Iningi lethu liyayesaba igama elithi "umdlavuza." Kuyinto evamile kakhulu. Kodwa namuhla, ngenxa yokuthi isayensi yezokwelapha isithuthuke kakhulu, sekuyinto engenzeka ukuphila ngokujwayelekile nezinhlobo ezithile zomdlavuza. Namuhla, sizokhuluma ngolunye uhlobo lomdlavuza wegazi. Leyo yi-CML, emele i-Chronic Myeloid Leukemia. Kungenzeka ukuthi uke wezwa leli gama ngemva kokuhlolwa kwegazi okuvamile. Ngakho-ke, ake sixoxe ngalo ngokuningiliziwe ngaphandle kokwesaba.
Kulungile, manje iyini le CML?
Kalula nje, i-CML ingumdlavuza wegazi lethu. Iqala emnkantsheni wamathambo ngaphakathi kwamathambo ethu. Umnkantshe wamathambo ufana nefektri eyenza izinhlobo zamangqamuzana umzimba wethu ozidingayo okuthiwa amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, nama-platelet. Ku-CML, kukhona okungahambi kahle ngamaseli okuqala e-myeloid kulawa maseli omnkantshe wamathambo, futhi aqala ukuhlukana nokwanda ngokungalawuleki.
Lokhu kubizwa nangokuthi 'i-chronic myelogenous leukemia' noma 'i-chronic granulocytic leukemia'.
Kodwa izindaba ezibaluleke kakhulu nezinhle kakhulu lapha ukuthi ngemithi ethuthukisiwe yanamuhla, abantu abaningi abane-CML bangaphila impilo evamile . Lokhu kusho ukuthi esikhundleni sokuba yisifo esibulalayo, sesibe yisimo esingamahlalakhona esingalawulwa ngemithi.
Le CML ithuthuka ngokushesha kangakanani?
Igama elithi "chronic" lisho "isikhathi eside." Futhi yilokho lesi sifo esiyikho. I-CML iyisifo esivame kakhulu. Ngezinye izikhathi ingaba khona iminyaka eminingi ngaphandle kwezimpawu. Abantu abaningi bathola ukuthi banaso ngengozi, lapho ukuhlolwa kwegazi okwenziwe ngesinye isizathu kukhombisa ukungajwayelekile ekubalweni kwamaseli egazi labo.
Kodwa uma ingelashwa, lokhu kungaba yisimo esisongela ukuphila zingakapheli iminyaka emithathu kuya kwemine. Ngakho-ke, kubaluleke kakhulu ukuxilonga nokuqala ukwelashwa kusenesikhathi.
Yiziphi izimpawu umuntu one-CML angase azibone?
Ngokuvamile, kungase kungabi khona izimpawu ezinkulu ezigabeni zokuqala. Kodwa-ke, kunezinye izimpawu ezivamile ezibonakala ngokuhamba kwesikhathi. Lezi ngokuvamile yizinto esicabanga ukuthi zivamile futhi singazinaki.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukukhathala okuqhubekayo kanye nobuthakathaka | Ukuzizwa ukhathele njalo, noma ngabe ulele kahle futhi ungenzi msebenzi. |
| Ubunzima bokuphefumula (i-Dyspnea) | Ukuwa ngenkathi uhamba ibanga elifushane noma ukhuphuka izitebhisi. |
| Umkhuhlane ngaphandle kwesizathu | Ukuzizwa ushisa ngaphandle kokugula okunye. |
| Ukujuluka ebusuku | Ukujuluka ebusuku kuze kufike lapho amashidi emanzi khona, yize igumbi libanda. |
| Ukwehlisa isisindo ngaphandle kwesizathu | Ukwehlisa isisindo ngokuzumayo ngaphandle kokunciphisa ukudla noma ukuzivocavoca. |
| Ukuvuvukala noma ukungakhululeki engxenyeni engenhla kwesobunxele yesisu | Lokhu kungenxa yokuvuvukala kwe-spleen, etholakala kule ngxenye yesisu. |
| Ukuzizwa usuthi ngisho nangemva kokudla kancane | Ubende obuvuvukile bungacindezela isisu, okukwenza uzizwe usuthi ngisho nangemva kokudla okuncane. |
Kungani i-CML ikhula? Ingabe idluliselwa ngofuzo?
Lo mbuzo uyinto abantu abaningi abanayo. Into ebaluleke kakhulu okufanele uyiqonde lapha ukuthi i-CML ayisona isifo esizuzwa njengefa . Lokhu kusho ukuthi izingane aziyithuthukisi ngoba nje abazali bazo babenayo. Futhi akuyona into ezuzwa njengefa.
I-CML yenzeka lapho kwenzeka ushintsho (ukuguqulwa) ezizakhini zofuzo zamaseli ethu, okungukuthi amaseli okuqala emnkantsheni wethambo, ngesikhathi sokuphila kwethu. Lokhu kubizwa ngokuthi 'ukuguqulwa okutholiwe'.
Kulungile, manje ake sibone ukuthi lokhu kusebenza kanjani. Kalula nje, kunje:
1. Kwenzeka ushintsho ezizakhini zofuzo zamaseli ethu okuqala, bese kwakheka i-gene entsha, eyengeziwe ebizwa ngokuthi i-'BCR-ABL'.
2. This new gene gives new instructions to stem cells to make an unusual form of an enzyme called `tyrosine kinase`.
3. Cabanga ngala ma-enzyme njengezinkinobho "zokuvula" kanye "nokuvala" esibanini. Lezi yizona ezilawula ukuhlukaniswa kwamaseli.
4. Kodwa leyo enzyme ye-`tyrosine kinase` eyakhiwe ngendlela engavamile ayinayo inkinobho ethi "vala". Ihlala "ivuliwe".
5. Ngenxa yokuthi akukho switch "yokuvala", amaseli okuqala emnkantsheni ayaqhubeka nokwamukela izimpawu zokuhlukanisa, ukuhlukanisa, nokwanda ngokungalawuleki.
6. Ngenxa yalokho, inani elikhulu lamaseli amhlophe egazi angakavuthwa (abizwa nangokuthi 'ama-blast') liqala ukwakheka.
7. Ngokuhamba kwesikhathi, la maseli angajwayelekile agcwalisa umongo wamathambo. Bese umongo wamathambo ulahlekelwa ikhono lawo lokwenza amangqamuzana abomvu egazi anempilo, amangqamuzana amhlophe egazi, nama-platelet. Ngenxa yalokho, izimpawu ezishiwo ngenhla ziqala ukuvela.
Izingozi kanye nezinkinga ezingaba khona zalokhu
Izici zengozi
Isici esiyingozi kuphela esaziwayo sokuthuthukisa i-CML ukuchayeka emazingeni aphezulu kakhulu emisebe . Kodwa-ke, lokhu akuvamile kakhulu. Amazinga emisebe esihlangana nawo empilweni evamile (isibonelo, ngokuthola i-X-ray) awayibangeli.
Izinkinga ezingaba khona
I-CML ingabangela izinkinga ezimbili eziyinhloko:
- I-anemia: Ukwehla kokukhiqizwa kwamangqamuzana abomvu egazi anempilo, okunciphisa inani lomoya-mpilo umzimba owudingayo, okubangela ukukhathala nokuphaphatheka.
- I-Splenomegaly: Inani elikhulu lamaseli egazi angajwayelekile aqoqana e-spleen, okubangela ukuthi ivuvuke. Lokhu kungabangela ukungakhululeki esiswini kanye nomuzwa wokugcwala ngisho nangemva kokudla okuncane.
Ngaphezu kwalokho, ezinye izifundo zibonise ukuthi abantu abane-CML bangase babe nengozi eyengeziwe kancane yokuthuthukisa ezinye izinhlobo zomdlavuza (umdlavuza wesibili).
Odokotela bayixilonga kanjani i-CML?
Udokotela wakho angase akusole lokhu ngokuhlolwa kwegazi okulula. Kodwa-ke, ukuqinisekisa lesi sifo, kudingeka ukuhlolwa okukhethekile okubheka izinguquko ezakhiweni zofuzo.
| Ukuhlolwa | Ubonani kulokhu? |
|---|---|
| Inani Eliphelele Legazi (i-CBC) | Bayahlola ukuthi inani lamaseli amhlophe egazi liphezulu kakhulu noma inani lamaseli abomvu egazi liphansi kakhulu. |
| Ukuphefumula/Ukuhlolwa Kwegazi Lomnkantsha Wamathambo | Kuthathwa isampula encane yomnkantsha wethambo bese ihlolwa ukuze kubonakale ukuthi kukhona yini ukuguquka kwezakhi zofuzo okubizwa ngokuthi `BCR-ABL`. |
| I-CT Scan (I-Computed Tomography Scan) | Hlola ukuthi umdlavuza ususakazekele kwezinye izingxenye zomzimba (isib. ubende, isibindi). |
| Ukuskena kwe-Ultrasound | Lolu vivinyo lusetshenziselwa ukubona ukuthi ngabe udengezi lukhulu kunolujwayelekile. |
Ziyini izigaba ze-CML?
Ngokungafani neminye imidlavuza, i-CML ayihlukaniswa njenge "zigaba 1, 2, 3, 4." Kunalokho, ihlukaniswa njenge "zigaba." Lokhu kunqunywa inani lamaseli amhlophe egazi angakavuthwa ('ama-blast') egazini nasemnkantsheni.
- Isigaba Esingapheli: Lesi yisigaba sokuqala. Kunamaseli angaphansi kuka-10% 'okuqhuma' egazini nasemnkantsheni. Abantu abangu-80-90% abatholakale bene-CML bakulesi sigaba. Laba bantu bangase babe nezimpawu noma bangabi nazo.
- Isigaba Esisheshisiwe: Kulesi sigaba, inani lamaseli 'okuqhuma' liyanda lifinyelele phakathi kuka-10% no-19%. Izimpawu ziqala ukubonakala kakhulu.
- Isigaba Sokuqhuma noma Inkinga Yokuqhuma: Lesi yisigaba esibi kakhulu nesisongela impilo. Inani lamaseli 'okuqhuma' landa ngo-20% noma ngaphezulu. Izimpawu ezifana nokukhathala okukhulu, umkhuhlane, kanye nokwehla kwesisindo ziba zimbi kakhulu.
- I-CML Engaphenduli: Leli igama elinikezwa i-CML engaphenduli ekwelashweni noma ephinde ivele ngemva kokwelashwa.
Yiziphi izindlela zokwelapha i-CML?
Yilapho izindaba ezinhle nge-CML zingena khona. Namuhla, kunezindlela zokwelapha eziphumelela kakhulu zalesi sifo.
Ukwelashwa okuyinhloko uhlobo lwemithi ebizwa ngokuthi i-Tyrosine Kinase Inhibitors (TKIs) . Lena imithi ethathwa njengamaphilisi.
Uyakhumbula i-enzyme engavamile esikhulume ngayo ngaphambilini esebenza njenge-"on" switch? Yilokho le mithi ehlose khona. Okwenziwa yi-TKIs ukuthi bavimbe leyo enzyme engenalo i-"off" switch ukuthi isebenze. Bayayivimba. Bese lawo maseli e-CML ahlukanisa ngokungalawuleki awatholi isignali yokwahlukana, futhi ngemva kwesikhashana lawo maseli ayafa.
Lawa ma-TKI enze umehluko omkhulu empilweni yeziguli ze-CML. Ngaphambi kokuba kufike lawa maphilisi, cishe ama-20% kuphela abantu abatholakale benawo ama-CML abasinda iminyaka emi-5. Kodwa namuhla, ngama-TKI, lelo phesenti selikhuphuke laya ngaphezu kwama-90%.
Le mithi ivame ukuthathwa impilo yonke. Ezinye zezinhlobo ezivame ukusetshenziswa ze-TKI yilezi:
- I-Imatinib
- I-Dasatinib
- I-Nilotinib
- I-Bosutinib
- I-Ponatinib
Ingabe ama-TKI anemiphumela emibi?
Yebo, njenganoma yimuphi umuthi, kungaba nemiphumela emibi. Kodwa ngokuvamile ingalawulwa. Evame kakhulu yile:
- Isisu esibuhlungu
- Ukukhathala
- Uhudo
- Ukugingqa imisipha
- Ukuvuvukala
- Ngezinye izikhathi, izinto ezifana nokulimala kwesibindi kanye nokubalwa kwamaseli egazi aphansi kungenzeka.
Udokotela wakho uzokhuluma nawe ngale miphumela emibi futhi akusize uyilawule.
Ingabe i-CML ingelapheka ngokuphelele?
Kuleli qophelo, okuwukuphela kwendlela "yokwelapha" i-CML iwukufakelwa kwe-allogeneic stem cell . Lokhu kuhilela ukufakelwa kwama-stem cell kusuka kumuntu ophilile angene esigulini. Kodwa-ke, lokhu kuyindlela yokwelapha eyinkimbinkimbi kakhulu futhi eyingozi. Ngakho-ke, ngokuvamile kwenziwa kuphela ezigulini ezingaphenduli kuma-TKI.
Kunjani ukuphila ne-CML futhi uyini umbono?
Uma i-CML ithola ukuphumula ngokwelashwa, awusenazo izimpawu futhi azikho izimpawu zesifo ezingatholakala ekuhlolweni. Lokhu kusho ukuthi ungaphila impilo evamile. Kodwa kuzodingeka uqhubeke uthatha imithi yokulawula lesi sifo. Kuzodingeka futhi ubone udokotela wakho njalo ukuze ahlolwe igazi ukuze ahlole ukuthi ukwelashwa kwakho kusebenza kahle kangakanani.
Ukuxolelwa Okungenakwelashwa (TFR)
Lokhu kuyintuthuko yakamuva nethembisayo kakhulu ekwelashweni kwe-CML. Lokhu kusho ukuthi ezinye iziguli ebezithatha ama-TKI isikhathi esithile futhi ezinesifo sazo esilawulwa kahle manje zingayeka ukuthatha imithi ngaphansi kokuqondisa kukadokotela wazo. Ngisho nangemva kokuyeka imithi, lesi sifo asikabuyi. Kodwa lokhu akunakwenzeka kuwo wonke umuntu. Kufanele uhlangabezane nezimfanelo ezithile zaso.
Into ebaluleke kakhulu ukuthi, ungalokothi uyeke ukuphuza imithi yakho nganoma yisiphi isizathu ngaphandle kokukhuluma nodokotela wakho. Lokho kungaba yingozi kakhulu.
Imibuzo ebalulekile okufanele uyibuze udokotela wakho
Uma uthola ukuthi une-CML, kuvamile ukuba nemibuzo eminingi engqondweni yakho. Ungesabi, buza udokotela wakho ngalezi zinto.
- Nginasiphi isigaba se-CML?
- Yiziphi izindlela zokwelapha enginazo?
- Ngizozizwa kanjani ngesikhathi sokwelashwa? Iyini imiphumela emibi?
- Ngingaqhubeka nomsebenzi wami ngenkathi ngithola ukwelashwa?
- Kukangaki ngidinga ukuhlolwa kwegazi ukuze ngibone ukuthi ukwelashwa kuphumelele yini?
- Angakanani amathuba okuba isifo sami siphinde siphele?
- Ingabe ukufakelwa i-stem cell kufaneleka esimweni sami?
- Ubani engingakhuluma naye mayelana nokuphatha izindleko zokwelapha?
Umlayezo Wokuya Nawe Ekhaya
- I-CML ingumdlavuza wegazi okhula kancane kancane. Ayilona ifa.
- Izindlela zokwelapha eziqondiwe zanamuhla, ezibizwa ngokuthi ama-TKI, zisebenza kahle kakhulu, zivumela abantu abaningi abane-CML ukuba baphile impilo evamile nende.
- Uma usutholakele ukuthi unesifo, ungesabi futhi ulandele imiyalelo kadokotela wakho ngqo.
- Kubalulekile ukuthatha imithi ngesikhathi futhi uye emitholampilo ukuze uyohlolwa ngesikhathi.
- Ungalokothi uyeke noma ushintshe ukwelashwa ngaphandle kwemvume kadokotela wakho.
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