Ingaba i-leukemia yimeko engaqhelekanga ebangelwa ngamayeza? Masithethe nge-Differentiation Syndrome!

Xa wena okanye umntu omaziyo enyangwa isifo esifana ne-leukemia, unokufumana iziphumo ebezingalindelekanga. Namhlanje, siza kuthetha ngokudibanisa iimpendulo ezinzulu ezinokwenzeka ngamayeza, ingakumbi lawo anikwa iintlobo ezimbini zomhlaza wegazi. Oogqirha babiza le Differentiation Syndrome . Ngenxa yokuba inokuba yingozi kakhulu, oogqirha badla ngokuqala ukunyanga iimpawu ngaphambi kokuba baqinisekise ngokuqinisekileyo, nto leyo enokunciphisa umngcipheko weengxaki ezisongela ubomi.

Yintoni i-Differentiation Syndrome?

Ngamafutshane, i-Differentiation Syndrome liqela leempendulo ezinzima umzimba onazo kumayeza athile asetyenziselwa ukunyanga iintlobo ezimbini zomhlaza wegazi, ezizezi: i-Acute Promyelocytic Leukemia (APL) kunye ne -Acute Myeloid Leukemia (AML) . Kufana nokuba ezinye zeeseli emzimbeni wethu "ziyaphambana" ngala mayeza zize ziqale ukukhupha izinto ezininzi ngaxeshanye. Yile nto ibangela uphawu ngalunye.

Khawuthelekelele umhlobo wakho efunyaniswa ukuba une-APL aze aqalise unyango. Kwiintsuku ezimbalwa, uba nomkhuhlane, abe nobunzima bokuphefumla, aze avuvuke kancinci. Ngelo xesha, oogqirha bacinga ukuba le yi-Differentiation Syndrome.

Zithini ezi Differentiation Agents?

Ii-differentiation agents luhlobo lwamayeza asetyenziswa ngoogqirha ukunyanga i-APL. I-APL inovelwano ngakumbi kunezinye iintlobo ze-AML kumayeza abangela ukuba iiseli zikhule, okanye zahluke . La mayeza anceda iiseli zomhlaza (isigaba se-blast cell) ukuba zikhule zibe ziiseli zegazi ezimhlophe eziqhelekileyo neziphilileyo. Yiyo loo nto oogqirha besebenzisa la mayeza okwahlula endaweni yokubanika amayeza e-chemotherapy ngokuthe ngqo.

Njengamanye amayeza omhlaza, la mayeza anceda ekumiseni okanye ekucothiseni ukukhula kweeseli zomhlaza. Oogqirha banokusebenzisa la mayeza okwahlulahlula bodwa, xa bedibene, okanye xa bedibene ne-chemotherapy. Banokuyinyanga ngempumelelo i-APL. Nangona kunjalo, abanye abantu abane-APL banokuba nemiphumo emibi kakhulu kwezi ziyobisi.

Ngawaphi amayeza anokubangela i-Differentiation Syndrome?

Le meko inokwenzeka ngenxa yee-differentiation agents ezinikwa i-APL. Imizekelo ibandakanya:

• I-All-trans-retinoic acid (ATRA) , olu luhlobo lwevithamini A.
• I-Arsenic Trioxide (ATO) luhlobo lwe-arsenic.

Kwakhona, kwabanye abantu abane-AML, oogqirhaIi-Isocitrate Dehydrogenase (IDH) inhibitors ziluhlobo lwamayeza e-chemotherapy asetyenziswayo. Ezi inhibitors ze-IDH (ivosidenib) kunye ne- (enasidenib) nazo zinokubangela i-Differentiation Syndrome. Ayizizo kuphela ezo, kodwa nee -FLT3 inhibitors (umz. (midostaurin) , (gilteritinib) ) zinokubangela le meko.

Ngubani onokufuna izithinteli ze-IDH?

• Abantu abanomhlaza obuye waphinda wavela.
• Abantu abanomhlaza okunzima ukunyanga.
• Abantu abane-gene mutation ethile (IDH1 okanye i-IDH2 mutation).
• Abo bangakwaziyo ukunyamezela unyango oluqhelekileyo lwe-chemotherapy.

Ngubani onokuba nethuba elikhulu lokufumana i-Differentiation Syndrome?

Abantu abaninzi abane-APL bane-white blood cell count ephantsi (WBC) . Nangona kunjalo, abo bane-WBC count ephezulu basengozini enkulu yokufumana i-Differentiation Syndrome. Kwezi meko, oogqirha badla ngokunika amayeza abizwa ngokuba yi-Prednisone okanye i-Dexamethasone ukunciphisa umngcipheko wesi sifo.

Ixhaphake kangakanani i-Differentiation Syndrome?

Esi sisifo esingaqhelekanga ngokwenene. I-AML lolona hlobo luqhelekileyo lwe-leukemia kubantu abadala, nangona ibangela malunga ne-1% yazo zonke iintlobo zomhlaza. E-United States, i-APL yenzeka kumntu omnye kwabangama-250,000.

Kwabo bane-AML kunye ne-APL:

• Malunga nama-25% ezigulane ze-APL ezifumene amayeza e-ATRA kunye ne-ATO ziye zafumana i-Differentiation Syndrome.
• Le meko ibikwe phakathi kwe-14% kunye ne-19% yezigulane ze-AML ezithatha izithinteli ze-IDH.

Yintoni ebangela le Differentiation Syndrome?

Abaphandi abakayazi kakuhle ukuba kutheni abanye abantu besabela kunyango lwe-APL ngolu hlobo. Izifundo zokuqala zibonisa ukuba amayeza omhlaza abangela ukuba iiseli ze-leukemia zikhuphe ngequbuliso inani elikhulu leekhemikhali zenkqubo yomzimba yokuzikhusela. Oku kubizwa ngokuba yi-cytokine release syndrome . Oku kuvutha okungalawulekiyo kubangela iimpawu ezahlukeneyo, ukusuka kwezincinci ukuya kwezinzima.

Ziziphi iimpawu ze-Differentiation Syndrome?

Umntu one-APL udla ngokuqala ukuba neempawu ze-Differentiation Syndrome kwiveki okanye ezimbini emva kokuqala i-ATRA kunye/okanye i-Arsenic Trioxide. Nangona kunjalo, ukuba uthatha unyango lwe-IDH inhibitor lwe-AML, kungathatha ixesha elide ukuba iimpawu zibonakale.Ingaphela (ezi mpawu zingavela naphi na ukusuka kusuku olunye ukuya kwiinyanga ezintlanu ukuya kwezintandathu emva kokuqala ukusebenzisa iyeza).

Ezi zezona mpawu zibonakala kakhulu:

• Ukukhwehlela .
• Ukwakheka kolwelo olungaphezulu olujikeleze intliziyo yakho kunye nemiphunga (iPleural Effusion) .
• Ukungasebenzi kakuhle kwezintso .
• Uxinzelelo lwegazi oluphantsi (Hypotension) .
• Amanqanaba aphantsi eoksijini egazini (iHypoxemia) .
• Ubunzima bokuphefumla (i-Dyspnea) .
• Ukudumba (ukudumba) kwezandla, iinyawo, nentamo.
• Umkhuhlane ngaphandle kwesizathu.
• Ukunyuka kobunzima ngaphandle kwesizathu.

Kubalulekile: Ukuba unenye okanye ngaphezulu kwezi mpawu, akuthethi ukuba ngokuqinisekileyo une-Differentiation Syndrome. Nangona kunjalo, kubalulekile ukwazisa ugqirha wakho ngokukhawuleza ukuba ubona nayiphi na kwezi mpawu.

Ziziphi iingxaki ezinokubakho ze-Differentiation Syndrome?

Le meko ngamanye amaxesha ingakhokelela kwiimeko ezinzima kakhulu. Umzekelo:

• Ukumelwa yintliziyo .
• Ukungasebenzi kakuhle kwezintso .
• Ukungasebenzi kakuhle kwemiphunga .
• Ukopha okuvela emiphungeni (i-Pulmonary Hemorrhage) .
• Ukukrala kwemiphunga .
• I-Sepsis ( usulelo olunzima olusasazeka emzimbeni wonke).

Ukuba ufumana naziphi na kwezi mpawu, fowunela ugqirha wakho ngoko nangoko . Ukuba unengxaki yokuphefumla okanye iintlungu esifubeni, fowunela u-911 (okanye inombolo yakho yongxamiseko yasekuhlaleni) ngoko nangoko . Abantu abane-APL badla ngokuphathwa esibhedlele de kuphele umngcipheko we-differentiation syndrome.

Ifunyanwa njani i-Differentiation Syndrome?

Kunokuba nzima ukufumanisa le meko kumntu one-APL, njengoko kukho ezinye iimeko ezininzi ezinokubangela iimpawu ezifanayo. Kwiimeko ezinzima, oogqirha banokuqala ukunyanga iimpawu ngokukhawuleza nje xa becinga ukuba kukho i-Differentiation Syndrome, nangaphambi kokuba baqinisekise ukuba yeyona ifanelekileyo.

Ugqirha wakho uza kucebisa iimvavanyo ezininzi ukuqinisekisa imeko kunye nokuthintela ezinye iimeko zonyango. Ezi zingabandakanya:

• Ubalo lwegazi olupheleleyo (i-CBC) .
• I-X-ray yesifuba .
• I-Echocardiogram (uvavanyo olujonga ukusebenza kwentliziyo).
• I-CT scan yesifuba .
• I-Bronchoscopy (uvavanyo olusebenzisa ikhamera ukujonga ngaphakathi kwemiphunga).
• Ezinye iimvavanyo zegazi (Umsebenzi wegazi).

Ngaba ikho indlela yokunyanga i-Differentiation Syndrome?

Kwiimeko ezininzi, abantu abane-acute promyelocytic leukemia (APL) banokuchacha ngokupheleleyo kwi-differentiation syndrome ukuba bafumana unyango olukhawulezileyo nolufanelekileyo . I-APL ngoku sisifo esinyangekayo kakhulu. Ngoko ke akukho nto yokoyika.

Iphathwa njani i-Differentiation Syndrome?

Oogqirha badla ngokunyanga iimpawu ze-differentiation syndrome nge -corticosteroid okanye amayeza e-glucocorticoid , afana ne -dexamethasone . Kwiimeko ezinzima, ugqirha wakho unokucebisa ukuba uyeke okwethutyana unyango lwakho lomhlaza de iimpawu zakho ziphele.

Uninzi lwabantu abane-APL banyangwa esibhedlele de kube umngcipheko we-differentiation syndrome udlulile. Ukuba ungumntu ongaphandle kwesigulana kwaye kurhanelwa ukuba une-differentiation syndrome, oogqirha bakho banokugqiba ekubeni bakugcine esibhedlele ubusuku bonke ukuze balawulwe okanye bajongwe. Iqela lakho lezonyango liza kukunceda ukuqinisekisa ukuxilongwa kwakho kwaye linyange ngokufanelekileyo naziphi na iimeko ezibangela iimpawu zakho.

Ndingenza ntoni ukunciphisa umngcipheko wokuba ne-Differentiation Syndrome?

Akukho nto unokuyenza ukunciphisa umngcipheko wakho wale meko. Ukuba usebenzisa i-chemotherapy okanye amanye amayeza omhlaza, xelela ugqirha wakho ngoko nangoko malunga nazo naziphi na iimpawu ozifumanayo . Kwakhona, qaphela ukuba zeziphi iimpawu ekufuneka uzijonge (njengoko sixoxe ngazo apha ngasentla) kwaye uthethe nogqirha wakho ukuba uneengxaki. Le yeyona nto ibalulekileyo.

Iyintoni imbono ye-Differentiation Syndrome?

Imbono ye-differentiation syndrome idla ngokuba ntle kubantu abaninzi. Kwiimeko ezininzi, ungaqhubeka nonyango lwakho lokulwa nomhlaza, nokuba ngexesha lonyango okanye emva kwalo usebenzisa ii-steroids. Iqela lakho lezonyango liza kuthetha nawe malunga neendlela onokukhetha kuzo unyango.

Ufanele ufune nini ingcebiso kagqirha nge-Differentiation Syndrome?

Ukuba ufumana naziphi na iimpawu ze-differentiation syndrome ngelixa unyangwa umhlaza, fowunela ugqirha wakho ngoko nangoko . Kunokuba nzima kuwe okanye kugqirha wakho ukufumanisa ukuba iimpawu zakho zibangelwa lunyango lomhlaza okanye yenye imeko. Unyango lwangethuba lunokunceda ekunciphiseni iimpawu nokunciphisa umngcipheko weengxaki.

Unyango lomhlaza lunokuba nzima. Nangona kunjalo, kunokudimaza ukwazi ukuba unyango ngokwalo lunemiphumo emibi. I-Differentiation Syndrome liqela leempendulo ezinokuba yingozi kunyango lomhlaza wegazi. Nangona kunjalo, inokunyangwa ukuba ifunyenwe kwaye inyangwa kwangethuba . Ngenxa yokuba iimpawu zinokuba mandundu ngokukhawuleza, oogqirha banokuqala ukukunyanga ngaphambi kokuba iziphumo zovavanyo lwakho ziqinisekise ukuba une-Differentiation Syndrome. Unyango lwangethuba lunokunceda ekunciphiseni iimpawu zakho kwaye lukubuyisele endleleni yokuchacha.

Umyalezo Wokuya Ekhaya

• I-Differentiation Syndrome yimpendulo enzima enokwenzeka ngenxa yamayeza athile anikwayo kwiintlobo ze-leukemia ezibizwa ngokuba yi-APL kunye ne-AML.
• Iimpawu ezinje ngomkhuhlane, ubunzima bokuphefumla, kunye nokudumba komzimba zinokubakho.
• Ukuba ubona ezi mpawu, kubalulekile ukwazisa ugqirha wakho ngoko nangoko .
• Ukuba ifunyenwe kwangethuba kwaye inyangwe ngamayeza afana neDexamethasone, inokuhlala inyangeka.
• Musa ukoyika xa usiva oku. Iqela lakho lezonyango liza kukunceda. Eyona nto ibalulekileyo kukubazisa ngalo naluphi na utshintsho, naziphi na iimpawu.

Isifo sokwahlukana, i-leukemia, unyango lomhlaza, iziphumo ebezingalindelekanga, i-APL, i-AML, i-ATRA, iimpawu