Ake sifunde nge-leukemia engavamile ekhula egazini? (I-Large Granular Lymphocytic Leukemia - LGL)

Wake wezwa ngohlobo lwe-leukemia olungavamile, kodwa olungavamile kakhulu oluvela egazini? Mhlawumbe uke wezwa ngomngane onalo. Noma mhlawumbe usanda kuzwa ngalo futhi wazibuza ngalo. Namuhla sizokhuluma nge-leukemia engavamile, kodwa ebaluleke kakhulu. Ibizwa ngokuthi i-Large Granular Lymphocytic Leukemia (LGL). Igama lingase lizwakale lide kancane, kodwa masiligcine lilula.

Kusho ukuthini ngempela i-LGL?

Kalula nje, i-LGL uhlobo lwe-leukemia olukhula kancane emzimbeni, oluhlala isikhathi eside (okusho ukuthi luhlala isikhathi eside). Luthinta uhlobo olukhethekile lweseli elimhlophe egazini lethu. Lawa maseli siwabiza ngokuthi ama-lymphocyte . Ubuwazi ukuthi ama-lymphocyte ayizingxenye ezibaluleke kakhulu zesimiso sethu sokuzivikela komzimba. Afana namasosha ebuthweni lethu. Yiwo alwa namagciwane afana namagciwane angena emizimbeni yethu, futhi yiwo enza ama-antibodies asivikela ezifweni.

Ngakho-ke, ku-LGL, okwenzekayo ukuthi lawa maseli okuthiwa ama-lymphocyte, ikakhulukazi izinhlobo ezimbili zamaseli abizwa ngokuthi ama-Cytotoxic T cells noma amaseli e-Natural Killer (amaseli e-NK), ashintsha ngendlela engavamile ngesizathu esithile futhi aqale ukuhlukana nokwanda ngokungalawuleki. Lawa maseli angajwayelekile abizwa ngokuthi amaseli e-LGL.

Lesi simo, esibizwa ngokuthi i-LGL, sivame ukukhula kancane kakhulu. Yingakho sibizwa ngokuthi i-leukemia engapheli. Sivame kakhulu kubantu abangaphezu kweminyaka engama-60. Odokotela bangayilapha i-LGL. Kodwa ngezinye izikhathi lesi simo singabuya, futhi singaba yinkinga yempilo yesikhathi eside.

Kunezinhlobo ezimbili eziyinhloko ze-LGL:

Kutholakale izinhlobo ezimbili eziyinhloko zalesi simo se-LGL. Lezi yizi:

1. I-T-cell enkulu ye-granular lymphocytic leukemia (T-LGL)

2. Isifo esingamahlalakhona se-lymphoproliferative samaseli e-NK (CLPD-NK)

Kuzo zombili izimo, njengoba kushiwo ngaphambili, okwenzekayo ukuthi amaseli e-T noma amaseli e-NK aba angajwayelekile.

Lesi simo siyithinta kanjani imizimba yethu?

Ungase uzibuze ukuthi hlobo luni lomphumela lesi sifo esibizwa ngokuthi i-LGL esinawo emizimbeni yethu. Njengoba lolu uhlobo lwe-Chronic Lymphocytic Leukemia, lawo maseli e-LGL angajwayelekile aya emnkantsheni wamathambo futhi aphazamise ukukhiqizwa kwamangqamuzana egazi ajwayelekile lapho. Kufana nesitshalo esibi esifikayo sithathe isitshalo esihle.

Lokhu kungabangela izinkinga ezimbili ezinkulu:

• I-Neutropenia : Lokhu ukwehla kwenani lama-granulocyte emzimbeni wethu.Ukwehla kwenani lamaseli amhlophe egazi (ama-granulocyte) (uhlobo oluvame kakhulu lwamaseli amhlophe egazi). Lapho la maseli ehla, ikhono lomzimba wethu lokulwa nezifo, noma ukuzivikela komzimba, liyancipha. Lokhu kwandisa ingozi yokutheleleka njalo.
• I-anemia : Kungenzeka ukuthi uke wezwa ngalokhu. I-anemia yilapho umzimba ulahlekelwa inani elidingekayo lamaseli abomvu egazi anempilo. Lesi simo singase senzeke ngoba amaseli e-LGL nawo athinta ukukhiqizwa kwamaseli abomvu egazi. Lapho kuvela i-anemia, uzizwa ukhathele futhi ukhathele kakhulu.

Ubani onamathuba amaningi okuthola lesi sifo?

I-LGL empeleni iyisifo esingavamile kakhulu . Uma ubheka emhlabeni wonke, lesi simo sibikwa kubantu abacishe babe munye kwabayisigidi. Lokho kusho ukuthi ezweni elifana neSri Lanka, laba bantu bangase babe bambalwa kakhulu. Esikhathini esiningi, lapho lesi sifo sitholakala, iziguli ziseminyakeni yazo engama-60.

Ziyini izimpawu? Sikuqonda kanjani lokhu?

Nakhu okumangazayo kancane. Abanye abantu abane-LGL bangahlala iminyaka eminingi bengenazo izimpawu . Ucwaningo olulodwa luthole ukuthi cishe ingxenye yesithathu yabantu abane-LGL babengenazo nhlobo izimpawu lapho bexilongwa. Bathole ukuthi banazo kuphela lapho ukuhlolwa kwegazi ngesinye isizathu kubonisa inani eliphansi kakhulu lamaseli abomvu egazi noma inani eliphansi lamaseli amhlophe egazi abizwa ngokuthi ama-neutrophils.

Kodwa-ke, kunezimpawu ezithile ezivamile abantu abathola izimpawu abangase bazibone:

• Ukukhathala okukhulu nokukhathala : Lolu uphawu oluvame kakhulu lwe-LGL. Ngokuvamile, lokhu kungenxa ye-anemia eshiwo ngenhla.
• Umkhuhlane ovamile kanye nokutheleleka okuphindaphindiwe : Ukutheleleka ngamagciwane kungabangela umkhuhlane. Lokhu kungenxa yobuthakathaka besimiso somzimba sokuzivikela.
• I-Splenomegaly: Lokhu kungukukhula kwe-spleen, isitho emzimbeni wethu. Lokhu kungenzeka ngenxa yezifo kanye nezinhlobo ezithile ze-anemia.

Khumbula, ukuba nalezi zimpawu akusho ukuthi une-LGL. Zingaba futhi izimpawu zezinye izifo eziningi. Ngakho-ke, uma ubhekene nento efana nale, kungcono ukubona udokotela ukuze akunike iseluleko.

Ingabe zikhona ezinye izimo ezihlobene ne-LGL?

Yebo, abantu abaningi abane-LGL batholakale benezinye izifo ezizimele . Okusho ukuthi, izimo lapho amasosha omzimba wethu ehlasela khona amangqamuzana ethu aphilile. Phakathi kwalezi, isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis yisona esivame kakhulu.

Ngaphezu kwalokho, ezinye izimo eziningana zingase zihlotshaniswe ne-LGL:

• I-anemia : Sesikhulume ngalokhu ngaphambili. Abanye abantu baba ne-anemia enzima futhi badinga ukumpontshelwa igazi ukuze balondoloze amazinga abo amangqamuzana abomvu egazi. Abanye abantu abane-LGLUhlobo lwe-anemia olubizwa ngokuthi i-hemolytic anemia nalo lungavela. Kulokhu, esikhundleni sokunciphisa ukukhiqizwa kwamangqamuzana abomvu egazi, amangqamuzana abomvu egazi akhona ayabhujiswa.
• I-Lymphocytosis : Lokhu ukwanda kwenani lamaseli amhlophe egazi abizwa ngokuthi ama-lymphocytes egazini. Lokhu kwanda kwama-lymphocytes kuvame ukubonakala kubantu abane-lymphocytic leukemias, ama-lymphomas, noma izifo ezibangelwa amagciwane.

Iyini imbangela yangempela ye-LGL?

Lokhu kuyinto odokotela abangakayiqondi ngokugcwele. Imbangela eqondile ye-LGL ayikakaziwa okwamanje. Kodwa-ke, bakholelwa ukuthi kukhona ukuxhumana phakathi kwalesi simo se-leukemia nokusebenza kwesimiso sethu somzimba sokuzivikela, izifo ezizimele, kanye nezinye izinhlobo zomdlavuza.

• Cishe abantu abangu-30% abane-LGL banezinye izifo ezizimele, njenge-rheumatoid arthritis.
• Abanye abangu -25% kuya ku-30% bangase babe nolunye uhlobo lwe-lymphoma noma olunye uhlobo lomdlavuza.
• Futhi, abantu abaningi abane-LGL banezinguquko ezakhiweni zabo zofuzo. Ikakhulukazi, kunezinguquko ezakhiweni ezimbili zofuzo ezibizwa ngokuthi i-STAT3 kanye ne -STAT5B . Lezi zakhi zofuzo ezimbili zidlala indima ebalulekile ekuvikeleni amasosha omzimba kanye nendlela amaseli ahlukana futhi aphindaphindeke ngayo.

Odokotela basithola kanjani lesi sifo?

Odokotela basebenzisa kakhulu ukuhlolwa kwegazi kanye nokuhlaziywa kwezakhi zofuzo ukuze baxilonge i-LGL. Nazi ezinye zezivivinyo ezivame ukwenziwa:

• Inani eliphelele legazi (i-CBC) elinomehluko : Lokhu kubala zonke izinhlobo zamaseli egazini lakho, ikakhulukazi ukuthi zingaki zohlobo ngalunye lwamaseli amhlophe egazi onawo.
• I-smear yegazi elingaphandle : Lokhu kuhilela ukubuka isampula yegazi ngaphansi kwe-microscope nokubala inani lamaseli e-LGL egazini.
• I-Flow cytometry : Lokhu ukuhlolwa kwelebhu okusetshenziselwa ukuhlaziya izici zamaseli. Lokhu kuhlolwa kuvame ukusetshenziselwa ukuhlonza nokuhlukanisa izinhlobo ze-leukemia.
• Ukuhlola ama-immunophenotyping : Lokhu kuhilela ukuthatha amasampula egazi noma ezicubu bese uzihlola ukuze kutholakale izimpawu ezithile ebusweni bamaseli. Lezi zimpawu zingasetshenziswa ukuhlonza izinhlobo ezithile zezifo.
• Ukuhlaziywa kokuhlela kabusha izakhi zofuzo ze-T-cell receptor (TCR) : Lokhu kuthatha isampula yegazi noma umnkantsha bese kubheka noma yiziphi izinkinga ngezakhi zofuzo ezilawula indlela asebenza ngayo amaseli e-T.
• Ukuhlolwa kofuzo : Ungahlola futhi izinguquko ku-STAT3 kanye ne-STAT5B ezishiwo ngaphambilini.

Ngaphezu kwalezi zivivinyo, ukuntuleka kwamasosha omzimbaEzinye izivivinyo, njengokuhlolwa komnkantsha wamathambo, zingenziwa ukuze kunqunywe ezinye izimo ezifana nokuntuleka kwamasosha omzimba, isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis, i-myelodysplasia , kanye nokuguqulwa kwe-myeloid . Amazinga e-immunoglobulin kanye namazinga e-monoclonal protein nawo angahlolwa.

Iphathwa kanjani i-LGL?

Ake sithi une-leukemia ye-T-LGL noma ye-CLPD-NK, kodwa awunazo izimpawu . Uma kunjalo, udokotela wakho angase ancome isu elibizwa ngokuthi "ukulinda ngokuqapha." Lokhu kuhilela ukuqapha impilo yakho njalo. Ngokuvamile, uzoba nokuhlolwa kwegazi njalo ezinyangeni ezimbalwa ukuze ubone ukuthi izimpawu ziyavela yini.

Kulabo abanezimpawu, ukwelashwa okucindezela amasosha omzimba kanye nama-steroid kunganikezwa. Odokotela bangase baqale ukwelashwa okulandelayo, noma bangase baqale ukwelashwa okunamandla aphansi. Ngenxa yokuthi i-LGL iyisifo esingavamile, abantu abaningi bafuna udokotela ochwepheshe kulesi sifo.

Asikwazi yini ukunciphisa ukwanda kwalesi sifo?

Ngeshwa, cha, asikwazi. Odokotela abasazi kahle ukuthi yini ebangela lokhu. Ngakho-ke, kunzima ukusho ukuthi bangakuvimbela kanjani. Kodwa-ke, kutholakale ukuthi abantu abanezifo zokuzivikela komzimba basengozini enkulu yokuthola lesi simo. Ngakho-ke, uma unesinye salezi zifo zokuzivikela komzimba, kuwumqondo omuhle ukubuza udokotela wakho ukuthi kufanele yini ukhathazeke nge-LGL.

Ingabe i-LGL iyisifo esibulalayo?

Ezimweni eziningi, i-LGL iyisifo esingamahlalakhona, hhayi ukufa okuzumayo . Cishe abantu abangu-75% abane-T-LGL leukemia kanye ne-CLPD-LGL leukemia baphila iminyaka emihlanu ngemva kokuxilongwa. Kodwa-ke, cishe abantu abangu-10% abanalezi zinhlobo ze-leukemia bafa ngenxa yokutheleleka okukhulu okungaba yinkinga ye-leukemia. Ngakho-ke, kubaluleke kakhulu ukuzivikela ezifweni.

Ngizinakekela kanjani? Ngiphila kanjani nalesi simo?

Uma une-LGL, kungenzeka ungabi nazo izimpawu. Kodwa-ke, kubalulekile ukunakekela impilo yakho iyonke, okuhlanganisa nokuhlolwa njalo . Kungakhathaliseki ukuthi unezimpawu noma cha, lezi ziphakamiso zingasiza:

• Yidla ukudla okunempilo : Yidla inyama engenamafutha amaningi, inhlanzi, izithelo, imifino kanye nokudla okusanhlamvu okuphelele.
• Vivinya umzimba njalo : Khetha ukuzivocavoca okuzwakala kukuhle futhi okufanelayo.
• Lala kahle : Ukuphumula okwanele kubaluleke kakhulu.
• Lawula ukucindezeleka.: Yenza izinto ezikwenza ujabule, uzindle, wenze i-yoga.
• Vikela amasosha omzimba wakho : Buza udokotela wakho ngemigomo kanye nezinye izinto ongazenza ukuvimbela ukutheleleka. Ngisho nezinto ezilula njengokugeza izandla zakho ngensipho nokuhlala kude nezindawo ezinabantu abaningi zingasiza.

Kungenzeka yini ukuphila impilo evamile unalesi simo?

Ngokuvamile, abantu abelashwa nge-LGL bavame ukuphila impilo evamile . Bangaphila isikhathi eside njengomuntu ongenaso lesi simo. Kodwa-ke, kubalulekile ukukhumbula ukuthi abanye abantu abane-LGL bangase babe nezifo zegazi ezingathi sína ezithinta ikhwalithi yempilo yabo.

Kufanele ngimbone nini udokotela?

Uma uba nezimpawu ezibonisa ukuthi isimo sakho singase sibe sibi kakhulu, kufanele nakanjani ubone udokotela wakho. Uma usuvele welashwa izimpawu, kufanele futhi utshele udokotela wakho nganoma yiziphi izinguquko oziqaphelayo emzimbeni wakho (isibonelo, izimpawu ziba zimbi kakhulu).

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

Njengoba i-LGL iyisifo esingavamile, kuvamile ukuba nemibuzo eminingi ngaso. Nansi eminye imibuzo esithemba ukuthi izokusiza ufunde kabanzi nge-LGL:

• Uhlobo luni lwe-LGL enginalo?
• Yiziphi izindlela zokwelapha lokhu?
• Ingabe ngizodinga ukwelashwa okungaphezu kokukodwa?
• Ngizizwa ngiphilile kakhulu manje. Ingabe ngizoba nezimpawu?
• Nginezinye izifo. Ingabe i-LGL izozenza zibe zimbi kakhulu?

Ungesabi ukubuza imibuzo efana nale. Udokotela wakho ukhona ukuzokusiza. Bazimisele ukuchaza konke ngendlela ongayiqonda.

Okokugcina, izinto okufanele uzikhumbule

I-Large granular lymphocytic leukemia (LGL) ingumdlavuza wegazi ongavamile othinta amangqamuzana akho amhlophe egazi. Ngisho noma unalesi simo, ungase ungaboni noma yiziphi izinguquko emzimbeni wakho ezingaba izimpawu ze-LGL. Ngezinye izikhathi, izimpawu zingase zingabonakali iminyaka eminingi.

Odokotela abakwazi ukwelapha lesi simo ngokuphelele. Kodwa-ke, kunezindlela zokwelapha ezingasiza ekulawuleni izimpawu zaso. Kuvamile ukuzizwa ushaqekile futhi wesaba uma uzwa ukuthi unesifo esingelapheki . Odokotela bakho bazoqonda ukuthi kungani uzizwa ngaleyo ndlela.

Bazokujabulela ukukuchazela ukuthi yini ongayenza ukuze unakekele impilo yakho manje, nokuthi yini ongayilindela uma kuvela izimpawu. Ukwazi ukuthi yini ongayilindela esikhathini esizayo kuzokunika ukuzethemba okukhulu namandla okuphila ne-LGL. Ngakho-ke, khuluma nodokotela wakho ngayo yonke imibuzo onayo. Thola ulwazi. Yileyo into engcono kakhulu ongayenza ngesikhathi esinjengalesi.

'I-LGL leukemia, umdlavuza wegazi, amaseli amhlophe egazi, ama-lymphocyte, i-neutropenia, i-anemia, isimiso somzimba sokuzivikela