Brief Summary of Treatment of Polycythemia Vera
Polycythemia vera , myeloproliferative neoplasm, inokonzerwa nemararamiro anoshandura anoita kuti kuve nokuwanda kwemasero matsvuku eropa ( erythrocytosis ). Sero rega rega rega uye seplatelet zvinyorwa zvinogonawo kukwidziridzwa. Iko kukura kwehuwandu hwemasero eropa (pasina kuwedzerwa muchikamu chemuviri cheropa) kunowedzera mukana wekugadzirisa hutambo.
Kudzidza kuti wakaonekwa kuti une polycythemia inogona kukuvadza uye iwe pachako ungashamisika, "inogona sei kurapwa?" Nemafaro, nekurapa, kupona kunowedzera kubva pamwedzi mitanhatu kusvikira pamwedzi 18 kusvikira kune makore gumi nematanhatu kana kupfuura.
Rimwe rematambudziko ekurapa polycythemia vera nderokuti vanhu vanopfuura 12 muzana yevanhu vachashandura kuva myelofibrosis uye vanenge 7 kubva muzana vachakurumidza kuve neukemia / myelodysplastic syndrome .
Kusiyana nevanhu vakawanda vane hutachiwana hunokosha , vanhu vane polycythemia vera vane zviratidzo zvakadai semusoro, chizivo, kucheneswa pakuonekwa. Zviratidzo izvi zvinowanzotambudza uye zvinoda kutanga kwerapi.
Phlebotomy yePV
Kunyanya kurapwa kwe polycythemia vera ndiko kurapa phlebotomy . Mukurapa phlebotomy, ropa rinobviswa pamuviri wakafanana neropa rekupa kuti kuderedza nhamba yemasero matsvuku eropa ari kupararira. Kurapa phlebotomy kunoenderera mberi nguva dzose kuchengetedza hematocrit (kuongororwa kwemasero matsvuku eropa) pasi pechimwe chiverengero, kazhinji 45 muzana yevarume uye 42 muzana yevakadzi. Phlebotomy inobata polycythemia vera nenzira mbiri: nekuderedza nhamba yemasero eropa kuburikidza nekubvisa muviri kubva mumuviri uye nekukonzera kushayikwa kunogadzirisa mutsva weropa rekushandiswa kwemasero.
Hydroxyurea yePV
Kune vanhu vane ngozi yakawanda yekuvandudza ropa clot (anopfuura makore makumi matanhatu, nhoroondo yeropa clot), chirwere chinowedzera chinodiwa. Kazhinji mishonga yokutanga inowedzera kurapautic phlebotomy inonzi hydroxyurea.
Hydroxyurea inonzi chemotherapeutic agent inoderedza kushandiswa kwemasero matsvuku eropa mumapfupa emapfupa.
Inogadzirisawo kugadzirwa kwemasero machena eropa uye maplatelet. Zvakafanana nedzimwe mamiriro ezvinhu anobatwa nehydroxyurea, inotanga pamwero wakaderera uye yakawedzera kusvikira hematocrit iri mune zvinangwa.
Inowanzochengetedzwa zvakanaka nezvikamu zvishoma zvemigumisiro kunze kwekuderera kwekugadzirwa kwemasero eropa. Dzimwe mimwe migumisiro inosanganisira muronda wemuromo, kuisa muviri (kusvibiswa kwemavara kweganda), kuputika, uye kushandiswa kwembambo (mitsetse yakaoma pasi pemisumari). Low dose aspirin inofanirwawo kufanirwa kutsvaga nzira yekurapa. Aspirin inokanganisa kukwanisa kweplatelets kusungirirana pamwe nekuderedza kushandiswa kwemafupa eropa. Aspirin haifaniri kushandiswa kana iwe wakambova nenhoroondo yekubuda ropa kukuru.
Interferon Alpha yePV
Kune vanhu vane kuchenesa kusingakanganwiki (kunonzi pruritus), vakadzi vane pamuviri kana mumakore ekutakura vana, kana kuratidzira kune maitiro ekurapa asati apera, interferon alpha ingashandiswa. Interferon alpha inorwara ine utachiona hunoita kuti kuderedza masero eropa rekuyera. Inogonawo kuderedza ukuru hwepleen uye kuchenesa. Zvimwe zvinosanganisa zvinosanganisira fivha, kushaya simba, kushungurudza, uye kurutsa kunogumira kubatsira kwechirapa ichi.
Busulfan yePV
Kune varwere vakakundikana hydroxyurea uye / kana interferon alpha, busulfan, chemotherapeutic mishonga, inogona kushandiswa.
Nhamba yacho inoshandurwa kuitira kuchengetedza ropa dema rekuyera uye platelet kuverengeka munzvimbo yakagamuchirwa.
Ruxolitinib yePV
Imwe mishonga inoshandiswa kune varwere yakakundikana dzimwe kurapwa iruuxolitinib . Iyi mishonga inobvisa Jenus Associated Kinase (JAK) enzyme iyo inowanzobatwa mu polycythemia vera uye mamwe myeloproliferaive neoplasms. Inowanzoshandiswa kuvanhu vanoita post-polycythemia vera myelofibrosis. Inogonawo kubatsira kune vanhu vane zviratidzo zvakasimba uye splenomegaly (yakawedzerwa spleen) inokonzera marwadzo makuru kana zvimwe zvinhu.
Yeuka, kunyange zvazvo polycythemia vera chirwere chisingaperi, iyo inozivikanwa mamiriro ezvinhu anokwanisa uye anokwanisa kutungamirira hupenyu hwakanaka hwehupenyu nawo.
Taura nachiremba wako pamusoro pezvipo zvakasiyana-siyana zvekurapa zviripo. Iye achakurudzira zvakanakisisa kwauri.
Sources:
Teferri A. Kurapa uye Kurapa kwePolycythemia Vera. Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Yakasvika musi waJune 22, 2016.)