Okufanele Ukwazi Ngomdlavuza Wegazi (i-Leukemia)
Yini iLeukemia?
ILeukemia iwuhlobo lomdlavuza oluqala ngokwanda okungajwayelekile nokungaphatheki kahle kwezicubu zegazi emgogodleni wamathambo, olungatholakala kunoma yiliphi iqembu leminyaka kodwa luvame kakhulu ezinganeni nakubantu abadala abaneminyaka engaphezu kwengu-50. Uma kutholakala kusenesikhathi, amathuba okuphumelela ekwelashweni ayanda kakhulu. Ngenxa yalokho, ukubona izimpawu zeleukemia ngesikhathi nokushesha ukuqala ukwelashwa kubalulekile empilweni yomuntu.
ILeukemia yenzeka uma izicubu eziyisisekelo emgogodleni wamathambo zikhula ngokushesha nangokungaphatheki kahle zingakabi sezingeni lokuvuthwa. Lokhu kuqala kuthinte izicubu zomgogodla wamathambo bese kuthi ngokuhamba kwesikhathi kusabalale emzimbeni wonke. Emgogodleni wamathambo kukhiqizwa izicubu zegazi ezibomvu (ama-erythrocytes), ezimhlophe (ama-leukocytes) kanye nezisiza ukopha (ama-thrombocytes). Ikakhulukazi izicubu zegazi ezimhlophe zidlala indima ebalulekile ekuvikeleni umzimba ezitheni ezifana nezifo ezithathelwanayo kanye nezicubu ezibonisa ukuthambekela komdlavuza.
Izicubu ezimhlophe zegazi azikhiqizwa kuphela emgogodleni wamathambo kodwa futhi nasemithanjeni yegazi, esilazini nasetimazini. Uma iLeukemia ingelashwa, ingaba nzima kakhulu. Izinhlobo zeleukemia ezisuselwa ekwandeni ngokweqile kwezicubu ezivuthiwe zivame ukuhamba kancane; kanti lezo ezisuselwa ekwandeni kwezicubu ezingakavuthwa zenzeka ngokushesha, zingavela ngezimpawu ezinzima emasontweni noma ezinyangeni ezimbalwa.
Izinhlobo ZeLeukemia Zikhona Zini?
Ngokuvamile, ama-leukemia ahlukaniswa abe amaqembu amabili amakhulu ngokuya ngesivinini sokuhamba kwawo: i-acute (esheshayo) kanye ne-chronic (ehamba kancane). Ama-leukemia asheshayo ahamba ngokwanda okusheshayo kwezicubu kanye nezimpawu ezivela ngokuzumayo, kanti ama-chronic ahamba kancane, iminyaka eminingi engabonakali kalula.
La maqembu amabili amakhulu ahlukaniswa futhi ngokuya ngohlobo lwezicubu zegazi ezimhlophe ezikhula ngokungajwayelekile:
Ezitholakala kumaseli e-myelocyte zibizwa ngokuthi "i-myelocytic leukemia",
Ezitholakala kumaseli e-lymphocyte zibizwa ngokuthi "i-lymphoblastic (noma i-lymphocytic) leukemia".
Kukhona nezinye izinhlobo ezingavamile kakhulu zeleukemia (isibonelo: i-juvenile myelomonocytic leukemia, i-hairy cell leukemia).
Izinto ezine eziyinhloko ezivame kakhulu zeleukemia yilezi:
1. I-Acute Lymphoblastic Leukemia (ALL)
Lena iyona evame kakhulu ezinganeni, kodwa ingatholakala nakubantu abadala. Kuleli gciwane, izicubu ezimhlophe ezisuselwe kuma-lymphocyte ezingakavuthwa zikhula ngokungaphatheki kahle. Izinga lokusinda kwe-ALL ezinganeni nakubantu abadala liyahlukahluka ngokuya ngeminyaka, impilo yonke kanye nokuphendula ekwelashweni.
2. I-Acute Myeloid Leukemia (AML)
Ivela ngenxa yokwanda okungajwayelekile kwezicubu ze-myelocyte zingakavuthwa. Ivame kakhulu kubantu abadala abasha nakubantu asebekhulile. Impumelelo yokwelashwa kwe-AML iya ngokuya ikhula ngenxa yezindlela ezintsha zokwelapha.
3. I-Chronic Lymphocytic Leukemia (KLL)
Ivame kakhulu kubantu asebekhulile, ikakhulukazi kulabo abaneminyaka engaphezu kwengu-60. Lapha, izicubu ezimhlophe ezivuthiwe kodwa ezingasebenzi kahle ziba ningi emzimbeni, zaphazamisa ukusebenza okuvamile komgogodla wamathambo nezinye izicubu.
4. I-Chronic Myeloid Leukemia (KML)
Ivame kakhulu kubantu abaneminyaka ephakathi kuka-25 no-60, lapho izicubu ze-myelocyte zikhula ngokungajwayelekile. Imithi emisha eqondene namaseli ethile isize kakhulu ekwandiseni amathuba okuphila kwabanezifo ze-KML.
Yiziphi Izimpawu ZeLeukemia?
Izimpawu zeleukemia zingafana nezinye izifo zomgogodla wamathambo futhi ngokuvamile zifaka:
Ukukhathala, ukubukeka uphaphathekile, ukukhathala ngokushesha, ukuphelelwa umoya (ngenxa yokuntuleka kwegazi)
Izifo ezivamile (ngenxa yokwehla kokuzivikela komzimba)
Ukopha okungalindelekile emzimbeni, emathunjini noma ngaphansi kwesikhumba, amabala amnyama kanye nezimpawu ezincane (petechiae)
Ukuntula isifiso sokudla, ukwehla kwesisindo, ukujuluka ebusuku
Izifo ezinesifo esiphezulu esithatha isikhathi eside
Ukwelashwa kwezinsini noma ubuhlungu bemisipha namalunga
Ukukhula kwezindlala zomzimba ezifana nentamo, ngaphansi kwekhwapha noma esithweni sangasese
Ukukhukhumala esikhumbeni noma esiswini
ILeukemia Ezinganeni: Izimpawu Nezibonakaliso
ILeukemia iyingxenye enkulu yezifo zomdlavuza ezitholakala ezinganeni, ikakhulukazi ezineminyaka ephakathi kuka-2 no-10. Ezinganeni ezisanda kuzalwa, izakhi ezivikelayo ezivela ebisi likanina zincipha ngokuhamba kwesikhathi bese uhlelo lokuzivikela komzimba luqhubeka nokukhula. Kulesi sikhathi, ezinye izifo ezithathelwanayo, ifa lezifo ezithile kanye nokuntuleka kwevithamini D kungandisa ingozi yokuthola i-leukemia.
Izimpawu ezivame kakhulu ezinganeni:
Ukuphaphatheka okubonakalayo esikhumbeni
Ukwehla kwesisindo, ukuntula isifiso sokudla
Izifo ezinesifo esiphezulu esithatha isikhathi eside noma eziphindaphindayo
Amabala amnyama noma ukukhukhumala emzimbeni
Ukukhula nokugcwala esiswini
Ubuhlungu bamathambo noma amalunga
Uma isifo siqhubeka, ukusabalala kwezicubu zomdlavuza ohlelweni lwezinzwa noma kwezinye izitho kungaholela kwezinye izimpawu ezifana nobuhlungu bekhanda, isicanucanu, noma ukuquleka.
Yiziphi Izinto Ezandisa Ingozi YeLeukemia?
ILeukemia itholakala ezingeni eliphezulu emhlabeni jikelele phakathi kwezifo zomdlavuza, futhi ivame kakhulu kubantu besilisa kunabesifazane. Izinto ezandisa ingozi yezinhlobo ezahlukene zeleukemia ziyahlukahluka:
I-Acute Lymphoblastic Leukemia (ALL)
Nakuba izimbangela zayo zingaziwa ngokuphelele, ukuvezwa emisebeni emikhulu, ezinye izinto ezikhemikhali (isibonelo: i-benzene), ukwelashwa kwezinye izifo ngomuthi wokubulala amaseli, ezinye izifo ezithathelwanayo (HTLV-1, Epstein–Barr virus), nezinye izifo ezifana ne-Down syndrome, Fanconi anemia, kungandisa ingozi ye-ALL.
I-Acute Myeloid Leukemia (AML)
Izinguquko zofuzo, ukukhula kweminyaka, ukusebenzisa ugwayi, ezinye izifo zegazi noma umlando wokwelashwa nge-chemotherapy, i-Down syndrome, konke lokhu kuyizinto ezandisa ingozi ye-AML.
I-Chronic Lymphocytic Leukemia (KLL)
Izimbangela ze-KLL azikacaci kahle. Kodwa, iminyaka ephakeme, ubulili besilisa, ukuvezwa kwezinye izinto ezikhemikhali kanye nomlando womndeni we-KLL kwandisa ingozi.
I-Chronic Myeloid Leukemia (KML)
I-KML ivame ukuhlotshaniswa noshintsho lofuzo olutholakala empilweni (hhayi oludluliselwa). Ushintsho olwaziwa ngokuthi "i-Philadelphia chromosome" lutholakala ezimweni eziningi ze-KML futhi luholela ekukhuleni okungaphatheki kahle kwezicubu emgogodleni wamathambo.
ILeukemia Ihlonzwa Kanjani?
Inhloso yokuhlola i-leukemia wukuqinisekisa ukuba khona kwesifo, uhlobo lwaso kanye nobubanzi baso. Izinyathelo eziyinhloko ezilandelwayo ngesikhathi sokuhlola yilezi:
Umlando ophelele kanye nokuhlolwa ngokomzimba: Kubhekwa ukuphaphatheka, ukukhula kwezindlala noma izitho, izinguquko esikhumbeni.
Izivivinyo zegazi: Kubalwa igazi eliphelele, i-biochemistry, ukusebenza kwesibindi kanye nezivivinyo zokopha.
Ukuhlolwa kwegazi elisakazekile: Kusetshenziswa ukuhlola ukuba khona kwezicubu ezingajwayelekile egazini.
I-biopsy/aspiration yomgogodla wamathambo: Ukuhlonza isifo ngokuphelele, ikakhulukazi ezimweni ezisheshayo, kuthathwa isampula yomgogodla wamathambo bese ihlolwa ngaphansi kwe-microscope.
Izivivinyo zofuzo nezamolekyuli: Ikakhulukazi ku-KML, kuhlolwa ushintsho lwe-Philadelphia chromosome kanye ne-BCR-ABL gene.
I-biopsy yomgogodla wamathambo ivame ukwenziwa esifubeni sesinqe bese ihlolwa ema-laboratory akhethekile.
Yiziphi Izindlela Zokwelapha Ezinikezwa KuLeukemia?
Uhlelo lokwelapha kufanele lwenziwe ngokucophelela luhlanganise uhlobo lweleukemia kanye nesimo sempilo yomuntu, lwenziwe nguchwepheshe kwezifo zegazi kanye nodokotela bomdlavuza. Izindlela ezisemqoka zokwelapha i-leukemia namuhla yilezi:
I-Chemotherapy
Kuhloswe ukususa izicubu ezingajwayelekile ngokusebenzisa imithi ehlukahlukene ye-chemotherapy. Imithi ezosetshenziswa kanye nendlela ezosetshenziswa ngayo kuncike ohlotsheni lweleukemia kanye nesimo somuntu.
I-Radiotherapy
Kuhloswe ukubhubhisa izicubu zeleukemia ngosizo lwemisebe enamandla aphezulu. I-radiotherapy ivame ukusetshenziswa ezimweni ezikhethiwe, kwesinye isikhathi njengengxenye yokulungiselela ukufakelwa kwezicubu eziyisisekelo.
Ukwelashwa Okusekelwe Emaseleni Nasemolekyulini
Imithi yesizukulwane esisha eqinisa uhlelo lokuzivikela noma eqondene nezicubu zomdlavuza (immunotherapy, ama-biological agents, ukwelashwa okuqondiswe kumaseli athile) idlala indima enkulu kwezinye izinhlobo zeleukemia. Ngokwesibonelo, ama-tyrosine kinase inhibitors aklanyelwe i-KML enze umehluko omkhulu ekwelashweni kwalesi sifo futhi anemiphumela engemibi encane uma kuqhathaniswa ne-chemotherapy.
Ukufakelwa Kwezicubu Eziyisisekelo (Umgogodla Wamathambo)
Le nqubo lapho umgogodla womgogodla ususwa ngokuphelele bese kufakwa izicubu zezitho eziphilile, ingenye yezindlela zokwelapha ezisebenza kakhulu futhi isetshenziswa ezigulini ezifanele. Ngesikhathi senqubo nangemva kwayo, kungavela imiphumela ethile emibi. Ikakhulukazi izinkinga ezihlobene nohlelo lokuzivikela emzimbeni (isb. i-GVHD), ukulimala kwezitho zomzimba kanye nengozi yokutheleleka kufanele kubhekwe. Ngenxa yalokho, inqubo yokufakelwa kufanele yenziwe ezikhungweni ezinolwazi.
Ukwelashwa Okusekelayo
Ukuze kuncishiswe ingozi yokopha, ukutheleleka kanye nokushoda kwegazi okubangelwa ukwelashwa ngekhemotherapi nezinye izindlela, kudingeka ukufakelwa kwegazi, imishanguzo yokuvikela ukutheleleka, uma kudingeka ama-antibiotic kanye nezinye izindlela zokusekela.
Ngenxa yezindlela zesimanje zokwelapha, izinga lokuphila ezigulini ze-leukemia selikhuphuke kakhulu eminyakeni yamuva. Ngokwesibonelo, eminyakeni yama-1970 izinga lokuphila iminyaka emihlanu belingaba ngu-30%, kanti ngokwezibalo zanamuhla, ngokwelashwa okufanele nokutholakala kokuxilongwa kusenesikhathi, leli zinga selidlule ku-60%.
Khumbula; ukuze kutholakale ukuxilongwa kusenesikhathi nokwelashwa okusebenzayo, uma izimpawu zibonakala, kufanele uye esikhungweni sezempilo ngokushesha, lokhu kuletha inzuzo enkulu ekuthuthukiseni izinga lempilo nasekuqondeni kwegciwane lesifo.
Imibuzo Evame Ukubuzwa
1. Ingabe i-leukemia iyathathelwana?
Cha, i-leukemia akuyona into ethathwa komunye umuntu. Ivela ngenxa yezinguquko zofuzo, izici zemvelo nezomuntu siqu futhi ayidluliselwa kumuntu omunye.
2. Yini ebangela i-leukemia ngokuqinisekile?
Imbangela eqondile ye-leukemia imvamisa ayaziwa. Kodwa izici zofuzo, ezinye izinto zamakhemikhali, imisebe yemvelo kanye namanye amagciwane kungenza kube sengozini enkulu.
3. Ingabe i-leukemia iyelapheka?
Izinhlobo eziningi ze-leukemia, ikakhulukazi uma kutholakala kusenesikhathi futhi kwelashwa ngendlela efanele, zingalawulwa noma zinyamalale ngokuphelele. Ithuba lokwelashwa lixhomeke ebudaleni besiguli, isimo jikelele kanye nohlobo lwe-leukemia.
4. Abantu abane-leukemia baphila isikhathi esingakanani?
Isikhathi sokuphila nge-leukemia sixhomeke ohlotsheni lwesifo, isikhathi sokuxilongwa, impendulo ekwelashweni kanye nezici zempilo yomuntu siqu. Namuhla, ngenxa yokwelashwa okuphumelelayo, ukuphila isikhathi eside kungenzeka.
5. Kungani i-leukemia ivame kakhulu ezinganeni?
Izici zofuzo ezithile kanye nezokuzivikela ezinganeni, uma zihlangana nezici zemvelo, zingadala ukuthambekela kwe-leukemia. Kodwa eziningi izingane, imbangela eqondile ayitholakali.
6. Ingabe ukufakelwa komgogodla womgogodla kufanelekile kubo bonke?
Cha, ukufakelwa komgogodla womgogodla akukhuthazwa kuzo zonke iziguli. Ukufaneleka kuhlolwa odokotela ngokweminyaka yesiguli, isimo sempilo jikelele, uhlobo lwesifo kanye nezinye izici zezokwelapha.
7. Yiziphi ezinye izifo ezihlangana nezimpawu ze-leukemia?
I-leukemia ingahlangana nezimpawu zokutheleleka okuthile, izinhlobo zokushoda kwegazi kanye nezinye izifo zegazi. Ukuhlolwa kwegazi okuphelele kanye nokuhlolwa okujulile kwenza kube lula ukuhlukanisa.
8. Kungenzeka yini ukuvimbela i-leukemia?
Noma kungenzeki ukuvimbela ngokuphelele, ukugwema ukubhema nezinto eziyingozi zamakhemikhali, ukuthatha imikhuba yokuphila enempilo, nokwenza ukuhlolwa kwezempilo njalo kusiza ekutholeni isifo kusenesikhathi.
9. Ingabe iziguli ze-leukemia zithambekele ekuthelelekeni?
Yebo, umgogodla womgogodla kanye nohlelo lokuzivikela emzimbeni kuthinteka. Ngakho-ke, kubalulekile ukunakekela ukuhlanzeka, ukugwema izindawo ezinabantu abaningi nezinezifo, futhi uma kudingeka ukuthatha izinyathelo zokuzivikela.
10. Ingabe i-leukemia ibangela ukuwa kwezinwele?
Ezinye izidakamizwa ezisetshenziswa ngesikhathi sokwelashwa (ikakhulukazi i-kemotherapi) zingabangela ukuwa kwezinwele. Lo mphumela uvamise ukuba wesikhashana futhi izinwele zingaphinda zikhule ngemva kokwelashwa.
11. Ingabe i-leukemia iyadluliselwa ngokozalo?
Ukudluliselwa ngokozalo akuvamile ezimweni eziningi ze-leukemia. Kodwa ezinye izifo zofuzo zingandisa ingozi yokuthola i-leukemia.
12. Yiziphi izinto okufanele zicatshangelwe ngesikhathi sokwelashwa kwe-leukemia?
Kubalulekile ukuvikela ekuthelelekeni, ukulandela izeluleko zodokotela ngokucophelela, ukungaphuthelwa ukuhlolwa njalo nokwazisa ithimba lezempilo mayelana nemiphumela emibi.
Imithombo
Inhlangano Yezempilo Yomhlaba (WHO): Leukemia
Izikhungo Zokulawula Nokuvimbela Izifo e-USA (CDC): Amaqiniso Ezifo Zegazi
American Cancer Society: Uhlolojikelele lwe-Leukemia
European Hematology Association: Imihlahlandlela ye-Leukemia
Cancer Research UK: Izinhlobo Nezindlela Zokwelapha i-Leukemia