Yini Okudingeka Ngiyazi Ngemiphumela Emibi Yokwelapha I-CML? Imibuzo Yodokotela Wakho

-Delile

• Yini engidinga ukuyazi ngemiphumela emibi yezokwelapha ze-CML?
• Ukwelashwa kweTyrosine kinase inhibitor (TKI)
• Ukwelashwa kwe-Biologic
• Ukwelashwa ngamakhemikhali
• Ukufakelwa kwe-stem cell
• I-Splenectomy
• Ingabe zikhona izinketho zokulawula imiphumela emibi?
• Ingabe imiphumela emibi igcina ngemuva kokuphela kokwelashwa?
• Ngingakutholaphi ukwesekwa?
• Ukuthatha

Ukubuka konke

Uhambo lwakho lwe-myeloid leukemia engapheli (i-CML) lungabandakanya ukwelashwa okuhlukahlukene okuhlukahlukene. Ngayinye yalezi zingaba nemiphumela engemihle ehlukile noma izinkinga. Akuwona wonke umuntu ophendula ngendlela efanayo ekungeneleleni, ngakho-ke kwesinye isikhathi udokotela wakho angenza ushintsho ohlelweni lwakho lokwelashwa.

Kungasiza ukukhuluma nodokotela wakho kusengaphambili ngengozi yemiphumela emibi. Le ngxoxo ingakusiza ukuthi uzilungiselele, ikakhulukazi uma izinketho zakho zokwelashwa zishintsha.

Ingakunika necebo lokusebenza. Funda kabanzi ukuze ufunde kabanzi ngokuthi ungaqala kanjani ingxoxo nodokotela wakho ukuze ukwazi ukushiya uzizwa unolwazi.

Yini engidinga ukuyazi ngemiphumela emibi yezokwelapha ze-CML?

Uhlelo lwakho lokwelashwa lwe-CML lungafaka:

• imithi, njengaleyo esetshenziselwa ukwelashwa okuqondisiwe noma i-chemotherapy
• ukufakelwa kwe-stem cell
• i-biologic noma i-immunotherapy
• ukuhlinzwa

Ngayinye yalezi zingenelelo iza nengozi yemiphumela emibi noma yezinkinga. Khumbula, uma udokotela wakho encoma ukwelashwa, bahlulele inzuzo engaba khona yokwelashwa ukudlula izingozi.

Kufanele njalo utshele udokotela wakho uma imiphumela yakho emibi ingavamile, ingalawuleki, noma ikukhathaza. Imiphumela emibi eminingi ingelashwa ngemithi, ngezinye izindlela zokwelashwa, noma ngokwenza izinguquko ohlelweni lwakho lokwelashwa.

Udokotela wakho angakunika imininingwane eminingi yokuthi ungaphatha nini imiphumela emibi ekhaya nokuthi kufanele ufune nini usizo lwezokwelapha.

Ukwelashwa kweTyrosine kinase inhibitor (TKI)

Ama-TKI awuhlobo lwezokwelapha ezihlosiwe, okusho ukuthi zisetshenziselwa ukubulala amangqamuzana omdlavuza ngaphandle kokubangela ukulimala kumaseli aphilile. Isibonelo, imithi engama-TKI ifaka phakathi:

• imatinib mesylate (Gleevec)
• i-dasatinib (Sprycel)
• I-nilotinib (Tasigna)
• bosutinib (Bosulif)
• i-ponatinib (Iclusig)

Kubantu abaningi, i-bosutinib ne-ponatinib zisetshenziswa kuphela ngemuva kokuba ezinye izindlela zokwelapha ze-TKI sezizamile.

Imiphumela emibi ejwayelekile yemithi ye-TKI ifaka:

• isicanucanu
• ukuhlanza
• isikhumba esomile noma esilumayo
• ukukhathala
• ubuhlungu bemisipha
• ubuhlungu obuhlangene

Umuthi ngamunye we-TKI ungaba nemiphumela yawo emibi engaba khona. Okuhlangenwe nakho kwakho kuzoya ngokuthi yimuphi umuthi owuthathayo nokuthi uphendula kanjani kuwo.

Kwezinye izimo, ukwelashwa kwe-TKI kungaba nemiphumela emibi kakhulu, njenge-anemia, izifo noma ukuphuma kwegazi. Lokhu akuvamile. Eminye imiphumela emibi ejwayelekile ifaka phakathi izinkinga zenhliziyo, izinkinga zesibindi, izinkinga zamaphaphu, noma ukugcinwa koketshezi okuzungeze inhliziyo namaphaphu.

Ithimba lakho lokunakekelwa kwezempilo lizokuqapha ngezimpawu zeminye imiphumela emibi kakhulu. Uma ubona ushintsho oluzumayo ocabanga ukuthi lungahle lube yimiphumela emibi yemithi yakho, yazisa udokotela wakho.

Ukwelashwa kwe-Biologic

Lolu hlobo lwezokwelapha lubizwa nangokuthi i-immunotherapy. Isibonelo, abanye abantu bathola ukwelashwa okufana ne-interferon alfa ukuphatha i-CML. Kungabekwa ukuthi kuphakamise ukubalwa kwegazi okuphansi.

Imiphumela emibi engaba khona ye-interferon alfa ifaka phakathi:

• isikhumba esibomvu futhi esilumayo
• izimpawu zomkhuhlane
• isicanucanu
• ukuhlanza
• ukungabi nesifiso sokudla
• ukukhathala
• umlomo obuhlungu
• isifo sohudo
• ukulahleka kwezinwele
• i-jaundice

Kungenzeka futhi ukuthi i-interferon alfa idale ukusabela okweqile kwabanye abantu, kodwa lokhu akuvamile.

Ukwelashwa ngamakhemikhali

I-Chemotherapy isebenza ngokuvimbela izinhlobo ezithile zamaseli ukuthi zingakhuli, kufaka phakathi amangqamuzana omdlavuza. Ukwelashwa kungabulala amaseli noma ukuwavimbele ekuhlukaneni.

Kunemithi eminingi yokwelashwa ngamakhemikhali, kanti kwesinye isikhathi lokhu kuhlanganiswa nezinye izindlela zokwelapha. Inhlanganisela ejwayelekile kakhulu yemithi etholwa abantu abelashwa i-CML yi-cytarabine ne-interferon alfa.

Imiphumela emibi yenkambo ejwayelekile ye-chemotherapy ye-CML ifaka:

• umlomo obuhlungu
• Umphimbo obuhlungu
• ukukhathala
• ukulahleka kwezinwele
• isifo sohudo
• ukuqunjelwa
• ukulahlekelwa isifiso sokudla
• isicanucanu
• ukuhlanza
• izinkinga zokuzala

Udokotela wakho angakunika eminye imininingwane ngemiphumela engemihle yemithi ethile yamakhemikhali oyitholayo.

Ukufakelwa kwe-stem cell

Ukufakelwa kwe-stem cell kubuyisa amaseli anempilo emzimbeni.

Kunezinhlobo ezahlukahlukene zokufakelwa ezisetshenziselwa i-CML. Abantu abathola ukufakelwa kwe-stem cell e-allogeneic bathola amaseli kumnikeli. Laba bantu basengozini yesimo esibizwa ngokuthi yi-graft versus host disease (GVHD).

I-GVHD yenzeka lapho amaseli omzimba wabanikeli ehlasela amaseli omzimba aphilile. Ngenxa yale ngozi, abantu bathola imithi yokucindezela amasosha omzimba usuku noma ezimbili ngaphambi kokufakelwa. Ngisho nangemva kokuthatha imishanguzo yokuvikela, kusengenzeka ukuthi umuntu azwe i-GVHD, kepha mancane kakhulu amathuba okuthi.

I-Splenectomy

Abanye abantu abane-CML bangasuswa ubende. Inhloso yalokhu kuhlinzeka ukukhulisa ukubalwa kwamaseli egazi noma ukuvimbela ukungakhululeki uma isitho sikhulu kakhulu ngenxa ye-CML.

Nganoma yikuphi ukuhlinzwa, izinkinga zingenzeka. Izinkinga ezivela kule nqubo zingafaka:

• ukutheleleka
• isicanucanu
• ukuhlanza
• ubuhlungu
• kunciphise ukusebenza komzimba

Ithimba lakho lokunakekelwa kwezempilo lizothatha izinyathelo zokunciphisa ubungozi bakho kunoma yiziphi izinkinga ezihlobene nokuhlinzwa. Iningi labantu liyalulama ekuhlinzweni emasontweni amane kuya kwayisithupha.

Ingabe zikhona izinketho zokulawula imiphumela emibi?

Udokotela wakho angakusiza ukuphatha imiphumela emibi yokwelashwa kwe-CML. Ngezinye izikhathi, lokho kungasho ukushintshela ekwelashweni okusha.

Kungase futhi kusho ukusebenzisa imishanguzo eyengeziwe ukwelapha izimpawu ezithile. Isibonelo, udokotela wakho angancoma ukunikezwa kwemithi noma izinketho zokuthenga ukuze unciphise isicanucanu noma welaphe ukuqubuka kwesikhumba.

Kukhona nezinto ongazenza ekhaya ukuze ukwazi ukuphatha imiphumela emibi:

• Ukuvivinya umzimba nokuvivinya umzimba okulula kungasiza ngokukhathala.
• Ukuvikela isikhumba sakho elangeni kungasiza ngokuqubuka.

Ngesikhathi sokwelashwa kwe-CML, ungathatha izinyathelo zokuzizwa ukhululekile. Qhubeka ukhulume ngokukhululekile nodokotela wakho.

Ingabe imiphumela emibi igcina ngemuva kokuphela kokwelashwa?

Ngokwe-Leukemia and Lymphoma Society, abanye abantu bangaba nemiphumela engemihle ngemuva kokuphela kwendlela yabo yokwelashwa.

Iningi labantu abaphila ne-CML bathatha ama-TKI impilo yabo yonke. Ngokubhekwa kwezokwelapha, abanye abantu bayakwazi ukuthatha umthamo owehlisiwe. Kubalulekile ukuthi ungalungisi umthamo wakho ngaphandle uma udokotela ekuncoma.

Impendulo yakho ohlelweni lwakho lokwelashwa ingashintsha ngokuhamba kwesikhathi. Ungase futhi ube nemiphumela engemihle emisha uma ushintsha imishanguzo ye-TKI. Udokotela wakho angakutshela ukuthi yini ongayilindela ngokuya ngemithi ethile oyithathayo.

Ngingakutholaphi ukwesekwa?

Abantu abaningi abaphila ne-CML bathola imininingwane ebalulekile nobungani ngokuxhumana nabanye abaphila nalesi simo. Kungasiza futhi kududuze ukukhuluma nabantu ababelane ngokuhlangenwe nakho noma okufanayo.

Udokotela wakho noma umtholampilo wangakini ungakusiza uthole amaqembu osizo endawo. I-Leukemia & Lymphoma Society inikela ngemininingwane ngamaqembu osekelo ngezahluko zawo zasendaweni. I-American Cancer Society nayo inezinsizakusebenza eziku-inthanethi ongazifinyelela.

Ukuthatha

Zonke izinketho zokwelashwa ziza nemiphumela emibi engaba khona, kodwa lokho akusho ukuthi uzohlangabezana nazo. Abantu abehlukene banezimpendulo ezingafani emithini. Ngokusebenzisana nodokotela wakho, ungaphatha noma imiphi imiphumela emibi oyitholayo.