Kodi mwana wanu amamva kutopa nthawi zonse, ali ndi khungu labuluu, kapena amakhala ndi malungo nthawi zonse? Nthawi zina izi zitha kukhala zizindikiro wamba. Koma nthawi zina, zinthu zazing'onozi zimatha kukhala chizindikiro cha matenda oopsa m'thupi. Lero tikambirana za mtundu wa khansa ya m'magazi yomwe imapezeka kwambiri pakati pa ana aang'ono, komanso ingakhudze akuluakulu. Dzina lake ndi Acute Lymphoblastic Leukemia, kapena (ALL) mwachidule. Musadandaule, tikambirana chilichonse mwachidule.
Mwachidule, kodi ALL imatanthauza chiyani?
Matenda a khansa ya m'magazi otchedwa Acute Lymphoblastic Leukemia (ALL) ndi mtundu wa khansa yomwe imayamba m'magazi mwathu. Magazi athu ali ndi maselo ofiira a magazi, maselo oyera a magazi, ndi ma platelet. Mtundu umodzi wa maselo oyera a magazi umatchedwa ma lymphocytes. Monga gulu lankhondo la dziko lathu, maselo amenewa amatiteteza polimbana ndi matenda ndi majeremusi omwe amalowa m'thupi mwathu.
Maselo a lymphocyte awa amapangidwa mu fupa mkati mwa mafupa athu. Nthawi zina, chifukwa cha kusintha kwa majini m'maselo a lymphocyte awa, amayamba kukhala maselo a khansa m'malo mwa maselo athanzi. Maselo a khansa awa amagawikana ndikuchulukana mwachangu popanda kulamulira, zomwe zimadzaza maselo athanzi. Izi zimangotchedwa ONSE.
Maselo a khansa awa samangokhala mu fupa louma lokha, koma amatha kuyenda m'magazi ndikufalikira (metastasize) m'thupi lonse.
Koma chofunika kwambiri n’chakuti ONSE, ngakhale ali ndi vuto lalikulu, ndi matenda ochiritsika kwathunthu ndi chithandizo choyenera. Chiŵerengero cha machiritso n’chokwera kwambiri, makamaka pakati pa ana aang’ono.
Kodi mitundu ikuluikulu ya ALL ndi iti?
Tikamalankhula za ma lymphocyte, pali mitundu iwiri ikuluikulu ya iwo: maselo a B ndi maselo a T. Khansa yonse imachokera ku mitundu iwiriyi ya maselo.
| Mtundu wa khansa | Kufotokozera kosavuta |
|---|---|
| B-selo ONSE (B-selo ONSE) | Uwu ndi mtundu wofala kwambiri. Umakhala pafupifupi 85% ya ALL mwa ana ndi 75%-80% ya ALL mwa akuluakulu. Maselo a B ndi mtundu wa maselo omwe amapanga ma antibodies motsutsana ndi majeremusi m'thupi lathu. |
| T-selo ONSE (T-selo ONSE) | Izi ndi zachilendo pang'ono. Pafupifupi 25% ya akuluakulu ndi 12%-15% ya ana amakula ndi mtundu uwu. Ma T cell ndi mtundu wa maselo omwe amapha mwachindunji majeremusi ndikuthandizira maselo ena m'thupi. |
Kuwonjezera pa mitundu iwiriyi, palinso mtundu wosowa kwambiri wotchedwa Natural Killer ALL. Dokotala wanu adzachita mayeso ofunikira kuti adziwe mtundu weniweni wa matenda omwe inu kapena mwana wanu muli nawo.
Kodi ndi zizindikiro ziti zomwe timaziona?
Pamene ALL ikukula, maselo a magazi abwinobwino m'thupi amachepa, zomwe zimayambitsa zizindikiro zosiyanasiyana. Zizindikirozi zimatha kubwera mwadzidzidzi kapena kukula pang'onopang'ono.
Chofunika: Kukhala ndi zizindikiro izi sikutanthauza kuti muli ndi zonse. Komabe, ngati muli ndi zizindikiro izi kwa milungu yoposa iwiri, ndikofunikira kuonana ndi dokotala kuti akupatseni upangiri.
| Chizindikiro | Zimatanthauza chiyani? |
|---|---|
| Kutopa kosalekeza komanso kufooka | Chifukwa cha kuchepa kwa maselo ofiira m'thupi (anemia), ngakhale kuchita ntchito zazing'ono kungakhale kotopetsa, ndipo thupi likhoza kuoneka lotumbululuka. |
| Kudwala pafupipafupi | Maselo oyera a magazi abwino akamachepa, mphamvu ya thupi yolimbana ndi matenda (chitetezo cha mthupi) imachepa. Zotsatira zake, matenda monga malungo ndi chimfine amatha kuchitika pafupipafupi. |
| Kutuluka magazi ndi kuvulala | Pamene ma platelet omwe amathandiza magazi kuundana achepa, kutuluka magazi m'mphuno, kutuluka magazi m'kamwa, komanso kuvulala pang'ono kungayambitse mawanga akuluakulu abuluu m'thupi. Azimayi amatha kutuluka magazi ambiri panthawi ya msambo. |
| Madontho ofiira pakhungu (petechiae) | Madontho ofiira ang'onoang'ono amaoneka pakhungu ngati kuti abayidwa ndi pini, chifukwa cha kutuluka magazi kuchokera m'mitsempha yamagazi yabwino kwambiri yomwe ili pansi pa khungu. |
| Kupweteka kwa mafupa ndi mafupa | Pamene maselo a khansa akudzaza mafupa, ululu waukulu ukhoza kuchitika m'mafupa ndi m'malo olumikizirana mafupa. |
| Ma lymph nodes otupa | Ziphuphu (tiziphuphu) m'malo monga khosi, m'khwapa, ndi m'mimba zimatha kutupa popanda kupweteka. |
| Zina mwazinthu | Zizindikiro monga kusowa chilakolako cha chakudya, kuchepa thupi, kutuluka thukuta usiku, komanso kupuma movutikira zingaonekenso. |
N’chifukwa chiyani matendawa amapezeka? Kodi zinthu zoopsa ndi ziti?
Palibe chifukwa chimodzi chokha chomwe chimayambitsa khansa YONSE. Chifukwa chachikulu, monga tafotokozera kale, ndi kusintha kwa majini komwe kumachitika panthawi yopanga maselo amagazi. Mwa ana aang'ono, kusintha kumeneku kungachitike asanabadwe.
Komabe, zinthu zingapo zapezeka zomwe zimawonjezera chiopsezo chotenga matendawa.
- Zaka: Chiwopsezochi chimakhala chachikulu kwambiri pakati pa ana osakwana zaka 15, makamaka omwe ali pakati pa zaka 2-5, komanso akuluakulu opitirira zaka 50.
- Matenda ena a majini: Anthu omwe ali ndi matenda enaake a majini, monga Down syndrome, ali ndi chiopsezo chachikulu chotenga matenda onse.
- Kukhudzidwa ndi kuwala kwa dzuwa: Kukhudzidwa ndi kuwala kwa dzuwa kochuluka, mwachitsanzo, ngati mudalandirapo chithandizo cha khansa ina, kungakulitse chiopsezo chanu.
- Mavairasi ena: Matenda ena a mavairasi, monga kachilombo ka Epstein-Barr, amakhulupiriranso kuti amawonjezera chiopsezo.
- Kugwiritsa ntchito fodya: Pakati pa akuluakulu, kukhudzidwa ndi zinthu zomwe zimayambitsa khansa monga kugwiritsa ntchito fodya kungakhalenso chifukwa.
Kodi dokotala amazindikira bwanji matendawa molondola?
Mukapita kukaonana ndi dokotala yemwe ali ndi zizindikiro zomwe mwatchula pamwambapa, choyamba adzakufunsani funso latsatanetsatane lokhudza zizindikiro zanu. Kenako adzakuyesani thupi ndikuyitanitsa mayeso angapo kuti atsimikizire matendawa.
- Mayeso a magazi:Kuyesa kwa magazi kwa nthawi zonse (Full Blood Count (FBC)) kungathe kuzindikira zolakwika mu chiwerengero cha maselo m'magazi.
- Kufufuza za mafupa: Iyi ndi njira yaikulu yoyesera yomwe imagwiritsidwa ntchito kutsimikizira matendawa. Chitsanzo chaching'ono cha mafupa chimatengedwa kuchokera pamalo monga fupa la m'chiuno pansi pa mankhwala oletsa ululu ndikuwunikidwa pansi pa maikulosikopu. Izi zitha kudziwa ngati maselo a khansa alipo, ndipo ngati alipo, mtundu wanji.
- Mayeso ojambulira: Kujambula kwa CT ndi PET scans zitha kuchitidwa kuti zione ngati khansa yafalikira mbali zina za thupi, mwachitsanzo, mpaka pachifuwa.
- Kuboola kwa msana/kupopera msana: Ngati pali kukayikira kulikonse kuti maselo a khansa afalikira ku ubongo kapena msana, madzi ochepa a msana amatengedwa kuchokera ku msana ndikuyesedwa.
Kodi mankhwala a ONSE ndi otani?
Pali njira zingapo zochizira matenda a ALL. Dokotala wanu adzakukonzerani njira yabwino kwambiri yochizira matenda anu kutengera zinthu zambiri, kuphatikizapo msinkhu wanu, mtundu wa matenda, ndi zizindikiro za majini zomwe zili m'maselo anu a khansa.
Chithandizo chachikulu: Chemotherapy
Chemotherapy ndi mankhwala amphamvu omwe amapha maselo a khansa. Ndi mankhwala akuluakulu a ONSE. Mankhwalawa amaperekedwa m'magawo angapo, kuyambira miyezi ingapo mpaka zaka ziwiri mpaka zitatu.
| Magawo a chithandizo | Chikuchitika ndi chiyani? |
|---|---|
| 1. Gawo loyamba (Kuyambitsa Kutulutsa) | Izi zimatenga pafupifupi milungu 4-6. Cholinga chachikulu ndikuwononga maselo ambiri a khansa mwachangu momwe zingathere. Panthawiyi, nthawi zambiri mumayenera kukhala kuchipatala. |
| 2. Chithandizo cha mitsempha (mankhwala otsogozedwa ndi CNS) | Mankhwalawa amaperekedwa kuti aletse maselo a khansa kufalikira ku ubongo ndi msana, kapena kuwawononga ngati afalikira. Izi nthawi zambiri zimachitika pagawo loyamba. |
| 3. Gawo lophatikiza | Matendawa akatha, gawoli limayamba kuwononga maselo onse otsala a khansa. Mudzagonekedwa m'chipatala kwa masiku angapo milungu ingapo iliyonse kwa miyezi ingapo ndikulandira mankhwala a m'mitsempha (IV). |
| 4. Gawo lokonza | Iyi ndi gawo lomaliza komanso lalitali kwambiri. Zimatenga zaka 2-3. Cholinga apa ndikuletsa matendawa kuti asabwererenso. Nthawi zambiri, mankhwala akumwa ndi mankhwala operekedwa kudzera m'mitsempha amaperekedwa kuchipatala. Palibe chifukwa chopita kuchipatala pafupipafupi. |
Mankhwala ena
- Chithandizo cholunjika: Izi zimaphatikizapo kupereka mankhwala omwe amalimbana ndi kusintha kwa majini komwe kumapezeka m'maselo a khansa okha. Mwachitsanzo, chithandizochi chimagwira ntchito kwambiri kwa anthu omwe ali ndi kusintha kwa majini kotchedwa Philadelphia chromosome.
- Chithandizo cha Immunotherapy: Izi zimaphatikizapo kulimbikitsa chitetezo chathu chamthupi kuti chiwononge maselo a khansa. Chithandizo cha maselo a CAR-T ndi njira yamakono yochizira yomwe ili m'gululi.
- Chithandizo cha radiation: Chithandizo cha radiation chingagwiritsidwe ntchito ngati khansa siikulandira chithandizo cha chemotherapy kapena pamene matendawa abwereranso.
- Kusamutsa mafupa: Ngati njira zina zothandizira sizikuyenda bwino kapena chiopsezo choti matendawa abwererenso chili chachikulu, mungatumizidwe kwa munthu wathanzi kuti akasamutse mafupa.
Kodi mwayi wochira matendawa ndi wotani?
Funso lalikulu kwambiri lomwe aliyense amafunsa ndi lakuti ALL ndi khansa yomwe imayankha bwino ikalandira chithandizo.
Kwa ana, zotsatira zake zimakhala zabwino kwambiri. 98% ya ana omwe amalandira chithandizo choyenera amachira kwathunthu matendawa. Chiŵerengero cha kupulumuka pambuyo pa zaka 5 matendawa atachiritsidwa ndi chokwera kufika pa 90%.
Chiwerengerochi n'chochepa pang'ono pakati pa akuluakulu. Chiŵerengero cha kupulumuka kwa zaka 5 kwa akuluakulu chili pakati pa 30% - 40%.
Koma ndikofunikira kumvetsetsa kuti izi ndi ziwerengero chabe. Momwe munthu amachitira chithandizo chingakhale chosiyana kwambiri ndi cha wina. Choncho musachite mantha ndi ziwerengerozi. Dokotala yekha amene amakuthandizani ndi amene angakupatseni chidziwitso chabwino kwambiri chokhudza matenda anu kapena a mwana wanu.
Ndizachibadwa kumva ngati moyo wanu ukuwonongeka mukapezeka ndi khansa. Makamaka ngati ndi mwana wanu. Koma kumbukirani, ALL ndi matenda ochiritsika kwambiri kuposa mitundu ina yambiri ya khansa. Khulupirirani gulu lanu lachipatala. Adzakhala nanu paulendowu, kukupatsani chithandizo chonse ndi mafotokozedwe omwe mukufuna.
Uthenga Wopita Nawo Kunyumba
- Khansa ya m'magazi yotchedwa Acute Lymphoblastic Leukemia (ALL) ndi khansa yomwe imayamba m'maselo oyera a m'magazi otchedwa lymphocytes, omwe ndi mtundu wa maselo oyera a m'magazi.
- Ngakhale kuti matendawa ndi ofala kwambiri pakati pa ana aang'ono, amatha kufalikira kwa aliyense wa msinkhu uliwonse.
- Ngati mukumva zizindikiro monga kutopa kosalekeza, kufiira, matenda obwerezabwereza, kuoneka buluu kwa thupi, ndi kupweteka kwa mafupa kwa milungu yoposa iwiri, funsani dokotala nthawi yomweyo.
- Ngakhale kuti ALL ndi matenda oopsa, amatha kuchiritsidwa kwathunthu ndi mankhwala monga chemotherapy. Chiŵerengero cha machiritso n'chokwera kwambiri, makamaka pakati pa ana.
- Njira yochizira ikhoza kukhala yayitali komanso yotopetsa, koma musachite mantha, khulupirirani madokotala anu, ndipo tsatirani malangizo awo molondola.
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