Owulidde ku kookolo ono ow’amaanyi ow’omusaayi? (Acute Promyelocytic Leukemia - APL) Ka twogere mu bujjuvu!

Wali owuliddeko ng’okooye nnyo mu bwangu, ng’ofunye ebiwundu ebitonotono, oba ng’ennyindo zitera okuvaamu omusaayi? Wadde nga tetufaayo nnyo ku bintu bino, mu mbeera ezitatera kubaawo, biyinza okuba obubonero bw’embeera ey’amaanyi ennyo, gamba nga Acute Promyelocytic Leukemia (APL) . Kale, teweeraliikiriranga, leero tugenda kwogera ku kookolo ono ow'omusaayi ayitibwa APL mu ngeri entegeerekeka era ennyangu.

Obulwadde bwa acute promyelocytic leukemia (APL) kye ki?

Mu ngeri ennyangu, APL kika kya kookolo w’omusaayi ekitatera kulabika . Mu butuufu kiri mu kibinja ekinene eky'abalwadde ba leukemia abayitibwa Acute Myeloid Leukemia . Ekifo ekikulu omusaayi we gukolebwa mu mubiri gwaffe gwe busimu bw'amagumba . Wano mu busimu buno obw’amagumba, olw’enkyukakyuka mu buzaale, kwe kugamba, enkyukakyuka mu buzaale , obutoffaali obweru obutali bwa bulijjo butandika okutondebwa. Obutoffaali buno obutali bwa bulijjo bwawukana ne bweyongera mu ngeri etafugibwa, ne busaasaana mu busimu bw’amagumba bwonna. Oluusi abasawo kino bakiyita APL leukemia, oba M3-leukemia .

APL mbeera ya maanyi nnyo. Obubonero bwayo busobola okujja mu bwangu ne bweyongera mangu. Okuvaamu omusaayi omungi kye kisinga okuleeta akabi. Naye waliwo amawulire amalungi! Olw’obujjanjabi obupya, omuli eddagala n’eddagala eppya eritali lya kemiko, abasawo basobola okufuga APL era emirundi mingi bagiwonya ddala.

Obulwadde buno butera kwenkana wa?

APL mu butuufu bulwadde obutatera kulabika nnyo . Ng’ekyokulabirako, mu nsi nga Amerika, abantu nga 30,000 bokka be bazuulibwa n’obulwadde buno buli mwaka. Ebiseera ebisinga, APL ezuulibwa mu bantu abali mu myaka gyabwe egy’obukulu 30 .

Bubonero ki obw’obulwadde bwa APL?

Obubonero bwa APL bubaawo ng’obusimu bwo obw’amagumba tebusobola kukola butoffaali bumyufu , obutoffaali obweru, n’obutoffaali obukola omusaayi nga bwe bwa bulijjo. Okukendeera kuno mu bika by'obutoffaali bino byonna kuyitibwa pancytopenia . Kino bwe kibaawo, osobola okufuna obubonero obw’amaanyi nga okukendeera kw’omusaayi , obuzibu bw’okuvaamu omusaayi olw’omusaayi okuzimba , n’okulwala ennyo.

Obubonero obulala obumanyiddwa ennyo mu APL bwe buno:

• Okuwulira ng’okooye nnyo era ng’okooye olw’obutoffaali obumyufu okukendeera (i.e. anemia).
• Obulwadde obutera okukwatibwa olw’obutoffaali obweru obutono obulwanyisa endwadde. Ebintu ng’omusujja n’omusujja bisobola okubaawo ennyo.
• Olw’okuba enkyukakyuka y’omubiri gwo yanguwa era amaanyi agava mu mmere ne gaayokebwa mangu, .Okugejja mu butali bugenderevu.

Obubonero bw’okuvaamu omusaayi

Omuntu alina APL alina obutoffaali obutono (platelets) n’ebintu ebizimba omusaayi ebiyamba omusaayi okuzimba. Omanyi platelets ze ziyamba okukomya oba okukendeeza omusaayi. Kale, bino bwe biba wansi, obuzibu butandika.

Bino bye bimu ku bubonero bw’okuvaamu omusaayi oguva ku APL:

• Okuvaamu omusaayi kuyinza okubaawo wonna mu mubiri. Ng’ekyokulabirako, okuvaamu omusaayi mu nnyindo , okuvaamu omusaayi ennyo mu nnyindo , era, mu bakyala, okuvaamu omusaayi omungi nga bagenda mu nsonga .
• Omusaayi gukuŋŋaana wansi w'olususu ne guleeta ebiwundu mu bifo eby'enjawulo ku mubiri . Ne bw’osalako katono kiyinza okuvaako ekiwundu ekinene.
• Oluusi omusaayi guyinza okuva mu bwongo (intracranial hemorrhage) . Kino bwe kibaawo, oyinza okukaluubirirwa okutambuza ebitundu byo, okulumwa omutwe ogw’amaanyi, era oyinza okufuna enkyukakyuka mu kulaba kwo. Kino kya mangu!
• Singa omusulo gwo guba muddugavu oba nga gulina emiguwa gy’omusaayi, kiyinza okuba nga kiva ku kuvaamu omusaayi mu nkola y’okugaaya emmere (okuvaamu omusaayi mu lubuto) .

Kiki ekivaako APL?

Obulwadde buno buva ku buzaale bubiri obufuga okukola obutoffaali bwaffe obw’omusaayi nga bukwatagana ne bukola obuzaale obutali bwa bulijjo obuyitibwa PML-RARa . Ekikulu, enkyukakyuka eno ey’obuzaale si kintu ky’osikira okuva mu bazadde bo . Kibaawo mu ngeri ya kimpowooze, ekitegeeza awatali nsonga, mu bulamu bwo. Abakugu n’okutuusa kati tebamanyi ddala kiki ekivaako enkyukakyuka eno ey’obuzaale.

Enkyukakyuka eno ereetera obutoffaali obweru okukula nga tebufugibwa, mu kifo ky’okukula obulungi, ate mu kifo ky’ekyo ne bukola obutoffaali obweru obutakuze (promyelocytes) . Obutoffaali buno obutakuze bujjuza obusimu bw’amagumba, ne buziba ekifo obutoffaali bw’omusaayi n’obutoffaali obukola omusaayi obulungi.

Bizibu ki ebiva mu APL?

APL mbeera eyinza okutta omuntu. Kino kiri bwe kityo kubanga omusaayi oguyitiridde ogubaawo guyinza okufuuka amangu ogw’akabi. Bw’oba ​​tosobola kulekera awo kuvaamu musaayi wadde ng’osalako katono, bw’oba ​​olina omusaayi mungi mu musulo oba mu musulo ng’ogenda mu kaabuyonjo, oba bw’oba ​​tosobola kulekera awo kuvaamu musaayi mu nnyindo, olina okulaba omusawo oba okugenda mu kisenge ky’abalwadde ab’amangu mu ddwaaliro mu bwangu .

Jjukira: Bw’oba ​​olina omusaayi ogutafugibwa, togubuusa maaso. Obujjanjabi obw’amangu kye kisumuluzo.

APL ezuulibwa etya?

Abasawo batera okukola ebigezo ebiwerako okuzuula obulwadde buno.

• Complete Blood Count (CBC): APL ereetera obutoffaali obweru obutali bwa bulijjo okukola. Okukebera kwa CBC kuyinza okutunuulira ebika by’obutoffaali bw’omusaayi eby’enjawulo n’omuwendo gw’obutoffaali obuyitibwa platelets mu sampuli y’omusaayi gwo.
• Okusiiga omusaayi ogw’okumpi:Mu kino, omusaayi guggyibwa ne gukeberebwa mu microscope. Oluvannyuma, batunuulira oba waliwo obutundutundu bungi obutonotono munda mu butoffaali obwo obweru obutakuze (promyelocytes), oba waliwo ebintu eby’enjawulo ebiyitibwa Auer rods . Bino bye bifaananyi bya APL.
• Bone Marrow Biopsy: Mu kukebera kuno, kaggyibwako akatundu akatono ak’amagumba go ne keekebejjebwa obutoffaali bwabwo.
• Flow Cytometry: Mu kukebera kuno, abakugu mu by’endwadde banoonya enkola za puloteyina ezenjawulo ku ngulu w’obutoffaali obutali bwa bulijjo. Enkola zino zisobola okukakasa APL.
• Okugezesebwa kwa Polymerase Chain Reaction (PCR): Okukebera kuno kusobola okuzuula obulungi okubeerawo kw’obuzaale obutali bwa bulijjo (PML-RARa) obuleeta APL.
• Cytogenetics: Kino kikebera enkyukakyuka ezenjawulo mu chromosomes z’obutoffaali obutali bwa bulijjo. Okuzuula enkyukakyuka zino y’engeri enkulu ey’okukakasa okuzuula obulwadde bwa APL.

Abasawo bassa APL mu kibinja ky’akabi akatono oba ak’akabi akanene okusinziira ku bungi bw’obutoffaali obweru bwo. Abantu abalina APL ey’akabi ennyo batera okufuna kookolo okuddamu oba okuddamu okulwala .

APL ejjanjabwa etya?

APL ejjanjabwa n’ebirungo ebigatta enjawulo , eddagala eriweweeza ku bulwadde, n’obujjanjabi obugendereddwamu . Mu butuufu, okuva obujjanjabi buno lwe bwazuulibwa mu myaka gya 1980, obulwadde buno, edda obwali bulowoozebwa nti butta, kati bufuuse obulwadde obuwonyezebwa. Kino kituukiddwaako kinene nnyo!

Eddagala erirongoosa obutoffaali ddagala eritali lya kemiko eriyamba obutoffaali obweru obutakuze, obutakuze okwawukana ne bufuuka obutoffaali obweru obwa bulijjo, obukuze. Eddagala lino eritali lya kemiko, eriwandiikiddwa wansi, livuddemu okusonyiyibwa n’okuwona ebitundu ebisukka mu 95%.

• All-trans-retinoic acid (ATRA) , oba tretinoin (Vesanoid ®) – Eno ngeri ya vitamiini A.
• Arsenic trioxide (ATO) – Eno ngeri ya arsenic.

Singa omusawo ateebereza nti olina APL, bayinza okukutandika ku ATRA ne bwe baba nga tebannaba kukeberebwa birala kukakasa bulwadde buno. Kino kiri bwe kityo kubanga okutandika obujjanjabi nga bukyali kiyinza okukendeeza ku bulabe bw’okuvaamu omusaayi oguyinza okutta omuntu.

Emitendera gy’obujjanjabi bwa APL

Obujjanjabi butera okukolebwa mu mitendera esatu: Induction, Consolidation, ne Maintenance. Obujjanjabi buyinza okwawukana okusinziira ku ddaala ly’akabi.

• Omutendera ogusooka (Induction): .Ekigendererwa ekikulu eky'omutendera guno kwe kutta obutoffaali bwa leukemia obumala okuteeka APL yo mu kusonyiyibwa . Okusonyiyibwa kitegeeza nti tolina bubonero bwonna era tewali kabonero ka leukemia kasobola kusangibwa ku kukeberebwa. Kino kikolebwa nga bakozesa eddagala eritali lya kemiko, eddagala, n’obujjanjabi obugendereddwamu. Mu kiseera kino, ojja kwetaaga okubeera mu ddwaaliro, ebiseera ebisinga okumala wiiki nnya ku mukaaga.
• Omutendera gw’okunyweza: Omusawo wo akola ku bulwadde bwa kkansa kino ayinza n’okukiyita ‘obujjanjabi obw’oluvannyuma lw’okusonyiyibwa’. Obujjanjabi buno bukuuma APL mu kusonyiyibwa era bugenda mu maaso n’okutta obutoffaali bwa leukemia bwonna obusigaddewo. Lino lye ddagala lye limu eryakozesebwa mu mutendera ogwasooka. Obujjanjabi buno busobola okumala emyezi nga munaana, ng’obujjanjabi buli luvannyuma lwa myezi ebiri. Oyinza okujjanjabibwa wiiki nnya n’oluvannyuma n’owummula wiiki nnya. Eddagala lino liyinza okuweebwa ng’empeke oba ng’eddagala eriweebwa mu misuwa (IV) .
• Omutendera gw’okulabirira: Guno bujjanjabi bugenda mu maaso, naye eddagala liweebwa ku ddoozi entono okusinga mu mutendera ogusooka n’ogw’okutebenkeza. Obujjanjabi buno obw’okuddaabiriza butera okuweebwa okumala omwaka nga gumu.

Omusawo wo ow’obulwadde bwa kkansa era ayinza okukuwa obujjanjabi obuyamba , gamba ng’okuteekebwamu omusaayi, awamu n’obujjanjabi buno.

Ebizibu ebiva mu bujjanjabi

Ekizibu ekisinga okutawaanya abantu, era nga kiyinza okuba eky’amaanyi ennyo, kiyitibwa obulwadde bwa differentiation syndrome . Kino kibinja kya bantu abakwatibwa ennyo eddagala lya APL. Ebiseera ebisinga bino bibaawo mu wiiki ssatu ezisooka ng’otandise obujjanjabi. Obubonero buyinza okuba obutono oba obw’amaanyi. Ebimu ku byo mulimu:

• Okukolola.
• Amazzi ag’enjawulo okwetoloola omutima gwo n’amawuggwe (pleural effusion) .
• Okulemererwa kw'ekibumba .
• Puleesa eya wansi (puleesa) .
• Okukendeera kw’omukka gwa oxygen mu musaayi (hypoxemia) .
• Obuzibu mu kussa (okusannyalala) .
• Okuzimba/ okuzimba emikono gyo, amagulu, n’ensingo.
• Omusujja ogujja awatali nsonga.
• Okugejja awatali nsonga.

Singa ofuna obulwadde buno obw’enjawulo, omusawo ayinza okuyimiriza obujjanjabi bwo okumala akaseera. Bayinza n’okukozesa eddagala eddala, gamba nga hydroxyurea, okukendeeza ku butoffaali bwo obweru.

Omuntu alina APL ayinza kusuubira ki?

Okutwalira awamu, enteekateeka y’obulwadde buno nnungi.. Wadde embeera ya buli muntu ya njawulo, okunoonyereza kulaga nti wakati wa 90% ne 95% ku bantu abalina APL bagenda mu kusonyiyibwa. Wabula APL esobola okudda oluvannyuma lw’okujjanjabibwa. Abantu abali wakati wa 5% ne 10% bajja kuddamu okulwala, ebiseera ebisinga mu myaka esatu egisooka oluvannyuma lw’okujjanjabwa. Olwo bajja kwetaaga obujjanjabi obulala oba obw’enjawulo.

Emiwendo gy’abawonawo

Olw’okuba APL bulwadde obutatera kulabika, kye tumanyi ku miwendo gy’okuwangaala kiva mu kugezesebwa okw’obujjanjabi okuzingiramu abalwadde ba APL ab’akabi akatono n’ab’akabi ennyo.

Okwekenenya okumu kulaga nti 99% ku balwadde ba APL ab’akabi akatono baba balamu oluvannyuma lw’emyaka ena oluvannyuma lw’okujjanjabwa. Okwekenenya okulala ku balwadde ba APL abali mu bulabe obw’amaanyi kulaga nti 86% balamu oluvannyuma lw’emyaka etaano oluvannyuma lw’okujjanjabwa. Bino ddala bivaamu birungi!

Nze nneerabirira ntya?

Olw’okuba APL esobola okuddamu, kikulu nnyo okulaba omusawo wo mu budde (follow-up appointments) .

Ojja kukeberebwa omusawo buli mwezi oba ebiri okumala omwaka ogusooka ng’omaze okujjanjabibwa. Oluvannyuma lw’omwaka ogusooka, ojja kwetaaga okulaba omusawo wo nga buli luvannyuma lwa myezi esatu oba ena okumala emyaka ebiri egijja. Okukebera nga CBC, PCR, n’okukebera obusigo bw’amagumba kuyinza okukolebwa mu kukyala kuno.

Ddi lwe nnina okugenda mu kisenge ky’abalwadde ab’amangu?

APL esobola okuddamu oluvannyuma lw’okujjanjabwa, era obubonero buyinza okweyongera amangu. Bw’oba ​​oli mu kusonyiyibwa APL, genda mu kisenge ky’abalwadde ab’amangu amangu ddala singa ofuna ekimu ku bino wammanga:

• Bwoba ovaamu omusaayi nga tosobola kwefuga .
• Singa ofuna okuzimba mu bwangu ng'olina obulumi mu magulu oba mu lubuto olwa wansi .

N’ekisembayo, obubaka obukulu

Acute promyelocytic leukemia (APL) kookolo w’omusaayi atatera kulabika ng’edda atwalibwa ng’obulwadde obutta, naye kati afuuse obulwadde obuwonyezebwa olw’obujjanjabi obw’omulembe.

Kyokka buno bukyali bulwadde bwa maanyi. Singa tezuuliddwa era n’ajjanjabwa mangu, kiyinza okutta omuntu . N’olwekyo bw’oba ​​olina obubonero ng’okuvaamu omusaayi mu ngeri etafugibwa, tobubuusa maaso. Ekisinga obukulu kwe kunoonya amagezi g’abasawo n’okuzuulibwa amangu ddala nga bwe kisoboka. Totya, beera muvumu, kubanga kati waliwo obujjanjabi obulungi ku kino!

` Leukemia, APL, Kookolo w’omusaayi, Kookolo w’omusaayi, Obusigo bw’amagumba, Okukendeera kw’omusaayi, ATRA, Chemotherapy, Acute Promyelocytic Leukemia, M3-Leukemia, PML-RARa, Okuvaamu omusaayi