So woate mogya mu kokoram a emu yɛ den yi ho asɛm? (Acute Promyelocytic Leukemia - APL) Momma yɛnka ho asɛm nkɔ akyiri!

So woate nka pɛn sɛ woabrɛ paa mpofirim, woanya akuru kakraa bi, anaasɛ wo sẽ taa tu mogya? Ɛwom sɛ yɛmfa yɛn adwene nsi saa nneɛma yi so kɛse de, nanso wɔ nsɛm a ɛntaa nsi mu no, ebetumi ayɛ tebea bi a emu yɛ den kɛse te sɛ Acute Promyelocytic Leukemia (APL) ho sɛnkyerɛnne . Enti, mma ɛnhaw wo, ɛnnɛ yɛbɛka mogya mu kokoram a wɔfrɛ no APL yi ho asɛm wɔ ɔkwan a emu da hɔ na ɛnyɛ den so.

Dɛn ne acute promyelocytic leukemia (APL)?

Sɛ yɛbɛka no tiawa a, APL yɛ mogya mu kokoram a ɛntaa nsi koraa . Ɛyɛ mogya mu kokoram kuw kɛse bi a wɔfrɛ no Acute Myeloid Leukemia no muni ankasa . Beae titiriw a wɔyɛ mogya wɔ yɛn nipadua mu ne nnompe mu ntini . Wɔ nnompe mu ntini yi mu ha, esiane awosu mu nsakrae, kyerɛ sɛ, awosu mu nsakrae , mogya mu nkwammoaa fitaa a ɛnteɛ fi ase ba. Saa nkwammoaa a ɛnteɛ yi mu paapae na ɛdɔɔso ntɛmntɛm a wontumi nni so na ɛtrɛw kɔ nnompe mu ntini no nyinaa mu. Ɛtɔ mmere bi a nnuruyɛfo frɛ eyi APL leukemia, anaa M3-leukemia .

APL yɛ tebea a emu yɛ den. Ne sɛnkyerɛnne ahorow betumi aba mpofirim na asɛe ntɛmntɛm. Mogya a ɛtɔ dodo no yɛ ade titiriw a ɛde asiane ba. Nanso asɛmpa bi wɔ hɔ! Ɛdenam ayaresa foforo a nnuru a wɔde sa yare ne nnuru foforo a ɛnyɛ nnuru a wɔde sa yare ka ho so no, nnuruyɛfo tumi di APL so na mpɛn pii no wɔsa no koraa.

Saa yare yi abu so dɛn?

APL yɛ yare a ɛntaa nsi koraa ankasa . Sɛ nhwɛso no, wɔ ɔman te sɛ United States mu no, afe biara nnipa bɛyɛ 30,000 pɛ na wohu sɛ wɔwɔ saa yare yi. Mpɛn pii no, wohu APL wɔ nnipa a wɔadi mfe 30 mu .

Dɛn ne APL ho sɛnkyerɛnne ahorow?

APL sɛnkyerɛnne ahorow ba bere a wo nnompe mu ntini ntumi nyɛ mogya mu nkwammoaa kɔkɔɔ , mogya mu nkwammoaa fitaa, ne mogya nkwammoaa a ɛte apɔw sɛnea ɛtaa yɛ no. Wɔfrɛ mogya mu nkwammoaa ahorow yi nyinaa a ɛso tew yi pancytopenia . Sɛ eyi ba a, wubetumi anya yare no ho sɛnkyerɛnne a emu yɛ den te sɛ mogya a ɛtɔ kɔ nipadua mu , mogyatɔw ho haw ahorow esiane mogya a ɛtwetwe , ne nyarewa a ɛtaa ba nti.

APL ho sɛnkyerɛnne afoforo a ɛtaa ba ne:

• Ɔbrɛ ne ɔbrɛ a wɔte nka kɛse esiane mogya mu nkwammoaa kɔkɔɔ a ɛso tew (i.e. mogya a ɛtɔ kɔ nipadua mu) nti.
• Nyarewa a ɛtaa ba esiane mogya mu nkwammoaa fitaa a ɛba fam a ɛko tia nyarewa nti. Nneɛma te sɛ atiridiinini ne atiridiinini tumi ba mpɛn pii.
• Esiane sɛ wo nipadua no mu nneɛma a ɛsakra no yɛ ntɛmntɛm na ahoɔden a efi aduan mu no hyew ntɛmntɛm nti, .Mu duru a wɔtew so a wɔanhyɛ da.

Mogya a ɛretu ho sɛnkyerɛnne

Obi a ɔwɔ APL no mogya mu nkwammoaa a ɛma mogya tu ne nneɛma a ɛma mogya tu a ɛboa ma mogya tu no sua. Wunim, mogya nkwammoaa ne nea ɛboa ma mogya tu gyae anaasɛ ɛtew so. Enti, sɛ eyinom sua a, ɔhaw no fi ase.

Mogya a ɛtɔ a APL de ba ho sɛnkyerɛnne ahorow bi ni:

• Mogya betumi atu wɔ nipadua no mu baabiara. Sɛ nhwɛso no, mogya a ɛtɔ gu anom , mogya a ɛtaa tu fi hwene mu , na wɔ mmea fam no, mogya a ɛtɔ kɛse wɔ brayɛ mu .
• Mogya boaboa ano wɔ honam ani na ɛma nipadua no mu mmeae ahorow . Sɛ wotwa ade ketewaa bi mpo a, ebetumi ama wabɔ akuru kɛse.
• Ɛtɔ mmere bi a mogya betumi atɔ amemene no mu (mogya a ɛba amemene no mu) . Sɛ eyi ba a, ebia ɛbɛyɛ den ama wo sɛ wobɛkanyan wo nsa ne wo nan, wo ti ayɛ wo yaw kɛse, na ebia nsakrae bɛba w’ani so. Eyi yɛ asɛm a egye ntɛmpɛ!
• Sɛ wo nsu mu yɛ tuntum anaasɛ mogya ayɛ no nsensanee a, ebetumi afi mogya a ɛretu wɔ aduan mu (yafunu mu mogya) .

Dɛn na ɛde APL ba?

Awosu mu nkwaadɔm abien a ɛhwɛ yɛn mogya mu nkwammoaa a wɔyɛ so a ɛka bom yɛ awosu mu abɔde a ɛnyɛ ne kwan so a wɔfrɛ no PML-RARa . Nea ɛho hia no, awosu mu nsakrae yi nyɛ biribi a wunya fi w’awofo hɔ . Ɛsi kwa, a ɛkyerɛ sɛ ntease biara nni mu, wɔ wo nkwa nna mu. Abenfo da so ara nnim nea ɛde awosu mu nsakrae yi ba ankasa.

Saa nkwaadɔm mu nsakrae yi ma mogya mu nkwammoaa fitaa nyin a wontumi nni so, sen sɛ ebenyin yiye, na mmom ɛyɛ mogya mu nkwammoaa fitaa a ennyinii (promyelocytes) . Saa nkwammoaa a ennyinii yi hyɛ nnompe mu ntini no ma, na ɛhyɛ baabi a mogya mu nkwammoaa ne mogya mu nkwammoaa a ɛte apɔw wom no.

Dɛn ne nsɛnnennen a ɛwɔ APL mu?

APL yɛ tebea a ɛde nkwa to asiane mu. Nea enti a ɛte saa ne sɛ mogya mmoroso a ɛba no betumi abɛyɛ nea asiane wom ntɛm. Sɛ wuntumi nnyae mogya a efi wo twitwa ketewaa bi mpo mu, sɛ mogya pii wɔ wo nsu mu anaa wo nsu mu bere a worekɔ tiafi, anaasɛ wuntumi nnyae mogya a ɛretu wo sẽ mu a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn anaa wokɔ ayaresabea dan a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu ntɛm ara .

Kae: Sɛ mogya retu wo a wuntumi nni so a, mmu w’ani ngu so da. Ayaresa a wɔde ma ntɛm no yɛ ade titiriw.

Ɔkwan bɛn so na wohu sɛ obi anya APL?

Nnuruyɛfo taa yɛ nhwehwɛmu ahorow pii de hu yare yi.

• Mogya Dodow a Edi Mu (CBC): APL ma mogya mu nkwammoaa fitaa a ɛnteɛ ba. CBC nhwehwɛmu betumi ahwɛ mogya mu nkwammoaa ahorow ne mogya mu nkwammoaa dodow a ɛwɔ wo mogya bi mu.
• Mogya a Wɔde Siesie Nneɛma a Ɛwɔ Akyi:Wɔ eyi mu no, wɔfa mogya bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu. Afei, wɔhwɛ sɛ ebia ntini nketenkete pii wɔ saa mogya mu nkwammoaa fitaa a ennyinii (promyelocytes) no mu, anaasɛ nneɛma titiriw bi wɔ hɔ a wɔfrɛ no Auer abaa . Eyinom yɛ APL su.
• Bone Marrow Biopsy: Wɔ sɔhwɛ yi mu no, wɔfa wo nnompe mu ntini ketewaa bi na wɔhwehwɛ ne nkwammoaa mu.
• Flow Cytometry: Wɔ sɔhwɛ yi mu no, nyarewa ho animdefo hwehwɛ protein pɔtee bi a ɛwɔ nkwammoaa a ɛnyɛ ne kwan so no ani. Saa nhwɛso ahorow yi betumi asi APL so dua.
• Polymerase Chain Reaction (PCR) sɔhwɛ: Saa sɔhwɛ yi tumi hu awosu mu abɔde a ɛnteɛ (PML-RARa) a ɛde APL ba no wɔ hɔ pɛpɛɛpɛ.
• Cytogenetics: Eyi hwehwɛ nsakrae pɔtee bi a ɛba nkwammoaa a ɛnyɛ ne kwan so no chromosomes mu. Nsakrae ahorow yi a wobehu no ne ɔkwan titiriw a wɔfa so si so dua sɛ wɔahu sɛ obi anya APL.

Nnuruyɛfo gyina wo mogya mu nkwammoaa fitaa dodow so bu APL sɛ asiane a ɛba fam anaasɛ asiane kɛse wom. Nnipa a wɔwɔ APL a asiane kɛse wom no taa nya kokoram a ɛsan ba bio anaasɛ ɛsan ba bio .

Ɔkwan bɛn so na wɔsa APL?

Wɔde nnuru a ɛma nsonsonoe , nnuru a wɔde sa yare, ne ayaresa a wɔde asi wɔn ani so a wɔaka abom sa APL . Nokwarem no, efi bere a wohuu saa nnuru yi wɔ 1980 mfe no mu no, saa yare yi a kan no na wosusuw sɛ ekum nnipa no abɛyɛ yare a wotumi sa. Eyi yɛ ade kɛse a wɔatumi ayɛ!

Nnuru a wɔde kyerɛ nkwammoaa mu nsonsonoe yɛ nnuru a ɛnyɛ nnuru a wɔde sa yare a ɛboa ma mogya mu nkwammoaa fitaa a ɛnyɛ ne kwan so a ennyinii no yɛ soronko ma ɛbɛyɛ mogya mu nkwammoaa fitaa a ɛteɛ na ɛho akokwaw. Saa nnuru a ɛnyɛ nnuru a wɔde sa yare yi a wɔabobɔ din wɔ ase ha no ama wɔagyae bɛboro 95% na wɔasa.

• All-trans-retinoic acid (ATRA) , anaa tretinoin (Vesanoid ®) – Eyi yɛ vitamin A bi.
• Arsenic trioxide (ATO) – Eyi yɛ arsenic bi.

Sɛ wo duruyɛfoɔ susu sɛ wowɔ APL a, ebia wɔbɛhyɛ wo ase wɔ ATRA so mpo ansa na nhwehwɛmu foforɔ akyerɛ sɛ yareɛ no wɔ hɔ. Nea enti a ɛte saa ne sɛ, sɛ wofi ayaresa ase ntɛm a, ebetumi atew mogya a ɛbɛtɔ obi a ɛde ne nkwa to asiane mu no so.

APL ayaresa no fã ahorow

Wɔtaa yɛ ayaresa no wɔ akwan abiɛsa so: Induction, Consolidation, ne Maintenance. Ayaresa no betumi ayɛ soronko a egyina asiane dodow a ɛwɔ mu no so.

• Mfitiaseɛ fã (Induction): .Botae titiriw a ɛwɔ saa ɔfã yi mu ne sɛ ebekum mogya mu nkwammoaa a ɛdɔɔso a ɛbɛma wo APL no agyae . Remission kyerɛ sɛ wunni sɛnkyerɛnne biara na wontumi nhu mogya mu kokoram ho sɛnkyerɛnne biara wɔ nhwehwɛmu ahorow mu. Wɔnam nnuru a ɛnyɛ nnuru a wɔde sa yare, nnuru a wɔde sa yare, ne ayaresa a wɔde wɔn ani asi so a wɔde di dwuma so na ɛyɛ eyi. Saa bere yi mu no, ebehia sɛ wotra ayaresabea hɔ, mpɛn pii no adapɛn anan kosi asia.
• Consolidation phase: Wo oncologist nso betumi afrɛ eyi ‘post-remission therapy’. Saa ayaresa yi ma APL no kɔ so yɛ mmerɛw na ɛkɔ so kunkum mogya mu nkwammoaa a aka biara. Eyi ne aduru koro no ara a wɔde dii dwuma wɔ ɔfã a edi kan no mu. Saa ayaresa yi tumi di bɛyɛ asram awotwe, na wɔsa no asram abien biara. Ebia wubenya ayaresa adapɛn anan na afei woagye w’ahome adapɛn anan. Wobetumi de saa aduru yi ama sɛ aduru anaasɛ aduru a wɔde fa ntini mu (IV) .
• Ɔfã a wɔde siesie: Eyi yɛ ayaresa a ɛkɔ so, nanso wɔde nnuru no ma wɔ dodow a ɛba fam sen nea wɔde ma wɔ mfiase ne nea ɛma ɛyɛ den no mu. Wɔtaa de saa ayaresa a wɔde siesie yi ma bɛyɛ afe biako.

Wo kokoram ho ɔyaresafo nso betumi de ayaresa a ɛboa , te sɛ mogya a wɔde ma, aka ayaresa yi ho ama wo.

Nsɛnnennen a ɛba wɔ ayaresa mu

Wɔfrɛ ɔhaw a ɛtaa ba, na ɛyɛ aniberesɛm kakra no, nsonsonoe a ɛma obi nya nsonsonoe . Eyi yɛ kuw bi a wɔyɛ wɔn ade denneennen wɔ APL nnuru ho. Mpɛn pii no, saa nneyɛe yi ba wɔ adapɛn abiɛsa a edi kan bere a wɔafi ayaresa ase no mu. Nsɛnkyerɛnne no betumi ayɛ nea emu nyɛ den anaasɛ emu yɛ den. Ebi ne:

• Ɛwa.
• Nsu foforo a ɛtwa wo koma ne w’ahurututu ho hyia (pleural effusion) .
• Adwene a entumi nyɛ adwuma yiye .
• Mogya mmoroso a ɛba fam (hypotension) .
• Oxygen dodow a ɛso tew wɔ mogya mu (hypoxemia) .
• Ɔhome a ɛyɛ den (dyspnea) .
• Wo nsa, wo nan, ne wo kɔn ho ahonhon/ ɔfe .
• Atiridii a ɛba a ntease biara nnim.
• Mu duru a ɛkɔ soro a ntease biara nnim.

Sɛ wunya saa nsonsonoe ho yare yi a, ebia wo duruyɛfo begyae w’ayaresa no kakra. Ebia wɔde nnuru afoforo te sɛ hydroxyurea nso bedi dwuma de atew wo mogya mu nkwammoaa fitaa dodow so.

Dɛn na obi a ɔwɔ APL betumi ahwɛ kwan?

Sɛ yɛbɛka no ɔkwan biara so a, yare no ho nkɔmhyɛ ye.. Ɛwom sɛ ɛsono obiara tebea de, nanso nhwehwɛmu ahorow ada no adi sɛ nnipa a wɔwɔ APL no mu 90% kosi 95% kɔ remission mu. Nanso, APL betumi asan aba bere a wɔasa no yare awie no. Nnipa 5% kɔsi 10% bɛsan anya yareɛ no bio, mpɛn pii no wɔ mfeɛ mmiɛnsa a ɛdi kan wɔ ayaresa akyi. Afei wobehia ayaresa foforo anaa ɔkwan foforo so.

Nnipa dodow a wonya nkwa

Esiane sɛ APL yɛ yare a ɛntaa nsi nti, nea yenim fa nkwa dodow ho no fi ayaresabea sɔhwɛ ahorow a ɛfa APL ayarefo a asiane nnim na asiane kɛse wom ho.

Nhwehwɛmu biako kyerɛ sɛ APL ayarefo a asiane nnim no mu 99% te ase wɔ mfe anan akyi wɔ ayaresa akyi. Nhwehwɛmu foforo a wɔyɛe wɔ APL ayarefo a asiane kɛse wom ho no kyerɛ sɛ 86% te ase mfe anum wɔ ayaresa akyi. Eyinom yɛ nea eye ankasa!

Mɛyɛ dɛn ahwɛ me ho?

Esiane sɛ APL betumi asan aba bio nti, ɛho hia yiye sɛ wokɔ wo duruyɛfo nkyɛn wɔ bere ano (nkɔhwɛ a wɔde di akyi) .

Wɔbɛhwɛ wo wɔ aduruyɛ mu ɔsram biara anaa abien biara wɔ afe a edi kan wɔ ayaresa akyi. Afe a edi kan no akyi no, ebehia sɛ wokɔ wo duruyɛfo nkyɛn bɛyɛ asram abiɛsa kosi anan biara wɔ mfe abien a edi hɔ no mu. Wobetumi ayɛ nhwehwɛmu te sɛ CBC, PCR, ne nnompe mu ntini mu nhwehwɛmu wɔ saa nsrahwɛ ahorow yi mu.

Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?

APL betumi asan aba bio bere a wɔasa no yare akyi, na yare no ho sɛnkyerɛnne betumi asɛe ntɛmntɛm. Sɛ wowɔ APL a, kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu ntɛm ara sɛ wuhyia nea edidi so yi mu biara a:

• Sɛ mogya retu wo a wuntumi nni so a .
• Sɛ wo hohoro mpofirim a ɛyaw wɔ wo nan anaa wo yafunu ase a .

Nea etwa to no, nkrasɛm a ɛho hia

Acute promyelocytic leukemia (APL) yɛ mogya mu kokoram a ɛntaa nsi a bere bi na wobu no sɛ ɛyɛ yare a edi awu, nanso mprempren abɛyɛ yare a wotumi sa esiane ayaresa a ɛkɔ akyiri nti.

Nanso, eyi da so ara yɛ yare a emu yɛ den. Sɛ wɔanhu na wɔansa no ntɛm a, ebetumi de nkwa ato asiane mu . Enti, sɛ wowɔ sɛnkyerɛnne ahorow te sɛ mogya a wotumi nni so a, mmu w’ani ngu so da. Ade a ɛho hia sen biara ne sɛ wobɛhwehwɛ aduruyɛfo afotu na woahu ntɛm ara sɛnea wubetumi. Nsuro, nya akokoduru, efisɛ mprempren ayaresa pa wɔ hɔ ma eyi!

` Kokoram, APL, Mogya mu Kokoram, Mogya mu Kokoram, Nnompe mu Ntini, Mogya a Wɔyare, ATRA, Nnuru a Wɔde Sa, Acute Promyelocytic Leukemia, M3-Leukemia, PML-RARa, Mogya a Ɛtu