekusakazweni. Igazi likhishwa nge-catheter e-intravenous (IV) futhi liqoqwe emshinini lapho amapulethi ahlukaniswa khona kwezinye izingxenye zegazi (amangqamuzana egazi amhlophe, amangqamuzana egazi abomvu, ne-plasma). Igazi, lisuse amaplatelet, libuyiselwa emzimbeni nge-IV noma isisombululo saline noma i-plasma. I-Plateletpheresis igcinelwe abantu abanezibalo eziphakeme kakhulu zeplatelet, ukwakheka kwe-clot esiyingozi (emaphashini, ebuchosheni), noma egazini. Umphumela we-platletpheresis wesikhashana ngakho-ke enye ukwelashwa kuzodinga ukuthi iqalwe ukulawula isikhathi eside kwenani leplatelet.
Zonke izinhlobo zokwelapha okukhulunywe ngazo ngenhla aziphilisi i-thrombocythemia ebalulekile. Zinciphisa inani leplatelet ngaleyo ndlela ukunciphisa ingozi yokuthuthukisa i-clot noma isifo se-von Willebrand esitholakale. Ngalesi sikhathi, alukho ukwelapha okwelashwa okumele kubhekane ne-thrombocythemia ebalulekile. Ngenhlanhla, naphezu kokuntula ukwelashwa okuphefumulayo, iningi labantu abane-thrombocythemia ebalulekile lingaphila ukuphila okugcwele okukhiqizayo.
Imithombo:
I-Teferri A. Ukuguqulwa Nokuphathwa Kwe-Essential Thrombocythemia. Ku: Phezulu, I-post TW (Ed), UpToDate, Waltham, MA. (Kufinyelelwe ngoJuni 15, 2016)