Inyangwa Njani I-Myeloid Leukemia (CML)?

Umxholo

• I-CML iphathwa njani?
• Iziyobisi zonyango ekujoliswe kuzo
• Imatinib (Gleevec)
• IDasatinib (iSprycel)
• Nilotinib (Tasigna)
• I-Bosutinib (Bosulif)
• IPonatinib (Iclusig)
• Unyango lwesigaba esikhawulezayo
• Ukufakelwa kweseli
• Unyango ngamayeza
• Uvavanyo lwezonyango
• Ezona zibhedlele zilungileyo zonyango lwe-CML
• Ukujamelana nemiphumo emibi yonyango
• Iingcebiso zokuhlala usempilweni ngexesha lonyango lwe-CML
• Inkxaso ngexesha lonyango
• Unyango lwe-Homeopathic
• Imbonakalo

I-CML iphathwa njani?

I-myeloid leukemia engapheliyo (i-CML) luhlobo lomhlaza ochaphazela umongo wethambo. Iqala kwiiseli ezenza igazi, iiseli zomhlaza ezakha kancinci kancinci ngokuhamba kwexesha. Iiseli ezinesifo azifi xa kufanele kwaye ngokuthe ngcembe zixinanise iiseli ezisempilweni.

I-CML inokubangelwa kukutshintsha kwemfuza okubangela ukuba iseli yegazi ivelise iprotein ye-tyrosine kinase kakhulu. Le proteni yile evumela ukuba iiseli zomhlaza zikhule kwaye zande.

Kukho iindlela ezahlukeneyo zonyango kwi-CML. Olu nyango lujolise ekupheliseni iiseli zegazi eziqulethe utshintsho lwemfuza. Xa ezi seli zisuswe ngempumelelo, esi sifo sinokuxolelwa.

Iziyobisi zonyango ekujoliswe kuzo

Inyathelo lokuqala kunyango kuhlala iklasi yamayeza abizwa ngokuba yi-tyrosine kinase inhibitors (TKIs). Oku kusebenza kakhulu ekulawuleni i-CML xa ikwisigaba esinganyangekiyo, kulapho inani leeseli zomhlaza egazini okanye kumongo wethambo liphantsi kakhulu.

Umsebenzi we-TKI ngokuthintela isenzo se-tyrosine kinase kunye nokumisa ukukhula kweeseli zomhlaza ezintsha. La machiza anokuthathwa ngomlomo ekhaya.

Ii-TKI ziye zaba lonyango oluqhelekileyo lwe-CML, kwaye zininzi ezikhoyo. Nangona kunjalo, ayinguye wonke umntu ophendulayo kunyango ngee-TKIs. Abanye abantu banokuxhathisa. Kule meko, kunokucetyiswa ichiza okanye unyango olwahlukileyo.

Abantu abaphendula kunyango nge-TKIs bahlala befuna ukubathatha ngokungapheliyo. Ngelixa unyango lwe-TKI lunokukhokelela kuxolelo, alususi ngokupheleleyo i-CML.

Imatinib (Gleevec)

I-Gleevec yayiyi-TKI yokuqala yokufika kwintengiso. Abantu abaninzi abane-CML baphendula ngokukhawuleza kwi-Gleevec. Iziphumo ebezingalindelekanga zihlala zinobulali kwaye zinokubandakanya:

• isicaphucaphu nokugabha
• urhudo
• ukudinwa
• ulwakhiwo lwamanzi, ngakumbi ebusweni, esiswini, nasemilenzeni
• iintlungu ezidibeneyo kunye nezihlunu
• irhashalala
• ubalo lwegazi olusezantsi

IDasatinib (iSprycel)

I-Dasatinib inokusetyenziswa njengonyango lodidi lokuqala, okanye xa iGleevec ingasebenzi okanye ingenakunyamezeleka. USprycel uneziphumo ebezingalindelekanga ezifanayo njengeGleevec.

I-Sprycel ikwabonakala ngathi inyusa umngcipheko we-pulmonary arterial hypertension (PAH). I-PAH yimeko enobungozi eyenzeka xa uxinzelelo lwegazi luphezulu kakhulu kwimithambo yemiphunga.

Esinye isiphumo esibi esibi seSprycel ngumngcipheko okhulayo wokuchithwa kwe-pleural. Ngeli xesha ulwelo luza kwakha lujikeleze imiphunga. I-Sprycel ayikhuthazwa kwabo baneengxaki zentliziyo okanye zemiphunga.

Nilotinib (Tasigna)

NjengoGleevec noSprycel, iNilotinib (iTasigna) ingalunyango lodidi lokuqala. Ukongeza, inokusetyenziswa ukuba ezinye iziyobisi azisebenzi okanye iziphumo ebezingalindelekanga zikhulu kakhulu.

I-Tasigna ineziphumo ebezingalindelekanga ezifanayo nezinye ii-TKIs, kunye nezinye iziphumo ebezingalindelekanga ezinobuzaza ekufuneka zijongiwe ngoogqirha. Oku kunokubandakanya:

• Ipancreas edlayo
• iingxaki zesibindi
• iingxaki ze-electrolyte
• ukuphuma kwegazi (ukopha)
• imeko ebukhali nenokubulala intliziyo ebizwa ngokuba yi-QT syndrome ende

I-Bosutinib (Bosulif)

Ngelixa iBosutinib (iBosulif) ngamanye amaxesha inokusetyenziswa njengonyango lodidi lokuqala lwe-CML, ihlala isetyenziswa kubantu esele bazamile ezinye ii-TKIs.

Ukongeza kwiziphumo ebezingalindelekanga eziqhelekileyo kwezinye ii-TKIs, iBosulif inokubangela ukonakala kwesibindi, ukonakala kwezintso, okanye iingxaki zentliziyo. Nangona kunjalo, ezi ntlobo zeziphumo ebezingalindelekanga zinqabile.

IPonatinib (Iclusig)

IPonatinib (Iclusig) lelona chiza lijolise kuguquko oluthile. Ngenxa yokuba kunokwenzeka kweziphumo ebezingalindelekanga ezimandundu, kufanelekile kuphela kwabo banolu tshintsho okanye abo bazame zonke ezinye ii-TKI ngaphandle kwempumelelo.

I-Iclusig yonyusa umngcipheko wamahlwili egazi anokubangela isifo sentliziyo okanye ukubetha kwaye kunokubangela nokusilela kwentliziyo. Ezinye iziphumo ebezingalindelekanga ezinokubakho zibandakanya iingxaki zesibindi kunye nepancreas.

Unyango lwesigaba esikhawulezayo

Kwinqanaba elikhawulezayo le-CML, iiseli zomhlaza ziqala ukwakha ngokukhawuleza okukhulu. Ngenxa yoku, abantu abakweli nqanaba banokungabi namathuba okuba baphendule ngokuzinzileyo kwezinye iintlobo zonyango.

Njengakwisigaba esinganyangekiyo, enye yeendlela zokuqala zonyango kunyango olukhawulezileyo lweCML kukusetyenziswa kwee-TKIs. Ukuba umntu sele ethatha iGleevec, idosi yabo inokunyuswa. Kwakhona kunokwenzeka ukuba baya kutshintshelwa kwi-TKI entsha endaweni yoko.

Olunye ukhetho olunokubakho kunyango olukhawulezileyo lubandakanya ukufakelwa kweseli okanye i-chemotherapy. Ezi zinokucetyiswa ngokukodwa kwabo unyango kunye ne-TKI lungakhange lusebenze.

Ukufakelwa kweseli

Ngokubanzi, inani labantu abaphantsi kwe-stem cell transplants ye-CML ngenxa yokusebenza kwe-TKIs. Ukutshintshwa kucetyiswa ngokukodwa kwabo bangaphendulanga kwezinye iindlela zonyango ze-CML okanye abanomngcipheko omkhulu we-CML.

Ukufakelwa kweseli ye-stem, iidosi eziphezulu zamayeza e-chemotherapy zisetyenziselwa ukubulala iiseli kumongo wethambo lakho, kubandakanya neeseli zomhlaza. Emva koko, iiseli zeziqu zokwenza igazi ezivela kulowo unikelayo, uhlala engumzalwana okanye ilungu losapho, zingeniswa kwigazi lakho.

Ezi iiseli zabanikeli zintsha zinokuqhubeka zithathe indawo yeeseli zomhlaza ezisuswe yichemotherapy. Ngokubanzi, ukufakelwa kweseli ye-stem kuphela kohlobo lonyango olunokunyanga i-CML.

Ukufakelwa kweeseli zestem kunokuba nzima emzimbeni kwaye kuthwala umngcipheko weziphumo ebezingalindelekanga ezibi. Ngenxa yoku, banokucetyiswa kuphela kubantu abane-CML abancinci kwaye banempilo entle ngokubanzi.

Unyango ngamayeza

I-Chemotherapy yayilunyango oluqhelekileyo lwe-CML ngaphambi kwe-TKIs. Kusanceda kwezinye izigulana ezingakhange zibe neziphumo ezilungileyo nge-TKIs.

Ngamanye amaxesha, ichemotherapy iya kumiselwa kunye ne-TKI. I-Chemotherapy inokusetyenziselwa ukubulala iiseli ezikhoyo ezinomhlaza, ngelixa ii-TKIs zigcina iiseli zomhlaza ezintsha ekubeni zenziwe.

Iziphumo ezinxulumene ne-chemotherapy zixhomekeka kwichiza le-chemotherapy elithathwayo. Banokubandakanya izinto ezinje:

• ukudinwa
• isicaphucaphu nokugabha
• ukulahleka kweenwele
• irhashalala
• ukwanda kokuchaphazeleka kosulelo
• ukungachumi

Uvavanyo lwezonyango

Uvavanyo lwezonyango olujolise kunyango lwe-CML luyaqhubeka. Injongo yolu vavanyo kukuvavanya ukhuseleko kunye nokusebenza kwonyango olutsha lwe-CML okanye ukuphucula kunyango lwe-CML esele ikho.

Ukuthatha inxaxheba kuvavanyo lweklinikhi kunokukunika ukufikelela kolona hlobo lonyango lonyango lutsha. Nangona kunjalo, kubalulekile ukuba ukhumbule ukuba unyango olusetyenziswe kuvavanyo lweklinikhi lunokuvela lungasebenzi njengonyango oluqhelekileyo lwe-CML.

Ukuba unomdla wokubhalisa kwilingo leklinikhi, thetha nogqirha wakho. Banokukunika umbono wokuba zeziphi izilingo onokuthi ufaneleke kuzo kunye nezibonelelo kunye nemingcipheko eyahambelana nayo.

Ukuba ungathanda ukufumana umbono wezilingo eziqhubekayo ngoku, kukho ezinye izixhobo onokuzifumana. IZiko leSizwe loMhlaza ligcina ulingo lwangoku lwe-CMI exhaswa yi-NCI. Ukongeza, iClinicalTrials.gov yindawo eneenkcukacha ezinokukhangelwa kulingo lwasesidlangalaleni nakwinkxaso yabucala.

Ezona zibhedlele zilungileyo zonyango lwe-CML

Emva kokuxilongwa komhlaza, uya kufuna ukufumana isibhedlele esineengcali ezijolise kunyango lwe-CML. Kukho iindlela ezimbalwa onokuthi uhambe ngazo:

• Cela ukuthunyelwa. Ugqirha wakho wokhathalelo oluphambili unokukwazi ukukunika ulwazi kwezona zibhedlele zibalaseleyo kwindawo yakho ukunyanga i-CML.
• Sebenzisa iKhomishini kwiLocator yeSibhedlele esiyiCancer. Ilawulwa yiAmerican College of Surgeons, esi sixhobo sikuvumela ukuba uthelekise iindawo ezahlukeneyo zonyango lomhlaza kwindawo yakho.
• Jonga iZiko loMhlaza leSizwe-amaziko abekiweyo. Oku kunokubandakanya amaziko abonelela ngonyango olusisiseko lomhlaza ngakumbi ngakumbi, ukhathalelo olubanzi. Unokulufumana uluhlu lwazo.

Ukujamelana nemiphumo emibi yonyango

Ezinye zeziphumo ebezingalindelekanga eziqhelekileyo kunyango oluninzi lwe-CML zibandakanya izinto ezinje:

• ukudinwa
• iintlungu neentlungu
• isicaphucaphu nokugabha
• ubalo lwegazi olusezantsi

Ukukhathala kungaphela kwaye kuphume. Ngezinye iintsuku unokuba namandla amaninzi, kwaye ngezinye iintsuku unokuziva udiniwe kakhulu. Ukuzivocavoca kunokuhlala kusetyenziselwa ukulwa nokudinwa. Thetha nogqirha wakho malunga nokuba zeziphi iintlobo zomsebenzi onokuzilungela.

Ugqirha wakho uya kusebenza nawe ukuphuhlisa isicwangciso sokunceda ukulawula intlungu. Oku kunokubandakanya izinto ezinje ngokuthatha amayeza amiselweyo, ukudibana nengcali yeentlungu, okanye ukusebenzisa iindlela zonyango ezongezelelweyo ezinje ngokuthambisa okanye ukwenza i-acupuncture.

Amayeza anokunceda ekuthomalaliseni iimpawu ezinjengokugabha kunye nokugabha. Ukongeza, unokukhetha ukunqanda ukutya okanye iziselo ezenza ezi mpawu zibe mbi ngakumbi.

Ubalo lwegazi oluphantsi lunokukwenza ukuba uthambekele kwiimeko ezininzi njenge-anemia, ukopha ngokulula, okanye usihla usulelo. Ukubeka iliso kwezi meko kubaluleke kakhulu ukuze ukwazi ukubona iimpawu zazo kwaye ufune ukhathalelo kwangexesha.

Iingcebiso zokuhlala usempilweni ngexesha lonyango lwe-CML

Landela ezi ngcebiso zingezantsi ukunceda ukuhlala usempilweni ngangokunokwenzeka xa usenza unyango lwe-CML:

• Qhubeka nokuhlala usebenza ngokwasemzimbeni.
• Yitya ukutya okusempilweni, ugxile kwiziqhamo kunye nemifuno.
• Nciphisa inani lotywala obuselayo.
• Hlamba izandla zakho rhoqo kwaye uhlambulule indawo ekuchukumisa kuyo ukuthintela usulelo.
• Zama ukuyeka ukutshaya.
• Thatha onke amayeza njengoko kuyalelwe.
• Yazisa iqela lakho lokhathalelo ukuba ngaba ufumana iimpawu ezintsha okanye eziya zisanda.

Inkxaso ngexesha lonyango

Kuqheleke ngokupheleleyo ukuziva izinto ezahlukeneyo ngelixa usanyangwa yi-CML. Ukongeza ekujonganeni nefuthe lonyango, ngamanye amaxesha unokuziva ukhathazekile, unxunguphele okanye ulusizi.

Vuleka kwaye uthembeke kubathandekayo bakho malunga nendlela oziva ngayo. Khumbula ukuba banokukhangela iindlela zokukuxhasa, ke babazise ukuba banganceda njani. Oku kunokubandakanya izinto ezinje ngokuhamba kwemisebenzi, ukunceda ngaphakathi endlwini, okanye nokubolekisa indlebe.

Ngamanye amaxesha, ukuthetha nengcali yezempilo yengqondo malunga neemvakalelo zakho kunokuba luncedo. Ukuba le yinto onomdla kuyo, ugqirha wakho unokunceda ukukuthumela kumcebisi okanye ugqirha.

Ukongeza, ukwabelana ngamava akho nabanye abatyhubela into efanayo kunokuba luncedo kakhulu. Qiniseka ukuba ubuza malunga namaqela enkxaso yomhlaza kwindawo yakho.

Unyango lwe-Homeopathic

Unyango oluncedisayo kunye nolunye uhlobo (i-CAM) lubandakanya iindlela ezingaqhelekanga zempilo, ezinje ngehomeopathy, ezisetyenziselwa endaweni kunye kunye nonyango oluqhelekileyo.

Okwangoku azikho iindlela zonyango ze-CAM eziqinisekisiweyo zokunyanga ngokuthe ngqo i-CML.

Nangona kunjalo, unokufumanisa ukuba ezinye iintlobo ze-CAM zikunceda ukuba umelane neempawu ze-CML okanye iziphumo ebezingalindelekanga ezinje ngokudinwa okanye iintlungu. Eminye imizekelo inokubandakanya izinto ezinje:

• ukuphulula
• iyoga
• ukutshiza
• ukucamngca

Soloko uthetha nogqirha wakho ngaphambi kokuqala naluphi na uhlobo lonyango lweCAM. Kungenzeka ukuba ezinye iintlobo zonyango lweCAM zingenza ukuba unyango lwakho lwe-CML lungasebenzi.

Imbonakalo

Unyango lodidi lokuqala lwe-CML zii-TKIs. Nangona la machiza aneziphumo ebezingalindelekanga ezininzi, ezinye zazo ezinokuba nzulu, zihlala zisebenza kakhulu ekunyangeni i-CML.

Ngapha koko, ama-5- kunye neminyaka eli-10 yokusinda kwe-CML ukusukela oko zaziswa okokuqala ii-TKIs. Ngelixa abantu abaninzi besiya kuxolelo ngelixa bekwii-TKI, bahlala befuna ukuqhubeka nokubathatha ubomi babo bonke.

Ayizizo zonke iimeko ze-CML eziphendula kunyango ngee-TKIs. Abanye abantu banokukhula ngokuchasene nabo, ngelixa abanye banokuba neentlobano zesifo ezinobungozi okanye ezinobungozi. Kule meko, ichemotherapy okanye ukufakelwa kweeseli ezinokucetyiswa kunokucetyiswa.

Kuhlala kubalulekile ukuba uthethe nogqirha wakho ngaphambi kokuqala unyango olutsha lwe-CML. Banokunika uluvo lweentlobo zeziphumo ebezingalindelekanga onokuzifumana kunye neendlela zokukunceda ujongane nazo.