I-Myeloma eminingi

I-Multiple myeloma ingumdlavuza ongavamile kodwa ongapheli oqala kumaseli e-plasma. Abantu ngokuvamile bathola ukuxilongwa kwabo ekupheleni kweminyaka engu-60. 

Iziguli eziningi sezivele zine-anemia ekuxilongweni kwayo. Imiphumela yezempilo yalo mdlavuza mikhulu. Isifo se-myeloma sithinta kakhulu impilo yamathambo, iningi leziguli libona ukulimala noma ukulahlekelwa. Lawa maqiniso agcizelela ukuthi kungani ukubona izimpawu kusenesikhathi kanye nokuxilonga ngokushesha kubalulekile ukuze ulawule lesi simo ngempumelelo.

Iyini i-Multiple Myeloma?

Isifo se-myeloma eminingi siqala lapho amangqamuzana e-plasma eba nomdlavuza. Lawa maseli anomdlavuza aphindaphindeka ngokushesha futhi aminyanise amangqamuzana anempilo akha igazi. Amaseli anomdlavuza futhi akha amasosha omzimba angajwayelekile abizwa ngokuthi ama-M protein. Amaprotheni angama-M angalimaza izitho zomzimba esikhundleni sokulwa nezifo njengama-antibodies ajwayelekile.

Izinhlobo ze-Myeloma eminingi

Kunezinhlobo eziningana ezikhona ngokusekelwe kumaprotheni angavamile akhiqizwa:

• I-Light chain myeloma (ama-15-20% amacala) - Ikhiqiza amasosha omzimba okukhanya kuphela
• I-myeloma engeyona imfihlo (i-1-3% yezimo) - Ikhiqiza amaprotheni amancane noma awanawo nhlobo
• IgG myeloma - Uhlobo oluvame kakhulu
• I-myeloma ebhemayo - Ifomu lokuqala ngaphandle kwezimpawu

Izimpawu eziningi ze-Myeloma 

Izimpawu zakuqala zingabandakanya:

• Ubuhlungu bethambo (ikakhulukazi ezinqulwini, emhlane, noma ogebheni)
• Ukukhathala okuqhubekayo
• Izifo ezitholakala njalo

Iziguli ezisesigabeni sokugcina zingase zithole:

• Ukudideka okukhulu noma inkungu yengqondo
• Ubuthakathaka obukhulu nokukhathala
• Izifo ezimbi kakhulu ezingaphenduli ekwelashweni
• Ukungathandi ukudla kanye nokuncipha okukhulu kwesisindo
• Ukuhluleka kwezinso
• Ukuphefumula kanzima

Amazinga aphezulu e-calcium angabangela izinkinga ezinzima. Iziguli zingase zizizwe zome kakhulu, ziqunjelwe, futhi zingawela ekukhomeni ngaphandle kokwelashwa.

Izinkinga ze-Myeloma eminingi

Ososayensi abakayitholi imbangela yangempela. I-Myeloma eminingi ivame ukuvela esimweni esiyingozi esibizwa ngokuthi i-monoclonal gammopathy of undetermined significance (MGUS).

Ingozi ye-Myeloma eminingi

Izinto ezikhulisa ubungozi zifaka:

• Uneminyaka engaphezu kwengu-65
• Ubulili besilisa
• Ubuzwe abamnyama (ubungozi obuphindwe kabili uma buqhathaniswa nabamhlophe)
• Umlando womndeni
• Ukukhuluphala
• Ukuxilongwa kwangaphambilini kwe-MGUS

Izinkinga ze-Myeloma eminingi

Izinkinga eziyinhloko zihlanganisa:

• Ukulimala kwamathambo nokuphuka
• Izinkinga zezinso
• I-anemia nezindaba zegazi
• Isivikelo somzimba sokuzivikela
• Amazinga aphezulu e-calcium

Ukuxilongwa kwe-Myeloma eminingi

Ukutholwa kusenesikhathi kwe-myeloma eminingi kusiza odokotela banikeze ukunakekelwa okungcono. Kufanele ukhulume nodokotela wakho ngokushesha uma uthola izimpawu ezingapheli.

Odokotela baqinisekisa i-myeloma eminingi ngokusebenzisa izivivinyo eziningana:

• Ukuhlolwa kwegazi okuhlanganisa amaprotheni e-M, amazinga e-calcium, i-hemoglobin, i-creatinine, amaketanga okukhanya amahhala.
• Ukuhlolwa komchamo thola amaprotheni e-Bence Jones
• I-biopsy yomnkantsha ibonisa iphesenti lamaseli e-plasma
• Ukuhlolwa kwesithombe (i-X-ray, i-MRI, i-CT, i-PET scans) kubonisa ukulimala kwamathambo

Ukwelapha okuningi kwe-Myeloma

Idinga ukwelashwa ngokushesha uma isitholakele. Izinketho zokwelashwa ziyatholakala uma kudingeka:

• Ukwelashwa okuhlosiwe kuhlasela iseli lomdlavuza othile 
• immunotherapy kuqinisa amasosha akho omzimba ukulwa nomdlavuza
• I-CAR-T cell therapy iqeqesha amangqamuzana omzimba ukuze aqondise i-myeloma
• Ukwelashwa ngamakhemikhali ibulala amangqamuzana akhula ngokushesha
• Ukufakelwa kwe-stem cell esikhundleni somnkantsha onesifo

Uzoyibona Nini Udokotela

Udinga usizo lwezokwelapha ngokushesha uma uhlangabezana:

• Ubuhlungu obungalindelekile bomhlane
• Ukuba ndikindiki komlenze noma ubuthakathaka
• Ukudideka noma izimpawu ezifana nesifo sohlangothi
• Ukuchama kancane

Prevention

Ayikho indlela yokuvimbela eqinisekisa impumelelo, kodwa unganciphisa ubungozi bakho ngoku:

• Ukugcina isisindo esinempilo
• Ukunciphisa ukuchayeka emisebeni
• Ukudla izithelo nemifino eminingi
• Ukuhlala usebenza
• Ukuhlala kude namakhemikhali ayingozi

Ukuhlolwa okuvamile kubaluleke kakhulu, ikakhulukazi uma une-MGUS. Ukungenelela okusheshayo kungayivimba ekubeni i-myeloma eminingi.

Isiphetho

I-Myeloma eminingi iletha izinselele eziningi ezimpilweni zeziguli, kodwa impumelelo yezokwelapha iqhubeka nokwenza ngcono imiphumela yazo. Lo mdlavuza wegazi udinga ukunakwa ngokushesha ngoba ukutholwa kusenesikhathi kungakhuphula amazinga empumelelo yokwelashwa. Lesi sifo sivame ukuvela ngobuhlungu bamathambo, ukukhathala, kanye nezifo eziphindaphindayo. Lezi zimpawu eziyisixwayiso zibalulekile ukuzibona, ikakhulukazi uma unobungozi obukhulu.

Iminyaka yakho yobudala idlala indima ebalulekile ekuthuthukiseni lesi simo, ikakhulukazi ngemva kweminyaka engu-65. Umlando womndeni walesi sifo nawo uphakamisa izimpawu ezibomvu. Abantu abanalezi zici zobungozi kufanele bahlolwe njalo bezempilo.

Amaqembu ezokwelapha manje anamathuluzi anamandla okunqanda i-myeloma eminingi. Izindlela zokwelapha ezihlosiwe, i-immunotherapy, kanye nokufakelwa kwe-stem cell kunikeza iziguli ithemba elisha. I-CAR-T cell therapy inikeza impumelelo enkulu ekulweni nalesi sifo.

Sonke isiguli sidinga ukwelashwa ngokushesha. Akekho ongavimbela ngokuphelele i-myeloma eminingi, kodwa ukukhetha okunempilo kungase kwehlise ubungozi bakho. Isisindo esihle, indlela yokuphila esebenzayo kanye nokudla okunomsoco kusekela impilo yakho yonke. Ukuzivikela kwakho okuhle kakhulu kulesi simo esinzima ukulalela umzimba wakho futhi uthole usizo lwezokwelapha lapho izimpawu ziqhubeka.

Imibuzo Evame Ukubuzwa

1. Yiziphi izimpawu zokuqala ze-myeloma?

I-myeloma eminingi ingase ingabonisi noma yiziphi izimpawu ekuqaleni. Izimpawu zokuqala ngokuvamile zihlanganisa:

• Ubuhlungu bethambo, ikakhulukazi emhlane, ezinqeni, noma ezimbanjeni
• Ukukhathala okungajwayelekile noma ubuthakathaka
• Amagciwane angapheli
• Ukulahlekelwa kwesisindo esingachaziwe
• Ukoma okwengeziwe nokuchama

Izimpawu zivame ukukhula kancane. Iningi labantu lifuna usizo lwezempilo ngenxa yobuhlungu bamathambo.

2. Yiziphi izimpawu zokugcina ze-myeloma eminingi?

Izimpawu ziba zimbi kakhulu njengoba i-myeloma eminingi iqhubeka. Iziguli ezisesigabeni sokugcina zingase zithole:

• Ukudideka okukhulu noma inkungu yengqondo
• Ubuthakathaka obukhulu nokukhathala
• Izifo ezinzima 
• Ukungathandi ukudla kanye nokuncipha okukhulu kwesisindo
• Ukuhluleka kwezinso
• Ukuphefumula kanzima
• Ukoma nokuchama njalo

3. Ingabe i-myeloma eminingi ibucayi?

Yebo, i-multiple myeloma ingumdlavuza wegazi oyingozi othinta amangqamuzana e-plasma futhi udinga ukunakekelwa ngokushesha kwezokwelapha. Lesi sifo silimaza amathambo nezitho zomzimba uma singelashwa. Luselude ukhalo okufanele siluhambe, kodwa singakhela phezu kwale nqubekelaphambili ezinkethweni zokwelapha. Iziguli eziningi zingakwazi ukulawula lesi sifo isikhathi eside ngokwelashwa, nakuba lingekho ikhambi elaziwayo okwamanje.

4. Itholwa kanjani i-myeloma kuqala?

Odokotela bavame ukuthola i-myeloma eminingi ngokusebenzisa:

• Ukuhlolwa kwegazi okubonisa amazinga aphezulu amaprotheni noma i-anemia
• Ukuhlolwa komchamo okuthola amaprotheni e-Bence Jones
• I-biopsy yomnkantsha ebonisa amaseli e-plasma angajwayelekile
• Ukuhlolwa kwezithombe ezibonisa ukulimala kwamathambo

Umsebenzi wegazi ovamile ngezinye izikhathi uveza lesi sifo ngaphambi kokuba kuvele izimpawu. Ukuxilongwa kwe-myeloma eminingi kudinga okungenani amaseli e-plasma angu-10% kumnkantsha wamathambo kanye nezimpawu zokulimala kwesitho.

UDkt. Akshay Lahoti

MBBS, DNB (Imithi Yangaphakathi), PDCC (Hemato-Oncology), DM (Clinical Hematology) AIIMS
Izibhedlela ze-CARE CHL, e-Indore

Ukuze Ubhukhe Isikhathi, shayela:

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