I-Chronic Lymphoid Leukemia: kuyini, izimpawu nokwelashwa

-Delile

• Izimpawu ze-LLC
• Ukuxilongwa kwenziwa kanjani
• Ukwelashwa kwe-LLC

I-Chronic Lymphoid Leukemia, eyaziwa nangokuthi i-LLC noma i-chronic lymphocytic leukemia, uhlobo lwe-leukemia olubonakala ngokwanda kwenani lama-lymphocyte avuthiwe egazini lomngcele, ngaphezu kokunyuka kwama-lymph node, ukwehla kwesisindo nokukhathala ngokweqile, ngokwesibonelo .

I-LLC ivame ukutholakala kusukela eminyakeni yobudala engama-65, ngoba lesi sifo sinokuguquguquka okuhamba kancane, futhi izimpawu zivame ukuqashelwa lapho lesi sifo sesivele sisesigabeni esithuthuke kakhulu. Ngenxa yokubambezeleka kokuvela kwezimpawu, lesi sifo sivame ukubonwa ngesikhathi sokuhlolwa kwegazi okujwayelekile, ikakhulukazi ukubalwa kwegazi, lapho kungabonakala khona ukwanda kwenani lama-lymphocyte.

Izimpawu ze-LLC

I-LLC ikhula ngaphezu kwezinyanga noma iminyaka, ngakho-ke, izimpawu zivela kancane kancane, futhi lesi sifo sivame ukukhonjwa lapho sesivele sisesigabeni esithuthuke kakhulu. Izimpawu zokubonisa ze-LLC yilezi:

• Ukwandisa ama-lymph node nama-lymph node;
• Ukukhathala;
• Ukuphefumula okuncane ngesikhathi sokuvivinya umzimba;
• Ukwandiswa kobende, okubizwa nangokuthi i-splenomegaly;
• I-hepatomegaly, okungukukhulisa isibindi;
• Ukutheleleka okuvamile kwesikhumba, umchamo namaphaphu;
• Ukwehla kwesisindo.

Njengoba lesi sifo singazivezi izimpawu esigabeni saso sokuqala, i-LLC ingabonakala ngemuva kokwenza izivivinyo ezijwayelekile, lapho ukwanda kwenani lama-lymphocyte nama-leukocyte kungabonakala ekuhlolweni kwegazi.

Ukuxilongwa kwenziwa kanjani

Ukuxilongwa kwe-Chronic Lymphoid Leukemia kwenziwa ngokuhlaziywa kwamaseli egazi ngomphumela wokubalwa kwegazi okuphelele, okwenziwa ngokuhlaziywa kwesampula segazi. Esibalweni esiphelele segazi se-LLC kungenzeka ukuthi kutholakale i-leukocytosis, imvamisa ingaphezulu kwama-25,000 cells / mm³ wegazi, ne-lymphocytosis ephikelelayo, imvamisa ingaphezulu kwama-lymphocyte ayi-5000 / mm³ wegazi. Ngaphezu kwalokho, ezinye iziguli zine-anemia ne-thrombocytopenia, okuwukwehla kwenani lama-platelet egazini. Bona ukuthi ayini amanani wesethenjwa segazi elimhlophe.

Yize esevuthiwe, ama-lymphocyte akhona egazini lomngcele mancane futhi abuthakathaka futhi, ngakho-ke, ngesikhathi sokwenza i-smear yegazi angadabuka futhi abangele izithunzi zenuzi, ezibizwa nangokuthi izithunzi zeGumprecht, nazo ezibhekelwa ngokuphelele ukuxilongwa.

Yize isibalo segazi sanele ukuqeda ukuxilongwa kwe-leukemia engapheli ye-lymphocytic, ukuhlolwa kwe-immunophenotyping kuyadingeka ukukhomba ubukhona bezimpawu eziqinisekisa ukuthi yi-leukemia ehlobene nokwanda kwama-lymphocyte ohlobo lwe-B nokuthi ahlala njalo. I-Immunophenotyping ithathwa njengezinga legolide lokuhlonza hhayi i-LLC kuphela kepha nezinye izinhlobo ze-leukemia.

Kwezinye izimo, udokotela angacela i-myelogram, okuwukuhlolwa okwenziwe ukuhlaziya amaseli akhona emnkantsheni wethambo, okuthi uma kwenzeka kuyi-LLC unama-lymphocyte angaphezu kwama-30% avuthiwe. Lokhu kuhlolwa, noma kunjalo, akucelwa kakhulu ukuxilonga lesi sifo, kepha ukuthi kuqinisekiswe ukuvela, iphethini lokungena kwama-lymphocyte nokuchaza ukubikezelwa. Qonda ukuthi i-myelogram yenziwa kanjani.

Ukwelashwa kwe-LLC

Ukwelashwa kwe-LLC kwenziwa ngokwesigaba sesifo:

• Ubungozi obuphansi: lapho kutholakala khona kuphela i-leukocytosis ne-lymphocytosis, ngaphandle kwezinye izimpawu. Ngakho-ke, udokotela uhambisana nesiguli futhi akudingekile ukuthi kwenziwe ukwelashwa;
• Ubungozi obuphakathi: lapho i-lymphocytosis, ukwandiswa kwama-lymph node nesibindi noma i-splenomegaly kuqinisekiswa khona, kudinga ukulandelwa kwezokwelapha ukuhlola ukuvela kwesifo nokwelashwa nge-chemo noma i-radiotherapy;
• Ubungozi obukhulu: lapho kutholakala khona izimpawu zesici se-CLL, ngaphezu kwe-anemia ne-thrombocytopenia, futhi ukwelashwa kufanele kuqalwe ngokushesha. Ukwelashwa okunconywe kakhulu kuleli cala ukufakelwa umnkantsha wethambo, futhi kuyadingeka ukwenziwa i-chemo ne-radiotherapy.

Lapho nje kutholakala ukwanda kwenani lama-lymphocyte egazini eliseceleni, kubalulekile ukuthi udokotela ahlole isimo esijwayelekile sesiguli ukuze kutholakale ukuxilongwa kwe-CLL nokwelashwa kungaqalwa nokuqhubeka kwesifo kungagwenywa.

Kokubili i-radiotherapy kanye ne-chemotherapy kungakhubaza kakhulu futhi kuphazamise izinga lomuntu lokuphila. Ngakho-ke, kuyathakazelisa ukuba nokudla okunempilo nokulinganiselayo ukuqinisekisa umuzwa wenhlalakahle nokunciphisa izimpawu ezihambisana nalezi zinhlobo zokwelashwa. Bheka ividiyo elandelayo kokudla okuhle ukukhulula imiphumela emibi yekhemotherapy: