I-lymphocytic leukemia Engapheli (CLL)

-Delile

• Iyini i-lymphocytic leukemia (CLL) engapheli?
• Ziyini izimpawu ze-CLL?
• Yini ukwelashwa kwe-CLL?
• Ukwelashwa ngamakhemikhali
• Imisebe
• Izindlela zokwelashwa ezihlosiwe
• Umnkantsha we-Bone noma i-peripheral blood stem cell transplant
• Ukumpontshelwa igazi
• Ukuhlinzwa
• Ixilongwa kanjani i-CLL?
• Qedela ukubalwa kwegazi (CBC) okunomehluko wamaseli amhlophe egazi (WBC)
• Ukuhlolwa kwe-Immunoglobulin
• Umnkantsha wethambo
• Iskena se-CT
• Ukugeleza kwe-cytometry ne-cytochemistry
• Ukuhlolwa kwe-genomic kanye ne-molecular
• Lithini inani lokusinda labantu abane-CLL?
• Ihlelwa kanjani i-CLL?
• Yini ebangela i-CLL, futhi ngabe zikhona izinto eziyingozi kulesi sifo?
• Ingabe zikhona izinkinga ezikhona zokwelashwa?
• Uyini umbono wesikhathi eside we-CLL?

Izithombe ze-Getty

Iyini i-lymphocytic leukemia (CLL) engapheli?

I-leukemia wuhlobo lomdlavuza ohilela amangqamuzana egazi lomuntu namaseli akha igazi. Kunezinhlobo eziningi ze-leukemia, ngayinye ethinta izinhlobo ezahlukene zamaseli egazi. I-lymphocytic leukemia engapheli, noma i-CLL, ithinta ama-lymphocyte.

Ama-lymphocyte awuhlobo lwamaseli amhlophe egazi (WBC). I-CLL ithinta ama-lymphocyte B, abizwa nangokuthi ama-B cell.

Amaseli B ajwayelekile ajikeleza egazini lakho futhi asize umzimba wakho ukulwa nokutheleleka. Amaseli B Anomdlavuza awalwi nezifo njengoba kwenza amaseli B ajwayelekile. Njengoba inani lamangqamuzana B anomdlavuza landa kancane kancane, aminyanisa ama-lymphocyte ajwayelekile.

I-CLL uhlobo oluvame kakhulu lwe-leukemia kubantu abadala. INational Cancer Institute (NCI) ilinganisela ukuthi amacala amasha angama-21,040 azokwenzeka e-United States ngo-2020.

Ziyini izimpawu ze-CLL?

Abanye abantu abane-CLL kungenzeka bangabi nazimpawu, kanti umdlavuza wabo ungatholwa kuphela ngesikhathi sokuhlolwa kwegazi okujwayelekile.

Uma unezimpawu, zifaka phakathi:

• ukukhathala
• imfiva
• ukutheleleka okuvamile noma ukugula
• ukuncipha kwesisindo okungaqondakali noma okungahlosiwe
• ukujuluka ebusuku
• Ukugodola
• ama-lymph node avuvukile

Ngesikhathi sokuhlolwa komzimba, udokotela wakho angathola futhi ukuthi ubende bakho, isibindi noma ama-lymph node akhulisiwe. Lokhu kungaba yizimpawu zokuthi umdlavuza ususabalele kulezi zitho. Lokhu kuvame ukwenzeka ezimeni ezisezingeni eliphakeme ze-CLL.

Uma lokhu kwenzeka kuwe, ungahle uzwe izigaxa ezibuhlungu entanyeni yakho noma ukuzwa ukugcwala noma ukuvuvukala esiswini sakho.

Yini ukwelashwa kwe-CLL?

Uma une-CLL enobungozi obuphansi, udokotela wakho angakweluleka ukuthi umane ulinde futhi ubuke izimpawu ezintsha. Isifo sakho kungenzeka singabi sibi kakhulu noma sidinge ukwelashwa iminyaka. Abanye abantu abalokothi badinge ukwelashwa.

Kwezinye izimo ze-CLL ezinobungozi obuphansi, udokotela wakho angancoma ukwelashwa. Isibonelo, bangancoma ukwelashwa uma une:

• izifo eziphikelelayo, eziphindaphindayo
• ukubalwa kwamaseli egazi aphansi
• ukukhathala noma ukujuluka ebusuku
• ama-lymph node abuhlungu

Uma une-CLL ephakathi noma engcupheni enkulu, udokotela wakho mhlawumbe uzokweluleka ukuthi uqhubeke nokwelashwa khona manjalo.

Ngezansi kukhona eminye imithi ongayincoma udokotela wakho.

Ukwelashwa ngamakhemikhali

I-Chemotherapy iyindlela yokwelashwa eyinhloko ye-CLL. Kubandakanya ukusebenzisa imithi ukubulala amangqamuzana omdlavuza. Ngokuya ngemithi ngqo odokotela bakho abakunikeze yona, ungabathatha ngemithambo yegazi noma ngomlomo.

Imisebe

Kule nqubo, izinhlayiya zamandla aphezulu noma amagagasi asetshenziselwa ukubulala amangqamuzana omdlavuza. Imisebe ayivamisile ukusetshenziselwa i-CLL, kepha uma unama-lymph node abuhlungu, avuvukile, ukwelashwa ngemisebe kungasiza ekunciphiseni nasekudambiseni ubuhlungu bakho.

Izindlela zokwelashwa ezihlosiwe

Imithi ehlosiwe igxila kofuzo oluthile, amaprotheni, noma izicubu ezinikela ekusindeni kwamangqamuzana omdlavuza. Lokhu kungafaka:

• amasosha omzimba monoclonal, anamathisela amaprotheni
• kinase inhibitors ezingabhubhisa amangqamuzana omdlavuza ngokuvimba ama-enzyme athile we-kinase

Umnkantsha we-Bone noma i-peripheral blood stem cell transplant

Uma une-CLL enobungozi obukhulu, lokhu kwelashwa kungaba yindlela. Kubandakanya ukuthatha ama-stem cells emnkantsheni wegazi noma egazini lomnikeli - imvamisa ilungu lomndeni - bese uwafaka emzimbeni wakho ukusiza ukusungula umnkantsha onempilo.

Ukumpontshelwa igazi

Uma ukubalwa kwamaseli egazi akho kuphansi, kungadingeka ukuthi udluliselwe ukumpontshelwa igazi ngomugqa we-intravenous (IV) ukuze uwenyuse.

Ukuhlinzwa

Kwezinye izimo, udokotela wakho angancoma ukuhlinzwa ukuze kususwe ubende uma kukhuliswa ngenxa ye-CLL.

Ixilongwa kanjani i-CLL?

Uma udokotela wakho esola ukuthi une-CLL, bangasebenzisa izivivinyo ezahlukahlukene ukuqinisekisa ukuxilongwa. Isibonelo, bangahle ba-oda ukuhlolwa okukodwa noma okuningi okulandelayo.

Qedela ukubalwa kwegazi (CBC) okunomehluko wamaseli amhlophe egazi (WBC)

Udokotela wakho angasebenzisa lokhu kuhlolwa kwegazi ukukala inani lezinhlobo ezahlukahlukene zamaseli egazini lakho, kufaka phakathi izinhlobo ezahlukahlukene zama-WBCs.

Uma une-CLL, uzoba nama-lymphocyte amaningi kunokujwayelekile.

Ukuhlolwa kwe-Immunoglobulin

Udokotela wakho angasebenzisa lokhu kuhlolwa kwegazi ukuze afunde uma unamasosha omzimba anele ukulwa nezifo.

Umnkantsha wethambo

Kule nqubo, udokotela wakho ufaka inaliti eneshubhu ekhethekile ethanjeni lakho lesinqe noma ithambo lesifuba ukuze uthole isampula lomnkantsha wakho wokuhlola.

Iskena se-CT

Udokotela wakho angasebenzisa izithombe ezenziwe i-CT scan ukubheka ama-lymph node avuvukile esifubeni noma esiswini sakho.

Ukugeleza kwe-cytometry ne-cytochemistry

Ngalezi zivivinyo, amakhemikhali noma amadayi asetshenziselwa ukubona omaka abahlukile kumaseli womdlavuza ukusiza ukuthola uhlobo lwe-leukemia. Isampula yegazi konke okudingekayo kulezi zivivinyo.

Ukuhlolwa kwe-genomic kanye ne-molecular

Lokhu kuhlolwa kubheka izakhi zofuzo, amaprotheni, kanye nezinguquko ze-chromosome ezingaba ngezinhlobo ezithile ze-leukemia. Zisiza futhi ukunquma ukuthi isifo sizothuthuka ngokushesha kangakanani futhi zisize udokotela wakho ukuthi akhethe izindlela zokwelashwa azokusebenzisa.

Ukuhlolwa kofuzo ukuthola lezo zinguquko noma ukuguqulwa komzimba kungafaka i-fluorescence in situ hybridization (FISH) kanye ne-polymerase chain reaction.

Lithini inani lokusinda labantu abane-CLL?

Izinga lokusinda leminyaka emihlanu kwabaseMelika abane-CLL lingamaphesenti angama-86.1, ngokusho kweNCI. Lesi sikhungo sibuye silinganisele ukuthi i-CLL izoholela ekufeni kwabantu abangu-4,060 e-United States ngo-2020.

Amanani okusinda aphansi kubantu asebekhulile abanalesi simo.

Ihlelwa kanjani i-CLL?

Uma udokotela wakho enquma ukuthi une-CLL, bazo-oda ukuqhutshekelwa kokuhlolwa ukukala ubukhulu besifo. Lokhu kusiza udokotela wakho ahlukanise isigaba somdlavuza, esizohola uhlelo lwakho lokwelashwa.

Ukuze ubeke i-CLL yakho, udokotela wakho mhlawumbe uzo-oda ukuhlolwa kwegazi ukuthola inani lakho elibomvu le-cell (RBC) kanye nenani elithile le-lymphocyte yegazi. Futhi bazobheka ukuthi ama-lymph node, ubende, noma isibindi sakho sikhulisiwe yini.

Ngaphansi kohlelo lwe-Rai lokuhlelwa, i-CLL ihlelwe kusuka ku-0 kuye ku-4. Isigaba se-Rai 0 CLL sinzima kakhulu, kanti i-Rai isigaba 4 yiso esithuthuke kakhulu.

Ngenhloso yokwelashwa, izigaba nazo zihlelwe zaba ngamazinga engcuphe. Isigaba se-Rai 0 sinobungozi obuphansi, izigaba ze-Rai 1 no-2 ziyingozi ephakathi, kanti izigaba ze-Rai 3 no-4 zisengozini enkulu, kuchaza i-American Cancer Society.

Nazi ezinye izimpawu ezijwayelekile ze-CLL esigabeni ngasinye:

• Isigaba 0: amazinga aphezulu ama-lymphocyte
• Isigaba 1: amazinga aphezulu ama-lymphocyte; ama-lymph node akhulisiwe
• Isigaba 2: amazinga aphezulu ama-lymphocyte; ama-lymph node angakhuliswa; ubende obukhulisiwe; isibindi esikhulisiwe
• isigaba 3: amazinga aphezulu ama-lymphocyte; i-anemia; Ama-lymph node, ubende, noma isibindi kungakhuliswa
• isigaba 4: amazinga aphezulu ama-lymphocyte; Ama-lymph node, ubende, noma isibindi kungakhuliswa; i-anemia engenzeka; amazinga aphansi wamaplatelets

Yini ebangela i-CLL, futhi ngabe zikhona izinto eziyingozi kulesi sifo?

Ochwepheshe abazi kahle ukuthi yini ebangela i-CLL. Kodwa-ke, kunezici zobungozi ezandisa amathuba okuthi umuntu athuthukise i-CLL.

Nazi ezinye zezinto ezinobungozi ezinamandla okukhulisa amathuba omuntu wokuthuthukisa i-CLL:

• Ubudala. I-CLL ayitholakali kutholakala kubantu abangaphansi kweminyaka engama-40 ubudala. Iningi lamacala e-CLL atholakala kubantu abaneminyaka engaphezu kwengama-50. Isilinganiso seminyaka yabantu abatholakala bene-CLL singama-71.
• Ucansi. Ithinta abesilisa abaningi kunabesifazane.
• Ubuhlanga. Kuvame kakhulu kubantu abadabuka eRussia naseYurophu futhi akuvamile ukutholakala kubantu baseMpumalanga Asia nabaseNingizimu-mpumalanga Asia.
• I-monoclonal B-cell lymphocytosis. Kunobungozi obuncane bokuthi lesi simo, esidala amazinga aphezulu we-lymphocyte, singaphenduka sibe yi-CLL.
• Imvelo. UMnyango Wezilwane Zase-United States wawuhlanganisa nokuchayeka ku-Agent Orange, isikhali samakhemikhali esasetshenziswa phakathi neMpi yaseVietnam, njengengozi ye-CLL.
• Umlando womndeni. Abantu abanezihlobo eziseduze ezinesifo se-CLL banengozi enkulu ye-CLL.

Ingabe zikhona izinkinga ezikhona zokwelashwa?

I-Chemotherapy inciphisa amasosha akho omzimba, ikushiye usengozini yokutheleleka. Ungakha futhi amazinga angajwayelekile wama-antibodies kanye nokubalwa kwamaseli egazi aphansi ngesikhathi se-chemotherapy.

Eminye imiphumela emibi ejwayelekile ye-chemotherapy ifaka:

• ukukhathala
• ukulahleka kwezinwele
• izilonda zomlomo
• ukulahlekelwa isifiso sokudla
• isicanucanu nokuhlanza

Kwezinye izimo, i-chemotherapy ingasiza ekuthuthukiseni amanye umdlavuza.

Ukushiswa ngemisebe, ukumpontshelwa igazi, nomnkantsha noma ukufakelwa amangqamuzana egazi asemaphethelweni egazi nakho kungabandakanya imiphumela emibi.

Ukubhekana nemiphumela ethile engemihle, udokotela wakho angakunikeza:

• IV i-immunoglobulin
• ama-corticosteroids
• ukususwa kobende
• umuthi we-rituximab

Khuluma nodokotela wakho ngemiphumela emibi elindelekile yokwelashwa kwakho. Bangakutshela ukuthi yiziphi izimpawu nemiphumela emibi edinga ukunakekelwa kwezempilo.

Uyini umbono wesikhathi eside we-CLL?

Amanani okusinda we-CLL ahluka kakhulu. Ubudala bakho, ubulili, ukungajwayelekile kwe-chromosome, kanye nezici zesifo somdlavuza kungathinta umbono wakho wesikhathi eside. Lesi sifo aselapheki kakhulu, kepha abantu abaningi baphila iminyaka eminingi nge-CLL.

Buza udokotela wakho mayelana necala lakho elithile. Bangakusiza uqonde ukuthi umdlavuza wakho usukhule kangakanani. Bangabuye baxoxe ngezinketho zakho zokwelashwa kanye nombono wesikhathi eside.