Waldenström macroglobulinemia

Waldenström macroglobulinemia (WM) yog mob cancer ntawm B lymphocytes (ib hom qe ntshav dawb). WM cuam tshuam nrog kev ua haujlwm ntawm cov protein hu ua IgM tiv thaiv kab mob.

WM yog los ntawm cov mob uas hu ua lymphoplasmacytic lymphoma. Tus mob no yog mob cancer rau cov qe ntshav dawb, uas cov B tiv thaiv kab mob hauv lub cev pib sib kis sai. Qhov tseeb yog vim li cas ntau dhau ntawm ntau lawm ntawm lub IgM antibody tsis paub. Kab mob siab C tuaj yeem ua rau muaj kev pheej hmoo ntau dua ntawm WM. Kev hloov noob tau feem ntau pom hauv cov hlwb ua haujlwm tsis zoo.

Kev tsim cov tshuaj tiv thaiv IgM ntau dhau tuaj yeem ua rau ntau hom teeb meem:

• Hyperviscosity, uas ua rau cov ntshav ua tuab heev. Qhov no tuaj yeem ua rau nws nyuaj rau cov ntshav ntws los ntawm cov hlab ntsha me.
• Neuropathy, lossis hlab ntuag puas, thaum lub IgM antibody reacts nrog cov hlab ntaws.
• Plawv tsis txaus, thaum cov tshuaj tiv thaiv IgM khi rau cov qe ntshav liab.
• Kab mob rau lub raum, thaum cov tshuaj tiv thaiv IgM tso rau hauv lub raum cov nqaij.
• Tus mob Cryoglobulinemia thiab vasculitis (mob rau cov hlab ntshav) thaum cov tshuaj tiv thaiv IgM ua rau cov txheej txheem tiv thaiv kab mob ua rau lub cev tsis muaj zog nrog cov mob khaub thuas.

WM yog muaj tsawg kawg nkaus. Cov neeg feem ntau uas muaj tus mob no muaj hnub nyoog 65 xyoos.

Cov tsos mob ntawm WM yuav suav nrog qee yam hauv qab no:

• Kev los ntshav ntawm cov pos hniav thiab ntswg
• Qhov muag plooj los sis tsis pom kev
• Bluish daim tawv nqaij hauv cov ntiv tes tom qab kis tau txias
• Kiv taub hau lossis feeb tsis meej
• Kev yooj yim bruising ntawm daim tawv nqaij
• Nkees
• Zawv plab
• Xuas tes, tingling, lossis mob mob hauv tes, taw, ntiv tes, ntiv taw, pob ntseg, lossis qhov ntswg
• Pob pob
• Cov qog ntshav tawm
• Tsis yuag yuag poob
• Lub zeem muag poob hauv ib qho muag

Txoj kev kuaj mob rau lub cev yuav qhia pom tias muaj hnoos qeev, daim siab, thiab cov qog ntshav. Kev kuaj qhov muag yuav pom tias cov leeg ntshav loj rau hauv cov leeg ntshav los ntshav retina.

Ib daim CBC qhia tau hais tias cov qe ntshav liab thiab qe ntshav tsawg tsawg. Tshuaj tso ntshav ntshav tuaj yeem pom pov thawj ntawm lub raum.

Ib txoj kev sim hu ua cov tshuaj protein electrophoresis qhia tau nce qib ntawm IgM antibody. Cov qib no feem ntau siab dua 300 milligrams ntawm ib qhov deciliter (mg / dL), lossis 3000 mg / L. Qhov tshuaj tiv thaiv kev tiv thaiv kab mob yuav ua kom pom tias qhov IgM antibody yog muab los ntawm ib hom xov tooj ntawm tes, (clonal).

Qhov kev ntsuas ntshav viscosity tuaj yeem qhia tau yog tias cov ntshav tau dhau los. Cov tsos mob feem ntau tshwm sim thaum cov ntshav plaub zaug tuab dua li ib txwm muaj.

Kev txiav tawm pob txha tawm ntawm cov pob txha yuav qhia cov xov tooj ntawm cov qe ntshav tsis txaus uas zoo li ob lub lymphocytes thiab ntshav hlwb.

Cov kev ntsuam xyuas ntxiv uas yuav ua tau muaj xws li:

• 24-teev tso zis protein
• Tag nrho cov protein
• Kev txhaj tshuaj tiv thaiv kab mob hauv cov zis
• T (thymus muab tau los) lymphocyte suav
• Ua pob xoo hluav taws xob

Qee cov neeg uas muaj WM uas muaj cov tshuaj tiv thaiv IgM ntau tsis muaj cov tsos mob. Tus mob no yog hu ua smoldering WM. Tsis muaj kev kho mob dab tsi ntxiv uas tsis yog ua tib zoo soj qab taug qab.

Hauv cov neeg muaj mob, kho hom phiaj txo qis cov tsos mob thiab txoj kev pheej hmoo ntawm kev tsim cov khoom nruab nrog cev. Tamsis no tsis muaj txoj kev khomob. Koj tus kws kho mob yuav qhia tias koj koom rau kev sim kho mob.

Plasmapheresis tshem tawm cov tshuaj tiv thaiv IgM los ntawm cov ntshav. Nws kuj tseem tswj tau cov tsos mob tshwm sim los ntawm cov ntshav tuab.

Cov tshuaj noj tshuaj yuav suav nrog corticosteroids, kev sib txuas ntawm cov tshuaj kho mob tshuaj thiab cov tshuaj monoclonal ua rau lub hlwb B, rituximab.

Txoj kev hloov cov hlwb pob txha taub hau yuav raug pom zoo rau qee cov neeg uas tsis muaj mob lwm tus.

Cov neeg uas muaj cov ntshav liab tsawg lossis ntshav dawb lossis qe ntshav dawb yuav xav tau qhov txhab ntshav lossis tshuaj tua kabmob.

Qhov nruab nrab txoj sia nyob yog kwv yees li 5 xyoos. Qee cov neeg nyob ntau dua 10 xyoo.

Hauv qee tus neeg, txoj kev tsis zoo yuav ua qee yam tshwm sim thiab maj mam tshwm sim.

Teeb meem ntawm WM yuav suav nrog:

• Hloov pauv ntawm lub hlwb kev xav, tejzaum nws ua rau tsis nco qab lawm
• Lub plawv tsis ua hauj lwm
• Lub plab zom mov txhaws ntshav lossis malabsorption
• Cov teeb meem tsis pom kev
• Khaus Khawb

Hu rau koj tus kws kho mob yog tias muaj cov tsos mob ntawm WM.

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

• Waldenström
• Tshuaj tua kabmob

Kapoor P, Ansell SM, Fonseca R, li al. Kev kuaj mob thiab kev tswj hwm ntawm Waldenström macroglobulinemia: Mayo stratification ntawm macroglobulinemia thiab kev pheej hmoo los kho mob (mSMART) cov lus qhia 2016. JAMA Oncol. 2017; 3 (9): 1257-1265. PMID: 28056114 pubmed.ncbi.nlm.nih.gov/28056114/.

Rajkumar SV. Plasma cell cuam tshuam. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil Tshuaj. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 178.

Treon SP, Castillo JJ, Hunter ZR, Merlini G. Waldenström macroglobulinemia / lymphoplasmacytic lymphoma. Hauv: Hoffman R, Benz EJ, Silberstein LE, li al, eds. Hematology: Qhov Ntsiab Cai thiab Kev Coj Ua. 7 tus ed. Philadelphia, PA: Elsevier; 2018: chap 87.