Kusho ukuthini uma unayo i-acute promyelocytic leukemia (APL) nokuthi uphathwa kanjani?
Sibutsetelo
I-acute promyelocytic leukemia (APL) iyinhlangano ye-acute myelogenous leukemia (AML) , umdlavuza wegazi. Ungase uzwe kuthiwa yi-M3 AML. ENyakatho Melika, i-APL ibamba cishe ama-10% kuwo wonke amacala we-AML. E-Italy nasezindaweni zaseNingizimu Melika, i-APL ingabonisa amacala amaningi angu-65%.
Kuyenzeka ngokulinganayo kwabesifazane nabesilisa, kanti iminyaka yobudala eqalayo ingu-40 ubudala.
Nakuba kufana nezindlela eziningi kwamanye ama-subtypes, i-APL ihlukile futhi inombuso wokwelashwa oqondile. Imiphumela yezokwelapha ye-APL inhle kakhulu, futhi kubhekwa njengenhlobo ephulukiswa kakhulu ye-leukemia. Amazinga okuphulukisa aphezulu kakhulu ngo-90%.
I-Genetics ne-Acute Promyelocytic Leukemia (APL)
Ukungajwayelekile komzimba noma ukuguqulwa okuvame ukubonwa kwi-DNA yamaseli e-leukemia kungukudluliselwa phakathi kwama-chromosomes 15 no-17 Lokhu kusho ukuthi ingxenye ye-chromosome 15 iyaqedwa, futhi ishintshwe ngengxenye ye-chromosome 17. Lokhu kuguquka kuholela ukukhiqizwa kwamaprotheni okubangela ukuthuthukiswa kwamangqamuzana egazi ukuba 'athandwe' esiteji se-promyelocytic, lapho amangqamuzana amhlophe egazi asemncane kakhulu futhi engapheli.
Yiziphi izithembiso?
I-Promyelocytes yizakhi eziwela emkhakheni ekuthuthukiseni lolu hlobo lwamaseli amhlophe egazi, "izinsana" eziba yi-myeloblasts noma ukuqhuma, kanti abantu abadala bayizi-myelocytes ezibizwa ngokuthi i-neutrophils, i-eosinophils, i-basophil, ne-monocytes.
Amaseli e-Promyelocytic leukemia angafaniswa nentsha yabantu. Babheka kancane njengabantu abadala, kodwa abakwazi ukuthola imisebenzi, bakhokhele izikweletu, baqhube imoto, noma benze imisebenzi yansuku zonke yabantu abavuthiwe ngokugcwele. Ngokufanayo, amaseli e-promyelocytic egazi aphelelwe amandla ukuze enze imisebenzi yezingqamuzana zegazi ezimhlophe ezivuthiwe emzimbeni.
Izimpawu Nezibonakaliso
Iziguli ezine-APL zikhombisa izimpawu eziningi ezifana nezinye izinhlobo ze-lemonemic acute myelogenous (AML). Izimpawu eziningi ze-leukemia ziwumphumela wamangqamuzana omdlavuza "aqhubekele" umnkantsha wamathambo futhi aphazamise ukukhiqizwa kwamaseli egazi abomvu ajwayelekile, anempilo, amangqamuzana egazi amhlophe namaplatelet. Lezi zimpawu nezimpawu zifaka:
- Ukuba namandla amancane, noma ukuzwa ukhathele sonke isikhathi
- Ukuzwa ukuphefumula okuncane uma wenza imisebenzi evamile
- Isikhumba esiphezulu
- Amafiva angachaziwe
- Ukwandisa isikhathi sokuphulukiswa kwezicucu kanye nemivimbo
- Amathambo noma amajoyini e-Achy
- Kunzima "ukulwa" nezifo
Ngaphezu kwalezi zibonakaliso ze-AML, iziguli ze-APL zikhombisa nezinye izimpawu zesici . Bazovame uku:
- Yiba nezinkinga ezinkulu zokuphuza ezifana nokulimala, i-nosebleeds, igazi emanzini noma emathunjini. Amantombazane nabesifazane abane-APL bangase babone isikhathi sokuya esikhathini esingavamile.
- Ngesikhathi esifanayo, kuvamise ukungaqabuki okwedlulele ngokweqile kwegazi.
Izimpawu ze-leukemia zingaba zingacacile kakhulu, futhi zingase zibe nezimpawu zenye, izimo ezingezona umdlavuza. Uma ukhathazekile ngempilo yakho, noma impilo yomuntu othandekayo, ngaso sonke isikhathi kungcono ukufuna iseluleko sochwepheshe bezokwelapha.
Ukwelapha
Ukwelashwa kwe-acute promyelocytic leukemia (APL) kuhluke kakhulu kunezinye izinhlobo ze-leukemia eziyingozi, ngakho ukuyiqonda kahle kuyigugu.
Iziguli eziningi ze-APL ziphathwa ngokuqala nge-trans-retinoic acid (ATRA), uhlobo olukhethekile lwe-vitamin A. ATRA ukwelashwa okuhlukile ngoba empeleni kuthonya amaseli we-promyelocytic leukemia ukuvuthwa, kufana nokuthi ikolishi elithweswa iziqu lishukumisa kanjani intsha yethu Ukuqhathanisa nomsebenzi omdala (kahle, okungenani ngezinye izikhathi). Lesi sigaba sokwelashwa sibhekwa ngokuthi "ukungeniswa."
Ngenkathi i-ATRA ingathola isiguli se-APL ekuxoxweni ngokususa wonke amaseli we-leukemia ekuvuthweni, ayikwazi ukuphulukisa umthombo we-leukemia. Ngenxa yalokho, imiphumela yesikhathi eside yokwelapha ithuthuka lapho odokotela bengezela amanye amakhemikhali ejwayelekile.
Lobu bubi bokubhekwa bubizwa ngokuthi "ukuhlanganiswa."
Ngemuva kwe-chemotherapy, abantu bavame ukuqhubeka ku-ATRA okungenani ngonyaka, ngezinye izikhathi kuhlanganiswe neminye imithi. Lesi sigaba sokugcina sokwelashwa sabizwa ngokuthi "ukugcinwa."
Uma i-leukemia ingaphenduki ku-ATRA nakumakhemikhali, noma uma ibuya, i-APL nayo ingaphathwa nge-arsenic trioxide (ATO).
Isibikezelo
Ukwelashwa kwe-APL kuphumelele kuningi lamacala.
Ukubhekana nokusekela
Yize noma i-acute promyelocytic leukemia ine-injection ephawulekayo, okungenani ngokuphathelene ne-leukemia, "ukufika lapho" kungaba nzima futhi kudle. Finyelela emndenini nabangani . Ungakhathazeki ngokudinga usizo futhi uthole usizo kule nkathi empilweni yakho. Ungamangala ukuthi akusizi nje kuphela, uma abanye besiza, kodwa kuletha injabulo nabo. Hlola lawa macebiso ekubhekaneni ne-leukemia ne-lymphoma .
Thatha isikhathi sokufunda ngokusinda. Lapho ukwelashwa komdlavuza kuphela, esikhundleni sokuzijabulisa, abantu abaningi bazizwa becindezelekile. Imiphumela emibi yokuqhubekayo yokwelapha kanye nesikhathi esichithwa kwi-roller coaster yomdlavuza engakusiza ingakusiza uzibuze ukuthi uzophinde uzizwe uphinde uphinde uphinde uzizwe yini. Cela usizo, futhi ungamukeli nje "okuvamile" kwakho. Kuningi okungenziwa ukusiza abasindile bomdlavuza. Futhi ungakhohlwa ukuthi, ngezinye izikhathi, okuhle kungavela emdlavuza kanye. Izifundo empeleni zisitshela ukuthi umdlavuza ushintsha abantu ngezindlela ezinhle , hhayi nje embi.
Imithombo
I-American Cancer Society. Ukwelashwa kwe-acute promyelocytic (M3) leukemia. Kubuyekezwe 02/22/16. http://www.cancer.org/cancer/leukemia-acutemyeloidaml/detailedguide/leukemia-acute-myeloid-myelogenous-treating-m3-leukemia
Jurcic, J., Soignet, S., Maslak, P. Ukuxilongwa Nokuphathwa Kwe-Acute Promyelocytic Leukemia. Imibiko Yamanje Ye-Oncology 2007. 9: 337-344.
I-Lemons, R., Keller, S., Gietzen, D., Dufner, J, Rebentisch, M., Feusner, J., Eilender, D. Okuyi-Promyelocytic Leukemia Journal of Pediatric Hematology / Oncology 1995. 17: 198- 210.
I-Sanz, M. Ukwelashwa Kwe-Acute Promyelocytic Leukemia. I-American Society of Hematology 2006. 147- 155.
Wiernik, P., Gallagher, R., Tallman, M. "Acute Promyelocytic Leukemia" e-Wiernik, P., Goldman, J., Dutcher, J., Kyle, R., (eds.) (2003) Igazi- 4th. I-New York: I-Cambridge University Press.