Uyafuna ukwazi nge-Hairy Cell Leukemia? Ake sixoxe!

Uzizwa ukhathele ngaso sonke isikhathi? Noma uphethwe umkhuhlane kanye nezifo ezingapheli? Ngezinye izikhathi lezi zinto zibhekwa njengezivamile, kodwa azivamile ukuba uphawu lwento ehlukile. Namuhla sizokhuluma ngomdlavuza wegazi ongavamile kodwa obaluleke kakhulu okubaluleke kakhulu ukuwuqaphela. Ubizwa ngokuthi "i-Hairy Cell Leukemia".

Iyini le "Hairy Cell Leukemia"?

Kalula nje, lolu uhlobo lomdlavuza oluqala egazini. Sinengxenye yomzimba wethu ebizwa ngokuthi umongo wamathambo. Kukulowo mongo lapho kwenziwa khona izinhlobo zamaseli egazini lethu. Kulawa, amaseli e-B (abizwa nangokuthi 'ama-B lymphocytes') awuhlobo lwamaseli amhlophe egazi. Umsebenzi wawo oyinhloko ukulwa namagciwane angena emizimbeni yethu futhi asivikele ezifweni.

Ngakho-ke, kulesi simo esibizwa ngokuthi 'iHairy Cell Leukemia', okwenzekayo ukuthi umongo wakho wethambo ukhiqiza amaseli e-B angavamile . Uma ubheka lawa maseli angavamile ngaphansi kwe-microscope, ungabona ukuthi anezinhlayiya ezincane ezifana nezinwele eziphuma kuwo. Yingakho lesi sifo sibizwa ngokuthi 'i-hairy cell leukemia' ngenxa yalokho kubukeka 'okunezinwele'. Sitholakala ngososayensi bezifo abahlola amaseli ngaphansi kwe-microscope.

Kungani lokhu kwenzeka? Kwenzekani emzimbeni?

Nakuba kungaziwa kahle ukuthi kungani lokhu kwenzeka, kunezinto ezimbalwa ezenzeka emzimbeni uma lesi simo senzeka. Cabanga ukuthi unengadi yemifino, futhi kwenzekani uma ukhula lukhula ngokungalawuleki? Imifino emihle ilahlekelwa isikhala futhi ingakhuli kahle, akunjalo? Yilokho okwenzekayo nalapha.

• Imiphumela yomongo wethambo: Lawo ma-B-cell angavamile aqala ukwakheka emmongo wethambo, njengokhula. Lokho kunciphisa ikhono lokukhiqiza amaseli egazi amhlophe anempilo, amaseli egazi abomvu, nama-platelet (amaseli asiza ukugoba kwegazi).
• Ukuvuvukala kwama-lymph node kanye ne-spleen: Lawa maseli angajwayelekile kuma-lymph node ethu kanye ne-spleen aqala ukuhlukana futhi aphindaphindeke, okubangela ukuthi lezo zitho zivuvuke.
• Imiphumela yesibindi: Ngezinye izikhathi la maseli angajwayelekile angasakazekela esibindini ngegazi futhi alimaze. Lokhu kungaholela ekuqongeleleni koketshezi esiswini (isimo esibizwa ngokuthi 'ama-ascites').

Ingabe lokhu kuvamile?

I-'Hairy Cell Leukemia' iyisifo esingavamile kakhulu . Ngisho nasezweni elifana neMelika, sivela cishe koyedwa kubantu abayikhulu lezinkulungwane. Kuthiwa futhi lesi simo sivame kakhulu kubantu abamhlophe kunakwamanye amaqembu ezinhlanga.

Ziyini izimpawu?

Ngezinye izikhathi abantu abane-Hairy Cell Leukemia bangase bangabi nazimpawu . Kodwa-ke, uma kuvela izimpawu, zingase zihlanganise:

• Ukukhathala: Lokhu kukhathala kungenzeka ngenxa yokwehla kwamazinga abomvu egazi (i-anemia).
• Umkhuhlane kanye nokutheleleka okuvamile:Ngenxa yamazinga aphansi amangqamuzana amhlophe egazi anempilo alwa nokutheleleka, umkhuhlane ovamile kanye nokutheleleka okukhulu kungenzeka kakhulu.
• Ubuhlungu besisu esingezansi kwesobunxele: Lapho amangqamuzana angajwayelekile e-spleen eqoqana futhi ebangela ukuba i-spleen ivuvuke, ungase uzwe ubuhlungu endaweni yesisu esingezansi kwesobunxele. I-spleen ingase ikhule futhi ikwenze uzizwe usuthi, futhi ungase uzizwe usuthi ngisho nangemva kokudla okuncane. Ungase futhi wehlise isisindo ngaphandle kokuzama.
• Ubuhlungu esiswini esingezansi kwesokudla: Uma isibindi sikhule kakhulu, ungase uzwe ubuhlungu ohlangothini lwesokudla.
• Ubunzima bokuphefumula: Lokhu kungenye impawu ye-anemia.
• Ama-lymph node avuvukele: Amaqhubu angenabuhlungu angavela entanyeni, emakhwapheni nasesiswini.
• Ukuphuka noma ukuphuma kwegazi okungavamile: Ngenxa yokuthi umongo wethambo awukhiqizi ama-platelet anele, okusiza ukujiya kwegazi, ngisho nokuminyana okuncane kakhulu nokuphuma kwegazi kungenzeka.

Okubalulekile: Ukuba nesinye noma ngaphezulu kwalezi zimpawu akusho ukuthi une-Hairy Cell Leukemia. Kodwa-ke, uma lezi zimpawu ziqhubeka, kungcono ukufuna iseluleko sezokwelapha.

Ziyini izimbangela? Ingabe zikhona yini izinto eziyingozi?

Ochwepheshe abakayazi imbangela eqondile yeHairy Cell Leukemia. Kodwa-ke, ucwaningo luthole ukuthi cishe abantu abangu-90% abanalesi sifo banokuguquka kwezakhi zofuzo. Kuthinta isakhi sofuzo esibizwa nge-BRAF. Lesi sakhi sofuzo sisiza amangqamuzana ukuba akhule. Ngakho-ke, uma sishintsha, amangqamuzana angajwayelekile aqala ukukhula futhi azalane ngokungalawuleki. Lolu shintsho lwezakhi zofuzo lwenzeka ngemva kokuzalwa kwethu. Kodwa-ke, akukacaci ukuthi yini ebangela lolo shintsho.

Kodwa-ke, kuye kwatholakala ezinye izinto ezibangela ingozi yokuthuthukisa lesi sifo:

• Ubudala: Lesi simo sivame ukuthinta abantu abaneminyaka ephakathi kuka-40 no-70. Isilinganiso sobudala lapho kutholakala ukuthi unalesi sifo sineminyaka engaba ngu-58.
• Ubulili: Lesi sifo sivame kakhulu kwabesilisa kunabesifazane.
• Ukuchayeka kwe-Agent Orange: Abacwaningi bakholelwa ukuthi kukhona ukuxhumana phakathi kwale khemikhali kanye ne-B-cell leukemia engapheli kanye ne-lymphoma (kufaka phakathi i-hairy cell leukemia).

Yiziphi izinkinga ezingabangelwa yilokhu?

I-Hairy Cell Leukemia ibangela ukwehla okukhulu kwenani lamaseli amhlophe egazi emzimbeni wakho alwa nokutheleleka, okwandisa ingozi yakho yokuthola izifo . Lokhu kungaba ukutheleleka ngamagciwane, amagciwane, noma isikhunta. Ngezinye izikhathi, lokhu kutheleleka kungaba yingozi empilweni.

Kukhona futhi ithuba elincane lokuthola uhlobo lwesibili lomdlavuza eminyakeni eminingi ngemva kokutholakala nokwelashwa. Isibonelo, izifundo ezilandele abantu abelashwe ngempumelelo i-Hairy Cell Leukemia iminyaka eyi-10-20 zibike amacala abanye abathola eminye imidlavuza.

Lesi sifo sitholakala kanjani?

Uma ubona udokotela, uzokubuza ngezinto ezifana nokuthi izimpawu zakho zaqala nini nokuthi uthola yini izifo njalo. Uzobuza nangomlando wakho wezokwelapha. Ngemuva kwalokho, bazokwenza ukuhlolwa ngokomzimba. Bangase bahlole nama-lymph node akho, u-spleen, nesibindi ukuze babone ukuthi awekho yini ukuvuvukala.

Ngemuva kwalokho, ungathunyelwa kudokotela we-hematologist noma kudokotela we-oncologist ukuze uthole ezinye izivivinyo zokuqinisekisa ukuxilongwa. Lezi zivivinyo zingafaka:

• Ukubalwa kwegazi okuphelele (i-CBC) kanye nomehluko: Lokhu kulinganisa inani lamaseli egazi abomvu namhlophe, kanye nama-platelet. Umehluko ulinganisa inani lezinhlobo ezahlukene zamaseli egazi amhlophe.
• I-smear yegazi elingaphandle: Odokotela bezifo babheka isampula yegazi ngaphansi kwesibonakhulu ukuze babheke amangqamuzana angajwayelekile anezimbobo ezifana "nezinwele".
• Ukufuthwa komnkantsha wethambo kanye ne-bone marrow biopsy: Lokhu kuhlolwa kungabona amangqamuzana angajwayelekile emnkantsha wethambo.
• I-CT scan (i-computed tomography - i-`CT` scan): I-`CT` scan ingathatha izithombe ezinemininingwane zengaphakathi lomzimba. Lokhu kungasetshenziswa ukubona usayizi we-spleen, isibindi, nama-lymph node, noma i-ultrasound yesisu.
• I-Flow cytometry: Lokhu kuhlola igazi kanye nomnkantsha ukuze kutholakale amaseli angajwayelekile, njengamaseli ezinwele. Kuhlola nosayizi, ukuma kwamaseli, kanye nokuba khona kwezimpawu zesimila. Izimpawu zesimila zingaba amaprotheni akhiqizwa amaseli omdlavuza.

Iphathwa kanjani?

Uma unesifo, kuzodingeka uselaphe kuqala. Ngemuva kwalokho, kuzoqalwa ezinye izindlela zokwelapha ukulawula izimpawu ze-'Hairy Cell Leukemia'. Kodwa-ke, njengoba sesishilo ngaphambili, akuwona wonke umuntu ozoba nezimpawu. Kubantu abanjalo, udokotela wakho we-hematologist noma udokotela wakho we-oncologist angase asikisele indlela ebizwa ngokuthi i-active surveillance . Uma kunezimpawu, angase akunikeze imithi.

Ukuqapha Okusebenzayo

I-Hairy Cell Leukemia yisifo esikhula kancane kakhulu . Kungathatha iminyaka ukuthi izimpawu zivele. Ngenxa yokuthi ukwelashwa komdlavuza kungabangela imiphumela emibi kanye nezinkinga, uma ungenazo izimpawu, udokotela wakho angase anqume ukulibazisa ukuqala ukwelashwa kuze kube yilapho izimpawu zibonakala.

Ngesikhathi sokuqapha okusebenzayo, uzobona udokotela wakho njalo ezinyangeni ezintathu kuya kweziyisithupha. Phakathi nalezo zikhathi zokuvakashela:

• Bazokubuza ngempilo yakho iyonke, ikakhulukazi uma uzizwa ukhathele kakhulu kunokujwayelekile.
• Kuzohlolwa ngokomzimba ukuze kuhlolwe ukuvuvukala kwesibindi kanye ne-spleen.
• Ukuhlolwa kwegazi kuyalelwe ukuhlola amazinga amaseli egazi nama-platelet.

Kungaba nzima kancane ngokomzwelo ukulinda izimpawu zivele ngaphambi kokuqala ukwelashwa. Kodwa udokotela wakho uzoyiqonda imizwa yakho futhi achaze ukuthi kungani kunconywa ukuqapha okusebenzayo.

Imithi

Ukwelashwa okuyinhloko kwabantu abane-leukemia yamaseli anoboya yi -chemotherapy . Imithi yokulwa nomdlavuza esetshenziswa kakhulu yi-Cladribine (Leustatin®) noma i-Pentostatin (Nipent®).

Uma ukwelashwa ngamakhemikhali kungasebenzi, noma uma lesi sifo siphinde sibuye, kunezinye izindlela zokwelapha:

• Ukwelashwa Ngezifo Ezingalawuleki: `I-Rituximab (i-Rituxan®)` iwukwelashwa kwe-`monoclonal antibody` okusetshenziselwa `i-Hairy Cell Leukemia`. Inganikezwa njengokwelashwa kokuqala nge-chemotherapy noma uma lesi sifo siphinde sibuye. Enye i-immunotherapy yi-`Recombinant Interferon Alfa-2b (Intron A®)`.
• Ukwelashwa okuqondiwe: Ku-Hairy Cell Leukemia ephinde yabuya, imithi ebizwa ngokuthi i-Rituximab kanye ne-Moxetumomab pasudotox (Lumoxiti®) (lolu uhlobo lwe-antibody-drug conjugate) ingasetshenziswa.
• Ukususwa kwe-splenectomy: Akuvamile kakhulu, lokhu kuhlinzwa kunganconywa uma ukwelashwa kwezokwelapha okufana nokwelashwa ngamakhemikhali kungasizi futhi i-spleen iqhubeka nokuvuvukala ngenxa yamaseli angajwayelekile ku-spleen.

Ingabe ikhona imiphumela emibi yokwelashwa?

Njenganoma yikuphi ukwelashwa komdlavuza, kungaba nemiphumela emibi. Ikakhulukazi, imithi yamakhemikhali ye-hairy cell leukemia yandisa ingozi yokutheleleka okusongela impilo . Udokotela wakho uzokuchazela ukuthi yiziphi izinyathelo ongazithatha ukuvimbela ukutheleleka nokuthi yiziphi izinguquko emzimbeni wakho ezingaba izimpawu zokutheleleka.

Yini ongayilindela ngenkathi uphila nalesi sifo?

Okwamanje akukho ukwelashwa kwe-Hairy Cell Leukemia. Kodwa-ke, ucwaningo lubonisa ukuthi ukwelashwa, okuhlanganisa ne-chemotherapy, kungagcina lesi sifo siphumule iminyaka eyi-10 noma ngaphezulu . Ukuxolelwa kusho ukuthi awunazo izimpawu futhi azikho izimpawu zesifo ezingatholakala ezivivinyweni. Ucwaningo oluhlaziye okuhlangenwe nakho kwabantu abane-Hairy Cell Leukemia luthole ukuthi ngemva kokwelashwa, bangaphila isikhathi eside njengabantu abangenaso lesi sifo.

Kodwa-ke, i-hairy cell leukemia ingaphinde ibuye eminyakeni eminingana ngemva kokwelashwa kokuqala. Kodwa-ke, uma lokho kwenzeka, kunezindlela zokwelapha ezingabuyisela lesi sifo esimweni esijwayelekile.

Abantu abaningi badinga ukunakekelwa kwezokwelapha kanye nokusekelwa impilo yonke, njengoba odokotela kudingeka baqaphe ukubuya kwesifo. Ngisho noma unesifo kodwa ungenazo izimpawu, kuzodingeka ukuthi uhlolwe futhi uhlolwe njalo ezinyangeni ezintathu kuya kweziyisithupha ngemva kokuxilongwa.

Lingakanani izinga lokululama?

Ngokusho kwe-Leukemia and Lymphoma Society, abantu abangu-90% abaphathwa ngomuthi we-chemotherapy i-Cladribine bayaphila eminyakeni emihlanu ngemuva kokwelashwa. Kodwa-ke, ukubikezela kwakho - okwenzekayo ngemva kokwelashwa - kuncike ezintweni eziningi . Ubudala bakho, impilo yakho iyonke, izimpawu, kanye nendlela umzimba wakho osabela ngayo ekwelashweni konke kudlala indima. Uma unemibuzo ngalokhu, buza udokotela wakho.

Kufanele ngiyinakekele kanjani impilo yami?

I-Hairy Cell Leukemia yandisa ingozi yokutheleleka okusongela impilo. Ungaqinisa amasosha omzimba wakho futhi uzivikele ezifweni . Nazi ezinye iziphakamiso:

• Yidla ukudla okunempilo: Izinto ezifana nezithelo, imifino, amaprotheni angenamafutha, kanye nokusanhlamvu okuphelele kusiza amasosha omzimba ukuthi asebenze kahle.
• Ukuzivocavoca nsuku zonke: Ukuzilolonga nsuku zonke kuhle ezicini eziningi zempilo yakho, okuhlanganisa nesimiso sakho somzimba sokuzivikela.
• Lala ngokwanele: Ukungalali ngokwanele kungenza amasosha omzimba wakho angasebenzi kahle.
• Thola imithi yakho yokugoma ngesikhathi: Imijovo iqeqesha umzimba wakho ukulwa namagciwane abangela izifo. Khuluma nodokotela wakho ngokuthi yimiphi imithi yokugoma oyidingayo nokuthi uzoyithola nini.

Kufanele ubonane nini nodokotela?

I-Hairy Cell Leukemia kanye nokwelashwa kwayo kungandisa ingozi yakho yokuthola izifo ezingathi sína, ngezinye izikhathi ezisongela ukuphila. Bheka udokotela ngokushesha uma unalezi zimpawu:

• Umkhuhlane ongaphezu kwama-degree Celsius angu-38 (100.4 degrees Fahrenheit) futhi onganciphi.
• Umphimbo obuhlungu ohlala izinsuku ezingaphezu kwezimbalwa noma oqhubeka uba mubi kakhulu.
• Ubuhlungu besisu obungapheli noma obuqhubeka buba bubi kakhulu.

Isifinyezo kanye Nokugcina (Umyalezo Oya Nawo Ekhaya)

Mhlawumbe ubuzizwa ukhathele kakhulu kunokujwayelekile ngaphandle kwesizathu. Noma mhlawumbe ubucabanga ngokutheleleka kokuphefumula okungakapheli naphezu kwayo yonke imithi obuyiphuza. Manje ukuhlolwa kubonise ukuthi unomdlavuza wegazi ongavamile obizwa ngokuthi 'i-Hairy Cell Leukemia', ongelapheki ngokuphelele ngokwelashwa.

Kodwa ungakhathazeki . Kunezindlela zokwelapha ezingagcina lesi simo silawulwa iminyaka eminingi ngaphandle kwezimpawu. 'Ukuxolelwa' kwesikhathi eside kusho ukuthi ithimba lakho lezokunakekelwa kwempilo lizoqapha impilo yakho impilo yakho yonke. Futhi, uma i-Hairy Cell Leukemia ibuya, abacwaningi bayaqhubeka nokufuna izindlela zokubuyisela lesi simo 'ekuxolelweni'.

Kunezinto ongazenza wena. Isibonelo, ukwelashwa komdlavuza kungandisa ingozi yakho yokutheleleka. Buza udokotela wakho ngemigomo kanye nezinye izinyathelo ongazithatha ukuze unciphise ingozi yakho yokutheleleka.Awuwedwa, kukhona odokotela kanye nabasebenzi bezempilo abazokusiza kulolu hambo.

I- Hairy Cell Leukemia, i-leukemia, umdlavuza wegazi, amaseli e-B, umongo wamathambo, ubende, izimpawu