I-acute myeloid leukemia - umuntu omdala

I-acute myeloid leukemia (AML) umdlavuza oqala ngaphakathi komnkantsha wethambo. Lesi isicubu esithambile esisenkabeni yamathambo esisiza ukwakha wonke amaseli egazi. Umdlavuza ukhula usuke kumaseli ngokuvamile abephenduka amaseli amhlophe egazi.

Okumnandi kusho ukuthi lesi sifo sikhula ngokushesha futhi imvamisa sinenkambo yolaka.

I-AML ingenye yezinhlobo ezivame kakhulu ze-leukemia kubantu abadala.

I-AML ivame kakhulu kwabesilisa kunabesifazane.

Umnkantsha wethambo usiza umzimba ukulwa nezifo futhi wenza nezinye izingxenye zegazi. Abantu abane-AML banamaseli amaningi angavamile okuvuthwa ngaphakathi komnkantsha wabo. Amaseli akhula ngokushesha okukhulu, abuyisele amangqamuzana egazi anempilo. Ngenxa yalokho, abantu abane-AML banamathuba amaningi okuthola izifo. Futhi banengozi eyengeziwe yokopha njengoba amanani amaseli egazi aphilile ancipha.

Isikhathi esiningi, umhlinzeki wezokunakekelwa kwempilo akakwazi ukukutshela ukuthi yini ebangelwe yi-AML. Kodwa-ke, izinto ezilandelayo zingaholela kwezinye izinhlobo ze-leukemia, kufaka phakathi i-AML:

• Ukuphazamiseka kwegazi, kufaka phakathi i-polycythemia vera, i-thrombocythemia ebalulekile, ne-myelodysplasia
• Amakhemikhali athile (isibonelo, i-benzene)
• Izidakamizwa ezithile ze-chemotherapy, kufaka phakathi i-etoposide nezidakamizwa ezaziwa njengama-alkylating agents
• Ukuvezwa amakhemikhali athile nezinto ezinobungozi
• Imisebe
• Amasosha omzimba abuthakathaka ngenxa yokufakelwa komzimba

Izinkinga ngezakhi zakho zofuzo nazo zingadala ukuthuthukiswa kwe-AML.

I-AML ayinazo izimpawu ezithile. Izimpawu ezibonwayo ikakhulukazi ngenxa yezimo ezihlobene. Izimpawu ze-AML zingafaka noma yikuphi okulandelayo:

• Ukopha okuphuma emakhaleni
• Ukopha nokuvuvukala (kuyaqabukela) ezinsinini
• Ukulimaza
• Ubuhlungu bamathambo noma isisa
• Imfiva nokukhathala
• Izinkathi ezinzima zokuya esikhathini
• Isikhumba esiphaphathekile
• Ukuphefumula (kuba kubi kakhulu ngokuzivocavoca umzimba)
• Ukwehla kwesisindo

Umhlinzeki uzokwenza ukuhlolwa ngokomzimba. Kungaba nezimpawu zesibindi sokuvuvukala, isibindi noma ama-lymph node. Ukuhlolwa okwenziwe kufaka:

• Ukubalwa kwegazi okuphelele (i-CBC) kungakhombisa i-anemia nenombolo ephansi yama-platelet. Ukubalwa kwamaseli amhlophe egazi (WBC) kungaba phezulu, kube phansi, noma kube okujwayelekile.
• Ukulangazelela umnkantsha we-bone kanye ne-biopsy kuzobonisa uma kukhona amaseli we-leukemia.

Uma umhlinzeki wakho efunda ukuthi unalo lolu hlobo lwe-leukemia, kuzokwenziwa olunye uvivinyo ukuthola uhlobo oluthile lwe-AML. Izinhlobo ezingaphansi zisuselwa kuzinguquko ezithile kuzakhi zofuzo (ukuguquka kwezakhi zofuzo) nokuthi amaseli we-leukemia avele kanjani ngaphansi kwesibonakhulu.

Ukwelashwa kubandakanya ukusebenzisa imithi (i-chemotherapy) ukubulala amangqamuzana omdlavuza. Izinhlobo eziningi ze-AML ziphathwa ngemithi engaphezu kweyodwa yamakhemikhali.

I-Chemotherapy ibulala namaseli ajwayelekile, futhi. Lokhu kungadala imiphumela emibi efana nale:

• Ingozi eyengeziwe yokopha
• Ingozi eyengeziwe yokutheleleka (udokotela wakho angafuna ukukugcina kude nabanye abantu ukuvikela ukutheleleka)
• Ukwehla kwesisindo (uzodinga ukudla amakhalori athe xaxa)
• Izilonda zomlomo

Ezinye izindlela zokweseka i-AML zingafaka:

• Ama-antibiotic ukwelapha ukutheleleka
• Ukumpontshelwa kwamangqamuzana egazi abomvu ukulwa ne-anemia
• Ukumpontshelwa Platelet ukulawula ukopha

Ukufakelwa komnkantsha (stem cell) kungazama. Lesi sinqumo sinqunywa yizici eziningana, kufaka phakathi:

• Iminyaka yakho nempilo yonke
• Izinguquko ezithile zofuzo kumaseli wegazi
• Ukutholakala kwabaxhasi

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

Lapho i-biopsy yomnkantsha ingabonisi bufakazi be-AML, kuthiwa uxolelwe. Wenza kahle kangakanani kuncike empilweni yakho isiyonke nakuhlobo lwezakhi zofuzo zamaseli e-AML.

Ukuxolelwa akufani nokwelashwa. Kudingeka ukwelashwa okwengeziwe, kungaba ngesimo samakhemikhali amaningi noma ukufakelwa umnkantsha wethambo.

Ngokwelashwa, abantu abasha abane-AML bavame ukwenza kangcono kunalabo abahlakulela lesi sifo besebekhulile. Izinga lokusinda leminyaka emihlanu liphansi kakhulu kubantu abadala kunabantu abasha. Ochwepheshe bathi lokhu ngokwengxenye kungenxa yokuthi abantu abasha bakwazi kangcono ukubekezelela imithi enamandla yamakhemikhali. Futhi, i-leukemia kubantu asebekhulile ivame ukumelana nokwelashwa kwamanje.

Uma umdlavuza ungabuyi (ubuyela emuva) kungakapheli iminyaka emihlanu utholakele, kungenzeka ukuthi welaphekile.

Shayela i-aphoyintimenti nomhlinzeki wakho uma:

• Thuthukisa izimpawu ze-AML
• Yiba ne-AML futhi ube nomkhuhlane ongeke uhambe noma ezinye izimpawu zokutheleleka

Uma usebenza ngemisebe noma amakhemikhali axhumene ne-leukemia, hlala ugqoke izinto zokuzivikela.

I-leukemia enamandla kakhulu; I-AML; I-leukemia enamandla ye-granulocytic; I-leukemia enamandla kakhulu ye-nonlymphocytic (ANLL); I-leukemia - i-acute myeloid (AML); I-leukemia - i-granulocytic enamandla; Umdlavuza wegazi - nonlymphocytic (ANLL)

• Ukufakelwa komnkantsha wethambo - ukukhipha

• Izinduku ze-Auer
• I-acute monocytic leukemia - isikhumba
• Amaseli egazi

I-Appelbaum FR. Ama-leukemi acute kubantu abadala. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 95.

UFaderl S, uKantarjian HM. Ukubonakaliswa komtholampilo nokwelashwa kwe-acute myeloid leukemia. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 59.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwabantu abadala i-myeloid leukemia treatment (PDQ) - inguqulo yezempilo. www.cancer.gov/types/leukemia/hp/ultult-aml-treatment-pdq. Kubuyekezwe u-Agasti 11, 2020. Kufinyelelwe ngo-Okthoba 9, 2020.