Omwana wo omuto awulira ng’akooye buli kiseera, ng’alina langi ya bbululu oba ng’afuna omusujja buli kiseera? Oluusi buno buyinza okuba obubonero obwa bulijjo. Naye oluusi, ebintu bino ebitonotono biyinza okuba akabonero k’embeera ey’amaanyi munda mu mubiri. Leero tugenda kwogera ku kika kya kookolo w’omusaayi naddala mu baana abato, naye nga asobola n’okukwata n’abantu abakulu. Erinnya lyayo ye Acute Lymphoblastic Leukemia, oba (ALL) mu bufunze. Teweeraliikiriranga, buli kimu tujja kwogera mu bigambo ebyangu.
Mu ngeri ennyangu, BYONNA bitegeeza ki?
Acute Lymphoblastic Leukemia (ALL) kika kya kookolo akula mu musaayi gwaffe. Omusaayi gwaffe gulimu obutoffaali obumyufu, obutoffaali obweru, n’obutoffaali obuyitibwa platelets. Ekika ekimu eky’obutoffaali obweru kiyitibwa lymphocytes. Okufaananako n’amagye g’eggwanga lyaffe, obutoffaali buno butukuuma nga bulwanyisa endwadde n’obuwuka obuyingira mu mibiri gyaffe.
Obutoffaali buno obuyitibwa lymphocyte bukolebwa mu busimu bw’amagumba obuli munda mu magumba gaffe. Oluusi, olw’enkyukakyuka mu buzaale mu butoffaali buno obw’obutoffaali obuyitibwa lymphocyte, butandika okufuuka obutoffaali bwa kookolo mu kifo ky’obutoffaali obulamu. Obutoffaali buno obwa kookolo bwawukana ne bweyongera mangu awatali kufugibwa, ne buziba obutoffaali obulamu. Kino kiyitibwa buyita BYONNA.
Obutoffaali buno obwa kookolo tebumala gasigala mu busimu bw’amagumba. Zisobola okuyita mu musaayi ne zisaasaana (metastasize) mu mubiri gwonna.
Naye ekisinga obukulu kiri nti BONNA wadde embeera ya maanyi, bulwadde obuwonyezebwa ddala nga bujjanjabiddwa bulungi. Omuwendo gw’abawona guli waggulu nnyo naddala mu baana abato.
Bika ki ebikulu ebya BONNA?
Bwe twogera ku lymphocytes, waliwo ebika byazo ebikulu bibiri: B cells ne T cells. Kkookolo yenna ava mu bika by’obutoffaali bino ebibiri.
| Ekika kya kookolo | Ennyinyonnyola ennyangu |
|---|---|
| B-obutoffaali BONNA (B-obutoffaali ALL) . | Kino kye kika ekisinga okubeerawo. Kikola ebitundu nga 85% ku ALL mu baana ate 75%-80% ku ALL mu bantu abakulu. Obutoffaali bwa B kye kika ky’obutoffaali obukola obutoffaali obuziyiza obuwuka mu mubiri gwaffe. |
| T-cell ALL (Obutoffaali bwa T ALL) . | Kino tekitera kubaawo katono. Abantu abakulu nga 25% n’abaana 12%-15% bafuna ekika kino. T cells kye kika ky’obutoffaali obutta obutereevu obuwuka ne buyamba obutoffaali obulala mu baserikale b’omubiri. |
Ng’oggyeeko ebika bino ebibiri, waliwo n’ekika ekitali kya bulijjo ennyo ekiyitibwa Natural Killer ALL. Omusawo wo ajja kukola ebigezo ebyetaagisa okuzuula ekika kyennyini ggwe oba omwana wo ky’olina.
Bubonero ki bwe tulaba?
BYONNA bwe bikula, obutoffaali bw’omusaayi obulungi mu mubiri bukendeera, ekivaako obubonero obw’enjawulo. Obubonero buno busobola okujja mu bwangu oba okukula mpolampola.
Ekikulu: Okubeera n’obubonero buno tekitegeeza nti olina BONNA. Wabula obubonero buno bw’oba olina okumala wiiki ezisukka mu bbiri, kyetaagisa okugenda ew’omusawo akuwe amagezi.
| Obubonero | Ekyo kitegeeza ki? |
|---|---|
| Okukoowa buli kiseera n’okufuuka omumyufu | Olw’okukendeera kw’obutoffaali obumyufu mu mubiri (anemia), n’okukola emirimu emitonotono kiyinza okukukooya, era omubiri guyinza okulabika ng’omumyufu. |
| Okulwala ennyo | Obutoffaali obweru obulamu bwe bukendeera, obusobozi bw’omubiri okulwanyisa endwadde (obusimu obuziyiza endwadde) bukendeera. N’ekyavaamu, endwadde ng’omusujja n’omusujja bisobola okubaawo emirundi mingi. |
| Okuvaamu omusaayi n’okunyiga | Olw’obusimu obuyamba omusaayi okuzimba bwe bukendeera, okuvaamu omusaayi mu nnyindo, okuvaamu omusaayi mu nnyindo, n’obuvune obutonotono bisobola okuvaako amabala amanene aga bbululu ku mubiri. Abakyala bayinza okuvaamu omusaayi omungi nga bali mu nsonga. |
| Amabala amamyufu ku lususu (petechiae) . | Obutundutundu obutono obumyufu bulabika ku lususu nga bulinga obufumitiddwa ppini, olw’okuvaamu omusaayi okuva mu misuwa emitono ennyo wansi w’olususu. |
| Obulumi bw’amagumba n’ennyondo | Obutoffaali bwa kookolo bwe bujjuza obusimu bw’amagumba, obulumi obw’amaanyi buyinza okubaawo mu magumba n’ennyondo. |
| Ennywanto z’omusaayi ezizimba | Ebizimba (nodules) mu bifo ng’ensingo, enkwaso, n’enkwaso bisobola okuzimba nga tebirina bulumi. |
| Ebintu ebirala ebirimu | Obubonero nga obutayagala mmere, okugejja, okutuuyana ekiro, n’okukaluubirirwa okussa nabwo buyinza okulabibwa. |
Lwaki obulwadde buno bubaawo? Biki ebiyinza okuvaako akabi?
Tewali kintu kimu kituufu ekivaako kookolo YONNA. Ekisinga okuvaako, nga bwe twayogeddeko emabegako, y’enkyukakyuka mu buzaale ezibeerawo mu kiseera ky’okutondebwa kw’obutoffaali bw’omusaayi. Mu baana abato, enkyukakyuka zino ziyinza okubaawo nga tebannaba na kuzaalibwa.
Wabula ensonga eziwerako zizuuliddwa ezongera obulabe bw’okukwatibwa obulwadde buno.
- Emyaka: Obulabe businga mu baana abali wansi w’emyaka 15 naddala abali wakati w’emyaka 2-5, n’abantu abakulu abasukka mu myaka 50.
- Ebizibu ebimu eby’obuzaale: Abantu abalina obuzibu obumu obw’obuzaale, gamba nga Down syndrome, balina akabi katono ak’okulwala ALL.
- Okukwatibwa obusannyalazo: Okukwatibwa obusannyalazo obw’amaanyi, okugeza, singa oba wali ofunye obujjanjabi bw’amasannyalaze ku kookolo omulala, kiyinza okwongera ku bulabe bwo.
- Akawuka akamu: Obulwadde obumu obuva ku kawuka, gamba nga akawuka ka Epstein-Barr, nabwo kirowoozebwa nti byongera ku bulabe.
- Okukozesa taaba: Mu bantu abakulu, okubeera n’ebirungo ebireeta kkansa ng’okukozesa taaba nakyo kiyinza okuba nga kye kivaako.
Omusawo azuula atya obulungi obulwadde buno?
Bw’ogenda ew’omusawo ng’alina obubonero bw’oyogedde waggulu, ajja kusooka kukubuuza ekibuuzo ekikwata ku bubonero bwo mu bujjuvu. Olwo agenda kwekebejja omubiri era alagire okukeberebwa okuwerako okukakasa nti alina obulwadde buno.
- Okukebera omusaayi:Okukebera okwa bulijjo okwa Full Blood Count (FBC) kuyinza okuzuula obutali bwa bulijjo mu muwendo gw’obutoffaali mu musaayi.
- Okukebera obusimu bw’amagumba: Kino kye kigezo ekikulu ekikozesebwa okukakasa nti omuntu azuuliddwa. Akatundu akatono ak’obusigo bw’amagumba kaggyibwa mu kifo ng’eggumba ly’ekisambi nga babusumulula ne bakeberebwa mu microscope. Kino kiyinza okuzuula ddala oba obutoffaali bwa kookolo buliwo era bwe kiba bwe kityo, kika ki.
- Okukebera ebifaananyi: Okukebera CT ne PET scans ziyinza okukolebwa okulaba oba kookolo asaasaanidde mu bitundu by’omubiri ebirala okugeza mu kifuba.
- Spinal tap/Lumbar puncture: Singa wabaawo okubuusabuusa kwonna nti obutoffaali bwa kookolo busaasaanidde ku bwongo oba ku mugongo, amazzi amatono ag’omugongo gaggyibwa mu mugongo ne gakeberebwa.
Bujjanjabi ki eri BONNA?
Waliwo obujjanjabi obuwerako eri BONNA. Omusawo wo ajja kukusalawo enteekateeka y’obujjanjabi esinga obulungi gy’oli okusinziira ku bintu bingi, omuli emyaka gyo, ekika ky’obulwadde, n’obubonero bw’obuzaale mu butoffaali bwa kookolo wo.
Obujjanjabi obukulu: Obujjanjabi bw’eddagala
Chemotherapy ddagala lya maanyi eritta obutoffaali bwa kookolo. Ye bujjanjabi obukulu eri BONNA. Obujjanjabi buno buweebwa mu mitendera egiwerako, okuva ku myezi mitono okutuuka ku myaka ebiri okutuuka ku esatu.
| Emitendera gy’obujjanjabi | Kiki ekigenda mu maaso? |
|---|---|
| 1. Omutendera ogusooka (Remission Induction) . | Kino kitwala wiiki nga 4-6. Ekigendererwa ekikulu kwe kusaanyaawo obutoffaali bwa kookolo bungi nga bwe kisoboka mu bwangu nga bwe kisoboka. Mu kiseera kino, emirundi mingi ojja kuba olina okusigala mu ddwaaliro. |
| 2. Obujjanjabi bw’obusimu (CNS-directed therapy) . | Obujjanjabi buno buweebwa okutangira obutoffaali bwa kookolo okusaasaana mu bwongo n’omugongo, oba okubusaanyawo singa buba busaasaana. Kino kitera okukolebwa mu mutendera ogusooka. |
| 3. Omutendera gw’okunyweza | Obulwadde bwe bumala okusonyiyibwa, omutendera guno gutandika okusaanyaawo obutoffaali bwa kookolo bwonna obusigaddewo. Ojja kuweebwa ekitanda okumala ennaku ntono buli luvannyuma lwa wiiki ntono okumala emyezi egiwerako era ofune eddagala eriweebwa mu misuwa (IV). |
| 4. Omutendera gw’okuddaabiriza | Guno gwe mutendera ogusembayo era ogusinga obuwanvu. Kitwala emyaka nga 2-3. Ekigendererwa wano kwe kutangira obulwadde buno obutadda. Ebiseera ebisinga, eddagala eriweebwa mu kamwa n’ery’omu misuwa liweebwa mu ddwaaliro. Tekyetaagisa kugenda nnyo mu ddwaaliro. |
Enzijanjaba endala
- Obujjanjabi obugendereddwamu: Kino kizingiramu okuwa eddagala erilumba enkyukakyuka ez’enjawulo ez’obuzaale ezisangibwa mu butoffaali bwa kookolo bwokka. Okugeza, obujjanjabi buno bukola nnyo mu bantu abalina enkyukakyuka mu buzaale eyitibwa Philadelphia chromosome.
- Obujjanjabi bw’abaserikale b’omubiri: Kino kizingiramu okusitula abaserikale baffe bennyini okusaanyaawo obutoffaali bwa kookolo. Enkola ya CAR-T cell therapy nkola ya mulembe ey’obujjanjabi egwa mu kiti kino.
- Obujjanjabi bw’amasannyalaze: Obujjanjabi bw’amasannyalaze buyinza okukozesebwa mu mbeera nga kookolo taddamu kujjanjaba ddagala oba ng’obulwadde buzzeemu.
- Okusimbuliza obusigo bw’amagumba: Singa obujjanjabi obulala tebufuna buwanguzi oba ng’obulabe bw’obulwadde buno buba bungi nnyo, oyinza okusindikibwa okusimbuliza obusigo bw’amagumba okuva ku muntu omulamu obulungi.
Emikisa ki egy’okuwonya obulwadde buno?
Kino kye kibuuzo ekisinga obunene mu birowoozo bya buli muntu. BYONNA kookolo akola bulungi nnyo ku bujjanjabi.
Mu baana, ebivaamu bisuubiza nnyo. Abaana 98% abafuna obujjanjabi obutuufu batuuka ku kusonyiyibwa ddala obulwadde buno. Omuwendo gw’abawangaala oluvannyuma lw’emyaka 5 ng’obulwadde buwonye guli waggulu nga 90%.
Ebitundu bino biba wansi katono mu bantu abakulu. Omuwendo gw’okuwangaala kw’emyaka 5 eri abantu abakulu guli wakati wa 30% - 40%.
Naye kikulu okukitegeera nti bino bibalo byokka. Engeri omuntu gy’akwatamu obujjanjabi eyinza okuba ey’enjawulo nnyo ku mulala. Kale ennamba zino tozikanga. Omusawo akujjanjaba yekka y’asobola okukuwa amawulire agasinga obulungi ku mbeera yo oba omwana wo.
Kya bulijjo okuwulira ng’obulamu bwo bugenda bugwa ng’ozuuliddwa nti olina kookolo. Naddala nga mwana wo. Naye jjukira nti BYONNA bulwadde obuwonyezebwa nnyo okusinga ebika bya kookolo ebirala bingi. Wesige ttiimu yo ey’abasawo. Bajja kuba naawe mu lugendo luno, nga bakuwa obuwagizi bwonna n’okunnyonnyola kw’olina okwetaaga.
Obubaka Obutwala Awaka
- Acute Lymphoblastic Leukemia (ALL) kookolo akula mu lymphocytes, ekika ky’obutoffaali obweru.
- Wadde obulwadde buno businga kubeera mu baana abato, busobola okukwatibwa omuntu yenna ow’emyaka gyonna.
- Bw’ofuna obubonero ng’okukoowa buli kiseera, okufuuka omumyufu, okulwala ennyo, omubiri okufuuka bbululu, n’okulumwa amagumba okumala wiiki ezisukka mu bbiri, funa amagezi mu bwangu omusawo.
- Wadde ALL bulwadde bwa maanyi, buwonyezebwa ddala n’obujjanjabi nga chemotherapy. Omuwendo gw’abawona guli waggulu nnyo naddala mu baana.
- Enkola y’obujjanjabi eyinza okuba empanvu ate ng’ekooya naye togitya, weesige abasawo bo era ogoberere ddala ebiragiro byabwe.
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