Ileukemia

Ileukemia

By Uhlaziyo lweMedia; Ukuhlaziywa ngu-Varixcare.cz. Igqityelwe ukuhlaziywa ngoMeyi 3, 2021.

Yintoni ileukemia?

Ukupapashwa kwezeMpilo eHarvard

Ileukemia luhlobo lomhlaza oluchaphazela amandla omzimba okwenza iiseli eziphilileyo zegazi. Iqala kumongo wethambo, iziko elithambileyo lamathambo ahlukeneyo. Kulapho kwenziwa khona iiseli ezintsha zegazi. Iiseli zegazi zibandakanya



  • Iiseli ezibomvu zegazi, ezithwala ioksijini ukusuka emiphungeni ziye kwizicwili zomzimba kwaye zithathe ikharbhon diokside ukuya emiphungeni ukuze ikhuphe
  • Iiplatelets, ezinceda ukujiya kwegazi
  • Amaseli egazi amhlophe, anceda ukulwa usulelo, iintsholongwane kunye nezifo.

Nangona umhlaza unokuchaphazela iiseli ezibomvu zegazi kunye neeplatelets, i-leukemia ngokubanzi ibhekisa kumhlaza weeseli ezimhlophe zegazi. Esi sifo sihlala sichaphazela enye yeentlobo ezimbini eziphambili zeeseli ezimhlophe zegazi: ii-lymphocyte kunye ne-granulocytes. Ezi seli zijikeleza umzimba wonke ukunceda amajoni omzimba alwe neentsholongwane, usulelo kunye nezinye izinto eziphilayo. Ii-leukemias ezivela kwii-lymphocyte zibizwa ngokuba yi-lymphocytic leukemias; ezo zivela kwii-granulocytes zibizwa ngokuba yi-myeloid, okanye i-myelogenous, leukemias.



Ileukemia iba buhlungu (iza ngesiquphe) okanye inganyangeki (ihlala ixesha elide). Uhlobo lweseli leukemic luchaza ukuba ngaba yi-leukemia okanye i-leukemia engapheliyo. I-leukemia engapheliyo ichaphazela abantwana; leukemia etsolo ichaphazela abantu abadala kunye nabantwana.

I-leukemia i-akhawunti malunga ne-2% yazo zonke i-cancer. Amadoda asengozini yokuphuhliswa sesi sifo kunabasetyhini, kwaye abamhlophe kunokwenzeka ukuba basiphuhlise kunabantu bezinye iintlanga okanye ubuhlanga. Abantu abadala banamathuba amaninzi okuphuhlisa i-leukemia kunabantwana. Ngapha koko, i-leukemia yenzeka rhoqo kubantu abadala. Xa esi sifo sivela ebantwaneni, senzeka ngokubanzi phambi kweminyaka eli-10.



Umhlaza wegazi unezizathu ezininzi ezinokubangela. Oku kubandakanya

iziphumo ebezingalindelekanga zexesha elide ze-lyrica
  • Ukubonakaliswa kwimisebe kunye neekhemikhali ezifana ne-benzene (efumaneka kwi-petroli engenanto) kunye nezinye i-hydrocarbons
  • Ukuboniswa kweearhente ezisetyenziselwa ukunyanga okanye ukulawula eminye imihlaza, kubandakanya imitha
  • Izinto ezithile ezingaqhelekanga kwimfuza, ezinjenge-Down syndrome.

I-leukemia ayikholelwa ukuba izuze ilifa; Uninzi lweziganeko zenzeka kubantu ngaphandle kwembali yosapho. Nangona kunjalo, ezinye iintlobo ze-leukemia, ezinjenge-lymphocytic leukemia engapheliyo, ngamanye amaxesha zibetha izihlobo ezisondeleyo kusapho olunye. Kodwa uninzi lwamaxesha, akukho sizathu sithile sinokuchongwa.

Leukemias ezintle
Nge-leukemia ebukhali, iiseli ezimhlophe ezimhlophe ezingafakwanga zanda ngokukhawuleza kumongo wethambo. Ixesha elingaphezulu, bayaxinanisa iiseli ezisempilweni. (Abaguli banokuqaphela ukuba bopha kakhulu okanye banengxaki yosulelo ngenxa yoko.) Xa ezi seli zifikelela kumanani aphezulu, ngamanye amaxesha zinokusasazeka ziye kwamanye amalungu, zibangele umonakalo. Oku kuyinyani ngokukodwa kwi-acute myeloid leukemia. Iintlobo ezimbini eziphambili ze-leukemia ebukhali zibandakanya iintlobo ezahlukeneyo zeeseli zegazi:



  • Iacute lymphocytic leukemia (YONKE) lolona hlobo luxhaphakileyo lweleukemia ebantwaneni, ikakhulu ichaphazela abo bangaphantsi kweminyaka eli-10. Abantu abadala ngamanye amaxesha bakhula BONKE, kodwa kunqabile kubantu abadala kuneminyaka engama-50. ukukhula zibe ziiseli zegazi eziqhelekileyo. Ezi seli zingaqhelekanga zixinanisa iiseli zegazi ezisempilweni. Banokuqokelela kwii-lymph node kwaye babangele ukudumba.
  • I-akhawunti ye-myeloid leukemia (AML) yesiqingatha seemeko ze-leukemia ezifunyenwe kulutsha nakubantu abakuma-20s. Yeyona leukemia ixhaphakileyo kubantu abadala. I-AML yenzeka xa iiseli zamandulo ezenza igazi ezibizwa ngokuba zii-myeloblast zivelisa ngaphandle kokukhula zibe ziiseli zegazi eziqhelekileyo. I-myeloblast engafakwanga ixinene ngomongo wethambo kwaye iphazamise ukuveliswa kweeseli zegazi eziqhelekileyo. Oku kukhokelela kwi-anemia, imeko apho umntu engenazo iiseli ezibomvu zegazi ezaneleyo. Inokubangela ukopha kunye nokugruzuka (ngenxa yokunqongophala kweeplatelets zegazi, ezinceda igazi ukuba lijiye) kunye nosulelo oluqhelekileyo (ngenxa yokunqongophala kweeseli ezimhlophe zokhuselo).

Zombini ZONKE kunye ne-AML zinee-subtypes ezininzi. Unyango kunye nokuxelwa kwangaphambili kunokwahluka ngandlela thile, kuxhomekeke kudidi olungezantsi.

Leukemias engapheliyo
I-leukemia engapheliyo kuxa umzimba uvelisa iiseli ezininzi zegazi eziphuhliswe kancinci. Ezi seli zihlala zingasebenzi njengeeseli zegazi esele zikhulile. I-leukemia enganyangekiyo ihlala ikhula kancinci kwaye sisigulo esincinci kakhulu kune-leukemia ebukhali. Zimbini iintlobo eziphambili ze-leukemia enganyangekiyo:

  • I-lymphocytic leukemia (CLL) engapheliyo inqabile kubantu abangaphantsi kweminyaka engama-30. Kusenokwenzeka ukuba ikhule njengomntu ubudala. Uninzi lweziganeko zenzeka kubantu abaphakathi kweminyaka engama-60 nama-70. Kwi-CLL, ii-lymphocyte ezingaqhelekanga azinako ukulwa usulelo kunye neeseli eziqhelekileyo ezinako. Ezi iiseli zomhlaza zihlala kumongo wethambo, egazini, kwi-spleen nakwi-lymph node. Banokubangela ukudumba, okubonakala ngathi ngamadlala adumbileyo. Abantu abane-CLL banokuphila ixesha elide, nokuba bengenalo unyango. Rhoqo, i-CLL ifunyanwa xa umntu esenza uvavanyo lwegazi oluqhelekileyo olubonisa amanqanaba aphezulu e-lymphocyte. Ixesha elingaphezulu, olu hlobo lwegazi lunokufuna unyango, ngakumbi ukuba umntu unesifo okanye ukhula ubalo lweeseli ezimhlophe.
  • I-myeloid leukemia engapheliyo (i-CML) yenzeka kakhulu kubantu abaphakathi kweminyaka engama-25 nama-60. Kwi-CML, iiseli ezingaqhelekanga ziluhlobo lweeseli zegazi ezibizwa ngokuba ziiseli ze-myeloid. I-CML ihlala ibandakanya umtya onesiphene se-DNA ebizwa ngokuba yi-chromosome yaseFiladelphia. (Esi sifo asizuzwa njengelifa; utshintsho olwenzeka kwi-DNA lubangelwa emva kokuzalwa.) Isiphene semfuza siphumela kwimveliso yeprotein engaqhelekanga. Iziyobisi ezibizwa ngokuba yi-tyrosine kinase inhibitors zithintela ukusebenza kwale protein engaqhelekanga, ukuphucula ukubala kwegazi lomntu. Ngamanye amaxesha, isiphene semfuza esingaqhelekanga sikhangeleka ngathi siyanyamalala. Ngaphandle koko, ezinye iimeko ze-CML zinokunyangeka ngokufakelwa komongo wethambo.

Zombini i-CLL kunye ne-CML zinee-subtypes. Babelana ngezinye zeempawu kunye nezinye iindlela zegazi. Unyango kunye nokuxelwa kwangaphambili kunokwahluka ngokuxhomekeke kuhlobo olungaphantsi.

Iifom ezininzi ze-leukemia

Ii-leukemias ze-lymphatic kunye ne-myelogenous zezona zixhaphakileyo. Nangona kunjalo, imihlaza yezinye iintlobo zeeseli zomongo wethambo inokukhula. Umzekelo, i-megakaryocytic leukemia ivela kwii-megakaryocyte, iiseli ezenza iiplatelets. (Iiplatelets zinceda igazi ukuba lijiye.) Olunye uhlobo olunqabileyo lweleukemia yi-erythroleukemia. Kuvela kwiiseli ezenza iiseli ezibomvu zegazi. Njenge-leukemias engapheliyo kunye ne-acute, iintlobo ezinqabileyo zesifo zinokuhlelwa ngokwee-subtypes. I-subtype ixhomekeke kuluphi uphawu lweeseli ezithwala umphezulu wazo.

Iimpawu

Iimpawu zokuqala ze-leukemia zibandakanya

  • Ifiva
  • Ukudinwa
  • Ukuqaqanjelwa ngamathambo okanye amalungu
  • Intloko ebuhlungu
  • Irhashalala
  • Izibilini ezivuthayo (i-lymph nodes)
  • Ukuphulukana nobunzima obungachazwanga
  • Ukopha okanye iintsini ezidumbileyo
  • Ipeni eyandisiweyo okanye isibindi, okanye imvakalelo yokugcwala esiswini
  • Ukusikeka okucothayo, ukuphuma kweempumlo, okanye ukubetha rhoqo.

Uninzi lwezi mpawu luhamba nomkhuhlane kunye nezinye iingxaki eziqhelekileyo zonyango. Ukuba unayo nayiphi na le mpawu, jonga ugqirha wakho. Unokuyiqonda ingxaki.

Uxilongo

Ugqirha wakho akanakukrokrela i-leukemia esekwe kwiimpawu zakho kuphela. Nangona kunjalo, ngexesha lovavanyo lwakho lomzimba, unokufumanisa ukuba une-lymph node okanye i-isibindi esandisiweyo. Ukuvavanywa kwegazi rhoqo, ngakumbi ukubalwa kweeseli zegazi, kunokuvelisa iziphumo ezingaqhelekanga.

44-527 ipilisi

Okwangoku, ugqirha unokuyalela ezinye iimvavanyo, kubandakanya

  • I-bone marrow biopsy (isampuli yomongo wethambo isuswe kwaye ihlolwe)
  • Olunye uvavanyo lwegazi, ukukhangela iiseli ezingaqhelekanga
  • Uvavanyo lokuchaphazeleka kwemfuza, njengeChromosome yaseFiladelphia.

Uvavanyo lwe-genetic lunokunceda ekuchongeni ngokuthe ngqo ukuba loluphi uhlobo lwe-leukemia onayo. (Uhlobo ngalunye kwezi zine ziphambili lunee-subtypes.) Olu vavanyo lubalaseleyo lunokunika imikhondo malunga nendlela oza kuphendula ngayo kunyango oluthile.

Ixesha elilindelekileyo

Ngokubanzi, i-leukemia engapheliyo iqhubeka kancinci kancinci kune-leukemia ebukhali. Ngaphandle kweziyobisi ezibizwa ngokuba yi-tyrosine kinase inhibitors okanye ukufakelwa umongo wethambo, abantu abane-CML banokuphila iminyaka eliqela de isifo sisebenze njenge-AML. Nokuba i-tyrosine kinase inhibitors inokulibazisa okanye ithintele ukuguqulwa kwe-leukemia engapheliyo kwi-leukemia ebukhali kuya kuhlala kubonakala.

Uthintelo

Akukho ndlela yokuthintela uninzi lweeukemia. Kwixesha elizayo, ukuvavanywa kofuzo kunokunceda ekuchongeni abantu abanethuba lokuphuhlisa isigulo. Kude kube ngoko, izalamane ezisondeleyo zabantu abane-leukemia kufuneka babe neemviwo eziqhelekileyo.

Unyango

Unyango lwe-leukemia luphakathi kwezona zinamandla kuzo zonke iindlela zonyango lomhlaza. Ileukemia ngumhlaza womongo wethambo. Le yindawo emzimbeni eyenza uninzi lweeseli zomzimba ezilwa neeseli. Unyango lwe-leukemia lusula ezi seli kunye neeseli zomhlaza.

Unyango luhlala luphazamisa kakhulu ukusebenza komzimba kunye nokukwazi komzimba ukulwa nosulelo. Izigulana zifuna isixa esikhulu sokhathalelo lokufumana kwakhona. Kungenxa yoko le nto abantu abanesi sifo kufuneka baphathwe kumaziko onyango ahlala enakekela abaguli be-leukemia kwaye ebonelela ngononophelo olugqwesileyo, ngakumbi ngamaxesha oxinzelelo lomzimba.

Leukemias ezintle
Ngokungafaniyo neminye imihlaza, unyango lwe-acute leukemia aluxhomekekanga ekubeni isifo sesihambele phambili kangakanani kodwa kwimeko yomntu lowo. Ngaba lo mntu sele enesi sifo? Okanye ngaba esi sifo siye sabuya emva kokuxolelwa (ixesha apho isifo silawulwa khona)?

KONKE, unyango ngokubanzi lwenzeka ngezigaba. Nangona kunjalo, ayizizo zonke izigulana ezifumana zonke ezi zigaba:

  • Isigaba 1 (unyango lokungenisa) sisebenzisa ichemotherapy esibhedlele ukuzama ukulawula isifo.
  • Isigaba 2 (ukudityaniswa) siyaqhubeka nokwenziwa kwemichiza, kodwa ngaphandle kwesigulana, ukugcina isifo sixolelwe. Oku kuthetha ukuba lo mntu ubuyela esibhedlele ukuze afumane unyango, kodwa akahlali ubusuku bonke.
  • Isigaba 3 (prophylaxis) sisebenzisa amayeza e-chemotherapy ahlukeneyo ukunqanda i-leukemia ekungeneni kwingqondo nakwinkqubo ye-nervous system. I-Chemotherapy inokudibaniswa nonyango lwemitha.
  • Isigaba 4 (ukugcinwa) kubandakanya iimviwo zomzimba rhoqo kunye novavanyo lwelabhoratri emva kokuba leukemia inyangiwe ukuqinisekisa ukuba ayibuyanga.
  • Ukuphindaphinda ZONKE zisebenzisa iidosi ezahlukeneyo zamayeza ahlukeneyo e-chemotherapy ukulwa nesi sifo ukuba siyabuya. Abantu banokufuna iminyaka eliqela ye-chemotherapy ukugcina i-leukemia ikhululwe. Abanye abantu banokufumana ukufakelwa komongo wethambo.

Nge-AML, unyango ngokubanzi luxhomekeke kubudala besigulana nakwimpilo iyonke. Kuyaxhomekeka kubalo lweeseli zegazi lomguli. Njengazo zonke, unyango luhlala luqala ngokunyanga ngenzame yokuthumela i-leukemia kuxolelo. Xa iiseli ze-leukemia zingasabonakali, unyango lokudibanisa luqala. Ukufakelwa komongo wethambo kungathathelwa ingqalelo kwisicwangciso sonyango.

Leukemias engapheliyo
Ukunyanga i-CLL, ugqirha wakho kufuneka aqale abeke ubungakanani bomhlaza. Oku kubizwa ngokuba yistage. Kukho amanqanaba amahlanu e-CLL:

  • Inqanaba 0. Zininzi ii-lymphocyte egazini. Ngokubanzi, azikho ezinye iimpawu zegazi.
  • Inqanaba I. I-lymph node zidumbile kuba zininzi ii-lymphocyte egazini.
  • Inqanaba II. Ii-lymph nodes, udakada, nesibindi zidumbile kuba zininzi ii-lymphocyte.
  • Inqanaba III. I-anemia ivelile kuba zimbalwa kakhulu iiseli ezibomvu zegazi egazini.
  • Inqanaba IV. Zimbalwa kakhulu iiplatelets egazini. I-lymph nodes, i-spleen, kunye nesibindi kunokuvuvukala. I-anemia inokubakho.

Unyango lwe-CLL luxhomekeke kwinqanaba lesi sifo, kunye nakwiminyaka yomntu kunye nempilo iyonke. Kwinqanaba le-0, unyango alunakufuneka, kodwa impilo yomntu iya kujongwa ngeliso elibukhali. Kwinqanaba I okanye II, ukubonwa (ngokubekwa esweni kufutshane) okanye i-chemotherapy lunyango oluqhelekileyo. KwiSigaba III okanye IV, i-chemotherapy enzulu kunye nesinye okanye ezininzi iziyobisi zonyango oluqhelekileyo. Abanye abantu banokufuna ukufakelwa umongo wethambo.

Kwi-CML, i-tyrosine kinase inhibitors iye yaba lonyango oluqhelekileyo, ngakumbi kubantu abakwisigaba sokuqala sesi sifo. Nokuba ukufakelwa umongo wethambo kwenziwa ngokuxhomekeke kwinqanaba lesifo, impilo yomntu, nokuba ngaba umniki womongo wethambo ofanelekileyo uyafumaneka.

Ukusetyenziswa kweendlela ekujoliswe kuzo kutshintshe kakhulu imeko yabantu abaninzi abane-CML. Izigulana zinokuphila ixesha elide nala mayeza. Bazilungisa ngokuthe ngqo iziphene zemichiza kwiiseli zomhlaza ezibavumele ukuba bakhule ngendlela engalawulekiyo.

Nini ukubiza iNgcali

Biza ugqirha wakho ukuba unayo nayiphi na impawu ye-leukemia. Oku kunokubandakanya

  • Ukutyumka ngokungaqhelekanga okanye ukopha
  • Amadlala ahlala edumbile
  • Ukuphulukana nobunzima obungachazwanga
  • Umkhuhlane oqhubekayo
  • Ukudinwa okungapheliyo.

Ukuba ufumene ukuba une-leukemia, cinga ngokudlulisela inkathalo yakho kwiziko lomhlaza elikhethekileyo.

Ukuxela kwangaphambili

Ukuphila ixesha elide kwe-leukemia kuyahluka kakhulu, kuxhomekeka kwizinto ezininzi, kubandakanya uhlobo lwe-leukemia kunye nobudala besigulana.

  • BONKE: Ngokubanzi, esi sifo siya kuxolelo phantse kubo bonke abantwana abanaso. Bangaphezu kwesine abantwana kwabahlanu abaphila iminyaka emihlanu ubuncinci. Ukuxela kwabantu abadala akulungile. Kuphela ngama-25% ukuya kuma-35% abantu abadala abaphila iminyaka emihlanu okanye nangaphezulu.
  • I-AML: Ngonyango olululo, uninzi lwabantu olunomhlaza lunokulindela ukuya kuxolelo. Phantse iipesenti ezingama-80 eziya kuxolelo ziya kwenza njalo kwinyanga enye yokunyanga. Kwabanye abantu, nangona kunjalo, esi sifo siza kubuya, sinciphise izinga lokunyanga.
  • I-CLL: Ngokomndilili, abantu abanomhlaza baphila iminyaka eli-9, nangona abanye behleli amashumi eminyaka. Ukuxolelwa kwenzeka kubantu abaninzi abanesifo se-I okanye sesi-II abaphathwa nge-chemotherapy, nangona umhlaza uhlala ubuya ngaxa lithile.
  • I-CML: Imbonakalo yabantu abane-leukemia enganyangekiyo iphuculwe ngokuphawulekayo kule minyaka ili-10 idlulileyo. Amanqanaba okusinda ngaphezulu kweminyaka emi-5 kubantu abaphathwe nge-tyrosine kinase inhibitor kuye kwaxelwa ukuba bonyuke njenge-90%.

Izixhobo zangaphandle

Umbutho weleukemia kunye neLymphoma Society
https://www.lls.org/

IZiko leSizwe loMhlaza (NCI)
http://www.nci.nih.gov/

ithatha ixesha elingakanani ukusebenza i-acyclovir

Umbutho woMhlaza waseMelika (ACS)
http://www.cancer.org/

Intliziyo kaZwelonke, iMiphunga, kunye neZiko leGazi (NHLBI)
http://www.nhlbi.nih.gov/

Inkcukacha ezithe vetshe

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