Myelodysplastic syndrome chirwere cheropa. Iyi pathology inokonzera kudonha kwehuwandu hwemasero eropa anotenderera. Ichi chirwere chinonziwo: myelodysplasia.

Mumuviri "une hutano", mwongo unoburitsa marudzi akasiyana emasero eropa:

- masero matsvuku eropa, achibvumira kupiwa kweokisijeni kumuviri wose;

- masero machena eropa, achibvumira muviri kurwisa exogenous agents uye nokudaro kudzivirira njodzi yehutachiona;

- maplatelet, ayo anobvumira kugwamba kweropa kuumba uye kupinda mukutamba mukubatanidzwa.

Panyaya yevarwere vane myelodysplastic syndrome, mwongo hauchakwanisi kugadzira aya masero matsvuku eropa, masero machena eropa uye maplatelet kazhinji. Masero eropa anogadzirwa zvisingaite zvichikonzera kusakura kwawo. Pasi pemamiriro ezvinhu ari kukura aya, mwongo une muunganidzwa wemasero eropa asina kujairika anobva agoverwa kuropa rose.

Mhando iyi yechirwere inogona kukura zvishoma nezvishoma kana kukura zvakanyanya.

 Kune marudzi akawanda echirwere: (2)

• refractory anemia, munyaya iyi, chete kugadzirwa kwemasero matsvuku eropa kunokanganisa;
• refractory cytopenia, apo masero ose (masero matsvuku eropa, masero machena eropa uye maplatelet) anokonzerwa;
• refractory anemia ine kuputika kwakanyanya, zvakare inokanganisa masero matsvuku eropa, masero machena eropa uye maplatelet uye zvinotungamira kune yakawedzera njodzi yekukudziridza acute leukemia.

Myelodysplastic syndrome inogona kubata vanhu vemazera ese. Zvisinei, vanhu vanonyanya kubatwa nechirwere ichi vari pakati pemakore 65 ne70. Mumwe chete muvarwere vashanu ari pasi pemakore makumi mashanu angabatwa nechirwere ichi. (50)

Vanhu vazhinji vane chirwere vane zviratidzo zvakapfava kusvika zvakapfava pakutanga. Izvi zviratidzo zvekliniki zvinozove zvakaoma.

Zviratidzo zvechirwere zvinosanganiswa nemhando dzakasiyana dzemasero eropa anobatwa.

Muchiitiko chekuti masero matsvuku eropa akakanganiswa, zviratidzo zvinosanganiswa ndezvi:

• kuneta;
• kushaya simba;
• kufema kunetseka.

Muchiitiko chekuti masero machena eropa ane hanya, zviratidzo zvekliniki zvinoguma ne:

• kuwedzera kwengozi yezvirwere zvakabatana nekuvapo kwezvirwere (mavhairasi, mabhakitiriya, zvipembenene, nezvimwewo).

Kana kuvandudzwa kweplatelet kune chekuita, isu tinowanzo cherechedza:

• kubuda ropa kwakanyanya uye kuonekwa kwekupwanya pasina chikonzero chechikonzero.

Mamwe maitiro e myelodysplastic syndrome akafanana nekiriniki zviratidzo zvinokura nekukurumidza kupfuura mamwe.

Mukuwedzera, vamwe varwere vangave vasipo nezviratidzo zvehutano. Kuongororwa kwechirwere saka kunoitwa mushure mekuita kuongororwa kweropa, kuratidzira kuderera kusingawanzoitiki kwemasero eropa anotenderera uye kukanganisa kwavo.

Zviratidzo zvechirwere zvakanangana nerudzi rwacho. Zvechokwadi, kana iri refractory anemia, zviratidzo zvinogadzirwa zvichave zvakanyanya kuneta, manzwiro ekushaya simba pamwe chete nemukana wekufema kunetseka. (2)

Vamwe vanhu vane myelodysplastic syndrome vanogona kukura acute myeloid leukemia. Igomarara remasero machena eropa.

Mabviro chaiwo emyelodysplastic syndrome haasati anyatsozivikanwa.

Nekudaro, hukama hwechikonzero nemhedzisiro yakaiswa pamberi kuti ionekwe kune mamwe makemikoro emakemikari, akadai sebenzene, uye kukura kweiyo pathology. Kemikari iyi, inorondedzerwa secarcinogenic kuvanhu, inowanikwa zvakanyanya muindasitiri yekugadzira mapurasitiki, rabha kana muindasitiri yepetrochemical.

Muzviitiko zvisingawanzoitiki, kukura kwechirwere ichi kunogona kusanganiswa neradiotherapy kana chemotherapy. Idzi inzira mbiri dzinoshandiswa zvakanyanya mukurapa gomarara. (2)

Zvikonzero zvechirwere ndezvi:

- kuratidzwa kune mamwe makemikari, akadai sebenzene;

-Kurapwa kwekutanga nechemotherapy uye / kana radiotherapy.

Kuongororwa kwemyelodysplastic syndrome kunotanga nekuongororwa kweropa pamwe nekuongororwa kwemapfupa emapfupa. Maedzo aya anobatsira kuona huwandu hwemasero eropa akajairika uye asina kujairika.

Kuongororwa kwemafupa emapfupa kunoitwa pasi peanesthesia yemunharaunda. Muenzaniso wayo unowanzo kutorwa kubva muhudyu yemunhu uye kuongororwa pasi pemaikorosikopu murabhoritari.

Kurapa kwechirwere kunoenderana zvakananga nemhando yechirwere uye mamiriro ezvinhu zvakananga kumunhu.

Chinangwa chekurapa ndechekudzoreredza mwero wakajairika wekutenderera masero eropa uye chimiro chavo.

Mumamiriro ezvinhu apo murwere anopa chimiro chechirwere chine ngozi shoma yekushandura kuva kenza, kunyorerwa kweimwe nzira yekurapa hakuzove yakakosha asi kunongoda kuongororwa nguva dzose kuburikidza nekuongorora ropa.

 Mishonga yemhando dzepamusoro dzechirwere ndeiyi:

• kuwedzerwa ropa;
• mishonga yekugadzirisa iron muropa, kazhinji mushure mokunge kuwedzerwa ropa kwaitwa;
• kubaya majekiseni ekukura, akadai se erythropoietin kana G-CSFs, kuwedzera kukura kwemasero eropa uye kubatsira mwongo kuburitsa masero eropa;
• mishonga inorwisa mabhakitiriya, mukurapa kwezvirwere zvinokonzerwa nekushomeka kwemasero machena eropa.

Mukuwedzera, mishonga yemhando: anti-thymocyte immunoglobulins (ATG) kana cyclosporine, inoderedza basa rekudzivirira muviri rinobvumira pfupa kugadzira masero eropa.

Kune vanhu vane njodzi yakakura yekuva nekenza, chemotherapy inogona kurongerwa kana kunyange stem cell transplant.

Chemotherapy inoparadza masero eropa asati akura nekumisa kukura kwawo. Inogona kurongerwa nemuromo (mapiritsi) kana intravenously.

Kurapa uku kunowanzobatanidzwa ne:

- cytarabine;

- fludarabine;

- daunorubicine;

- clofarabine;

- l'azacitidine.

Stem cell transplantation inoshandiswa nenzira yakaoma yechirwere. Muchirevo chechinyorwa chino, kutapurirana kwe stem masero kunonyanya kuitwa muzvidzidzo zvevadiki.

Kurapa uku kunowanzo kusanganiswa nechemotherapy uye / kana yekutanga radiotherapy. Mushure mekuparadzwa kwemasero eropa anokonzerwa nechirwere, kuchinjwa kwemasero ane utano kunogona kubudirira. (2)