Iindidi / ileukemia / isigulana / unyango lwabantu abadala-pdq

Unyango lwabadala olunamandla lweMyeloid Leukemia (?) - Inguqulelo yeMonde

Ulwazi Jikelele malunga ne-Myeloid Leukemia yabantu abadala

IINGONGOMA EZIPHAMBILI

• I-Adult acute myeloid leukemia (AML) luhlobo lomhlaza apho umongo wethambo wenza i-myeloblast engaqhelekanga (uhlobo lweseli emhlophe yegazi), iiseli ezibomvu zegazi, okanye iiplatelets.

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

• Kukho iintlobo ezahlukeneyo ze-AML.

• Ukutshaya, unyango lwe-chemotherapy lwangaphambili, kunye nokuvezwa kwimitha kunokuchaphazela umngcipheko we-AML yabantu abadala.

• Iimpawu kunye neempawu ze-AML yabantu abadala zibandakanya umkhuhlane, ukuziva udiniwe, kunye nokugruzuka okulula okanye ukopha.

• Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga i-AML yabantu abadala.

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

I-Adult acute myeloid leukemia (AML) luhlobo lomhlaza apho umongo wethambo wenza i-myeloblast engaqhelekanga (uhlobo lweseli emhlophe yegazi), iiseli ezibomvu zegazi, okanye iiplatelets.

I-leukemia yabantu abadala ye-myeloid (AML) ngumhlaza wegazi kunye nomongo wethambo. Olu hlobo lomhlaza luhlala lusiba mandundu ngokukhawuleza ukuba alunyangwa. Luhlobo oluqhelekileyo lwe-leukemia ebukhali kubantu abadala. I-AML ikwabizwa ngokuba yi-acute myelogenous leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, kunye neacute nonlymphocytic leukemia.

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 ye-lymphoid stem iyiseli yegazi emhlophe.

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

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

• Amaseli egazi amhlophe alwa nosulelo kunye nezifo.

• Iiplatelets ezenza amahlwili egazi ayeke ukopha.

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

Kwi-AML, iiseli ze-myeloid stem zihlala ziba luhlobo lweeseli ezimhlophe ezingafakwanga ezibizwa ngokuba zii-myeloblasts (okanye ukuqhuma kwe-myeloid). I-myeloblasts kwi-AML ayiqhelekanga kwaye ayibi ziiseli ezimhlophe zegazi. Ngamanye amaxesha kwi-AML, iiseli ezininzi zeziqu ziye zaba ziiseli ezibomvu zegazi okanye iiplatelets. Ezi iiseli zegazi zimhlophe ngokungaqhelekanga, iiseli ezibomvu zegazi, okanye iiplatelets zikwabizwa ngokuba ziiseli zegazi okanye ukuqhuma. Iiseli ze-leukemia zinokwakha kumongo wethambo nasegazini ngenxa yoko akukho ndawo incinci yeeseli ezimhlophe eziphilileyo, iiseli ezibomvu zegazi kunye neeplatelets. Xa oku kusenzeka, usulelo, i-anemia, okanye ukopha ngokulula kunokwenzeka. Iiseli ze-leukemia zinokusasazeka ngaphandle kwegazi ziye kwamanye amalungu omzimba, kubandakanya inkqubo ye-nervous system (ubuchopho kunye nentambo yomqolo), ulusu kunye neentsini.

Esi sishwankathelo simalunga ne-AML yabantu abadala. Jonga ezi zishwankathelo zilandelayo ze- zolwazi malunga nezinye iintlobo ze-leukemia:

• Ubuncinci be-Myeloid Leukemia / Olunye unyango lweMyeloid Malignancies

• Unyango lwe-Myelogenous Leukemia enganyangekiyo

• Unyango lweLukymphoblastic Leukemia yabantu abadala

• Unyango lwe-Acute Lymphoblastic Leukemia

• Unyango lweLymphocytic Leukemia enganyangekiyo

• Unyango lweeuksi zeSeli leenwele

Kukho iintlobo ezahlukeneyo ze-AML.

Uninzi lwee-AML subtypes zisekwe kwindlela ezivuthwe ngayo (eziphuhlisiweyo) iiseli zomhlaza ngexesha lokuchongwa kunye nendlela ezahluke ngayo kwiiseli eziqhelekileyo.

I-leukemia ye-promyelocytic Acute (APL) sisihlokwana se-AML esenzeka xa iinxalenye ezimbini zemfuza zinamathela kunye. I-APL ihlala ivela kubantu abadala abaphakathi. Iimpawu ze-APL zinokubandakanya ukopha kunye nokwenza amahlwili egazi.

Ukutshaya, unyango lwe-chemotherapy lwangaphambili, kunye nokuvezwa kwimitha kunokuchaphazela umngcipheko we-AML yabantu abadala.

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 kwi-AML zibandakanya oku kulandelayo:

• Ukuba yindoda.

• Ukutshaya, ngakumbi emva kweminyaka engama-60.

• Ukuba unyango lwe-chemotherapy okanye unyango lwe-radiation ngaphambili.

• Ukuba unyango lwe-acute lymphoblastic leukemia (BONKE) ngaphambili.

• Ukuvezwa kwimitha evela kwibhombu yeatom okanye kwi-benzene yemichiza.

• Ukuba nembali yokuphazamiseka kwegazi njenge-myelodysplastic syndrome.

Iimpawu kunye neempawu ze-AML yabantu abadala zibandakanya umkhuhlane, ukuziva udiniwe, kunye nokugruzuka okulula okanye ukopha.

Iimpawu zokuqala kunye neempawu ze-AML zinokufana nezo zibangelwa ngumkhuhlane okanye ezinye izifo eziqhelekileyo. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ifiva.

• Ukuqhawukelwa ngumphefumlo.

• Ukutyumza okulula okanye ukopha.

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

• Ubuthathaka okanye uziva udiniwe.

• Ukwehla kobunzima okanye ukulahleka kwesidlo.

Uvavanyo oluvavanya igazi kunye nomongo wethambo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga i-AML yabantu abadala.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

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

• Gcwalisa ubalo lwegazi (i-CBC): Inkqubo apho kuthathwa khona isampulu yegazi kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

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

• Inxalenye yesampulu eyenziwe ngeeseli 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.

• 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 iimpawu zomhlaza.

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.

• Uhlalutyo lweCytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yegazi okanye umongo wethambo zibalwa kwaye zijongwa kulo naluphi na utshintsho, njengokwaphuka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango. Olunye uvavanyo, olunje nge-fluorescence in situ hybridization (FISH), inokwenziwa kwakhona ukujonga utshintsho oluthile kwii-chromosomes.

• Immunophenotyping: Uvavanyo lwaselabhoratri olusebenzisa izilwa-buhlungu ukufumanisa iiseli zomhlaza ngokusekwe kwiindidi zeantianti okanye iimpawu zokumakisha kumphezulu weeseli. 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.

• Ukubuyela umva kuvavanyo lwe-polymerase test reaction reaction (RT-PCR): Uvavanyo lwaselebhu apho inani lezixhobo zemfuza ezibizwa ngokuba yi-mRNA ezenziwe ngumfuzo othile zilinganiswa. I-enzyme ebizwa ngokuba yi-reverse transcriptase isetyenziselwa ukuguqula iqhekeza elithile le-RNA libe sisiqwengana se-DNA, esinokwandiswa (senziwe ngamanani amakhulu) yenye i-enzyme ebizwa ngokuba yi-DNA polymerase. Iikopi ze-DNA ezandisiweyo zinceda ukuxelela ukuba ngaba i-mRNA ethile yenziwa ngumfuzo. I-RT-PCR inokusetyenziselwa ukukhangela ukwenziwa kwezinto ezithile ezinokubonisa ubukho beeseli zomhlaza. Olu vavanyo lunokusetyenziselwa ukujonga utshintsho oluthile kwimfuza okanye kwi-chromosome, enokunceda ukufumanisa umhlaza. Olu vavanyo lusetyenziselwa ukufumanisa iintlobo ezithile ze-AML kubandakanya i-acute promyelocytic leukemia (APL).

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

Ukuxela kwangaphambili (ithuba lokuchacha) kunye nokhetho kunyango luxhomekeke:

• Ubudala besigulana.

• Inkqutyana ye-AML.

• Nokuba isigulana sifumene ichemotherapy ngaphambili ukunyanga umhlaza owahlukileyo.

• Nokuba kukho imbali yesifo segazi esifana ne-myelodysplastic syndrome.

• Nokuba umhlaza unwenwele kwinkqubo ye-nervous system.

• Nokuba umhlaza unyangwe ngaphambili okanye waphinda wabuya (buyela).

Kubalulekile ukuba i-leukemia ebukhali inyangwe kwangoko.

Amanqanaba e-Acute Myeloid Leukemia yabantu abadala

IINGONGOMA EZIPHAMBILI

• Xa sele kufunyenwe isifo se-myeloid leukemia yabantu abadala, uvavanyo luyenziwa ukufumanisa ukuba umhlaza usasazekile na kwamanye amalungu omzimba.

• Akukho nkqubo yokumisela esemgangathweni ye-AML yabantu abadala.

Xa sele kufunyenwe isifo se-myeloid leukemia yabantu abadala, uvavanyo luyenziwa ukufumanisa ukuba umhlaza usasazekile na kwamanye amalungu omzimba.

Ubungakanani okanye ukusasazeka komhlaza kuhlala kuchazwa njengezigaba. Kwi-leukemia yabantu abadala i-myeloid leukemia (AML), i-subtype ye-AML kunye nokuba i-leukemia isasazeke ngaphandle kwegazi kunye nomongo wethambo kusetyenziswa endaweni yeqonga lokucwangcisa unyango. Olu vavanyo lulandelayo kunye neenkqubo zinokusetyenziselwa ukumisela ukuba i-leukemia isasazekile:

• 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.

Akukho nkqubo yokumisela esemgangathweni ye-AML yabantu abadala.

Esi sifo sichazwa ngokunganyangwa, ukuxolelwa, okanye ukuphindaphinda.

Umntu omdala onganyangekiyo i-AML

Kwi-AML yabantu abadala enganyangekiyo, esi sifo sisandula ukufunyanwa. Ayikanyangwa ngaphandle kokunciphisa iimpawu kunye neempawu ezinje ngomkhuhlane, ukopha, okanye iintlungu, kwaye oku kulandelayo kuyinyani:

• Ubalo olupheleleyo lwegazi aluqhelekanga.

• Ubuncinane i-20% yeeseli kumongo wethambo zii blast (iiseli zegazi).

• Kukho iimpawu okanye iimpawu zegazi.

I-AML yabantu abadala ekuxolelweni

Kwi-AML yabantu abadala ekuxolelweni, isifo siye sanyangwa kwaye oku kulandelayo kuyinyani:

• Inani elipheleleyo legazi liqhelekile.

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

• Akukho miqondiso okanye zimpawu ze-leukemia kwingqondo kunye nentambo yomqolo okanye kwenye indawo emzimbeni.

Ukuphinda-phinda abantu abadala i-AML

Ukuphinda-phinda i-AML ngumhlaza obuye wabuya (ubuye) emva kokuba unyangiwe. I-AML inokubuyela egazini okanye kumongo wethambo.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-leukemia yabantu abadala.
• Unyango lwe-AML yabantu abadala ihlala inezigaba ezi-2.
• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Unyango ngamayeza

• Unyango ngemitha

• I-Chemotherapy kunye nokufakelwa kweseli

• Olunye unyango lweziyobisi

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ekujoliswe kulo

• Unyango lwe-myeloid leukemia yabantu abadala lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

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

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-leukemia yabantu abadala.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-leukemia yabantu abadala. 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 lwe-AML yabantu abadala ihlala inezigaba ezi-2.

Amanqanaba onyango ama-2 e-AML yabantu abadala zezi:

• 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 emva kokuba leukemia ikwixolelo. 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.

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). I-Intrathecal chemotherapy inokusetyenziselwa ukunyanga i-AML yabantu abadala ethe yasasazeka kwingqondo nakwintambo yomqolo. Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza.

Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kwi-subtype ye-AML ephathwa ngayo nokuba iiseli ze-leukemia zisasazekile kwingqondo nakumqolo.

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 kwi-Acute Myeloid Leukemia ngolwazi oluthe kratya.

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 ophathwayo kunye nokuba iiseli ze-leukemia zisasazekile kwingqondo nakumqolo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-AML yabantu abadala.

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.

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.

Olunye unyango lweziyobisi

I-Arsenic trioxide kunye nayo yonke i-trans retinoic acid (ATRA) ngamachiza abulala umhlaza abulala iiseli ze-leukemia, amise iiseli ze-leukemia ekwahlukaneni, okanye ancede iiseli ze-leukemia zikhule zibe ziiseli ezimhlophe zegazi. La machiza asetyenziswa kunyango lwe-AML ebizwa ngokuba yi-acute promyelocytic leukemia.

Jonga iziyobisi ezivunyiweyo kwi-Acute Myeloid Leukemia ngolwazi oluthe kratya.

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 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 lolunye uhlobo lonyango ekujoliswe kulo olufundwayo kunyango lwe-AML yabantu abadala.

Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu ezivela 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.

Unyango lwe-myeloid leukemia yabantu abadala lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

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.

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 lwe-Myeloid Leukemia yabantu abadala

Kweli Candelo

• Ukungafunyanwa okungafunekiyo kwabantu abadala i-Myeloid Leukemia

• Abantu abadala abaKhuselekileyo iMyeloid Leukemia kuXolelo

• Ukuphinda-phinda kwabaNtu abadala kwi-Myeloid Leukemia

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

Ukungafunyanwa okungafunekiyo kwabantu abadala i-Myeloid Leukemia

Unyango oluqhelekileyo lwe-myeloid leukemia yabantu abadala enganyangekiyo ngexesha lesigaba sokungeniswa kuxolelo luxhomekeke kudidi lwe-AML kwaye inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Umdibaniso wedosi ephezulu.

• I-chemotherapy yedosi ephantsi.

• Unyango lwe-chemotherapy.

• Yonke i-trans retinoic acid (ATRA) kunye ne-arsenic trioxide kunyango lwe-acute promyelocytic leukemia (APL).

• I-ATRA kunye nokudibanisa i-chemotherapy elandelwa yi-arsenic trioxide kunyango lwe-APL.

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.

Abantu abadala abaKhuselekileyo iMyeloid Leukemia kuXolelo

Unyango lwe-AML yabantu abadala ngexesha lokuxolelwa kuxhomekeke kudidi lwe-AML kwaye inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango oluphezulu lwe-chemotherapy, kunye okanye ngaphandle kwonyango lwemitha, kunye nokufakelwa kweseli ye-stem usebenzisa iiseli zesigulana.

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli ye-stem usebenzisa iiseli zeziqu zabaxhasi

• Uvavanyo lweklinikhi lwe-arsenic trioxide.

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 kwi-Myeloid Leukemia

Akukho nyango luqhelekileyo lwe-AML yabantu abadala ephindayo. Unyango luxhomekeke kudidi lwe-AML kwaye lunokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango olujolise kwi-antibody monoclonal.

• Ukufakelwa kweseli kwestem usebenzisa iiseli zesigulana okanye iiseli ezinikelayo.

• Unyango lwe-Arsenic trioxide.

• Uvavanyo lweklinikhi yonyango lwe-arsenic trioxide elandelwa kukufakwa kweseli.

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 abanesifo somhlaza wegazi

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga neleukemia yabantu abadala ebukhali, jonga oku kulandelayo:

• Ikhasi lasekhaya leleukemia

• Iziyobisi ezivunyiweyo kwi-Acute Myeloid 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