Iindidi / ileukemia / isigulana / lonke unyango-pdq

Unyango lwe-Acute Lymphoblastic Leukemia Treatment (®) -Patient Version

Ulwazi oluBanzi malunga neAceute Acute Lymphoblastic Leukemia

IINGONGOMA EZIPHAMBILI

• Ubuntwana obunzima be-lymphoblastic leukemia (BONKE) luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi ezingafakwanga (uhlobo lweseli emhlophe yegazi).

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

• Unyango lwangaphambili lomhlaza kunye neemeko ezithile zofuzo zichaphazela umngcipheko wokuba nobuntwana BONKE.

• Iimpawu zobuntwana ZONKE zibandakanya umkhuhlane kunye nokugruzuka.

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

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

Ubuntwana obunzima be-lymphoblastic leukemia (BONKE) luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi ezingafakwanga (uhlobo lweseli emhlophe yegazi).

Ubuntwana be-lymphoblastic leukemia (ekwabizwa ngokuba YONKE okanye i-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.

BONKE lolona hlobo luqhelekileyo lomhlaza ebantwaneni.

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

Kumntwana osempilweni, 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.

• Amaseli egazi amhlophe alwa 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.

Kumntwana onazo ZONKE, iiseli ezininzi zeziqu ziba zii-lymphoblasts, iiL lymphocyte, okanye iiL lymphocyte. Iiseli azisebenzi njengee-lymphocyte eziqhelekileyo kwaye azikwazi ukulwa nosulelo kakuhle. Ezi seli ngumhlaza (weleukemia) iiseli. Kwakhona, njengoko inani leeseli zegazi lenyuka egazini nakumongo wamathambo, kuncinci indawo yeeseli ezimhlophe eziphilileyo, iiseli ezibomvu zegazi kunye neeplatelets. Oku kunokukhokelela kusulelo, i-anemia, kunye nokopha ngokulula.

Esi sishwankathelo simalunga ne-leukemia ebukhali ye-lymphoblastic ebantwaneni, kulutsha nakwabantu abadala abancinci. Jonga ezi zishwankathelo zilandelayo ze- zolwazi malunga nezinye iintlobo ze-leukemia:

• Ubuncinci be-Myeloid Leukemia / Olunye unyango lweMyeloid Malignancies

• Unyango lweLukymphoblastic Leukemia yabantu abadala

• Unyango lweLymphocytic Leukemia enganyangekiyo

• Unyango lwabantu abadala abaNamandla

• Unyango lwe-Myelogenous Leukemia enganyangekiyo

• Unyango lweeuksi zeSeli leenwele

Unyango lwangaphambili lomhlaza kunye neemeko ezithile zofuzo zichaphazela umngcipheko wokuba nobuntwana BONKE.

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 umntwana wakho usengozini.

Izinto ezinokubangela umngcipheko kuzo ZONKE zibandakanya oku kulandelayo:

• Ukuvezwa kwimitha ye-x ngaphambi kokuzalwa.

• Ukuvezwa kwimitha.

• Unyango lwangaphambili ngekhemotherapy.

• Ukuba neemeko ezithile zofuzo, ezinje:

• Isifo esiphantsi.

• Uhlobo lwe-Neurofibromatosis 1.

• Isifo seBloom.

• I-Fanconi anemia.

• Ataxia-telangiectasia.

• Isifo seLi-Fraumeni.

• Ukusilela kokulungiswa kokungalingani komgaqo-siseko (uguquko kwiijeni ezithile ezinqanda i-DNA ukuba ingazilungisi, ekhokelela ekukhuleni komhlaza besebancinci).

• Ukuba notshintsho oluthile kwii-chromosomes okanye kwimfuza.

Iimpawu zobuntwana ZONKE zibandakanya umkhuhlane kunye nokugruzuka.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa bubuntwana BONKE okanye ezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Ifiva.

• Ukutyumza okulula okanye ukopha.

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

• Intlungu okanye ithambo.

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

• Intlungu okanye imvakalelo yokugcwala ngaphantsi kweembambo.

• Ubuthathaka, ukuziva udiniwe, okanye ujongekile.

• Ukuphelelwa ngumdla wokutya.

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

Ezi mvavanyo zilandelayo kunye neenkqubo zingasetyenziselwa ukuxilonga ubuntwana BONKE kwaye ufumanise ukuba iiseli zegazi zegazi zisasazekile kwamanye amalungu omzimba anjengengqondo okanye amasende:

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 (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 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.

• 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.

• Umnqweno wethambo kunye ne-biopsy: Ukususwa komongo wethambo kunye neqhekeza elincinci lokufaka inaliti engenamathambo kwi-hipbone okanye kwi-breastbone. Ugqirha wezifo ujonga umongo wethambo kunye nethambo phantsi kwemicroscope ukukhangela iimpawu zomhlaza.

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

Olu vavanyo lulandelayo lwenziwa egazini okanye kumongo 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, iiseli zomhlaza ziyajongwa ukuba ngaba zii-lymphocyte okanye ii-T lymphocyte.

• 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.

Le nkqubo yenziwa emva kokuba kufunyaniswe ukuba i-leukemia ifunyenwe ukuba iiseli ze-leukemia sele zisasazekile kwingqondo nakumqolo. I-intrathecal chemotherapy inikwa emva kokuba isampulu yolwelo isuswe ukunyanga naziphi na iiseli ze-leukemia ezinokuthi zisasazeke kwingqondo nakumqolo.

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba. I-x-ray yesifuba yenziwe ukubona ukuba iiseli ze-leukemia zenze ubunzima embindini wesifuba.

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

Ukuxela kwangaphambili (ithuba lokuchacha) kuxhomekeke:

• Kukhawuleza kangakanani kwaye kunciphe kangakanani ukubala kweeseli zegazi emva kwenyanga yokuqala yonyango.

• Ubudala ngexesha lokuchongwa, isini, ubuhlanga, kunye nemvelaphi yobuhlanga.

• Inani leeseli ezimhlophe zegazi egazini ngexesha lokuqonda isifo.

• Nokuba iiseli zegazi zegazi zaqala kwiiL lymphocyte okanye iiL lymphocyte.

• Nokuba kukho utshintsho oluthile kwii-chromosomes okanye kwimfuza yee-lymphocyte ezinomhlaza.

• Nokuba umntwana une-Down syndrome.

• Nokuba iiseli ze-leukemia ziyafumaneka kulwelo lwe-cerebrospinal.

• Ubunzima bomntwana ngexesha lokuqonda isifo kunye nonyango.

Ukhetho lonyango luxhomekeke:

• Nokuba iiseli zegazi zegazi zaqala kwiiL lymphocyte okanye iiL lymphocyte.

• Nokuba umntwana unomngcipheko osezantsi, umngcipheko okanye umngcipheko omkhulu BONKE.

• Ubudala bomntwana ngexesha lokuchongwa.

• Nokuba kukho utshintsho oluthile kwii-chromosomes zee-lymphocyte, ezinje nge-chromosome yaseFiladelphia.

• Nokuba umntwana waphathwa nge-steroids ngaphambi kokuqala konyango lokungeniswa.

• Ngokukhawuleza kwaye isezantsi kangakanani inani leeseli leukemia liyehla ngexesha lonyango.

Kwi-leukemia ebuyela umva (ibuya umva) emva konyango, isifo kunye nokukhethwa kunyango kuxhomekeke koku kulandelayo:

• Kuthatha ixesha elingakanani phakathi kwexesha lokuchongwa kwaye xa i-leukemia ibuya.

• Nokuba i-leukemia ibuyela kumongo wethambo okanye kwamanye amalungu omzimba.

Amaqela emingcipheko yaBantwana aBakho eLymphoblastic Leukemia

IINGONGOMA EZIPHAMBILI

• Ebuntwaneni BONKE, amaqela omngcipheko asetyenziselwa ukucwangcisa unyango.

• Ukubuyela kwakhona kubuntwana BONKE ngumhlaza obuyileyo emva kokuba unyangwe.

Ebuntwaneni BONKE, amaqela omngcipheko asetyenziselwa ukucwangcisa unyango.

Kukho amaqela omngcipheko amathathu ebuntwaneni BONKE. Bachazwa njenge:

• Umngcipheko osezantsi (ophantsi): Kubandakanya abantwana abaneminyaka eli-1 ukuya kwengaphantsi kweminyaka eli-10 abaneseli yegazi elimhlophe elingaphantsi kwama-50,000 / µL ngexesha lokuchongwa.

• Umngcipheko ophezulu: Kubandakanya abantwana abaneminyaka eli-10 nangaphezulu kunye / okanye abantwana abaneseli emhlophe yegazi engama-50,000 / µL okanye nangaphezulu ngexesha lokuchongwa.

• Umngcipheko omkhulu kakhulu: Kubandakanya abantwana abangaphantsi kweminyaka yobudala e-1, abantwana abaneenguqu ezithile kwimfuza, abantwana abanempendulo ecothayo kunyango lokuqala, kunye nabantwana abaneempawu ze-leukemia emva kweeveki ezi-4 zokuqala zonyango.

Ezinye izinto ezichaphazela iqela lomngcipheko zibandakanya oku kulandelayo:

• Nokuba iiseli zegazi zegazi zaqala kwiiL lymphocyte okanye iiL lymphocyte.

• Nokuba kukho utshintsho oluthile kwii-chromosomes okanye kwimfuza yee-lymphocyte.

• Ngokukhawuleza kwaye isezantsi kangakanani inani leeseli leukemia liyehla emva konyango lokuqala.

• Nokuba iiseli ze-leukemia zifunyenwe kulwelo lwe-cerebrospinal ngexesha lokuqonda isifo.

Kubalulekile ukuba ulazi iqela lomngcipheko ukuze ucwangcise unyango. Abantwana abasemngciphekweni omkhulu okanye abasemngciphekweni omkhulu BONKE badla ngokufumana amachiza e-anticancer kunye / okanye iidosi eziphezulu zamayeza e-anticancer kunabantwana abanomngcipheko osemgangathweni BONKE.

Ukubuyela kwakhona kubuntwana BONKE ngumhlaza obuyileyo emva kokuba unyangwe.

I-leukemia inokubuyela egazini kunye nomongo wethambo, ingqondo, umnqonqo, amasende, okanye amanye amalungu omzimba.

Ubuntwana obuchasayo BONKE ngumhlaza ongaphenduliyo kunyango.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango lwe-leukemia ebuntwaneni ebukhali (BONKE).

• Abantwana abanabo BONKE kufuneka unyango lwabo lucwangciswe liqela loogqirha abaziingcali kunyango lwegazi lobuntwana.

• Unyango lwe-lymphoblastic leukemia ebuntwaneni lunokubangela iziphumo ebezingalindelekanga.

• Unyango lobuntwana BONKE luhlala lunezigaba ezithathu.

• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Unyango ngamayeza

• Unyango ngemitha

• I-Chemotherapy kunye nokufakelwa kweseli

• Unyango ekujoliswe kulo

• Unyango lunikezelwa ukubulala iiseli ze-leukemia ezisasazekileyo okanye ezinokuthi zisasaze kwingqondo, umnqonqo, okanye amasende.

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-T-cell ye-antigen receptor (CAR)

• 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 lwe-leukemia ebuntwaneni ebukhali (BONKE).

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abane-acute lymphoblastic leukemia (BONKE). 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.

Kuba umhlaza ebantwaneni unqabile, ukuthatha inxaxheba kuvavanyo lweklinikhi kufuneka kuthathelwe ingqalelo. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Abantwana abanabo BONKE kufuneka unyango lwabo lucwangciswe liqela loogqirha abaziingcali kunyango lwegazi lobuntwana. Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye abaqeqeshi bezempilo yabantwana abaziingcali ekunyangeni abantwana abane-leukemia kwaye begxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• Ugqirha wonyango.

• Ugqirha wezonyango.

• Ugqirha wabantwana.

• Imitha ye-oncologist.

• Ingcali yonyango.

• Ugqirha wezifo.

• Ingcali yezonyango.

• Ingcali yomongikazi wabantwana.

• Unontlalontle.

• Ingcali yokuvuselela.

• Ingcali yeengqondo.

• Ingcali kubomi bomntwana.

Unyango lwe-lymphoblastic leukemia ebuntwaneni lunokubangela iziphumo ebezingalindelekanga.

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

Iimviwo zokulandela rhoqo zibaluleke kakhulu. Iziphumo ebezingalindelekanga ezivela kunyango lomhlaza eziqala emva konyango kwaye ziqhubeke iinyanga okanye iminyaka zibizwa ngokuba ziziphumo ezifike kade.

Iziphumo zokunyanga komhlaza zingabandakanya oku kulandelayo:

• Iingxaki zomzimba, kubandakanya iingxaki zentliziyo, imithambo yegazi, isibindi, okanye amathambo, kunye nokuzala. Xa i-dexrazoxane inikezelwa ngamachiza e-chemotherapy abizwa ngokuba yi-anthracyclines, umngcipheko weempembelelo zentliziyo esezantsi ziyehla.

• Utshintsho kwiimvakalelo, iimvakalelo, ukucinga, ukufunda, okanye inkumbulo. Abantwana abangaphantsi kweminyaka emi-4 abafumene unyango ngemitha kwingqondo banomngcipheko ophezulu woku.

• Umhlaza wesibini (iintlobo ezintsha zomhlaza) okanye ezinye iimeko, ezinje ngamathumba obuchopho, umhlaza wedlala lengqula, i-acute myeloid leukemia, kunye ne-myelodysplastic syndrome.

Ezinye iziphumo ezinokufika emva kwexesha zinokunyangwa okanye zilawulwe. Kubalulekile ukuba uthethe noogqirha bomntwana wakho malunga neziphumo ezinokubakho emva kwexesha ezibangelwa lunyango oluthile. Jonga isishwankathelo se- malunga neZiphumo eziMva zaNyango zoMhlaza woMntwana.

Unyango lobuntwana BONKE luhlala lunezigaba ezithathu.

Unyango lobuntwana BONKE lwenziwa ngezigaba:

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

• Ukudityaniswa / ukuqiniswa: Eli linqanaba lesibini lonyango. Iqala nje ukuba i-leukemia ikhululwe. Injongo yokudityaniswa / unyango lokuqiniswa kukubulala nayiphi na iiseli ze-leukemia ezihlala emzimbeni kwaye zinokubangela ukubuyela umva.

• Isondlo: Eli linqanaba lesithathu lonyango. Injongo kukubulala naziphi na iiseli zegazi ezinokuphinda zibuye kwaye zibangele ukubuyela umva. Rhoqo unyango lomhlaza lunikwa ngeedosi ezisezantsi kunalezo zisetyenziswa ngexesha lokuxolelwa kunye nokudityaniswa / izigaba zokuqiniswa. Ukungathathi amayeza ngokuyalelwa ngugqirha ngexesha lolondolozo kunyusa ithuba lokuba umhlaza ubuye. Oku kukwabizwa ngokuba sisigaba sokuqhubeka sonyango.

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 ichemotherapy ibekwa ngqo kwi-cerebrospinal fluid (intrathecal), kwilungu, okanye kwisisu esifana nesisu, amachiza ikakhulu achaphazela iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza.

Indlela ichemotherapy enikwa ngayo ixhomekeke kwiqela lomngcipheko lomntwana. Abantwana abasemngciphekweni omkhulu BONKE bafumana iziyobisi ezingaphaya komhlaza kunye needosi eziphezulu zamachiza e-anticancer kunabantwana abanomngcipheko osemgangathweni BONKE. I-chemotherapy ye-Intrathecal ingasetyenziselwa ukunyanga ebuntwaneni YONKE into ethe yasasazeka, okanye isasazeka, kwingqondo nakwintambo yomqolo.

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 ophathwayo. Unyango lwangaphandle lwemitha lungasetyenziselwa ukunyanga ebuntwaneni YONKE into ethe yasasazeka, okanye inokuthi isasaze, iye kwingqondo, kwintambo yomqolo, okanye kumasende. Ingasetyenziselwa ukulungisa umongo wethambo lokufakelwa kweseli.

I-Chemotherapy kunye nokufakelwa kweseli

I-Chemotherapy kwaye ngamanye amaxesha umzimba opheleleyo we-irradiation unikezelwa 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 kunye nonyango lwe-radiation, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Ukufakelwa kweseli kwestem kunqabile ukuba kusetyenziswe njengonyango lokuqala lwabantwana nakwishumi elivisayo BONKE. Isetyenziswa rhoqo njengenxalenye yonyango YONKE ebuyela umva (ibuya emva konyango).

Jonga iziyobisi ezivunyiweyo ukuze ufumane ulwazi oluthe kratya ngeLymphoblastic Leukemia.

Ukufakelwa kweseli. (Inyathelo 1): Igazi lithathwa emthanjeni engalweni yomnikeli. 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 lunyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo:

• I-Tyrosine kinase inhibitors (i-TKIs) zijolise kunyango lwamachiza athintela i-enzyme, i-tyrosine kinase, ebangela ukuba iiseli ezinesiqu zibe ziiseli ezimhlophe zegazi okanye ukuqhuma kunokuba umzimba ufuna. I-Imatinib mesylate yi-TKI esetyenziselwa unyango lwabantwana abane-chromosome-positive ye-Philadelphia BONKE. I-Dasatinib kunye ne-ruxolitinib zii-TKIs ezifundwayo kunyango lwe-ALL.

• 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 zii-antibodies ze-monoclonal ezifundwayo kunyango lobuntwana obunqabileyo BONKE.

• Unyango lwe-Proteasome inhibitor luhlobo lonyango ekujoliswe kulo oluvimba isenzo seproteasomes kwiiseli zomhlaza. IiProteasomes zisusa iiproteni ezingasafunekiyo kwiseli. Xa iiproteasomes zivaliwe, iiproteni ziyakha kwiseli kwaye kunokubangela ukuba iseli yomhlaza ife. I-Bortezomib luhlobo lonyango lweproteasome inhibitor esetyenziselwa ukunyanga ubuntwana obuye babuya BONKE.

Iindidi ezintsha zonyango olujolisiweyo ziyafundwa kunyango lobuntwana BONKE.

Jonga iziyobisi ezivunyiweyo ukuze ufumane ulwazi oluthe kratya ngeLymphoblastic Leukemia.

Unyango lunikezelwa ukubulala iiseli ze-leukemia ezisasazekileyo okanye ezinokuthi zisasaze kwingqondo, umnqonqo, okanye amasende.

Unyango lokubulala iiseli ze-leukemia okanye ukuthintela ukusasazeka kweeseli ze-leukemia kwingqondo nakwintambo yomqolo (inkqubo ye-nervous system; i-CNS) ibizwa ngokuba lonyango olujolise kwi-CNS. I-Chemotherapy ingasetyenziselwa ukuphatha iiseli ze-leukemia ezisasazekayo, okanye zingasasazeka, kwingqondo kunye nentambo yomgogodla. Ngenxa yokuba iidosi ezisemgangathweni zonyango lwe-chemotherapy zinokungafikeleli kwiiseli ze-leukemia kwi-CNS, iiseli ziyakwazi ukufihla kwi-CNS. Inkqubo yechemotherapy enikezwe ngeedosi eziphezulu okanye kwi-intrathecal chemotherapy (kwi-cerebrospinal fluid) iyakwazi ukufikelela kwiiseli ze-leukemia kwi-CNS. Ngamanye amaxesha unyango lwangaphandle lwemitha kwingqondo luyanikwa.

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 engezantsi yomzobo, kukujova amachiza ngqo kwi-CSF kwinxalenye esezantsi yomqolo womqolo, emva kokuba indawo encinci kumqolo ongezantsi iphakathi.

Olu nyango lunikwa ukongeza kunyango olusetyenziselwa ukubulala iiseli zegazi kuwo wonke umzimba. Bonke abantwana abanabo BONKE bafumana unyango olujolise kwi-CNS njengenxalenye yonyango lokungenisa kunye nokudityaniswa / unyango lokuqiniswa ngamanye amaxesha ngexesha lonyango lokugcina.

Ukuba iiseli ze-leukemia zisasazeka kumasende, unyango lubandakanya amathamo aphezulu e-chemotherapy yenkqubo kwaye ngamanye amaxesha unyango lwemitha.

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-T-cell ye-antigen receptor (CAR)

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 lobuntwana BONKE obuye wabuya (wabuya) okwesibini.

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.

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 yomntwana wakho itshintshile okanye ukuba umhlaza ubuye wabuya (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Umnqweno wethambo kunye ne-biopsy yenziwa ngawo onke amanqanaba onyango ukubona ukuba lusebenza njani unyango.

Ukhetho kunyango lweLukemia enobunzima beLymphoblastic

Kweli Candelo

• Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (umngcipheko osezantsi)

• Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (Umngcipheko ophezulu)

• Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (Umngcipheko oPhezulu kakhulu)

• Ukuchongwa ngokuKhawulezayo kwabaNtwana kwiLymphoblastic Leukemia (amaqela aKhethekileyo)

• I-T-cell ebuntwaneni i-lymphoblastic leukemia

• Iintsana ezinazo ZONKE

• Abantwana abaneminyaka eyi-10 nangaphezulu kunye nolutsha kunye nabo BONKE

• I-chromosome-yeFiladelfiya-YONKE

• Ubuntwana obunomdla kwiLymphoblastic Leukemia

• Ukuphinda ubuye ebuntwaneni kwiLymphoblastic Leukemia

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

Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (umngcipheko osezantsi)

Unyango lomngcipheko womntwana osemngciphekweni we-lymphoblastic leukemia (BONKE) ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nezigaba zolondolozo zihlala zibandakanya indibaniselwano ngekhemotherapy. Xa abantwana bexolelwe emva konyango lokungeniswa kuxolelwaniso, ukufakelwa kweseli ye-stem kusetyenziswa iiseli zeziqu ezivela kumnikeli zinokwenziwa. Xa abantwana bengekho kuxolelo emva konyango lokuxolelwa ukuxolelwa, olunye unyango luhlala lunyango olufanayo olunikwa abantwana abanomngcipheko omkhulu BONKE.

I-chemotherapy ye-intrathecal inikezelwa ukukhusela ukusasazeka kweeseli ze-leukemia kwingqondo nakumgogodla.

Unyango olufundwayo kuvavanyo lweklinikhi yomngcipheko osemgangathweni ZONKE zibandakanya iirejimeni ezintsha ze-chemotherapy.

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.

Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (Umngcipheko ophezulu)

Unyango lwe-lempemia ye-lymphoblastic leukemia (YONKE) ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nokugcinwa kwezigaba kuhlala kubandakanya indibaniselwano yonyango. Abantwana abakumngcipheko omkhulu BONKE iqela banikwa iziyobisi ezichasayo kunye namayeza aphezulu, ngakumbi ngexesha lesigaba sokuqinisa / sokuqinisa, kunabantwana abakwiqela elisemngciphekweni osemgangathweni.

I-Intrathecal kunye ne-systemic chemotherapy zinikezelwa ukuthintela okanye ukunyanga ukusasazeka kweeseli zegazi kwi-brain and spinal cord. Ngamanye amaxesha unyango lwe-radiation kwingqondo luyanikwa.

Unyango olufundwayo kuvavanyo lweklinikhi yomngcipheko omkhulu BONKE kubandakanya iirejimeni ezintsha ze-chemotherapy kunye okanye ngaphandle kwonyango ekujoliswe kulo okanye ukufakelwa kweseli ye-stem.

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.

Ukuchongwa kwaBantwana abasandula ukufumanisa isifo seLymphoblastic Leukemia (Umngcipheko oPhezulu kakhulu)

Unyango lwe-lempemia ye-lymphoblastic leukemia (YONKE) ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nokugcinwa kwezigaba kuhlala kubandakanya indibaniselwano yemichiza. Abantwana abakumngcipheko omkhulu BONKE iqela banikwa iziyobisi ezingaphezulu komhlaza kunabantwana abakwiqela elisemngciphekweni omkhulu. Akucaci nokuba ukufakelwa kwe-stem cell ngexesha lokuxolelwa kokuqala kuya kunceda umntwana aphile ixesha elide.

I-Intrathecal kunye ne-systemic chemotherapy zinikezelwa ukuthintela okanye ukunyanga ukusasazeka kweeseli zegazi kwi-brain and spinal cord. Ngamanye amaxesha unyango lwe-radiation kwingqondo luyanikwa.

Unyango olufundwayo kuvavanyo lweklinikhi kumngcipheko ophezulu kakhulu ZONKE zibandakanya iirejimeni ezintsha ze-chemotherapy kunye okanye ngaphandle kwonyango ekujoliswe kulo.

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.

Ukuchongwa ngokuKhawulezayo kwabaNtwana kwiLymphoblastic Leukemia (amaqela aKhethekileyo)

I-T-cell ebuntwaneni i-lymphoblastic leukemia

Unyango lwe-T-cell ebuntwaneni i-lymphoblastic leukemia (YONKE) ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nezigaba zolondolozo zihlala zibandakanya ukudityaniswa kwekhemotherapy. Abantwana abane-T-cell BONKE banikwa amayeza e-anticancer kunye namayeza aphezulu kunamachiza e-anticancer kunabantwana abakwiqela elisengozini yokufumana umngcipheko.

I-intrathecal kunye ne-systemic chemotherapy inikezelwa ukuthintela ukusasazeka kweeseli zegazi kwi-brain and spinal cord. Ngamanye amaxesha unyango lwe-radiation kwingqondo luyanikwa.

Unyango olufundwayo kuvavanyo lweklinikhi kwi-T-cell ZONKE zibandakanya iiarhente ezintsha ze-anticancer kunye neechemotherapy regimens kunye okanye ngaphandle kwonyango ekujoliswe kulo.

Iintsana ezinazo ZONKE

Unyango lweentsana NGONKE ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nokugcinwa kwezigaba kuhlala kubandakanya indibaniselwano yemichiza. Iintsana ezinazo ZONKE zinikwa amayeza anticancer ahlukeneyo kunye needosi eziphezulu zamachiza e-anticancer kunabantwana abanonyaka omnye nangaphezulu kwiqela elinomngcipheko osemgangathweni. Akucaci nokuba ukufakelwa kwe-stem cell ngexesha lokuxolelwa kokuqala kuya kunceda umntwana aphile ixesha elide.

I-intrathecal kunye ne-systemic chemotherapy inikezelwa ukuthintela ukusasazeka kweeseli zegazi kwi-brain and spinal cord.

Unyango olufundwayo kuvavanyo lweklinikhi lweentsana ezinazo ZONKE zibandakanya ichemotherapy yabantwana abanotshintsho oluthile.

Abantwana abaneminyaka eyi-10 nangaphezulu kunye nolutsha kunye nabo BONKE

Unyango LONKE kubantwana nakwishumi elivisayo (iminyaka eli-10 nangaphezulu) ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nezigaba zolondolozo zihlala zibandakanya indibaniselwano ngekhemotherapy. Abantwana abaneminyaka eli-10 nangaphezulu kunye nolutsha olunayo BONKE banikwa iziyobisi ezingaphaya komhlaza kunye namayeza aphezulu kunamachiza abonisa umdlavuza kunabantwana abakwiqela elisemngciphekweni oqhelekileyo.

I-intrathecal kunye ne-systemic chemotherapy inikezelwa ukuthintela ukusasazeka kweeseli zegazi kwi-brain and spinal cord. Ngamanye amaxesha unyango lwe-radiation kwingqondo luyanikwa.

Unyango olufundwayo kuvavanyo lweklinikhi lwabantwana abaneminyaka eli-10 nangaphezulu kunye nolutsha nabo BONKE kubandakanya iiarhente ezintsha ze-anticancer kunye neerejimeni zonyango kunye okanye ngaphandle kwonyango ekujoliswe kulo.

I-chromosome-yeFiladelfiya-YONKE

Unyango lwe-chromosome-ebuntwaneni obunomdla kubuntwana BONKE ngexesha lokuxolelwa, ukudityaniswa / ukuqiniswa, kunye nezigaba zokugcina zinokubandakanya oku kulandelayo:

• Indibaniselwano ye-chemotherapy kunye nonyango ekujoliswe kulo kunye ne-tyrosine kinase inhibitor (imatinib mesylate) kunye okanye ngaphandle kokufakwa kweseli kwistem usebenzisa iiseli zeziqu ezivela kulowo unikelayo.

Unyango olufundwa kuvavanyo lweklinikhi kwi-chromosome-positive yobuntwana ye-Philadelphia ZONKE zibandakanya irejimeni entsha yonyango ekujoliswe kulo (imatinib mesylate) kunye nokudityaniswa kwekhemotherapy kunye okanye ngaphandle kokufakwa 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.

Ubuntwana obunomdla kwiLymphoblastic Leukemia

Akukho lunyango lusemgangathweni kunyango lwe-leukemia ye-lymphoblastic acute ebuntwaneni (YONKE).

Unyango lobuntwana obunqabileyo BONKE kunokubandakanya oku kulandelayo:

• Unyango ekujoliswe kulo (i-blinatumomab okanye i-inotuzumab).

• Unyango lwe-T-cell ye-antigen receptor (CAR).

Ukuphinda ubuye ebuntwaneni kwiLymphoblastic Leukemia

Unyango oluqhelekileyo lokuphindaphinda ebuntwaneni i-lymphoblastic leukemia (YONKE) ebuyela kumongo wethambo inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy kunye okanye ngaphandle kwonyango ekujoliswe kulo (bortezomib).

• Ukufakelwa kweseli kwestem, usebenzisa iiseli zeziqu ezivela kumxhasi.

Unyango oluqhelekileyo lokuphindaphinda ebuntwaneni i-lymphoblastic leukemia (YONKE) ebuya ngaphandle komongo wethambo inokubandakanya oku kulandelayo:

• Inkqubo ye-chemotherapy yenkqubo kunye ne-intrathecal chemotherapy kunye nonyango lwe-radiation kwingqondo kunye / okanye intambo yomqolo yomhlaza obuyela kwingqondo nakwintambo yomqolo kuphela.

• Ukudibanisa i-chemotherapy kunye nokunyanga ngemitha kumhlaza obuyela kumatyhalarha kuphela.

• Ukufakelwa kweseli kwintsholongwane yomhlaza obuye wabuya kwingqondo kunye / okanye kwintambo yomqolo.

Olunye lonyango olufundwayo kuvavanyo lweklinikhi yokubuyela ebuntwaneni ZONKE zibandakanya:

• Inkqubo entsha yokudibanisa i-chemotherapy kunye nonyango ekujoliswe kulo (blinatumomab).

• Uhlobo olutsha lwechiza lokunyanga ngamayeza.

• Unyango lwe-T-cell ye-antigen receptor (CAR).

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.

Ukuze ufunde okungakumbi malunga neLyukemia yeLymphoblastic Leukemia

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga neleukemia ye-lymphoblastic acute ebuntwaneni, jonga oku kulandelayo:

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iziyobisi ezivunyiweyo kwi-Acute Lymphoblastic Leukemia

• Utyando lweSeli oluQulunqwe ngegazi

• Iithagethi zoMhlaza ezijolise kuko

Ngolwazi oluthe kratya lomhlaza wabantwana kunye nezinye izixhobo zomhlaza ngokubanzi, jonga oku kulandelayo:

• Malunga noMhlaza

• Umhlaza wabantwana

• Unyango lokuKhangela uMhlaza waBantwanaPhuma kwiNgcazelo yokuzihlangula

• Iziphumo zokugqibela zonyango lweCancer yoMntwana

• Abafikisayo kunye naBantu abaDala abaDala abanomhlaza

• Abantwana abanomhlaza: Isikhokelo sabazali

• Umhlaza kuBantwana nakwishumi elivisayo

• Ukuqokelela

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli