Ingabe Iphathwa Kanjani i-Chronic Myeloid Leukemia (CML)?

-Delile

• I-CML iphathwa kanjani?
• Imithi yokwelashwa ehlosiwe
• I-Imatinib (Gleevec)
• I-Dasatinib (Sprycel)
• I-Nilotinib (Tasigna)
• I-Bosutinib (Bosulif)
• I-Ponatinib (Iclusig)
• Ukwelashwa kwesigaba esisheshayo
• Ukufakelwa kwe-stem cell
• Ukwelashwa ngamakhemikhali
• Ukuhlolwa kwemitholampilo
• Izibhedlela ezihamba phambili zokwelashwa kwe-CML
• Ukubhekana nemiphumela emibi yokwelashwa
• Amathiphu wokuhlala uphilile ngesikhathi sokwelashwa kwe-CML
• Ukusekelwa ngesikhathi sokwelashwa
• Izindlela zokwelashwa kwe-homeopathic
• Umbono

I-CML iphathwa kanjani?

I-Chronic myeloid leukemia (CML) uhlobo lomdlavuza oluthinta umnkantsha. Iqala kumaseli akha igazi, amaseli omdlavuza akha kancane ngokuhamba kwesikhathi. Amaseli agulayo awafi lapho kufanele futhi kancane kancane aminyanise amangqamuzana aphilile.

I-CML kungenzeka idalwe ukuguquka kwezakhi zofuzo okwenza ukuthi iseli legazi likhiqize amaprotheni amaningi we-tyrosine kinase. Le phrotheni yiyo evumela ukuthi amangqamuzana omdlavuza akhule futhi ande.

Kunezinketho zokwelashwa ezahlukahlukene ze-CML. Lezi zindlela zokwelashwa zigxila ekususeni amangqamuzana egazi aqukethe ukuguquka kwezakhi zofuzo. Lapho la maseli esuswa ngempumelelo, lesi sifo singangena ekuxolelweni.

Imithi yokwelashwa ehlosiwe

Isinyathelo sokuqala ekwelashweni imvamisa kuyisigaba semithi ebizwa nge-tyrosine kinase inhibitors (TKIs). Lokhu kusebenza kahle ekuphatheni i-CML lapho kusesigabeni esingalapheki, okuyilapho inani lamangqamuzana omdlavuza egazini noma emnkantsheni wethambo lincane.

Ama-TKI asebenza ngokuvimba isenzo se-tyrosine kinase nokumisa ukukhula kwamangqamuzana omdlavuza amasha. Le mithi ingathathwa ngomlomo ekhaya.

Ama-TKIs abe ukwelashwa okujwayelekile kwe-CML, futhi kuneziningi ezitholakalayo. Kodwa-ke, akuwona wonke umuntu ophendula ekwelashweni ngama-TKIs. Abanye abantu bangaze bangazweli. Kulezi zimo, kunganconywa umuthi ohlukile noma ukwelashwa.

Abantu abaphendula ekwelashweni ngama-TKI kaningi badinga ukuwaphuza unomphela. Ngenkathi ukwelashwa kwe-TKI kungaholela ekuxolelweni, akuqedi ngokuphelele i-CML.

I-Imatinib (Gleevec)

IGleevec bekuyi-TKI yokuqala ukungena emakethe. Abantu abaningi abane-CML baphendula ngokushesha ku-Gleevec. Imiphumela emibi ivame ukuba mncane futhi ingafaka:

• isicanucanu nokuhlanza
• isifo sohudo
• ukukhathala
• ukwanda ketshezi, ikakhulukazi ebusweni, esiswini nasemilenzeni
• Ubuhlungu bamalunga nemisipha
• ukuqubuka kwesikhumba
• ukubalwa kwegazi okuphansi

I-Dasatinib (Sprycel)

I-Dasatinib ingasetshenziswa njengokwelashwa komugqa wokuqala, noma lapho i-Gleevec ingasebenzi noma ingenakubekezelelwa. I-Sprycel inemiphumela emibi efanayo ne-Gleevec.

I-Sprycel nayo ibonakala ikhulisa ubungozi be-pulmonary arterial hypertension (PAH).I-PAH yisimo esiyingozi esenzeka lapho umfutho wegazi uphezulu kakhulu emithanjeni yamaphaphu.

Omunye umphumela ongemuhle kakhulu weSprycel ubungozi obengeziwe bokuchithwa kwe-pleural. Yilapho-ke uketshezi lukhula luzungeze amaphaphu. I-Sprycel ayinconywa kulabo abanezinkinga zenhliziyo noma zamaphaphu.

I-Nilotinib (Tasigna)

NjengoGleevec noSprycel, iNilotinib (Tasigna) nayo ingaba ukwelashwa komugqa wokuqala. Ngokwengeziwe, ingasetshenziswa uma ezinye izidakamizwa zingasebenzi noma imiphumela emibi mikhulu kakhulu.

I-Tasigna inemiphumela engemihle efanayo namanye ama-TKIs, kanye neminye imiphumela emibi engaba yimbi kakhulu odokotela okufanele bayibheke. Lokhu kungafaka:

• amanyikwe avuthayo
• izinkinga zesibindi
• Izinkinga ze-electrolyte
• ukopha (ukuphuma kwegazi)
• isimo senhliziyo esibi futhi esingaba yingozi esibizwa nge-QT syndrome ende

I-Bosutinib (Bosulif)

Ngenkathi iBosutinib (Bosulif) kwesinye isikhathi ingasetshenziswa njengokwelashwa komugqa wokuqala we-CML, ijwayele ukusetshenziswa kubantu asebevele bazama amanye ama-TKIs.

Ngaphezu kwemiphumela emibi ejwayelekile kwamanye ama-TKIs, iBosulif nayo ingadala ukulimala kwesibindi, ukulimala kwezinso, noma izinkinga zenhliziyo. Kodwa-ke, lezi zinhlobo zemiphumela emibi azivamile.

I-Ponatinib (Iclusig)

I-Ponatinib (Iclusig) ukuphela kwesidakamizwa esikhomba ukuguqulwa kohlobo oluthile. Ngenxa yamandla emiphumela emibi kakhulu, kufanelekile kuphela kulabo abanalokhu kuguqulwa kofuzo noma abazame wonke amanye ama-TKI ngaphandle kwempumelelo.

I-Iclusig inyusa ubungozi bamahlule egazi angadala isifo senhliziyo noma isifo sohlangothi futhi ingadala nokwehluleka kwenhliziyo okucinana. Eminye imiphumela emibi engaba khona ifaka phakathi izinkinga zesibindi kanye namanyikwe avuvukele.

Ukwelashwa kwesigaba esisheshayo

Esigabeni esisheshayo se-CML, amangqamuzana omdlavuza aqala ukwakha ngokushesha okukhulu. Ngenxa yalokhu, abantu abakulesi sigaba kungenzeka bangabi namathuba amancane okuthola impendulo eqhubekayo kwezinye izinhlobo zokwelashwa.

Njengasesigabeni esingapheli, enye yezindlela zokuqala zokwelashwa zesigaba esisheshayo i-CML ukusetshenziswa kwama-TKIs. Uma umuntu esevele ethatha i-Gleevec, umthamo wakhe ungakhuphuka. Kungenzeka futhi ukuthi bazoshintshelwa ku-TKI entsha esikhundleni salokho.

Ezinye izindlela zokwelashwa ezingaba khona zesigaba esisheshayo zifaka ukufakelwa kwe-stem cell noma i-chemotherapy. Lokhu kunganconywa ikakhulukazi kulabo ukwelashwa ngama-TKI okungasebenzanga kubo.

Ukufakelwa kwe-stem cell

Kukonke, inani labantu abasebenza ukufakelwa ama-stem cell kwe-CML ngenxa yokusebenza kwama-TKIs. Ukufakelwa kwesinye isikhathi kunconywa kulabo abangaphendulanga kwezinye izindlela zokwelashwa ze-CML noma abanefomu enobungozi obukhulu be-CML.

Ekufakelweni kwe-stem cell, imithamo ephezulu yemithi yokwelapha ngamakhemikhali isetshenziselwa ukubulala amaseli emnkantsheni wakho wethambo, kufaka phakathi amangqamuzana omdlavuza. Ngemuva kwalokho, amaseli ama-stem akha igazi avela kumnikeli, imvamisa oyiselamani noma ilunga lomndeni, afakwa egazini lakho.

Lawa maseli amasha abaxhasi angaqhubeka esikhundleni samangqamuzana omdlavuza asuswe yi-chemotherapy. Sekukonke, ukufakelwa kwe-stem cell yilona kuphela uhlobo lokwelashwa olungaphulukisa i-CML.

Ukufakelwa kwama-stem cell kungaba nzima kakhulu emzimbeni futhi kube nengozi yemiphumela emibi kakhulu. Ngenxa yalokhu, bangahle banconyelwe kuphela abantu abane-CML abasebasha futhi abanempilo ejwayelekile.

Ukwelashwa ngamakhemikhali

I-Chemotherapy kwakuyindlela ejwayelekile yokwelashwa kwe-CML ngaphambi kwama-TKIs. Kusasiza kwezinye iziguli ezingazange zithole imiphumela emihle ngama-TKIs.

Kwesinye isikhathi, kuzobekwa i-chemotherapy kanye ne-TKI. I-Chemotherapy ingasetshenziselwa ukubulala amangqamuzana anomdlavuza akhona, kuyilapho ama-TKI egcina amangqamuzana omdlavuza amasha ekwakhekeni.

Imiphumela emibi ehlotshaniswa nokwelashwa ngamakhemikhali incike kumuthi wamakhemikhali othathwayo. Zingafaka izinto ezifana:

• ukukhathala
• isicanucanu nokuhlanza
• ukulahleka kwezinwele
• ukuqubuka kwesikhumba
• ukwanda kokungenwa yizifo
• ukungazali

Ukuhlolwa kwemitholampilo

Ukuhlolwa kwemitholampilo okugxile ekwelashweni kwe-CML kuyaqhubeka. Inhloso yalezi zivivinyo ngokujwayelekile ukuhlola ukuphepha nokusebenza kwezindlela ezintsha zokwelapha ze-CML noma ukuthuthuka ekwelashweni kwe-CML okukhona.

Ukubamba iqhaza esivivinyweni somtholampilo kungakunika ukufinyelela kuzinhlobo zokwelashwa ezintsha sha, nezintsha kakhulu. Kodwa-ke, kubalulekile futhi ukukhumbula ukuthi ukwelashwa okusetshenziswe esivivinyweni somtholampilo kungahle kungabonakali ukuthi kusebenza kahle njengokwelashwa okujwayelekile kwe-CML.

Uma unentshisekelo yokubhalisa esivivinyweni somtholampilo, khuluma nodokotela wakho. Bangakunika umbono wokuthi yiziphi izilingo ongafaneleka kuzo kanye nezinzuzo nezingozi ezahlukahlukene ezihlotshaniswa nenye yazo.

Uma ungathanda ukuthola umbono wokuhlolwa okwenzekayo njengamanje, kukhona ezinye izinsiza ongazithola. INational Cancer Institute igcina izivivinyo ze-CML ezisekelwa yi-NCI zamanje. Ngokwengeziwe, iClinicalTrials.gov iyi-database eseshekayo yokuhlolwa komtholampilo ngasese nangasese.

Izibhedlela ezihamba phambili zokwelashwa kwe-CML

Ngemuva kokuxilongwa komdlavuza, uzofuna ukuthola isibhedlela esinabachwepheshe abagxile ekwelashweni kwe-CML. Kunezindlela ezimbalwa ongakwenza ngazo lokhu:

• Cela ukuthunyelwa. Udokotela wakho oyinhloko angakwazi ukukunikeza imininingwane ngezibhedlela ezihamba phambili endaweni yakho yokwelapha i-CML.
• Sebenzisa iKhomishini Yesibhedlela Esinomdlavuza. Iphethwe yi-American College of Odgeons, leli thuluzi likuvumela ukuba uqhathanise izindawo ezahlukahlukene zokwelashwa komdlavuza endaweni yakho.
• Bheka izikhungo ezikhethiwe zeNational Cancer Institute. Lokhu kungafaka izikhungo ezinikeza ukwelashwa komdlavuza okuyisisekelo ekunakekelweni okukhethekile, okuphelele. Ungathola uhlu lwazo.

Ukubhekana nemiphumela emibi yokwelashwa

Eminye imiphumela emibi ejwayelekile ekwelashweni okuningi kwe-CML ifaka izinto ezinjengalezi:

• ukukhathala
• izinhlungu nezinhlungu
• isicanucanu nokuhlanza
• ukubalwa kwegazi okuphansi

Ukukhathala kungancipha futhi kugeleze. Kwezinye izinsuku ungaba namandla amaningi, kanti ezinye izinsuku ungazizwa ukhathele kakhulu. Ukuvivinya umzimba kungasetshenziselwa ukulwa nokukhathala. Khuluma nodokotela wakho mayelana nokuthi yiziphi izinhlobo zomsebenzi ongakulungela.

Udokotela wakho uzophinde asebenze nawe ukuthuthukisa uhlelo lokusiza ukuphatha izinhlungu. Lokhu kungafaka izinto njengokuthatha imishanguzo enqunyiwe, ukuhlangana nodokotela wezinhlungu, noma ukusebenzisa izindlela zokwelapha ezihambisanayo njenge-massage noma i-acupuncture.

Imithi ingasiza ekunciphiseni izimpawu ezifana nesicanucanu nokuhlanza. Ngokwengeziwe, ungakhetha ukugwema ukudla noma iziphuzo ezenza lezi zimpawu zibe zimbi kakhulu.

Ukubalwa kwegazi okuphansi kungakwenza uthambekele kakhulu ezimeni eziningana njenge-anemia, ukopha kalula, noma ukwehla ngezifo. Ukuqapha lezi zimo kubaluleke kakhulu ukuze ukwazi ukubona izimpawu zazo futhi ufune ukunakekelwa okufika ngesikhathi.

Amathiphu wokuhlala uphilile ngesikhathi sokwelashwa kwe-CML

Landela izeluleko ezingeziwe ezingezansi ukusiza ukuhlala uphilile ngangokunokwenzeka ngenkathi uthola ukwelashwa kwe-CML:

• Qhubeka nokuhlala uvivinya umzimba.
• Yidla ukudla okunempilo, ugxile kwizithelo nemifino emisha.
• Nciphisa inani lotshwala obudlayo.
• Geza izandla zakho njalo bese uhlanza izindawo ezithinta kakhulu ukugwema ukuthola ukutheleleka.
• Zama ukuyeka ukubhema.
• Thatha yonke imithi njengoba iqondisiwe.
• Vumela ithimba lakho lokunakekela likwazi uma uhlangabezana nezimpawu ezintsha noma eziya ziba zimbi.

Ukusekelwa ngesikhathi sokwelashwa

Kuyinto ejwayelekile ngokuphelele ukuzwa izinto ezahlukahlukene ngenkathi uselashwa i-CML. Ngaphezu kokubhekana nemiphumela yokwelashwa emzimbeni, kwesinye isikhathi ungazizwa ukhungathekile, ukhathazekile noma udabukile.

Vuleleka futhi uthembeke kubathandekayo bakho mayelana nokuthi uzizwa kanjani. Khumbula ukuthi kungenzeka bafuna izindlela zokukusekela, ngakho-ke bazise ukuthi bangasiza kanjani. Lokhu kungabandakanya izinto ezinjengokusebenza ngandlela thile, ukusiza endlini, noma ngisho nokubolekisa indlebe.

Kwesinye isikhathi, ukukhuluma nochwepheshe wezempilo yengqondo ngemizwa yakho nakho kungasiza. Uma lokhu kuyinto onentshisekelo kuyo, udokotela wakho angakusiza ukukudlulisela kumeluleki noma kumelaphi.

Ngokwengeziwe, ukwabelana ngokuhlangenwe nakho kwakho nabanye abadlula kokufanayo nakho kungasiza kakhulu. Qiniseka ukuthi ubuza ngamaqembu okusekela umdlavuza endaweni yangakini.

Izindlela zokwelashwa kwe-homeopathic

Imithi ehambisanayo neyenye indlela (i-CAM) ifaka imikhuba yezempilo engajwayelekile, efana ne-homeopathy, esetshenziswa esikhundleni sezindlela zokwelashwa ezivamile.

Okwamanje azikho izindlela zokwelashwa ze-CAM ezifakazelwe ukuthi ziphatha ngqo i-CML.

Kodwa-ke, ungathola ukuthi ezinye izinhlobo ze-CAM zikusiza ukuba ubhekane nezimpawu ze-CML noma imiphumela emibi yomuthi njengokukhathala noma ubuhlungu. Ezinye izibonelo zingafaka izinto ezifana:

• ukubhucungwa umzimba
• i-yoga
• ukutshopa
• ukuzindla

Njalo khuluma nodokotela wakho ngaphambi kokuqala noma yiluphi uhlobo lokwelashwa kwe-CAM. Kungenzeka ukuthi ezinye izinhlobo zokwelashwa kwe-CAM zingenza ukwelashwa kwakho kwe-CML kungasebenzi kahle.

Umbono

Ukwelashwa komugqa wokuqala we-CML ama-TKIs. Yize le mithi inemiphumela emibi ethile, eminye yayo ingaba mibi, ivame ukusebenza ngempumelelo kakhulu ekwelapheni i-CML.

Eqinisweni, amazinga okusinda eminyaka engu-5 no-10 we-CML kusukela ekuqaleni kwethulwa ama-TKIs. Ngenkathi abantu abaningi bengena ekuxolelweni ngenkathi bekuma-TKIs, imvamisa badinga ukuqhubeka nokubathatha impilo yabo yonke.

Akuwona wonke amacala e-CML aphendula ekwelashweni ngama-TKIs. Abanye abantu bangakhula ukumelana nabo, kanti abanye bangaba nezinhlobo zezifo ezinolaka noma ezinobungozi obukhulu. Kulezi zimo, i-chemotherapy noma ukufakelwa kwe-stem cell kunganconywa.

Kuhlale kubalulekile ukukhuluma nodokotela wakho ngaphambi kokuqala ukwelashwa okusha kwe-CML. Bangakunika umbono wezinhlobo zemiphumela emibi ongayithola kanye nezindlela zokukusiza ubhekane nayo.