Ðe ɖeɖi tea viwò suea ŋu ɣesiaɣi, eƒe ŋutigbalẽ le blɔ, alo asrã nɔa eŋu ɣesiaɣia? Ɣeaɖewoɣi la, esiawo ate ŋu anye dzesi siwo sɔ ko. Gake ɣeaɖewoɣi la, nu sue siawo ate ŋu anye nɔnɔme sesẽ aɖe si le ŋutilãa me ƒe dzesi. Egbea míele nu ƒom tso ʋumenugbagbeviɣidɔ ƒomevi aɖe si bɔ ɖe ɖevi suewo koŋ dome, gake ate ŋu adze ame tsitsiwo hã dzi. Eƒe ŋkɔe nye Acute Lymphoblastic Leukemia, alo (ALL) kpuie. Mègatsi dzi o, míaƒo nu tso nusianu ŋu le nya bɔbɔewo me.
Kpuie ko la, nukae WO KAtã fia?
Acute Lymphoblastic Leukemia (ALL) nye kansa ƒomevi aɖe si dona le míaƒe ʋu me. Ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩwo le míaƒe ʋu me. Woyɔa ʋumenugbagbevi ɣi ƒomevi ɖeka be ʋumenugbagbevi dzĩwo. Abe alesi wòle le míaƒe dukɔa ƒe asrafowo gome ene la, lãmenugbagbevi siawo kpɔa mía ta to avuwɔwɔ kple dɔléle kple dɔlékui siwo gena ɖe míaƒe ŋutilã me me.
Wowɔa ʋumenugbagbevi siawo le ƒumeŋuɖui si le míaƒe ƒuwo me la me. Ɣeaɖewoɣi la, le domenyiŋusẽfianu ƒe tɔtrɔ le ʋumenugbagbevi siawo me ta la, wodzea kansa lãmenugbagbeviwo nyenye gɔme le esi teƒe be woazu lãmenugbagbevi siwo le lãmesẽ me. Kansa lãmenugbagbevi siawo mãna hedzina ɖe edzi kabakaba evɔ womeɖua wo dzi o, si wɔnɛ be lãmenugbagbevi siwo le lãmesẽ me la xea mɔ na wo. Ðeko woyɔa esia be ALL.
Menye ƒumeŋuɖui me koe kansa lãmenugbagbevi siawo nɔa anyi o. Woate ŋu azɔ mɔ to ʋua me eye woakaka (metastasize) ɖe ŋutilã bliboa me.
Gake nu vevitɔe nye be togbɔ be ALL, togbɔ be enye nɔnɔme sesẽ hã la, enye dɔléle si woate ŋu ada keŋkeŋ ne wodae nyuie. Dɔyɔyɔ ƒe agbɔsɔsɔme sɔ gbɔ ŋutɔ, vevietɔ le ɖevi suewo dome.
Nukawoe nye ALL ƒomevi veviwo?
Ne míeƒo nu tso ʋumenugbagbevi dzĩwo ŋu la, wo dometɔ vevi evee li: B lãmenugbagbeviwo kple T lãmenugbagbeviwo. KANSA katã dzɔna tso lãmenugbagbevi ƒomevi eve siawo me.
| Kansa ƒomevi | Numeɖeɖe bɔbɔe |
|---|---|
| B-lãmenugbagbeviwo KAtã (B-lãmenugbagbeviwo KAtã) . | Esiae nye ƒomevi si bɔ wu. Exɔa abe 85% le ALL me le ɖeviwo me eye 75%-80% le ALL me le ame tsitsiwo me. B lãmenugbagbeviwo nye lãmenugbagbevi ƒomevi siwo wɔa dɔlékui siwo tsia tre ɖe dɔlékuiwo ŋu le míaƒe ŋutilã me. |
| T-cell ALL (T-cell ALL) . | Esia mebɔ vie o. Ame tsitsi siwo ade 25% kple ɖevi 12%-15% xɔa nɔnɔme sia ƒomevi. T lãmenugbagbeviwo nye lãmenugbagbevi siwo wua dɔlékuiwo tẽ eye wokpena ɖe lãmenugbagbevi bubu siwo le dɔlélenutsiŋutete me ŋu. |
Tsɔ kpe ɖe ƒomevi eve siawo ŋu la, ƒomevi aɖe hã li si mebɔ kura o si woyɔna be Natural Killer ALL. Wò ɖɔkta awɔ dodokpɔ siwo hiã be yeanya ƒomevi si tututu le wò alo viwòa ŋu.
Dzesi kawoe míekpɔna?
Ne ALL va do la, ŋutilãa ƒe ʋumenugbagbevi siwo le lãmesẽ me la vɔna, si hea dzesi vovovowo vɛ. Dzesi siawo ate ŋu ava kpata alo adze egɔme vivivi.
Vevietɔ: Dzesi siawo ƒe amesinɔnɔ mefia be WO KAtã le ŋuwò o. Gake ne dzesi siawo le ŋuwò wu kwasiɖa eve la, ele vevie be nàyi ɖɔkta gbɔ aɖaɖo aɖaŋu na wò.
| Dzesi si dzena | Nukae ema fia? |
|---|---|
| Ðeɖiteameŋu kple ŋutigbalẽ ƒe amadede dzẽ ɣesiaɣi | Le ʋumenugbagbevi dzĩwo ƒe ɖiɖi le ŋutilãa me (ʋusɔgbɔdɔ) ta la, dɔ suewo wɔwɔ gɔ̃ hã ate ŋu ate ɖeɖi ame ŋu, eye ŋutilãa ate ŋu adze abe ɖe wòle ɣie ene. |
| Dɔléle enuenu | Ne ʋumenugbagbevi ɣi siwo le lãmesẽ me dzi ɖe kpɔtɔ la, ŋutete si le ŋutilãa si be wòawɔ avu kple dɔléle (dɔlélenutsiŋutete) dzi ɖena kpɔtɔna. Esia wɔnɛ be dɔlélewo abe asrã kple dzamezã ene ate ŋu adze ame dzi enuenu. |
| Ʋu si le dodom kple abi ƒe ƒoƒo | Esi ʋumenugbagbevi dzĩ siwo kpena ɖe ʋu ƒe sisi ŋu dzi le ɖeɖem kpɔtɔ la, ʋu si dona le ŋɔti me, ʋu si le dodom le aɖuwo me, kple abi suewo gɔ̃ hã ate ŋu ana teƒe blɔ gãwo nanɔ ŋutilãa ŋu. Ʋu ate ŋu ado le nyɔnuwo me vevie le dzinukpɔkpɔ me. |
| Teƒe dzĩ siwo le ŋutigbalẽa ŋu (petechiae) . | Teƒe dzĩ suesuesuewo dzena le ŋutigbalẽa ŋu abe ɖe wotsɔ pin ƒo wo ene, le ʋu si dona le ʋuka nyui ŋutɔ siwo le ŋutigbalẽa te me ta. |
| Ƒu kple ƒunukpeƒewo ƒe vevesese | Esi kansa lãmenugbagbeviwo yɔ ƒumeŋuɖui me la, vevesese sesẽ ate ŋu adzɔ le ƒuwo kple ƒunukpeƒewo. |
| Lãmetsiŋusẽ ƒe ʋuka siwo vuvu | Kpe (nodules) siwo le teƒewo abe kɔ, akɔta, kple akɔta ene ate ŋu avuvu vevesese manɔmee. |
| Nɔnɔme bubuwo | Woate ŋu akpɔ dzesiwo abe nuɖuɖu ƒe dzodzro, lolo, fifia le zã me, kple gbɔgbɔ sesẽ hã. |
Nukatae dɔléle sia dzɔna? Nukawoe nye afɔku siwo le eme?
Nu ɖeka aɖeke meli koŋ si gbɔ kansa KAtã tsona o. Nusi koŋ gbɔ wòtsona, abe alesi míedzro eme va yi ene, enye domenyiŋusẽfianu ƒe tɔtrɔ siwo dzɔna le ʋumenugbagbeviɣiwo ƒe wɔwɔme me. Le ɖevi suewo gome la, tɔtrɔ siawo ate ŋu adzɔ hafi woadzi wo gɔ̃ hã.
Gake wode dzesi nu geɖe siwo nana dɔléle sia xɔxɔ ƒe afɔkua dzina ɖe edzi.
- Ƒe: Afɔkua lolo wu le ɖevi siwo mexɔ ƒe 15 haɖe o, vevietɔ esiwo xɔ tso ƒe 2-5, kple ame tsitsi siwo xɔ wu ƒe 50 dome.
- Domenyiŋusẽfianu aɖewo: Amesiwo ŋu domenyiŋusẽfianu ƒe dɔléle aɖewo le, abe Down syndrome ene, ate ŋu axɔ ALL vie.
- Kekeli ƒe dɔwɔwɔ: Le kpɔɖeŋu me, ne èzã keklẽŋusẽ ƒe atike na kansa bubu va yi la, ate ŋu ana wò afɔkua nadzi ɖe edzi.
- Dɔlékui aɖewo: Woxɔe se be dɔlékui aɖewo ƒe dɔlékuiwo abe Epstein-Barr dɔlékui ene hã nana afɔkua dzina ɖe edzi.
- Atamazazã: Le ame tsitsiwo dome la, kansadɔlékuiwo abe atamanono ene zazã hã ate ŋu anye nusi gbɔ wòtso.
Aleke ɖɔkta awɔ anya dɔléle sia pɛpɛpɛ?
Ne èyi ɖɔkta gbɔ kple dzesi siwo nèyɔ ɖe etame la, abia nya aɖe wò tsitotsito tso wò dzesiawo ŋu gbã. Emegbe ado eƒe ŋutilã kpɔ eye wòaɖe gbe be woawɔ dodokpɔ geɖe atsɔ aɖo kpe dɔlélea dzi.
- Ʋudodokpɔ:Blood Blood Count (FBC) dodokpɔ si wowɔna edziedzi ate ŋu ade dzesi lãmenugbagbevi siwo le ʋua me ƒe xexlẽme si mesɔ o.
- Ƒumeŋuɖui me ɖeɖe: Esiae nye dodokpɔ vevitɔ si wozãna tsɔ ɖoa kpe dɔlélea dzi. Woɖea ƒumeŋuɖui sue aɖe tso teƒe aɖe abe akɔtaƒu ene le atike si naa alɔ̃dɔdɔ ame me eye wodonɛ kpɔ le nusuekpɔmɔ̃ me. Esia ate ŋu anya ne kansa lãmenugbagbeviwo le wo me pɛpɛpɛ eye ne ele nenema la, woanya ƒomevi ka.
- Nɔnɔmetatawo dodokpɔ: Woate ŋu awɔ CT scan kple PET scan atsɔ akpɔe ɖa be kansa la kaka ɖe ŋutilã ƒe akpa bubuwo, le kpɔɖeŋu me, yi akɔta.
- Spinal tap/Lumbar puncture: Ne ɖikeke aɖe li be kansa lãmenugbagbeviwo kaka ɖe ahɔhɔ̃ alo aklã me la, woɖea aklã me tsi sue aɖe tso aklã me hedonɛ kpɔna.
Nukae nye atikewɔwɔ na ALL?
Atikewɔwɔ vovovowo li na ALL. Wò ɖɔkta anɔ te ɖe nu geɖe dzi atso nya me le atikewɔwɔ ƒe ɖoɖo nyuitɔ kekeake ŋu na wò, siwo dometɔ aɖewoe nye ƒe si nèxɔ, dɔléle si ƒomevi nèle, kple domenyiŋusẽfianu ƒe dzesi siwo le wò kansa lãmenugbagbeviwo me.
Atikewɔwɔ vevitɔ: Atikewo zazã
Atikewɔmɔnu nye atike sẽŋu aɖe si wua kansa lãmenugbagbeviwo. Enye atike vevitɔ na ALL. Wowɔa atike sia le akpa vovovowo me, eye wòxɔa tso ɣleti ʋɛ aɖewo va ɖo ƒe eve va ɖo ƒe etɔ̃.
| Atikewɔwɔ ƒe afɔɖeɖewo | Nukae le dzɔdzɔm? |
|---|---|
| 1. Akpa Gbãtɔ (Remission Induction) . | Esia xɔa abe kwasiɖa 4-6 ene. Taɖodzinu vevitɔe nye be woatsrɔ̃ kansadɔlékui geɖe alesi woate ŋui kaba ale si woate ŋui. Le ɣeyiɣi sia me la, ahiã be nànɔ kɔdzi zi geɖe. |
| 2. Lãmetsiŋusẽ ƒe dɔdamɔnu (CNS-directed therapy) . | Wowɔa atike sia be woatsɔ axe mɔ na kansa lãmenugbagbeviwo be woagakaka ɖe ahɔhɔ̃ kple aklã me o, alo be woatsɔ atsrɔ̃ wo ne wokaka. Zi geɖe la, wowɔa esia le akpa gbãtɔ me. |
| 3. Nuwɔwɔ ɖekae ƒe akpa | Ne dɔlélea le ɖeɖem kpɔtɔ vɔ la, akpa sia dzea kansa lãmenugbagbevi ɖesiaɖe si susɔ la tsɔtsrɔ̃ gɔme. Woaxɔ wò ɖe kɔdzi ŋkeke ʋɛ aɖewo kwasiɖa ʋɛ aɖewo ɖesiaɖe hena ɣleti geɖe eye woaxɔ atike siwo wodona ɖe ʋuka me (IV). |
| 4. Beléle na xɔa ƒe akpa | Esiae nye akpa mamlɛtɔ si didi wu. Exɔa abe ƒe 2-3 ene. Taɖodzinu si le afisiae nye be woaxe mɔ na dɔlélea be wòagatrɔ ava o. Zi geɖe la, wodoa atike siwo woano kple atike siwo wodona ɖe ʋuka me le atikewɔƒea. Mehiã be woayi kɔdzi zi geɖe o. |
Atikewɔwɔ bubuwo
- Atikewɔwɔ si woɖo taɖodzinu na: Esia bia be woana atike siwo dzea domenyiŋusẽfianu ƒe tɔtrɔ tɔxɛ siwo wokpɔna le kansa lãmenugbagbeviwo me ɖeɖeko dzi. Le kpɔɖeŋu me, atikewɔwɔ sia wɔa dɔ ŋutɔ le amesiwo ƒe domenyiŋusẽfianu ƒe tɔtrɔ si woyɔna be Philadelphia chromosome ŋu.
- Dɔlélenutsiŋutete ƒe dɔdamɔnu: Esia bia be míaʋã mía ŋutɔwo ƒe dɔlélenutsiŋutete be wòatsrɔ̃ kansa lãmenugbagbeviwo. CAR-T lãmenugbagbeviwo ƒe dɔdamɔnu nye egbegbe atikewɔwɔmɔnu si dze le hatsotso sia me.
- Kekelidɔdamɔnu: Woate ŋu azã keklẽŋusẽdɔdamɔnu le nɔnɔme siwo me kansa la mewɔa nu ɖe atikewɔmɔnu ŋu o alo ne dɔlélea gadze egɔme ake.
- Ƒumeŋuɖui dodo: Ne dɔdamɔnu bubuwo medze edzi o alo afɔku si le dɔlélea ƒe tɔtrɔgbɔ me lolo ŋutɔ la, woate ŋu aɖo wò ɖe ame si le lãmesẽ me gbɔ be woado wò ƒumeŋuɖui.
Mɔnukpɔkpɔ kawoe li be woada dɔléle sia?
Esiae nye nyabiase gãtɔ kekeake si le amesiame ƒe susu me. ALL nye kansa si wɔa nu nyuie ŋutɔ ne wodae.
Le ɖeviwo gome la, emetsonuwo doa ŋugbe ŋutɔ. Ðevi siwo wowɔ atike na nyuie ƒe 98% kpɔa dɔlélea ƒe tsɔtsɔ keŋkeŋ. Agbetsitsi ƒe agbɔsɔsɔme le ƒe 5 megbe le dɔlélea dada vɔ megbe la sɔ gbɔ abe 90% ene.
Alafa memamã sia le ʋɛ vie le ame tsitsiwo dome. Ƒe 5 ƒe agbetsitsi ƒe agbɔsɔsɔme na ame tsitsiwo le 30% - 40% dome.
Gake ele vevie be míase egɔme be akɔntabubuwo koe esiawo nye. Alesi ame aɖe wɔa nui ɖe atikewɔwɔ ŋu ate ŋu ato vovo kura tso ame bubu gbɔ. Eyata xexlẽdzesi siawo megavɔ̃ o. Ðɔkta si da dɔ na wò koe ate ŋu ana nyatakaka nyuitɔ kekeake wò tso wò alo viwò ƒe nɔnɔmea ŋu.
Enye nusi sɔ be nàse le ɖokuiwò me be yeƒe agbe le gbagbãm ne wokpɔ kansa le ŋuwò. Vevietɔ ne viwòe. Gake ɖo ŋku edzi be ALL nye dɔléle si woate ŋu ada wu kansa ƒomevi bubu geɖe. Ka ɖe wò atikewɔlawo ƒe ƒuƒoƒoa dzi. Woanɔ kpli wò le mɔzɔzɔ sia me, ana kpekpeɖeŋu kple numeɖeɖe siwo katã nèhiã la wò.
Gbedasi si Wotsɔ Yi Aƒeme
- Acute Lymphoblastic Leukemia (ALL) nye kansa si dona le ʋumenugbagbevi dzĩwo, si nye ʋumenugbagbevi ɣi ƒomevi aɖe me.
- Togbɔ be ɖevi suewo mee dɔléle sia bɔ ɖo wu hã la, ate ŋu adze ame sia ame si xɔ ƒe ɖesiaɖe la dzi.
- Ne èkpɔ dzesiwo abe ɖeɖiteameŋu atraɖii, ɣie, dɔléle enuenu, ŋutilã ƒe blɔ, kple ƒu ƒe vevesese wu kwasiɖa eve la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
- Togbɔ be ALL nye dɔléle sesẽ aɖe hã la, woate ŋu adae keŋkeŋ ne wozã atikewo abe atikewɔmɔnu ene. Dɔyɔyɔ ƒe agbɔsɔsɔme sɔ gbɔ ŋutɔ, vevietɔ le ɖeviwo dome.
- Dɔdamɔnua ate ŋu axɔ ɣeyiɣi didi eye wòate ɖeɖi ame ŋu, gake mègavɔ̃e o, ka ɖe wò ɖɔktawo dzi, eye nàwɔ ɖe woƒe mɔfiamewo dzi pɛpɛpɛ.
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