Ese wigeze wumva iby'iyi kanseri ikomeye y'amaraso? (Acute Promyelocytic Leukemia - APL) Reka tuganire birambuye!

Ese wigeze wumva unaniwe cyane mu buryo butunguranye, ukagira ibikomere bike, cyangwa ukagira amaraso menshi mu ishinya? Nubwo tutita cyane kuri ibi bintu, mu bihe bidasanzwe, bishobora kuba ibimenyetso by'indwara ikomeye cyane, nka Acute Promyelocytic Leukemia (APL) . Rero, ntugahangayike, uyu munsi turaganira kuri iyi kanseri y'amaraso yitwa APL mu buryo bwumvikana kandi bworoshye.

Leukemia itera promyelocytic (APL) ni iki?

Muri make, APL ni ubwoko budasanzwe bwa kanseri y'amaraso . Mu by'ukuri iri mu itsinda rinini rya kanseri zifata amaraso yitwa Acute Myeloid Leukemia . Ahantu hakuru amaraso akorerwa mu mubiri wacu ni umwongo w'amagufwa . Aha muri uyu mwongo w'amagufwa, bitewe n'impinduka mu miterere y'uturemangingo, uturemangingo tw'amaraso tudasanzwe dutangira kubaho. Utwo turemangingo tudasanzwe twigabanyamo kabiri kandi tukagwira mu buryo butunguranye, tugakwirakwira mu mwongo w'amagufwa. Hari igihe abaganga babyita APL leukemia, cyangwa M3-leukemia .

APL ni indwara ikomeye. Ibimenyetso byayo bishobora kugaragara mu buryo butunguranye kandi bikarushaho kwiyongera vuba. Kuva amaraso menshi ni ikintu gikomeye gishobora gutera ibyago. Ariko hari inkuru nziza! Hamwe n'uburyo bushya bwo kuvura, harimo imiti ya chimiotherapie n'imiti mishya idakoresha imiti ya chimiotherapie, abaganga barashobora kugenzura APL kandi akenshi bakayikiza burundu.

Iyi ndwara ikunze kugaragara mu rugero rungana iki?

Mu by’ukuri indwara ya APL ni indwara idakunze kugaragara cyane. Urugero, mu gihugu nka Leta Zunze Ubumwe za Amerika, abantu bagera ku 30.000 gusa ni bo bafatwa n’iyi ndwara buri mwaka. Akenshi, APL ifatwa n’abantu bari mu kigero cy’imyaka 30 .

Ni ibihe bimenyetso bya APL?

Ibimenyetso bya APL bibaho iyo umwongo w'amagufwa yawe udashobora gukora uturemangingo dutukura tw’amaraso , uturemangingo tw’umweru, na plaquettes nk’uko bisanzwe. Uku kugabanuka kw’utwo bwoko bwose bw’uturemangingo tw’amaraso byitwa pancytopenia . Iyo ibi bibaye, ushobora kugira ibimenyetso bikomeye nko kubura amaraso , ibibazo byo kuva amaraso bitewe no kuvura amaraso, ndetse no kurwara indwara nyinshi.

Ibindi bimenyetso bisanzwe bya APL ni ibi bikurikira:

• Kumva unaniwe cyane kandi unaniwe bitewe no kugabanuka k'uturemangingo dutukura mu maraso (ni ukuvuga kubura amaraso).
• Kwandura indwara kenshi bitewe n'uturemangingo tw'amaraso tw'umweru dukeya turwanya indwara. Ibintu nk'umuriro n'ibicurane bishobora kubaho kenshi.
• Kubera ko imikorere y'umubiri wawe yihuta kandi ingufu ziva mu biribwa zigashya vuba,Kugabanya ibiro utabigambiriye.

Ibimenyetso byo kuva amaraso

Umuntu ufite APL aba afite umubare muto wa platelets n'ibintu bigabanya amaraso bifasha kugabanya amaraso . Urabizi, platelets ni zo zifasha guhagarika cyangwa kugabanya kuva amaraso. Rero, iyo ibi biri hasi, ikibazo kiratangira.

Dore bimwe mu bimenyetso by'amaraso aterwa na APL:

• Kuva amaraso bishobora kubaho ahantu hose mu mubiri. Urugero, kuva amaraso mu ishinya , kuva amaraso kenshi mu mazuru , no kuva amaraso menshi mu mihango y'abagore.
• Amaraso yikusanyiriza munsi y'uruhu agatera udusebe ahantu hatandukanye ku mubiri . Ndetse n'igisebe gito gishobora gutera igisebe kinini.
• Hari igihe kuva amaraso bishobora kubaho mu bwonko (kuva amaraso mu bwonko) . Ibi bibaye, ushobora kugira ingorane zo kwimura amaguru n'amaboko, ukababara umutwe cyane, ndetse ugashobora no kugira impinduka mu maso. Ibi ni ibintu byihutirwa!
• Niba umwanda wawe ari umukara cyangwa ufite imirongo y'amaraso, bishobora guterwa no kuva amaraso mu gifu (kuva amaraso mu nda) .

Ni iki gitera APL?

Iyi ndwara iterwa na za jeni ebyiri zigenzura ikorwa ry'uturemangingo tw'amaraso yacu twishyira hamwe tugakora jeni idasanzwe yitwa PML-RARa . Icy'ingenzi ni uko iyi mihindagurikire y'uturemangingo atari ikintu uvukana ku babyeyi bawe . Bibaho ku buryo butunguranye, nta mpamvu, mu gihe cy'ubuzima bwawe. Impuguke ntizimenya neza icyatera iyi mihindagurikire y'uturemangingo.

Iyi mpinduka ituma uturemangingo tw’amaraso twera dukura nabi, aho gukura neza, ahubwo tugakora uturemangingo tw’amaraso twera tudakuze (promyelocytes) . Utwo turemangingo tudakuze twuzuza umwongo w’amagufwa, tugashyira ahantu hatagira uturemangingo tw’amaraso n’udupira tw’amaraso tuzima.

Ni izihe ngorane za APL?

APL ni indwara ishobora gushyira ubuzima mu kaga. Ibi biterwa nuko kuva amaraso menshi cyane bishobora guhita biba akaga. Niba udashobora guhagarika kuva amaraso no mu gisebe gito, niba ufite amaraso menshi mu mwanda wawe cyangwa mu nkari iyo ugiye mu bwiherero, cyangwa niba udashobora guhagarika kuva amaraso mu ishinya, ugomba kujya kwa muganga cyangwa kujya mu cyumba cy’ubutabazi bw’ibanze cy’ibitaro ako kanya .

Ibuka: Niba ufite amaraso adatekanye, ntuzigere ubyirengagiza. Kuvurwa vuba ni ingenzi.

Indwara ya APL ipimwa ite?

Ubusanzwe abaganga bakora ibizamini byinshi kugira ngo bamenye iyi ndwara.

• Umubare wuzuye w'amaraso (CBC): APL ituma uturemangingo tw'umweru tw'amaraso tudasanzwe dukora. Ikizamini cya CBC gishobora kureba ubwoko butandukanye bw'uturemangingo tw'amaraso n'umubare wa plaquettes mu gipimo cy'amaraso yawe.
• Gusiga amaraso ku ruhande rw'umubiri:Muri ibi, amaraso arafatwa agasuzumwa hifashishijwe mikorosikopi. Hanyuma, bareba niba hari utunyangingo twinshi duto muri utwo turemangingo tw’amaraso tw’umweru tudakuze (promyelocytes), cyangwa niba hari ibintu byihariye byitwa Auer rods . Ibi biranga APL.
• Isuzuma ry'Umwobo w'Amagufwa: Muri iki kizamini, hafatwa urugero ruto rw'umusobo w'amagufwa yawe hanyuma hagasuzumwa uturemangingo twawo.
• Isuzuma ry’imiterere y’uturemangingo: Muri iki kizamini, abahanga mu by’indwara bareba imiterere ya poroteyine runaka ku buso bw’uturemangingo tudasanzwe. Iyi imiterere ishobora kwemeza APL.
• Ikizamini cya Polymerase Chain Reaction (PCR): Iki kizamini gishobora kugaragaza neza niba hari gene idasanzwe (PML-RARa) itera APL.
• Cytogenetics: Iyi ni uburyo bwo gupima impinduka zihariye muri chromosomes z'uturemangingo tudasanzwe. Kubona izi mpinduka ni bwo buryo bw'ingenzi bwo kwemeza ko APL yasuzumwe.

Abaganga bashyira APL mu byiciro nk'ifite ibyago bike cyangwa ibyago byinshi bitewe n'umubare w'uturemangingo tw'amaraso yawe. Abantu bafite APL ifite ibyago byinshi baba bafite ibyago byinshi byo kurwara kanseri isubira cyangwa kongera kuyirwara .

Indwara ya APL ivurwa ite?

APL ivurwa hakoreshejwe imiti igabanya ubukana bw'indwara , imiti igabanya ubukana bw'indwara, n'imiti ivura indwara . Mu by'ukuri, kuva ubwo buvuzi bwavumbuwe mu myaka ya 1980, iyi ndwara, mbere yafatwaga nk'iyica, ubu yabaye indwara ivurwa neza. Iyi ni intambwe ikomeye!

Imiti igabanya uturemangingo ni imiti idakoresha imiti ivura indwara ya chimiotherapie ifasha uturemangingo tw’amaraso twera tudakuze guhinduka uturemangingo tw’amaraso twera dusanzwe kandi dukuze. Iyi miti idakoresha imiti ivura indwara ya chimiotherapie, yavuzwe hano hepfo, yatumye habaho kugabanuka no gukira ku kigero kirenga 95%.

• Acide ya trans-retinoic (ATRA) , cyangwa tretinoin (Vesanoid ®) – Iyi ni ubwoko bwa vitamine A.
• Arsenic trioxide (ATO) – Iyi ni ubwoko bwa arsenic.

Niba umuganga wawe akeka ko ufite APL, ashobora kugutangira ATRA mbere yuko ibindi bipimo byemeza ko indwara ihari. Ibi biterwa nuko gutangira kuvurwa hakiri kare bishobora kugabanya ibyago byo kuva amaraso mu buryo bushobora kuguhitana.

Intambwe zo kuvura APL

Ubusanzwe kuvura bikorwa mu byiciro bitatu: Kwinjiza, Guhuza, no Kubungabunga. Kuvura bishobora gutandukana bitewe n'urwego rw'ibyago.

• Icyiciro cya mbere (Induction):Intego nyamukuru y'iki cyiciro ni ukwica uturemangingo twa leukemia duhagije kugira ngo APL yawe igabanuke . Gusubiramo bivuze ko nta bimenyetso ufite kandi nta bimenyetso bya leukemia bishobora kuboneka mu bipimo. Ibi bikorwa hakoreshejwe imiti itari imiti ikoreshwa mu buvuzi, imiti ikoreshwa mu buvuzi, n'imiti ikoreshwa mu buryo bwihariye. Muri iki gihe, uzakenera kuguma mu bitaro, ubusanzwe ibyumweru bine kugeza kuri bitandatu.
• Icyiciro cyo guhuza: Umuganga wawe w’indwara ya kanseri ashobora kandi kwita ubu buryo ‘ubuvuzi bwa nyuma yo kurekurwa’. Ubu buryo butuma APL ikomeza kugabanuka kandi bugakomeza kwica uturemangingo twose twa leukemia dusigaye. Uyu ni wo muti wakoreshejwe mu cyiciro cya mbere. Ubu buryo bushobora kumara amezi umunani, buri mezi abiri buvurwa. Ushobora guhabwa ibyumweru bine by’ubuvuzi hanyuma ukaruhuka ibyumweru bine. Uyu muti ushobora gutangwa nk’ibinini cyangwa nk’ubuvuzi bwo mu mitsi (IV) .
• Icyiciro cyo kubungabunga: Ubu ni uburyo bwo kuvura bukomeza, ariko umuti utangwa ku gipimo gito ugereranije no mu cyiciro cya mbere n'icyo kubungabunga. Ubu buryo bwo kubungabunga busanzwe butangwa mu gihe cy'umwaka umwe.

Umuganga wawe w’indwara ya kanseri ashobora kandi kuguha uburyo bwo kuvura bugufasha , nko guterwa amaraso, hamwe n’ubu buryo bwo kuvura.

Ingorane zo kuvurwa

Ingorane ikunze kugaragara cyane, kandi ikomeye gato, yitwa differentiation syndrome . Iyi ni itsinda ry'ingaruka zikomeye ku miti ya APL. Izi ngaruka zikunze kubaho mu byumweru bitatu bya mbere uhereye igihe umuntu yatangiye kuvurwa. Ibimenyetso bishobora kuba byoroheje cyangwa bikomeye. Bimwe muri byo birimo:

• Inkorora.
• Amazi menshi akikije umutima wawe n'ibihaha (pleural effusion) .
• Kunanirwa kw'impyiko .
• Umuvuduko w'amaraso uri hasi (hypotension) .
• Kugabanuka k'urugero rwa ogisijeni mu maraso (hypoxemia) .
• Kugorwa no guhumeka (dyspnea) .
• Kubyimba/ kubyimba amaboko, amaguru, n'ijosi.
• Umuriro uza nta mpamvu.
• Kongera ibiro nta mpamvu.

Iyo ugize iyi ndwara yo gutandukanya ibice by'umubiri (differentiation syndrome), muganga wawe ashobora guhagarika imiti yawe igihe runaka. Ashobora no gukoresha indi miti, nka hydroxyurea, kugira ngo agabanye umubare w'uturemangingo tw'amaraso twera.

Ni iki umuntu ufite APL yakwitega?

Muri rusange, imiterere y'indwara ni myiza.Nubwo imimerere ya buri wese itandukanye, ubushakashatsi bwagaragaje ko hagati ya 90% na 95% by'abantu bafite APL basubira mu buzima bwabo. Ariko, APL ishobora kugaruka nyuma yo kuvurwa. Hagati ya 5% na 10% by'abantu bazasubira mu buzima bwabo, akenshi mu myaka itatu ya mbere nyuma yo kuvurwa. Hanyuma bazakenera ubundi buvuzi cyangwa ubundi.

Igipimo cy'abarokotse

Kubera ko APL ari indwara idakunze kugaragara, icyo tuzi ku mibare y’abarokoka gituruka ku mageragezwa ya muganga arimo abarwayi ba APL bafite ibyago bike kandi bafite ibyago byinshi.

Isesengura rimwe ryerekana ko 99% by'abarwayi ba APL bafite ibyago bike baba bakiriho nyuma y'imyaka ine bavuwe. Irindi sesengura ry'abarwayi ba APL bafite ibyago byinshi ryerekana ko 86% baba bakiriho nyuma y'imyaka itanu bavuwe. Ibi ni ibisubizo byiza cyane!

Nitwara nte?

Kubera ko APL ishobora kugaruka, ni ngombwa cyane ko ubonana na muganga wawe ku gihe (gahunda zo gukurikirana) .

Uzajya ukorerwa isuzuma rya muganga buri kwezi cyangwa abiri mu mwaka wa mbere nyuma yo kuvurwa. Nyuma y'umwaka wa mbere, uzakenera kujya kwa muganga wawe buri mezi atatu kugeza kuri ane mu myaka ibiri iri imbere. Ibizamini nka CBC, PCR, na biopsy y'umusemburo w'amagufwa bishobora gukorwa muri izi suzuma.

Ni ryari nkwiye kujya mu cyumba cy’ubutabazi bw’ibanze?

APL ishobora kongera kugaruka nyuma yo kuvurwa, kandi ibimenyetso bishobora kwiyongera vuba. Niba ugize ikibazo cyo kugabanuka kwa APL, jya mu cyumba cy’ubutabazi bw’ibanze vuba niba uhuye n’ibi bikurikira:

• Niba urimo kuva amaraso mu buryo butunguranye .
• Niba ubyimbye mu buryo butunguranye ukagira ububabare mu maguru yawe cyangwa mu nda yo hasi .

Hanyuma, ubutumwa bw'ingenzi

Leukemia yo mu maraso iterwa n'indwara ya APL (Acute promyelocytic leukemia - APL) ni kanseri idasanzwe yo mu maraso yafatwaga nk'indwara yica, ariko ubu yahindutse indwara ivurwa bitewe n'ubuvuzi bugezweho.

Ariko, iyi ndwara iracyari ikomeye. Iyo idasuzumwe kandi igavurwa vuba, ishobora gushyira ubuzima mu kaga . Kubwibyo, niba ufite ibimenyetso nko kuva amaraso mu buryo budasubirwaho, ntukirengagize. Icy'ingenzi ni ukugisha inama kwa muganga no kwisuzumisha vuba bishoboka. Ntutinye, gira ubutwari, kuko ubu hari uburyo bwiza bwo kuvura ibi!

` Leukemia, APL, Kanseri y'amaraso, Kanseri y'amaraso, Umwotsi w'amagufwa, Anemia, ATRA, Chimiotherapie, Leukemia yo mu bwoko bwa Promyelocytic, M3-Leukemia, PML-RARa, Kuva amaraso