Kuthetha ukuthini ukuba unayo i-leukemia ye-promyelocytic (APL) eyiyo kwaye uphathwa njani?
Sibanzi
I-acute lemonemic leukemia (APL) i- subtype ye-lemonemic acute leememiagenous (AML) , umhlaza wegazi. Ungayiva kwakhona ekubhekiswe kuyo njenge M3 AML. KwiNyakatho yeMerika, i-APL iphendula malunga ne-10% yazo zonke iimeko ze-AML. E-Itali kunye nakwiindawo eMzantsi Melika, i-APL inokuthi ibone inani elinama-65% lamatyala.
Iyenzeka ngokufanayo kwintombi kunye namadoda, kwaye ubudala bokuqala buyiminyaka engama-40 ubudala.
Nangona ifana neendlela ezininzi kwezinye i-subtypes, i-APL iyahluke kwaye inenkqubo yonyango ekhethekileyo. Iziphumo zonyango ze-APL zintle kakhulu, kwaye ithathwa njengoluhlobo oluphilileyo lwe-leukemia. Amanqanaba okunyanga aphezulu njengama-90%.
I-Genetics ne-Acute Promyelocytic Leukemia (APL)
Ukungaqhelekanga kwemfuza okanye ukuguqulwa kwamanzi kwi-DNA yamaseli e-leukemia kukudluliselwa phakathi kwe-chromosomes 15 ne-17. Oku kuthetha ukuba inxalenye ye-chromosome 15 iyacima, kwaye ishintshaniswa nenxalenye ye-chromosome 17. Olu tshintsho lukhokelela ukuveliswa kweprotheni eyenza ukuphuhliswa kweeseli zegazi "kubambelele" kwisigaba se-promyelocytic, xa iiseli zegazi ezimhlophe zincinci kwaye zincinci.
Ziziphi i-Promyelocytes?
I-Promyelocytes iiseli eziwela kumgca ekuphuhlisweni kwelo hlobo lweeseli zamhlophe zegazi, kunye "neentsana" ziyi-myeloblasts okanye i-blasts, kwaye abantu abadala bayizi-myelocytes ezaziwa njenge-neutrophils, i-eosinophil, i-basophil, kunye ne-monocytes.
Iiseli ze-leukemia ze-Promyelocytic zingafaniswa nabantu abaselula. Bajonge njengabantu abadala, kodwa abanako ukufumana imisebenzi, ukuhlawula iibill, ukuqhuba imoto, okanye ukwenza imisebenzi yemihla ngemihla yabantu abaqolileyo. Ngokufanayo, iiseli ze-promyelocytic zegazi zingaphuthunyanga ukuba zenze iindima zeeseli zegazi ezimhlophe ngokugcwele emzimbeni.
Izimpawu kunye neMpawu
Izigulane nge-APL zibonisa ezininzi iimpawu ezifanayo nezinye iindidi ze-leukemia (AIM). Uninzi lweempawu ze-leukemia zibangelwa yintsholongwane yamangqamuzana "ekhupha" umongo wethambo kwaye iphazamise ukuveliswa kweeseko eziqhelekileyo zegazi, amaseli egazi ezimhlophe kunye neeplatelet. Le miqondiso kunye neempawu zibandakanya:
- Ukuba namandla angaphantsi, okanye ukuziva udele ngexesha lonke
- Ukuvakalelwa kukuphefumula xa wenza imisebenzi eqhelekileyo
- Isikhumba
- Iintsholongwane ezingachazwanga
- Ukongezwa kwexesha lokuphulukisa ukutywa kunye nemivimbo
- Amathambo okanye amanxeba aseAky
- Ubunzima "ukulwa" nezifo
Ukongezelela kule miqondiso ye-AML, izigulane ze-APL zibonisa ezinye iimpawu zompawu . Baza kubakho rhoqo:
- Unemiba enzima yokuphuma kwegazi efana nokuqhaqhaza, i-nosebleeds, igazi kumchamo okanye ukuhamba. Amantombazana kunye nabasetyhini abane-APL banokuqaphela ixesha eliqhelekileyo lokuya esikhathini.
- Ngelo xesha, kudla ngokungaqhelekanga, ukugqithisa ngokweqile igazi.
Iimpawu ze-leukemia zingabonakali kakhulu, kwaye zinokuba zizibonakaliso zezinye iimeko ezingekho komhlaza. Ukuba unenkxalabo malunga nempilo yakho, okanye impilo yomntu othandekayo, kuhlale kukulungele ukufuna iingcebiso zengcali yezobugcisa.
Unyango
Unyango lwe-leukemia ye-promyelocytic ye-acute (APL) ehluke kakhulu kuneyezinye iindidi ze-leukemia eqaqambileyo, ngoko ukuchonga ngokufanelekileyo kubalulekile.
Uninzi lwezigulane ze-APL ziphathwa ngokusesikweni kunye ne-transtinoic acid esebenzayo (i-ATRA), uhlobo oluthile lwe-vitamin A. I-ATRA yonyango iyingqayizivele kuba inyanzelisa iiselithi ze-lemonemic leukemia zivuthiwe, njengokufana nendlela iikholeji ezithweswa ngayo iikholeji ezithintela abantwana abaselula Ukuthelekiswa kwendima yabantu abadala (kakuhle, ubuncinci ngamanye amaxesha). Eli nqanaba lonyango libhekiselwe "njengokungeniswa."
Nangona i-ATRA ingafumana isigulane se-APL ekuxoxisweni ngokususa zonke iiseli ze-leukemia ukuba zikhule, ayikwazi ukuphilisa umthombo we-leukemia. Ngenxa yoko, iziphumo zexesha elide zonyango ziphucula xa oogqirha bongeza enye i- chemotherapy ejwayelekile.
Ubuso bonyango bubizwa ngokuba "ukuhlanganiswa."
Emva kwekhemotherapy, abantu bahlala beqhubeka kwi-ATRA ubuncinane ngonyaka, ngamanye amaxesha badibene namanye amayeza. Esi sigaba sokugqibela sonyango kuthiwa "ukugcinwa."
Ukuba i-leukemia ayiphenduli kwi-ATRA kunye ne-chemotherapy, okanye xa ibuya, i-APL inokuphathwa kwakhona nge-arsenic trioxide (ATO).
Prognosis
Unyango lwe-APL uphumelele kwininzi lamatyala.
Ukunyamezela kunye nenkxaso
Nangona i-leukemia ekhangayo i-promyelocytic ine-hormone ephawulekayo, ubuncinci ngokubhekiselele kwi-leukemia, "ukufika khona" kunokuba kunzima kwaye kunzima. Fumana kwiintsapho kunye nabahlobo . Ungakhathazeki ngokufuna uncedo kwaye ufumane uncedo kweli nqanaba ebomini bakho. Usenokumangaliswa kukuba akusikuncedi kuphela, xa abanye banceda, kodwa kubangela ukuba nabo babe nolonwabo. Hlola ezi ngcebiso malunga nokujongana ne-leukemia kunye ne-lymphoma .
Thatha ixesha lokufunda malunga nokusinda. Xa unyango lomhlaza luphela, kunokuba abantu baninzi baziva becinezelekile. Imiphumo engapheliyo yonyango kunye nexesha elichithwe kwi-coaster emotionary cancer of cancer ingakushiya ukuba uzibuze ukuba uya kuphinda uzive uqhelekileyo kwakhona. Cela uncedo, kwaye ungamkeli nje "entsha entsha". Kukho okuninzi okunokwenziwa ukuze kuncede abasindileyo bebele. Futhi ungakulibali ukuba, ngamanye amaxesha, okulungileyo kunokuvela kumhlaza. Izifundo ngokwenene zisitshela ukuba umdlavuza utshintsha abantu ngendlela efanelekileyo , kungekhona nje embi.
Imithombo
American Cancer Society. Unyango lwe-acute promyelocytic (M3) leukemia. Ukuhlaziywa 02/22/16. http://www.cancer.org/cancer/leukemia-acutemyeloidaml/detailedguide/leukemia-acute-myeloid-myelogenous-reating-m3-leukemia
Jurcic, J., Soignet, S., Maslak, P. Ukuxilongwa kunye nokunyangwa kwe-Acute Promyelocytic Leukemia. Imibiko yeOncology Current 2007: 9: 337-344.
I-Lemons, R., Keller, S., Gietzen, D., Dufner, J, Rebentisch, M., Feusner, J., Eilender, D. I-Promyelocytic Leukemia Journal of Pediatric Hematology / Oncology 1995. 17: 198- 210.
I-Sanz, M. Ukunyangwa kwe-Acute Promyelocytic Leukemia. I-American Society of Hematology 2006. 147- 155.
Wiernik, P., Gallagher, R., Tallman, M. "I-Acute Promyelocytic Leukemia" e-Wiernik, P., Goldman, J., Dutcher, J., Kyle, R., i-eds (2003) Iingxaki ze-Neoplastic Igazi- 4. I-New York: I-Cambridge University Press.