Leukemia Limfositik Kronik

Leukemia, limfoma dan myeloma adalah tiga jenis kanser darah utama yang lazim kita dengar. Namun banyak lagi jenis penyakit gangguan darah yang wujud dan berpotensi mengancam nyawa termasuk leukemia limfositik kronik (chronic lymphocytic leukaemia (CLL)).

CLL ialah sejenis kanser darah membabitkan sel darah putih tertentu dipanggil limfosit. Ia dirujuk sebagai ‘leukemia’ kerana limfosit berkanser ditemui dalam darah dan sumsum tulang. CLL paling biasa bermula dalam limfosit-B iaitu komponen penting dalam sistem imun badan.

Ia bukan penyakit diwarisi, namun mereka yang mempunyai sejarah CLL atau limfoma lain (kanser yang bermula dalam sel sistem imun) dalam keluarga akan lebih berkemungkinan menghidap penyakit itu.

Lazimnya ia muncul sebagai penyakit indolen yang bermaksud lambat berkembang dan biasanya membabitkan warga tua. Kira-kira 70 hingga 80 peratus pesakit mula didiagnosis selepas usia 55 tahun dengan umur median ketika didiagnosis ialah 72 tahun.

Presiden Persatuan Hematologi Malaysia, Dr Alan Teh berkata, CLL adalah penyakit yang lambat berkembang. Disebabkan itu kira-kira 40 hingga 60 peratus pesakit tidak menunjukkan sebarang simptom penyakit.

“Sebilangan pesakit menyangka simptom dialami adalah masalah kesihatan biasa yang lain. Selalunya pesakit berasa sihat tubuh badan, namun penyakit ini akan dikesan melalui rutin ujian darah yang dijalankan ketika pemeriksaan kesihatan biasa.

“Oleh itu, CLL sering didiagnosis secara kebetulan. Sebahagian besar pesakit CLL adalah warga tua dan penghidap penyakit lain yang menyebabkan kemoterapi intensif tidak sesuai untuk mereka,” katanya pada pelancaran Gazyva (obinutuzumab) untuk rawatan CLL di ibu negara baru-baru ini.

Gazyva khusus untuk penghidap CLL yang mempunyai penyakit lain dan tidak pernah menerima rawatan. Sebelum ini rawatan pesakit CLL adalah kemoterapi sahaja atau gabungan kemoterapi bersama rituximab.

Daftar Kanser Kebangsaan Malaysia 2007 melaporkan CLL merangkumi sebanyak 8.1 peratus daripada kes leukemia limfoid di Malaysia. Namun, CLL adalah leukemia yang paling biasa berlaku di negara Barat, ia sangat jarang berlaku di rantau Asia.

Disebabkan pesakit CLL mungkin tidak menunjukkan sebarang simptom selama beberapa tahun, diagnosis mengenainya sukar dilakukan, namun ada situasi di mana CLL didiagnosis secara kebetulan.

Penyelidik Kajian CLL 11, Francesc Bosch berkata Gazyva ialah pilihan baru yang membantu pesakit bertindak balas dengan lebih berkesan terhadap rawatan dan ia akan dizahirkan sebagai tempoh remisi (atau pengurangan simptom penyakit) yang lebih panjang.

“Kajian CLL 11 membuat perbandingan antara rawatan gabungan Gazyva dan kemoterapi dan dengan kemoterapi sahaja serta gabungan rituximab dengan kemoterapi dalam CLL.

“Hasil kajian ini menunjukkan pengurangan ketara sebanyak 82 peratus daripada aspek risiko perkembangan penyakit apabila Gazyva digabungkan dengan kemoterapi berbanding rawatan kemoterapi sahaja serta pengurangan sebanyak 61 peratus berbanding rawatan dengan rituximab dan kemoterapi.

“Gazyva juga didapati berkesan mengurangkan risiko kematian dalam kalangan pesakit CLL yang tidak pernah dirawat sebelum ini iaitu sebanyak 59 peratus berbanding mereka yang menerima rawatan kemoterapi sahaja,” katanya.

Turut Hadir,Ketua Perkhidmatan Hematologi Kebangsaan, Datuk Dr Chang Kian Meng serta Pengarah Urusan Roche Malaysia, Dr Aitallah Mejri.

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