Matenda a m'magazi a Lymphocytic (CLL)

Zamkati

• Kodi lymphocytic leukemia (CLL) ndi chiyani?
• Kodi zizindikiro za CLL ndi ziti?
• Kodi chithandizo cha CLL ndi chiani?
• Chemotherapy
• Mafunde
• Njira zochiritsira
• Mafupa a m'mafupa kapena zotumphukira zamagazi zamagazi
• Kuikidwa magazi
• Opaleshoni
• Kodi CLL imapezeka bwanji?
• Kuwerengera kwathunthu kwa magazi (CBC) wokhala ndi mawonekedwe oyera amwazi (WBC)
• Kuyesedwa kwa Immunoglobulin
• Kutupa kwa mafupa
• Kujambula kwa CT
• Kuyenda kwa cytometry ndi cytochemistry
• Kuyesa kwa genomic ndi mamolekyulu
• Kodi mitengo yopulumuka ndi yotani kwa anthu omwe ali ndi CLL?
• Kodi CLL idakhazikitsidwa bwanji?
• Nchiyani chimayambitsa CLL, ndipo kodi pali zoopsa za matendawa?
• Kodi pali zovuta zina zamankhwala?
• Kodi chiyembekezo chanthawi yayitali cha CLL ndi chiyani?

Zithunzi za Getty

Kodi lymphocytic leukemia (CLL) ndi chiyani?

Khansa ya m'magazi ndi mtundu wa khansa yomwe imakhudza maselo amwazi wamagazi ndi maselo opanga magazi. Pali mitundu yambiri ya khansa ya m'magazi, iliyonse yomwe imakhudza mitundu yosiyanasiyana yamagazi. Matenda a m'magazi a lymphocytic, kapena CLL, amakhudza ma lymphocyte.

Ma lymphocyte ndi mtundu wama cell oyera (WBC). CLL imakhudza ma lymphocyte B, omwe amatchedwanso B maselo.

Maselo abwinobwino a B amayenda m'magazi anu ndikuthandizira thupi lanu kulimbana ndi matenda. Maselo a khansa a B samalimbana ndi matenda monga momwe maselo amtundu wa B amachitira. Maselo a B omwe ali ndi khansa akamachulukirachulukira, amadzaza ma lymphocyte abwinobwino.

CLL ndiye mtundu wofala kwambiri wa khansa ya m'magazi mwa akulu. National Cancer Institute (NCI) ikuyerekeza kuti milandu yatsopano 21,040 ichitika ku United States mu 2020.

Kodi zizindikiro za CLL ndi ziti?

Anthu ena omwe ali ndi CLL sangakhale ndi zizindikilo zilizonse, ndipo khansa yawo imangopezeka pakamayesedwa magazi nthawi zonse.

Ngati muli ndi zizindikiro, zimaphatikizapo:

• kutopa
• malungo
• matenda opatsirana kapena matenda
• kuonda kosadziwika kapena kosayembekezereka
• thukuta usiku
• kuzizira
• zotupa zam'mimba zotupa

Mukamayesedwa, dokotala wanu amathanso kuwona kuti nthenda zanu, chiwindi, kapena ma lymph node zakula. Izi zitha kukhala zizindikilo kuti khansara yafalikira ku ziwalozi. Izi zimachitika nthawi zambiri ku CLL.

Izi zikakuchitikirani, mutha kumva zipsera zopweteka m'khosi mwanu kapena kumva kukhuta kapena kutupa m'mimba mwanu.

Kodi chithandizo cha CLL ndi chiani?

Ngati muli ndi chiopsezo cha CLL, adokotala angakulimbikitseni kuti mungodikirira ndikuwona zizindikiro zatsopano. Matenda anu sangakule kwambiri kapena angafune chithandizo kwa zaka. Anthu ena safuna chithandizo.

Nthawi zina CLL yomwe ili pachiwopsezo chachikulu, dokotala wanu amalimbikitsa chithandizo. Mwachitsanzo, angakulimbikitseni kulandira chithandizo ngati muli ndi:

• kulimbikira, matenda obwereza
• kuchuluka kwa maselo amwazi wamagazi
• kutopa kapena thukuta usiku
• ma lymph node opweteka

Ngati muli ndi CLL wapakatikati kapena woopsa, dokotala wanu angakulimbikitseni kuti mupite kuchipatala nthawi yomweyo.

Pansipa pali mankhwala ena omwe dokotala angakulimbikitseni.

Chemotherapy

Chemotherapy ndiye chithandizo chachikulu cha CLL. Zimaphatikizapo kugwiritsa ntchito mankhwala kupha ma cell a khansa. Kutengera mankhwala omwe dokotala akukupatsani, mutha kuwamwa kudzera mumitsempha kapena pakamwa.

Mafunde

Mwa njirayi, ma particles amphamvu kapena mafunde amagwiritsidwa ntchito kupha ma cell a khansa. Poizoniyu sagwiritsidwa ntchito nthawi zambiri ku CLL, koma ngati muli ndi zotupa zopweteka, zotupa zamankhwala, mankhwala a radiation angathandize kuwachepetsera ndikuchepetsa ululu wanu.

Njira zochiritsira

Njira zochiritsira zomwe zimayang'aniridwa zimayang'ana kwambiri majini, mapuloteni, kapena zotupa zomwe zimapangitsa kuti maselo a khansa apulumuke. Izi zingaphatikizepo:

• ma monoclonal antibodies, omwe amalumikizana ndi mapuloteni
• kinase inhibitors omwe amatha kuwononga maselo a khansa potseka ma enzyme ena a kinase

Mafupa a m'mafupa kapena zotumphukira zamagazi zamagazi

Ngati muli ndi chiopsezo cha CLL, mankhwalawa atha kukhala osankha. Zimaphatikizapo kutenga ma cell am'mafupa kapena magazi a woperekayo - nthawi zambiri mamembala am'banja - ndikuziyika m'thupi lanu kuti zithandizire kukhazikitsa fupa labwino.

Kuikidwa magazi

Ngati kuchuluka kwama cell anu ndikotsika, mungafunike kulandila magazi kudzera mumtambo (IV) wowonjezera.

Opaleshoni

Nthawi zina, dokotala wanu amalimbikitsa kuchitidwa opaleshoni kuti achotse ndulu ngati yakula chifukwa cha CLL.

Kodi CLL imapezeka bwanji?

Ngati dokotala akukayikira kuti muli ndi CLL, atha kugwiritsa ntchito mayeso osiyanasiyana kutsimikizira kuti ali ndi matendawa. Mwachitsanzo, mwina adzaitanitsa mayeso amodzi kapena angapo otsatirawa.

Kuwerengera kwathunthu kwa magazi (CBC) wokhala ndi mawonekedwe oyera amwazi (WBC)

Dokotala wanu amatha kugwiritsa ntchito mayeso amwaziwa kuti athe kuyeza kuchuluka kwama cell m'mwazi mwanu, kuphatikiza mitundu yosiyanasiyana ya WBCs.

Ngati muli ndi CLL, mudzakhala ndi ma lymphocyte ambiri kuposa masiku onse.

Kuyesedwa kwa Immunoglobulin

Dokotala wanu amatha kugwiritsa ntchito mayeso amwaziwa ngati ali ndi ma antibodies okwanira kulimbana ndi matenda.

Kutupa kwa mafupa

Pochita izi, dokotala wanu amalowetsa singano ndi chubu chapadera m'chiuno mwanu kapena m'chifuwa kuti mupeze fupa lanu kuti muyesedwe.

Kujambula kwa CT

Dokotala wanu amatha kugwiritsa ntchito zithunzi zopangidwa ndi CT scan kuti ayang'ane ma lymph node otupa pachifuwa kapena pamimba.

Kuyenda kwa cytometry ndi cytochemistry

Ndi mayeserowa, mankhwala kapena utoto amagwiritsidwa ntchito kuwona zolembera zapadera pamaselo a khansa kuti zithandizire kudziwa mtundu wa leukemia. Kuyeza magazi ndikomwe kumafunikira pakuyesa uku.

Kuyesa kwa genomic ndi mamolekyulu

Mayeserowa amayang'ana majini, mapuloteni, ndi kusintha kwa chromosome komwe kumatha kukhala kosiyana ndi mitundu ina ya khansa ya m'magazi. Amathandizanso kudziwa kuti matendawa apitilira msanga bwanji ndikuthandizira dokotala kusankha njira zamankhwala zomwe angagwiritse ntchito.

Kuyesedwa kwa majini kuti apeze kusintha koteroko kungaphatikizepo kuyeserera kwa ma hybridization (FISH) ndi polymerase chain reaction.

Kodi mitengo yopulumuka ndi yotani kwa anthu omwe ali ndi CLL?

Kutha kwa zaka 5 kwa anthu aku America omwe ali ndi CLL ndi 86.1%, malinga ndi NCI. Bungweli likuyerekeza kuti CLL ipangitsa kuti anthu 4,060 amwalire ku United States ku 2020.

Mitengo yopulumuka ndiyotsika kwa okalamba omwe ali ndi vutoli.

Kodi CLL idakhazikitsidwa bwanji?

Ngati dokotala atazindikira kuti muli ndi CLL, adzaitanitsa mayeso ena kuti adziwe kukula kwa matendawa. Izi zimathandiza dokotala kusanja gawo la khansa, lomwe liziwongolera dongosolo lanu.

Kuti mukonzekere CLL yanu, dokotala wanu atha kuyitanitsa mayeso amwazi kuti mupeze kuchuluka kwanu kwama cell of red (RBC) ndi kuchuluka kwa ma lymphocyte. Ayeneranso kufufuza ngati ma lymph node, ndulu, kapena chiwindi zakula.

Pansi pa dongosolo la Rai, CLL idakhazikitsidwa kuyambira 0 mpaka 4. Rai siteji 0 CLL ndiyovuta kwambiri, pomwe Rai siteji 4 ndiyotsogola kwambiri.

Pazithandizo, magawowa aphatikizidwanso m'magulu azowopsa. Rai siteji 0 ndiyowopsa, Rai magawo 1 ndi 2 ali pachiwopsezo chapakati, ndipo magawo a Rai 3 ndi 4 ali pachiwopsezo chachikulu, akufotokoza American Cancer Society.

Nazi zina mwazizindikiro za CLL pagawo lililonse:

• Gawo 0: kuchuluka kwa ma lymphocyte
• Gawo 1: kuchuluka kwa ma lymphocyte; ma lymph node owonjezera
• Gawo 2: kuchuluka kwa ma lymphocyte; ma lymph node amatha kukulitsidwa; kukulitsa ndulu; chiwindi chomwe chingakulitse
• Gawo 3: kuchuluka kwa ma lymphocyte; kusowa magazi; Ma lymph node, ndulu, kapena chiwindi zitha kukulitsidwa
• Gawo 4: kuchuluka kwa ma lymphocyte; ma lymph node, ndulu, kapena chiwindi zitha kukulitsidwa; kuchepa kwa magazi m'thupi; magulu otsika a mapulateleti

Nchiyani chimayambitsa CLL, ndipo kodi pali zoopsa za matendawa?

Akatswiri sakudziwa zomwe zimayambitsa CLL. Komabe, pali zifukwa zoopsa zomwe zimapangitsa kuti munthu akhale ndi mwayi wopanga CLL.

Nazi zina mwaziwopsezo zomwe zingathe kukulitsa mwayi wamunthu wopanga CLL:

• Zaka. CLL sichipezeka kawirikawiri mwa anthu ochepera zaka 40. Ambiri mwa milandu ya CLL amapezeka mwa anthu azaka zopitilira 50. Avereji ya zaka za omwe amapezeka ndi CLL ndi 71.
• Kugonana. Zimakhudza amuna ambiri kuposa akazi.
• Mtundu. Zimapezeka kwambiri mwa anthu ochokera ku Russia ndi ku Europe ndipo sizipezeka kwambiri mwa anthu ochokera kum'mawa kwa Asia ndi ku Southeast Asia.
• Monoclonal B-khungu lymphocytosis. Pali chiopsezo chochepa kuti vutoli, lomwe limayambitsa ma lymphocyte apamwamba, limatha kusintha kukhala CLL.
• Chilengedwe. Dipatimenti yaku US ya Veterans Affairs idaphatikizira kuwonekera kwa Agent Orange, chida chamankhwala chomwe chinagwiritsidwa ntchito pankhondo ya Vietnam, ngati chiwopsezo ku CLL.
• Mbiri ya banja. Anthu omwe ali ndi achibale omwe ali ndi kachilombo ka CLL ali ndi chiopsezo chachikulu cha CLL.

Kodi pali zovuta zina zamankhwala?

Chemotherapy imafooketsa chitetezo cha m'thupi lanu, ndikukusiyani pachiwopsezo cha matenda. Muthanso kukhala ndi ma antibodies osadziwika bwino komanso kuchuluka kwama cell ochepa panthawi yamankhwala a chemotherapy.

Zotsatira zina zofala za chemotherapy ndi monga:

• kutopa
• kutayika tsitsi
• zilonda mkamwa
• kusowa chilakolako
• nseru ndi kusanza

Nthawi zina, chemotherapy imatha kuthandizira kukulitsa khansa zina.

Kutentha kwa magazi, kuthiridwa magazi, ndi mafupa kapena zotumphukira zamagazi zimathandizanso.

Kuti athane ndi zovuta zina, dokotala akhoza kukupatsani:

• IV immunoglobulin
• corticosteroids
• Kuchotsa ndulu
• mankhwala rituximab

Lankhulani ndi dokotala wanu za zotsatirapo zoyipa zamankhwala anu. Amatha kukuwuzani zisonyezo ndi zovuta zomwe zimafunikira kuchipatala.

Kodi chiyembekezo chanthawi yayitali cha CLL ndi chiyani?

Mitengo yopulumuka ya CLL imasiyanasiyana kwambiri. Msinkhu wanu, kugonana, zovuta za chromosome, komanso mawonekedwe am'magazi am'magazi angakhudze momwe mungadzionere kwa nthawi yayitali. Matendawa samachiritsidwa kawirikawiri, koma anthu ambiri amakhala zaka zambiri ndi CLL.

Funsani dokotala wanu za vuto lanu. Amatha kukuthandizani kumvetsetsa momwe khansara yayambira kale. Akhozanso kukambirana zosankha zanu zamankhwala komanso chiyembekezo cha nthawi yayitali.