I-Myeloma kunye ne-myeloma ezininzi zibhekisela kwisifo esifanayo. Kukho iintlobo ezahlukeneyo ze-myeloma, kunye nokwahlula kwenziwa ngumsebenzi wesi sifo, kunye neentlobo ze-antibodies, okanye iiproteni ze-immunoglobulin, eziveliswa ngokwemvelo.
Umntu oqala ukufumana ingxaki ye-myeloma okanye unokungenayo nayiphi na impawu. Iziganeko zinokuvela kwiimpawu ezinzima kwiimpawu ezinzima kunye neengxaki ezifuna unyango olusakhulayo.
Olunye uhlobo oluthile lwe-myeloma - monoclonal gammopathy lokubaluleka okungagqithwanga (MGUS) - luvelisa ama-antibodies angaphezulu kumazinga aphantsi, kodwa akwenzayo ngaphandle kweengxaki ezinzima kwizitho. Iyakhula ibe yi-myeloma esebenzayo, kodwa xa iyenzayo, ngokuqhelekileyo yenza ngokukhawuleza. Akunabo bonke abane-MGUS baya kuqhubeka nokuphuhlisa i-myeloma, kodwa abanye banokuthi, kutheni iliso lonyaka ludingekile. I-MGUS, nangona iimeko ezinobungozi, iqhuba umngcipheko weenguqu kwi-myeloma yamanqanaba kwisilinganiso se ~ 1,5 ekhulwini ngonyaka.
MGUS
Kukho ukungafani okona-2 phakathi kweMGUS kunye ne-myeloma:
1. Xa umhlaza okanye esinye isifo kubangele amazinga angavamile okwenziwa kwiprotheni ye-antibody, loo proteyini ibizwa ngokuthi iparaprotein. Isixa sale paraprotein singaphantsi kwama-30 g / L (<3g / dL) kwi-MGUS.
2. Iiseli zeplasma ziyi- essenti ngaphezu kweepesenti ezili-10 zomyinge we-matrons examination in MGUS.
Smoldering Myeloma
I-Myeloma isoloko ifunyenwe ngumsebenzi wegazi rhoqo xa izigulane zivavanyelwa into engahambelaniyo.
Ukukhwaza okanye i-myeloma indolom yinkqubela phambili, ifom yokuqala yesifo. Nangona amazinga eeseli ze-plasma ezivelisa ulwaphulo lomnxeba kunye ne / okanye amanqanaba aphakamileyo e- M-protein angakho, akukho monakalo omkhulu kumathambo okanye kwiintso.
Ngokutshitshisa, i-myeloma engummangaliso:
1. Inani leparaprotein lingaphezu kwama-30 g / L (<3g / dL).
2. Iiseli ze-plasma zingaphezulu kweepesenti ezili-10 kwimviwo yomnxeba wethambo.
Umehluko omkhulu phakathi kokutshitshisa i-myeloma kunye ne-myeloma epheleleyo ngokugqithiseleyo kukungabikho kwelungu elihlobene ne-myeloma okanye ukukhubazeka kwamathambo.
Multiel Myeloma
I-Symptomatic, okanye i-myeloma esebenzayo inenani elongeziweyo lamaseli e-plasma kumnatha wethambo, i-M-protein efunyenwe egazini okanye emcimbini - kunye nomonakalo womzimba. I-myeloma yamaninzi idinga unyango. Kwezinye iimeko ze-myeloma ezininzi, iiseli zomhlaza ziya kuqokelela kwithambo elilodwa kwaye zenze i-tumor ebizwa nge- plasmacytoma .
Izimpawu neempawu ze-myeloma ezininzi ziyahluka kwaye zingaquka:
- Intlungu yesifo, ingakumbi emthonjeni okanye esifubeni
- Ukuxhamla, ukuzithemba, ukulahleka kwesidlo, ukulahleka kwesisindo
- Ingqondo yengqondo, ukudideka, ukukhathala
- Usulelo lwezifo kunye nezifo
- Ubuthathaka okanye ukuphazamiseka emilenzeni
- Ukomeleza ngokweqile, ukucoca rhoqo
Iimpawu ze-myelomas zibonakaliswa kwakhona ngeentlobo zeeprotheni ze-immunoglobulin ezitholakala egazini. I-Immunoglobulins iqulethe iindawo ezahlukileyo-ezibizwa ngokuba ngamaketanga anzima kunye namaketanga alula. Ama-antibodies abizwa ngolu hlobo lwenxantanxu olunzima (i-G, A, M, D, okanye i-E).
- I-protein ephambili ye-myeloma yimihlobo ye-IgG.
- Okungaqhelekanga yi-IgA myelomas.
- Ii-myelomas ze-IgD kunye ne-IgE ziyinto engavamile kakhulu.
- Ukukhutshwa ngokweqile kwe-IgM yimeko engavumelekanga ebizwa ngokuba yi- Waldenstrom's macroglobulinemia .
Ezinye iintlobo ze-myelomas zivelisa i-immunoglobulin engaphelelanga yamaketanga alula. Ezi zibizwa ngokuba yi-myelomas yokukhanya. Iiprotheni zethungelwano zokukhanya zibizwa ngokuba yi- Bence-Jones amaprotheni . Xa ama-protein aseBence-Jones e-urine, aqokelela ezintsheni aze enze umonakalo.
Kukho nezinye izifo ezingabonakaliyo apho iiseli zomhlaza zenza iinqwelo ezinzima zodwa. Ezi zibizwa ngokuba zizifo ezixinayo kwaye zingabandakanyeka kunye ne-myeloma.
Phantse i-1 ekhulwini ye-myelomas kuthiwa yi -myeloma engeyona eyimfihlo . Kulezi zigulane, ukuveliswa kwe-M-proteins okanye iminyango yokukhanya ayanele ngokwaneleyo kwigazi okanye kumchamo. Uvavanyo oluthile lufunekayo ukuchonga izifo kwezi zi gulane.
Imithombo
Sonneveld P, Broijl A. Ukwelashwa kwe-myeloma ephindaphindiweyo kunye neyengxaki. Haematologica. 2016; 101 (4): 396-406.
Palumbo A, Anderson K. I-myeloma yamaninzi. N Engl J Med. 2011; 364 (11): 1046-1060.
UKyle, uRobert noRajkumar, S. Vincent "I-Myeloma yamaninzi" Igazi 15 Matshi 2008 111: 2962-2972.
Lin, Pei "I-Plasma Cell Myeloma" Iiklinikhi zeHematology / i-Oncology yeNyakatho Melika 2009 23: 709-727.
UNau, uKonrad noLee, uWilliam "I-Myeloma yamaninzi: Ukuxilongwa kunye noNyango" I- American Family Physician 1 Oktobha 2008 78: 853-859.