I-leukemia engapheli yomzimba (CML)

I-chronic myelogenous leukemia (CML) umdlavuza oqala ngaphakathi komnkantsha wethambo. Lesi isicubu esithambile esisenkabeni yamathambo esisiza ukwakha wonke amaseli egazi.

I-CML ibangela ukukhula okungalawuleki kwamaseli angavuthiwe futhi avuthiwe enza uhlobo oluthile lwamaseli amhlophe egazi abizwa ngamaseli we-myeloid. Amaseli agulayo akhela emnkantsheni nasengxenyeni yegazi.

Isizathu se-CML sihlobene ne-chromosome engavamile ebizwa nge-chromosome yaseFiladelphia.

Ukuvezwa kwemisebe kungakhuphula ubungozi bokuthuthukisa i-CML. Ukuvezwa ngemisebe kungaba kusuka ekwelashweni ngemisebe okwakusetshenziswa ukwelapha umdlavuza wegilo noma iHodgkin lymphoma noma inhlekelele yenuzi.

Kuthatha iminyaka eminingi ukuthuthukisa i-leukemia kusuka ekuvezweni ngemisebe. Iningi labantu elilashelwa umdlavuza onemisebe ye-radiation aliyenzi i-leukemia. Futhi iningi labantu abane-CML aliboniswanga imisebe.

I-CML ivame ukwenzeka kubantu abadala abaneminyaka yobudala nasezinganeni.

I-leukemia engapheli emithanjeni ihlelwe ngezigaba:

• Okungapheli
• Kuyashesha
• Inkinga yokuqhuma

Isigaba esingapheli singahlala izinyanga noma iminyaka. Lesi sifo singahle sibe nezimpawu ezimbalwa noma singabi naso ngalesi sikhathi. Iningi labantu litholwa ngalesi sigaba, lapho lihlolwe igazi ngezinye izizathu.

Isigaba esisheshayo yisigaba esiyingozi kakhulu. Amaseli we-leukemia akhula msinyana. Izimpawu ezijwayelekile zifaka imfiva (noma ingenalo igciwane), ubuhlungu bamathambo, nobende obuvuvukele.

I-CML engalashwa iholela esigabeni senkinga yokuqhuma. Ukopha nokutheleleka kungenzeka ngenxa yokwehluleka komnkantsha wethambo.

Ezinye izimpawu ezingaba khona zenkinga yokuqhuma zihlanganisa:

• Ukulimaza
• Ukujuluka okweqile (ukujuluka ebusuku)
• Ukukhathala
• Imfiva
• Ingcindezi ngaphansi kwezimbambo ezingezansi kwesobunxele kusuka ku-spleen evuvukile
• I-Rash - amamaki abomvu abomvu akhomba esikhunjeni (petechiae)
• Ubuthakathaka

Ukuhlolwa komzimba kuvame ukuveza ubende obuvuvukele. Isibalo segazi esiphelele (i-CBC) sikhombisa inani elinyukile lamaseli amhlophe anamafomu amaningi angavuthiwe akhona nenani elikhulisiwe lama-platelet. Lezi yizingxenye zegazi ezisiza ukujiya kwegazi.

Olunye uvivinyo olungenziwa lubandakanya:

• I-bone marrow biopsy
• Ukuhlolwa kwegazi nomnkantsha wamathambo ukuthola i-chromosome yaseFiladelphia
• Ukubalwa kweplatelet

Imithi ekhomba amaprotheni angajwayelekile enziwe yi-chromosome yaseFiladelphia imvamisa iyindlela yokuqala yokwelashwa kwe-CML. Le mithi ingaphuzwa njengamaphilisi. Abantu abaphathwa ngalezi zidakamizwa bavame ukungena ekuxolelweni ngokushesha futhi bangahlala ekuthethelelweni iminyaka eminingi.

Kwesinye isikhathi, i-chemotherapy isetshenziswa kuqala ukunciphisa ukubalwa kwamaseli amhlophe egazi uma kuphezulu kakhulu ekuxilongweni.

Isigaba senkinga yokuqhuma sinzima kakhulu ukwelashwa. Lokhu kungenxa yokuthi kunenani eliphezulu kakhulu lamaseli egazi amhlophe angavuthiwe (amangqamuzana e-leukemia) amelana nokwelashwa.

Ukuphela kokwelapha okwaziwayo kwe-CML ukufakelwa umnkantsha wethambo, noma ukufakelwa kwe-stem cell. Iningi labantu, noma kunjalo, alidingi ukufakelwa kabusha ngoba imithi ehlosiwe iyaphumelela. Xoxa ngezinketho zakho ne-oncologist yakho.

Wena nomhlinzeki wakho wokunakekelwa kwezempilo kungadingeka ukuthi niphathe ezinye izindaba eziningi noma ukukhathazeka ngesikhathi sokwelashwa kwe-leukemia, kufaka phakathi:

• Ukuphatha izilwane ezifuywayo ngesikhathi se-chemotherapy
• Izinkinga zokopha
• Ukudla ama-calories anele uma ugula
• Ukuvuvukala nobuhlungu emlonyeni wakho
• Ukudla okuphephile ngesikhathi sokwelashwa komdlavuza

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

Imithi ehlosiwe ithuthukise kakhulu umbono wabantu abane-CML. Lapho izimpawu nezimpawu ze-CML zihamba futhi ukubalwa kwegazi kanye nomnkantsha wamathambo kubonakala kuyinto ejwayelekile, lowo muntu ubhekwa ekuxolelweni. Iningi labantu lingahlala lithethelelwe iminyaka eminingi ngenkathi likulo muthi.

Ukufakelwa kwe-stem cell noma umnkantsha wethambo kuvame ukubhekwa kubantu abanezifo zabo ezibuyayo noma eziba zimbi kakhulu ngenkathi bethatha imithi yokuqala. Ukufakelwa kungabuye kunconywe kubantu abatholakala besesimweni esisheshayo noma ekuqhumeni kwenhlekelele.

Inkinga yokuqhuma kungaholela ezinkingeni, kufaka phakathi ukutheleleka, ukopha, ukukhathala, umkhuhlane ongachazeki, nezinkinga zezinso. I-Chemotherapy ingaba nemiphumela emibi kakhulu, kuya ngemithi esetshenzisiwe.

Gwema ukuvezwa yimisebe uma kungenzeka.

CML; I-leukemia engapheli ye-myeloid; I-CGL; I-leukemia engapheli ye-granulocytic; I-leukemia - i-granulocytic engapheli

• Ukufakelwa komnkantsha wethambo - ukukhipha

• Ukufiswa komnkantsha wethambo
• I-myelocytic leukemia engapheli - umbono omncane
• I-leukemia engapheli ye-myelocytic
• I-leukemia engapheli ye-myelocytic

UKantarjian H, uCortes J. I-leukemia engapheli ye-myeloid. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 98.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwenguqulo yezempilo ye-myelogenous leukemia treatment (PDQ). www.cancer.gov/types/leukemia/hp/cml-treatment-pdq. Kubuyekezwe uFebhuwari 8, 2019. Kufinyelelwe ngoMashi 20, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology: (imihlahlandlela ye-NCCN) .I-myeloid leukemia engapheli. Inguqulo 3.2020. www.nccn.org/professionals/physician_gls/pdf/cml.pdf. Kubuyekezwe ngoJanuwari 30, 2020. Kufinyelelwe ngoMashi 23, 2020.

I-Radich J. I-leukemia engapheli ye-myeloid. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 175.