Types/leukemia/patient/cll-treatment-pdq

Unyango lweLymphocytic Leukemia enganyangekiyo (®) -Patient Version

Ulwazi ngokubanzi malunga neLymphocytic Leukemia

IINGONGOMA EZIPHAMBILI

• I-lymphocytic leukemia engapheliyo luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi (uhlobo lweseli emhlophe yegazi).

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

• Ukwaluphala kunokuchaphazela umngcipheko wokuba ne-leukemia engapheliyo.

• Iimpawu kunye neempawu ze-lymphocytic leukemia ezingapheliyo zibandakanya ukudumba kwe-lymph node kunye nokudinwa.

• Uvavanyo oluvavanya igazi, umongo wethambo, kunye ne-lymph node zisetyenziselwa ukufumanisa isifo se-lymphocytic leukemia.

• Izinto ezithile zichaphazela ukhetho kunyango kunye nokuxela kwangaphambili (ithuba lokuchacha).

I-lymphocytic leukemia engapheliyo luhlobo lomhlaza apho umongo wethambo wenza ii-lymphocyte ezininzi (uhlobo lweseli emhlophe yegazi).

I-lymphocytic leukemia engapheliyo (ekwabizwa ngokuba yi-CLL) sisifo segazi kunye nomongo wethambo esihlala sisiba mandundu ngokuthe kratya. I-CLL yenye yeentlobo eziqhelekileyo ze-leukemia kubantu abadala. Ihlala ivela ngexesha okanye emva kweminyaka ephakathi; kunqabile ukuba kwenzeke ebantwaneni.

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, umzimba wenza iiseli ze-stem zegazi (iiseli ezingafakwanga) 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.

• Amaseli egazi amhlophe alwa nosulelo kunye nezifo.

• Iiplatelets ezenza amahlwili egazi ayeke ukopha.

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 zokulwa 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.

Kwi-CLL, iiseli ezininzi zegazi ziba zii-lymphocyte ezingaqhelekanga kwaye azibi ziiseli ezimhlophe zegazi. Ii-lymphocyte ezingaqhelekanga zinokubizwa ngokuba ziiseli zegazi. Ii-lymphocyte azikwazi ukulwa nosulelo kakuhle. Kwakhona, njengoko inani lee-lymphocyte landa egazini nakumongo wamathambo, kuncinci indawo yeeseli ezimhlophe eziphilileyo, iiseli ezibomvu zegazi kunye neeplatelets. Oku kunokubangela usulelo, i-anemia, kunye nokopha ngokulula.

Esi sishwankathelo malunga ne-lymphocytic leukemia. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga ne-leukemia:

• Unyango lweLukymphoblastic Leukemia yabantu abadala.

• Unyango lwe-Acute Lymphoblastic Leukemia.

• Unyango lwabantu abadala abaNamandla.

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

• Unyango lwe-Myelogenous Leukemia enganyangekiyo.

• Unyango lweeuksi zeSeli leenwele.

Ukwaluphala kunokuchaphazela umngcipheko wokuba ne-leukemia engapheliyo.

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. Imiba yomngcipheko kwi-CLL ibandakanya oku kulandelayo:

• Ukuba mdala okanye mdala, uyindoda, okanye umhlophe.

• Imbali yosapho ye-CLL okanye umhlaza wenkqubo ye-lymph.

• Ukuba nezihlobo ezingamaJuda aseRussia okanye amaJuda aseMpuma Yurophu.

Iimpawu kunye neempawu ze-lymphocytic leukemia ezingapheliyo zibandakanya ukudumba kwe-lymph node kunye nokudinwa.

Ngokwesiqhelo i-CLL ayibangeli zimpawu okanye zimpawu kwaye ifumaneka kuvavanyo lwegazi oluqhelekileyo. Iimpawu kunye neempawu zinokubangelwa yi-CLL okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukudumba okungenasiphelo kwee-lymph node entanyeni, phantsi kwekhwapha, esiswini, okanye emhlubulweni.

• Ndiziva ndidiniwe.

• Intlungu okanye ukugcwala ngaphantsi kweembambo.

• Umkhuhlane kunye nosulelo.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Uvavanyo oluvavanya igazi, umongo wethambo, kunye ne-lymph node zisetyenziselwa ukufumanisa isifo se-lymphocytic leukemia.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: 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 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.

• 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.

• I-FISH (i-fluorescence in situ hybridization): Uvavanyo lwaselebhu olusetyenziselwa ukujonga nokubala ii-genes okanye ii-chromosomes kwiiseli nakwizicubu. Amacandelo e-DNA aqukethe idayi ye-fluorescent yenziwa elebhu kwaye yongezwa kwisampulu yeeseli zomguli okanye izicwili. Xa ezi ziqwenga zeDNA zidayiweyo zinamathela kwimfuza ethile okanye kwiindawo zechromosomes kwisampulu, ziyakhanya xa zijongwa phantsi kwemicroscope ebengezelayo. Uvavanyo lwe-FISH lusetyenziselwa ukunceda ekuchongeni umhlaza kunye nokunceda ekucwangciseni unyango.

• Ukuhamba kwe-cytometry: Uvavanyo lwelebhu olulinganisa inani leeseli kwisampulu, ipesenti yeeseli eziphilayo kwisampulu, kunye neempawu ezithile zeeseli, ezinje ngobungakanani, imilo, kunye nobukho beempawu zethumba (okanye ezinye) umphezulu weseli. Iiseli ezivela kwisampulu yegazi lesigulana, umongo wethambo, okanye ezinye izicwili zinamabala edayi ye-fluorescent, ibekwe kulwelo, emva koko idlulise nganye nganye kwitampu yokukhanya. Iziphumo zovavanyo zisekwe kwindlela iiseli ezazinebala ledayi ye-fluorescent zisabela njani kwimbonakalo yokukhanya. Olu vavanyo lusetyenziselwa ukunceda ekuchongeni nasekulawuleni iintlobo ezithile zomhlaza, ezinje ngeleukemia kunye ne-lymphoma.

• Uvavanyo lwe-IgVH lokutshintsha kwemfuza: Uvavanyo lwelabhoratri apho kuvavanywa khona isampulu yegazi okanye izicwili zotshintsho oluthile kuhlobo lwe-IgVH. Izigulana ezinokuguqulwa kwemfuza ye-IgVH zinokuxela okungcono.

• 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.

Izinto ezithile zichaphazela ukhetho kunyango kunye nokuxela kwangaphambili (ithuba lokuchacha).

Ukhetho lonyango luxhomekeke:

• Inqanaba lesi sifo.

• Iseli ebomvu yegazi, iseli emhlophe yegazi, kunye neeplatelet zegazi.

v Nokuba ngaba kukho imiqondiso okanye iimpawu, ezinje ngomkhuhlane, ukugodola, okanye ukunciphisa umzimba.

• Nokuba isibindi, udakada, okanye ii-lymph node zikhulu kunesiqhelo.

• Impendulo kunyango lokuqala.

• Nokuba i-CLL iphinde yabuya (buyela).

Ukuxelwa kwangaphambili kuxhomekeke:

• Nokuba kukho utshintsho kwi-DNA kunye nohlobo lotshintsho, ukuba lukhona.

• Nokuba ii-lymphocyte zisasazekile kuwo wonke umongo wethambo.

• Inqanaba lesi sifo.

• Nokuba i-CLL iya kuba bhetele kunyango okanye iphinde yabuya (buyela).

• Nokuba i-CLL iqhubela phambili kwi-lymphoma okanye i-prolymphocytic leukemia.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

Amanqanaba e-lymphocytic leukemia

IINGONGOMA EZIPHAMBILI

• Emva kokuba i-lymphocytic leukemia engapheliyo ifunyenwe, iimvavanyo zenziwa ukufumanisa ukuba umhlaza usasazeke kangakanani kwigazi kunye nomongo wethambo.

• La manyathelo alandelayo asetyenziselwa i-lymphocytic leukemia enganyangekiyo:

• Inqanaba 0

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

Emva kokuba i-lymphocytic leukemia engapheliyo ifunyenwe, iimvavanyo zenziwa ukufumanisa ukuba umhlaza usasazeke kangakanani kwigazi kunye nomongo wethambo.

Inqanaba yinkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazeke kangakanani. Kubalulekile ukuba wazi inqanaba lesifo ukuze ucwangcise olona nyango lululo. Ezi mvavanyo zilandelayo zinokusetyenziswa kwinkqubo yokubeka esiteji:

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

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

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, 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.

• Iskena se-PET-CT: Inkqubo edibanisa imifanekiso evela kwiskena se-positron emission tomography (PET) kunye nekhompyuter ye-tomography (CT). Ukuskena i-PET kunye ne-CT kwenziwa ngaxeshanye kumatshini omnye. Izikena ezidityanisiweyo zinika imifanekiso eneenkcukacha ngakumbi yeendawo ezingaphakathi komzimba kunokuba iskena sinikwe sisodwa. Ukuskena i-PET yinkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• 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.

• Uvavanyo lwe-Antiglobulin: Uvavanyo ekujongwa kulo isampulu yegazi phantsi kwemicroscope ukufumanisa ukuba ngaba akukho zintsholongwane zingaphezulu komhlaba kwiiseli ezibomvu zegazi okanye iiplatelets. Ezi zintsholongwane zinokuphendula zitshabalalise iiseli ezibomvu zegazi kunye neeplatelets. Olu vavanyo lukwabizwa ngokuba luvavanyo lweCombombs.

La manyathelo alandelayo asetyenziselwa i-lymphocytic leukemia enganyangekiyo:

Inqanaba 0

Kwinqanaba le-lymphocytic leukemia engapheliyo, zininzi ii-lymphocyte egazini, kodwa azikho ezinye iimpawu okanye iimpawu ze-leukemia. Isigaba se-lymphocytic leukemia esingapheliyo asiyonto (ukukhula kancinci).

Inqanaba I

Kwinqanaba I-lymphocytic leukemia engapheliyo, zininzi ii-lymphocyte egazini kwaye ii-lymph node zikhulu kunesiqhelo.

Inqanaba II

Kwinqanaba II i-lymphocytic leukemia engapheliyo, zininzi ii-lymphocyte egazini, isibindi okanye udakada mkhulu kunesiqhelo, kwaye ii-lymph node zinokuba nkulu kuneqhelekileyo.

Inqanaba III

Kwinqanaba lesithathu le-lymphocytic leukemia, zininzi ii-lymphocyte egazini kwaye zimbalwa kakhulu iiseli ezibomvu zegazi. Ii-lymph node, isibindi, okanye udakada kunokuba nkulu kuneqhelekileyo.

Inqanaba IV

Kwinqanaba IV i-lymphocytic leukemia engapheliyo, zininzi ii-lymphocyte egazini kunye neeplatelets ezimbalwa. Ii-lymph node, isibindi, okanye udakada kunokuba nkulu kunesiqhelo kwaye kunokubakho iiseli ezibomvu zegazi ezimbalwa.

Ukuphinda-phinda okanye ukuphikisa iLukemia engapheliyo

Ukuphindaphindeka kwe-lymphocytic leukemia ngumhlaza ophindaphindiweyo (ubuyile), ngesiqhelo emva kwexesha apho umhlaza ungafumanekiyo. I-Refractory chronic lymphocytic leukemia ngumhlaza ongangcono kunyango.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-lymphocytic leukemia.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ukulinda ulindile

• Unyango ngemitha
• Unyango ngamayeza

• Ugqirha

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• I-Chemotherapy kunye nokufakelwa kweseli

• Unyango lwe-Immunotherapy

• Unyango lwe-lymphocytic leukemia engapheliyo kunokubangela 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-lymphocytic leukemia.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-lymphocytic 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.

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ukulinda ulindile

Ukuhlala ulindile kubeka esweni imeko yesigulana ngaphandle kokunikezela ngonyango de kuvele iimpawu okanye utshintsho. Oku kukwabizwa ngokuba kukujonga. Ngeli xesha, iingxaki ezibangelwa sesi sifo, ezinjengosulelo, ziyanyangwa.

Unyango ngemitha Unyango ngemitha lunyango olusebenzisa amandla amakhulu e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-lymphocytic leukemia engapheliyo.

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, ilungu, okanye indawo yomzimba efana nesisu, okanye iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Jonga iziyobisi ezivunyiweyo zeLymphocytic Leukemia engapheliyo ngolwazi oluthe kratya.

Ugqirha

I-Splenectomy yotyando lokususa udakada.

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, unyango lwe-tyrosine kinase inhibitor, kunye ne-BCL2 ye-inhibitor yonyango ziindidi zonyango olujolisiweyo olusetyenziswa kunyango lwe-lymphocytic leukemia.

Unyango lweTyrosine kinase inhibitor lunyango lomhlaza oluvimba iibhloko ezifunekayo ekukhuleni kwamathumba.

Unyango lwe-BCL2 inhibitor lunyango lomhlaza oluthintela iprotein ebizwa ngokuba yi-BCL2. Unyango lwe-BCL2 inhibitor lusenokubulala iiseli zomhlaza kwaye lunokubenza babe novakalelo ngakumbi kwezinye iziyobisi ezichaphazela umhlaza.

Jonga iziyobisi ezivunyiweyo zeLymphocytic Leukemia engapheliyo 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.

I-Chemotherapy kunye nokufakelwa kweseli

I-Chemotherapy nge-stem cell transplant yindlela yokunika i-chemotherapy kunye nokutshintsha iiseli ezenza igazi ezichithwe ngumhlaza. Iiseli zeziqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana okanye somnikeli kwaye zibandisiwe kwaye zigcinwe. Emva kokuba i-chemotherapy igqityiwe, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

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 lwe-lymphocytic leukemia.

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.

Unyango lwe-lymphocytic leukemia engapheliyo kunokubangela 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 lonyango ngeSigaba

Kweli Candelo

• Isigaba 0 seLymphocytic Leukemia

• Isigaba I, iSigaba II, iSigaba III, kunye neSigaba IV seLymphocytic Leukemia

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

Isigaba 0 seLymphocytic Leukemia

Unyango lwenqanaba le-lymphocytic leukemia engapheliyo ihlala ilindile.

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.

Isigaba I, iSigaba II, iSigaba III, kunye neSigaba IV seLymphocytic Leukemia

Unyango lwenqanaba I, isigaba II, isigaba III, kunye nenqanaba IV i-lymphocytic leukemia inokubandakanya oku kulandelayo:

• Ukubukela ukulinda xa kukho iimpawu ezimbalwa okanye kungekho zimpawu.

• Unyango ekujoliswe kulo nge-monoclonal antibody, i-tyrosine kinase inhibitor, okanye i-BCL2 inhibitor.

• I-Chemotherapy nge-1 okanye ngaphezulu iziyobisi, kunye okanye ngaphandle kwe-steroids okanye unyango lwe-monoclonal antibody.

• Unyango lwedosi ephantsi yedosi ephantsi kwiindawo zomzimba apho umhlaza ufumaneka khona, njengepleen okanye i-lymph node.

• Uvavanyo lwezonyango lwe-chemotherapy kunye nonyango lwe-biologic kunye nokufakelwa kweseli.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

Ukhetho kunyango lweLymphocytic engapheliyo

Ileukemia

Unyango lwe-lempemia engapheliyo ye-lymphocytic leukemia inokubandakanya enye yeendlela zonyango ezichazwe apha ngasentla okanye ukubhaliswa kuvavanyo lweklinikhi yonyango olutsha. Jonga iSigaba I, iSigaba II, iSigaba III, kunye neSigaba IV seLymphocytic Leukemia icandelo ngolwazi olungakumbi.

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 neLymphocytic Leukemia

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga neleukemia engapheliyo ye-lymphocytic, bona oku kulandelayo:

• Ikhasi lasekhaya leleukemia

• Iziyobisi ezivunyiweyo zeLymphocytic Leukemia engapheliyo

• Iithagethi zoMhlaza ezijolise kuko

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

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