Types/leukemia/patient/adult-all-treatment-pdq

Unyango lwaBantu abaDala oluKhuselekileyo lweLymphoblastic Leukemia (?) - Inguqulelo yeMonde

Ulwazi Ngokubanzi Malunga neLyukemia yeLymphoblastic Leukemia

IINGONGOMA EZIPHAMBILI

• I-leukemia yabantu abadala ye-lymphoblastic leukemia (YONKE) luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi kakhulu (uhlobo lweseli emhlophe yegazi).

• Ileukemia inokuchaphazela iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

• I-chemotherapy yangaphambili kunye nokuvezwa kwimitha kunokunyusa umngcipheko wokuphuhlisa ZONKE.

• Iimpawu kunye neempawu zabantu abadala ZONKE zibandakanya umkhuhlane, ukuziva udiniwe, kunye nokugruzuka okulula okanye ukopha.

• Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga abantu abadala BONKE.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

I-leukemia yabantu abadala ye-lymphoblastic leukemia (YONKE) luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi kakhulu (uhlobo lweseli emhlophe yegazi).

I-leukemia yabantu abadala ye-lymphoblastic leukemia (BONKE; ekwabizwa ngokuba yi-acute lymphocytic leukemia) ngumhlaza wegazi kunye nomongo wethambo. Olu hlobo lomhlaza luhlala lusiba mandundu ngokukhawuleza ukuba alunyangwa.

Umzimba wethambo. Ithambo lenziwe ngethambo elidibeneyo, ithambo lesiponji kunye nomongo wethambo. Ithambo elidityanisiweyo lenza umaleko wangaphandle wethambo. Ithambo lesiponji lifumaneka ikakhulu kwiziphelo zamathambo kwaye liqukethe umongo obomvu. Umongo wethambo ufumaneka embindini wamathambo kwaye unemithambo yegazi emininzi. Zimbini iintlobo zomongo wethambo: obomvu nomthubi. Umongo obomvu uqukethe iiseli zegazi ezinokuthi zibe ziiseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets. Umongo omthubi wenziwe ikakhulu ngamafutha.

Ileukemia inokuchaphazela iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

Ngokwesiqhelo, umongo wethambo wenza iiseli zegazi (ezingafakwanga iiseli) eziba ziiseli zegazi ezivuthiweyo ngokuhamba kwexesha. Iseli yegazi inokuba siseli se-myeloid okanye iseli ye-lymphoid stem.

Iseli yeseli ye-myeloid iba yenye yeentlobo ezintathu zeeseli zegazi ezivuthiweyo:

• Iiseli ezibomvu zegazi ezithwala ioksijini kunye nezinye izinto kuwo onke amalungu omzimba.

• Iiplatelets ezenza amahlwili egazi ayeke ukopha.

• IiGranulocytes (iiseli ezimhlophe zegazi) ezilwa nosulelo kunye nezifo.

Iseli ye-lymphoid stem cell iba yi-lymphoblast cell kwaye emva koko ibe yenye yeentlobo ezintathu ze-lymphocyte (iiseli ezimhlophe zegazi):

• Ii-lymphocyte ze-B ezenza ii-antibodies zokunceda ukulwa usulelo.

• I-lymphocyte T ezinceda ii-lymphocyte ze-B zenze ii-antibodies ezinceda ukulwa usulelo.

• Iiseli zombulali zendalo ezihlasela iiseli zomhlaza kunye neentsholongwane.

Ukuphuhliswa kweseli yegazi. Iseli yegazi ihamba ngamanqanaba aliqela ukuze ibe yiseli ebomvu yegazi, iplatelet, okanye iseli yegazi emhlophe.

KWEZO ZONKE, iiseli ezininzi ezinamagama ziba zii-lymphoblast, ii-lymphocyte B, okanye ii-lymphocyte ze-T. Ezi iiseli zikwabizwa ngokuba ziiseli zegazi. Ezi seli zegazi azikwazi ukulwa usulelo kakuhle. Kwakhona, njengoko inani leeseli zegazi lenyuka egazini nakumongo wamathambo, kuncinci indawo yeeseli ezimhlophe eziphilileyo, iiseli ezibomvu zegazi kunye neeplatelets. Oku kunokubangela usulelo, i-anemia, kunye nokopha ngokulula. Umhlaza unganwenwela nakwinkqubo ye-nervous system (ingqondo kunye nomqolo womqolo).

Esi sishwankathelo simalunga nomhlaza we-lymphoblastic leukemia yabantu abadala. Jonga ezi zishwankathelo zilandelayo ze- zolwazi malunga nezinye iintlobo ze-leukemia:

• Unyango lwe-Acute Lymphoblastic Leukemia.

• Unyango lwabantu abadala abaNamandla.

• Ubuncinci be-Myeloid Leukemia / Olunye unyango lweMyeloid Malignancies.

• Unyango lweLymphocytic Leukemia enganyangekiyo.

• Unyango lwe-Myelogenous Leukemia enganyangekiyo.

• Unyango lweeuksi zeSeli leenwele.

I-chemotherapy yangaphambili kunye nokuvezwa kwimitha kunokunyusa umngcipheko wokuphuhlisa ZONKE.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini. Izinto ezinokubangela umngcipheko kuzo ZONKE zibandakanya oku kulandelayo:

• Ukuba yindoda.

• Ukuba mhlophe.

• Ukuba mdala kunama-70.

• Unyango lwangaphambili ngekhemotherapy okanye unyango ngemitha.

• Ukuvezwa kumanqanaba aphezulu emitha kwindalo esingqongileyo (enje ngemitha yenyukliya).

• Ukuba neengxaki ezithile zemfuza, ezinjenge-Down syndrome.

Iimpawu kunye neempawu zabantu abadala ZONKE zibandakanya umkhuhlane, ukuziva udiniwe, kunye nokugruzuka okulula okanye ukopha.

Iimpawu zokuqala kunye neempawu ZONKE zinokufana nomkhuhlane okanye ezinye izifo eziqhelekileyo. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ubuthathaka okanye uziva udiniwe.

• Umkhuhlane okanye ukubila ebusuku.

• Ukutyumza okulula okanye ukopha.

• I-Petechiae (tyaba, khomba amabala phantsi kolusu, okubangelwa ligazi).

• Ukuqhawukelwa ngumphefumlo.

• Ukwehla kobunzima okanye ukulahleka kwesidlo.

• Ubuhlungu emathanjeni okanye esiswini.

• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo.

• Amaqhuma angenasiphelo entanyeni, ngaphantsi kwekhwapha, esiswini, okanye emhlubulweni.

• Ukuba nosulelo oluninzi.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa yi-leukemia yabantu abadala ye-lymphoblastic leukemia okanye zezinye iimeko.

Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga abantu abadala BONKE.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngokusuleleka okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Gcwalisa ubalo lwegazi (CBC) ngokwahluka-hlukeneyo: Inkqubo apho isampulu yegazi itsalwa kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi kunye neeplatelets.

• Inani nohlobo lweeseli ezimhlophe zegazi.

• Isixa sehemoglobin (iprotein ethwala ioksijini) kwiiseli ezibomvu zegazi.

• Inxalenye yesampulu yegazi eyenziwe ziiseli ezibomvu zegazi.

Gcwalisa ubalo lwegazi (CBC). Igazi liqokelelwa ngokufaka inaliti emthanjeni kwaye livumele igazi ukuba lingene kumbhobho. Isampulu yegazi ithunyelwa elebhu kwaye iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets kubalwa. I-CBC isetyenziselwa ukuvavanya, ukufumanisa isifo, kunye nokubeka iliso kwiimeko ezininzi ezahlukeneyo.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• I-peripheral blood smear: Inkqubo apho isampuli yegazi ihlolwe khona ukuqhuma kweeseli, inani kunye neentlobo zeeseli ezimhlophe zegazi, inani leeplatelets, kunye nokutshintsha kwimo yeeseli zegazi.

• Umnqweno womongo wethambo kunye ne-biopsy: Ukususwa komongo wethambo, igazi, kunye nesiqwenga samathambo ngokufaka inaliti engenanto kumqolo okanye ithambo lesifuba. Ugqirha wezifo ujonga umongo wethambo, igazi kunye nethambo phantsi kwemicroscope ukukhangela iiseli ezingaqhelekanga.

Umnqweno wethambo lomnqweno kunye ne-biopsy. Emva kokuba indawo encinci yolusu iphonyiwe, inaliti yomongo wethambo ifakwa kwisithambo sethambo lesigulana. Iisampulu zegazi, ithambo, kunye nomongo wethambo ziyasuswa ukuze zihlolwe phantsi kwemicroscope.

Olu vavanyo lulandelayo lunokwenziwa kwiisampuli zegazi okanye umongo wethambo osusiweyo:

• Uhlalutyo lwe-cytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yegazi okanye umongo wethambo ubalwa kwaye ujongwa kulo naluphi na utshintsho, njengokwaphuka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Umzekelo, e-Philadelphia i-chromosome-positive YONKE, inxenye ye-chromosome enye itshintsha indawo nenxalenye yenye i-chromosome. Oku kubizwa ngokuba yi "chromosome yaseFiladelphia." Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

I-chromosome yaseFiladelphia. Iqhekeza le-chromosome 9 kunye neqhekeza le-chromosome 22 kunye neendawo zorhwebo. Uhlobo lwe-BCR-ABL lwenziwa kwi-chromosome 22 apho iqhekeza le-chromosome 9 linamathela. I-chromosome 22 etshintshiweyo ibizwa ngokuba yi-chromosome yaseFiladelphia.

• Immunophenotyping: Uvavanyo lwaselabhoratri olusebenzisa izilwa-buhlungu ukufumanisa iiseli zomhlaza ngokusekwe kwiindidi zeantigens okanye iimpawu zokumakisha phezu kweeseli. Olu vavanyo lusetyenziselwa ukunceda ukufumanisa iintlobo ezithile ze-leukemia. Umzekelo, isifundo secytochemistry sinokuvavanya iiseli kwisampulu yethishu kusetyenziswa iikhemikhali (idayi) ukujonga utshintsho oluthile kwisampulu. Ikhemikhali inokubangela utshintsho lombala kuhlobo olunye lweeseli leukemia kodwa hayi kolunye uhlobo lweseli leukemia.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Ubudala besigulana.

• Nokuba umhlaza usasazekile waya kwingqondo okanye kumqolo womqolo.

• Nokuba kukho utshintsho oluthile kwimfuza, kubandakanya ichromosome yaseFiladelphia.

• Nokuba umhlaza wakhe wanyangwa ngaphambili okanye waphinda wabuya (buyela).

Amanqanaba e-Acute Lymphoblastic Leukemia

IINGONGOMA EZIPHAMBILI

• Nje ukuba kufunyaniswe ukuba sele kufunyenwe umntu omdala, kwenziwa iimvavanyo ukufumanisa ukuba umhlaza usasazekile na kwinkqubo yeemvakalelo (ubuchopho nomqolo) okanye kwamanye amalungu omzimba.

• Akukho nkqubo yokubeka emgangathweni yabantu abadala YONKE.

Nje ukuba kufunyaniswe ukuba sele kufunyenwe umntu omdala, kwenziwa iimvavanyo ukufumanisa ukuba umhlaza usasazekile na kwinkqubo yeemvakalelo (ubuchopho nomqolo) okanye kwamanye amalungu omzimba.

Ubungakanani okanye ukusasazeka komhlaza kuhlala kuchazwa njengezigaba. Kubalulekile ukuba wazi ukuba i-leukemia isasazekile ngaphandle kwegazi kunye nomongo wethambo ukuze ucwangcise unyango. Olu vavanyo lulandelayo kunye neenkqubo zinokusetyenziselwa ukumisela ukuba i-leukemia isasazekile:

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Ukugqobhoza iLumbar: Inkqubo esetyenziselwa ukuqokelela isampulu ye-cerebrospinal fluid (CSF) ukusuka kumqolo womqolo. Oku kwenziwa ngokubeka inaliti phakathi kwamathambo amabini emqolo kunye nakwi-CSF ejikeleze intambo yomqolo kunye nokususa isampulu yolwelo. Isampulu ye-CSF ihlolwe phantsi kwemicroscope ngeempawu zokuba iiseli ze-leukemia zisasazeke kwingqondo nakumqolo. Le nkqubo ikwabizwa ngokuba yi-LP okanye impompo yomqolo.

Ukugqobhoza iLumbar. Isigulana silele endaweni egobileyo phezu kwetafile. Emva kokuba indawo encinci kumqolo ongezantsi ifakwe inaliti, inaliti yomgogodla (inaliti ende, ebhityileyo) ifakwe kwinxalenye esezantsi yomqolo womqolo ukususa ulwelo lwe-cerebrospinal fluid (CSF, eboniswe ngombala oluhlaza okwesibhakabhaka). Ulwelo lunokuthunyelwa kwilabhoratri kuvavanyo.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zesisu, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

Akukho nkqubo yokubeka emgangathweni yabantu abadala YONKE.

Esi sifo sichazwa ngokunganyangwa, ukuxolelwa, okanye ukuphindaphinda.

Ukunganyangwa kwabantu abadala BONKE

ZONKE zisandula ukufunyanwa kwaye khange zinyangwe ngaphandle kokunciphisa iimpawu kunye neempawu ezinje ngomkhuhlane, ukopha, okanye iintlungu.

• Ubalo olupheleleyo lwegazi aluqhelekanga.

• Ngaphezulu kwe-5% yeeseli kumongo wethambo ziqhushumbo (iiseli zegazi).

• Kukho iimpawu kunye neempawu leukemia.

Abantu abadala BONKE kuxolelo

BONKE baphathwe.

• Inani elipheleleyo legazi liqhelekile.

• I-5% okanye ezimbalwa iiseli kumongo wethambo ziqhuma (iiseli ze-leukemia).

• Akukho zimpawu zibonakalisayo ze-leukemia ngaphandle komongo wethambo.

Ukuphinda-phinda kwabaNtu abaDala kwiLymphoblastic Leukemia

Umhlaza ophindaphindiweyo we-lymphoblastic leukemia (YONKE) ngumhlaza ophindaphindiweyo (ubuyile) emva kokuxolelwa. ZONKE zinokubuya zibuyele egazini, kumongo wethambo, okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinabantu abadala BONKE.
• Unyango lwabantu abadala ZONKE zihlala zinezigaba ezibini.
• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Unyango ngamayeza

• Unyango ngemitha

• I-Chemotherapy kunye nokufakelwa kweseli

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-Immunotherapy

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Unyango lwe-acute lymphoblastic leukemia lunokubangela iziphumo ebezingalindelekanga.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinabantu abadala BONKE.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-leukemia yabantu abadala (i-leukemia). Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Unyango lwabantu abadala ZONKE zihlala zinezigaba ezibini.

Unyango lwabantu abadala BONKE lwenziwa ngezigaba:

• Unyango lokungenisa uxolelo: Eli linqanaba lokuqala lonyango. Injongo kukubulala iiseli zegazi egazini kunye nomongo wethambo. Oku kubeka i-leukemia kuxolelo.

• Unyango lwasemva kokuxolelwa: Eli linqanaba lesibini lonyango. Iqala nje ukuba i-leukemia ikhululwe. Injongo yonyango emva kokuxolelwa kukubulala naziphi na iiseli zegazi ezinokungasebenzi kodwa ezinokuqala ukubuyela kwakhona kwaye zibangele ukubuyela umva. Eli nqanaba likwabizwa ngokuba lunyango lokuqhubekeka nokunyanga.

Unyango olubizwa ngokuba lu-central nervous system (CNS) unyango lweprhylaxis luhlala lunikezelwa kwinqanaba ngalinye lonyango. Ngenxa yokuba iidosi ezisemgangathweni zonyango lwe-chemotherapy zinokungafikeleli kwiiseli ze-leukemia kwi-CNS (ingqondo kunye nentambo yomqolo), iiseli ze-leukemia ziyakwazi ukufihla kwi-CNS. I-chemotherapy yenkqubo enikezwe ngeedosi eziphezulu, i-intrathecal chemotherapy, kunye nonyango lwemitha kwingqondo ziyakwazi ukufikelela kwiiseli ze-leukemia kwi-CNS. Olu nyango lunikezelwa ukubulala iiseli zegazi kunye nokunciphisa ithuba lokuba i-leukemia ibuye (ibuye).

Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid (i-intrathecal chemotherapy), ilungu, okanye isinqe somzimba esifana nesisu, amachiza ikakhulu achaphazela iiseli zomhlaza kwezo ndawo (i-chemotherapy yengingqi). Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza. Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

I-Intrathecal chemotherapy inokusetyenziselwa ukunyanga abantu abadala YONKE into ethe yasasazeka, okanye isasazeka, kwingqondo nakwintambo yomqolo. Xa isetyenziselwa ukunciphisa ithuba lokuba iiseli ze-leukemia zisasazeke kwingqondo nakwintambo yomqolo, ibizwa ngokuba yi-CNS prophylaxis.

Unyango lwe-chemotherapy. Amachiza e-anticancer afakwe kwisithuba se-intrathecal, esi sithuba esigcina i-cerebrospinal fluid (CSF, eboniswe ngombala oluhlaza okwesibhakabhaka). Zimbini iindlela zokwenza oku. Enye indlela, eboniswe kwinxalenye ephezulu yomzobo, kukujova amachiza kwindawo yokugcina izilwanyana i-Ommaya (isikhongozeli esimile okomgangatho obekwe phantsi kwentloko entloko ngexesha lotyando; ibamba amachiza njengoko ehamba ngombhobho omncinci esiya kwingqondo ). Enye indlela, eboniswe kwinxalenye esezantsi yomzobo, kukujova amachiza ngqo kwi-CSF kwinxalenye esezantsi yomqolo womqolo, emva kokuba indawo encinci kumqolo ongezantsi ifakwe amanxeba.

Jonga iziyobisi ezivunyiweyo ukuze ufumane ulwazi oluthe kratya ngeLymphoblastic Leukemia.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo lomhlaza. Unyango lwangaphandle lwemitha lungasetyenziselwa ukunyanga abantu abadala BONKE esele lisasazekile, okanye linokusasazeka, kwingqondo nakwintambo yomqolo. Xa isetyenziswe ngale ndlela, ibizwa ngokuba yinkqubo ye-nervous system (CNS) yonyango lwengcwele okanye i-CNS prophylaxis. Unyango lwangaphandle lwemitha lusenokusetyenziswa njengonyango lokunyanga ukukhupha iimpawu kunye nokuphucula umgangatho wobomi.

I-Chemotherapy kunye nokufakelwa kweseli

I-Chemotherapy inikezelwa ukubulala iiseli zomhlaza. Iiseli ezisempilweni, kubandakanya iiseli ezenza igazi, nazo ziyatshatyalaliswa lunyango lomhlaza. Ukufakelwa kweseli kwistem kunyango endaweni yeeseli ezenza igazi. Iiseli zeziqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana okanye somnikeli kwaye zibandisiwe kwaye zigcinwe. Emva kokuba isiguli sigqibe i-chemotherapy, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Jonga iziyobisi ezivunyiweyo ukuze ufumane ulwazi oluthe kratya ngeLymphoblastic Leukemia.

Ukufakelwa kweseli. (Inyathelo 1): Igazi lithathwa emthanjeni engalweni yomnikeli. Isigulana okanye omnye umntu angangumnikeli. Igazi lihamba ngomatshini osusa iiseli zeziqu. Emva koko igazi libuyiselwa kulowo unikeleyo ngomthambo okwenye ingalo. (Inyathelo 2): Isigulana sifumana ichemotherapy yokubulala iiseli ezenza igazi. Isigulana sinokufumana unyango ngemitha (engaboniswanga). (Inyathelo 3): Isigulana sifumana iiseli zeziqu ngokusebenzisa ipayinti ebekwe kwisitya segazi esifubeni.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Unyango lwe-monoclonal antibody kunye ne-tyrosine kinase inhibitor yonyango ziindidi zonyango olujolisiweyo olusetyenziselwa ukunyanga abantu abadala BONKE.

Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu, ukusuka kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Blinatumomab kunye ne-inotuzumab ozogamicin zii-anti-monoclonal antibodies ezisetyenziselwa ukufakelwa kweseli ye-stem ukunyanga bonke abantu abadala.

Unyango lweTyrosine kinase inhibitor luyithintela i-enzyme, i-tyrosine kinase, ebangela ukuba iiseli ezi-stem zikhule zibe ziiseli ezimhlophe zegazi (ukuqhuma) kunokuba umzimba ufuna. I-Imatinib mesylate (Gleevec), i-dasatinib, kunye ne-nilotinib zi-tyrosine kinase inhibitors ezisetyenziselwa ukunyanga abantu abadala BONKE.

Jonga iziyobisi ezivunyiweyo ukuze ufumane ulwazi oluthe kratya ngeLymphoblastic Leukemia.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

Unyango lwe-CAR T-cell luhlobo lwe-immunotherapy etshintsha iiseli ze-T zesigulana (uhlobo lweseli yomzimba yokuzikhusela) ukuze zihlasele iiproteni ezithile kubuso beeseli zomhlaza. Iiseli ze-T zithathwa kwisigulana kwaye ii-receptors ezizodwa zongezwa kumphezulu wazo kwilabhoratri. Iiseli eziguqulweyo zibizwa ngokuba ziiseli ze-chimeric antigen receptor (CAR) T. Iiseli ze-CAR T zikhula elebhu kwaye zinikwa isigulana ngokufakwa. Iiseli ze-CAR T ziphindaphindeka kwigazi lesigulana kwaye zihlasela iiseli zomhlaza. Unyango lwe-CAR T-cell lufundwa kunyango lwabantu abadala ZONKE eziye zaphinda zabuya (buyela).

Unyango lwe-CAR T-cell. Uhlobo lonyango apho iiseli ze-T zesigulana (uhlobo lweseli yomzimba yokuzikhusela) ziguqulwa kwilabhoratri ukuze zibophelele kwiiseli zomhlaza kwaye zibabulale. Igazi eliphuma emthanjeni engalweni yesigulana lihamba lingena kwityhubhu lisiya kumatshini weapheresis (ongaboniswanga), osusa iiseli ezimhlophe zegazi, kubandakanya neeseli zeT, kwaye uthumele lonke igazi libuyele kwisigulana. Emva koko, i-gene ye-receptor ekhethekileyo ebizwa ngokuba yi-chimeric antigen receptor (CAR) ifakwe kwiiseli ze-T elebhu. Izigidi zeeseli ze-CAR T zikhuliswa elebhu zize zinikwe isigulana ngokufakwa. Iiseli ze-CAR T ziyakwazi ukubopha kwi-antigen kwiiseli zomhlaza kwaye zibabulale.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Unyango lwe-acute lymphoblastic leukemia lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga eziqala ngexesha lonyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Iziphumo ebezingalindelekanga ezivela kunyango lomhlaza eziqala emva konyango kwaye ziqhubeke iinyanga okanye iminyaka zibizwa ngokuba ziziphumo ezifike kade. Iziphumo zokugqibela zonyango kubo BONKE zinokubandakanya umngcipheko wesibini somhlaza (iintlobo ezintsha zomhlaza). Iimviwo zokulandelela rhoqo zibaluleke kakhulu kumaxhoba exesha elide.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukhetho kunyango lweLukemia egugileyo yabantu abadala

Kweli Candelo

• Unyango lwaBantu abaDala olunganyangekiyo lweLymphoblastic Leukemia

• I-leukemia yabantu abadala eyiLymphoblastic Leukemia kuXolelo

• Ukuphinda-phinda kwabaNtu abaDala kwiLymphoblastic Leukemia

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwaBantu abaDala olunganyangekiyo lweLymphoblastic Leukemia

Unyango oluqhelekileyo lwe-leukemia yabantu abadala ye-lymphoblastic leukemia (BONKE) ngexesha lesigaba sokungenisa uxolelo kubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango lweTyrosine kinase inhibitor nge-imatinib mesylate, kwizigulana ezithile. Abanye baba baguli baya kuba nokudibanisa i-chemotherapy.

• Unonophelo oluxhasayo kubandakanya i-antibiotics kunye neeseli ezibomvu zegazi kunye nokufakwa kwegazi.

• Unyango lwe-CNS prophylaxis kubandakanya ichemotherapy (i-intrathecal kunye / okanye inkqubo) kunye okanye ngaphandle kwonyango lwemitha kwingqondo.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

I-leukemia yabantu abadala eyiLymphoblastic Leukemia kuXolelo

Unyango olusemgangathweni lwabantu abadala BONKE ngexesha lesigaba sokuxolelwa kubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Unyango lwe-Tyrosine kinase inhibitor nge-imatinib, nilotinib, okanye i-dasatinib.

• I-Chemotherapy kunye nokufakelwa kweseli.

• Unyango lwe-CNS prophylaxis kubandakanya ichemotherapy (i-intrathecal kunye / okanye inkqubo) kunye okanye ngaphandle kwonyango lwemitha kwingqondo.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukuphinda-phinda kwabaNtu abaDala kwiLymphoblastic Leukemia

Unyango olusemgangathweni lwabantu abadala abaphindayo BONKE lunokubandakanya oku kulandelayo:

• Ukudityaniswa kwe-chemotherapy elandelwa kukufakelwa kweseli.

• Unyango lwe-monoclonal antibody (blinatumomab okanye inotuzumab ozogamicin) elandelwa kukufakwa kweseli.

• Unyango lwedosi ephantsi njengokhathalelo lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lweTyrosine kinase inhibitor nge-dasatinib kwizigulana ezithile.

Olunye lonyango olufundwayo kuvavanyo lweklinikhi kubantu abadala abaphindayo ZONKE zibandakanya oku kulandelayo:

• Uvavanyo lweklinikhi yokufakelwa kweseli kwintsholongwane usebenzisa iiseli zesigulana.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo.

• Uvavanyo lweklinikhi yonyango lwe-antigen receptor (CAR) T-cell yonyango.

• Uvavanyo lweklinikhi yamachiza amatsha omhlaza.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga nabantu abadala abaNomdla kwiLymphoblastic Leukemia

Ngolwazi oluthe kratya kwiZiko loMhlaza leLizwe malunga nomhlaza we-lymphoblastic leukemia, bona oku kulandelayo:

• Ikhasi lasekhaya leleukemia

• Iziyobisi ezivunyiweyo kwi-Acute Lymphoblastic Leukemia

• Utyando lweSeli oluQulunqwe ngegazi

• Iithagethi zoMhlaza ezijolise kuko

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli