Myeloma da myeloma mai yawa sunaye daban-daban don ciwon daji. Magangancin kalma yana da zaɓi kuma yana nufin yawan ciwace-ciwacen da ke ci gaba da ƙasusuwan mutane tare da wannan cuta.
Myeloma, cutar sankarar bargo, da lymphoma su ne manyan cututtukan jini guda uku ko rashin tausayi. Daga cikin uku, myeloma shine mafi mahimmanci. Samun damar samar da ƙwayar myeloma tare da shekaru da yawancin mutanen da aka bincikar su a cikin shekarun 60 da suka wuce. Kodayake yana iya faruwa a kananan yara, kasa da kashi ɗaya cikin dari na lokuta suna cikin wadanda shekarun da suka kai 35.
Menene Myeloma?
Myeloma shine ciwon daji wanda ke farawa a cikin kasusuwa . A cikin lafiyayye mai kyau, ƙwayar kasusuwa shine nama mai rai wanda ya rushe a cikin ɓoye na ciki na wasu kasusuwa. A can, yana ci gaba da yada sabon jinin jinin jini da nau'in jini na kowane nau'i, tabbatar da cewa kuna da samfuwar jini a cikin jini.
Duk da haka, myeloma shine ciwon daji musamman game da kwayar plasma s-wani nau'i na musamman na jini. Babban aiki na kwayoyin cutar plasma shine sanya kwayoyin cutar, wadanda sunadarai na microscopic da ke nuna masu haɗari na kasashen waje don halakarwa.
Kwayoyin cutar plasma masu lafiya sun ɓoye duk wani ɓangaren nau'i na kwayoyin cuta don kai farmaki akan wata kwayar cuta. A cikin myeloma, akwai 'clone' na kwayoyin plasma masu rauni-yawancin kwafin kwararren ƙwayar plasma daya a cikin kututture na kasusuwan samar da wata sunadarai daidai (wani protein monoclonal ko M protein ) wanda yake da mawuyacin. Wannan mummunan clone na kwayoyin plasma ba sa jira don wani ɓangaren ƙwayar cuta ya mamaye; yana samar da furotin M kullum kuma yana da yawa.
Kamar dai yadda kwayar cutar plasma mai kirki ta zama wani ƙuƙwalwar ƙwayar cuta ba har yanzu ba a san shi ba, amma masana kimiyya suna samun ƙasa. Abu mai mahimmanci, yanzu an fahimci cewa myeloma na iya kasancewa ga dangin ƙwayoyin cutar ƙwayar cutar plasma. Mutane da yawa tare da wasu kwayoyin cutar ƙwayoyin cutar ƙwayar cuta ta ƙarshe sun haifar da myeloma.
Cutar cututtuka
Ba duk wanda ke da myeloma na da alamun bayyanar da farko, don haka kamawa da myeloma a farkon kullun yana da kalubale. Kwayoyin cututtuka don dubawa sun haɗa da wadannan:
- Raɗa baƙin ciki, musamman a kashin baya ko kirji
- Wulo
- Rashin asarar rashin nauyi
- Kwayoyin cuta masu yawa
- Rashin zuciya, maƙarƙashiya, da / ko rashin ci
- Ji jin ƙishi sosai
- Rikici ko ƙwaƙwalwar ƙwaƙwalwa
- Ƙuntatawa ko rauni a kafafu
Sau da yawa ana nuna alamar cututtuka na myeloma tare da irin abubuwan da ke tattare da kyamaran miki da / ko kuma sunadaran sunadaran antibody. Misali:
- Yayinda kwayoyin halitta masu haɗuwa a cikin kasusuwa suke ƙaruwa, ciwo na kashi, raunin kasusuwa da fractures mai yiwuwa ne, mai yiwuwa yana da lalacewa.
- Lokacin da kwayoyin myeloma fara farawa daga jikin jini, jiki zai iya samar da ƙananan tantanin halitta. Ƙananan jinin jini, ko anemia , zasu iya taimakawa wajen bayyanar da rashin ƙarfi da damuwa. Rashin gajeren jini yana iya sa ku kara kamuwa da cuta. Kuma lakarancin platelet zai iya haifar da matsalolin jini daga raunin da ya faru wanda ba zai zama mai tsanani ba.
- Kwayoyin Myeloma za su iya siffanta wasu kwayoyin halitta don karya kasusuwan, sake watsi da alli wanda zai iya kaiwa gagarumar matakan jini. An san shi a matsayin hypercalcemia, wannan haɗari a cikin jinin jini ya zo tare da tsarin kansa na bayyanar cututtuka, ciki har da matsanancin ƙishirwa / matsananciyar urination, rikice-rikice, ƙarfin zuciya mai tsanani, ciwo mai ciki, da hasara na ci.
- Wani lokaci kwayoyin myeloma suna samar da sunadaran da ke cutar da kodan da jijiyoyi. Wannan zai iya haifar da cututtukan koda, ko kuma a cikin yanayin jijiyoyin da suka shafi jijiyoyi, ƙididdigewa, tingling ko rauni. Irin wannan tingling da zafi a hannayensu, makamai, ƙafafu, da ƙafafunsu ana san su ne neuropathy.
- Ginin gina jiki na myeloma zai iya haifar da yaduwar jini-kusan kamar ƙara yawan gari zuwa pancake batter. Wannan mai tsanani ana kiransa hyperviscosity. Zai iya rage jini zuwa kwakwalwa da kuma haifar da rikicewa, damuwa, da sauran cututtuka.
Shin akwai takaddama na farko?
Sakamakon asirin farko na myeloma yana da kalubale kamar yadda bayyanar cututtuka bazai fito ba har sai matakan ci gaba. Wani lokaci, akwai alamun bayyanar cututtukan da aka danganta da wasu cututtuka. Duk da haka, masana kimiyya sun gano wani iyali na cututtukan kwayoyin cutar plasma, wasu daga cikinsu zasu iya cigaba da ci gaba zuwa myeloma, irin su:
- Monoclonal Gammopathy na Ƙananan Alamar (MGUS)
- Plasmacytoma, ko kuma ƙwayar cuta.
MGUS
Lokacin da kake da takardun yawa na wannan antibody, an san wannan a matsayin mawallafi na monoclonal ko MG. Mutane tare da myeloma na iya samun MG, amma ba kowa da MG na da myeloma ba. A gaskiya, akwai cututtukan cututtuka da suka shafi MG da yawa kuma yawancin su ba likitoci ba ne.
Lokacin da mutum yana da MG amma babu alamun abin da ke haddasa shi, an san shi kamar MG na muhimmancin da ba a ƙaddara ko MGUS ba. Ba duk wanda ke tare da MGUS zai ci gaba da bunkasa myeloma ba, amma wasu na iya, wanda shine dalilin sa ido na shekara-shekara ya zama dole.
Ko da yake yana da mummunar yanayin, MGUS yana ɗauke da hadari na zama myeloma a cikin kimanin kashi 1.5 cikin dari a kowace shekara. Kwayoyin rashin daidaito sun wuce sama da yawan ƙwayoyin plasma masu ciwo a cikin kututtukan kasuwa kuma suna da matakan M mafi girma a cikin jini. MGUS yawanci ana kula amma ba a bi da su ba.
Plasmacytoma
Wasu lokuta akwai hujjoji guda daya na kwayar cutar kwayar cutar daya. Lokacin da wannan ya faru, an kira shi plasmacytoma ko raunin plasmacytoma na kashi, maimakon myeloma.
Hannar ƙwayar cutar ta jiki ɗaya zata iya ci gaba a waje da kasusuwa a cikin wani kwaya. A wannan yanayin, an kira shi wani plasmacytoma. Mutane da yawa tare da ciwon ƙwayar cuta guda ɗaya za su ci gaba da samar da myeloma mai yawa, don haka kula da hankali ga alamun myeloma yana da muhimmanci.
Abin da ke faruwa a Myeloma?
Ka yi la'akari da kututtukan ka kamar yadda filin wasan kwallon kafa ya kunshi magoya baya. Kowace fan shine tantanin halitta kuma akwai nau'in tantanin halitta. A cikin wannan filin wasa, kwayoyin plasma sune magoya bayan da aka ba su alama don yin wasa a wasan kwaikwayo. Kuma kowane kwayar plasma / fan yana da alamar launin bambance daban-daban, wanda yake wakiltar mahimmancin antibody da yake yi.
A cikin kututture mai yalwa, wasu nau'in kwayar halitta ba su da yawan kwayoyin plasma. Saboda haka, a filinmu, mafi yawan magoya baya samun launuka masu launi. Duk da haka, akwai magoya masu yawa da masu launin launi don cika filin wasa tare da kusan kowane inuwa na kowane launi-bambancin kwayoyi daban-daban.
Ka yi la'akari da cewa kwayar plasma guda ɗaya dake riƙe da launin toka mai launin launin fatar tana motsawa kuma yana kulawa don rufe kanta, zama magoya biyu, kowannensu yana riƙe da launin toka. Sa'an nan biyu zama hudu, hudu zama takwas, da sauransu-duk riƙe da launin toka. A ƙarshe, akwai alamun launuka masu launin toka fiye da yadda aka sa ran. Launin launin toka suna wakiltar nau'i nau'i na irin wannan furotin-protein na monoclonal ko amintattun M - saboda yana fitowa ne daga clone guda ɗaya na sel. Wannan yawancin kwayar halitta guda daya cikin jini ko fitsari wani abu ne da za'a iya gano a jarrabawar jarraba.
Yanzu zaton wani cell daga m clone ya tashi don saya abin sha, amma sai ya koma zuwa ɓangaren ɓangare na zama, har yanzu ci gaba da clone kanta. Clone yana farawa a cikin sabon sashe, sannan kuma biyu sun zama hudu, hudu sun zama takwas, da sauransu.
Wadannan ƙwayoyin ƙwayoyin plasma masu kyau zasu iya fara ɗaukar filin wasa. Suna tarwatsa layuka da sassan wurin zama wanda ke da amfani da kwayoyin halitta mai laushi, kamar wadanda suke samar da ku na kwayoyin ja, sel fata, platelets, har ma sauran kwayoyin plasma dauke da launi na launin. Saboda haka, kamar yadda adadin launin launin toka yana ƙaruwa, yawan adadin al'ada, polyclonal launuka masu launi na iya ragewa.
Kuma ƙwayoyin clones masu kyau zasu iya rinjayar wasu ƙwayoyin dake kusa da filin wasa. Kwayoyin sallah na Plasma na iya saki manzannin sunadaran da ke sa '' magoya '' kusa da su suyi rashin dacewa. Wasu daga cikinsu (osteoclasts) za su fara haɗuwa a cikin simintin filin wasa ( kashi na kashi ), watsar da girgije na ƙura (calcium) wanda yada cikin filin wasa da kuma bayan (jini).
Iri
Lokacin da myeloma ke tasowa, zai iya fitowa kuma ya bambanta a cikin mutane daban-daban. Wasu daga cikin sharuddan da aka yi amfani da su don rarraba myeloma sun haɗa da:
- Asymptomatic Myeloma
- Smoldering Myeloma
- Symptomatic ko Active Myeloma
- Haske Sarkar Myeloma
- Nonsecretory Myeloma
- Myelomas na bambancin kwayoyin halitta
Asymptomatic vs. Smoldering vs. Active / Symptomatic Myeloma
A wasu mutane, akwai lokacin "in-tsakanin" cuta-yanayin da ke tsakanin MGUS da myeloma aiki, wato. Lokacin da wannan ya faru, an kira shi myeloma asymptomatic kuma, a irin waɗannan lokuta akwai wasu alamu na rashin lafiya ko kuma myeloma nawa.
A smoldering myeloma, kasusuwa kashi ya cika da sauran ƙwayoyin plasma. Wasu kashi 10 cikin 100 ko fiye daga cikin kwayoyin halitta mai iya zama daga nauyin myeloma da / ko M na matakan sunada sama da 30 g / L. Duk da haka, a cikin smydering myeloma, har yanzu babu wani anemia, babu gazawar koda, babu matakan da aka ƙera a cikin jini, kuma babu lalacewar lalacewa na kasusuwa. Smumdering myeloma yawanci ana lura amma ba a bi da su; duk da haka, masu bincike suna kallon yiwuwar samun magani a wasu lokuta.
Symptomatic ko aiki myeloma yana bukatar a bi da shi. Akwai M sunadarai a cikin jini ko fitsari da kuma yawan ƙwayoyin ƙwayoyin plasma da yawa a cikin kasusuwa. Ƙunƙarar yatsa na iya bayyana a sassa na kashi, da raunana kashin, haifar da ciwo, da kuma kara haɗarin fashe. Kuma, waɗannan abubuwa ba a cikin bayanin kwatancin myeloma na walƙiya ba daga sama zasu iya samuwa a cikin myeloma aiki.
Maganin taimakon sunadaran Myeloma
Irin nauyin sunadarai na kwayoyin myeloma yana taimakawa wajen sanin irin nau'in myeloma daya yana da. Antibodies sune manyan sunadaran dake da sassa daban-daban ko sarƙoƙi. Sassan nauyi, ko sarƙaƙƙiya masu sutura, da sassan haske, ko sassan haske, duk sun taru domin su zama daya daga cikin kwayoyin halitta.
A yayin da ake kiran wani antibody ko immunoglobulin, nauyin sarƙaƙƙiya sun ƙayyade abin da wasika ta zo bayan immunoglobulin (Ig). Saboda haka, alal misali, kashi mafi mahimmanci da aka samo a cikin sunadaran Myeloma M shine IgG, wanda ke da asali game da 60 zuwa 70 bisa dari na lokuta myeloma. Gaba ita ce IgA. Kadan, IgD ko IgE yana iya shiga.
A wasu lokuta, kwayoyin myeloma zasu iya haifar da kwayar cutar kawai ko kuma za su iya ɓoye sakonni kawai. Wadannan ana kiransu sunadaran Bence-Jones kuma suna da ƙananan cewa sau da yawa suna wucewa daga kodan cikin cikin fitsari. Kusan kashi 20 cikin dari na duk lokuta na ƙwayoyin myeloma kawai.
Kusan kashi ɗaya cikin 100 na duk lokuta na myeloma bazai ɓoye sunadarai M ko sigogi masu haske don ganewa ba. A cikin waɗannan lokuta, ana amfani da gwaje-gwaje masu ƙwarewa ko alamar myeloma tare da gano ƙwayoyin plasma marasa maɗaurai a cikin ɓacin jini don kai ga ganewar asali.
Tsarin Halitta
Akwai hanyoyi masu yawa wadanda suka hada da myeloma. Anyi nazarin jerin DNA don haka an san shi, alal misali, cewa ciwon daya daga cikin wadannan nau'o'in kwayoyin halitta na iya shafar ko tsinkaya yadda cutar za ta amsa maganin . Masu bincike sunyi fatan cewa irin wannan labarun kwayoyin zai ci gaba da taimakawa wajen jagorantar ci gaba a cikin maganin myeloma.
Dalilin
A mafi yawancin lokuta, masana kimiyya basu san daidai yadda myeloma zai fara ba . Tambayoyi sun bambanta tsakanin 'yan Afirka-' yan Afirka da yawa fiye da Caucasian-Americans da Caucasian-Americans mafi girma fiye da Asia-Amirkawa-duk da haka dalilai ba su sani ba. An gano wasu kwayoyin canzawa a cikin kwayoyin cutar plasma, amma abin da ya sa wadannan canje-canje a farkon wuri basu bayyana ba.
An tsara kwayoyin halittar DNA, wanda aka kunshe cikin nau'i nau'in nau'i na chromosomes. A wasu kwayoyin myeloma na mutane, wasu ɓangaren lambar chromosome 13 sun ɓace, wanda aka sani da maye gurbin. Wadannan bayanan sun bayyana sunyi myeloma karin magani.
A cikin kimanin kashi 50 cikin dari na mutanen da ke tare da myeloma, m clone yana da chromosome tare da abin da ake kira sashi-wani ɓangare na daya daga cikin kwayoyin halitta ya canza tare da wani ɓangare na wani chromosome a cikin kwayoyin myeloma. Lokacin da irin waɗannan canje-canjen sun juya mummunan kwayoyin akan ko kashe, zai iya inganta malignancy.
Masu bincike kuma sunyi imanin cewa cututtuka a wasu kwayoyin halitta a cikin kasusuwan kasusuwa zasu iya taka rawar a cikin myeloma. Alal misali, wasu kwayoyin halittar da ba'ayi da ake kira dendritic sel zasu iya sanya siginar sinadaran da zai haifar da kwayoyin plasma lafiya. Sabili da haka, ƙwayoyin kisa da kwayoyin dendritic zasu iya taimakawa wajen bunkasa myeloma.
Sanin asali
Idan bayyanar cututtuka sun nuna myeloma, jarrabawar jarraji akan jini da / ko fitsari, siffar ƙasusuwan, da kuma kasusuwan kasusuwan maniyyi.
Gwajin jini
- Cikakken Cutar (CBC): Wannan ya haɗa da ƙididdigar jini na nau'o'i daban-daban don sanin ko lambobinku sun faɗi a cikin wani ɓangare na al'ada ko maras kyau. Lokacin da kwayoyin myeloma suka yada cikin kasusuwa, wasu ƙwayar jini za su kasance ƙasa. Ƙananan ƙwayar jinin jini shine sananne ne.
- Immunoglobulins (Ig) Kayyadadden: An kirkiro kimanin Ig don ganin abin da, idan akwai, daga cikin nau'o'in nau'i daban-daban guda biyar, suna karuwa matakan-IgA, IgD, IgE, IgG, da kuma IgM. A cikin myeloma, ɗayan waɗannan na iya zama babba kuma wasu na iya zama ƙasa da al'ada. Sauran alamu suna yiwuwa.
- SPEP da UPEP: Wannan yana nufin furotin na lantarki electrophoresis da kuma furotin furotin electrophoresis. Wadannan gwaje-gwaje na iya gano ko akwai ƙwayar gina jiki na monoclonal.
- Harshen Wutan Lantarki: Wannan jarabawar ya ƙididdige adadin sassan haske a cikin jini. Ana iya yin wannan, alal misali, a cikin mai haƙuri tare da myeloma wanda ba'a samo asalin M ba daga SPEP.
Bone Marrow Tests da Biopsies
Mutanen da ke da myeloma suna da kwayar cutar ƙwayoyin cuta da yawa a cikin kullun nama. Sabili da haka, kasusuwan maniyyi na kasusuwan da ake nema don yin la'akari da ƙididdiga kuma samo samfurori. Ana iya yin ko dai a asibitin likita ko a asibiti. Ana nazarin samfurori na biopsy daga likitancin mutum kuma yana cigaba da gwada gwajin gwaje-gwaje.
Nazarin Halitta na Ƙwayoyin Ciki
Ana yin gwaje-gwajen kwayoyin halitta a jikin kwayoyin halitta kamar wani ɓangare na ganewar asali da kimantawa na myeloma. Nazarin cytogenic yana nufin gwaje-gwaje da ke nazarin canje-canje a cikin chromosomes na kwayoyin myeloma.
Wasu maye gurbi da gyare-gyare na kwayoyin halitta sun taimaka ma likitoci suyi hango yadda yadda mummunan zai iya nuna hali. Akwai gwaje-gwajen daban-daban da ake amfani dashi don amfani da su don kimanta cutar ta mutum sau da yawa idan an samu kwayoyin.
Amyloid Biopsy
Babban matakan masu ciwon sunadaran antibody sun sanya myeloma marasa lafiya don haɓaka amyloidosis. Amyloid abu ne wanda zai iya ginawa a kowace jikin kuma biopsy yana taimakawa wajen tantance wannan cuta. Yawancin lokaci, wannan kwayar halitta ta shafi amfani da allura don cire wasu mai ciki.
Scans da Hoto
Kwayoyin myeloma sun san suna iya yin kullun cututtuka a kasusuwa. Suna iya ɗaukar wasu kwayoyin da ake kira osteoclasts don halakar kashi ko yin sautin mai laushi a yankuna masu rarraba.
Sau da yawa jerin rahotannin x da suka hada da mafi yawan kasusuwa sunyi. Lokacin da irin wannan hoton ya yi, an san shi a matsayin binciken kashi ko binciken skeletal. Wasu nau'o'in hotunan zasu iya taimakawa musamman a wasu lokuta, irin su gano plasmacytomas wanda ba za'a iya gani akan hasken rana ba.
Lokacin da za a ga likitan
Ka yi la'akari da yin ganawa da likitanka idan kana da wasu alamu ko alamun da ke damuwa da kai. Hanyoyin cututtuka na myeloma na iya zama mai banƙyama da rashin fahimta.
Idan an gano ku tare da MGUS ko ƙwayar cutar ƙwaƙwalwar ƙaƙa, yana da muhimmanci ku da likitan ku ci gaba da idanu akan abubuwan da waɗannan kwayoyin cutar plasma zasu iya ci gaba zuwa myeloma. Ku tambayi likita koyaushe tambayoyin da kuke da shi game da yanayinku.
Kalma Daga
Idan kai ko wanda kake ƙauna da aka gano kwanan nan tare da myeloma, yana da kyau al'ada don jin dadi, fushi, ɓarna, ko duk abin da ke sama. Sanarwar maganin ciwon daji shine canza rayuwa a hanyoyi da yawa . Yana iya taimaka wajen jin labarin wasu mutane. Bita bita, tarurruka, har ma da kafofin watsa labarun su ne kyakkyawan hanyar da za su iya haɗuwa da wasu waɗanda za su iya raba gwagwarmaya ko samun irin abubuwan da suka faru da fahimta.
> Sources:
> Hengeveld PJ, Kersten MJ. B-cell activating factor a cikin pathophysiology na m myeloma m: a manufa ga far? Ciwon Kankara ta Blood. 2015; 5 (2): e282-.
> Sonneveld P, Broijl A. Jiyya na sake koma baya da kuma myeloma mai yawa. Haematologica. 2016; 101 (4): 396-406.
> Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011; 364 (11): 1046-1060.