Ileukemia enganyangekiyo yeLymphocytic (CLL)

Umxholo

• Yintoni i-lymphocytic leukemia (CLL) engapheliyo?
• Zithini iimpawu ze-CLL?
• Luthini unyango lwe-CLL?
• Unyango ngamayeza
• Imitha
• Unyango ekujoliswe kulo
• Umongo wethambo okanye ukufakelwa kwegazi kwi-cell stem
• Utofelo-gazi
• Ugqirha
• Ichongwa njani i-CLL?
• Gcwalisa inani legazi (CBC) ngeeseli ezimhlophe zegazi (WBC) umahluko
• Uvavanyo lwe-Immunoglobulin
• Umongo wethambo
• Ukuskena i-CT
• Ukuhamba kwecytometry kunye necytochemistry
• Uvavanyo lweGenomic kunye nemolekyuli
• Lithini inqanaba lokusinda kubantu abane-CLL?
• Ihlelwe njani i-CLL?
• Yintoni ebangela i-CLL, kwaye ngaba kukho izinto ezinobungozi kwesi sifo?
• Ngaba zikhona iingxaki ezikhoyo kunyango?
• Ithini imbonakalo yexesha elide ye-CLL?

Imifanekiso kaGetty

Yintoni i-lymphocytic leukemia (CLL) engapheliyo?

Ileukemia luhlobo lomhlaza olubandakanya iiseli zegazi lomntu kunye neeseli ezenza igazi. Zininzi iintlobo ze-leukemia, nganye ichaphazela iintlobo ezahlukeneyo zeeseli zegazi. I-lymphocytic leukemia engapheliyo, okanye i-CLL, ichaphazela ii-lymphocyte.

I-lymphocyte luhlobo lweeseli ezimhlophe zegazi (WBC). I-CLL ichaphazela ii-lymphocyte ze-B, ezibizwa ngokuba yii-B.

Iiseli eziqhelekileyo ze-B zijikeleza egazini lakho kwaye zinceda umzimba wakho ukuba ulwe nosulelo. Iiseli ezinomhlaza B azilwi nosulelo njengoko iiseli eziqhelekileyo ze-B zisenza. Njengoko inani leeseli zomhlaza B landa ngokuthe chu, ziyaxinanisa ii-lymphocyte eziqhelekileyo.

I-CLL lolona hlobo luqhelekileyo lweleukemia kubantu abadala. IZiko leSizwe loMhlaza (i-NCI) ​​liqikelela ukuba ngamatyala amatsha angama-21,040 aya kwenzeka e-United States ngo-2020.

Zithini iimpawu ze-CLL?

Abanye abantu abane-CLL abanakho ukuba neempawu, kwaye umhlaza wabo unokufunyanwa kuphela ngexesha lovavanyo lwegazi oluqhelekileyo.

Ukuba unayo impawu, zibandakanya:

• ukudinwa
• ifiva
• usulelo rhoqo okanye ukugula
• ukuncipha komzimba okungachazwanga okanye okungalindelekanga
• ukubila ebusuku
• Ukugodola
• ukudumba kwamalungu enkovu

Ngethuba lovavanyo lomzimba, ugqirha wakho unokufumana ukuba i-spleen, isibindi, okanye i-lymph nodes zandisiwe. Oku kunokuba yimiqondiso yokuba umhlaza usasazekile kula malungu. Oku kuhlala kusenzeka kwiimeko eziphambili ze-CLL.

Ukuba oku kuyenzeka kuwe, unokuziva kukho izigaqa ezibuhlungu entanyeni yakho okanye uvakalelo lokugcwala okanye ukudumba esiswini sakho.

Luthini unyango lwe-CLL?

Ukuba unomngcipheko ophantsi we-CLL, ugqirha unokukucebisa ukuba ulinde kwaye ubukele iimpawu ezintsha. Isifo sakho sinokungabi mandundu okanye sifune unyango iminyaka. Abanye abantu abaze bafune unyango.

Kwezinye iimeko ze-CLL ezinobungozi obuphantsi, ugqirha wakho unokuncoma unyango. Umzekelo, banokucebisa unyango ukuba:

• Ukuqhubeka, izifo ezenzeka rhoqo
• iiseli zegazi ezisezantsi
• ukudinwa okanye ukubila ebusuku
• I-lymph nodes ezibuhlungu

Ukuba une-CLL ephakathi okanye enobungozi obukhulu, ugqirha wakho uya kukucebisa ukuba uqhubeke nonyango kwangoko.

Apha ngezantsi kukho unyango olunokucetyiswa ngugqirha wakho.

Unyango ngamayeza

I-Chemotherapy yonyango oluphambili lwe-CLL. Kubandakanya ukusebenzisa amayeza ukubulala iiseli zomhlaza. Kuxhomekeke kunyango oluchanekileyo oluyalelwa ngugqirha, ungabathatha ngenqanawa okanye ngomlomo.

Imitha

Kule nkqubo, amasuntswana amandla aphezulu okanye amaza asetyenziselwa ukubulala iiseli zomhlaza. I-radiation ayisoloko isetyenziselwa i-CLL, kodwa ukuba unentlungu, i-lymph nodes ezivuvuzayo, unyango lwe-radiation lunokunceda ukunciphisa kunye nokunciphisa intlungu yakho.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lujolise kwiijethi ezithile, iiproteni, okanye izicwili ezinegalelo ekusindisweni kweeseli zomhlaza. Oku kunokubandakanya:

• izilwa-monoclonal antibodies, ezincamathele kwiiproteni
• kinase inhibitors ezinokutshabalalisa iiseli zomhlaza ngokuthintela ii-enzyme ezithile ze-kinase

Umongo wethambo okanye ukufakelwa kwegazi kwi-cell stem

Ukuba unomngcipheko omkhulu we-CLL, olu nyango lunokukhetha. Kubandakanya ukuthatha iiseli zesitshixo kumongo wethambo okanye kwigazi lomnikeli- zihlala zililungu losapho - kwaye uzitshintshele emzimbeni wakho ukunceda ukuseka umongo wethambo.

Utofelo-gazi

Ukuba ubalo lweeseli zakho zegazi luphantsi, unokufuna ukufumana utofelo-gazi ngokusebenzisa intambo yegazi (IV) ukuze ubonyuse.

Ugqirha

Ngamanye amaxesha, ugqirha wakho unokucebisa utyando ukususa udakada ukuba luye lwandiswa ngenxa ye-CLL.

Ichongwa njani i-CLL?

Ukuba ugqirha wakho ukrokrela ukuba une-CLL, banokusebenzisa iimvavanyo ezahlukeneyo ukuqinisekisa isifo. Umzekelo, baya kuyalela enye okanye nangaphezulu kwezi mvavanyo zilandelayo.

Gcwalisa inani legazi (CBC) ngeeseli ezimhlophe zegazi (WBC) umahluko

Ugqirha wakho unokusebenzisa olu vavanyo lwegazi ukulinganisa inani leentlobo ezahlukeneyo zeeseli egazini lakho, kubandakanya iintlobo ezahlukeneyo ze-WBCs.

Ukuba unayo i-CLL, uya kuba nee-lymphocyte ezingaphezulu kwesiqhelo.

Uvavanyo lwe-Immunoglobulin

Ugqirha wakho angalusebenzisa olu vavanyo lwegazi ukuze afunde ukuba uneentsholongwane ezaneleyo zokulwa usulelo.

Umongo wethambo

Kule nkqubo, ugqirha wakho ufaka inaliti enetyhubhu ekhethekileyo kwithambo lakho lesinqe okanye ithambo lesifuba ukuze ufumane isampulu yomongo wethambo lakho ukuze uvavanywe.

Ukuskena i-CT

Ugqirha wakho angasebenzisa imifanekiso eyenziwe yi-CT scan ukujonga i-lymph nodes ezivuvukileyo esifubeni sakho okanye kwisisu.

Ukuhamba kwecytometry kunye necytochemistry

Ngale mvavanyo, iikhemikhali okanye idayi zisetyenziselwa ukubona amanqaku ahlukileyo kwiiseli zomhlaza ukunceda ukumisela uhlobo lweleukemia. Isampulu yegazi yiyo yonke into efunekayo kolu vavanyo.

Uvavanyo lweGenomic kunye nemolekyuli

Ezi mvavanyo zijonga kwimfuza, iiproteni, kunye notshintsho lwechromosome ezinokuthi zahluke kwiintlobo ezithile zegazi. Bayanceda ukufumanisa ukuba isifo siza kukhawuleza kangakanani kwaye bancede ugqirha wakho akhethe unyango aza kulusebenzisa.

Ukuvavanywa kwemfuza ukufumana olo tshintsho okanye utshintsho olunokubandakanya ukubonwa kwe-fluorescence in situ hybridization (FISH) kunye nokuphendula kwetyathanga le-polymerase.

Lithini inqanaba lokusinda kubantu abane-CLL?

Inqanaba lokusinda kweminyaka emi-5 yabantu baseMelika abane-CLL ngama-86.1 eepesenti, ngokwe-NCI. Eli ziko liqikelela ukuba i-CLL iya kubangela ukusweleka kwabantu abangama-4,060 e-United States ngo-2020.

Amaxabiso okusinda aphantsi kubantu abadala abanemeko.

Ihlelwe njani i-CLL?

Ukuba ugqirha wakho ufumanisa ukuba une-CLL, baya kuyalela ukuvavanywa ngakumbi ukujonga ubungakanani besifo. Oku kunceda ugqirha wakho ukuba ahlele inqanaba lomhlaza, oya kuthi ukhokele isicwangciso sakho sonyango.

Ukubeka i-CLL yakho kwinqanaba, ugqirha wakho uya kuthi aodole iimvavanyo zegazi ukuze ufumane inani elibomvu leeseli zegazi (RBC) kunye nenani elithile le-lymphocyte yegazi. Kananjalo baya kujonga ukuba ii-lymph node, udakada, okanye isibindi sandisiwe.

Ngaphantsi kwenkqubo yohlelo lweRai, i-CLL ibekwe kwi-0 ukuya kwi-4. I-Rai yenqanaba le-0 i-CLL yeyona inzima kakhulu, ngelixa iRai inqanaba lesi-4 lelona lihambele phambili.

Ngeenjongo zonyango, amanqanaba aqokelelwe ngokwamanqanaba omngcipheko. Inqanaba le-Rai 0 ngumngcipheko ophantsi, amanqanaba e-Rai 1 kunye ne-2 abasemngciphekweni ophakathi, kwaye iRai inqanaba 3 kunye ne-4 banomngcipheko omkhulu, ucacisa uMbutho waseMelika waseCancer.

Nazi ezinye zeempawu ze-CLL kwinqanaba ngalinye:

• Inqanaba 0: amanqanaba aphezulu e-lymphocyte
• Inqanaba 1: amanqanaba aphezulu e-lymphocyte; ukwandisa ii-lymph node
• Inqanaba 2: amanqanaba aphezulu e-lymphocyte; Izakhi zofuzo zinokwandiswa; ipeni eyandisiweyo; isibindi esinokwandiswa
• Inqanaba 3: amanqanaba aphezulu e-lymphocyte; ianemia; I-lymph nodes, i-spleen, okanye isibindi sinokunyuswa
• Inqanaba 4: amanqanaba aphezulu e-lymphocyte; I-lymph nodes, i-spleen, okanye isibindi sinokunyuswa; i-anemia enokwenzeka; amanqanaba asezantsi eeplatelets

Yintoni ebangela i-CLL, kwaye ngaba kukho izinto ezinobungozi kwesi sifo?

Iingcali azazi ncam ukuba yintoni ebangela i-CLL. Nangona kunjalo, kukho izinto ezinobungozi ezonyusa amathuba omntu okuphuhlisa i-CLL.

Nazi izinto ezinobungozi ezinokubakho ukuphakamisa amathuba okuba umntu aphuhlise i-CLL:

• Ubudala. I-CLL ayifane ifumaneke kubantu abangaphantsi kweminyaka engama-40 ubudala. Uninzi lwamatyala e-CLL afunyaniswa kubantu abangaphezu kweminyaka engama-50. Iminyaka yobudala yabantu abafunyaniswe ukuba bane-CLL ngama-71.
• Ukwabelana ngesondo. Ichaphazela amadoda ngakumbi kunabafazi.
• Ubuhlanga. Kuqheleke kakhulu kubantu abanemvelaphi yaseRussia neyaseYurophu kwaye kunqabile ukuba kufumaneke kubantu baseMpuma Asia naseMzantsi-mpuma weAsia.
• I-Monoclonal B-cell lymphocytosis. Kukho umngcipheko omncinci wokuba le meko, ebangela amanqanaba aphezulu kunee-lymphocyte, inokujika ibe yi-CLL.
• Indalo esingqongileyo. ISebe laseMelika leMicimbi yeVeterans libandakanya ukubhengeza iAgent Orange, isixhobo semichiza esasetyenziswa ngexesha leMfazwe yaseVietnam, njengomngcipheko weCLL.
• Imbali yosapho. Abantu abanezihlobo ezikufutshane kunye nokuchongwa kwe-CLL banomngcipheko ophezulu we-CLL.

Ngaba zikhona iingxaki ezikhoyo kunyango?

I-Chemotherapy iyenza buthathaka inkqubo yomzimba yokuzikhusela, ikushiye usesichengeni sokosuleleka. Unako kwakhona ukuphuhlisa amanqanaba angaqhelekanga omzimba kunye neeseli eziphantsi zeeseli zegazi ngexesha lekhemotherapy.

Ezinye iziphumo eziqhelekileyo zechemotherapy zibandakanya:

• ukudinwa
• ukulahleka kweenwele
• izilonda zomlomo
• Ukuphelelwa ngumdla wokutya
• isicaphucaphu nokugabha

Ngamanye amaxesha, ichemotherapy inokuba negalelo kuphuhliso lweminye imihlaza.

Imitha, utofelo-gazi, kunye nomongo wethambo okanye ukufakelwa kwegazi kwiseli kungabandakanya neziphumo ebezingalindelekanga.

Ukujongana nemiphumo ethile, ugqirha unokumisela:

• IV immunoglobulin
• icorticosteroids
• ukususwa kwepeni
• iyeza lonyango

Thetha nogqirha wakho malunga neziphumo ebezingalindelekanga zonyango lwakho. Banokukuxelela ukuba zeziphi iimpawu kunye neziphumo ebezingalindelekanga ezifuna unyango.

Ithini imbonakalo yexesha elide ye-CLL?

Amaxabiso okusinda kwi-CLL ahluka kakhulu. Ubudala bakho, isini, ukungaqheleki chromosome, kunye neempawu zeseli zomhlaza zinokuchaphazela umbono wakho wexesha elide. Esi sifo kunqabile ukuba sinyangeke, kodwa uninzi lwabantu luhlala iminyaka emininzi nge-CLL.

Buza ugqirha wakho malunga nemeko ethile. Banokukunceda uqonde ukuba umhlaza wakho sele uhambele phambili kangakanani. Banokuxoxa nangokhetho lwakho lonyango kunye nembono yexesha elide.