Waldenström macroglobulinemia

Waldenström macroglobulinemia (WM) igomarara reB lymphocyte (rudzi rwechena reropa). WM inosanganiswa nekuwedzeredzwa kweprotein inonzi IgM antibodies.

WM inoguma yemamiriro anonzi lymphoplasmacytic lymphoma. Ichi kenza yemasero machena eropa, umo maB immune maseru anotanga kupatsanuka nekukurumidza. Icho chaicho chikonzero chekunyanyisa kugadzirwa kweiyo IgM antibody hazvizivikanwe. Hepatitis C inogona kuwedzera njodzi yeWM. Gene shanduko dzinowanzo kuwanikwa mumasero akaipa eB.

Kugadzirwa kweakawandisa IgM antibodies kunogona kukonzera akati wandei ematambudziko.

• Hyperviscosity, iyo inoita kuti ropa rinyanye kukora. Izvi zvinogona kuita kuti zvive zvakaoma kuti ropa riyerere kuburikidza nemidziyo midiki yeropa.
• Neuropathy, kana kukuvara kwetsinga, apo antibody yeIgM ikapindirana nemhasuru yeturu.
• Anemia, apo antibody yeIgM inosunga kumasero matsvuku eropa.
• Chirwere cheitsvo, apo iyo IgM antibody inoisa mune yeitsvo tishu.
• Cryoglobulinemia uye vasculitis (kuzvimba kwemitsipa yeropa) apo antibody yeIgM inogadzira immune immune pamwe nekutonhora kuratidzwa.

WM ishoma kwazvo. Vanhu vazhinji vane chirwere ichi vanopfuura makore makumi matanhatu nemashanu ekuberekwa.

Zviratidzo zveWM zvinogona kusanganisira chero zvinotevera:

• Kubuda ropa kwematinji nemumhino
• Kukanganiswa kana kuderera kwemaonero
• Bluish ganda muminwe mushure mekutonhora kutonhora
• Dzungu kana kuvhiringidzika
• Kupwanya kuri nyore kweganda
• Kuneta
• Manyoka
• Unhu, kugwinha, kana kupisa marwadzo mumaoko, tsoka, zvigunwe, zvigunwe, nzeve, kana mhino
• Mapundu
• Kuzvimba gland
• Kurasikirwa kwekurema kwemaune
• Kuona kurasikirwa mune rimwe ziso

Kuongorora kwepanyama kunogona kuratidza kuzvimba kwepleen, chiropa, uye lymph node. Kuongororwa kwemaziso kunogona kuratidza kuwedzerwa mutsinga muitina kana kubuda kweropa (kubuda ropa).

Iyo CBC inoratidza yakaderera nhamba yemasero matsvuku eropa uye maplatelet. Ropa kemisitiri rinogona kuratidza humbowo hwehosha yeitsvo.

Chiyero chinonzi serum protein electrophoresis inoratidza yakawedzera mwero weiyo IgM antibody. Matanho anowanzo kwira kupfuura mazana matatu emamirigiramu padigilita (mg / dL), kana 3000 mg / L. Kuongororwa kwema immunofixation kuchaitwa kuratidza kuti iyo IgM antibody inotorwa kubva kune imwechete sero mhando, (clonal).

Iyo serum viscosity test inogona kuudza kana ropa rave gobvu. Zviratidzo zvinowanzoitika kana ropa rakapetwa kana zvakapetwa kupfuura zvakajairwa.

Bone marrow biopsy inoratidza huwandu hwakawanda hweasero asina kujairika anotaridzika kunge ma lymphocyte uye masero eplasma.

Kuwedzera bvunzo dzinogona kuitwa dzinosanganisira:

• 24-awa weti puroteni
• Yakazara mapuroteni
• Immunofixation mune weti
• T (thymus yakatorwa) lymphocyte kuverenga
• Bone x-ray

Vamwe vanhu vane WM vakawedzera maGM antibodies havana zviratidzo. Aya mamiriro anozivikanwa sekupfungaira WM. Hapana kurapwa kunodiwa kunze kwekungwarira kutevedza.

Mune vanhu vane zviratidzo, kurapwa kunovavarira kudzikisa zviratidzo uye njodzi yekukuvara kwenhengo. Iko hakuna ikozvino kurapa kwakaringana. Mutapi wako wezvehutano anogona kukuudza kuti iwe utore chikamu mukutongwa kwekiriniki.

Plasmapheresis inobvisa IgM antibodies kubva muropa. Iyo zvakare inokurumidza kudzora zviratidzo zvinokonzerwa nekuwedzera kweropa.

Mishonga inogona kusanganisira corticosteroids, mubatanidzwa wemakemotherapy mishonga uye monoclonal antibody kumaB maseru, rituximab.

Autologous stem cell yekuisa inogona kukurudzirwa kune vamwe vanhu vane hutano hwakanaka.

Vanhu vane huwandu hwakaderera hwematsvuku kana machena masero eropa kana maplatelet vangangoda kuwedzerwa ropa kana maantibayoti.

Ivhareji yekupona ingangoita makore mashanu. Vamwe vanhu vanorarama makore anodarika gumi.

Mune vamwe vanhu, kusagadzikana kunogona kuburitsa mashoma zviratidzo uye kufambira mberi zvishoma nezvishoma.

Zvinetso zveWM zvinogona kusanganisira:

• Shanduko mukushanda kwepfungwa, pamwe zvichitungamira kukoma
• Kutadza kwemoyo
• Kubuda kwepamuviri kubuda ropa kana malabsorption
• Matambudziko ekuona
• Mikoko

Bata mupi wako kana zviratidzo zveWM zvichikura.

Waldenström macroglobulinemia; Macroglobulinemia - yekutanga; Lymphoplasmacytic lymphoma; Monoclonal macroglobulinemia

• Waldenström
• Antibodies

Kapoor P, Ansell SM, Fonseca R, et al. Kuongororwa uye manejimendi eWaldenström macroglobulinemia: Mayo stratification ye macroglobulinemia uye njodzi-yakashandurwa kurapa (mSMART) mirayiridzo 2016. JAMA Oncol. 2017; 3 (9): 1257-1265. PMID: 28056114 pubmed.ncbi.nlm.nih.gov/28056114/.

Rajkumar SV. Plasma maseru kusagadzikana. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 178.

Treon SP, Castillo JJ, Hunter ZR, Merlini G. Waldenström macroglobulinemia / lymphoplasmacytic lymphoma. Muna: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 87.