Zvaunofanira Kuziva NezveGomarara reRopa (Leukemia)

Chii chinonzi Leukemia?

Leukemia imhando yekenza inobuda nekukura kusingadzorwi uye kusina kujairika kwemaseru eropa mudumbu remapfupa, inogona kuonekwa kune vanhu vemazera ese asi inonyanya kuwanikwa kuvana nevakuru vane makore anopfuura makumi mashanu. Kubudirira kwekurapa kunowedzera zvakanyanya kana chirwere ichi chikanzi chawanikwa nekukurumidza. Nekudaro, zvakakosha kuti zviratidzo zveleukemia zionekwe nenguva uye kurapwa kutange nokukurumidza sezvinobvira.

Leukemia inoitika kana maseru ekutanga mudumbu remapfupa akatadza kukura zvizere uye otanga kuwanda nekukurumidza uye kusingadzorwi. Izvi zvinotanga zvichikanganisa dumbu remapfupa uye zvinogona kupararira mumuviri wose. Mudumbu remapfupa munogadzirwa maseru matsvuku eropa (erythrocytes), maseru machena eropa (leukocytes) uye maseru anobatsira pakusunga ropa (platelets). Maseru machena eropa ane basa guru mukudzivirira muviri kubva kuzvirwere uye maseru ane mukana wekuva kenza.

Maseru machena eropa anogonawo kugadzirwa mune mamwe matishu akaita sema lymph nodes, spleen uye thymus. Kana leukemia isina kurapwa, inogona kufambira mberi zvakaoma. Leukemia inobva pakuwanda kwemaseru machena akura inowanzo famba zvishoma nezvishoma; asi kana maseru asina kukura ari kuwanda, chirwere chinofambira mberi nekukurumidza uye chinoratidza zviratidzo zvakanyanya mumavhiki kana mwedzi mishoma.

Ndedzipi Mhando dzeLeukemia?

Leukemia inowanzopatsanurwa kuita zvikamu zviviri zvikuru zvinoenderana nekukurumidza kwekufambira mberi kwechirwere: acute (inofambira mberi nekukurumidza) uye chronic (inofambira mberi zvishoma nezvishoma). Acute leukemia inoratidzwa nekuwanda kwemaseru uye zviratidzo zvinotanga nekukurumidza, nepo chronic ichifambira mberi zvishoma nezvishoma kwemakore akawanda.

Zvikamu zviviri izvi zvikuru zvinopatsanurwazve zvinoenderana nerudzi rwemaseru machena eropa ari kuwanda zvisina kujairika:

• Leukemia inobva kumasero eMyeloid inonzi “myeloid leukemia”,

• Leukemia inobva kuma lymphocytes inonzi “lymphoblastic (kana kuti lymphocytic) leukemia”.

Kune dzimwe mhando dzeleukemia dzisingawanikwi kazhinji (semuenzaniso: juvenile myelomonocytic leukemia, hairy cell leukemia).

Mhando ina huru dzeleukemia dzinowanzoonekwa ndedzidzi:

1. Acute Lymphoblastic Leukemia (ALL)

Iyi ndiyo mhando ye leukemia inonyanya kuwanikwa kuvana, asi inogona kuwanikwawo kuvanhu vakuru. Maseru machena eropa asina kukura anobva kuma lymphocytes anowanda zvisina kujairika. Huwandu hwevanopona neALL hunosiyana zvichienderana nezera, hutano hwese uye kupindura kurapwa.

2. Acute Myeloid Leukemia (AML)

Inobuda nekukura kusingadzorwi kwemaseru eMyeloid asina kukura. Inowanzoonekwa kuvanhu vakuru vechidiki nevakuru. Kubudirira kwekurapa AML kuri kuramba kuchiwedzera nekufambira mberi kwekurapa.

3. Chronic Lymphocytic Leukemia (CLL)

Inonyanya kuwanikwa kune vanhu vakuru, kunyanya vanopfuura makore makumi matanhatu. Maseru e lymphocyte akura asi asina basa anoungana mumuviri, zvichikanganisa kushanda kwedumbu remapfupa nemamwe matishu.

4. Chronic Myeloid Leukemia (CML)

CML inowanzoonekwa pakati pemakore makumi maviri nemashanu kusvika makumi matanhatu. Masero eMyeloid anowanda zvisina kujairika. Mishonga mitsva inotarisira mamorekuru yakawedzera kubudirira kwekurapa uye hupenyu hwevarwere.

Zviratidzo zveLeukemia ndezvipi?

Zviratidzo zveleukemia zvinogona kufanana nezvimwe zvirwere zvedumbu remapfupa uye zvinowanzosanganisira zvinotevera:

• Kusava nesimba, kusviba kweganda, kuneta nekukurumidza, kushaya mweya (nekuda kwekushomeka kweropa)

• Kuwanda kwezvirwere (nekuda kwekusashanda zvakanaka kwehurongwa hwekudzivirira zvirwere)

• Kuputika kweropa pasina chikonzero pachiso, pasi peganda kana mukanwa, mavanga uye mapundu madiki (petechiae)

• Kushaya chido chekudya, kuderera kwehuremu, kudikitira usiku

• Kupisa kwemuviri kwechinguva chakareba

• Kurwadziwa kwemapfupa nemajoini

• Kukura kwemasumbu ema lymph nodes mumutsipa, pasi pemapendekete kana muchiuno

• Kuzvimba kweganda kana dumbu

Leukemia Kuvana: Zviratidzo uye Zvinoratidza

Leukemia inoumba chikamu chakakosha chezvirwere zvekenza zvinowanika kuvana, uye inonyanya kuwanikwa pakati pemakore maviri kusvika gumi. Kuvacheche, zvinhu zvinodzivirira zvinobva mukaka waamai zvinoderera nekufamba kwenguva uye hurongwa hwekudzivirira hunotanga kushanda hoga. Panguva iyi, mamwe mavhairasi, kugara nemhuri ine nhoroondo yechirwere ichi uye kushomeka kweVitamin D zvinogona kuwedzera njodzi ye leukemia.

Zviratidzo zvinowanzoonekwa kuvana:

• Kusviba kweganda kunooneka

• Kudzikira kwehuremu, kushaya chido chekudya

• Kupisa kwemuviri kunotora nguva refu kana kudzokorora

• Mavanga nemazvimba mumuviri

• Kukura uye kuzara mudumbu

• Kurwadziwa kwemapfupa kana majoini

Pafambira mberi kwechirwere, kupararira kwemasero ekenza kuCentral Nervous System kana kune mamwe matishu kunogona kukonzera zviratidzo zvakaita sekurwadziwa kwemusoro, kurutsa, kana kupfumbata.

Ndezvipi Zvinowedzera Njodzi yeLeukemia?

Leukemia inorongwa pakati pezvirwere zvekenza zvakakosha pasi rose uye inowanzoonekwa zvakanyanya kuvarume pane vakadzi. Zvinowedzera njodzi zvakasiyana zvichienderana nemhando dzeleukemia:

Acute Lymphoblastic Leukemia (ALL)

Kunyange zvikonzero zvese zvisingazivikanwi, kuiswa kune radiation yakakwira, mamwe makemikari (semuenzaniso: benzene), nhoroondo yekurapwa nechemotherapy, mamwe mavhairasi (HTLV-1, Epstein–Barr virus), mamwe matenda anobva mugene (Down syndrome, Fanconi anemia) zvinogona kuwedzera njodzi yeALL.

Acute Myeloid Leukemia (AML)

Kuchinja kwemagene, kuwedzera kwemakore, kushandisa fodya, mamwe matenda eropa kana nhoroondo yekurapwa nechemotherapy, Down syndrome, ndizvo zvinozivikanwa se njodzi yeAML.

Chronic Lymphocytic Leukemia (CLL)

Chikonzero cheCLL hachina kunyatsojeka. Asi kuwedzera kwemakore, kuva murume, kuiswa kune mamwe makemikari uye nhoroondo yemhuri ine CLL zvinowedzera njodzi.

Chronic Myeloid Leukemia (CML)

CML inowanzobatanidzwa nechinja chemagene chinowanikwa muupenyu (chisiri chekuberekwa nacho). Chinja chinonzi “Philadelphia chromosome” chinowanikwa mune akawanda eCML uye chinokonzera kukura kusingadzorwi kwemasero mudumbu remapfupa.

Leukemia Inoonekwa Sei?

Chinangwa chekuona leukemia ndechekuziva chirwere, mhando yacho uye kuti chafambira mberi zvakadii. Matanho anotevera anowanzoteverwa pakuongorora:

• Nhoroondo yakadzama uye kuongororwa kwemuviri: Kusviba kweganda kunoratidza anemia, kukura kwemasumbu ema lymph nodes kana matishu, uye kuchinja kweganda kunoongororwa.

• Miedzo yeropa: Kuverengwa kwakazara kweropa, biochemistry, kushanda kwematehwe emuviri uye miedzo yekusunga ropa inoitwa.

• Peripheral blood smear: Kushandiswa kuona maseru asina kujairika muropa.

• Bone marrow biopsy/aspiration: Kuti chirwere chionekwe zvakasimba, kunyanya mune acute cases, sampuli inotorwa mudumbu remapfupa uye inoongororwa pasi pemikrosikopu.

• Genetic uye molecular tests: Kunyanya muCML, kutsvaga Philadelphia chromosome uye BCR-ABL gene mutation.

Bone marrow biopsy inowanzoitwa pabendekete uye inoongororwa mumarabhoritari akakosha.

Chii Chinoitwa Mukurapa Leukemia?

Chirongwa chekurapa chinofanira kugadzirwa zvichienderana nemhando ye leukemia uye hutano hwese hwemurwere, uye chigadzirwe nechikwata chine hunyanzvi hwezvirwere zveropa nekenza. Nzira huru dzekurapa leukemia dzinoshandiswa mazuva ano ndedzidzi:

Chemotherapy

Chinangwa ndechekubvisa maseru asina kujairika nerubatsiro rwemishonga yakasiyana yechemotherapy. Mishonga inofanira kusarudzwa zvinoenderana nemhando ye leukemia uye mamiriro emurwere.

Radiotherapy

Kushandiswa kwemwaranzi ine simba repamusoro kubvisa maseru ekenza. Radiotherapy inowanzoitwa kune mamwe marwere, dzimwe nguva sechikamu chekugadzirira bone marrow transplant.

Kurapa kweBiological uye Molecular

Mishonga yemhando itsva inowedzera simba rehurongwa hwekudzivirira kana kutarisira maseru ekenza (immunotherapy, biological agents, molecular targeted therapies) ine basa guru mune dzimwe mhando dzeleukemia. Semuenzaniso, tyrosine kinase inhibitors yakagadzirwa yeCML yakachinja kurapwa kwechirwere ichi uye ine mhedzisiro shoma pane chemotherapy.

Kuchinjwa kweStem Cell (Bone Marrow Transplant)

Iyi nzira iyo mapfupa emuviri anobviswa zvachose uye kutsiviwa nemasero matsva ane utano, ndeimwe yenzira dzinoshanda zvikuru dzekurapa uye inoitwa kune varwere vakakodzera. Munguva yekuitwa kwechirongwa ichi uye mushure mawo, zvimwe zvinokonzeresa zvinogona kuoneka. Kunyanya, matambudziko ane chekuita nehurongwa hwekudzivirira zvirwere (semuenzaniso GVHD), kukuvara kwemapfupa uye njodzi yekutapukirwa zvinofanira kufungwa nezvazvo. Nechikonzero ichi, chirongwa chekutamisirwa chinofanira kuitwa muzvivako zvine ruzivo.

Maitiro Ekutsigira Kurapa

Kuti kuderedze njodzi yekuderera kweropa, kutapukirwa uye kubuda ropa kunokonzerwa nechemotherapy uye mamwe marapirwo, zvinodikanwa kupa ropa, mishonga inodzivirira utachiona, kana zvichidiwa mabiotiki uye mamwe marapirwo ekutsigira.

Nekuda kwemaitiro matsva ekurapa, huwandu hwevarwere veleukemia vanorarama hwakawedzera zvakanyanya mumakore achangopfuura. Semuenzaniso, kuma1970, huwandu hwevarwere vaipona kwemakore mashanu hwaingova pa30%, asi zvinoenderana nedata razvino, nekukurumidza kuona chirwere uye kurapwa kwakakodzera, huwandu uhu hunonzi hwakakwira kupfuura 60%.

Rangarirai; kuti muwane kurapwa kunobudirira uye kuona chirwere nekukurumidza, kana muchiona zviratidzo, kukurumidza kuenda kunzvimbo yezvehutano kunopa mukana mukuru kuhutano hwenyu uye mafambiro echirwere.

Mibvunzo Inonyanya Kubvunzwa

1. Leukemia inotapurirana here?

Aiwa, leukemia hachisi chirwere chinotapurirana. Inokonzerwa nekuchinja kwemajini, zvinhu zvakatipoteredza uye njodzi dzemunhu oga uye haina kutapurirana kubva kumunhu kuenda kune mumwe.

2. Chii chinonyatso kukonzera leukemia?

Chikonzero cheleukemia kazhinji hachizivikanwi. Asi zvinhu zvemajini, mamwe makemikari, kupiswa nemwaranzi uye mamwe mavhairasi zvinogona kuwedzera njodzi.

3. Leukemia inorapika here?

Marudzi mazhinji eleukemia, kunyanya kana yawanikwa nekukurumidza uye ikarapwa nemazvo, anogona kudzorwa kana kubviswa zvachose. Mikana yekurapwa inotsamira pazera remurwere, mamiriro ake uye rudzi rweleukemia.

4. Vanorwara neLeukemia vanorarama kwenguva yakareba sei?

Kureba kwehupenyu muLeukemia kunonyatsoenderana nerudzi rwechirwere, nguva yakawanikwa chirwere, mhinduro pakurapwa uye mamiriro ehutano hwemunhu. Nhasi uno, nekubudirira kwekurapwa, hupenyu hurefu hunogoneka.

5. Nei leukemia ichiwanda kuvana?

Kuvana, zvimwe zvinhu zvemajini uye zvine chekuita nehurongwa hwekudzivirira zvirwere, kana zvabatanidzwa nezvinhu zvakatipoteredza, zvinogona kukonzera mukana wekuwana leukemia. Asi, kune vazhinji vevana, chikonzero chacho hachigone kuwanikwa.

6. Kutamisirwa kwemapfupa kwakakodzera munhu wese here?

Aiwa, kutamisirwa kwemapfupa hakukurudzirwi kune murwere wese. Kukodzera kunoongororwa navanachiremba zvichienderana nezera remurwere, mamiriro ake ehutano, rudzi rwechirwere uye zvimwe zvinhu zvehutano.

7. Zviratidzo zveLeukemia zvinogona kuvhiringana nezvirwere zvipi?

Leukemia inogona kuvhiringana nezviratidzo zvemamwe utachiona, marudzi ekuderera kweropa uye mamwe marwere eropa. Ongororo yakazara yeropa uye mimwe miedzo yakadzama inobatsira pakuziva musiyano.

8. Zvinogoneka here kudzivirira leukemia?

Kunyange zvazvo zvisingagone kudzivirirwa zvachose, kudzivirira fodya uye makemikari ane ngozi, kuita hupenyu hwakanaka uye kuita ongororo dzechirwere nguva nenguva zvinobatsira kuona chirwere nekukurumidza.

9. Varwere veleukemia vanonyanya kutapukirwa here?

Hongu, mapfupa emuviri uye hurongwa hwekudzivirira zvirwere zvinokanganiswa. Saka, kuchenesa kwakakosha, kudzivirira nzvimbo dzine vanhu vakawanda kana dzine utachiona uye kutora matanho ekudzivirira kana zvichidiwa kwakakosha.

10. Leukemia inokonzeresa kudonha kwebvudzi here?

Mamwe mishonga inoshandiswa mukurapwa (kunyanya chemotherapy) inogona kukonzera kudonha kwebvudzi. Izvi zvinowanzoita kwenguva pfupi uye bvudzi rinogona kudzoka mushure mekupedza kurapwa.

11. Leukemia inopfuudzwa nemhuri here?

Kupfuudzwa kwemhuri hakuwanzoitika mumarudzi mazhinji eleukemia. Asi mamwe matambudziko emuchadenga anogona kuwedzera njodzi yekuwana leukemia.

12. Ndezvipi zvinofanira kucherechedzwa mukurapwa kweleukemia?

Kudzivirira utachiona, kutevera zvakarairwa nachiremba, kuita ongororo nguva nenguva uye kuzivisa chikwata chezvehutano nezve zvinokonzeresa zvakakosha.

Zvinyorwa

• Sangano reHutano rePasi Pose (WHO): Leukemia

• Centers for Disease Control and Prevention (CDC) yeAmerica: Leukemia Patient Facts

• American Cancer Society: Leukemia Overview

• European Hematology Association: Leukemia Guidelines

• Cancer Research UK: Leukemia Types and Treatments