Yala jolidɛsɛ ye bana kabakoma ye min bɛ sɔrɔ furaw fɛ wa? An ka kuma Differentiation Syndrome kan!

Ni aw walima aw dɔnbaga dɔ bɛ ka furakɛli kɛ bana dɔ la i n’a fɔ jolidɛsɛ, aw bɛ se ka kɔlɔlɔw sɔrɔ aw ma deli ka minnu sɔrɔ. Bi, an bɛna kuma faritanabana jugumanba dɔw kan minnu bɛ se ka kɛ ni furaw ye, kɛrɛnkɛrɛnnenya la minnu bɛ di joli kansɛri suguya fila ma. Dɔgɔtɔrɔw b' o wele ko Differentiation Syndrome . Ikomi a bɛ se ka juguya kosɛbɛ, dɔgɔtɔrɔw ka teli ka bana taamasiɲɛw furakɛli daminɛ sani u ka se ka a jira tiɲɛ na, o bɛ se ka dɔ bɔ gɛlɛyaw la minnu bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la.

Diferentiation Syndrome ye mun ye?

N’an y’a fɔ cogo nɔgɔman na, Differentiation Syndrome ye farikolo ka faritanabana jugumanw kulu ye minnu bɛ kɛ fura dɔw la minnu bɛ kɛ ka joli kansɛri suguya fila furakɛ, olu ye jolidɛsɛ jugumanba ye (APL) ani jolidɛsɛ jugumanba (AML) A bɛ i n’a fɔ an farikolo kɔnɔ farikolo yɔrɔ dɔw bɛ "dibi" ni nin fura ninnu ye ka fɛn caman bɔli daminɛ siɲɛ kelen. O de bɛ a taamasiɲɛ kelen-kelen bɛɛ lase mɔgɔ ma.

Miiri k’a filɛ ko APL bana sɔrɔla i terikɛ dɔ la, ka furakɛli daminɛ. Tile damadɔ kɔnɔ, farigan bɛ don a la dɔrɔn, ninakili ka gɛlɛn, a bɛ funu dɔɔni. O waati la, dɔgɔtɔrɔw bɛ sigasiga ko nin ye Differentiation Syndrome ye.

O Danfaralanw ye mun ye?

Danfaralanw ye fura suguya dɔ ye dɔgɔtɔrɔw bɛ min kɛ ka APL furakɛ. APL ka teli ka tɛmɛ AML suguya tɔw kan furaw la minnu bɛ kɛ sababu ye ka farikolokisɛw kɔgɔ, walima ka danfara don u ni ɲɔgɔn cɛ . Nin fura ninnu bɛ kansɛribanakisɛw dɛmɛ (blast cell stage) ka kɛ joli kuru finmanw ye minnu ka ɲi, minnu ka kɛnɛ. O de kama dɔgɔtɔrɔw bɛ nin danfara fura ninnu kɛ sanni u ka chimiothérapie furaw di u ma k’u ɲɛsin u ma.

I n’a fɔ kansɛri fura tɔw, o furaw bɛ dɛmɛ ka kansɛribanakisɛw falenni jɔ walima k’u sumaya. Dɔgɔtɔrɔw bɛ se ka nin danfaralan ninnu kɛ u kelen na, ka u fara ɲɔgɔn kan, walima ka u fara ɲɔgɔn kan ni chimiothérapie ye. U bɛ se ka APL furakɛ ka ɲɛ. Nka, APL bɛ mɔgɔ minnu na, olu dɔw bɛ se ka kɔlɔlɔ jugumanw sɔrɔ fura ninnu fɛ.

Fura jumɛnw bɛ se ka kɛ sababu ye ka Differentiation Syndrome (Diferentiation Syndrome) bila mɔgɔ la?

Nin bana in bɛ se ka sɔrɔ danfaralanw fɛ minnu dira APL ma. Misali dɔw ye ninnu ye:

• Asidi all-trans-retinoïque (ATRA) ye witamini A suguya dɔ ye.
• Arsenic Trioxide (ATO) ye asɛki suguya dɔ ye.

Ani fana, AML bɛ mɔgɔ dɔw la, dɔgɔtɔrɔwIsocitrate Dehydrogenase (IDH) inhibiteurs ye chimiothérapie fura suguya dɔ ye min bɛ kɛ. Nin IDH balilan ninnu (ivosidenib) ani (enasidenib) fana bɛ se ka kɛ sababu ye ka Differentiation Syndrome (Syndrome de Différenciation) bila mɔgɔ la. O dɔrɔn tɛ, nka FLT3 balilanw fana (misali la (midostaurin) , (gilteritinib) ) bɛ se ka nin bana in bila mɔgɔ la.

Jɔnw mago bɛ se ka kɛ IDH balilanw na?

• Mɔgɔ minnu ka kansɛri seginna ka kɛ.
• Kansɛri bɛ mɔgɔ minnu na, minnu furakɛli ka gɛlɛn.
• Mɔgɔ minnu ka jɛnɛya sɛgɛsɛgɛli kɛrɛnkɛrɛnnen dɔ bɛ u la (IDH1 walima IDH2 fɛn falen).
• Minnu tɛ se ka furakɛli kɛcogo kɔrɔ muɲu.

Jɔn de ka teli ka kɛ ni Differentiation Syndrome ye?

APL bɛ mɔgɔ caman na, joli kuru finmanw hakɛ (WBC) ka dɔgɔn . Nka, minnu ka WBC hakɛ ka ca, olu farati ka bon ka diferentiation Syndrome sɔrɔ. Nin bana ninnu na, dɔgɔtɔrɔw ka teli ka fura dɔ di mɔgɔ ma min bɛ wele ko Prednisone walima Dexamethasone walasa ka dɔ bɔ nin bana in farati la.

Differentiation Syndrome ka teli ka kɛ cogo di?

tiɲɛ na , nin ye bana ye min man ca kosɛbɛ . AML ye jolidɛsɛ suguya ye min ka ca balikuw la, hali ni a bɛ kɛ kansɛri bɛɛ la 1% ɲɔgɔn ye. Ameriki jamana na, APL bɛ sɔrɔ mɔgɔ kelen ɲɔgɔn na mɔgɔ 250 000 o 250 000 la.

AML ni APL bɛ mɔgɔ minnu na:

• APL banabagatɔ 25% ɲɔgɔn minnu ye ATRA ni ATO furaw ta, olu ye Differentiation Syndrome sɔrɔ.
• Nin bana in fɔra AML banabagatɔ 14% ni 19% cɛ minnu bɛ IDH balilanw ta.

Mun de bɛ nin danfara in sababuya?

Ɲininikɛlaw t’a dɔn hali bi tigitigi mun na mɔgɔ dɔw bɛ APL furakɛli jaabi nin cogo in na. Kalan fɔlɔw y’a jira ko kansɛri furaw bɛ kɛ sababu ye ka jolidɛsɛbanakisɛw bɔ farikolo tangalanw hakɛ caman na yɔrɔnin kelen. o bɛ wele ko sitokini bɔli bana . O funu min tɛ kunbɛn, o bɛ taamasiɲɛ caman lase mɔgɔ ma, k’a ta a jugumanba la ka taa a bila a jugumanba la.

Differentiation Syndrome taamasiɲɛw ye jumɛnw ye?

A ka ca a la, APL bɛ mɔgɔ min na, o tigi bɛ daminɛ ka Differentiation Syndrome taamasiɲɛw sɔrɔ dɔgɔkun kelen walima dɔgɔkun fila kɔnɔ ATRA ni/walima Arsenic Trioxide daminɛ kɔfɛ. Nka ni aw bɛ IDH inhibiteur furakɛli kɛ AML la, a bɛ se ka mɛn dɔɔni sani bana taamasiɲɛw ka bɔ kɛnɛ kan.A bɛ se ka ban (o taamasiɲɛw bɛ se ka ye yɔrɔ o yɔrɔ, k’a ta tile kelen na ka se kalo duuru fo kalo wɔɔrɔ ma fura tali daminɛ kɔfɛ).

Ninnu ye bana taamasiɲɛw ye minnu ka teli ka ye:

• Sɔgɔsɔgɔ .
• Ji wɛrɛ bɛ caya aw dusukun ni fogonfogon lamini na (Pleural Effusion) .
• Sugunɛbilenni .
• Tansiyɔn jiginni (Tansiyɔn jiginni) .
• Oksizɛni hakɛ dɔgɔyali joli la (Hypoxemia) .
• Ninakili gɛlɛya (Dyspnea) .
• Bolo, senw ani kɔla funu (funu) .
• Sumaya sababu tɛ.
• Kisɛya sɔrɔli kun tɛ.

Nafama: Ni nin taamasiɲɛ kelen walima caman bɛ aw la, o kɔrɔ tɛ ko siga t’a la ko aw bɛ ni Differentiation Syndrome ye. Nka, a nafa ka bon ka dɔgɔtɔrɔ ladɔnniya joona ni aw ye nin taamasiɲɛ ninnu dɔ ye.

Gɛlɛya jumɛnw bɛ se ka sɔrɔ Differentiation Syndrome fɛ?

O bana in bɛ se ka kɛ sababu ye tuma dɔw la ka ko juguba dɔw lase mɔgɔ ma. I n'a fo:

• Dusukun tantanni .
• Sugunɛbilenni .
• Fogonfogonlabana .
• Joli bɔli fogonfogon la (Fogonfogon la joli) .
• Sɔgɔsɔgɔninjɛ .
• Sepsis ( bana jugumanba min bɛ jɛnsɛn farikolo fan bɛɛ la).

Ni nin taamasiɲɛ ninnu dɔ ye aw ye, aw bɛ dɔgɔtɔrɔ wele o yɔrɔnin bɛɛ . Ni ninakili ka gɛlɛn walima ni disidimi bɛ aw la, aw bɛ 911 (walima aw ka sigida kɔrɔtɔko nimɔrɔ) wele o yɔrɔnin bɛɛ . APL bɛ mɔgɔ minnu na, a ka ca a la, olu bɛ furakɛ dɔgɔtɔrɔso la fo ka se diferential syndrome farati ka tɛmɛ.

Differentiation Syndrome bɛ sɔrɔ cogo di?

A bɛ se ka gɛlɛya ka nin bana in sɛgɛsɛgɛ APL bɛ mɔgɔ min na, barisa bana caman wɛrɛw bɛ yen minnu bɛ se ka o taamasiɲɛ suguw lase mɔgɔ ma. Ni bana jugumanw don, dɔgɔtɔrɔw bɛ se ka bana taamasiɲɛw furakɛli daminɛ ni u sigalen don dɔrɔn ko Differentiation Syndrome bɛ u la, hali sani u ka se k’a jira ko a bɛnnen don.

Aw ka dɔgɔtɔrɔ bɛna sɛgɛsɛgɛli caman kɛ walasa ka bana in sɛgɛsɛgɛ ani ka furakɛli bana wɛrɛw bɔ kɛnɛ kan. Olu bɛ se ka kɛ ninnu ye:

• Joli jate dafalen (CBC) .
• Disi ka X-ray .
• Echocardiogramme (sɛgɛsɛgɛli min bɛ dusukun baarakɛcogo lajɛ).
• Disi CT scan ( CT scan ) .
• Bronchoscopy (sɛgɛsɛgɛli min bɛ kɛ ni kamera ye walasa ka fogonfogon kɔnɔna lajɛ).
• Joli sɛgɛsɛgɛli wɛrɛw (Joli baara).

Yala fura bɛ yen min bɛ wele ko Differentiation Syndrome wa?

A ka ca a la, jolidɛsɛ jugumanba (APL) bɛ mɔgɔ minnu na, olu bɛ se ka kɛnɛya pewu ka bɔ danfara la ni u ye furakɛli teliya la ani ka ɲɛ . APL bɛ se ka furakɛ kosɛbɛ sisan. O la sa, siran foyi tɛ yen.

Differentiation Syndrome bɛ furakɛ cogo di?

A ka ca a la dɔgɔtɔrɔw bɛ danfara taamasiɲɛw furakɛ ni kɔritikositɛri walima gulukokɔritikosidi fura ye, i n’a fɔ dexamethasone . Ni bana juguman don, dɔgɔtɔrɔ bɛ se fana ka a fɔ aw ye ko aw ka kansɛri furakɛli dabila waati dɔɔni fo aw ka bana taamasiɲɛw ka nɔgɔya.

APL bɛ mɔgɔ minnu na, olu fanba bɛ furakɛ dɔgɔtɔrɔso la fo ka se diferential syndrome farati ka tɛmɛ. Ni aw ye kɛnɛyaso kɔkanna ye ani ni siga bɛ a la ko danfara bɛ aw la, aw ka dɔgɔtɔrɔw bɛ se k’a latigɛ ka aw bila dɔgɔtɔrɔso la su fɛ walasa ka aw furakɛ walima ka aw kɔlɔsi. Aw ka dɔgɔtɔrɔso jɛkulu bɛna aw dɛmɛ ka aw ka bana sɛgɛsɛgɛli dafa ani ka bana suguya bɛɛ furakɛ ka ɲɛ, bana minnu bɛ aw ka bana taamasiɲɛw bila mɔgɔ la.

Ne bɛ se ka mun kɛ walasa ka dɔ bɔ ne ka bana sɔrɔli la ni Differentiation Syndrome ye?

Tiɲɛ na, foyi tɛ yen aw bɛ se ka min kɛ walasa ka dɔ bɔ aw ka nin bana in farati la. Ni aw bɛ chimiothérapie walima kansɛri fura wɛrɛw ta, aw bɛ taamasiɲɛ o taamasiɲɛw fɔ aw ka dɔgɔtɔrɔ ye o yɔrɔnin bɛɛ . Ani fana, aw ka kan ka aw janto taamasiɲɛ minnu na (i n’a fɔ an y’a ɲɛfɔ cogo min na sanfɛ) ani ka kuma aw ka dɔgɔtɔrɔ fɛ ni haminanko dɔw bɛ aw la. O de ye ko ye min nafa ka bon kosɛbɛ.

Differentiation Syndrome (Syndrome de Différenciation) bɛna kɛ cogo di?

A ka c’a la, diferential syndrome (diferential syndrome) jateminɛ ka ɲi mɔgɔ fanba ma. A ka ca a la, aw bɛ se ka t’a fɛ aw ka kansɛribana furakɛli la, furakɛli senfɛ walima furakɛli kɔfɛ ni furakisɛw ye. Aw ka dɔgɔtɔrɔso jɛkulu bɛna kuma aw fɛ aw ka furakɛli suguyaw kan.

Tuma jumɛn na aw ka kan ka dɔgɔtɔrɔ ka ladilikan ɲini Differentiation Syndrome (Syndrome de Différenciation) ko la?

Ni aw ye danfara don taamasiɲɛ dɔw ye ka aw to kansɛri furakɛli la, aw bɛ aw ka dɔgɔtɔrɔ wele o yɔrɔnin bɛɛ . A bɛ se ka gɛlɛya aw ma walima aw ka dɔgɔtɔrɔ ma k’a dɔn ni aw ka bana taamasiɲɛw sababu bɔra kansɛri furakɛli la walima ni bana wɛrɛ ye. Furakɛli joona bɛ se ka dɛmɛ don ka bana taamasiɲɛw nɔgɔya ani ka dɔ bɔ gɛlɛyaw la.

Kansɛri furakɛli bɛ se ka kɛ gɛlɛya ye. Nka, a bɛ se ka mɔgɔ fari faga k’a dɔn ko furakɛli yɛrɛ bɛ kɔlɔlɔw lase mɔgɔ ma. Differentiation Syndrome ye joli kansɛri furakɛli kɔlɔlɔw ye minnu bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la. Nka, a bɛ se ka furakɛ ni a sɔrɔla ka furakɛ joona . Ikomi bana taamasiɲɛw bɛ se ka juguya joona, dɔgɔtɔrɔw bɛ se ka aw furakɛli daminɛ sani aw ka sɛgɛsɛgɛli jaabiw ka a jira ko danfara bɛ aw la. Furakɛli joona bɛ se ka aw dɛmɛ ka aw ka bana taamasiɲɛw nɔgɔya ani ka aw bila kɛnɛya sira kan kokura.

Take-Home cikan

• Differentiation Syndrome ye faritanabana jugumanba ye min bɛ se ka sɔrɔ fura dɔw fɛ minnu bɛ kɛ ka jolidɛsɛ furakɛ i n’a fɔ APL ni AML.
• A taamasiɲɛw i n’a fɔ farigan, ninakili gɛlɛya, ani farikolo funu, olu bɛ se ka sɔrɔ.
• Ni aw ye nin taamasiɲɛ ninnu kɔlɔsi, a nafa ka bon aw ka dɔgɔtɔrɔ ladɔnniya joona .
• Ni a sɔrɔla joona ani ni a furakɛra ni furaw ye i n’a fɔ Dexamethasone, a ka ca a la a bɛ se ka kɛnɛya.
• Aw kana siran ni aw ye nin mɛn. Aw ka dɔgɔtɔrɔso jɛkulu bɛna aw dɛmɛ. Min nafa ka bon kosɛbɛ, o ye ka u ladɔnniya fɛn o fɛn na, fɛn o fɛn bɛ fɛn caman Changements, fɛn o fɛn taamasiɲɛw.

` Danfaralan, jolidɛsɛ, kansɛri furakɛli, kɔlɔlɔw, APL, AML, ATRA, taamasiɲɛw