Uninzi lwethu luyaloyika igama elithi "umhlaza." Yinto eqhelekileyo kakhulu. Kodwa namhlanje, ngenxa yokuba isayensi yezonyango ihambele phambili kakhulu, kuye kwenzeka ukuba umntu aphile ngokuqhelekileyo neentlobo ezithile zomhlaza. Namhlanje, siza kuthetha ngolunye uhlobo lomhlaza wegazi. Loo nto yi-CML, emele i-Chronic Myeloid Leukemia. Usenokuba ulivile eli gama emva kovavanyo lwegazi oluqhelekileyo. Ngoko ke, masithethe ngalo ngokweenkcukacha ngaphandle kokoyika.
Kulungile, yintoni ke le CML?
Ngamafutshane, i-CML ngumhlaza wegazi lethu. Iqala kumongo wethambo ngaphakathi emathanjeni ethu. Umongo wethambo ufana nomzi-mveliso owenza iintlobo zeeseli ezifunekayo emzimbeni wethu ezibizwa ngokuba ziiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelets. Kwi-CML, kukho into engalunganga ngeeseli ze-myeloid stem kwezi seli zomongo wethambo, kwaye ziqala ukwahlukana kwaye zande ngokungalawulekiyo.
Oku kukwabizwa ngokuba yi-`chronic myelogenous leukemia` okanye i-`chronic granulocytic leukemia`.
Kodwa iindaba ezibalulekileyo nezibalaseleyo apha kukuba ngonyango oluphambili lwanamhlanje, uninzi lwabantu abane-CML banokuphila ubomi obuqhelekileyo . Oku kuthetha ukuba endaweni yokuba sisifo esibulalayo, siye saba yimeko engapheliyo enokulawulwa ngamayeza.
Ikhawuleza kangakanani le CML?
Igama elithi "chronic" lithetha "ixesha elide." Kwaye yiloo nto esi sifo sinjalo. I-CML sisifo esiqhelekileyo. Ngamanye amaxesha inokubakho iminyaka emininzi ngaphandle kweempawu. Abantu abaninzi bafumanisa ukuba banaso ngengozi, xa uvavanyo lwegazi olwenziwe ngesinye isizathu lubonisa ukungaqhelekanga kwinani leeseli zegazi zabo.
Kodwa ukuba ayinyangwa, le meko inokuba yingxaki esongela ubomi kwiminyaka emithathu ukuya kwemine. Kungoko ke, kubaluleke kakhulu ukuyixilonga nokuqala unyango kwangethuba.
Zeziphi iimpawu umntu one-CML anokuzibona?
Amaxesha amaninzi, kusenokungabikho zimpawu zibalulekileyo kwizigaba zokuqala. Nangona kunjalo, kukho ezinye iimpawu eziqhelekileyo ezibonakala ngokuhamba kwexesha. Ezi zizinto esizicinga ukuba ziqhelekile kwaye singazinanzi.
| Uphawu | Ingcaciso elula |
|---|---|
| Ukudinwa rhoqo kunye nobuthathaka | Ndisoloko ndiziva ndidiniwe, nokuba ulele kakuhle kwaye awenzi msebenzi. |
| Ubunzima bokuphefumla (i-Dyspnea) | Ukuwa xa uhamba umgama omfutshane okanye unyuka izinyuko. |
| Umkhuhlane ngaphandle kwesizathu | Ukuziva ushushu ngaphandle kwesinye isifo. |
| Ukubila ebusuku | Ukubila ebusuku kude kube manzi amashiti, nangona igumbi libanda. |
| Ukunciphisa umzimba ngaphandle kwesizathu | Ukunciphisa umzimba ngequbuliso ngaphandle kokunciphisa ukutya okanye ukwenza umthambo. |
| Ukudumba okanye ukungakhululeki kwinxalenye ephezulu yasekhohlo yesisu | Oku kungenxa yokudumba kwespleen, ekwindawo yesisu. |
| Ukuziva ugcwele nangona emva kokutya kancinci | I-spleen evuvukileyo ingacinezela isisu, ikwenze uzive ugcwele nasemva kokutya kancinci. |
Kutheni i-CML ikhula? Ngaba idluliselwa kwilifa?
Lo mbuzo yinto abantu abaninzi abanayo. Eyona nto ibalulekileyo ekufuneka uyiqonde apha kukuba i-CML ayisosifo esizuzwa njengelifa . Oku kuthetha ukuba abantwana abayikhuli kuba abazali babo benayo. Kwaye ayisiyonto ezuzwa njengelifa.
I-CML yenzeka xa utshintsho (uguquko) lusenzeka kwiijini zeeseli zethu, oko kukuthi iiseli ze-stem kwi-bone marrow, ngexesha lobomi bethu. Oku kubizwa ngokuba yi-'acquired mutation'.
Kulungile, ngoku masibone ukuba oku kusebenza njani. Kalula nje, kunje:
1. Utshintsho lwenzeka kwiijini zeeseli zethu ze-stem, kwaye kwakheka ijini entsha, eyongeziweyo ebizwa ngokuba yi-'BCR-ABL'.
2. This new gene gives new instructions to stem cells to make an unusual form of an enzyme called `tyrosine kinase`.
3. Cinga ngezi enzymes njengeswitshi ezithi "vula" kunye "vala" kwisibane. Ezi zezona zinto zilawula ukwahlulwahlulwa kweeseli.
4. Kodwa loo enzyme ye-`tyrosine kinase` eyenziwe ngendlela engaqhelekanga ayinayo i-"off" switch. Ihlala "ivuliwe".
5. Ngenxa yokuba akukho switch "yokucima", ii-stem cells kwi-bone marrow ziyaqhubeka zifumana imiqondiso yokwahlulahlula, ukwahlulahlula, nokwanda ngokungalawulekiyo.
6. Ngenxa yoko, inani elikhulu leeseli ezimhlophe zegazi ezingavuthwanga (ezikwabizwa ngokuba yi-'blasts') ziqala ukwakheka.
7. Ekuhambeni kwexesha, ezi seli zingaqhelekanga zizalisa umongo wamathambo. Emva koko umongo wamathambo ulahlekelwa ngamandla awo okwenza iiseli ezibomvu zegazi ezisempilweni, iiseli ezimhlophe zegazi, kunye neeplatelets. Ngenxa yoko, iimpawu ezikhankanyiweyo apha ngasentla ziqala ukubonakala.
Iingozi kunye neengxaki ezinokubakho zoku
Izinto ezinobungozi
Eyona nto ibalulekileyo yomngcipheko wokukhula kwe-CML kukuvezwa kumanqanaba aphezulu kakhulu emitha . Nangona kunjalo, oku kunqabile kakhulu. Amanqanaba emitha esiwafumanayo kubomi obuqhelekileyo (umzekelo, ngokufumana i-X-ray) awabangeli loo nto.
Iingxaki ezinokwenzeka
I-CML inokubangela iingxaki ezimbini eziphambili:
- I-anemia: Ukuncipha kwemveliso yeeseli ezibomvu zegazi ezisempilweni, nto leyo enciphisa ubungakanani beoksijini efunekayo emzimbeni, nto leyo ebangela ukudinwa kunye nokukhanya.
- I-Splenomegaly: Inani elikhulu leeseli zegazi ezingaqhelekanga ziqokelelana kwi-spleen, nto leyo ebangela ukuba idumbe. Oku kunokubangela ukungakhululeki esiswini kunye nokuziva ugcwele nasemva kokutya kancinci.
Ukongeza, ezinye izifundo zibonise ukuba abantu abane-CML banokuba nomngcipheko okhulayo wokufumana ezinye iintlobo zomhlaza (umhlaza wesibini).
Oogqirha bayixilonga njani i-CML?
Ugqirha wakho unokukukrokrela oku ngovavanyo olulula lwegazi. Nangona kunjalo, ukuqinisekisa isifo, kufuneka uvavanyo olukhethekileyo olujonga utshintsho kwizakhi zofuzo.
| Uvavanyo | Ubona ntoni kule nto? |
|---|---|
| Inani elipheleleyo legazi (i-CBC) | Bayajonga ukuba ingaba inani leeseli ezimhlophe zegazi liphezulu kakhulu okanye inani leeseli ezibomvu zegazi liphantsi kakhulu. |
| Ukuphefumla/Ukuxilongwa kweBone Marrow | Kuthathwa isampulu encinci yomongo wethambo ize ivavanywe ukuze kubonwe ukuba kukho utshintsho lwemfuza olubizwa ngokuba yi-'BCR-ABL' na. |
| I-CT Scan (I-Computed Tomography Scan) | Jonga ukuba umhlaza usasazeke na kwamanye amalungu omzimba (umz., ipleyini, isibindi). |
| Iskena se-Ultrasound | Olu vavanyo lusetyenziselwa ukubona ukuba i-spleen inkulu kunesiqhelo. |
Zithini iinqanaba ze-CML?
Ngokungafaniyo neminye imidla yomhlaza, i-CML ayihlelwanga njenge "zigaba 1, 2, 3, 4." Endaweni yoko, ihlelwa njenge "zigaba." Oku kuchazwa linani leeseli ezimhlophe zegazi ezingavuthwanga ('iiblast') egazini nakwithambo lomongo.
- Isigaba Esingapheliyo: Eli lelona nqanaba lokuqala. Kukho ngaphantsi kwe-10% yeeseli 'zokuqhuma' egazini nakwithambo. Ama-80-90% abantu abafunyaniswe bene-CML bakweli nqanaba. Aba bantu basenokuba neempawu okanye bangabi nazo.
- Isigaba Esikhawulezileyo: Kule sigaba, inani leeseli `eziqhumayo` liyanda liye phakathi kwe-10% ne-19%. Iimpawu ziqala ukubonakala ngakumbi.
- Isigaba Sokuqhuma okanye Ingxaki Yokuqhuma: Eli lelona nqanaba linzima nelisongela ubomi. Inani leeseli 'zokuqhuma' liyanda ngama-20% nangaphezulu. Iimpawu ezinje ngokudinwa kakhulu, umkhuhlane, kunye nokunciphisa umzimba ziba nzima.
- I-CML Engavumiyo: Eli ligama elinikwa i-CML engaphenduliyo kunyango okanye ephinda ivele emva konyango.
Ziziphi iindlela zonyango ze-CML?
Kulapho iindaba ezimnandi malunga ne-CML zingena khona. Namhlanje, kukho unyango olusebenzayo kakhulu lwesi sifo.
Unyango oluphambili ludidi lwamayeza abizwa ngokuba yiTyrosine Kinase Inhibitors (TKIs) . La ngamayeza athathwa njengeepilisi.
Uyakhumbula i-enzyme engaqhelekanga esathetha ngayo ngaphambili esebenza njengeswitshi "evuliweyo"? Yiloo nto la mayeza ajolise kuyo. Oko kwenziwa zii-TKIs kukuthintela loo enzyme ingasebenziyo. Bayayithintela. Emva koko ezo seli ze-CML ezahlulahlula ngokungalawulekiyo azifumani signal yokwahlukana, kwaye emva kwexesha elithile ezo seli ziyafa.
Ezi TKI zenze umahluko omkhulu kubomi bezigulane ze CML. Ngaphambi kokuba la mayeza eze, malunga nama-20% kuphela abantu abafunyaniswe bene CML abaphila iminyaka emi-5. Kodwa namhlanje, ngee TKI, elo pesenti linyuke laya kutsho ngaphezulu kwama-90%.
La mayeza adla ngokuthathwa ubomi bonke. Ezinye zeentlobo ze-TKI ezisetyenziswa rhoqo zezi:
- I-Imatinib
- I-Dasatinib
- I-Nilotinib
- I-Bosutinib
- I-Ponatinib
Ngaba ii-TKI zineziphumo ebezingalindelekanga?
Ewe, njengayo nayiphi na iyeza, zinokubakho iziphumo ebezingalindelekanga. Kodwa zihlala zilawulwa. Ezona zixhaphakileyo zezi:
- Isisu esibuhlungu
- Ukudinwa
- Urhudo
- Ukuqengqeleka kwezihlunu
- Ukudumba
- Ngamanye amaxesha, izinto ezinje ngokonakala kwesibindi kunye nokubalwa kweeseli zegazi eziphantsi zinokwenzeka.
Ugqirha wakho uza kuthetha nawe ngezi ziphumo ebezingalindelekanga aze akuncede uzilawule.
Ngaba i-CML inganyangeka ngokupheleleyo?
Okwangoku, indlela ekuphela kwayo "yokunyanga" i-CML kukufakelwa i-allogeneic stem cell . Oku kuquka ukufakelwa ii-stem cells ezivela kumntu ophilileyo zisiwe kwisigulana. Nangona kunjalo, olu lunyango oluntsonkothileyo nolunobungozi. Ke ngoko, ludla ngokwenziwa kuphela kwizigulana ezingaphenduliyo kwi-TKIs.
Kunjani ukuphila ne-CML kwaye injani imbono?
Xa i-CML isiya esiphelweni ngonyango, awusenazo iimpawu kwaye akukho zimpawu zesifo ezinokubonwa kwiimvavanyo. Oku kuthetha ukuba ungaphila ubomi obuqhelekileyo. Kodwa kuya kufuneka uqhubeke usela amayeza okulawula isifo. Kuya kufuneka ubone ugqirha wakho rhoqo ukuze ahlolwe igazi ukuze ajonge ukuba unyango lwakho lusebenza kakuhle kangakanani na.
Uxolelo OlungenaNyango (TFR)
Olu lolona phuhliso lwamva nje noluthembisayo kunyango lwe-CML. Oku kuthetha ukuba abanye abaguli abebesebenzisa ii-TKI okwethutyana kwaye isifo sabo silawulwa kakuhle ngoku banokuyeka ukuthatha amayeza phantsi kweliso likagqirha wabo. Kwanasemva kokuyeka amayeza, isifo asikabuyi. Kodwa oku akunakwenzeka kuwo wonke umntu. Kufuneka uhlangabezane neemfaneleko ezithile ukuze ufumane unyango.
Eyona nto ibalulekileyo kukuba, ungaze uyeke ukuthatha amayeza akho nangasiphi na isizathu ngaphandle kokuthetha nogqirha wakho. Oko kunokuba yingozi kakhulu.
Imibuzo ebalulekileyo yokubuza ugqirha wakho
Xa ufumanisa ukuba une-CML, kuyinto eqhelekileyo ukuba nemibuzo emininzi engqondweni yakho. Musa ukoyika, buza ugqirha wakho ngezi zinto.
- Leliphi inqanaba le-CML endinalo?
- Ziziphi iindlela zonyango endinazo?
- Ndiza kuziva njani ngexesha lonyango? Zithini iziphumo ebezingalindelekanga?
- Ndingaqhubeka nomsebenzi wam ngelixa ndifumana unyango?
- Kufuneka ndivavanywe igazi kangaphi ukuze ndibone ukuba unyango luphumelele na?
- Zithini amathuba okuba isifo sam siphinde siphele?
- Ngaba ukufakelwa i-stem cell kufanelekile kwimeko yam?
- Ngubani endingathetha naye malunga nokulawula iindleko zonyango?
Umyalezo Wokuya Ekhaya
- I-CML ngumhlaza wegazi okhula kancinci. Ayilofuzo.
- Iindlela zonyango ezijoliswe kuzo namhlanje, ezibizwa ngokuba zii-TKI, zisebenza kakhulu, zivumela abantu abaninzi abane-CML ukuba baphile ubomi obuqhelekileyo nobude.
- Wakuba ufunyenwe unesifo, musa ukoyika kwaye ulandele imiyalelo kagqirha wakho ngokuchanekileyo.
- Kubalulekile ukuthatha amayeza ngexesha kwaye uye kwiikliniki ukuze uhlolwe ngexesha.
- Ungaze uyeke okanye utshintshe unyango ngaphandle kwemvume kagqirha wakho.
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