Ingqwalasela ye-leukemia
I-leukemia yigama eliqhelekileyo elibhekisela kwiindidi ezahlukeneyo zomhlaza wegazi. I-leukemia inokuchaphazela abantu ngendlela eyahlukileyo, kwaye unyango luyahlukahluka ngokuxhomekeka kuhlobo lwe-leukemia abanalo. Umntu unokufumana i-leukemia kunanoma yiphina iminyaka, kodwa phakathi kwabantu abadala, i-leukemia ixhaphake kakhulu kulabo abangaphezu kweminyaka engama-60. Abantwana abavumi ukuvelisa umhlaza ngemilinganiselo efanayo nabantu abadala. Nangona kunjalo, xa abantwana behlakulela umdlavuza, i-leukemia yinto eqhelekileyo, kubangelwa ubuninzi beentlanzi ezintathu ezisemncinci kwiminyaka eselula.
> Iiseli ze-leukemia emnzini wethambo zingenza iiselm zegazi ezimhlophe ezingavamile.
Yintoni i-Leukemia?
I-leukemia ngumhlaza weeseli ezenza igazi-ezo iiseli zomzimba eziqhubekayo zinikezela ngokubonelela ngeeseli ezibomvu negazi ezimhlophe, kunye neeplatelets ezenza igazi lakho livale. Uhlobo lwe-leukemia umntu uthembele ngokuthe ngqo kwindlela yokwenza igazi eyenziwe yilezi apho i-leukemia iphuhlisiwe.
I-leukemia iqala emnzini wethambo-i- spongy, isahlulo sangaphakathi samathambo athile apho iiseli ezenza igazi zifunyanwa ngobuninzi.
Iiseli ze-leukemia emnzini wethambo zikhokelela kwimveliso yamaseli e-white white engafanelekanga, enokufunyanwa kwigazi, ebizwa ngokuba ngumjikelezo wendawo . Ngamanye amaxesha kwi-leukemia, iimvavanyo zegazi zingabonisa ukuba zininzi iiseli zegazi ezimhlophe kunye namanani aphezulu eeseli zegazi zakuqala okanye ezingaphantsi kwegazi.
Ngamanye amaxesha, kunokuba neenombolo eziphezulu zeeseli ezenza igazi ezaziwa njengezikhupha ngaphandle kwegazi. Iiseli ze-leukemia zingalimaza iiseli eziqhelekileyo ezenziwe ngegazi emnzini wethambo, ezibangele amanqanaba angaphantsi-aqhelekileyo amaseli egazi abomvu, iiseli zegazi ezimhlophe kunye neeplatelets kwigazi lomda.
Ukunqongophala okunjalo kunokubonakala kwiimvavanyo zegazi, kwaye kunokubangelwa neempawu.
Ukuqonda iintlobo zeeukemia
Iintlobo ezine eziphambili ze-leukemia zi:
- I-acute lymphoblastic leukemia (YONKE)
- I-leukemia (i-AML)
- I-lymphocytic leukemia (CLL) engapheliyo
- I-leukemia engapheliyo ye-myelogenous (CML)
Igama ngalinye, njengoko ubonayo, libonisa ukuba umhlaza uthathwa njenge-acute leyemia.
- I-leukemia eqhelekileyo iqhubela phambili ngokukhawuleza ngaphandle kwonyango.
- I-leukemia engapheliyo iyaqhubeka ihamba kancane. Nangona kunjalo, i-leukemia engapheliyo, inokuba nayo inokuthi 'ishintshe' ibe yi-leukemia enobudlova.
I-leukemia ekhangelekileyo, njenge-ALL and AML, ithuthuka ukususela ekuqaleni, i-immlast blasts. Ezi iiseli ezenza igazi aziyeki ukwahlula xa ukuqhuma okuqhelekileyo kuya kuvela, kwaye ukukhula kunye nokunyuka kwexesha kubonakala kunokukhawuleza kunokuba kune-leukemia engapheliyo.
Ngakolunye uhlangothi, i-leukemi esingaqhelekanga njenge-CLL kunye ne-CML, ngakwelinye icala, ivela kwiiseli ezenza igazi ezivuthiwe xa zifaniswa nokuqhuma, nangona zihlala zingavamile. Ukuhlolwa kwegazi kubantu abanalo leukemi kungabonisa ukuba bambalwa okanye akukho ukukhanya kweeseli ezijikelezayo.
Ezi khansela zivame ukukhula ngokuthe ngcembe kuneeukemi.
Yintoni eyenza i-Leukemia Syelogenous okanye iLymphocytic?
Ukongeza kwinto enzima okanye engapheliyo, kubalulekile nokuba i-leukemia iyimilenze okanye i-lymphocytic kuba oku, kunokukunceda ukuqikelela ukuba umhlaza uza kuziphatha njani kwaye ungcono kangakanani ukuwuphatha .
Ukuze uqonde ukuba lithetha ukuthini le migaqo, ufuna umboniso omfutshane wendlela umzimba wakho ngokuqhelekileyo wenza ngayo amatsha eeseli ezitsha ukuba athathe indawo yabantu abadala abafa okanye baphelelwe yile:
Ngokuhlukileyo njengoko kunjalo, onke amangqamuzana ebomvu namhlophe amhlophe avela kwinto efana neseli 'esikhulu senkokheli', ebizwa ngokuba yi- hematopoietic stem cell, okanye i-HSC . Unayo i-HSC emininzi yamathambo akho kunye nabanye kwigazi lakho, ngokunjalo.
Ukususela kwi-HSC nganye, 'izizukulwana' ezininzi zeeseli ezenziwe ngegazi zivela kwinqaku, ngokuhlukana kweeseli, ekugqibeleni zivelise iintlobo eziqhelekileyo zeselununu ezivuthiweyo ezifumaneka kwigazi lomntu. Isizukulwana ngasinye sihamba phambili ekuvuthweni, isizukulwana esilandelayo siphuma ngokukhawuleza.
Iiseli ezivela kwizizukulwana ezahlukileyo zinikezwa ngamagama ahlukeneyo, njengama-progenitors okanye abaphambili, kuxhomekeke kwindlela ekude ngayo kwi-HSC 'kwintsapho' oya kuyo.
Njengoko uqhubela phambili ngexesha, kude ne-HSC, ungaqala ukuxelela ukuba yeyiphi 'intsapho' iseli elenza igazi.
Iintsapho ezimbini ezivelele kwintsapho zineentsapho ze- lymphoid kunye nezindwendwe . Imigaqo eyahlukeneyo isetyenziswa ukubhekisela kwintsapho efanayo; Ngokomzekelo, i-lymphoid kunye ne-lymphocytic, ne-myeloid ne-myelogenous.
- I-Lymphocytic ibhekisela kwintsapho ekugqibeleni ivelisa i-lymphocyte yabantu abadala, iqela leeseli ezimhlophe zegazi.
- I-Myelogenous ibhekiselele kwintsapho ekugqibeleni iphakamisa iiseli zegazi ezibomvu, izisele zegazi ezimhlophe ezingezona i-lymphocytic-kuquka neutrophils, umzekelo-kunye neeseli ezenza iiplatelet zakho, ezibizwa ngokuthi i-megakaryocytes, ezenza igazi liguqulwe.
Kwi-leukemia, umhlaza ukhula kwiseli leyo yindawo ethile emva 'kwintsapho' yamathambo egazi amatsha. Iisampula eziqulethe iisukemia, kuquka iisampula zegazi kunye ne-biopsy, zihlalutyiwe kwibhubhoratri ukuze zichonge ukuba iiseli zomhlaza zithengiswayo okanye zi-lymphocytic.
Yintoni Ebangelwa Abantu Ukufumana I-Leukemia?
Kwiimeko ezininzi, izazinzulu azizi kakuhle indlela i-leukemia eqala ngayo.
Kodwa ngenxa yeentlobo zeengcambu ze-leukemia, iziganeko zengozi ziye zachongwa. Imiba yengozi ziqhagamshelwano eziza kunceda oososayensi baqonde kakuhle isifo kunye nophuhliso lwayo. Nangona kunjalo, ngenxa yokuba unomngcipheko ongekho kuthetha ukuba uya kuvelisa eso sifo.
Kwimeko kwinqanaba: Kwi-AML, kufumaneka izixhumanisi ezilandelayo, kodwa abaninzi abantu abafumana i-AML abanalo mngcipheko:
- Ukutshaya
- Ukutshatyalaliswa kwexesha elide kumazinga aphakamileyo e-benzene, ikhemikhali efunyenwe kumsi wesigare kunye nokusetyenziswa kwamashishini athile
- Uphuhliso lwangaphambili ngezilwanyana ezithile zeyeza
- Amanqanaba aphakamileyo emitha
- Iimeko ezithile zofuzo zikhoyo xa zizalwa
- Ukuba nelungu losapho olusondeleyo olufumana i-AM
Amanqanaba aphakamileyo emisebe edibeneyo adibeneyo nakwi-ALL and CML. Imbali yentsapho nayo iya kudlala kwezinye iimeko, njengeCLL.
Iziganeko eziqhelekileyo zeLukemia
Iimpawu ze-leukemia ziphazamisekile kwezinye iimeko kwaye zingabikho kwamanye abantu, esiyaziyo akuthuthuzeliyo. Baya kufika ngokukhawuleza okanye ngokukhawuleza. Ngamanye amaxesha iimpawu kunye neempawu zokuqala zingenangqiqo, ezifana neempawu ezifana nomkhuhlane kunye nokukhathala, okanye zibandakanya ukusuleleka kwezifo. Nangona kunjalo, i-leukemia ingahlakulela ngakumbi ngokucacileyo kwaye ibe neempawu ezicacileyo. Iimpawu zokubheka ziquka ezi zilandelayo:
- Fever
- Izifo ezifayo
- Ukuqhwala okanye ukuphuma
- Ukukhathala
- Ubuthathaka
- Ukungathobeli ukuvuthwa ngokomzimba
- Iintlungu zesisu okanye ukuzaliseka
- Ukulahlekelwa kwesisindo esingenziyo
- Ukwandiswa kwe-lymph nodes ipere kunye / okanye isibindi
- Intlungu yesifo
Iintlobo eziqhelekileyo ze-leukemia zingavelisa iimpawu ezifana neenthambo kunye nentlungu edibeneyo, umkhuhlane , ukukhupha ebusuku, ukukhathala, ubuthathaka, isikhumba esiluhlaza, ukuphuma okulula okanye ukunyakaza , ukulahlekelwa kwesisindo, kunye nabanye, kubandakanywa ne-lymph nodes, i-spleen, nesibindi.
Iimpawu ze-leukemia ezifana nokuziva udinwe kakhulu kwaye unobuthakathaka, xa ukususela kwi-cells ebomvu yegazi, okanye ukuphazamiseka kwegazi , kunokubonakalisa ukuba umthambo we-bone ophilileyo uthatyathwe ngamaseli e-leukemia.
Iimpawu zohlobo olulodwa lwe-leukemia
Ngamanye amaxesha, uhlobo oluthile okanye i-subset ye-leukemia inokuba nesifo okanye uphawu lweempawu ezingaqhelekanga kwezinye iintlobo ze-leukemia.
Ngokomzekelo, i-leukemia ekhangeleleneyo, i-subset ye-leukemia enesifo esiyingozi , inezibonakaliso ezithile zobomi begazi kunye nokugqithisa, ngaphezu kweempawu eziqhelekileyo ezingezona i-leukemia.
Kwi- acute lymphocytic leukemia , eyona nto ibetha abantwana, i-leukemia ingangena emzimbeni ojikeleze ingqondo kunye nomgudu womgudu, ukuvelisa iimpawu ezinxulumene nezifo ezinjengentloko, umbono ogqabileyo, ukuhlanjululwa kwesantya, nokuhlanza (ngaphezu kweempawu ezingezizo ezithile).
Kwi- leukemia engapheliyo ye-myelogenous , ubuninzi beepesenti ezingama-40 zezigulane abanakho iimpawu kuzo zonke, kwaye ukuxilongwa kulandelelwano oluqhelekileyo okanye ukutyelela enye inkxalabo.
I-Leukemia Diagnosis
Xa iimpawu, iziphumo zeemvavanyo zenyama, imbali yonyango kunye nezinye izikhombisi zibonisa ukuba i-leukemia yinto enokwenzeka, iintlobo ezahlukeneyo zovavanyo zingasetyenziselwa ukuxilongwa ngokusemthethweni. Iimvavanyo zegazi kunye neemvavanyo zomnatha weethambo zifunwa ngokubanzi ukuqinisekisa isi sifo, kunye neempompo zomgudu zenziwa kwezinye iimeko. Iimvavanyo zegazi kunye neemvavanyo zomnatha zethambo nazo zinceda ekufumaneni i-AML, YONKE, i-CML kunye ne-CLL subtypes. Iimvavanyo ezisuka kwamanye amasayithi nazo zinokuthathwa ukunceda ukuhlola i-leukemia kunye nokukunceda ukukhokela unyango.
Uvavanyo lweGazi
Inani elipheleleyo legazi, okanye i- CBC , libandakanya ukubala ngokuzenzekelayo kweeseli zegazi kwiindidi ezahlukileyo ukuchonga ukuba ngaba amanani akho awela kwibala eliqhelekileyo okanye elingavamile. I-CBC idla ngokuqhutywa kunye nokubala 'okuhlukileyo', okuza kubonelela ngenani leentlobo zeeseli, njenge-neutrophils kunye ne-lymphocyte, phantsi kwe-ambuland elithi 'i-white cell cell'.
I- blood smear inikezela ngokubhekiselele: Kuyenziwe ukuvavanya iiseli zegazi ezincinci, ngokuphindaphindiweyo emva kweCBC enekhampani eyahlukanayo ibonisa ukuba iiseli ezingaqhelekanga okanye ezifayo zikhoyo. Kwi-smear yegazi, iiseli ezifayo kunye nokungaqhelekanga ziyakwazi ukubonakaliswa kwindlela enokwenzeka ngayo ngokubonakala kwazo ezincinci.
Ukuxilongwa kokuqala kunye nokuvavanya kufaka nezinye iimvavanyo zegazi, ezifana negazi, ukujonga iingxaki ze-leukemia ezinokwenzeka kwezinye iziko, umzekelo.
I-Bone Marrow
I-biopsy yinkqubo apho isampuli yamaseli isuswa emzimbeni ukuze kuphinde ifundwe. I-bone marrow biopsy ngokuqhelekileyo iqala ngomnxeba wethambo, apho inani elincinci lomkhuhlane lomncuba lithathwa kwisirinji. Emva koko, ngenxa ye-biopsy ngokwayo, inaliti enkulu ixhomekeke ngokunyakaza okukhenkcelayo kwisithambo (ngokuqhelekileyo i-hipbone) ukufumana isampula encinci, yomlenze wesibhakabhaka. Iimvavanyo ze-Biopsy zivavanywa ngumhlaza wezilwanyana kwaye ziqhubeke nokuhlolwa kovavanyo lweebhoratri. Ngokuxhomekeke kuhlobo lwe-leukemia olukhankanyweyo, i-biopsies kwezinye iisayithi, ezinjenge-lymph nodes, inokubandakanyeka.
I-Lumbar Ukutshintshwa / Umtya we-Spinal Tap
Ukugqitywa kwesibhakabhaka okanye umpompo ongeyomnxeba ungenziwa ukuze uhlolisise i-leukemia. Ngaphantsi kwe-anesthetic yendawo, inaliti efakwe kwindawo yempuphu ukufikelela kumanzi ojikelezayo kwaye uhlambe umgudu; isampuli yomlambo ikhutshwe, kunye naliphi na iiseli ze-leukemia ezikhoyo. I-pathologist iphinda ihlalutye le mveliso.
Ukuhlolwa kweGenesis yeeCells Cancerous
Iimvavanyo ze-Genetic zisoloko zenziwa kwiiseli ezingaqhelekanga njengenxalenye yokuxilongwa nokuvavanya i-leukemia. Uhlalutyo lwe-Cytogenic lubhekisela kwimvavanyo ehlola utshintsho kuma-chromosomes weeseli ze-leukemia. Ukutshintshwa kwezinto ezithile kunye nokulungiswa kwemvelo kwakhona kunceda oogqirha baxelele ukuba ukuziphatha kakubi kungaziphatha njani.
Imizobo kunye nokuTyekisa
Ngamanye amaxesha ukucinga kweengcamango kuthatha indima ekuncedeni oogqirha ukuba bafumane iiseli kwinxalenye ethile yomzimba nge-biopsy, okanye ukufumanisa ukuba i-lymph nodes okanye ezinye izitho zandisiwe.
Ukuxilongwa kweentlobo ezahlukeneyo ze-Leukemia
I-AML ifunyaniswa ngethambo lomongo we-biopsy kunye nohlalutyo lwebhubhoratri lwamaseli e-bone. I-AML ngamanye amaxesha ingasasazeka kwintsholongwane ejikeleze ingqondo kunye nomthambo womgudu, ngoko ke oogqirha banokwenza i-lumbar patch or spinal tap ukuze kubekho uhlalutyo oluhlalutyo. Iimvavanyo zisetyenziselwa ukutyhila imbonakalo yemfuza ye-AML, kubandakanywa iimpawu ze-chromosomal kunye neentsholongwane ezithile kunye neenguqu zofuzo.
I-CLL ifumaneka ngamaxesha amaninzi kubantu abangenazo iimpawu. I-CLL inokuthi ithathelwe ingqalelo njengesifo sokuxilongwa xa umntu omdala enexabiso eliphezulu lymphocyte, okanye ukuphakama ngenxa ye-lymphocyte eyongezelelweyo. Izibalo eziphezulu ze-lymphocyte nazo ziyakwenzeka kunye nezinye, iimeko ezingekho komhlaza ezifana ne-infectous mononucleosis kunye ne-pertussis, nangona kunjalo; nazo zenzeka kwezinye iisetyana zegazi.
Kwezinye iimeko ze-CLL, iimvavanyo zegazi zanele ngokwaneleyo ukuxilongwa, kodwa ukuvavanya umongo weethambo kunceda ukuxelela indlela ephambili ngayo, kwaye iimvavanyo zomnatha wee-bone zenziwa rhoqo ngaphambi kokuba unyango. Kwezinye iimeko ze-CLL, inxalenye ye-chromosome ingase ilahleke , enokuchaphazela umbono, ngoko ukuhlolwa kofuzo kweeseli ezingaqhelekanga kubalulekile.
I-CML , njenge-CLL, isoloko ixilongwa phambi kokuba umntu unempawu. I-CML ingaqale ikhunjulwe ngokuchonga iziphumo zayo eziqhelekileyo egazini ize ithole amathambo. Uninzi lwezigulane ezine-CML zininzi zamaseli egazi ezimhlophe kunye neeseli ezininzi ezifayo kwigazi labo. Ngamanye amaxesha izigulane ze-CML zinamanani aphantsi amaseli obomvu okanye iiplatelet zegazi. Ezi ziphumo zingabhekisela kwi-leukemia, kodwa ukuxilongwa ngokuqhelekileyo kufuna olunye uphando lwegazi okanye uvavanyo lomongo we-bone ukuze uqinisekiswe.
Kubantu abanomdla we-CML, umongo wethambo usoloko ungumngcwabo ophezulu, oku kuthetha ukuba unamaseli aphindaphindiweyo egazi kunokuba kulindeleke kuba uzele iiseli ze-leukemia. Olunye uhlobo lweemvavanyo zemizimba yeeseli ezingavumelekanga zenziwa ukujonga i-chromosome yeFiladelphia kunye / okanye i-gene-BCL-ABL.
BONKE abaqhelekanga ukuba baxilongwa ngaphandle kokuhlola umongo wethambo. Uninzi lwabantu abaneZONKE baninzi kakhulu amangqamuzana egazi abamhlophe egazini lawo, kwaye awanalo iiseli ezibomvu okanye iiplatelet. Uninzi lweeseli zegazi ezimhlophe ziya kuba lymphoblasts okanye ukuqhuma. Ezi i-lymphoblast zi-lymphocytes ezincinane ezingasebenzi ngokuqhelekileyo. Njengama-AML, ekubeni bonke BANINGA basasazeka kwingingqi ejikeleze ingqondo kunye nomtya wokugcoba, umbane ohlamba ezi ziko angathathwa sampulu nge-puncture or tap or tap. Nje ngezinye iintlobo ze-leukemia, iimvavanyo ezizodwa zibonisa iimpawu zeeseli ezingaqhelekanga ukukunceda ukufumanisa i-diagnostic and leukemia subtypes. Ngokomzekelo, esinye isicampu se-sampuli siphendukela iinxalenye zeeseli ezimnyama ukuba ziyii-cell ze-AML kodwa kungenjalo ukuba ZONKE iiseli.
Ukuhlolwa kwe-Chromosome kunendima e-AML kuba, njenge-CML, abanye abantu abane-ALL bahlaziywa kwiikhamosomes zabo ezikhokelela kwi-chromosome yaseFiladelphia. Phantse iipesenti ezingama-25 zabantu abadala kunye NONKE banalo okungaqhelekanga kwiiseli ze-leukemia.
Ngezantsi ziqikelelo zeenombolo zoluhlu olutsha lwe-leukemia eUnited States ngamnye ngonyaka:
- 19,950 amatyala amatsha e-AML
- Amatyala amatsha angama-18 960 a-CLL
- Amatyala amatsha ayi-8,220 we-CML
- 6,590 amatyala amatsha
Ngexesha lokujonga uDokotela wakho
Ufanele wenze ukuqeshana nodokotela wakho ukuba unayo nayiphi na imiqondiso okanye iimpawu eziqhubekayo ezikukhathazayo. Iimpawu ze-leukemia zingabonakali kwaye zingabalulekanga. Kwezinye iimeko, i-leukemia ifunyanwe ngexesha leemvavanyo zegazi ezenzelwa esinye isizathu.
Ekubeni ezininzi iimpawu ze-leukemia nazo zibonakalisa iimpawu eziqhelekileyo (kwaye, kwezinye iimeko, ubuncinci malunga nokugula), kubalulekile ukuba ungakhathazeki. Ukusebenza nogqirha wakho kunokukunceda ukufumana iziphumo okanye izibonakaliso zomzimba wakho kumxholo, ukuvumela ukuqwalaselwa ngokucophelela kwamanyathelo alandelayo afanelekileyo.
ILizwi
Ukuxilongwa kwe-leukemia kunokubeka ihlabathi lakho. Ingaba nguwe, othandekayo, okanye mhlawumbi wakho umntwana, i-leukemia yinto yokufumanisa ukuba akukho mntu ulungele. Yazi ukuba ngokuqhelekileyo uzive ukhululekile.
Imfundo yinyathelo lokuqala, kwaye kuya kukunceda ukuba uthathe uhambo lwakho lomhlaza. Phantse kuzo zonke iimeko, kukho inkqubo yokuphulukana nayo kufuneka iyenze-enye engaveli kwi-bag ye-IV, ipilisi, okanye ukumpontshelwa igazi.
Yisebenzise uluntu kunye nezibonelelo. Funda kubantu abahamba ngeembadada zakho. Yazi ukuba awukhe wedwa, nokuba ngamanye amaxesha uvakalelwa ngathi unjalo. Yaye, qho ukubuza imibuzo.
> Imithombo:
> I-Leukemia & Lymphoma Society. https://www.lls.org/sites/default/files/file_assets/understandingleukemia.pd
> INational Cancer Institute. I-Leukemia - I-Health Professional Version (PDQ). http://www.cancer.gov/types/leukemia/hp