Inobuzaza kangakanani iMonoclonal Gammopathy yokuBaluleka okungamiselwanga (MGUS)?

Umxholo

• Yintoni iMGUS?
• I-MGUS ifunyaniswa njani?
• Yintoni ebangela iMGUS?
• Iqhubeka njani iMGUS ekuhambeni kwexesha?
• Ngaba lukhona unyango lwe-MGUS?
• Yintoni imbonakalo?

Yintoni iMGUS?

I-MGUS, mfutshane kwi-monoclonal gammopathy yokubaluleka okungagqitywanga, yimeko ebangela ukuba umzimba wenze iprotheyini engaqhelekanga. Le protein ibizwa ngokuba yi-monoclonal protein, okanye M protein. Yenziwe ziiseli ezimhlophe zegazi ezibizwa ngokuba ziiseli zeplasma kumongo wethambo lomzimba.

Ngokwesiqhelo, i-MGUS ayisosizathu senkxalabo kwaye ayinayo imiphumo emibi yezempilo. Nangona kunjalo, abantu abane-MGUS banomngcipheko okonyukayo wokukhula kwezifo zomongo wegazi kunye nethambo. Oku kubandakanya umhlaza wegazi, njenge-myeloma okanye i-lymphoma.

Ngamanye amaxesha, iiseli ezisempilweni kumongo wethambo zinokuxinana xa umzimba usenza izixa ezikhulu kakhulu zeeprotheyini ze-M. Oku kungakhokelela ekonakaleni kwezicubu emzimbeni wonke.

Oogqirha bahlala becebisa ukuba babeke iliso kubantu abane-MGUS ngokwenza uvavanyo lwegazi rhoqo ukujonga naziphi na iimpawu zomhlaza okanye isifo, ezinokuthi ziphuhle ekuhambeni kwexesha.

I-MGUS ifunyaniswa njani?

I-MGUS ihlala ikhokelela kwimpawu zokugula. Oogqirha abaninzi bafumana M protein egazini labantu abane-MGUS ngelixa bevavanya ezinye iimeko. Abanye abantu banokuba neempawu ezinje ngerhashalala, ukuba ndindisholo, okanye ukubetha emzimbeni.

Ubukho beeproteni ze-M kumchamo okanye egazini luphawu olunye lwe-MGUS. Ezinye iiproteni ziphakanyisiwe egazini xa umntu ene-MGUS. Oku kunokuba yimiqondiso yezinye iimeko zempilo, ezinjengokuphelelwa ngamanzi emzimbeni kunye ne-hepatitis.

Ukulawula ezinye iimeko okanye ukubona ukuba i-MGUS ibangela iingxaki zakho zempilo, ugqirha unokuqhuba olunye uvavanyo. Olu vavanyo lubandakanya:

• Uvavanyo lwegazi oluneenkcukacha. Eminye imizekelo ibandakanya inani elipheleleyo legazi, uvavanyo lwe-serum creatinine, kunye novavanyo lwe-serum calcium. Uvavanyo lunokunceda ukukhangela ukungalingani kweeseli zegazi, amanqanaba aphezulu e-calcium, kunye nokwehla kokusebenza kwezintso. Ezi mpawu zihlala zinxulunyaniswa neemeko ezinxulumene ne-MGUS, ezinje nge-myeloma ezininzi.
• Uvavanyo lweeprotheyini lweeyure ezingama-24. Olu vavanyo lunokubona ukuba ngaba iiprotheyini ze-M zikhutshwe kumchamo wakho kwaye ujonge nawuphi na umonakalo wezintso, onokuba luphawu lwesimo esinzulu esinxulumene neMGUS.
• Ukujonga iimvavanyo. Iskena se-CT okanye i-MRI inokujonga umzimba ukuba unengxaki yokuqaqanjelwa kwamathambo okunxulunyaniswa neemeko ezinxulumene neMGUS.
• Umongo wethambo. Ugqirha usebenzisa le nkqubo ukukhangela iimpawu zomhlaza womongo wethambo kunye nezifo ezinxulumene neMGUS. I-biopsy ihlala yenziwa kuphela xa ubonakalisa iimpawu zokungabikho kwegazi, ukusilela kwezintso, izilonda zethambo, okanye amanqanaba aphezulu e-calcium, njengoko ezi ziyimpawu zesifo.

Yintoni ebangela iMGUS?

Iingcali aziqinisekanga ncam ukuba yintoni ebangela i-MGUS. Kucingelwa ukuba iinguqu ezithile zemfuza kunye nemeko yokusingqongileyo inokuchaphazela ukuba ingaba umntu uyayiphuhlisa na le meko.

Yintoni oogqirha abayaziyo kukuba i-MGUS ibangela iiseli ezingaqhelekanga zeplasma kumongo wethambo ukuvelisa iiprotein ze-M.

Iqhubeka njani iMGUS ekuhambeni kwexesha?

Abantu abaninzi abane-MGUS abaze baphele benemicimbi yezempilo enxulumene nale meko.

Nangona kunjalo, ngokweKliniki yaseMayo, malunga neepesenti enye yabantu abane-MGUS bahlakulela imeko yezempilo enzulu minyaka le. Uhlobo lweemeko ezinokuthi lukhule luxhomekeke kuhlobo lwe-MGUS onayo.

Zintathu iintlobo ze-MGUS, nganye inxulumene nomngcipheko ophakamileyo weemeko ezithile zempilo. Oku kubandakanya:

• I-non-IgM MGUS (ibandakanya i-IgG, i-IgA okanye i-IgD MGUS). Oku kuchaphazela elona nani liphezulu labantu abane-MGUS. Kukho ukwanda kwamathuba okuba i-non-IgM MGUS iya kukhula ibe yi-myeloma eninzi. Abanye abantu, i-non-IgM MGUS inokukhokelela kwezinye iingxaki ezinzulu, ezinje nge-immunoglobulin light chain (AL) amyloidosis okanye isifo sokuhambisa isifo.
• IgM MGUS. Oku kuchaphazela malunga neepesenti ezili-15 zabo bane-MGUS. Olu hlobo lwe-MGUS luthwala umngcipheko womhlaza onqabileyo obizwa ngokuba yiWaldenstrom macroglobulinemia, kunye ne-lymphoma, AL amyloidosis, kunye ne-myeloma ezininzi.
• Ikhonkco lokukhanya MGUS (LC-MGUS). Oku kuhlulwe kuphela kutshanje. Ibangela ukuba iiprotheyini ze-M zibhaqwe kumchamo, kwaye zinokukhokelela kukhanyiso lokukhanya oluninzi lwe-myeloma, AL amyloidosis, okanye isifo sokuhambisa isifo.

Izifo ezibangelwe yi-MGUS zinokubangela ukwaphuka kwamathambo, amahlwili egazi, kunye neengxaki zezintso ekuhambeni kwexesha. Ezi ngxaki zinokukwenza ukulawula imeko kunye nokunyanga naziphi na izifo ezinxulumene noko.

Ngaba lukhona unyango lwe-MGUS?

Akukho ndlela yokuphatha i-MGUS. Ayizihambeli yodwa, kodwa ayisoloko ibangela iimpawu okanye ikhule ibe kwimeko enzulu.

Ugqirha uya kuncomela ukujongwa rhoqo kunye novavanyo lwegazi ukugcina iso kwimpilo yakho. Ngokwesiqhelo, ezi zinto zivavanywayo ziqala kwiinyanga ezintandathu emva kokufumanisa okokuqala i-MGUS.

Ngaphandle kokujonga igazi kutshintsho kwiiproteni ze-M, ugqirha uya kujonga iimpawu ezithile ezinokubonisa ukuba isifo siyahambela phambili. Ezi mpawu zibandakanya:

• i-anemia okanye ezinye izinto ezingaqhelekanga zegazi
• ukopha
• utshintsho kumbono okanye ukuva
• umkhuhlane okanye ukubila ebusuku
• intloko ebuhlungu kunye nesiyezi
• iingxaki zentliziyo nezintso
• iintlungu, kubandakanya iintlungu zemithambo-luvo kunye neentlungu zethambo
• ukudumba kwesibindi, i-lymph node, okanye udakada
• ukudinwa kunye okanye ngaphandle kobuthathaka
• ukunciphisa umzimba ngempazamo

Ngenxa yokuba i-MGUS inokukhokelela kwiimeko ezonakalisa ukonakala kwethambo, ugqirha unokucebisa ukuba uthathe amayeza ukunyusa uxinano lwethambo lakho ukuba une-osteoporosis. Amanye ala mayeza aquka:

• I-alendronate (iBinosto, iFosamax)
• i-risedronate (Actonel, Atelvia)
• ibandronate (iBoniva)
• i-zoledronic acid (i-Reclast, iZometa)

Yintoni imbonakalo?

Uninzi lwabantu abane-MGUS aluphuhlisi iimeko ezinzulu zegazi kunye nomongo wethambo. Nangona kunjalo, umngcipheko wakho unokuqikelelwa ngokutyelelwa rhoqo ngugqirha kunye novavanyo lwegazi. Ugqirha wakho unokumisela umngcipheko wokuba i-MGUS iqhubekele kwesinye isifo ngokuthathela ingqalelo:

• Ukubala, uhlobo, kunye nobungakanani beeproteni ze-M ezifumaneka kwigazi lakho. Iiprotheyini ezinkulu kunye nezininzi ezininzi ze-M zingabonakalisa isifo esandayo.
• Umgangatho weetyathanga zokukhanya zasimahla (olunye uhlobo lweprotein) egazini lakho. Amanqanaba aphakamileyo eetyathanga zokukhanya simahla lolunye uphawu lwezifo ezikhulayo.
• Iminyaka oye wafunyaniswa ngayo. Okukhona uneMGUS, kokukhona uya usanda umngcipheko wokuba nesifo esibi.

Ukuba wena okanye umntu obathandayo ufumanisa ukuba une-MGUS, qiniseka ukuba ulandela izicwangciso zikagqirha wakho zokujonga imeko yakho.

Ukuhlala ngaphezulu kwe-MGUS yakho kunokunciphisa umngcipheko weengxaki. Inokunyusa namathuba akho eziphumo ezilungileyo ngakumbi ukuba ungaphuhlisa nasiphi na isifo esinxulumene neMGUS.

Ukugcina indlela yokuphila esempilweni kunokukhokelela kwiziphumo ezingcono. Ungakwenza oku ngokulala ngokwaneleyo nokwenza imithambo, ukunciphisa uxinzelelo, kunye nokutya ukutya okusempilweni okunje ngeziqhamo kunye nemifuno.