Thrombocythemia ea bohlokoa

Bohlokoa ba thrombocythemia (ET) ke boemo boo mokong oa masapo o hlahisang liplatelete tse ngata haholo. Liplatelete ke karolo ea mali e thusang ho koala mali.

ET e hlahisoa ke tlhahiso e fetelletseng ea liplatelete. Kaha liplatelete tsena ha li sebetse ka mokhoa o tloaelehileng, ho ba le mali le ho tsoa mali ke mathata a tloaelehileng. Ha e sa alafatsoe, ET e mpefala ha nako e ntse e feta.

ET ke karolo ea sehlopha sa maemo a tsejoang e le mathata a myeloproliferative. Tse ling li kenyelletsa:

• Leukemia e sa foleng ea 'mele (kankere e qalang mokong oa masapo)
• Polycythemia vera (lefu la moko oa masapo le lebisang keketseho e sa tloaelehang ea palo ea lisele tsa mali)
• Myelofibrosis ea mantlha (pherekano ea moko oa masapo moo 'moko o nkeloang sebaka ke lisele tsa' mele tse bofubelu)

Batho ba bangata ba nang le ET ba na le phetoho ea lefutso (JAK2, CALR, kapa MPL).

ET e atile haholo bathong ba lilemong tse bohareng. E ka boela ea bonoa ho batho ba bacha, haholo basali ba ka tlase ho lilemo tse 40.

Matšoao a maqeba a mali a ka kenyelletsa tse latelang:

• Ho tšoaroa ke hlooho (e tloaelehileng haholo)
• Ho ruruha, ho bata, kapa ho ba putsoa matsohong le maotong
• Ho ikutloa o tsekela kapa o le hlooho e thata
• Mathata a pono
• Ho otloa hanyane ka hanyane (litlhaselo tsa nakoana tsa ischemic) kapa stroke

Haeba ho tsoa mali ke bothata, matšoao a ka kenyelletsa efe kapa efe ea tse latelang:

• Ho longoa habonolo le ho tsoa mali ka nko ea mali
• Ho tsoa mali ka mpeng, masese, tsamaiso ea ho ntša metsi, kapa letlalo
• Ho tsoa mali ho tsoa mareneneng
• Ho tsoa mali nako e telele ho tsoa ho liopereishene kapa ho tlosoa ha meno

Boholo ba nako, ET e fumanoa ka liteko tsa mali tse etsoang bakeng sa mathata a mang a bophelo pele matšoao a hlaha.

Mofani oa hao oa tlhokomelo ea bophelo a ka 'na a hlokomela sebete se atolositsoeng kapa spleen ha a hlahlojoa' meleng. U kanna oa ba le phallo e sa tloaelehang ea mali menoaneng kapa maotong a bakang tšenyo ea letlalo libakeng tsena.

Liteko tse ling li ka kenyelletsa:

• Tlhahiso ea moko oa masapo
• Palo e felletseng ea mali (CBC)
• Liteko tsa lefutso (ho batla phetoho liphatseng tsa JAK2, CALR, kapa MPL)
• Boemo ba asiti ea Uric

Haeba u na le mathata a sokelang bophelo, u ka ba le kalafo e bitsoang platelet pheresis. E fokotsa kapele liplatelete maling.

Nako e telele, meriana e sebelisoa ho fokotsa palo ea platelet ho qoba mathata. Meriana e tloaelehileng haholo e sebelisitsoeng e kenyelletsa hydroxyurea, interferon-alpha, kapa anagrelide. Ho batho ba bang ba nang le phetoho ea JAK2, li-inhibitors tse khethehileng tsa protheine ea JAK2 li ka sebelisoa.

Ho batho ba kotsing e kholo ea ho koala, aspirin ka tekanyetso e tlase (81 ho isa ho 100 mg ka letsatsi) e ka fokotsa likarolo tsa ho koala.

Batho ba bangata ha ba hloke kalafo efe kapa efe, empa ba tlameha ho lateloa haufi-ufi ke mofani oa bona.

Liphetho li ka fapana. Batho ba bangata ba ka nka nako e telele ntle le mathata mme ba phela nako e tloaelehileng. Ho batho ba fokolang, mathata a tsoang tšollo ea mali le mali a ka baka mathata a tebileng.

Maemong a sa tloaelehang, lefu lena le ka fetoha leukemia e matla kapa myelofibrosis.

Mathata a ka kenyelletsa:

• Lefu la mali le bohloko kapa myelofibrosis
• Ho tsoa mali a mangata (hemorrhage)
• Setorouku, tlhaselo ya pelo, kapa madi a madi matsohong kapa maotong

Bitsa mofani oa hau haeba:

• U tsoa mali a sa hlalosoang a tsoelang pele nako e telele ho feta kamoo a lokelang.
• U hlokomela bohloko ba sefuba, bohloko ba leoto, pherekano, bofokoli, ho ba shohlo, kapa matšoao a mang a macha.

Thrombocythemia ea mantlha; Thrombocytosis ea bohlokoa

• Lisele tsa mali

Mascarenhas J, Iancu-Rubin C, Kremyanskaya M, Najfeld V, Hoffman R. Bohlokoa thrombocythemia. Ka: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Melao-motheo le Tloaelo ea Motheo. La 7th. Philadelphia, PA: Elsevier; 2018: khaolo ea 69.

Tefferi A. Polycythemia vera, thrombocythemia ea bohlokoa, le myelofibrosis ea mantlha. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 166.