Izibonakaliso nezimpawu ze-leukemia kanye nezinye izifo zomdlavuza wegazi zingacacile futhi zingase zifane nezinye izimo eziningi ezingathí sina. Kubaluleke kakhulu ukuthi udokotela abe nokuhlonza okuqondile ukuthi:
- Ukubikezela ukuthi lesi sifo sizoqhubeka kanjani
- Hlela ukwelashwa okuphumelela kakhulu
Ngokujwayelekile, lapho umuntu ebonisa izimpawu noma izimpawu ze-leukemia, adluliselwa kuchwepheshe we- hematology / oncology .
Lokhu kuzoba udokotela ozonquma ukuxilongwa, kanye nokuhlela noma yikuphi ukwelashwa okungadingeka. Ezinye izinhlobo ze-leukemia ziyashesha kakhulu ukukhula futhi zingabhekwa, kuyilapho ezinye zidinga ukwelashwa okusheshayo. Eminye yemibuzo eyisisekelo ongase ufune ukuyibuza udokotela wakho kuyokusiza ukuthi uqonde ukuthi yini elandelayo, isibonelo: Ingabe uhlobo lwami lwe-leukemia lungenzeka ukuthi luqhubeke ngokushesha? Yeka ukuthi isabela kanjani uhlobo lwami lwe-leukemia okungenzeka lubekwe ezithombeni ezitholakalayo? Ngingumkhethi wezovivinyo zomtholampilo, kanti ungangincoma yini kimi? Kungani noma kungani?
Ukubona i-Leukemia
Ukuhlolwa ngokomzimba kanye nomlando wezokwelapha: Umlando kanye nomzimba kuyisici sokuqala ekuxilongweni kwe-leukemia. Lapho abahlinzeki bezempilo bebona isiguli esagcina sithola ukuthi une-leukemia, cishe kuyoqala njalo ngokuhlolwa ngokomzimba nomlando wezokwelapha. Bazoba nesithakazelo sokwazi imininingwane mayelana nanoma yiziphi izimpawu ozobhekana nazo futhi bazokwenza ukuhlolwa okuphelele kwekhanda kuya kweyodwa.
Izinhlobo ezahlukene ze-leukemia zingase zihlotshaniswe nokuthola okuhlukile ekuhlolweni ngokomzimba. Ngezinye izikhathi kungase kube nezibonakaliso zokugaya okungavamile noma ukulimala. Ngezinye izikhathi kungase kube nokwandiswa kwezitho ezithile ezithile njengebindi noma ipeni. Ngesinye isikhathi kungase kube khona izibonakaliso zangaphandle ze-leukemia ukuthi udokotela angakwazi ukuyihlola ekuhloleni ngokomzimba.
Kunoma yikuphi, izifo eziningi zingabonakala njenge-leukemia, ngakho-ke ukuxilongwa kwe-leukemia kudinga ukuhlolwa okwengeziwe.
Umsebenzi wegazi: Igazi livame ukuthathwa lisuka emthanjeni engalweni yakho bese lithunyelwa ebhokisatri kuma-tubes wokuhlola. Ama-sampuli ahlolwe bese amangqamuzana ahlolwa ngaphansi kwe-microscope. Ukuhlolwa kwegazi okuvamile kwe-leukemia kuhlanganisa:
- Gcwalisa i-Blood Count (CBC): Ukuhlola ukukala amazinga amangqamuzana abomvu, amangqamuzana amhlophe, namaplatelets emzimbeni kanye nendlela amangqamuzana abukeka ngayo.
- I-Peripheral Blood Smear: Amangqamuzana egazi adayiwe futhi abukwa ngaphansi kwe-microscope ukuze kube khona amangqamuzana "aqhuma" amancane.
Ukufingqa Kwe-Basic Leukemia Imiphumela Yomsebenzi Wegazi : I-leukemia efanayo ingabangela ukutholwa okuhlukile ekuhlolweni kwegazi ezincane kumaphuzu ahlukene phakathi nenkathi yesifo, kodwa lapha kukhona okutholwa okujwayelekile okujwayelekile kwe-CBC ngayinye yezinhlobo ezine eziyinhloko ze-leukemia .
Izifo | Imiphumela ye-CBC | Imiphumela ye-Blood Smear |
I-Acute Myelogenous Leukemia (AML) | • Inani eliphansi kunezinto ezivamile zamaseli abomvu namaplatelet | • Amakhulu amangqamuzana amhlophe amhlophe |
I-Lucphocytic Acute Leukemia (YONKE) | • Inani eliphansi kunezinto ezivamile zamaseli abomvu namaplatelet | • Amakhulu amangqamuzana amhlophe amhlophe |
I-Chronic Myelogenous Leukemia (CML) | • Ukubala kwesibalo segazi esinciphile kunciphile futhi isibalo samhlophe segciwane livame ukuphakama kakhulu | • Kwangathi angabonisa amanye amangqamuzana amhlophe |
I-Lymphocytic Leukemia (CLL) engapheli | • Amaseli abomvu nama-platelet angase ahle noma anganciphisi | • Amangqamuzana amhlophe amancane noma angenawo amhlophe |
Ukuhlolwa kwe-Bone Marrow : Ngokuvamile, ukwaziswa okuhlinzekwe ngegazi okusendaweni yakho akukwanele ukuqhubeka ngokulandela ukuxilongwa kanye nokwelapha okungenzeka. Amaseli egazi ekusakazeni kwakho konke akhiqizwa emzimbeni wakho "wegazi cell factor," i-bone marrow. Udokotela wakho angase ancoma inqubo ukuthola isampula somnkantsha osuka ku-hipbone yakho. Lokhu kuyaziwa ngokuthi i-bone marrow biopsy, futhi umnyoba wethambo ususwe usebenzisa inaliti ende, encane. Emnothweni wethambo, kungabikho kokubili amangqamuzana enempilo ayenzayo egazi kanye namaseli we-leukemia, evame ukuhluka okungafani.
Ukuhlolwa okukhethekile kwamangqamuzana akho e-leukemia kungabonisa izimpawu ezithile ezisetshenziselwa ukunquma izinketho zakho zokwelashwa.
Ukuhlolwa kwe-Spinal Fluid (I-Lumbar Puncture): Udokotela angase akhethe ukuhlola umthamo ojikelezayo ngentambo yomgogodla ukucacisa ukuthi kukhona yini amaseli we-leukemia akhona. Lokhu kuhlolwa, okubizwa ngokuthi i-lumbar puncture (noma "umgogodla womgogodla") kungenziwa ehhovisi likadokotela noma emtholampilo.
Phakathi nale nqubo, udokotela uzoba nesiguli ngecala lakhe, noma abeke bona bathembele phambili etafuleni ngakho "bazingelwa" ngaphezulu. Udokotela uzobe ehlanza indawo phezu komgogodla, futhi asebenzise inaliti encane ukuletha imithi yokwehlisa isayithi. Khona-ke, inaliti ende ifakwa ngemuva, phakathi kwama-vertebrae, nasendaweni ehambisana nomgogodla. Olunye uketshezi luzoxoshwa bese luthunyelwa ebhodini ukuze kuhlaziywe okunye.
Ngokuvamile, udokotela uzoba nokuphumula kwesiguli endaweni efanayo ngesikhathi esifushane kulandela inqubo.
I-Leukemia Isiteji
Ukugxilonga kubhekisela ohlelweni odokotela nodokotela bama laboratory abazama ukuhlukanisa ngayo i-leukemia yakho. Ngokuvamise emdlalweni wesifo somdlavuza, kunesilinganiso esithile sokuthi lesi sifo sisakaze kangakanani, noma kunjalo, i-leukemia ijwayele ukukhulunywa kancane kancane. Izinhlobo ezahlukene ze-leukemia zihlukaniswa, noma zihlelwe, ngokuhlukile, futhi.
Kungenzeka ukuthi uke wazwa uhlelo oluthile olusetshenziselwa ukuqhutshwa komunye uhlobo lomdlavuza-isibonelo, "unomdlavuza we-colon IV," noma "unesifo somdlavuza wesifuba sesigaba se-III," njll. Le ndlela yokubala isetshenziselwa ukuchaza izinhlobo eziningi yomdlavuza kanye nesibonelo sokusabalalisa kuwo wonke umzimba, kodwa angasetshenziswa kangako emacaleni e-leukemia angenzi ama-tumor aqinile.
Ukuze uthole i-lymphocytic leukemia , noma i-CLL , odokotela abaningi basebenzisa uhlelo lwe-Rai. Lolu hlelo lungase lube uhlobo oluhlukile, ngoba lubonakala luseduze nalokho okwenzeka eminye imikhakha yomdlavuza. Izitebhisi zithembele ngokuyingxenye ekusakazeni kwezinye izitho, isibindi, nesipere. Izigaba ze-Rai zibalwa ngo-0 kuya ku-IV futhi zingahlukaniswa ngezigaba eziphansi, eziphakathi neziphezulu.
Ukuze uthole i-lymphocytic leukemia , noma i-ALL, noma kunjalo, isiteji asikwenzi ngale ndlela, futhi ngokuvamile lesi sifo asifaki izixuku ezithintekayo ezikhula ngokweqile. KONKE izosakazeka kwezinye izitho ngisho nangaphambi kokuba itholakale, ngakho kunokusebenzisa izindlela zesitayela zendabuko, odokotela bavame ukuba nesigatshana se-ALL kanye nesiguli sonyaka. Lokhu kuvame ukubandakanya ukuhlolwa kwe-cytology, i-cytometry yokugeleza kanye nezinye izivivinyo ze-lab ukukhomba i-subtype YONKE.
Ngokufanayo, i-myelogenous leukemia noma i-AML lesi sifo ngokuvamile ayitholakali kuze kube yilapho isakaze kwezinye izitho, ngakho-ke umdlavuza wendabuko awudingi. I-subtype ye-AML ihlukaniswa ngokusebenzisa uhlelo lwe-cytological (amaselula). Kunezinhlelo ezihlukahlukene zokusekela ezisetshenziswayo. Esikhathini sohlelo lwesiFulentshi-American-British (FAB), i-AML ihlukaniswa ngamasentimitha angu-8, i-M0 nge-M7. I-World Health Organization (WHO) ithuthukise uhlelo oluhlukile lwe-AML stage ezama ukucacisa ngokucacile ukubikezela (umbono).
Ukuze uthole i-myeloid leukemia engapheli (CML), udokotela wakho uzohlola ukuhlolwa kwegazi kanye namathambo omnyo ukucacisa inani lamaseli aphethwe. Kunezinyathelo ezintathu ze-CML: ezingapheli, ezisheshayo futhi ezisezingeni eliphezulu . Isikhathi esingaphansi kwesigaba sokuqala se-CML. Iziguli eziningi ze-CML zixilongwa ngesikhathi se-CML ezingapheli uma kungase kube nezimpawu ezincane, ikakhulukazi uzizwa ukhathele noma ulele phansi. Uma i-CML ingalinganiselwe empilweni yayo yokwelapha ngesikhathi sesigaba esingapheli, ingaba nobudlova, okungaholela esigabeni esisheshayo. Njengoba i-leukemia yomuntu iqhubeka isigaba esheshayo, izimpawu zingase zivelele kakhulu. Isigaba esihlukumezayo kakhulu sibhekwa ngokuthi yi-CML, noma inhlekelele yokuqhuma. Lesi sigaba sibonakala ngokutholakala kwamangqamuzana amaningi angama-blood-forming-amaphesenti angu-20 noma ngaphezulu ahlanganisa ama-myeloblasts noma i-lymphoblasts-emathangeni abo noma egazini, futhi izimpawu zifana nezomdlavuza we-myeloid acute.
Imibuzo Yokubuza Udokotela Wakho
Izivivinyo nezinqubo zingasabisa uma ungaqiniseki ukuthi yini ongayilindela. Ungase ufune ukubhala phansi imibuzo ecela ukusiza ukulungiselela. Ezinye izibonelo zemibuzo ongase ufune ukubuza umhlinzeki wakho wezempilo:
- Ukuhlolwa lokhu kuzokwenziwa kuphi?
- Iyiphi inqubo yalesi sivivinyo?
- Ngidinga ukuletha othile nami?
- Ngidinga ukuzila ukudlala?
- Ngikwazi yini ukubuyela emsebenzini emva kokuhlolwa?
- Kuzothatha isikhathi esingakanani ukubuyisela imiphumela?
- Ngizothola kanjani imiphumela?
- Kufanele ngilindele noma yimiphi imiphumela emibi evela kuloluvivinyo?
- Ingabe lolu luhlolo luyobe luhlanganiswe uhlelo lwami lwezempilo?
Zizwa ukhululekile ukuthatha amanothi kuyilapho umhlinzeki wakho wezempilo ephendula imibuzo yakho. Baphendule imibuzo yakho ngendlela ehlukile uma ungaqondi. Ithimba lakho lizokufuna ukwazi kahle ngaphambi kwanoma iyiphi inqubo.
Ukuzinakekela Wena
Uma wena noma ingane yakho ihlolwe i-leukemia, lokhu cishe yisikhathi esesabekayo nesicindezelayo empilweni yakho. Ungase ungaqiniseki ngekusasa, ukhathazekile ngokuthi kuyothinta kanjani ukuxilongwa kwe-leukemia emndenini wakho. Ngaphezu kwalokho, ungase uzizwe ungaphili kahle ngokomzimba.
Nakuba kungenakwenzeka ukukhohlwa konke ukucindezeleka ongaphansi kwakho, kubalulekile ukuzivumela isikhathi esithile sokuthula, sokucabanga usuku nosuku lokwenza izinto ezikuthokozisa. Kungenzeka ukuhamba ekukhanyeni kwelanga, ukuxoxa nomngane omdala phezu kwekhofi. Noma yini eyokusiza ukuthi uphumule futhi uphinde uxhumane ne "omdala" wena. Mhlawumbe uzomangala ukubona ukuthi umzimba wakho uzizwa kangcono uma ingqondo yakho ikhululekile.
Izwi elivela
Uma usujwayele uhlelo lwesiteji somunye umdlavuza ongenayo i-leukemia njengomdlavuza webele noma umdlavuza wesifo sofuba, izigaba ze-leukemia zingase zingahumushi kahle ekuqaleni. Izigaba ze-leukemia ziyahlukahluka ngokusho uhlobo oluthile lwe-leukemia. I-white cell cell count at the time of diagnosis ngezinye izikhathi isetshenziselwa ukusiza isigaba segazi. Amanye amathuluzi, njengokwesimo se-CML ne-AML, afaka ukuhlaziya inani le-myeloblasts, noma amangqamuzana amhlophe egazi omhlophe, atholakala egazini noma ematheni.
Esinye sezihlukaniso eziyinhloko zokunaka ekuqaleni kungukuthi i-leukemia yakho ingumdlavuza wegazi ongapheli noma i-leukemia ephakeme. Izinhlobo ezingapheli ze-leukemia zingagcina zithuthuka futhi zibe nobudlova, noma kunjalo, igama elingapheli ngokuvamile libhekisela ekukhuleni okuqhubekayo nokuqhubekayo kunegama elibi.
Ngaphandle kwesigaba esiyisisekelo se-leukemia, amathegi amancane kakhulu noma "amaki" ngaphandle kwamangqamuzana e-leukemia akho angatholwa yizivivinyo zelabhu futhi ngokuvamile kubalulekile ekuchasweni futhi kuhlelwe phambili ngemuva kokuxilongwa. Iziguli ezimbili ezinesifo esifanayo sohlobo lwe-leukemia zingase zibe nokuhlangenwe nakho okuhlukile ngesifo, izimpendulo ezihlukene zokwelashwa, kanye nezibikezelo ezihlukile.
Okokugcina, i-leukemia yiyona eyingozi kunazo zonke ebuntwaneni, futhi izikhathi eziningi i- leukemia yengane ibhekwe njengelungu legazi elidala labantu abadala. Uma ufuna ulwazi ngenxa yengane ene-leukemia, qaphela ukuthi ngezinye izikhathi ukwelashwa nokuguqulwa kwegazi kuhluka phakathi kwamaqembu amabili, nakuba i-leukemia ingaba negama elifanayo.
> Imithombo:
> I-American Cancer Society. I-leukemia ihlolwe kanjani. 2017
> Caldwell, B. (2007). I-leukemias enamandla. Ku-Ciesla >, B >. (Umq.) Hematology in Practice (k. 159-185). Philadelphia, Pennsylvania: FA Davis Inkampani.
> Finnegan >, K. > (2007). Ukukhathazeka okungapheliyo kwe-myeloproliferative. KuCiesla, B. (Umhl.) Hematology in Practice (pp.187-203). Philadelphia, Pennsylvania: FA Davis Inkampani.
> I-Leukemia & Lymphoma Society. Ukuhlolwa kwegazi. 2017.