Ingabe nawe unenkinga yegazi? Ake sixoxe nge-CMML (Chronic Myelomonocytic Leukemia)!

Wake wezwa ngesifo esibizwa ngokuthi i-'CMML' noma i-Chronic Myelomonocytic Leukemia ? Mhlawumbe akunjalo. Ngoba uhlobo olungavamile lomdlavuza wegazi. Kodwa kubaluleke kakhulu kithi ukuqaphela lokhu. Ngoba kuthinta indlela imizimba yethu eyenza ngayo igazi. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Kuyini i-CMML? Masiyiqonde kalula!

Kalula nje, umongo wakho wethambo – ingxenye ethambile engaphakathi kwamathambo akho – yiyo eyenza igazi. Umuntu one-CMML unomkhiqizo ophezulu kakhulu wohlobo lwamaseli amhlophe egazi abizwa ngokuthi ama-monocyte . Lawa ma-monocyte angajwayelekile acindezela amangqamuzana abomvu egazi aphilile, ama-platelet , kanye namanye amangqamuzana amhlophe egazi aphilile esiwadingayo. Cabanga ngakho njengokhula engadini olucindezela izihlahla ezinempilo.

Odokotela bahlukanisa lesi simo njenge-Myeloproliferative neoplasm/Myelodysplastic syndrome (MPN/ MDS ). Nakuba lokhu kungase kubonakale njengenhlanganisela yamagama eyinkimbinkimbi, empeleni kusho ukuthi:

• I-Myeloproliferative neoplasm (MPN): Lokhu kwenzeka lapho umongo wakho wethambo ukhiqiza uhlobo olulodwa lweseli legazi oluningi kakhulu . Uma kukhiqizwa uhlobo olulodwa kakhulu, ibhalansi yegazi iyaphazamiseka futhi igazi lingasebenzi kahle.
• I-Myelodysplastic syndrome (MDS): Lesi yisimo lapho amangqamuzana egazi akhiqizwa umnkantsha wakho eba angajwayelekile futhi angabi nesimo esihle . Ngokukhethekile, esikhundleni samangqamuzana egazi aphilile, avuthiwe, akhiqiza amangqamuzana angavuthiwe amaningi abizwa ngokuthi ama-blast cell.

I-CMML ngezinye izikhathi ingakhula kancane kakhulu. Kodwa ngezinye izikhathi ingaba ngokushesha futhi ibe nzima kakhulu. Udokotela wakho uzokuchazela ngemithi yokwelapha engalawula ukukhula kwayo.

Ziyini izimpawu ze-CMML? Ingabe nawe unazo lezi?

Izimpawu ze-CMML azibonakali ngaso sonke isikhathi. Ngezinye izikhathi ukuhlolwa kwegazi kuyinkomba yokuqala. Ngisho noma izimpawu zivela, zivame ukuvela kancane kancane. Bona ukuthi lezi zimpawu zizwakala zijwayelekile yini kuwe:

• Ukuzizwa ukhathele futhi ubuthakathaka ngaso sonke isikhathi: Lokhu kungenxa yokwehla kwamangqamuzana abomvu egazi, okuyi -anemia .
• Ukugula okuvamile kanye nezifo:Lokhu kungenxa yokwehla kwamangqamuzana amhlophe egazi, okubizwa ngokuthi i-neutropenia.
• Ukopha kwamakhala njalo, okuphenduka kube luhlaza okwesibhakabhaka ngisho noma kunokulimala okuncane: Lokhu kungenxa yokwehla kwama-platelet, okubizwa ngokuthi i-thrombocytopenia.
• I-Splenomegaly : Ukwanda kwe-spleen, okutholakala ohlangothini olungaphezulu kwesobunxele lwesisu sakho.
• I-Hepatomegaly : Ukwanda kwesibindi.
• Ukwehlisa isisindo okungachazeki.
• Ukujuluka ebusuku.
• Ubuhlungu bethambo.
• Imfiva.

Khumbula, akuwona wonke umuntu onalezi zimpawu one-CMML. Kodwa uma lezi zimpawu ziqhubeka, kungcono ukubona udokotela.

Ingabe ikhona imbangela ethile ye-CMML?

Abacwaningi abakakazi kahle ukuthi yini ebangela i-CMML. Kodwa-ke, bathole izinguquko eziningana zezakhi zofuzo ezihlotshaniswa nalesi sifo. Uma utholakale une-CMML, cishe unezinguquko zezakhi zofuzo ezingaphezu kweyodwa. Ezinye zezinguquko zezakhi zofuzo ezivame kakhulu zifaka:

• `TET2`
• `SRSF2`
• `ASXL1`
• `RAS` (lokhu kujwayelekile kakhulu)

Udokotela wakho uzokutshela okwengeziwe ngaleli jini.

Ubani osengozini enkulu yokuthola i-CMML?

Kunezici eziningana eziyingozi ezingathinta ukuthuthukiswa kwe-CMML:

• Ubudala: Ingozi yokuthola lesi sifo iyanda njengoba ukhula. Isilinganiso sobudala bokuxilongwa siphakathi kweminyaka engu-73 no-75 ubudala. Lokhu kusho ukuthi ingxenye yalabo abatholakale benalesi sifo bancane kunalokho, kanti enye ingxenye ikhulile.
• Ubulili: I-CMML ivame kakhulu kwabesilisa kunakwabesifazane.
• Ukwelashwa komdlavuza ngaphambilini: Cishe umuntu oyedwa kwabayishumi abathola i-CMML wake wathola i-chemotherapy noma i-radiation yomdlavuza ngaphambilini. Kodwa odokotela banikeza lokhu kwelashwa kuphela uma izinzuzo zokwelashwa zidlula ngokusobala ingozi yokuba nomdlavuza esikhathini esizayo.

Yiziphi ezinye izinkinga ezingaba khona kulesi simo?

Cishe abantu ababili kwabayishumi abane-CMML bazoba nomunye umdlavuza wegazi ongathi sína obizwa ngokuthi i-acute myeloid leukemia (AML). Khuluma nodokotela wakho ngengozi yakho yokuthola i-AML ngokusekelwe ekuxilongweni kwakho kanye nezici eziyingozi.

Odokotela bayixilonga kanjani i-CMML?

Udokotela wakho uzobuza ngezimpawu zakho bese ethatha umlando wakho wezokwelapha. Ngemuva kwalokho uzokwenza izivivinyo eziningana ukuhlola amaseli akho egazi. Lezi zivivinyo zingafaka:

• Ukubalwa kwegazi okuphelele (i-CBC): Uma inani lama-monocytes liphezulu kakhulu (i-monocytosis), kungaba uphawu lwe-CMML.
• I-smear yegazi elingaphandle: Uma ama-monocyte ebonakala engajwayelekile noma engavuthiwe (amaseli okuqhuma) uma ebhekwa ngaphansi kwe-microscope, lokhu kungaba uphawu lwe-CMML.
• Ukuhlolwa komnkantsha wethambo: Ngezinye izikhathi udokotela kungadingeka athathe isampula encane yomnkantsha wethambo bese eyihlola elabhorethri ukuze abone ukuthi kukhona yini ama-monocyte angajwayelekile.
• Ukuhlolwa kwezakhi zofuzo: Odokotela baphinde bafune ukuguquka kwezakhi zofuzo okuhlobene neminye imidlavuza yegazi. Lokhu kubavumela ukuthi bakhiphe ezinye izifo ezinezimpawu ezifanayo kanye nemiphumela yokuhlolwa kwegazi.

Yiziphi izigaba ze-CMML?

Odokotela banquma ukuthi i-CMML isakazeke kangakanani, noma ukuthi imbi kangakanani (ukukhula komdlavuza), ngokusekelwe enanini lamaseli okuqhuma egazini lakho kanye nomnkantsha wamathambo. Lezi zigaba ezimbili yilezi:

• I-CMML-1: Amaseli okuqhuma angaphansi kwama-4 kwangu-100 egazini lakho. Amaseli okuqhuma angaphansi kwama-9 kwangu-100 emnkantsheni wakho wamathambo angamaseli okuqhuma.
• I-CMML-2: Phakathi kwamaseli angu-5 no-19 kwangu-100 egazini lakho kukhona amaseli okuqhuma. Phakathi kwamaseli angu-10 no-19 kwangu-100 emnkantsheni wakho wamathambo kukhona amaseli okuqhuma.

Kukulesi sigaba lapho udokotela wakho ezonquma khona ukuthi yikuphi ukwelashwa okufanele futhi okusebenzayo kakhulu kuwe.

Yiziphi izindlela zokwelapha i-CMML?

Okokuqala, ungadinga ukwelashwa ukuqinisekisa ukuthi unamaseli egazi anele anempilo. Lokhu kungafaka phakathi imithi yokwandisa inani lamaseli egazi lakho noma ukumpontshelwa igazi njalo. Lokhu kungaba yingxenye yokunakekelwa kokunciphisa ubuhlungu ukulawula izimpawu.

Ezinye izindlela zokwelapha eziqondisa ngqo i-CMML yilezi:

• Ukufakelwa kwe-allogeneic stem cell: Lokhu ukuphela kokwelashwa okungayelapha ngokuphelele i-CMML. Kodwa-ke, akufanele wonke umuntu. Kungabangela nezinkinga ezisongela ukuphila njengesifo se-graft-versus-host.
• Ukwelashwa ngamakhemikhali: Imithi yokwelapha ngamakhemikhali imisa ukukhula okungalawuleki kwama-monocyte. Lokhu kungasiza ekunciphiseni izimpawu. Lokhu kusebenzisa imithi efana ne-Hydroxyurea kanye ne-Hypomethylating agents (HMA).
• Izivivinyo zemitholampilo:Uma ezinye izindlela zokwelapha zingasizi, udokotela wakho angase asikisele ukuthi uhlanganyele esivivinyweni somtholampilo. Izivivinyo zezokwelapha okwamanje ziphenya ukusebenza kahle kwezindlela zokwelapha ezintsha (isb., ukwelashwa okuqondiwe, ukwelashwa nge-immunotherapy) kwe-CMML.

Kufanele ngimbone nini udokotela?

Kuzodingeka ubone udokotela wakho njalo (ngokuvamile kanye ngenyanga kuya kanye njalo ezinyangeni eziyisithupha). Kubaluleke kakhulu ukuthi ugcine la ma-aphoyintimenti. Phakathi nala ma-aphoyintimenti, udokotela wakho uzobuza ngezimpawu zakho, enze ukuhlolwa kwegazi, ahlole ukuthi ukwelashwa kwakho kusebenza kahle kangakanani, futhi enze noma yiziphi izinguquko ezidingekayo.

Okwamanje, uma uhlangabezana nanoma yimiphi imiphumela emibi engalindelekile neyingozi ekwelashweni kwakho , khuluma nodokotela wakho ngokushesha . Udokotela wakho uzokutshela ukuthi yiziphi izimpawu okufanele uziqaphele, kuye ngokwelashwa okutholayo.

Yini ongayilindela uma uphila nalesi simo?

Isilinganiso sokuphila esimaphakathi somuntu otholakale ene-CMML cishe singunyaka owodwa kuya kwemithathu. Futhi, "isilinganiso" siyinani eliphakathi. Lokhu kusho ukuthi ingxenye yabantu ingaba nesikhathi sokuphila esifushane kanye nesigamu sokuphila isikhathi eside. Kodwa-ke, kunezici eziningi ezinquma ukubikezela kwakho. Lezi zifaka:

• Imiphumela yokuhlolwa kwegazi: Ukubalwa kwamaseli akho egazi kungakunikeza izinkomba mayelana nokubikezela kwakho. Ukubalwa kwamaseli akho egazi, amaseli aqhumayo, kanye nama-platelet kuyizindinganiso ezibalulekile. Izinga le-hemoglobin yakho nalo liyinani elibalulekile udokotela wakho avame ukulihlola.
• Ukuguquka kwezakhi zofuzo: Ezinye izinguquko zezakhi zofuzo, isibonelo ukuguquka kwezakhi zofuzo ze-`ASXL1`, zihlotshaniswa nokubikezela okubi kakhulu.
• Ukuvama kokumpontshelwa igazi: Ngaphandle kokuthi udinga ukumpontshelwa igazi njalo ukuze ubuyisele amangqamuzana egazi lakho, umphumela wakho uvame ukuba muhle.

Ukubikezela kwakho kuncike ekutheni isimo sakho siqhubekela ku-'AML' (i-acute myeloid leukemia). Lokhu kungenzeka kakhulu uma une-'CMML-2'.

Yini engingayenza ukuze ngihlale ngiphilile futhi nginamandla?

Uma une-CMML, enye yezinto ezinhle kakhulu ongayenza ukuthatha umthwalo wemfanelo ngempilo yakho ngazo zonke izindlela ongazisebenzisa . Ngalesi sikhathi, kubalulekile ukudla ukudla okunomsoco nokulala ngokwanele. Ukulinganisela phakathi kokusebenza nokuphumula okwanele nakho kubalulekile. Ukuxhumana nabanye abaphila nomdlavuza kuyindlela enhle yokulwa nemizwa yokuba nesizungu. Khuluma nodokotela wezokwelapha onolwazi lokusebenza neziguli ezinomdlavuza.

Umdlavuza ungenza umuntu azizwe engenamandla, kodwa khumbula, usalawula impilo yakho.Futhi kunezindlela zokwelapha ezizokusiza.

Ukuphila ne-CMML akulula. Umphumela wakho uncike ezintweni eziningi ezihlukile kuwe. Cela udokotela wakho akuchazele ukuthi ziyini lezi zinto nokuthi zithinta kanjani ukubikezela kwakho. Qonda izinketho zakho zokwelashwa ukuze uqiniseke ukuthi ukunakekelwa okukhethayo kuzohlangabezana nemigomo yakho.

Umyalezo obaluleke kakhulu okufanele uwuthathe uye nawo ekhaya

I-CMML yisimo esibucayi. Kodwa uma uqaphela, usebenzisana nodokotela wakho, uthola ukwelashwa okufanele, futhi wenze izinguquko ezinhle endleleni yokuphila, ungazama ukuphila kahle nalesi simo. Ungalokothi ulahle ithemba. Umndeni wakho, abangani, nodokotela bakhona ukukusiza. Awuwedwa. Uma unemibuzo noma ukukhathazeka, ungesabi ukubuza udokotela wakho. Kuyilungelo lakho.

` I-CMML, i-Chronic Myelomonocytic Leukemia, Umdlavuza Wegazi, Umongo Wethambo, Ama-Monocyte, Izimpawu, Ukwelashwa