Wakambonzwa nezveChronic Lymphocytic Leukemia (CLL) here? Ngatikurukurei zvakadzama nezvazvo!

Dzimwe nguva unongonzwa kuneta zvakanyanya here? Kana kuti unowanzo rwara nefivha here? Une mapundu madiki anonzwa sekunge ari pamutsipa wako, muhapwa, kana muzvidya? Izvi zvinogona kuva zviratidzo zveChronic Lymphocytic Leukemia, kana CLL muchidimbu. Asi usazvidya moyo, nekuti kuva nezviratidzo izvi zvese hazvirevi kuti une chirwere ichi. Asi zvakakosha kuziva zvinhu zvakaita seizvi. Saka ngatitaurei nezveCLL nenzira iri nyore nhasi, zvakanaka here?

Chii chinonzi chronic lymphocytic leukemia (CLL)? Zvichitaurwa zviri nyore...

Chirwere chegomarara remuropa (CLL) igomarara remuropa. Ndiyo mhando yegomarara remuropa rinowanzoonekwa nevanhu vakuru. Masero eropa anogadzirwa mumongo wemapfupa. Izvi zvinoitika kana malymphocyte, rudzi rwesero reropa jena rine hutano mumongo wemapfupa, achiva asina kujairika, zvichireva kuti anochinja ova kenza. Masero aya egomarara anowanda zvisingadzoreki, achivhara masero eropa ane hutano nemaplatelet, izvo zvinobatsira kuti ropa rigwambe.

CLL inowanzoonekwa nevanhu vane makore anopfuura 65. Zvisinei, dzimwe nguva inogona kuitika kune vanhu vane makore ari pakati pe30 neanopfuura. Uyezve, vamwe vanhu vanogona kuva neCLL vasina zviratidzo . Vanhu vazhinji vanoziva nezvechirwere ichi pavanoongororwa ropa kuti vaone chimwe chirwere kana panguva yekuongororwa kwechiremba kwegore negore.

Parizvino, hapana mushonga weCLL. Asi izvozvo hazvisi zvekunetseka. Mumakore gumi apfuura, vanachiremba vakagadzira nzira itsva dzekurapa dzinogona kudzora CLL uye kuita kuti irege kurwara . Kurapa uku kwakabvumira vanhu vane CLL kurarama kwenguva yakareba.

Ndeapi marudzi makuru eCLL?

Kune mhando mbiri huru dzemasero machena eropa mumuviri wedu, dzinonzi lymphocytes. CLL inogona kukura mune imwe chete yemhando mbiri idzi.

• B-lymphocytes (B-cells): Aya ndiwo masero anogadzira ma antibodies, rudzi rweprotein inoziva nekurwisa utachiona hunokuvadza, mabhakitiriya, mavhairasi, uye kunyange masero ekenza.
• T-lymphocytes (T-cells): Idzi dzinodzora mashandiro emasoja emuviri mumuviri wedu. Dzinowanawo nekuparadza masero asina kujairika, akadai semasero ekenza.

Rudzi rweCLL rwakajairika iB-cell CLL . Pane chirwere chakafanana chinokanganisa T-cells, chinonzi T-cell prolymphocytic leukemia (PLL). Zvisinei, vanhu vane PLL vanokura zviratidzo nekukurumidza kupfuura vanhu vane B- cell CLL.

Chirwere ichi chinonzi CLL chakajairika zvakadii?

Kutaura zvazviri, chirwere che chronic lymphocytic leukemia (CLL) ndeimwe yemhando dze leukemia dzinowanikwa zvakanyanya muvanhu vakuru. MuUnited States, chirwere ichi chinobata vanhu vanosvika 5 pavanhu 100,000. American Cancer Society inofungidzira kuti pachava nevanhu vatsva vanosvika 18,700 vane CLL muna 2023 chete. Kuti tinzwisise izvi, vanhu vatsva vanopfuura 238,000 vane kenza yemapapu (imwe yekenza dzakajairika) vanotarisirwa kutaurwa nezvavo muna 2023. Saka, kunyange zvazvo CLL ingasaita seyakajairika, ndeimwe yemhando dze leukemia dzakajairika.

Ndezvipi zviratidzo zveCLL?

Sezvatakambotaura, vamwe vanhu vanogona kuva neCLL vasina zviratidzo . Zvinogona kutora mwedzi kana makore kuti zviratidzo zvionekwe. Zviratidzo zvakajairika ndeizvi:

• Kuneta: CLL inogona kukanganisa masero matsvuku eropa, zvichikonzera anemia. Kuneta chiratidzo chinowanzoonekwa cheanemia.
• Fivha: Fivha chiratidzo chehutachiona. Nekuti CLL inokanganisa masero machena eropa ane hutano, une mukana wekutapukirwa nehutachiona.
• Ma lymph nodes akazvimba mumutsipa, muhapwa, muhudyu, kana mudumbu.
• Kudikitira husiku.
• Kudzikira uremu kusingatsananguriki.
• Kurwadziwa kana kunzwa kuzara pasi pembabvu dzako: CLL inogona kukanganisa chiropa chako kana chirebvu. Kana masero egomarara akaungana munhengo idzi, anogona kuzvimba.

Sei CLL ichikura? Ndezvipi zvinhu zvinokonzera njodzi?

Chirwere che chronic lymphocytic leukemia (CLL) chinokura kana mamwe machinjiko, kana kuti shanduko, akaitika muma chromosome nemajini edu muhupenyu hwedu. Zvisinei, vaongorori vezvekurapa havasati vava nechokwadi chekuti chii chinokonzera shanduko idzi. Zvisinei, vakaona zvinhu zvinoverengeka zvinogona kukanganisa izvi:

• Nhoroondo yemhuri: Ongororo yakaratidza kuti kana mumwe wehama dzako dzepedyo, kureva amai vako, baba vako, vanun'una vako, kana vana, aine CLL, njodzi yako yekubatwa neCLL inogona kuwedzera nekaviri kusvika kana.
• Zera: Paavhareji, varwere vanenge vane makore angangoita 71 kana vaonekwa kuti vane CLL.
• Bonde: Varume vane mukana mukuru wekuva neCLL.
• Kusangana neAgent Orange: Tsvagiridzo yakaratidza hukama pakati peAgent Orange, kemikari yakashandiswa panguva yeHondo yeVietnam, neCLL.
• Lymphocytosis yemasero eB-monoclonal:Muchirwere ichi, une mhando imwe chete yeB-cell muropa rako kupfuura zvakajairika. Kana uine chirwere ichi, une mukana mudiki wekuva neCLL.

Ndezvipi zvinetso zvinogona kuitika nekuda kweCLL?

CLL inokanganisa masero matsvuku eropa, masero machena eropa, uye maplatelet. Funga nezvazvo, masero matsvuku eropa anotakura okisijeni mumuviri wese. Masero machena eropa anotidzivirira kubva kuzvirwere. Maplatelet anobatsira kuumbwa kweropa. Saka, kana ukarasikirwa nemasero aya eropa ane hutano uye maplatelet, unogona kuva nematambudziko akadai se:

• Lymphoma: Pakati pe2% ne10% yevanhu vane CLL vanogona kukura nerudzi rwekenza inonzi lymphoma.
• Kenza yeganda, kenza yemapapu, kana kenza yemuura: CLL inoshayisa simba masoja emuviri wako simba rekudzivirira muviri, zvichiita kuti asakwanise kukudzivirira kubva kuzvirwere zvinopararira, kusanganisira masero ekenza. Izvi zvinogona kuwedzera njodzi yako yekubatwa nemamwe marudzi ekenza.
• Anemia: Anemia inogona kuitika kana pasina masero matsvuku eropa akakwana ekutakura okisijeni mumuviri wese.
• Thrombocytopenia: CLL inogona kukanganisa kugoverwa kwemaplatelet mumuviri wako. Izvi zvinogona kukonzera kubuda ropa.
• Kutapukirwa kwakajairika: Kana usina masero machena eropa akakwana, une mukana wekutapukirwa nehutachiona hwemabhakitiriya, hwefungus, kana hwemavhairasi.
• Zvirwere zve autoimmune: Vamwe vanhu vane CLL vanogona kuva nemamiriro ezvinhu akadai se autoimmune hemolytic anemia.

CLL inoonekwa sei?

Paunoenda kunoona chiremba, iye achakubvunza nezvezviratidzo zvako. Zvadaro, vachakuongororwa muviri uye vanogona kuraira mimwe miedzo, yakaita se:

• Kuverengwa kweropa rose (CBC) uye musiyano: Kuongororwa uku kunoyera huwandu hwemasero matsvuku eropa, masero machena eropa, uye maplatelet muropa rako. Kunoongororawo huwandu hwehemoglobin (puroteni inotakura okisijeni) mumasero matsvuku eropa rako.
• Kuongororwa kweropa: Nyanzvi yekurabhoritari yezvekurapa inoongorora masero eropa rako pasi pemaikorosikopu kuti ione kana masero ekenza aripo.
• Kuyerera kwemasero eropa: Iyi bvunzo yemurabhoritari inogona kupa ruzivo rwakawanda nezvemasero eropa rako. MuCLL, inoshandiswa kuona kana masero machena eropa rako aine masero eCLL.
• Kuongororwa kwemajini:Vanachiremba vanoshandisa bvunzo dzakadai se fluorescent in situ hybridization (FISH) uye immunoglobulin heavy chain (IGHV) kuti vaongorore ma chromosome nemajini ako. Kunzwisisa shanduko dzakaitika muma chromosome nemajini aya kunobatsira vanachiremba kusarudza nzira yekurapa CLL.

Matanho eCLL

Vanachiremba ndivo vanosarudza danho regomarara kuti varonge kurapwa uye vafanotaura mafambiro egomarara. Kune nzira mbiri huru dzinoshandiswa kuunganidza CLL: Rai staging system uye Binet staging system .

Dzimwe nguva, paunoverenga zvikamu izvi nemanhamba nemabhii, unganzwa kutya uye kusagadzikana. Ungatofunga kuti, "Ndiwo matsananguriro anoita chirwere changu mufomura here?" Vanachiremba vanonzwisisa izvozvo. Kana usina kujeka pane zviri kutaurwa, kana kuti zvichikuremera, ndapota bvunza chiremba wako kuti akutsanangurire kuti nzira iyi yezvikamu inoshanda sei pachirwere chako.

Sisitimu yeRai yekufambisa

Nzira iyi inoronga CLL zvichienderana nemukana wekuti iwedzere kuipa uye kana kurapwa kuchizodiwa:

• Njodzi shoma (yaimbozivikanwa seRai stage 0): Une lymphocytosis (kuwedzera kwehuwandu hwemalymphocytes), uye kune masero machena eropa asina kujairika muropa uye/kana mumongo wemapfupa.
• Njodzi yepakati (yaimbozivikanwa seRai danho rekutanga kana danho rechipiri): Une lymphocytosis, lymph nodes dzakazvimba, uye chiropa chakakura uye/kana chiropa.
• Njodzi huru (yaimbozivikanwa seRai Stage III): Une anemia kana thrombocytopenia (nhamba shoma yemaplatelet).

Sisitimu yekugadzira ma "binet"

Nzira iyi inobva pakuwanda kwemasero eropa rako nemaplatelet, pamwe nehuwandu hwenzvimbo dzine lymph nodes dzakazvimba mumuviri wako:

• Danho A: Hauna anemia (huwandu hushoma hwemasero matsvuku eropa) kana huwandu hushoma hwemaplatelet. Zvisinei, une lymph nodes dzakazvimba munzvimbo mbiri pamuviri wako. Semuenzaniso, unogona kunge uine lymph nodes dzakazvimba mumutsipa wako nemuhudyu.
• Danho B: Kune ma lymph nodes akazvimba munzvimbo nhatu pamuviri, kana kuti chiropa kana spleen zvakazvimba. Zvisinei, hapana anemia, uye huwandu hweplatelet hwakajairwa.
• Danho C: Une anemia uye lymph nodes dzakazvimba munzvimbo nhatu kana kupfuura pamuviri wako.

CLL inorapwa sei?

Nzira dzekurapa dzinoenderana nezviratidzo zvako uye mhedzisiro yebvunzo. Semuenzaniso, kana uine CLL yekutanga, chiremba wako anogona kukurudzira "kumirira wakatarisa/kutarisa zviri kuitika."Unogona kushandisa nzira inonzi "monitoring." Izvi zvinosanganisira kunyatsoongorora hutano hwako, zviratidzo, uye mhedzisiro yebvunzo pasina kutanga kurapwa.

Mhedzisiro yekuongororwa kwemajini inogonawo kukanganisa sarudzo dzekurapa. Semuenzaniso, shanduko dzemajini dzinogona kureva kuti mamiriro ako anogona kuipa nekukurumidza, kana kuti kurapwa kwakajairika kweCLL kungasashande zvakanaka sezvaitarisirwa.

Mishonga inonyanya kushandiswa yeCLL ndeyekurapa zvakanangana uye chemotherapy . Dzimwe nguva kurapwa nemwaranzi kunoshandiswa kuderedza zviratidzo zveCLL. Imwe neimwe yemishonga iyi inogona kukonzera migumisiro yakasiyana. Chiremba wako achatsanangura zvakajeka mabhenefiti, migumisiro, uye matambudziko angangoitika kwenguva refu ekurapwa kwauri kugamuchira.

Kurapa kwakanangana

Kurapa uku kunoshanda nekutarisa masero ekenza. Muchirwere che lymphocytic leukemia chisingaperi, kurapwa uku kunoshanda nekumisa kukura kwemasero machena eropa ane kenza. Mamwe marapirwo akagadzirirwa kuuraya masero ekenza pasina kukuvadza masero ane hutano. Mimwe yemishonga inoshandiswa pakurapa uku ndeiyi:

• Kurapa kweBruton's tyrosine kinase (BTK) inhibitor: Kurapa uku kunovhara enzyme inobatsira masero eB kugadzira masero machena eropa akawanda. Mienzaniso: ibrutinib (Imbruvica®) , acalabrutinib (Calquence®) , uye zanubrutinib (Brukinsa ®) .
• Kurapa kweBCL2 inhibitor: Mushonga wevenetoclax (Venclexta®) unovhara puroteni inonzi BCL2 inowanikwa mumasero eleukemia, kusanganisira masero eCLL. Kurapa uku kunogona kuuraya masero eleukemia kana kuita kuti ave nyore kubatwa nemimwe mishonga yekurwisa kenza.
• Kurapa kweMonoclonal antibody: Iyi imhando ye immunotherapy. Monoclonal antibodies imhando yeantibody inogadzirwa murabhoritari. Inomisa kukura kwemasero ekenza kana kuuraya masero ekenza. Mienzaniso: rituximab (Rituxan®) uye obinutuzumab (Gazyva®) .

Kurapwa nemakemikari

Chiremba wako anogona kushandisa chemotherapy senzira huru yekurapa chirwere che chronic lymphocytic leukemia. Mimwe yemishonga inonyanya kushandiswa yechemotherapy yeCLL ndeiyi:

• Fludarabine (Fludarabine - Fludara®)
• Chlorambucil (Chlorambucil - Leukeran®)
• Cyclophosphamide (Cytoxan®)
• Bendamustine (Bendamustine - Treanda®)

Kurapa nekudzivirira muviri

Nzira iyi yekurapa inoshanda nekudzorera kana kusimbisa masoja emuviri wako, ichibatsira kuparadza masero ekenza kana kunonotsa kukura kwawo.

Kune CLL isina kupindura kuchemotherapy, yakadzoka (yakadzokororwa) CLL, kana kuti iri kuipa, vanachiremba vanogona kushandisa mushonga we immunotherapy lenalidomide (Revlimid®) .

Vaongorori vezvekurapa vari kudzidzawo nezvekurapa kwe chimeric antigen receptor (CAR-T) kune varwere veCLL vasingapindure kurapwa kwakajairika.

Unogona kurarama kwenguva yakareba sei uine CLL?

Chirwere cheCLL (chronic lymphocytic leukemia) chinowanzo famba zvishoma nezvishoma. Unogona kurarama neCLL kwemakore usati wava nezviratidzo. Kana zviratidzo zvangoonekwa, vanachiremba vane nzira dzinoshanda kwazvo dzekurapa dzinogona kuisa CLL mukurerukirwa . Kurerukirwa uku kubva kuCLL kunowanzogara kwemakore akati wandei chirwere chisati chadzoka. Zvisinei, chiremba wako anogona kukurudzira dzimwe nzira dzekurapa dzinogona kuisa CLL mukurerukirwa zvakare. CLL hairapiki, asi vanhu vane chirwere vanogona kurarama hupenyu hurefu, hwakazara.

Sangano reNational Cancer Institute rinofungidzira kuti 87.9% yevarwere vane CLL vari vapenyu makore mashanu mushure mekuonekwa vaine chirwere ichi. Zvisinei, kana tichifunga nezvehuwandu hwevanhu vanorarama nechirwere ichi, zvakakosha kuyeuka kuti uhwu hufungidziro hwakavakirwa paruzivo rweboka guru revarwere vane CLL. Zvinhu zvakawanda zvinogona kukanganisa huwandu hwevanhu vanorarama nechirwere ichi, kusanganisira hutano hwako, danho rechirwere chako pakuongororwa, uye kuti chirwere chako chinopindura sei kurapwa. Kana uine mibvunzo, bvunza chiremba wako zvaunotarisira zvichienderana nemamiriro ako ezvinhu.

Chii chinoitika pakuguma kweCLL?

Izwi rekuti "chikamu chekupedzisira" rinoreva kuti mishonga haichashandi mukutonga kana kumisa chirwere cheCLL. Panguva iyoyo, unogona kunge uine hutachiona hunogona kutyisidzira hupenyu kana kubuda ropa kusingadzoreki uko vanachiremba vangasakwanisa kurapa.

Mamiriro ezvinhu aya anogona kudzivirirwa here?

Parizvino hapana nzira inozivikanwa yekudzivirira CLL.

Zvakaita sei kugara neCLL?

Zvinoenderana nemamiriro ako ezvinhu. Unogona kuva neCLL usina zviratidzo. Kana uine zviratidzo, kune mishonga yekuderedza zviratidzo uye kugadzirisa chirwere chacho. Zvisinei, chirwere hachizoperi zvachose.

Heano mamwe mazano anogona kukubatsira paunenge uchirarama neCLL:

• Zvidzivirire kubva kuzvirwere:Vanhu vane CLL vari panjodzi yakakura yekuwana hutachiona. Humwe hutachiona hunogona kuisa hupenyu panjodzi. Bvunza chiremba wako kuti ndeapi majekiseni akakunakira.
• Ziva hutano hwako: Ungangove uri panjodzi yakakura yekuva nekenza yeganda, kenza yemapapu, kana kenza yeura. Bvunza chiremba wako nezvekuongororwa kwekenza.
• Kudzora kushushikana: Vanhu vazhinji vane CLL vanopinda muzvikamu zvekureruka uye kudzokera shure. Sezvo chirwere ichi chichienderera mberi, unogona kunetseka uye kutya. Kana zvakadaro, bvunza chiremba wako nezvezvirongwa kana masevhisi anogona kukubatsira kudzora kushushikana kwako.
• Idya chikafu chine hutano: Zvimwe zviratidzo zveCLL zvinogona kukonzera kuti ushaye chido chekudya. Taura nachiremba wako nezvekuwana mazano kubva kune nyanzvi yezvekudya. Kana chido chako chekudya chiri chakanaka, edza kudya chikafu chine hutano chinosanganisira mapuroteni asina mafuta akawanda, zviyo zvese, michero nemiriwo, uye mafuta ane hutano. Izvi zvinogona kuvandudza hutano hwako hwese.
• Kurovedza muviri: Kurovedza muviri kunokubatsira kudzora kushushikana uye kukuita kuti ugare wakafara.
• Zorora: CLL inogona kuita kuti unzwe kuneta zvakanyanya. Zorora paunenge uchinzwa sekuti unoda kuzorora.
• Ziva zvekutarisira: Ruzivo isimba. Bvunza chiremba wako zviratidzo zvekuti chirwere chako chingave chiri kuipa. Kana zvakadaro, chiremba wako anogona kukurudzira mamwe marapirwo anogona kubatsira kudzora CLL yako zviri nani.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Ungada kubvunza mibvunzo yakaita seiyi:

• Ndine rudzii rwechirwere che lymphocytic leukemia chisingaperi?
• Handina zviratidzo. Ndinofanira kutanga riini kurapwa?
• Ndedzipi nzira dzekurapa dzandinadzo?
• Ndichazofanira kurapwa nekusingaperi here?
• Kurapwa kuchaita kuti dambudziko rangu rive nani here?

Pakupedzisira, zvinhu zvekurangarira (Mharidzo Yekuenda Kumba)

Chirwere cheCLL (chronic lymphocytic leukemia) imhando yeleukemia inonyanya kuwanikwa muvanhu vakuru. Unogona kuva nechirwere ichi kwemakore akawanda usina zviratidzo. Kana uine CLL, ungasafanira kutanga kurapwa nekukasika. Kunyange zvazvo vanachiremba vasingakwanise kuirapa zvachose, kune mishonga inogona kuderedza zviratidzo zveCLL uye kuita kuti chirwere chisanyanya kuipa . Vamwe vanhu vane CLL vanorarama kwemakore akawanda.

Kurarama nechirwere chisingaperi seCLL hakusi nyore nguva dzose. Unogona kupfuura nematanho akati wandei ekuzorora uye kudzoka. Munguva yega yega yekutenderera, unogona kunetseka nezvezvichaitika zvinotevera. Vanachiremba vako vanonzwisisa kuti zvakaita sei kurarama nechirwere chisingaperi. Vachafara kupindura chero mibvunzo yaungave nayo uye vanokubatsira nenzira yavanogona. Saka, usambotya kutaura nachiremba wako nezvezvinokunetsa.

Leukemia , CLL, kenza yeropa, zviratidzo, kurapwa, lymphocytes, kupora