Izinto Ekufuneka Uziqonde Ngomhlaza Wegazi (iLösemi)
Yintoni iLösemi?
ILösemi luhlobo lomhlaza oluqala ngokwanda okungaqhelekanga nokungalawulekiyo kweeseli zegazi kwi-ithambo lomongo, olunokubonakala kuzo zonke iintlanga zeminyaka, kodwa luhlala lufumaneka rhoqo kubantwana nakubantu abadala abangaphezulu kweminyaka engama-50. Kwimeko apho kufunyanwa kwangethuba, impumelelo kunyango iyanda kakhulu. Ngenxa yoko, kubalulekile ukuqaphela iimpawu zelösemi ngexesha elifanelekileyo kwaye kuqale unyango ngokukhawuleza.
ILösemi yenziwa kukwanda okukhawulezayo nokungalawulekiyo kweeseli ezingekavuthwa kakuhle kwi-ithambo lomongo. Le meko iqala ichaphazela ithambo lomongo kwaye inokusasazeka emzimbeni wonke ngokuhamba kwexesha. Kwi-ithambo lomongo kuveliswa iiseli zegazi ezibomvu (iialyuvar), ezimhlophe (iakyuvar), kunye neeseli zokuthintela igazi (iitrombosit). Iiseli zegazi ezimhlophe zidlala indima ebalulekileyo ekukhuseleni umzimba kwizifo kunye neeseli ezibonisa umkhwa wokuba ngumhlaza.
Iiseli ezimhlophe aziveliswa kuphela kwi-ithambo lomongo, kodwa nakwiindawo ezifana neenodi zelengfa, isileya kunye ne-thymus. Ukuba ilösemi ayinyangwanga, inokuba nzima. Iintlobo zelösemi ezisekelwe ekwandeni okugqithisileyo kweeseli ezimhlophe ezivuthwe kakuhle zihlala zihamba kancinci; kodwa xa kukho ukwanda okugqithisileyo kweeseli ezingekavuthwa kakuhle, imeko ihamba ngokukhawuleza kwaye iimpawu zinokubonakala kwiiveki ezimbalwa okanye iinyanga.
Zeziphi Iintlobo zeLösemi?
ILösemi ihlulwa ngamaqela amabini aphambili ngokuxhomekeke kwisantya sokuhamba kwayo: akut (ehamba ngokukhawuleza) kunye nekhroniki (ehamba kancinci). Iintlobo zelösemi ezikhawulezayo zibonakala ngokwanda okukhawulezayo kweeseli kunye neempawu ezize ngomsinyane, ngelixa iintlobo zekhroniki zihlala ziqhubeka kancinci iminyaka emininzi.
La maqela mabini aphambili ahlulwa ngokuxhomekeke kudidi lweeseli zegazi ezimhlophe ezikhula ngokungaqhelekanga:
Ezo zivela kwiiseli ze-myeloid zibizwa ngokuba "yi-myeloid lösemi",
Ezo zisuka kwiiseli ze-lymphocyte zibizwa ngokuba "yi-lymphoblastic (okanye lymphocytic) lösemi".
Kukho nezinye iintlobo zelösemi ezingaqhelekanga (umzekelo: i-juvenile myelomonocytic lösemi, i-hairy cell lösemi).
Ezona ntlobo zine zelösemi zixhaphakileyo zezi:
1. Akut Lenfoblastik Lösemi (ALL)
Luhlobo oluqhelekileyo kakhulu kubantwana, kodwa lunokubonakala nakubantu abadala. Kule meko, iiseli ezimhlophe ezingekavuthwa kakuhle ezisuka kwiiseli ze-lymphocyte zanda ngokungalawulekiyo. Amanqanaba okusinda kwe-ALL kubantu abadala nakubantwana axhomekeke kwiminyaka, impilo iyonke kunye nempendulo kunyango.
2. Akut Myeloid Lösemi (AML)
Ivela ngenxa yokwanda okungaqhelekanga kweeseli ze-myeloid ezingekavuthwa kakuhle. Ibonakala rhoqo kubantu abadala abancinci nakwabo badala kakhulu. Impumelelo kunyango lwe-AML iya isanda ngenxa yeendlela zonyango eziphucukileyo.
3. Kronik Lenfositik Lösemi (KLL)
Ihlala ifunyanwa kubantu abadala, ngakumbi ngaphezulu kweminyaka engama-60. Kule ntlobo, iiseli ze-lymphocyte ezivuthwe kakuhle kodwa ezingasebenziyo ziqokelela emzimbeni, zaphazamise ukusebenza kakuhle kwe-ithambo lomongo kunye nezinye izicubu.
4. Kronik Myeloid Lösemi (KML)
KML ixhaphakile kubantu abaneminyaka engama-25 ukuya kuma-60, kwaye iiseli ze-myeloid zanda ngokungaqhelekanga. Amayeza amatsha ajolise kwiithagethi ze-molecular aphucule amanqanaba okusinda.
Zeziphi Iimpawu zeLösemi?
Iimpawu zelösemi zinokufana nezinye izifo ze-ithambo lomongo kwaye zihlala ziquka ezi zilandelayo:
Ukudinwa, ukungabi nombala, ukukhathala ngokukhawuleza, ukuphefumla nzima (ngenxa yokungabikho kwegazi)
Izifo ezihlala zibuya (ngenxa yokuba buthathaka inkqubo yokuzikhusela)
Ukopha okungalindelekanga kumphunga, emlonyeni okanye phantsi kolusu, amabala amnyama kunye neempawu ezincinci (petechiae)
Ukungafuni kudla, ukwehla kobunzima, ukubila ebusuku
Izifo ezinzima ezihlala ixesha elide kunye nobushushu obuphezulu
Iintlungu zemisipha kunye namalungu
Ukukhula kwee-node zelengfa kwiindawo ezifana entanyeni, phantsi kweengalo okanye esinqeni
Ukudumba kolusu okanye esiswini
Lösemi Kubantwana: Iimpawu Neempawu
ILösemi yinxalenye ebalulekileyo yomhlaza obonakala kubantwana, ngakumbi phakathi kweminyaka emi-2 ukuya kweli-10. Kubantwana abancinci, izinto ezikhuselayo ezivela ebisini likanina ziye zehle ngokuhamba kwexesha kwaye inkqubo yokuzikhusela iqhubeka nokuphuhliswa. Kule nkqubo, ezinye izifo ze-virus, ukuxhathisa kwezizukulwana kunye nokunqongophala kweVitamin D kunokunyusa umngcipheko wokuphuhlisa ilösemi.
Iimpawu ezixhaphakileyo kubantwana:
Ukungabi nombala okubonakalayo kolusu
Ukwehla kobunzima, ukungafuni kudla
Izifo ezishushu ezihlala ixesha elide okanye ezibuya rhoqo
Amabala amnyama kunye nokudumba emzimbeni
Ukukhula kunye nokuziva ugcwele esiswini
Iintlungu zemisipha okanye zamalungu
Kwiimeko ezinzima, ukusasazeka kweeseli zomhlaza kwinkqubo yemithambo-luvo okanye kwezinye izitho kunokubangela iimpawu ezongezelelweyo ezifana nentloko ebuhlungu, isicaphucaphu, okanye iziqabu.
Zeziphi Izinto Ezonyusa Umngcipheko weLösemi?
ILösemi ithathwa njengomhlaza obalulekileyo kwihlabathi liphela, kwaye ibonakala rhoqo kubantu besilisa kunakwabesifazane. Izinto ezonyusa umngcipheko zitshintsha ngokuxhomekeke kudidi lwe-lösemi:
Akut Lenfoblastik Lösemi (ALL)
Nangona zonke izizathu zingacaci kakuhle, ukuvezwa kwi-radiation ephezulu, ezinye izinto zekhemikhali (umzekelo: i-benzene), imbali yokufumana i-chemotherapy, ezinye izifo ze-virus (HTLV-1, Epstein–Barr virus), ezinye izifo ezifunyanwa ngokuzalwa (Down syndrome, Fanconi anemia), zinokunyusa umngcipheko we-ALL.
Akut Myeloid Lösemi (AML)
Iinguqu ezifunyenwe kwi-genetic, umngcipheko okhula ngokukhula kweminyaka, ukusetyenziswa kukagqirha, ezinye izifo zegazi okanye imbali ye-chemotherapy, kunye ne-Down syndrome, zonke zaziwa njengezinto ezonyusa umngcipheko we-AML.
Kronik Lenfositik Lösemi (KLL)
Izizathu ze-KLL azicaci kakuhle. Nangona kunjalo, ubudala obuphambili, isini sesilisa, ukuvezwa kwezinye izinto zekhemikhali kunye nembali yosapho ye-KLL zonyusa umngcipheko.
Kronik Myeloid Lösemi (KML)
I-KML idla ngokunxulunyaniswa notshintsho lwe-genetic olufunyanwa ebomini (hayi olufunyanwa kusapho). Utshintsho lwe-genetic olubizwa ngokuba "yi-Philadelphia chromosome" lufunyanwa kwimeko ezininzi ze-KML kwaye lukhokelela ekwandeni okungalawulekiyo kweeseli kwi-ithambo lomongo.
Lösemi Iqinisekiswa Njani?
Injongo yokuqinisekisa ilösemi kukuchonga ubukho besifo, uhlobo lwaso kunye nokusasazeka kwaso ngokuchanekileyo. Kwinkqubo yokuqinisekisa, la manyathelo aphambili alandelayo ayalandelwa:
Imbali eneenkcukacha kunye novavanyo lomzimba: Kuqwalaselwa ukungabi nombala okubangelwa yi-anemia, ukukhula kwee-node zelengfa okanye izitho, kunye notshintsho kulusu.
Uvavanyo lwegazi: Uvavanyo olupheleleyo lwegazi, i-biochemistry, imisebenzi yesibindi kunye novavanyo lokuthintela igazi lwenziwa.
Ukuhlolwa kwegazi elijikelezayo: Kusetyenziswa ukuhlola ubukho beeseli ezingaqhelekanga egazini.
I-biopsy/aspiration ye-ithambo lomongo: Ukuqinisekisa isifo, ngakumbi kwiimeko ezikhawulezayo, isampulu ethathwe kwi-ithambo lomongo ihlolwa phantsi kwe-microscope.
Uvavanyo lwe-genetic kunye ne-molecular: Ngokukodwa kwi-KML, kuphandwa utshintsho lwe-Philadelphia chromosome kunye ne-BCR-ABL gene.
I-biopsy ye-ithambo lomongo ihlala isetyenziswa kwi-pelvis kwaye ihlolwa kwiilabhoratri ezizodwa.
Yintoni Enikelwayo Kunyango lweLösemi?
Isicwangciso sonyango kufuneka senziwe ngokuthathela ingqalelo uhlobo lwe-lösemi kunye nempilo iyonke yomntu, phantsi kweqela leengcali kwi-hematology kunye ne-oncology. Namhlanje, ezi ndlela zilandelayo zonyango zisetyenziswa kunyango lwe-lösemi:
Chemotherapy
Kujoliswe ekutshabalaliseni iiseli ezingaqhelekanga kusetyenziswa amayeza ahlukeneyo e-chemotherapy. Ukusetyenziswa kwamayeza kunye nendlela yokuwasebenzisa kuxhomekeke kuhlobo lwe-lösemi kunye nemeko yomntu.
Radiotherapy
Kusetyenziswa imitha enamandla aphezulu ukutshabalalisa iiseli ze-lösemi. I-radiotherapy isetyenziswa kwiimeko ezikhethiweyo, ngamanye amaxesha njengolungiselelo lokufakelwa kweeseli zomongo.
Unyango Olusekwe kwi-Biology kunye ne-Molecular
Amayeza amatsha ajolise ekomelezeni inkqubo yokuzikhusela okanye ekujoliseni iiseli zomhlaza (immunotherapy, biological agents, molecular targeted therapies) adlala indima ebalulekileyo kwezinye iintlobo zelösemi. Umzekelo, i-tyrosine kinase inhibitors ephuhliswe kwi-KML iye yaphucula kakhulu unyango lwesi sifo kwaye ineziphumo ebezingaphantsi kune-chemotherapy.
Ukufakelwa kweSeli yoMongo (Stem Cell Transplantation)
Le nkqubo apho umnqonqo-mithambo wegazi ususwa ngokupheleleyo kwaye utshintshwa ngeeseli zengcambu ezisempilweni, yenye yezona ndlela zonyango zisebenzayo kwaye isetyenziswa kwizigulana ezifanelekileyo. Ngexesha lenkqubo nasemva kwayo, kunokubonakala ezinye iziphumo ebezingalindelekanga. Ingakumbi iingxaki ezinxulumene nenkqubo yokuzikhusela emzimbeni (umz. GVHD), umonakalo kwizitho zomzimba kunye nomngcipheko wosulelo kufuneka kuthathelwe ingqalelo. Ngenxa yoko, inkqubo yokufakelwa kufuneka yenziwe kwiziko elinamava.
Unyango Oluxhasayo
Ukuze kuncitshiswe umngcipheko wokuphelelwa ligazi, usulelo kunye nokopha okubangelwa yi-chemotherapy kunye nezinye iindlela zonyango, kuyimfuneko ukufaka igazi, amayeza okuthintela usulelo, ukuba kuyimfuneko i-antibiotics kunye nezinye iindlela zonyango ezixhasayo.
Ngenxa yeendlela zonyango zale mihla, amazinga okusinda kwizigulana ze-leukemia anyuke kakhulu kwiminyaka yakutshanje. Umzekelo, ngeminyaka yoo-1970, inqanaba lokusinda iminyaka emi-5 lalingama-30%, kodwa ngokweenkcukacha zanamhlanje, ngonyango olufanelekileyo kunye nokufunyanwa kwangethuba, eli nqanaba lixelwa ukuba lingaphezulu kwama-60%.
Khumbula; ukuze kufunyanwe kwangethuba kwaye kufezekiswe unyango olusebenzayo, xa uqaphela iimpawu, kufuneka uye kwindawo yezempilo ngaphandle kokulibazisa, oko kunika inzuzo enkulu kumgangatho wobomi kunye nendlela esihamba ngayo isifo.
Imibuzo Ebuzwa Rhoqo
1. Ingaba i-leukemia iyosulela?
Hayi, i-leukemia asiyosuleli. Ivela ngenxa yeenguqu ezizalelweyo, izinto ezikhoyo kwindalo kunye nemingcipheko yomntu ngamnye, ayidluliselwa komnye umntu.
2. Yintoni kanye kanye ebangela i-leukemia?
Unobangela ochanekileyo we-leukemia awaziwa rhoqo. Kodwa izinto ezizalelweyo, ezinye izinto zekhemikhali, imitha kunye nezinye izinto ezikhoyo kwindalo kunye neentsholongwane ezithile zinokunyusa umngcipheko.
3. Ingaba i-leukemia iyanyangeka?
Iindidi ezininzi ze-leukemia, ngakumbi xa kufunyanwa kwangethuba kwaye kufezekiswa unyango olufanelekileyo, zinokulawulwa okanye zisuswe ngokupheleleyo. Ithuba lonyango lixhomekeke kwiminyaka yesigulana, imeko yaso iyonke kunye nodidi lwe-leukemia.
4. Abantu abane-leukemia bahlala ixesha elingakanani?
Ixesha lokusinda kwi-leukemia lixhomekeke kudidi lwesifo, ixesha lokufunyanwa, impendulo kunyango kunye neempawu zempilo zomntu. Namhlanje, ngenxa yonyango oluphumelelayo, ukusinda ixesha elide kunokwenzeka.
5. Kutheni i-leukemia ixhaphake ngakumbi kubantwana?
Kubantwana, ezinye iimpawu ezizalelweyo kunye nezozikhuselo, xa zidibene nezinto ezikhoyo kwindalo, zinokubangela ukuthambekela kwi-leukemia. Kodwa uninzi lwabantwana, unobangela ochanekileyo awufumaneki.
6. Ingaba ukufakelwa komnqonqo-mithambo wegazi kufanelekile kubo bonke?
Hayi, ukufakelwa komnqonqo-mithambo wegazi akucetyiswa kuzo zonke izigulana. Ukufaneleka kugwetywa ngugqirha ngokweminyaka yesigulana, imeko yempilo iyonke, udidi lwesifo kunye nezinye izinto zonyango.
7. Iimpawu ze-leukemia zingadityaniswa nezinye izifo?
I-leukemia; inokuba neempawu ezifanayo nezinye iintsholongwane, iintlobo zokuphelelwa ligazi kunye nezinye izifo zegazi. Uvavanyo olupheleleyo lwegazi kunye nophando oluphambili luyanceda ekwahluleni.
8. Ingaba kunokwenzeka ukuthintela i-leukemia?
Nangona ingenakuthintelwa ngokupheleleyo, ukuphepha ukutshaya kunye nezinto zekhemikhali eziyingozi, ukufumana imikhwa yokuphila enempilo, kunye nokuhlolwa rhoqo kwezempilo kunceda ekufumaneni isifo kwangethuba.
9. Ingaba izigulana ze-leukemia zixhaphake ngakumbi kusulelo?
Ewe, umnqonqo-mithambo wegazi kunye nenkqubo yokuzikhusela emzimbeni ziyachaphazeleka. Ngenxa yoko, kubalulekile ukugcina ucoceko, ukuphepha iindawo ezixineneyo nezosulelekileyo, kwaye ukuba kuyimfuneko, ukuthatha amanyathelo okuzikhusela.
10. Ingaba iinwele ziyawa kwi-leukemia?
Amanye amayeza asetyenziswa ngexesha lonyango (ingakumbi i-chemotherapy) angabangela ukuwa kweenwele. Lo mphumo uhlala uyexeshana kwaye emva konyango iinwele zinokuphinda zikhule.
11. Ingaba i-leukemia iyadluliselwa ngokozalo?
Ukudluliselwa ngokozalo akufane kwenzeke kwiimeko ezininzi ze-leukemia. Kodwa ezinye iisindrom ezizalelweyo zinokunyusa umngcipheko wokuphuhlisa i-leukemia.
12. Yintoni ekufuneka ithathelwe ingqalelo ngexesha lonyango lwe-leukemia?
Kubalulekile ukuzikhusela kusulelo, ukulandela ngononophelo iingcebiso zonyango, ukungaphoswa kukuhlolwa rhoqo kunye nokwazisa iqela lezempilo malunga neziphumo ebezingalindelekanga.
Imithombo
Umbutho WezeMpilo Wehlabathi (WHO): Leukemia
Iziko laseMelika loLawulo noThintelo lweZifo (CDC): Iinyani ngezigulana ze-Leukemia
American Cancer Society: Uhlalutyo lwe-Leukemia
European Hematology Association: Imigaqo-nkqubo ye-Leukemia
Cancer Research UK: Iindidi kunye nonyango lwe-Leukemia