Migumisiro yeKemotherapy Yakakonzera Myelosuppression
Tsanangudzo
Myelosuppression inotsanangurwa sekuderera kwekugona kwemuti wemapfupa kubudisa masero eropa. Izvo zvinowanzoitika kakawanda nekenza semagumisiro emagetsi echemotherapy , asi kune zvimwe zvinokonzera zvakare.
Mitsara Inobatwa Myelosuppression
Myelosuppression inogona kukonzera kukura kwekugadzirwa kwe:
- Masero matsvuku eropa (RBCs)
- Masero eropa (WBCs)
- Platelets
Hematopoiesis, Bone Marrow, uye Myelosuppression
Kunyatsonzwisisa myelosuppression kunobatsira kutaura pamusoro pebasa remafupa emapfupa. Mune mapfupa emapfupa, ose masero eropa-masero matsvuku eropa, masero masero eropa, uye maplatelet-anotanga neine rimwe cell type: the hematopoietic stem cell .
Hematopoietic stem masero ane simba rekuchinja kune chero rudzi rwesero reropa. Aya masero anoenda munzira dzakasiyana sezvaanosiyanisa mumasero matsvuku eropa, maplatelets, uye masero eropa, uyezve mune mamwe masero akadai akadai semhando dzakasiyana dzemasero machena eropa. Asi iyo yose inotanga nemasero emadzimai. Myelosuppression inoreva nzira inopanganisa masero aya, uye. naizvozvo, inobata zvose zvakasiyana-siyana zvemasero eropa. Izwi rokuti myeloablation rinoreva kuora mwoyo kwakanyanya umo pasina masero eropa anoitwa.
Zvinokonzera
Kune nzira dzakawanda umo marora emapfupa anogona kugadziriswa kuitira kuti irege kubereka masero eropa.
- Kukuvara kwemasero emadzimai - Chikonzero chinonyanya kukosha chekuita myelosuppression kunokonzerwa nemishonga inononoka kukwanisa kwemasero ekudzivirira uye zvizvarwa zvakananga kuparadzanisa nekuwedzera. Zvose zvemasero edu eropa zvinoramba zvichiri kuzadzikiswa. Mishonga yakadai sedhemotherapy mishonga inoita zvinodhaka-induced bone marrow kuderedza.
- Kudzokorora kwemafupa / kuputika - Mushonga wepfupa unogona "kubuda kunze" nezvinhu zvakadai sekenza yeropa kana kenza yemasitasi kuitira kuti pave "nzvimbo" yekushandiswa kwemasero eropa.
- Utsi hwemapfupa ehupombwe - Panzvimbo yekudzvinyirirwa nemishonga, marora emapfupa anogona kunogona kuparadzwa nemarudzi akasiyana-siyana emishonga uye makemikari. Kana izvi zvikaitika, kumisa mishonga hakuzoiti kuti mapfupa emapfupa aite zvakare basa rake rokugadzira masero eropa.
Zvimwe Zvinokonzera Myelosuppression
Nzira dzinogona kukonzera myelosuppression dzinosanganisira:
- Chemotherapy-induced bone marrow suppression . Chemotherapy inouraya masero ose anokurumidza kuparadzanisa akadai sekenza masero, kusanganisira masero anozova ose evanhu masero eropa.
- Cancers yemapfupa emafuta akadai se-leukemias, lymphomas, myeloma, kenza yemasitema kumapfupa emapfupa anogona kuita kuti "kuvhara" saka hapana nzvimbo yokuti hematopoiesis iitwe.
- Dheberate myelosuppression / myeloablation - Muropa rekenza rinopinda neropa rinowanikwa mumapfupa emapfupa, chirwere chemhemotherapy chakakosha chinoshandiswa kubvisa marora. Apo pfupa remapfupa "rakajeka" kupfurikidza kwemapfupa emapfupa kana kuputira ropa stem cell transplant inobva yaitwa kuti idzorezve marora emapfupa nemasero asina tsvina emuropa.
Kukanganisa kweMatare Eropa
Apo masero emadzimai ari kukura uye kuparadzanisa uye anonyanya kuenzaniswa nemhando dzakasiyana dzemasero eropa (apo pane mafuta ekuderedza marora kana myelosuppression) kukanganisa kworudzi rwemasazi eropa kunonzi:
- Anemia - Anemia inoreva kusakwana kwemasero matsvuku eropa. Anemia inogona kukonzera kuneta, kushaya simba, kupera, kukurumidza kwemwoyo, kuperevedza kwefema, uye kuchena. Chemotherapy-induced anemia inowanzokonzera kukonzera panguva yekemotherapy.
- Leukopenia - Leukopenia inoreva kusakwana kwemasero machena eropa. Nekaukopenia vanhu vanopinda mungozi yehutachiona, saka zviratidzo zvinogona kunge zviri zviratidzo zvezvirwere zvakadai sefivha, kukwezva, uye kurwadziwa nekugunzva. Nekenza, kazhinji vanhu vanonzwa nezve chemotherapy-induced neutropenia . Neutrophils ndeyeropa rechechi yeropa iro ndiro mutsara wekutanga wezvidziviriro zvakare zvirwere nemaabhakitiriya, mavairasi, uye fungus (uye zvinopesana nemasero emukenza pamwe chete.)
- Thrombocytopenia - Thrombocytopenia inoreva kushaya kweplatelets. Nhamba yakaderera yemaplatelet inogona kuguma nekupwanya uye kubuda ropa. Chemotherapy-induced thrombocytopenia inogona kunge isina dambudziko kakawanda sekuti inotaura neutropenia asi inogona kukonzera kubuda kukuru mune vamwe vanhu.
Myelosuppression Ndiyo Yakadai seIndunosuppression?
Iwe unogona kushamisika kana kuzvidzivirira uye kushandiswa kwemasimba kwakafanana. Mukugadzirisa myelosuppression, kubudiswa kwemasero matsvuku eropa kunoderera, saka kuchava nekudzivirira kwezvirwere. Asi kuzvidzora hazvirevi nguva dzose kutora mitosuppression. Somuenzaniso, mishonga (kana imwe nzira) inogona kudzivisa masero eropa rega kana zvimwe zvikamu zvemuviri wezvirwere zvemuviri, asi hazviiti maitiro matsvuku eropa kana maplatelet.
Kurapa
Kurapa kwemyelosuppression kunosanganisira kubata chero chii chinokonzerwa nekuita myelosuppression kunoitika. Kana yakabatana nemishonga kana chemotherapy, kurapwa kunogona kumira kana kunonoka. Kana zvakakonzerwa nokupinda kwemafupa emapfupa, uye zvinokonzera kuwedzera, kurapwa kwekenza mumapfupa emasese ndiyo danho rinokosha kupfuura dzose. Kana zvikakonzerwa nekushaiwa kwemafupa, zvichava zvakakosha kuona kana kusakanganiswa kwemapfupa emapfupa kuchidzokorora, uye kana zvisina kudaro, kurapwa kwakafanana nekugadziridzwa kwemasero eropa uye kupfurikidza kwemafuta emafuta kunogona kuonekwa.
Nezviratidzo zvine chokuita nekurembera, mishonga inogona kuendeswa kune imwe sero inoshaya inokonzera zviratidzo. Nokuda kwekushaya ropa, kuwedzerwa ropa, kushandiswa kwesimbi, kana kukura zvinhu zvinogona kupiwa. Neutropenia inokonzerwa nehutachiwana hwehutachiona kana kuvapo kwehutachiona, kukura zvinhu (zvakadai seNeulasta) zvinogona kushandiswa uye chirwere chacho chakabatwa nehasha nekubatana nemishonga inorwisa mabhakitiriya. Kune hutsika hwepamaplateti hunosimudza dambudziko rekuwedzerwa kubuda ropa kunogona kudiwa.
Izvo zvakabatanidzwa pamusoro pe chemotherapy-induced anemia, neutropenia, uye thrombocytopenia inorondedzera mishonga iyi chaiyo inogona kufungidzirwa kana kushandiswa kwemishonga kunobatanidza chemotherapy.
Uyewo Anozivikanwa Se: Bone marrow kuderedza
Mienzaniso: Pamusana pekutsungirira kukuru, Rick's oncologist akaratidza kuti akamirira kwevhiki vasati vatevera chirwere chemotherapy.
> Sources:
> Coates, T., Drug-Induced Neutropenia uye Agranulocytosis. UpToDate . Yashandurwa 08/01/16.
> Weinzierl, E., uye D. Arber. The Differential Diagnosis uye Bone Marrow Kuongorora kweNew-Onset-Pancytopnia. American Journal of Clinical Pathology . 2013. 139 (1): 9-29.