I-acute myeloid leukemia (AML)

Yini i-acute myeloid leukemia (AML)?

Iyini i-acute myeloid leukemia?

Uhlobo lomdlavuza oluthinta igazi nomnkantsha i-acute myeloid leukemia (AML). Asikho isifo esisodwa i-AML. Yigama elinikezwe iqembu le-leukemia elakha emnkantsheni we-myeloid cell line. Amangqamuzana egazi abomvu, amaplatelet nawo wonke amangqamuzana egazi amhlophe, ngaphandle kwama-lymphocyte, angamaseli e-myeloid.

Ukukhiqizwa ngokweqile kwamangqamuzana egazi amhlophe angavuthiwe abizwa ngokuthi ama-myeloblasts noma ukuqhuma kwe-leukemic, kubonisa i-AML. Umnkantsha ugcwele la mangqamuzana, okwenza ukuba ungakhiqizi amangqamuzana egazi avamile. Zingaphinde zichitheke futhi zijikeleze umzimba wonke ziye egazini. Abakwazi ukwenza kahle ukuvimbela noma ukulwa nokutheleleka ngenxa yokungavuthwa kwabo. I-anemia, ukopha ngokushesha, kanye/noma imihuzuko kungase kubangelwe izinombolo ezinganele zamaseli abomvu nama-platelet akhiwe umnkantsha.

I-acute myeloid leukemia ngezinye izikhathi ibizwa ngokuthi i-acute myelocytic, myelogenous noma i-granulocytic leukemia.

Kungenzeka ukuthi uzwile kabanzi ngalolu hlobo umdlavuza wegazi muva nje ngemuva kokuba umdlali wegalofu okhokhelwayo u-Jarrod Lyle ehlulwe empini yakhe enzima nalesi sifo.

Iluphi uhlobo lwe-AML enginalo?

Ngokusekelwe ebukhoneni bamaseli e-leukemic ngaphansi kwe-microscope, i-AML ihlukaniswa ngezinhlobo eziyisishiyagalombili ezihlukene. I-subtype ngayinye ihlinzeka ngedatha ngohlobo lwengqamuzana legazi elihilelekile kanye nephuzu emnkantsheni owayeka ukuvuthwa kahle. Lokhu kwaziwa njengendlela yokuhlukanisa i-French-American-British (FAB).

Ukuze kuhlelwe ngokwethembeke kakhudlwana i-AML, uhlelo olusha lwe-AML lweNhlangano Yezempilo Yomhlaba olusha lusebenzisa ulwazi olwengeziwe olutholakala ezindleleni zaselabhorethri ezithuthuke kakhulu, njengezifundo zofuzo. Lolu lwazi luphinde lunikeze ulwazi olunembe kakhudlwana ngenkambo (isifo sokubikezela) kanye nendlela engcono yokusingatha, uhlobo oluthile oluncane lwe-AML.

Ezinye izinhlobo ezincane ze-AML zihlotshaniswa nezimpawu ezithile, njengokuhlangana kwe-acute promyelocytic leukemia (APML noma i-M3) enokukhubazeka okopha kanye nokujiyisa igazi.

Iyini i-prognosis ye-AML?

Isakhiwo sofuzo samaseli we-leukemic yisici esibaluleke kakhulu ekunqumeni ukubikezelwa kwe-AML. I-prognosis enhle kakhulu ihlotshaniswa nokuguqulwa kwe-cytogenetic kunezinye. Lokhu kusho ukuthi maningi amathuba okuthi, futhi angaphulukiswa, asabele kahle ekwelashweni.

Izinguquko ezithandekayo ze-cytogenetic zihlanganisa: i-chromosome 8 kuya ku-21 t(8;21) translocation, ukuguqulwa kwe-chromosome 16; i-inv(16) kanye ne-chromosome 15 kuya ku-17 translocation; t (15;17). Lokhu kushintsha kokugcina kubonwa ku-acute promyelocytic leukemia ye-AML subtype (APML noma i-M3). I-APML iphathwa ngendlela ehlukile futhi ngokuvamile ine-prognosis ephezulu kakhulu uma iqhathaniswa nezinye izinhlobo ze-AML.

Ukubikezela okumaphakathi noma okuphakathi kuhlotshaniswa nezinye izinguquko ze-cytogenetic, kanti ezinye zihlotshaniswa nokubikezela okubuthakathaka noma okungalungile. Kubalulekile ukukhumbula ukuthi akukho 'okuhle' noma 'okubi-okuyingozi' ukuguqulwa kwe-cytogenetic akukho ezimweni eziningi ze-AML. Abantu abane-cytogenetics 'yemvelo' nabo babhekwa njengabanokubikezela okumaphakathi.

Izimbangela

Kubantu abadala, i-AML ingenye yezinhlobo ezivame kakhulu ze-leukemia.

Kwabesilisa, i-AML ivame kakhulu kunakwabesifazane.

Umnkantsha usiza umzimba ukulwa nezifo futhi udale ezinye izakhi zegazi. Ngaphakathi komnkantsha wabo, abantu abane-AML banamaseli amaningi angavuthiwe angajwayelekile. Amaseli anda futhi athathe indawo yamaseli egazi anempilo ngokushesha okukhulu. Ngenxa yalokho, abantu be-AML banamathuba amaningi okuba nezifo. Lapho izinombolo zamangqamuzana egazi anempilo zehla, nawo abe nethuba elikhulayo lokopha.

Uchwepheshe wezokunakekelwa kwempilo ngeke akutshele, isikhathi esiningi, ukuthi yini ebangele i-AML. Izinto ezilandelayo zingaholela ezinhlotsheni ezithile ze-leukemia, njenge-AML:

Ukuphazamiseka kwegazi, okuhlanganisa i-polycythemia vera, i-thrombocythemia ebalulekile, ne-myelodysplasia
Amakhemikhali athile (isibonelo, benzene)
Imithi ethile ye-chemotherapy, kuhlanganise ne-etoposide nezidakamizwa ezaziwa ngokuthi ama-alkylating agents
Ukuchayeka kumakhemikhali athile nezinto eziyingozi
Umswakama
Amasosha omzimba abuthakathaka ngenxa yokufakelwa isitho somzimba

Izinkinga ngezakhi zakho zofuzo zingase futhi zibangele ukuthuthukiswa kwe-AML.

Izingozi Zezingozi

Izimo eziningi ze-AML azinambangela eyaziwayo. Azikho izimbangela ezicacile (izici eziyingozi) ukuthi kungani lesi sifo sisungulwe phakathi kwabantu abaningi abane-AML. Awukwazi ukubamba i-AML yomunye umuntu.

Abacwaningi bahlonze izinto ezingaba yingozi, okuhlanganisa:

Ukuchayeka kaningi kukhemikhali benzene, okulimaza i-DNA yamangqamuzana omnkantsha avamile. Ingxenye yokuchayeka kuzwelonke ku-benzene ivela entuthuni kagwayi, ngokusho kwe- Isikhungo Sokubhaliswa Kwezinto Eziyingozi kanye Nezifo, kuyilapho imikhiqizo ye-petroleum inomthelela eningini le-benzene emkhathini. I-Benzene isekhona ezimeni eziningi zokukhiqiza, kodwa ukulawula okuqinile kokusetshenziswa kwayo kunokuchayeka okulinganiselwe ku-benzene emsebenzini.
Izifo ezithile zofuzo njenge-Down syndrome, uhlobo lwe-neurofibromatosis 1, i-Bloom syndrome, i-Trisomy 8, I-Fanconi anemia, i-Klinefelter syndrome, i-Wiskott-Aldrich syndrome, i-Kostmann syndrome kanye ne-Shwachman-Diamond syndrome.
Ukwelashwa ngamakhemikhali okwedlule noma ngemisebe kweminye imidlavuza.
Ukuqhubeka kweminye imidlavuza yegazi noma iziyaluyalu, i-polycythemia vera, i-myelofibrosis eyinhloko, i-thrombocythemia ebalulekile kanye ne-myelodysplastic syndromes (MDS).

Ukuxilongwa kwe-AML

Izimpawu ezivame kakhulu ze-acute myeloid leukemia (AML) zihlanganisa:

Umkhuhlane
Ukuphelelwa umoya
Ukulimala noma ukopha okungajwayelekile
Ukuzizwa ukhathele kakhulu futhi ubuthakathaka
Ukugula ngenxa yezifo kalula kunokuvamile.

Uma unesinye salezi zimpawu, bona udokotela wakho.

Ungase udluliselwe ku-oncologist noma i-hematologist udokotela womndeni wakho - odokotela abaxilonga futhi belaphe i-leukemia. Ukuze uthole ukuthi unayo yini i-AML nokuthi uhlobo luni onalo udokotela angenza izivivinyo. Lapho udokotela wakho efunda okwengeziwe ngomdlavuza wakho, ayanda amathuba okwelashwa okuphumelelayo.

Ukuhlolwa Komzimba

Udokotela wakho uzobuza imibuzo mayelana nempilo yakho ngesikhathi sokuqokwa kwakho. Udokotela wakho uzohlola umzimba ukuze abone izimpawu zomdlavuza ngesikhathi sokuhlolwa, njengemihuzuko noma amabala egazi ngaphansi kwesikhumba.

Ukuhlolwa kwe-AML

I-AML ithinta amangqamuzana egazi angavuthiwe abizwa ngama-stem cells akhula abe amaseli amhlophe egazi, amangqamuzana egazi abomvu, nama-platelet. Lamangqamuzana egazi enziwa emnkantsheni wakho - into eyisiponji ngaphakathi emathanjeni akho. Ku-AML, ama-stem cells awajwayelekile futhi awakwazi ukukhula abe amaseli egazi anempilo.

Lokhu kuhlola kubheka amaseli angakavuthwa noma angajwayelekile egazini lakho kanye nomnkantsha wamathambo:

Ukuhlolwa kwegazi
Ukuhlolwa komnkantsha
Ukukhishwa kwe-Lumbar
Ukuhlola ukuhlolwa
Ukuhlolwa kofuzo

Izivivinyo zegazi

Ngesikhathi sokuhlolwa kwegazi, udokotela wakho usebenzisa inaliti ukuze athathe isampula yegazi emthanjeni osengalweni yakho. Odokotela basebenzisa izinhlobo ezahlukene zokuhlolwa kwegazi ukuxilonga i-AML:

Isibalo segazi esiphelele (CBC). Lokhu kuhlola kuhlola ukuthi mangaki amangqamuzana amhlophe egazi, amangqamuzana abomvu egazi, namaplatelet onawo. Nge-AML, ungase ube namaseli egazi amhlophe amaningi kanye namaseli abomvu egazi ambalwa namaplatelet kunokujwayelekile.
I-peripheral blood smear. Kulokhu kuhlolwa, isampula yegazi lakho ihlolwa ngesibonakhulu. Ihlola inombolo, ukwakheka, nobukhulu bamangqamuzana amhlophe egazi, futhi ibheka amangqamuzana egazi amhlophe angavuthiwe abizwa ngokuthi ama-blasts.

Ukuhlola Umnkantsha Wamathambo

Uzodinga nokuhlolwa komnkantsha ukuze uqinisekise ukuthi une-AML. Isampula encane yomnkantsha wamathambo ingathathwa udokotela. Khona-ke, ukuze abone ukuthi akhona yini amaseli akhubazekile (umdlavuza), omunye udokotela angase abheke amaseli ngesibonakhulu. Uma amaphesenti angu-20 noma ngaphezulu amangqamuzana egazi emnkantsha engavuthiwe, i-AML ingaxilongwa.

Ukwelashwa kwe-AML

I-acute myeloid leukemia (AML) iphoqa umnkantsha ukuthi ukhiqize inqwaba yamaseli egazi abizwa ngokuthi ama-blast cell ayivelakancane futhi angathuthukisiwe. Lawa mangqamuzana aminyanisa amangqamuzana egazi abomvu avuthiwe, amangqamuzana amhlophe egazi nama- platelet azinzile. Inhloso yokwelashwa kwe-AML ukubulala amangqamuzana egazi angavuthiwe angasebenzi egazini nomnkantsha. Umgomo uwukubeka ekukhululekeni okuphelele, okusho ukuthi awunazo izimpawu zegazi noma izimpawu zomdlavuza.

Ukwelashwa okuningana okuhlukene kusebenza ku-AML:

Ukwelashwa ngamakhemikhali
Ukufakelwa kwe-stem cell
Umswakama
Ukwelapha okuhlosiwe

Ukwelashwa kwakho kuzoba nezigaba ezimbili:

Isigaba 1: Ukwelashwa kokungeniswa kokukhululwa.

Ukuze ubulale amangqamuzana okuqhuma kwe-leukemia amaningi ngangokunokwenzeka, uzothola imithamo enzima ye-chemotherapy. Imithi yokwelapha okuhlosiwe isekhona.

Umnkantsha wakho kufanele uqale ukwenza amangqamuzana egazi anempilo emasontweni amane kuya kwangu-6 ngemva kokwelashwa. Udokotela wakho uzothatha isampula yomnkantsha wakho futhi enze izivivinyo ukuze abone ukuthi akhona yini amangqamuzana e-leukemia asele egazini lakho. Uma zingekho izimpawu zamangqamuzana egazi leukemia, odokotela bakubiza ngokuthi ukukhululwa.” Ukukusiza ukuthi uhlale uxolelwe, uzodinga futhi ukuthola ukwelashwa kwangemuva kokuxolelwa.

Isigaba sesi-2: Ukwelashwa kwangemva kokuxolelwa. Ukwelashwa kwangemva kokuxolelwa kusebenzisa izindlela eziningi zokwelapha ukusula noma yimaphi amangqamuzana omdlavuza okungenzeka ashiywe ngemva kokwelashwa ngamakhemikhali. Lokhu kubizwa ngokuthi ukuxolelwa okuphelele. Unezinketho ezintathu:

I-Chemotherapy. Ungathola imijikelezo eminingana ye-chemotherapy yedosi ephezulu kanye ngenyanga.
I-Allogenic (kusuka kumnikeli) i-stem cell transplant
I-Autologous (okusuka kuwe) ukufakelwa kwe-stem cell

Ukwelashwa ngamakhemikhali

Ukuze kucekelwe phansi amangqamuzana omdlavuza emzimbeni wonke, i-chemotherapy isebenzisa imithi enamandla. Uthola le mithi ngomlomo, nge-IV, noma ngomjovo ngaphansi kwesikhumba sakho.

Uma umdlavuza ususabalele, uketshezi oluzungeze ubuchopho nomgogodla luzothola ukwelashwa ngamakhemikhali. Yilokhu odokotela abakubiza nge-intra-thecal chemotherapy.

Okuqhamuka uma udla imishanguzo: I-Chemotherapy isebenza ngokubhubhisa amaseli emzimbeni wakho ahlukana ngokushesha. Amangqamuzana omdlavuza ahlukana ngokushesha, kodwa kanjalo namanye amangqamuzana, njengalawo asohlelweni lwakho lokuzivikela ezifweni, ulwelwesi lomlomo wakho namathumbu, kanye nezicubu zezinwele zakho. Ungase ube nemiphumela engemihle efana nalena njengoba ukwelashwa ngamakhemikhali kulimaza lawa maseli anempilo :

I-nausea nokuhlanza
Ukulahlekelwa izinwele
Izilonda zomlomo
Ukukhathala
Ukulahlekelwa kwesifiso
Uhudo nokuqunjelwa
Ukulimala okulula nokopha
Ayanda amathuba okuba nezifo

Lapho ukwelashwa kuphela, iningi lale miphumela emibi kufanele yehle. Udokotela wakho angakunikeza imithi kanye nezinye izindlela zokwelapha ukusiza ukuphatha imiphumela emibi ye-chemotherapy.