Ingabe ingane yakho encane izizwa ikhathele ngaso sonke isikhathi, inombala oluhlaza okwesibhakabhaka, noma inomkhuhlane ngaso sonke isikhathi? Ngezinye izikhathi lezi zingaba izimpawu ezivamile. Kodwa ngezinye izikhathi, lezi zinto ezincane zingaba uphawu lwesimo esibi ngaphakathi emzimbeni. Namuhla sizokhuluma ngohlobo lomdlavuza wegazi oluvame kakhulu ezinganeni ezincane, kodwa futhi lungathinta nabantu abadala. Igama lalo yi-Acute Lymphoblastic Leukemia, noma (KONKE) ngamafuphi. Ungakhathazeki, sizoxoxa ngakho konke ngamagama alula.
Kalula nje, kusho ukuthini ukuthi KONKE?
I-Acute Lymphoblastic Leukemia (ALL) uhlobo lomdlavuza oluvela egazini lethu. Igazi lethu liqukethe amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, nama-platelet. Olunye uhlobo lwamangqamuzana amhlophe egazi lubizwa ngokuthi ama-lymphocyte. Njengebutho lezwe lethu, lawa maseli asivikela ngokulwa nezifo namagciwane angena emizimbeni yethu.
Lawa maseli e-lymphocyte akhiqizwa emnkantsheni wamathambo ngaphakathi kwamathambo ethu. Ngezinye izikhathi, ngenxa yokuguquka kwezakhi zofuzo kula maseli e-lymphocyte, aqala ukuba amaseli omdlavuza esikhundleni samaseli anempilo. Lawa maseli omdlavuza ahlukana futhi ande ngokushesha ngaphandle kokulawula, aminyanise amaseli anempilo. Lokhu kubizwa ngokuthi YONKE.
Lawa maseli omdlavuza awagcini nje ngokuhlala emnkantsheni wamathambo. Angahamba egazini futhi asakazeke (asakazeke) emzimbeni wonke.
Kodwa into ebaluleke kakhulu ukuthi YONKE, nakuba kuyisimo esibucayi, iyisifo eselapheka ngokuphelele ngokwelashwa okufanele. Izinga lokwelapha liphezulu kakhulu, ikakhulukazi ezinganeni ezincane.
Yiziphi izinhlobo eziyinhloko ZONKE?
Uma sikhuluma ngama-lymphocyte, kunezinhlobo ezimbili eziyinhloko zawo: amaseli e-B namaseli e-T. WONKE umdlavuza uvela kulezi zinhlobo ezimbili zamaseli.
| Uhlobo lomdlavuza | Incazelo elula |
|---|---|
| B-cell ALL (B-cell ALL) | Lolu uhlobo oluvame kakhulu. Luhlanganisa cishe u-85% wabo bonke ezinganeni kanye no-75%-80% wabo bonke kubantu abadala. Amaseli e-B awuhlobo lwamaseli enza ama-antibodies ngokumelene namagciwane emzimbeni wethu. |
| Iseli T LONKE (Iseli T LONKE) | Lokhu kuyinto engavamile kancane. Cishe ama-25% abantu abadala kanye no-12%-15% wezingane bakhula lolu hlobo. Ama-T cell awuhlobo lwamaseli abulala ngqo amagciwane futhi asize amanye amaseli ohlelweni lokuzivikela komzimba. |
Ngaphezu kwalezi zinhlobo ezimbili, kukhona nohlobo olungavamile kakhulu olubizwa ngokuthi i-Natural Killer ALL. Udokotela wakho uzokwenza izivivinyo ezidingekayo ukuze athole ukuthi wena noma ingane yakho inaluphi uhlobo.
Yiziphi izimpawu esizibonayo?
Uma konke kukhula, amangqamuzana egazi aphilile omzimba ayaphela, okubangela izimpawu ezahlukahlukene. Lezi zimpawu zingavela ngokuzumayo noma zikhule kancane kancane.
Okubalulekile: Ukuba nalezi zimpawu akusho ukuthi unakho konke. Kodwa-ke, uma unalezi zimpawu isikhathi esingaphezu kwamasonto amabili, kubalulekile ukubona udokotela ukuze akunike iseluleko.
| Isibonakaliso | Kusho ukuthini lokho? |
|---|---|
| Ukukhathala okuqhubekayo kanye nobuthakathaka | Ngenxa yokwehla kwamangqamuzana abomvu egazi emzimbeni (i-anemia), ngisho nokwenza imisebenzi emincane kungaba yinto ekhathazayo, futhi umzimba ungase ubonakale uphaphathekile. |
| Ukugula njalo | Njengoba amangqamuzana amhlophe egazi aphilile ehla, ikhono lomzimba lokulwa nezifo (amasosha omzimba) liyancipha. Ngenxa yalokho, izifo ezifana nomkhuhlane kanye nomkhuhlane zingavela njalo. |
| Ukopha kanye nokudumba | Njengoba ama-platelet asiza ukujiya kwegazi ehla, ukuphuma kwegazi ekhaleni, ukuphuma kwegazi ezinsinini, ngisho nokulimala okuncane kungabangela amabala amakhulu aluhlaza okwesibhakabhaka emzimbeni. Abesifazane bangase bophe igazi kakhulu ngesikhathi sokuya esikhathini. |
| Amabala abomvu esikhumbeni (i-petechiae) | Amabala amancane abomvu avela esikhumbeni njengokungathi ahlatshwe yiphini, ngenxa yokopha okuvela emithanjeni yegazi emincane kakhulu ngaphansi kwesikhumba. |
| Ubuhlungu bamathambo namalunga | Njengoba amangqamuzana omdlavuza egcwalisa umongo wamathambo, ubuhlungu obukhulu bungaba khona emathanjeni nasemalungeni. |
| Ama-lymph node avuvukele | Amaqhubu (amaqhubu) ezindaweni ezifana nentamo, emakhwapheni, kanye nasesinqeni angavuvukala ngaphandle kobuhlungu. |
| Ezinye izici | Izimpawu ezifana nokulahlekelwa yisifiso sokudla, ukwehla kwesisindo, ukujuluka ebusuku, kanye nobunzima bokuphefumula nazo zingabonakala. |
Kungani lesi sifo senzeka? Yiziphi izinto ezibangela ingozi?
Ayikho imbangela eyodwa eqondile yalo lonke umdlavuza. Imbangela eyinhloko, njengoba sixoxile ngaphambili, ukuguquka kwezakhi zofuzo okwenzeka ngesikhathi kwakheka amaseli egazi. Ezinganeni ezincane, lokhu kuguquka kungenzeka ngaphambi kokuba zizalwe.
Kodwa-ke, kunezici eziningana eziye zatholakala ezikhulisa ingozi yokuthola lesi sifo.
- Ubudala: Ingozi iphezulu kakhulu ezinganeni ezingaphansi kweminyaka eyi-15 ubudala, ikakhulukazi lezo eziphakathi kweminyaka emi-2-5 ubudala, kanye nabantu abadala abangaphezu kweminyaka engama-50 ubudala.
- Izifo ezithile zofuzo: Abantu abanezinkinga ezithile zofuzo, njenge-Down syndrome, banengozi enkulu kancane yokuthola i-ALL.
- Ukuchayeka emisebeni: Ukuchayeka emazingeni aphezulu emisebeni, isibonelo, uma wake welashwa ngemisebe ngomunye umdlavuza, kungandisa ingozi yakho.
- Amagciwane athile: Ukutheleleka okuthile kwegciwane, njengegciwane le-Epstein-Barr, kukholakala ukuthi kwandisa ingozi.
- Ukusetshenziswa kukagwayi: Phakathi kwabantu abadala, ukuchayeka ezintweni ezibangela umdlavuza njengokusetshenziswa kukagwayi nakho kungaba yimbangela.
Udokotela usithola kanjani lesi sifo ngokunembile?
Uma uya kudokotela onezimpawu ozishilo ngenhla, uzoqala ngokukubuza umbuzo onemininingwane mayelana nezimpawu zakho. Uzobe esekwenza ukuhlolwa ngokomzimba bese eyala ukuhlolwa okuningana ukuqinisekisa ukuxilongwa.
- Ukuhlolwa kwegazi:Ukuhlolwa kwe-Full Blood Count (FBC) okuvamile kungabona ukungalingani enanini lamaseli egazini.
- I-Bone marrow biopsy: Lolu vivinyo oluyinhloko lokuqinisekisa lesi sifo. Isampula encane yomnkantsha ithathwa endaweni efana nethambo le-hip ngaphansi kwe-anesthesia bese ihlolwa ngaphansi kwe-microscope. Lokhu kungasho ngqo ukuthi amangqamuzana omdlavuza akhona yini nokuthi, uma kunjalo, hlobo luni.
- Ukuhlolwa kwezithombe: Ukuskena kwe-CT kanye nokuskena kwe-PET kungenziwa ukuze kubonwe ukuthi umdlavuza ususakazekele kwezinye izingxenye zomzimba, isibonelo, esifubeni.
- Ukubhoboza umgogodla/umgogodla: Uma kukhona ukungabaza kokuthi amangqamuzana omdlavuza asakazekele ebuchosheni noma emgogodleni, inani elincane loketshezi lomgogodla liyathathwa emgogodleni bese lihlolwa.
Yiziphi izindlela zokwelapha ZONKE?
Kunezindlela eziningana zokwelapha ZONKE. Udokotela wakho uzonquma uhlelo lokwelashwa olungcono kakhulu kuwe ngokusekelwe ezicini eziningi, okuhlanganisa iminyaka yakho, uhlobo lwesifo, kanye nezimpawu zofuzo emaseli akho omdlavuza.
Ukwelashwa Okuyinhloko: Ukwelashwa ngamakhemikhali
Ukwelashwa ngamakhemikhali kuyisidakamizwa esinamandla esibulala amangqamuzana omdlavuza. Kuyindlela yokwelapha eyinhloko YABO BONKE. Lokhu kwelashwa kunikezwa ngezigaba eziningana, kusukela ezinyangeni ezimbalwa kuya eminyakeni emibili kuya kwemithathu.
| Izigaba zokwelapha | Kwenzekani? |
|---|---|
| 1. Isigaba sokuqala (Ukukhululwa Kwe-Remission) | Lokhu kuthatha cishe amasonto angu-4-6. Umgomo oyinhloko ukubhubhisa amangqamuzana omdlavuza amaningi ngangokunokwenzeka ngokushesha okukhulu. Phakathi nalesi sikhathi, kuzodingeka uhlale esibhedlela. |
| 2. Ukwelashwa kwesimiso sezinzwa (ukwelashwa okuqondiswa yi-CNS) | Lokhu kwelashwa kunikezwa ukuvimbela amangqamuzana omdlavuza ukuthi angasabalali aye ebuchosheni nasemgogodleni, noma ukuwabhubhisa uma esesabalele. Lokhu kuvame ukwenziwa esigabeni sokuqala. |
| 3. Isigaba sokuhlanganiswa | Ngemva kokuba isifo sesiphelile, lesi sigaba siqala ukubhubhisa noma yimaphi amangqamuzana omdlavuza asele. Uzolaliswa esibhedlela izinsuku ezimbalwa njalo emavikini ambalwa izinyanga eziningana futhi uthole imithi yokwelapha ngemithambo yegazi (IV). |
| 4. Isigaba sokulungisa | Lesi yisigaba sokugcina neside kakhulu. Kuthatha iminyaka emi-2-3. Umgomo lapha ukuvimbela lesi sifo ukuthi singabuyi. Ngokuvamile, imithi yomlomo kanye nemithi yokufakwa emthanjeni inikezwa emtholampilo. Asikho isidingo sokuya esibhedlela njalo. |
Ezinye izindlela zokwelapha
- Ukwelashwa okuqondiwe: Lokhu kuhilela ukunikeza imithi ehlasela izinguquko ezithile zofuzo ezitholakala kumaseli omdlavuza kuphela. Isibonelo, lokhu kwelashwa kusebenza kakhulu kubantu abanoshintsho lofuzo olubizwa ngokuthi i-Philadelphia chromosome.
- Ukwelashwa nge-immunotherapy: Lokhu kuhilela ukuvuselela amasosha omzimba ethu ukuze abhubhise amangqamuzana omdlavuza. Ukwelashwa nge-CAR-T cell kuyindlela yokwelapha yesimanje ewela ngaphansi kwalesi sigaba.
- Ukwelashwa ngemisebe: Ukwelashwa ngemisebe kungasetshenziswa ezimweni lapho umdlavuza ungasabeli ku-chemotherapy noma lapho lesi sifo siphinde sibuye.
- Ukufakelwa umnkantsha: Uma ezinye izindlela zokwelapha zingaphumeleli noma ingozi yokuthi lesi sifo sibuye iphezulu kakhulu, ungathunyelwa kumuntu ophilile ukuze uyofakelwa umnkantsha.
Angakanani amathuba okwelapha lesi sifo?
Lona ngumbuzo omkhulu kunayo yonke engqondweni yawo wonke umuntu. ALL umdlavuza osabela kahle kakhulu ekwelashweni.
Ezinganeni, imiphumela iyathembisa kakhulu. Ama-98% ezingane ezithola ukwelashwa okufanele athola ukuphulukiswa okuphelele kwalesi sifo. Izinga lokusinda ngemva kweminyaka emi-5 ngemva kokuba lesi sifo selaphekile liphezulu lifinyelela kuma-90%.
Leli phesenti liphansi kancane kubantu abadala. Izinga lokusinda kweminyaka emihlanu kubantu abadala liphakathi kuka-30% - 40%.
Kodwa kubalulekile ukuqonda ukuthi lezi yizibalo nje. Indlela umuntu asabela ngayo ekwelashweni ingahluka kakhulu komunye. Ngakho ungakhathazeki ngalezi zinombolo. Udokotela okwelaphayo kuphela ongakunikeza ulwazi olungcono kakhulu ngesimo sakho noma sengane yakho.
Kuvamile ukuzizwa sengathi impilo yakho iyawohloka uma utholakala unomdlavuza. Ikakhulukazi uma kuyingane yakho. Kodwa khumbula, KONKE kuyisifo eselaphekayo kakhulu kunezinye izinhlobo eziningi zomdlavuza. Themba ithimba lakho lezokwelapha. Bazoba nawe kulolu hambo, bakunikeze lonke usekelo nezincazelo ozidingayo.
Umlayezo Wokuya Nawe Ekhaya
- I-Acute Lymphoblastic Leukemia (ALL) umdlavuza okhula kuma-lymphocyte, uhlobo lweseli elimhlophe legazi.
- Nakuba lesi sifo sivame kakhulu ezinganeni ezincane, singakhula kunoma ubani wanoma yimuphi ubudala.
- Uma uhlangabezana nezimpawu ezifana nokukhathala okuqhubekayo, ukuphaphatheka, ukugula njalo, ukuba luhlaza okwesibhakabhaka komzimba, kanye nobuhlungu bamathambo isikhathi esingaphezu kwamasonto amabili, funa iseluleko sikadokotela ngokushesha.
- Nakuba i-ALL iyisifo esibi kakhulu, iyelapheka ngokuphelele ngokwelashwa okufana nokwelashwa ngamakhemikhali. Izinga lokwelashwa liphezulu kakhulu, ikakhulukazi ezinganeni.
- Inqubo yokwelapha ingaba yinde futhi ikhathaze, kodwa ungesabi, themba odokotela bakho, futhi ulandele imiyalelo yabo ngqo.
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