Vazhinji vedu tinotya izwi rekuti "kenza." Chinhu chinowanzoitika. Asi nhasi, nekuda kwekuti sainzi yezvekurapa yafambira mberi zvakanyanya, zvave kukwanisika kurarama nemarudzi akasiyana ekenza. Nhasi, tichataura nezveimwe mhando yekenza yeropa yakadaro. Iyo CML, inomiririra Chronic Myeloid Leukemia. Ungave wakanzwa zita iri mushure mekuongororwa ropa nguva dzose. Saka, ngatitaurei nezvazvo zvakadzama tisingatyi.
Zvakanaka, saka chii chinonzi CML iyi?
Zvichitaurwa zviri nyore, CML igomarara reropa redu. Rinotanga mumongo wemapfupa mukati memapfupa edu. Mongo wemapfupa wakafanana nefekitori inogadzira mhando dzemasero anodiwa nemuviri wedu anonzi masero matsvuku eropa, masero machena eropa, uye maplatelet. MuCML, pane chimwe chinhu chinoitika chisina kunaka nemasero e myeloid ari mumasero aya emongo wemapfupa, uye anotanga kupatsanurana nekuwanda zvisingadzoreki.
Izvi zvinonziwo `chronic myelogenous leukemia` kana `chronic granulocytic leukemia`.
Asi nhau dzakakosha uye dzakanakisa pano ndedzekuti nekurapwa kwazvino uno, vanhu vazhinji vane CML vanogona kurarama hupenyu hwakajairika . Izvi zvinoreva kuti pachinzvimbo chekuva chirwere chinouraya, chave chirwere chisingaperi chinogona kudzorwa nemishonga.
CML iyi inofambira mberi nekukurumidza sei?
Izwi rekuti "chronic" rinoreva "nguva refu." Uye ndizvo zvakaita chirwere ichi. CML chirwere chinowanzoitika. Dzimwe nguva inogona kuvapo kwemakore pasina zviratidzo. Vanhu vazhinji vanoona kuti vane chirwere ichi netsaona, kana kuongororwa kweropa kwakaitwa nechimwe chikonzero kuchiratidza kusarongeka kwehuwandu hwemasero eropa ravo.
Asi kana zvikasarapwa, izvi zvinogona kuva chirwere chinouraya mukati memakore matatu kusvika mana. Saka, zvakakosha zvikuru kuongorora chirwere ichi uye kutanga kurapwa nekukurumidza.
Ndezvipi zviratidzo zvingaonekwa nemunhu ane CML?
Kazhinji, panogona kunge pasina zviratidzo zvikuru pakutanga. Zvisinei, pane zvimwe zviratidzo zvinowanzoonekwa nekufamba kwenguva. Izvi zvinowanzova zvinhu zvatinofunga kuti zvakajairika uye zvatinofuratira.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Kuneta nguva dzose uye kushaya simba | Kugara uchinzwa kuneta, kunyangwe ukarara zvakanaka uye usingaite basa. |
| Kutadza kufema zvakanaka (Dyspnea) | Kudonha uchifamba chinhambwe chipfupi kana kukwira masitepisi. |
| Fivha isina chikonzero | Kunzwa kupisa pasina chimwe chirwere. |
| Kudikitira husiku | Kudikitira husiku kusvika pakunyorova machira, kunyangwe mumba muchitonhora. |
| Kuderedza uremu pasina chikonzero | Kudzikira uremu kamwe kamwe pasina kudya kana kurovedza muviri. |
| Kuzvimba kana kusagadzikana mudumbu rekumusoro kuruboshwe | Izvi zvinokonzerwa nekuzvimba kwepleen, iri muchikamu ichi chedumbu. |
| Kunzwa kuguta kunyangwe mushure mekudya zvishoma | Chiropa chakazvimba chinogona kudzvanya dumbu, zvichiita kuti unzwe wakaguta kunyangwe mushure mekudya zvishoma. |
Sei CML ichikura? Inogarwa nhaka here?
Mubvunzo uyu une vanhu vazhinji. Chinhu chakakosha kunzwisisa pano ndechekuti CML haisi chirwere chinogarwa nhaka . Izvi zvinoreva kuti vana havaikure nekuda kwekuti vabereki vavo vaiva nayo. Uye haisi chinhu chinogarwa nhaka.
CML inoitika kana shanduko (mutation) ikaitika mumajini emasero edu, kureva masero ekutanga ari mumongo wemapfupa, munguva yedu yehupenyu. Izvi zvinonzi `acquired mutation`.
Zvakanaka, ngationei kuti izvi zvinoshanda sei. Zvichitaurwa zviri nyore, zvakaita seizvi:
1. Kuchinja kunoitika mumajini emasero edu ekutanga, uye jini idzva, rakawedzerwa rinonzi `BCR-ABL` rinoumbwa.
2. This new gene gives new instructions to stem cells to make an unusual form of an enzyme called `tyrosine kinase`.
3. Funga nezvema enzyme aya sema "swichi" dzinoshandisa "on" uye "off" pachiedza. Aya ndiwo anodzora kupatsanurwa kwemasero.
4. Asi enzyme iyoyo ye `tyrosine kinase` isina kugadzirwa zvakanaka haina "off" switch. Inogara "yakabatidzwa".
5. Nekuti hapana "off" switch, masero emuviri ari mubhonzo remapfupa anoramba achigamuchira zviratidzo zvekuparadzanisa, kupatsanura, uye kuwanda zvisingadzoreki.
6. Nekuda kweizvozvo, nhamba huru yemasero machena eropa asati akura (anonziwo 'blasts') anotanga kuumbwa.
7. Nekufamba kwenguva, masero aya asina kujairika anozadza mupfupa. Ipapo mupfupa unorasikirwa nekukwanisa kwawo kugadzira masero matsvuku eropa, masero machena eropa, uye maplatelet ane hutano. Nekuda kweizvozvo, zviratidzo zvataurwa pamusoro apa zvinotanga kuoneka.
Njodzi nematambudziko angangoitika eizvi
Zvinhu zvine njodzi
Chinhu chega chinozivikanwa chinokonzera CML injodzi yekusangana nemwaranzi yakawanda kwazvo . Zvisinei, izvi hazviwanzoitiki. Mwero wemwaranzi watinosangana nawo muhupenyu hwemazuva ese (semuenzaniso, kubva pakutora X-ray) haukonzeri.
Matambudziko anogona kuitika
CML inogona kukonzera matambudziko maviri makuru:
- Anemia: Kuderera kwekugadzirwa kwemasero matsvuku eropa ane hutano, izvo zvinoderedza huwandu hweokisijeni hunodiwa nemuviri, zvichikonzera kuneta uye kucheneruka.
- Splenomegaly: Huwandu hwakawanda hwemasero eropa asina kujairika anoungana muspleen, zvichiita kuti izvimbe. Izvi zvinogona kukonzera kusagadzikana mudumbu uye kunzwa kuguta kunyangwe mushure mekudya zvishoma.
Pamusoro pezvo, zvimwe zvidzidzo zvakaratidza kuti vanhu vane CML vanogona kunge vaine mukana wakawedzera wekuva nemamwe marudzi ekenza (kenza yechipiri).
Vanachiremba vanoongorora sei CML?
Chiremba wako anogona kufungidzira izvi nekuongororwa ropa zviri nyore. Zvisinei, kuti chirwere chisimbiswe, bvunzo dzakakosha dzinotsvaga shanduko mumajini dzinodiwa.
| Bvunzo | Chii chaunoona pane izvi? |
|---|---|
| Kuwanda Kweropa Rakazara (CBC) | Vanotarisa kuti vaone kana huwandu hwemasero machena eropa hwakanyanya kukwira kana kuti huwandu hwemasero matsvuku eropa hwakanyanya kuderera. |
| Kufema/Kuongorora Bone Morrow | Sampuro diki yemongo wemapfupa inotorwa yoongororwa kuti ione kana kushanduka kwemajini kunonzi `BCR-ABL` kuripo. |
| Kuongororwa kweCT (Kuongororwa kweComputed Tomography) | Tarisa kana kenza yapararira kune dzimwe nhengo dzemuviri (semuenzaniso chiropa, chiropa). |
| Kuskena kweUltrasound | Bvunzo iyi inoshandiswa kuona kana chirwatata chakakura kupfuura zvakajairwa. |
Ndezvipi zvikamu zveCML?
Kusiyana nedzimwe kenza, CML haina kuiswa muchikamu che "zvikamu 1, 2, 3, 4." Asi, inoiswa muchikamu che "zvikamu." Izvi zvinoonekwa nehuwandu hwemasero machena eropa asina kuibva ('blasts') muropa nemumongo wemapfupa.
- Chikamu Chisingaperi: Iri ndiro danho rekutanga. Kune masero e'blasts' ari pasi pe10% muropa nemumongo wemapfupa. 80-90% yevanhu vanoonekwa vaine CML vari padanho iri. Vanhu ava vanogona kunge vaine zviratidzo kana kuti vasina.
- Chikamu Chinokurumidza: Muchikamu chino, huwandu hwemasero 'anoputika' hunowedzera kusvika pakati pe10% ne19%. Zviratidzo zvinotanga kuoneka zvakanyanya.
- Dambudziko reBlost Phase kana kuti Blast Crisis: Iri ndiro danho rakanyanya kuoma uye rinoisa upenyu panjodzi. Huwandu hwemasero e'blasts' hunowedzera ne20% kana kupfuura. Zviratidzo zvakaita sekuneta zvakanyanya, fivha, uye kudzikira kwehuremu zvinova zvakanyanya.
- CML Inodzivirira: Iri ndiro zita rinopiwa CML isingapindure kana yarapwa kana kuti inodzoka mushure mekurapwa.
Ndezvipi zvirongwa zvekurapa CML?
Apa ndipo panouya mashoko akanaka nezve CML. Nhasi, kune mishonga inoshanda zvikuru yechirwere ichi.
Mushonga mukuru imhando yemishonga inonzi Tyrosine Kinase Inhibitors (TKIs) . Iyi mishonga inotorwa semapiritsi.
Unoyeuka here enzyme isingawanzoitiki yatakambotaura nezvayo inoshanda se "on" switch? Ndizvo zvinonangwa nemishonga iyi. Zvinoitwa neTKIs ndezvekuti vanomisa enzyme isina "off" switch kuti isashande. Vanoivhara. Zvadaro masero eCML anoparadzanisa zvisingadzoreki haawani chiratidzo chekupatsanura, uye mushure mechinguva masero iwayo anofa.
MaTKI aya akaita mutsauko mukuru muhupenyu hwevarwere veCML. Mishonga iyi isati yasvika, vanhu vanosvika 20% chete ndivo vakaonekwa vaine CML vakararama kwemakore mashanu. Asi nhasi, neTKIs, huwandu ihwohwo hwawedzera kusvika pamusoro pe90%.
Mishonga iyi inowanzo nwiwa kweupenyu hwese. Mamwe emhando dzeTKIs dzinoshandiswa zvakanyanya ndeaya:
- Imatinib
- Dasatinib
- Nilotinib
- Bosutinib
- Ponatinib
MaTKI ane migumisiro yakaipa here?
Ehe, semushonga upi zvawo, panogona kuva nemigumisiro yakaipa. Asi inogona kudzorwa. Inonyanya kukosha ndeiyi:
- Marwadzo emudumbu
- Kuneta
- Manyoka
- Kutenderedza tsandanyama
- Kuora kweganda
- Dzimwe nguva, zvinhu zvakaita sekukuvadzwa kwechiropa uye kuderera kwemasero eropa zvinogona kuitika.
Chiremba wako achakutaurira nezvemigumisiro iyi uye achakubatsira kuidzora.
CML inorapika zvachose here?
Panguva ino, nzira chete yekurapa CML ndeyekuisirwa masero emuviri anokonzera chirwere (allogeneic stem cell transplant ). Izvi zvinosanganisira kuisa masero emuviri kubva kumunhu ane hutano mumurwere. Zvisinei, iyi imishonga yakaoma uye ine njodzi. Saka, inowanzoitirwa varwere vasingapindure kuzvirwere zveTKI.
Zvakaita sei kurarama neCML uye tarisiro yacho yakaita sei?
Kana CML yapera mushure mekurapwa, hausisina zviratidzo uye hapana zviratidzo zvechirwere zvinogona kuonekwa pakuongororwa. Izvi zvinoreva kuti unogona kurarama hupenyu hwakajairika. Asi uchafanira kuramba uchitora mishonga yekudzivirira chirwere. Uchafanirawo kuona chiremba wako nguva nenguva kuti aongororwe ropa rako kuti uone kuti kurapwa kwako kuri kushanda zvakanaka sei.
Kuregererwa Pasina Kurapwa (TFR)
Iyi ndiyo nzira itsva uye ine tariro huru yekurapa CML. Izvi zvinoreva kuti vamwe varwere vanga vachitora mishonga yeTKI kwenguva yakati uye vane chirwere chakanyanya kudzorwa vanogona kurega kutora mishonga vachitarisirwa nachiremba wavo. Kunyangwe mushure mekurega mushonga, chirwere hachina kudzoka. Asi izvi hazvigoneke kune wese munhu. Unofanira kuzadzisa zvimwe zvinodiwa kuti uzviwane.
Chinhu chinonyanya kukosha ndechekuti, usamborega kutora mushonga wako chero chikonzero chipi zvacho usina kutaura nachiremba wako. Izvozvo zvinogona kuva nengozi zvikuru.
Mibvunzo inokosha yekubvunza chiremba wako
Kana ukaona kuti une CML, zvakajairika kuva nemibvunzo yakawanda mupfungwa dzako. Usatya, bvunza chiremba wako nezvezvinhu izvi.
- Ndechipi chikamu cheCML chandinacho?
- Ndedzipi nzira dzekurapa dzandinadzo?
- Ndichanzwa sei panguva yekurapwa? Ndezvipi zvinokonzeresa migumisiro?
- Ndingaenderera mberi nebasa rangu here ndichirapwa?
- Kangani kandinofanira kuongororwa ropa kuti ndione kana kurapwa kwacho kwabudirira?
- Mikana yekuti chirwere changu chirambe chiripo ndeyei?
- Kuisirwa stem cell kwakakodzera here padambudziko rangu?
- Ndiani wandingataura naye nezvekutarisira mari yekurapwa?
Mharidzo Yekuenda Nayo Kumba
- CML ikenza yeropa iri kukura zvishoma nezvishoma. Haina kugarwa nhaka.
- Mishonga yanhasi inonzi TKIs inoshanda zvikuru, ichibvumira vanhu vazhinji vane CML kurarama hupenyu hwakajairwa uye hurefu.
- Kana wangoonekwa uine chirwere ichi, usavhunduka uye tevera mirairo yachiremba wako nemazvo.
- Zvakakosha kutora mishonga nenguva uye kuenda kumakiriniki kunoongororwa nenguva.
- Usambofa wakarega kana kuchinja kurapwa usina mvumo yachiremba wako.
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