Myelofibrosis: Ddala tumanyi ku kookolo ono ow’omusaayi?

Bulijjo owulira ng’okooye era ng’okooye awatali nsonga? Olina ebiwundu ku mubiri gwo gwonna? Owulira ng’ozitowa katono oba ng’owulira ng’ojjudde ku ludda olwa kkono olw’olubuto lwo? Wandibaawo ensonga enkulu emabega w’ebintu bino gye tutalowoozaako. Eyo mbeera eyitibwa myelofibrosis. Totya nga owulira erinnya lino. Tugenda kwogera ku kiki kye kiri, lwaki kibaawo, obubonero bwe buli, n’obujjanjabi bwe buli mu ngeri ennyangu ennyo gy’osobola okutegeera.

Mu ngeri ennyangu, obulwadde bwa myelofibrosis kye ki?

Lowooza ku magumba amanene agali munda mu mibiri gyaffe ng’amakolero agakola omusaayi. Amakolero gano tugayita obusigo bw'amagumba . Mu busimu buno mwe buva ebika byonna ebisatu eby’obutoffaali bw’omusaayi obukulu mu mibiri gyaffe.

1. Obutoffaali obumyufu: Butambuza omukka gwa oxygen mu mubiri gwonna.

2. Obutoffaali bw’omusaayi obweru: Bulwanyisa endwadde n’obuwuka.

3. Platelets: Zikola ebizimba omusaayi ne zikoma okuvaamu omusaayi.

Myelofibrosis kika kya kookolo w’omusaayi atatera kulabika ng’obusimu bw’amagumba, ekkolero erikola omusaayi, bujjula mpolampola ebitundu by’enkovu. Ng’omuddo bwe gugenda gukwata ennimiro eggimu mpolampola, ekitundu kino eky’enkovu kiremesa obusigo bw’amagumba okukola obutoffaali bw’omusaayi mu ngeri eya bulijjo.

Olw’okuba omulimu guno tegukolebwa bulungi, enseke zaffe , nga kino kye kitundu ekiri ku ludda olwa waggulu olwa kkono olw’olubuto, egezaako okuyamba ku mulimu guno. Kwe kugamba, enseke zitandika okukola omusaayi. Naye ogwo si gwe mulimu gwayo omukulu. Olw’ensonga eno, ennywanto ziyitiridde okuzitowa, era mpolampola zitandika okukula n’okuzimba. Abalwadde bangi bafuna obubonero n’okuzimba kuno okw’ennywanto.

Buno butera kuba bulwadde bwa bulamu bwonna, era emirundi mingi bugenda bugenda mpola nnyo. Kyokka oluusi kiyinza okweyongera amangu, ate mu bantu abamu kiyinza okukula ne kifuuka obulwadde bwa acute leukemia. Eno y’ensonga lwaki omusawo ajja kukulondoola nnyo ng’omaze okuzuulibwa.

Waliwo ebika ebikulu eby’obulwadde bwa myelofibrosis?

Yee, kino kirina ebika bibiri ebikulu.

• Primary Myelofibrosis: Kino kye kika ekisinga okubeerawo. Kibaawo mu ngeri eyeetongodde, nga tekikwatibwako bulwadde bulala bwonna.
• Obulwadde bwa Myelofibrosis obw’okubiri:Kino kibaawo ng’embeera endala ezeekuusa ku musaayi zifuuse za maanyi. Okugeza omuntu alina obulwadde bwa Essential Thrombocythemia oba Polycythemia Vera asobola okufuna obulwadde bwa myelofibrosis okumala ekiseera. Endwadde zino zonna ziri mu kibinja kya kookolo w’omusaayi ekiyitibwa Myeloproliferative Neoplasms (MPNs). Mu ngeri ennyangu, endwadde zino zonna zireetera obusimu bw’amagumba okukola ekika ky’obutoffaali bw’omusaayi ekimu oba ebisingawo okusinga bwe bulina okukola.

Bubonero ki obulaga obulwadde buno? Tumanya tutya?

Ebiseera ebisinga, obulwadde buno bukula mpola nnyo. N’olwekyo, kiyinza okumala emyaka nga tekiraga bubonero bwonna. Obubonero bwe butandika okulabika, ekintu ekisooka okujja mu birowoozo byange kwe kukoowa ennyo . Kino kiva ku butabeera na butoffaali bumyufu mu mubiri, nga kino kibeera kya kukendeera mu musaayi. Ng’oggyeeko kino, olw’ennywanto okugaziwa, oyinza okuwulira ng’ozitowa, obulumi oba okuwulira ng’ojjudde mu kitundu kya waggulu ekya kkono eky’olubuto.

Ka tulabe obubonero obulala obuli mu kipande wansi.

Lwaki kino kibaawo? Ensonga ze ziruwa?

Abasawo n’okutuusa kati tebamanyi kituufu ekivaako obulwadde bwa primary myelofibrosis, naye bategeera bulungi engeri gye bubaawo.

Kitandikira ku nkyukakyuka mu buzaale mu katoffaali akayitibwa stem cell, akatoffaali akasooka okukola omusaayi mu busimu bw’amagumba . Akatoffaali akalina obuzaale obukyamu kafuuka akatoffaali ka kookolo, ne kaawukana mangu ne keekola kkopi zaako. Obutoffaali buno obwa kookolo bujjuza obusimu bw’amagumba bwonna.

Abasawo bakizudde nti abantu bangi abalina obulwadde buno balina enkyukakyuka eziwerako ezitera okubaawo mu buzaale bwabwe. Ebikulu ku bino bye bino:

• JAK2 (JACK-BBIRI) .
• CALR (Cal-R) (Ekibiina ky’Oluganda) .
• MPL

Enkyukakyuka zino mu buzaale ze zireeta obuzibu buno mu busimu bw’amagumba.

Ani ali mu bulabe obw’amaanyi obw’okukwatibwa obulwadde buno?

Wadde omuntu yenna asobola okukwatibwa obulwadde buno, abantu abamu bali mu bulabe bwa maanyi.

• Emyaka egisukka mu 60: Obulwadde buno businga kuzuulibwa mu bakadde.
• Okubeerawo kw’endwadde endala ez’omusaayi:Ku abo abalina endwadde nga `Essential Thrombocytosis` oba `Polycythemia Vera`, ze twayogeddeko emabegako.
• Okukwatibwa obusannyalazo obuyitibwa ionizing radiation: Okukwatibwa emisinde egy’amaanyi. (Kino tekitera kubaawo nnyo).
• Okukwatibwa eddagala erimu: Okubeera mu ddagala erikozesebwa mu makolero okumala ebbanga eddene, nga benzene (kino nakyo tekitera kubaawo nnyo).

Bizibu ki ebiyinza okubaawo olw’obulwadde buno?

Obulwadde bwa myelofibrosis bwe bugenda bweyongera, ebizibu eby’enjawulo bisobola okubaawo.

Okukendeera kw’obutoffaali bw’omusaayi

Ebitundu by’enkovu bwe bikuŋŋaana mu busimu bw’amagumba, bifuuka ebitasobola kukola butoffaali bwa musaayi bulamu. Kino kiyinza okuvaako obutoffaali obumyufu okukendeera, ekivaako okukendeera kw’omusaayi , n’okukendeera kw’obutoffaali obukola omusaayi, ne kyongera obulabe bw’okuvaamu omusaayi.

Okutondebwa kw’obutoffaali bw’omusaayi obw’ebweru w’ekibumba okuva mu busimu bw’amagumba

Obusigo bw’amagumba bwe butasobola kukola mulimu gwabwo, ebitundu ng’ennywanto n’ekibumba bitandika okukola omusaayi. Kino kiyinza okuvaako ebitundu ebyo okuzimba n’okukosa enkola yaabyo.

Puleesa ya waggulu mu Portal Vein

Omusuwa oguyitibwa portal vein gwe musuwa omukulu ogutwala omusaayi okuva mu nseke okutuuka mu kibumba. Ensigo egaziye esobola okulemesa omusaayi okuyita mu musuwa guno, ne kyongera puleesa munda mu gwo. Kino kiyinza okuvaamu omusaayi ogw’amaanyi.

Okufuuka obulwadde bwa acute leukemia

Mu balwadde abamu, obulwadde bwa myelofibrosis busobola okutuuka ekiseera ne bufuuka ekika kya leukemia eky’amaanyi ennyo era ekisaasaana amangu ekiyitibwa Acute Myeloid Leukemia (AML).

Omusawo azuula atya obulungi obulwadde buno?

Oluvannyuma lw’okuwuliriza obubonero bwo n’okukwekebejja, omusawo ajja kulagira okukeberebwa okuwerako okukakasa nti olina obulwadde buno.

1. Okukebera omusaayi: Bino bikebera oba obutoffaali bwo (obumyufu, obweru, obutafaali) bwa bulijjo oba si bwa bulijjo. Era bakebera oba enkula y’obutoffaali bw’omusaayi si ya bulijjo.

2. Okukebera ebifaananyi: Oyinza okukolebwa CT scan oba ultrasound scan okulaba oba ennywanto oba ekibumba kyo kigaziye. MRI scan nayo esobola okuyamba okulaba oba waliwo enkovu yonna mu busimu bw’amagumba.

3. Bone Marrow Biopsy: Kino kye kigezo ekisinga obukulu okukakasa obulwadde buno. Mu kino, akatundu akatono ak’obusigo bw’amagumba kaggyibwa, ebiseera ebisinga okuva mu ggumba ly’ekisambi oba eggumba eddala eddene, wansi w’eddagala eriwunyiriza erya light. Kisindikibwa mu laabu okuzuula ddala ebitundu by’enkovu ebibeerawo, oba waliwo obutoffaali bwa kookolo, era oba waliwo enkyukakyuka yonna mu buzaale nga `JAK2` gye twayogeddeko emabegako.

Okusinziira ku bivudde mu kukebera kuno, omusawo wo ajja kuzuula oba obulwadde bwo buli mu ntandikwa (prefibrotic) oba mu mitendera egy’oku ntikko (overt). Era bajja kwekenneenya omutindo gw’akabi ko (akabi akatono, ak’omu makkati oba ak’amaanyi) okusinziira ku bubonero bwo n’ekika ky’enkyukakyuka mu buzaale. Obujjanjabi butegekebwa okusinziira ku ddaala lino ery’akabi.

Bujjanjabi ki obukolebwa ku kino?

Enkola y’obujjanjabi esinziira ku bulabe bw’obulwadde bwo, obuzibu bw’obubonero bwo, emyaka gyo, n’obulamu bwo okutwalira awamu.

Waliwo obujjanjabi obuwerako ku mbeera ez’akabi ak’omu makkati n’ez’akabi ennyo . Ekigendererwa ekikulu eky’obujjanjabi kwe kufuga obubonero n’okutangira obulwadde buno okweyongera.

Okukyusa Obutoffaali bw’Ensigo

Buno bwe bujjanjabi bwokka obusobola okuwonya ddala obulwadde bwa myelofibrosis. Wabula nkola ya bulabe nnyo ng’erina ebizibu eby’amaanyi. N’olwekyo, tekisaanira balwadde bonna. Ebiseera ebisinga abasawo bateesa ku bujjanjabi buno eri abali mu bulabe obw’amaanyi, abavubuka n’abantu abatalina ndwadde ndala ez’amaanyi.

Kino kizingiramu okusaanyaawo ddala obusigo bw’amagumba bw’omulwadde obulwadde n’okuwa omulwadde obutoffaali obusibuka mu mubiri obufunibwa okuva eri omugabi omulamu.