I-lymphocytic leukemia engapheli (CLL)

I-chronic lymphocytic leukemia (CLL) umdlavuza wohlobo lwamaseli amhlophe egazi abizwa ngama-lymphocyte. Lawa maseli atholakala emnkantsheni wethambo nakwezinye izingxenye zomzimba. Umnkantsha wethambo yizicubu ezithambile ezisenkabeni yamathambo ezisiza ukwakha wonke amaseli egazi.

I-CLL ibangela ukwanda kancane kohlobo oluthile lwamaseli amhlophe egazi abizwa ngama-B lymphocyte, noma amaseli B. Amaseli womdlavuza asakazeka egazini nasemnkantsheni wethambo. I-CLL nayo ingathinta ama-lymph node noma ezinye izitho ezifana nesibindi nobende. I-CLL ekugcineni ingadala ukuthi umnkantsha wethambo ulahlekelwe ngumsebenzi.

Imbangela ye-CLL ayaziwa. Asikho isixhumanisi semisebe. Akucaci ukuthi amakhemikhali athile angadala i-CLL. Ukuvezwa kwe-Agent Orange ngesikhathi seMpi yaseVietnam kuye kwaxhunyaniswa nengozi ethe xaxa yokuthuthukisa i-CLL.

I-CLL ivame ukuthinta abantu abadala asebekhulile, ikakhulukazi labo abangaphezu kweminyaka engama-60. Abantu abangaphansi kweminyaka engama-45 kuyaqabukela beba ne-CLL. I-CLL ivame kakhulu kwabamhlophe kunezinye izinhlanga. Kuvame kakhulu emadodeni kunabesifazane. Abanye abantu abane-CLL banamalungu omndeni analesi sifo.

Izimpawu zivame ukukhula kancane. I-CLL imvamisa ayizibangeli izimpawu ekuqaleni. Kungatholakala ngokuhlolwa kwegazi okwenziwe kubantu ngezinye izizathu.

Izimpawu ze-CLL zingafaka:

• Ama-lymph node akhulisiwe, isibindi noma ubende
• Ukujuluka okweqile, ukujuluka ebusuku
• Ukukhathala
• Imfiva
• Ukutheleleka okuhlala kubuya (kuyaphindeka), ngaphandle kokwelapha
• Ukuphelelwa isifiso sokudla noma ukusutha ngokushesha okukhulu (ukusutha kokuqala)
• Ukwehla kwesisindo

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Ukuhlolwa kokuthola i-CLL kungafaka:

• Qedela ukubalwa kwegazi (CBC) ngokuhlukaniswa kwamaseli egazi.
• Ukuhlolwa kwe-cytometry yokugeleza kwamaseli amhlophe egazi.
• I-Fluorescent in situ hybridization (FISH) isetshenziselwa ukubheka nokubala izakhi zofuzo noma ama-chromosomes. Lokhu kuhlolwa kungasiza ukuxilonga i-CLL noma ukuqondisa ukwelashwa.
• Ukuhlolelwa ezinye izinguquko zofuzo kungasiza ukubikezela ukuthi umdlavuza uzophendula kanjani ekwelashweni.

Abantu abane-CLL bavame ukuba nesibalo samaseli amhlophe aphakeme kakhulu.

Ukuhlolwa okubheka ushintsho ku-DNA ngaphakathi kwamangqamuzana omdlavuza nakho kungenziwa. Imiphumela evela kulezi zivivinyo nasekuhlolweni kwesiteji isiza umhlinzeki wakho ukuthi anqume ukwelashwa kwakho.

Uma unesigaba sokuqala se-CLL, umhlinzeki wakho uzokuqapha nje eduze. Ukwelashwa akuvame ukunikezwa i-CLL yokuqala, ngaphandle uma une:

• Izifo ezilokhu zibuya
• Umdlavuza wegazi okhuphuka ngokushesha
• Iseli elibomvu legazi eliphansi noma ukubalwa kweplatelet
• Ukukhathala, ukulahlekelwa isifiso sokudla, ukunciphisa umzimba, noma ukujuluka ebusuku
• Ama-lymph node avuvukile

I-Chemotherapy, kubandakanya nemithi ehlosiwe, isetshenziselwa ukwelapha i-CLL. Umhlinzeki wakho uzonquma ukuthi yiluphi uhlobo lwemithi olulungele wena.

Ukumpontshelwa igazi noma ukufakwa kwegazi kungadingeka uma isibalo segazi siphansi.

Umongo wethambo noma ukufakelwa kwe-stem cell kungasetshenziswa kubantu abasebasha abane-CLL esezingeni eliphakeme noma enobungozi obukhulu. Ukufakelwa kabusha kuwukuphela kokwelapha okunikeza ikhambi elingaba khona le-CLL, kodwa futhi kunezingozi. Umhlinzeki wakho uzoxoxa nawe ngobungozi nezinzuzo.

Wena nomhlinzeki wakho kungadingeka ukuthi niphathe okunye ukukhathazeka ngesikhathi sokwelashwa kwe-leukemia, kufaka phakathi:

• Ukuphatha izilwane ezifuywayo ngesikhathi se-chemotherapy
• Izinkinga zokopha
• Umlomo owomile
• Ukudla amakhalori anele
• Ukudla okuphephile ngesikhathi sokwelashwa komdlavuza

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Umhlinzeki wakho angaxoxa nawe ngombono we-CLL yakho ngokususelwa esigabeni sayo nokuthi iphendula kahle kanjani ekwelashweni.

Izinkinga ze-CLL nokwelashwa kwayo kungafaka:

• I-autoimmune hemolytic anemia, isimo lapho amaseli abomvu abhujiswa amasosha omzimba
• Ukopha kusuka kunani eliphansi leplatelet
• I-Hypogammaglobulinemia, isimo lapho kunezinga eliphansi lama-antibody kunokujwayelekile, elingakhuphula ubungozi bokutheleleka.
• Idiopathic thrombocytopenic purpura (ITP), isifo sokopha
• Ukutheleleka okuhlala kubuya (kuyaphinda)
• Ukukhathala okungahle kusuka kubumnene kuya kokubi
• Eminye imidlavuza, kufaka phakathi i-lymphoma enolaka kakhulu (ukuguqulwa kweRichter)
• Imiphumela emibi ye-chemotherapy

Shayela umhlinzeki uma uhlakulela ama-lymph node noma ukukhathala okungaqondakali, ukulimaza, ukujuluka ngokweqile, noma ukunciphisa umzimba.

CLL; I-leukemia - i-lymphocytic engapheli (CLL); Umdlavuza wegazi - i-leukemia engapheli ye-lymphocytic; Umdlavuza wamathambo - i-leukemia engapheli ye-lymphocytic; I-Lymphoma - i-leukemia engapheli ye-lymphocytic

• Ukufakelwa komnkantsha wethambo - ukukhipha

• Ukufiswa komnkantsha wethambo
• Izinduku ze-Auer
• I-lymphocytic leukemia engapheli - umbono omncane
• Amasosha omzimba

I-Awan FT, Byrd JC. I-leukemia engapheli ye-lymphocytic. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 99.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwe-lymphocytic leukemia treatment (PDQ) - inguqulo yezobuchwepheshe yezempilo. www.cancer.gov/types/leukemia/hp/cll-treatment-pdq. Kubuyekezwe uJanuwari 22, 2020. Kufinyelelwe ngoFebhuwari 27, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology. I-lymphocytic leukemia engapheli / i-lymphoma encane ye-lymphocytic. Inguqulo 4.2020. www.nccn.org/professionals/physician_gls/pdf/cll.pdf. Kubuyekezwe uDisemba 20, 2019. Kufinyelelwe ngoFebhuwari 27, 2020.