Izinketho Zokwelapha ze-CML ngeSigaba: Isigaba Esingamahlalakhona, Esisheshayo, Nesokuqhuma

-Delile

• Isigaba esingapheli i-CML
• Isigaba esisheshisiwe i-CML
• Blast isigaba CML
• Ezinye izindlela zokwelapha
• Ukuqapha ukwelashwa kwakho
• Ukuthatha

I-chronic myeloid leukemia (CML) yaziwa nangokuthi i-leukemia engapheli emithambo yegazi. Kulolu hlobo lomdlavuza, umnkantsha ukhiqiza amangqamuzana egazi amhlophe amaningi kakhulu.

Uma lesi sifo singelashwa kahle, siya ngokuya siba sibi kakhulu. Ingadlulela esigabeni esingapheli, esigabeni esisheshayo, esigabeni sokuqhuma.

Uma une-CML, uhlelo lwakho lokwelashwa luzoncika ngokwengxenye esigabeni sesifo.

Funda ukuze ufunde kabanzi ngezinketho zokwelashwa zesigaba ngasinye.

Isigaba esingapheli i-CML

I-CML ivame ukwelashwa kakhulu lapho itholakala kusenesikhathi, esigabeni esingelapheki.

Ukwelapha isigaba esingalapheki se-CML, udokotela wakho kungenzeka anikeze uhlobo lomuthi owaziwa nge-tyrosine kinase inhibitor (TKI).

Izinhlobo eziningi ze-TKI ziyatholakala ukwelapha i-CML, kufaka phakathi:

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

I-Gleevec imvamisa iluhlobo lokuqala lwe-TKI enqunyelwe i-CML. Kodwa-ke, iTasigna noma iSpryrcel nayo ingahle ibekwe njengokwelashwa komugqa wokuqala.

Uma lezo zinhlobo ze-TKI zingakusebenzeli kahle, yeka ukusebenza, noma ibangele imiphumela emibi engabekezeleleki, udokotela wakho angakunika iBosulif.

Udokotela wakho uzokunika kuphela i-Iclusig uma umdlavuza ungaphenduli kahle kwezinye izinhlobo zama-TKIs noma uthuthukisa uhlobo lokuguqulwa kwezakhi zofuzo, olwaziwa njenge-T315I mutation.

Uma umzimba wakho ungaphenduli kahle kuma-TKIs, udokotela wakho angakunikeza imithi yamakhemikhali noma uhlobo lomuthi owaziwa ngokuthi i-interferon ukwelapha isigaba esingalapheki se-CML.

Ezimweni ezingavamile, bangancoma ukufakelwa kwe-stem cell. Kodwa-ke, lokhu kwelashwa kuvame ukusetshenziselwa ukwelapha isigaba esisheshayo se-CML.

Isigaba esisheshisiwe i-CML

Esigabeni esisheshayo i-CML, amaseli we-leukemia aqala ukwanda ngokushesha okukhulu. Amaseli avame ukuthuthukisa ukuguqulwa kwezakhi zofuzo okwandisa ukukhula kwawo futhi kunciphise ukusebenza kahle kokwelashwa.

Uma usheshise isigaba se-CML, uhlelo lwakho lokwelashwa olunconyiwe luzoya ngezindlela zokwelashwa ozitholile esikhathini esedlule.

Uma ungakaze uthole ukwelashwa kwe-CML, udokotela wakho kungenzeka anikeze i-TKI ukuthi iqale.

Uma usuvele uthathe i-TKI, udokotela wakho angakhuphula umthamo wakho noma akushintshele kolunye uhlobo lwe-TKI. Uma amangqamuzana akho omdlavuza enokuguquka kwe-T315I, angahle anikeze i-Iclusig.

Uma ama-TKI engasebenzi kahle kuwe, udokotela wakho angakunikeza ukwelashwa nge-interferon.

Kwezinye izimo, udokotela wakho angangeza i-chemotherapy ohlelweni lwakho lwezokwelapha. Imithi ye-Chemotherapy ingasiza ukuletha umdlavuza ekuxolelweni, kepha imane iyeke ukusebenza ngokuhamba kwesikhathi.

Uma umncane futhi uphilile, udokotela wakho angancoma ukufakelwa kwe-stem cell ngemuva kokuya kwezinye izindlela zokwelashwa. Lokhu kuzosiza ukugcwalisa amangqamuzana akho akha igazi.

Ekufakelweni kwe-stem autologous autologous, udokotela wakho uzoqoqa amanye amangqamuzana akho ngaphambi kokuthola ukwelashwa. Ngemuva kokwelashwa, azofaka lawo maseli emzimbeni wakho.

Ekufakelweni kwe-allogenic stem cell, udokotela wakho uzokunika ama-stem cells avela kumnikeli ofanelana kahle. Bangakulandela lokho kufakelwa ngokufakwa kwamaseli amhlophe egazi avela kulowo onikelayo.

Udokotela wakho mhlawumbe uzozama ukuletha umdlavuza ekuxolelweni ngemithi ngaphambi kokuncoma ukufakelwa kwe-stem cell.

Blast isigaba CML

Esigabeni sokuqhuma i-CML, amangqamuzana omdlavuza ayanda ngokushesha futhi abangele izimpawu ezibonakalayo.

Ukwelashwa kuvame ukungasebenzi kahle ngesikhathi sokuqhuma, uma kuqhathaniswa nezigaba zangaphambilini zesifo. Ngenxa yalokhu, iningi labantu elinesigaba sokuqhuma i-CML alikwazi ukwelashwa umdlavuza.

Uma uhlakulela isigaba se-blast CML, udokotela wakho uzocubungula umlando wakho wokwelashwa kwangaphambili.

Uma ungakatholi ukwelashwa okwedlule kwe-CML, bangahle bakunikeze imithamo ephezulu ye-TKI.

Uma ngabe usuvele uthathe i-TKI, bangakhuphula umthamo wakho noma bakweluleke ukuthi ushintshele kolunye uhlobo lwe-TKI. Uma amaseli wakho we-leukemia enokuguquka kwe-T315I, angahle anikeze i-Iclusig.

Udokotela wakho angaphinde anikeze i-chemotherapy ukusiza ukunciphisa umdlavuza noma ukukhulula izimpawu. Kodwa-ke, i-chemotherapy ivame ukungasebenzi kahle esigabeni sokuqhuma kunezigaba zangaphambilini.

Uma isimo sakho siphendula kahle ekwelashweni ngemithi, udokotela wakho angancoma ukufakelwa kwe-stem cell. Kodwa-ke, lokhu kwelashwa kubuye kungasebenzi kahle esigabeni sokuqhuma.

Ezinye izindlela zokwelapha

Ngaphezu kokwelashwa okuchazwe ngenhla, udokotela wakho angakunikeza izindlela zokwelapha ukusiza ukukhulula izimpawu noma ukwelapha izinkinga ezingaba khona ze-CML.

Isibonelo, bangahle banikeze:

• inqubo eyaziwa ngokuthi i-leukapheresis ukususa amangqamuzana amhlophe egazi egazini lakho
• izici zokukhula zokukhuthaza ukululama komnkantsha wamathambo, uma usebenzisa i-chemotherapy
• ukuhlinzwa ukuze ususe ubende lwakho, uma lukhula
• ukwelashwa ngemisebe, uma uhlakulela ubende obukhulisiwe noma ubuhlungu bamathambo
• imithi elwa namagciwane, i-antiviral, noma i-antifungal, uma uba nezifo
• ukumpontshelwa igazi noma i-plasma

Bangancoma nokwelulekwa noma okunye ukusekelwa kwezempilo yengqondo, uma ukuthola kunzima ukubhekana nemiphumela yezenhlalo noma engokomzwelo yesimo sakho.

Kwezinye izimo, bangahle bakukhuthaze ukuthi ubhalise esivivinyweni somtholampilo ukuthola ukwelashwa kokuhlola kwe-CML. Imishanguzo emisha iyenziwa manje futhi iyahlolelwa lesi sifo.

Ukuqapha ukwelashwa kwakho

Uma uthola ukwelashwa kwe-CML, udokotela wakho anga-oda ukuhlolwa kwegazi njalo ukuqapha ukuthi umzimba wakho uphendula kanjani.

Uma uhlelo lwakho lwamanje lokwelashwa lubonakala lusebenza kahle, udokotela wakho cishe uzokweluleka ukuthi uqhubeke nalolo hlelo.

Uma ukwelashwa kwakho kwamanje kungabonakali kusebenza kahle noma kungasebenzi kangako ngokuhamba kwesikhathi, udokotela wakho angakunikeza imithi ehlukile noma ezinye izindlela zokwelapha.

Iningi labantu abane-CML badinga ukuthatha i-TKI iminyaka eminingana noma ngokungapheli.

Ukuthatha

Uma une-CML, uhlelo lokwelashwa lwakho olunconywayo luzoncika esigabeni sesifo, kanye neminyaka yakho, impilo yakho yonke, kanye nomlando wezokwelapha ezedlule.

Kunezindlela zokwelapha eziningana ezisiza ukubambezela ukukhula komdlavuza, ukunciphisa izicubu, nokuqeda izimpawu. Ukwelashwa kuvame ukungasebenzi kahle njengoba isifo siqhubeka.

Khuluma nodokotela wakho ukuze ufunde kabanzi mayelana nezinketho zakho zokwelashwa, kufaka phakathi izinzuzo ezingaba khona nezingozi zezindlela ezahlukahlukene zokwelashwa.