Myelodysplastic syndromes (MDS) iboka remapfupa emapfupa ane huwandu hwekuwedzera kuva mutezo wemukemikari (AML) . Kunyange zvazvo zvirwere izvi zvingave nezviratidzo zvakasiyana siyana uye kurapwa, chinhu chimwe chete chavari pamwe chete ndezvekuti chinokanganisa kuwanda kwei uye kuti mafuta emapfupa anokwanisa sei kubudisa masero eropa.
Vanenge zviuru gumi vanovaka MDS muUnited States gore negore.
Mamwe mazwi anoshandiswa kutsanangura MDS ndiwo preleukemia, hematopoietic dysplasia, subacute myeloid leukemia, oligoblastic leukemia, kana kuputika kweukemukari.
MDS Inovandudza Sei?
MDS inotanga neDNA kukanganisa kana kushanduka muropa rimwe-forming (hematopoietic) stem cell . Somugumisiro wekukuvadza uku, marora emapfupa anotanga kuderedza masero eropa uye anozadzwa nemasero kana "kuputika" masero.
Mune MDS, panewo kuwedzerwa kwepurogiramu yekufa kwechiremera (apoptosis), iyo inotungamirira kune chirevo chinonakidza. Nepo pangave kuwedzera kukura kwemasero mumuro, havararami kwenguva yakakwana yekubudiswa muropa. Saka, vanhu vane MDS vanowanzotambura nehutachiwana hwehutachiona ( hutachiona hwemasero matsvuku eropa,) thrombocytopenia (pasi shoma, kuverengera, uye neutropenia )
Risk Factors
Hazvizivikanwe chii chinokonzera kushanduka kunoita myelodysplastic syndromes, uye 90% yenguva iyo hapana chikonzero chaicho chechirwere.
Zvimwe zvinogona kuisa pangozi zvinokonzerwa nekuwedzera zvinosanganisira:
- Zera: Nguva yepakati yekufungidzirwa ndeye makumi manomwe, kunyange zvazvo MDS yakaratidzwa kunyange muvana vaduku.
- Iroising radiation - Vanhu vakagamuchira marapirwo emishonga emishonga yekenza, pamwe nekusvibiswa nemirasi yeioni inobva mabhomu eatomu uye nengozi dzenyukireya vari pangozi yakawanda.
- Kemikari inowedzera: Kuisa kune mamwe makemikari aripo, masimbi ane simba, fertilizer, pesticidhe, uye maruva anouraya anomutsa dambudziko rechirwere.
- Utsi hwefodya
- Dieseri inopera
Icho Chinonzi Pre Preukemia?
Kuyera kwenhamba yezvipembenene masero mumarongo inoratidza kuti chirwere chacho chakanyanya sei - iyo yakawanda isina masero, yakaoma zvikuru. Kana imwe nguva marrow ako anoratidza kuti huwandu hwehuwandu hwahwo hunoumba hunopfuura 20% kuputika kwemasero, mamiriro acho anoonekwa se AML.
Inenge 30% yematambudziko e MDS anofambira mberi kuenda ku AML. Zvisinei, zvakakosha kuziva kuti kunyange kana kushanduka uku kusati kwaitika, chirwere chinopera simba, thrombocytopenia, uye neutropenia inosanganiswa ne MDS ichiri kutyisa upenyu.
Subtypes
Hakusi kungoongorora kweMDC kunosanganisira kukanganisa kwakasiyana-siyana kwemapfupa emapfupa, pane zvinhu zvakawanda mukati meimwe yemamiriro ezvinhu aya anogadza mararamiro uye kufanirwa kwechirwere chacho. Somugumisiro, masayendisiti ave achiedza kurwisana nehurongwa hwehutano hunofunga nezvezvinhu izvi zvose zvakasiyana.
Chokutanga chezvigadzirwa ndechechiFrench- American- British (FAB). Inoputsa MDS pasi kusvika ku 5 subtypes inotarisa kuti iyo bone marrow inotarisa sei uye migumisiro yehuwandu hwehutano hwehutachiona (CBC) :
- Refractory anemia (RA)
- Kuratidzira anemia neine ringed sideroblasts (RARS)
- Kugadzirisa anemia neokuwedzera kwemafuro (RAEB)
- Kuratidzira anemia nekumhanya kwakanyanya mukushandurwa (RAEB-T)
- Chronic monomyelocytic leukemia (CMML)
Kubvira pakuvandudzirwa kwezvinyorwa zveFAB muna 1982, masayendisiti akadzidza zvakawanda nezvemaitiro ekusaremara anoendesa kuMDC uye basa iro mamiriro ezvinhu aya anoita munguva yechirwere. Somugumisiro, muna 2001, World Health Organization (WHO) yakabudisa dzimwe shanduko kune FAB system. Vakawedzera mamwe mamiriro - 5q- syndrome, MDS isina kusimbiswa (MDS-U), uye refractory cytopenia nemitauro yakawanda dysplasia (RCMD) - uye ikaparadzanisa vamwe vakaita sa RAEB ne CMML zvichienderana nehuwandu hwemhepo inoputika mumapfupa.
Vakatsanangurawo kuti chero chinhu chipi nechipi chinopfuura 20% chekuputika mumurongo chakaita AML, zvichiita kuti RAEB-T ipeukemia inopesana neMDC.
Nzira yechitatu yekugadzirisa MDS iri kushandisa International Prognostic Scoring System (IPSS). Iyi nzira inoshandisa zvitatu zvekutarisa kuti MDS ichafambira mberi sei: nhamba yemasero muropa rechirwere chechirwere, nhamba yevasina kufema masero mumapfupa emapfupa, uye cytogenetics (rudzi rwemaitiro asina kukanganisa akabatanidzwa neMDC).
Kubva pazvinhu izvi, IPSS inoparadzanisa varwere muzvikamu zvina zvinoratidza "ngozi" ye MDS- pasi, pakati-1, pakati-2, uye kumusoro. IIPSS inopa nzira yakagadziridzwa yekufanotaurira zviitiko zveMDC, sarudza kufungidzira, uye kuronga kurapwa.
Primary Primary / Secondary MDS
Mune varwere vazhinji, MDS inoita seyikudziridza nokuda kwechikonzero chisingazivikanwi, kunze kwebhuruu. Izvi zvinonzi MDS primary kana de novo . Sezvakakonzerwa neukweukemia uye mamwe matambudziko emapfupa emapfupa, masayendisiti haasi kunyatsoziva kuti chii chinokonzera MDS.
Sekondari MDS inotaura nezvechiitiko apo inotevera kurapa yapfuura nemakemikrasi kana remhiyo reradio.
Kuziva
MDS inowanikwa inoshandisa nzira imwe chete inoshandiswa kuongororwa neukemia .
Danho rokutanga nderokuongorora ropa rekuenderera kwerwere kune ropa rakazara kuverenga (CBC). Uyu muedzo unotarisa nhamba yemasero matsvuku eropa, masera masero eropa, uye maplatelet muropa kuti awane pfungwa yakawanda yezviri kuitika mumuro. Muzviitiko zvakawanda, munhu ane MDS acharatidza nhamba dzakaderera dzemasero matsvuku eropa (anemia), uye zvichida maplatelet (thrombocytopenia) uye neutrophils (neutropenia) zvakare.
Kana pasina chimwe chikonzero chinogona kuwanika kuti murwere ave nechirwere chemaperembudzi, vanachiremba vanozoita mapfupa emaspirate emafuta uye biopsy . Mune murwere neMDC, marora acharatidza maitiro asingaoneki uyewo kuwedzerwa kwemazuva mashoma kana kuti "kuputika" masero. Apo masero ari kuongororwa pamusana wegeneti, acharatidza kutendeuka kana kuchinja kune chromosomes.
Zviratidzo nezviratidzo
Varwere vane MDS vanogona kuwana zviratidzo zvekushaya ropa rehupenyu zvakadai sokuti:
- Kupfupika kwepfufu nechinguva chiduku
- Pale pepa
- Kunzwa kuneta
- Chipfuva chepfu
- Chizutu
Varwere vashomanana vachavewo nezviratidzo zve neutropenia uye thrombocytopenia zvakare, kusanganisira zvinetso zvekubuda ropa uye kuoma kurwisa zvirwere.
Zvakakosha kucherechedza kuti pane zvimwe zvakawanda, zvisingatauriki mamiriro ezvinhu anogona kuita zviratidzo nezviratidzo. Kana iwe uchinetseka pamusoro pehupi hupi hwehutano uhu huri kutarisana nawo, nguva dzose huri nani kuvakurukura navo nechiremba wako kana vamwe vashandi vezvokurapa.
Summing It Up
MDS haisi chirwere chimwe chete, pane chikwata chemamiriro ezvinhu chinokonzera kushandiswa kwokuti mafuta emashonga anoshanda sei.
Sezvo sayenzi ichinyanya kudzidza zvakawanda pamusoro peizivi uye basa ravanoita mukukudziridza kwezvirwere zvemarudzi aya, tiri kudzidzawo zvakawanda pamusoro pezvinhu zvinosarudza nzira yavanotora uye zvingagoneka. Mune ramangwana, vatsvakurudzi vachakwanisa kushandisa ruzivo urwu kuumba hutsva uye hunobudirira hurapa hwe MDS.
Sources:
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