Ngaba umntwana wakho uziva ediniwe ngalo lonke ixesha, enombala oluhlaza okwesibhakabhaka, okanye enomkhuhlane ngalo lonke ixesha? Ngamanye amaxesha ezi zinokuba ziimpawu eziqhelekileyo. Kodwa ngamanye amaxesha, ezi zinto zincinci zinokuba luphawu lwesifo esinzulu emzimbeni. Namhlanje siza kuthetha ngohlobo lomhlaza wegazi oluxhaphake kakhulu kubantwana abancinci, kodwa lunokuchaphazela nabantu abadala. Igama lalo yi-Acute Lymphoblastic Leukemia, okanye (YONKE) ngamafutshane. Ungakhathazeki, siza kuthetha ngayo yonke into ngokulula.
Ngamafutshane, kuthetha ukuthini u-ALL?
I-Acute Lymphoblastic Leukemia (ALL) luhlobo lomhlaza oluvela egazini lethu. Igazi lethu liqulathe iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets. Olunye uhlobo lweeseli ezimhlophe zegazi lubizwa ngokuba zii-lymphocytes. Njengomkhosi welizwe lethu, ezi seli zisikhusela ngokulwa nezifo kunye neentsholongwane ezingena emizimbeni yethu.
Ezi seli ze-lymphocyte ziveliswa kumongo wethambo ngaphakathi emathanjeni ethu. Ngamanye amaxesha, ngenxa yotshintsho lwemfuza kwezi seli ze-lymphocyte, ziqala ukuba ziiseli zomhlaza endaweni yeeseli eziphilileyo. Ezi seli zomhlaza ziyahlukana kwaye zande ngokukhawuleza ngaphandle kolawulo, ziminyanisa iiseli eziphilileyo. Oku kubizwa nje ngokuba ZONKE.
Ezi seli zomhlaza azihlali nje kuphela kumongo wethambo, zinokuhamba ngegazi zize zisasazeke (zisasazeke) emzimbeni wonke.
Kodwa eyona nto ibalulekileyo kukuba YONKE, nangona iyimeko enzima, sisifo esinokunyangwa ngokupheleleyo ngonyango olufanelekileyo. Izinga lokunyangwa liphezulu kakhulu, ingakumbi kubantwana abancinci.
Ziziphi iintlobo eziphambili ze-ALL?
Xa sithetha ngee-lymphocytes, kukho iintlobo ezimbini eziphambili zazo: ii-B cells kunye nee-T cells. YONKE i-cancer ivela kwezi ntlobo zimbini zeeseli.
| Uhlobo lomhlaza | Ingcaciso elula |
|---|---|
| I-B-cell YONKE (I-B-cell YONKE) | Olu lolona hlobo luxhaphakileyo. Lumalunga ne-85% yazo zonke ezifunyanwa ebantwaneni kunye ne-75%-80% yazo zonke ezifunyanwa kubantu abadala. Ii-B cells luhlobo lweeseli ezenza ii-antibodies ezichasene neentsholongwane emzimbeni wethu. |
| Iiseli ze-T ZONKE (Iiseli ze-T ZONKE) | Oku kunqabile kancinci. Malunga nama-25% abantu abadala kunye ne-12%-15% yabantwana bakhula ngolu hlobo. Ii-T cells luhlobo lweeseli ezibulala ngokuthe ngqo iintsholongwane kwaye zincede ezinye iiseli kwinkqubo yomzimba yokuzikhusela. |
Ukongeza kwezi ntlobo zimbini, kukwakho nohlobo olungaqhelekanga kakhulu olubizwa ngokuba yiNatural Killer ALL. Ugqirha wakho uza kwenza uvavanyo olufunekayo ukuze afumanise ukuba loluphi uhlobo wena okanye umntwana wakho olunalo.
Zeziphi iimpawu esizibonayo?
Xa zonke zikhula, iiseli zegazi ezisempilweni zomzimba ziyaphela, nto leyo ebangela iimpawu ezahlukeneyo. Ezi mpawu zinokuvela ngequbuliso okanye zikhule kancinci kancinci.
Kubalulekile: Ukuba nezi mpawu akuthethi ukuba unazo zonke. Nangona kunjalo, ukuba unazo ezi mpawu kangangeeveki ezingaphezu kwezimbini, kubalulekile ukubona ugqirha ukuze akunike ingcebiso.
| Uphawu | Ithetha ntoni le nto? |
|---|---|
| Ukudinwa rhoqo kunye nobuthathaka | Ngenxa yokuncipha kweeseli ezibomvu zegazi emzimbeni (i-anemia), nokwenza imisebenzi emincinci kunokuba nzima, kwaye umzimba usenokubonakala umhlophe. |
| Ukugula rhoqo | Njengoko iiseli ezimhlophe zegazi ezisempilweni zincipha, amandla omzimba okulwa nezifo (amasosha omzimba) ayancipha. Ngenxa yoko, izifo ezifana nomkhuhlane kunye nomkhuhlane zinokuvela rhoqo. |
| Ukopha kunye nokudumba | Njengoko iiplatelets ezinceda ukujiya kwegazi kuncipha, ukopha empumlweni, ukopha kweentsini, kwanokulimala okuncinci kunokubangela amabala amakhulu aluhlaza emzimbeni. Abafazi bangopha kakhulu ngexesha lokuya exesheni. |
| Amabala abomvu eluswini (i-petechiae) | Amabala amancinci abomvu avela eluswini ngokungathi ahlatywe yipini, ngenxa yokopha kwegazi kwimithambo yegazi emincinci phantsi kolusu. |
| Intlungu yamathambo namalungu | Njengoko iiseli zomhlaza zizalisa umongo wethambo, iintlungu eziqatha zinokubakho emathanjeni nasemalungeni. |
| Ii-lymph nodes ezivuvukileyo | Amaqhuqhuva (iiqhuqhuva) kwiindawo ezifana nentamo, emakhwapheni, nasemqolo anokudumba ngaphandle kwentlungu. |
| Ezinye iimpawu | Iimpawu ezinje ngokulahlekelwa ngumdla wokutya, ukwehla kobunzima bomzimba, ukubila ebusuku, kunye nobunzima bokuphefumla nazo zinokubonakala. |
Kutheni esi sifo senzeka? Zithini izinto ezibangela umngcipheko?
Akukho sizathu sithile sikhethekileyo salo mhlaza WONKE. Isizathu esiphambili, njengoko besitshilo ngaphambili, kukuguquka kwezakhi zofuzo okwenzeka ngexesha lokwenziwa kweeseli zegazi. Kubantwana abancinci, olu tshintsho lunokwenzeka ngaphambi kokuba bazalwe.
Nangona kunjalo, kukho izinto ezininzi eziye zachongwa ezonyusa umngcipheko wokufumana esi sifo.
- Ubudala: Umngcipheko uphezulu kubantwana abangaphantsi kweminyaka eli-15 ubudala, ingakumbi abo baphakathi kweminyaka emi-2-5 ubudala, kunye nabantu abadala abangaphezu kweminyaka engama-50 ubudala.
- Izifo ezithile zemfuza: Abantu abaneengxaki ezithile zemfuza, ezifana neDown syndrome, banomngcipheko ophezulu kancinci wokufumana zonke izifo.
- Ukuvezwa kwimitha: Ukuvezwa kumanqanaba aphezulu emitha, umzekelo, ukuba ukhe wasebenzisa unyango lwemitha ngaphambili lomhlaza, kunokunyusa umngcipheko wakho.
- Iintsholongwane ezithile: Kukholeleka ukuba ezinye izifo ezibangelwa ziintsholongwane, ezifana ne-Epstein-Barr virus, nazo ziyandisa umngcipheko.
- Ukusetyenziswa kwecuba: Phakathi kwabantu abadala, ukuchatshazelwa zizinto ezibangela umhlaza ezifana nokusetyenziswa kwecuba nako kunokuba yimbangela.
Ugqirha uluchonga njani ngokuchanekileyo olu sifo?
Xa usiya kugqirha oneempawu ozikhankanyileyo apha ngasentla, uza kuqala akubuze umbuzo oneenkcukacha malunga neempawu zakho. Emva koko uza kwenza uvavanyo lomzimba aze acele iimvavanyo ezininzi ukuqinisekisa ukuba unesifo.
- Uvavanyo lwegazi:Uvavanyo oluqhelekileyo lwe-Full Blood Count (FBC) lunokufumanisa ukungaqheleki kwinani leeseli egazini.
- I-Bone marrow biopsy: Olu lolona vavanyo luphambili olusetyenziselwa ukuqinisekisa ukuxilongwa. Isampuli encinci yomongo wethambo ithathwa kwindawo efana nethambo lesinqe phantsi kwe-anesthesia ize ihlolwe phantsi kwe-microscope. Oku kunokumisela ngokuchanekileyo ukuba kukho iiseli zomhlaza kwaye, ukuba kunjalo, loluphi uhlobo.
- Uvavanyo lwemifanekiso: Ii-CT scans kunye nee-PET scans zingenziwa ukuze kubonwe ukuba umhlaza usasazeke na kwamanye amalungu omzimba, umzekelo, ukuya esifubeni.
- Ukubhoboza umqolo/ukubhoboza i-Lumbar: Ukuba kukho amathandabuzo okuba iiseli zomhlaza zisasazeke engqondweni okanye emgogodleni, kuthathwa ulwelo oluncinci lomqolo oluvela emgogodleni luze luvavanywe.
Zithini iindlela zonyango zabo bonke?
Kukho iindlela ezahlukeneyo zonyango ze-ALL. Ugqirha wakho uya kumisela isicwangciso sonyango esifanelekileyo kuwe ngokusekelwe kwizinto ezininzi, kuquka ubudala bakho, uhlobo lwesifo, kunye neempawu zemfuza kwiiseli zakho zomhlaza.
Unyango oluphambili: I-Chemotherapy
I-Chemotherapy liyeza elinamandla elibulala iiseli zomhlaza. Lolona nyango luphambili kubo bonke. Olu nyango lunikezelwa ngamanqanaba ahlukeneyo, ukusuka kwiinyanga ezimbalwa ukuya kwiminyaka emibini ukuya kwemithathu.
| Amanqanaba onyango | Kwenzekani? |
|---|---|
| 1. Isigaba sokuqala (Ukuqaliswa kokukhululwa) | Oku kuthatha malunga neeveki ezi-4-6. Injongo ephambili kukutshabalalisa iiseli zomhlaza ezininzi kangangoko kunokwenzeka ngokukhawuleza. Ngeli xesha, kuya kufuneka uhlale esibhedlele rhoqo. |
| 2. Unyango lwenkqubo yemithambo-luvo (unyango olulawulwa yi-CNS) | Olu nyango lunikezelwa ukuthintela iiseli zomhlaza ukuba zingasasazeki engqondweni nasemgogodleni, okanye ukuzitshabalalisa ukuba zisasazekile. Oku kudla ngokwenziwa kwinqanaba lokuqala. |
| 3. Isigaba sokudityaniswa | Emva kokuba isifo siphelile, eli nqanaba liqala ukutshabalalisa naziphi na iiseli zomhlaza eziseleyo. Uza kulaliswa esibhedlele iintsuku ezimbalwa rhoqo emva kweeveki ezimbalwa kangangeenyanga ezininzi kwaye ufumane amayeza e-intravenous (IV). |
| 4. Isigaba sokulungisa | Eli lelona nqanaba lokugqibela nelide kakhulu. Kuthatha malunga neminyaka emi-2-3. Injongo apha kukuthintela ukuba isifo singabuyi. Amaxesha amaninzi, amayeza omlomo kunye namayeza e-intravenous anikwa ekliniki. Akukho mfuneko yokuya esibhedlele rhoqo. |
Ezinye iindlela zonyango
- Unyango olujoliswe kulo: Oku kuquka ukunika amayeza ahlasela utshintsho oluthile lwemfuza olufumaneka kwiiseli zomhlaza kuphela. Umzekelo, olu nyango lusebenza kakhulu kubantu abanotshintsho lwemfuza olubizwa ngokuba yiPhiladelphia chromosome.
- Unyango lwe-Immunotherapy: Oku kuquka ukuvuselela amasosha omzimba ethu ukuze atshabalalise iiseli zomhlaza. Unyango lweeseli ze-CAR-T yindlela yonyango yanamhlanje ewela phantsi kolu didi.
- Unyango ngemitha: Unyango ngemitha lungasetyenziswa kwiimeko apho umhlaza ungaphenduli kwi-chemotherapy okanye xa isifo siphinda sivela.
- Ukufakelwa komongo wethambo: Ukuba ezinye iindlela zonyango aziphumeleli okanye umngcipheko wokubuya kwesifo uphezulu kakhulu, ungathunyelwa kumntu ophilileyo ukuze ufakwe umongo wethambo.
Zithini amathuba okunyanga esi sifo?
Lo ngumbuzo omkhulu engqondweni yomntu wonke. YONKE ngumhlaza osabela kakuhle kunyango.
Kubantwana, iziphumo zithembisa kakhulu. Ama-98% abantwana abafumana unyango olufanelekileyo bafumana ukukhululeka ngokupheleleyo kwesi sifo. Izinga lokusinda emva kweminyaka emi-5 emva kokuba isifo sinyangiwe liphezulu ukuya kuma-90%.
Eli nani liphantsi kancinci phakathi kwabantu abadala. Izinga lokusinda kweminyaka emi-5 kubantu abadala liphakathi kwe-30% - 40%.
Kodwa kubalulekile ukuqonda ukuba ezi ziinkcukacha-manani nje. Indlela umntu asabela ngayo kunyango inokwahluka kakhulu kwenye. Ngoko ke ungothuswa ngala manani. Ngugqirha okunyangayo kuphela onokukunika ulwazi olungcono malunga nemeko yakho okanye yomntwana wakho.
Kuqhelekile ukuziva ngathi ubomi bakho buyawohloka xa ufunyaniswa ukuba unomhlaza. Ingakumbi ukuba ngumntwana wakho. Kodwa khumbula, YONKE sisifo esinyangekayo kunezinye iintlobo ezininzi zomhlaza. Themba iqela lakho lezonyango. Baza kuba nawe kolu hambo, bekunika lonke inkxaso kunye neengcaciso ozifunayo.
Umyalezo Wokuya Ekhaya
- I-Acute Lymphoblastic Leukemia (ALL) ngumhlaza okhula kwi-lymphocytes, uhlobo lweseli emhlophe yegazi.
- Nangona esi sifo sixhaphake kakhulu kubantwana abancinci, sinokukhula nakubani na wanoma yiphi na iminyaka.
- Ukuba ufumana iimpawu ezifana nokudinwa rhoqo, ukuba mdaka, ukugula rhoqo, ukuba luhlaza okwesibhakabhaka emzimbeni, kunye nentlungu yamathambo kangangeeveki ezingaphezu kwezimbini, funa ingcebiso kagqirha ngokukhawuleza.
- Nangona i-ALL sisifo esibi kakhulu, iyanyangeka ngokupheleleyo ngonyango olufana ne-chemotherapy. Izinga lokunyangwa liphezulu kakhulu, ingakumbi ebantwaneni.
- Inkqubo yonyango inokuba nde kwaye idinwe, kodwa ungoyiki, bathembe oogqirha bakho, kwaye ulandele imiyalelo yabo ngokuchanekileyo.
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