Ðe nèdi hã be yeanya nu tso ʋumenugbagbeviɣidɔ sia ŋua? Mina míaƒo nu tso Acute Monocytic Leukemia (AMoL) ŋu!

Èse Acute Monocytic Leukemia, alo AMoL ŋkɔ kpɔa? Ŋkɔa aɖi nusi wɔ nuku vie, gake enye kansa ƒomevi aɖe si gblẽa nu le ʋua ŋu. Bu eŋu kpɔ ne nane gblẽ le míaƒe ŋutilã ƒe lãmenugbagbevi siwo wɔa ʋu me, eye le esi teƒe be ʋumenugbagbevi siwo le lãmesẽ me nanɔ la, kansa lãmenugbagbeviwo te wɔwɔ? Emae nye nusi dzɔna le nya sia me. Togbɔ be esia nye ŋutinya vevi aɖe vie hã la, mina míaƒo nu tso eŋu bɔbɔe, le mɔ si gɔme nàte ŋu ase nu.

Nukae nye nusi woyɔna be Acute Monocytic Leukemia sia?

Kpuie ko la, Acute Monocytic Leukemia (AMoL) nye kansa ƒomevi aɖe si le ʋumenugbagbeviɣidɔ ƒe ƒuƒoƒo si woyɔna be Acute Myeloid Leukemia (AML) me. Ènya be ʋumenugbagbeviɣidɔ nye ʋumenugbagbeviɣidɔ. Eyata AMoL sia hã nye ʋumenugbagbeviɣidɔ . Edzɔna ne nu gblẽ le ʋumenugbagbeviwo wɔwɔ ƒe ɖoɖo si le míaƒe ŋutilã me ŋu. Ne míagblɔe tututu la, lãmenugbagbevi siwo metsi o siwo wòle be woazu ʋumenugbagbevi siwo le lãmesẽ me, si fia lãmenugbagbevi siwo woyɔna be blast , la trɔna hezua kansa lãmenugbagbeviwo.

Le AMoL me la, lãmenugbagbevi siawo siwo metsi o, alo blasts, tɔa te le woƒe mɔwo dzi ne wole tsitsim va zu ʋumenugbagbevi ɣi ƒomevi aɖe si woyɔna be monocytes . Gake le esi teƒe be woazu monocyte siwo le lãmesẽ me la, wotsia anyi le afisi wometsi o, alo wowó, eye wozua kansa lãmenugbagbeviwo.

Ʋumenugbagbeviɣidɔ sesẽ nye kansa si nu sẽ ŋutɔ, si kakana kabakaba . Wò ɖɔkta akpe ɖe ŋuwò nàkpɔ atike nyuitɔ kekeake na wò dɔlélea. Mègatsi dzi o, míaƒo nu tso esia ŋu tsitotsito.

Ðe esia ƒomevi aɖewo lia?

Ẽ, Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) da AMoL ɖe hatsotsowo me le lãmenugbagbevi ƒomevi si va zua kansa (i.e., monocytes) nu. Wogayɔnɛ be AML-M5 le Franse-Amerika-Britain (FAB) ƒe hatsotsowo me toto ƒe ɖoɖo xoxoa nu. Le ɖoɖo sia te la, wogama AML-M5 ɖe hatsotso eve me:

Ʋumenugbagbeviɣidɔ sesẽ si me ʋumenugbagbeviɣidɔ le (AML-M5a) .

Le ƒomevi sia me la, lãmenugbagbeviawo ƒe 80% ya teti zua kansa hafi tsina bliboe. Wokpɔa esia ƒomevi zi geɖe le ɖevi suewo kple sɔhɛ tsitsiwo ŋu .

Ʋumenugbagbeviɣidɔ sesẽ (AML-M5b) .

Le esia me la, lãmenugbagbevi siwo mesɔ kura o va zua kansa le lãmenugbagbeviwo ƒe tsitsi ƒe afɔɖeɖe si de ŋgɔ vie me. Esia ƒomevi mekpɔa ŋusẽ ɖe ƒexɔxɔ ƒe hatsotso aɖe koŋ dzi o .

Dɔdamɔnu siawo kpena ɖe ɖɔktawo ŋu be woanya dɔlélea. Gake ƒomevi ɖeka mesẽna wu evelia o. Wo ame evea siaa nye nɔnɔme siwo hiã be woalé ŋku ɖe wo ŋu le mɔ ɖeka nu.

Nukae nye esia ƒe dzesiwo?

AMoL ƒe dzesiwo dzena zi geɖe eye woyia edzi kabakaba . Dzesiawo dometɔ aɖewoe nye esi:

• Abi kple ʋu si dona le ame ŋu bɔbɔeEdzɔna (ʋu si le dodom le aɖuwo me, ʋu si dona le ŋɔti me enuenu, kple bubuawo) Tsɔe be èxɔ abi gã aɖe ne èdo go ɖe teƒe aɖe ko gɔ̃ hã, alo ʋu le dodom le wò aɖuwo me ŋutɔ ne èle aɖuwo klɔm.
• Teƒe suesuesue siwo ƒe amadede nye aŋutiɖiɖi, dzĩ, alo aŋutiɖiɖi le ŋutigbalẽa te ( petechiae ). Esiawo ate ŋu adze abe ʋuʋudedi suesuesuewo ene, gake le nyateƒe me la, wonye ʋu ƒe teƒe siwo le dodom le ŋutigbalẽa te.
• Aɖuɖɔtoewo ƒe vuvu alo aɖuɖɔtoewo ƒe tsitsi fũ akpa.
• Gbɔdzɔgbɔdzɔ kple ɖeɖiteameŋu si gbɔ eme . Ðeko nàse le ɖokuiwò me be ŋusẽ aɖeke mele ye ŋu o. Ðeɖiteameŋu ƒe seselelãme ne èfɔ le ŋdi me gɔ̃ hã.
• Yagbɔgbɔ sesẽ.
• Nuɖuɖua mevivina o.
• Lolo dzi ɖeɖe kpɔtɔ le susu aɖeke manɔmee . Ne èle lolo dzi ɖem kpɔtɔ nuɖuɖumadzroame manɔmee la, ke enye nusi ŋu wòle be nàlé ŋku ɖo.
• Ŋutilã si ƒe ŋutigbalẽ le ɣie.
• Taɖuame.
• Asrã.

Ɣeaɖewoɣi la, ʋumenugbagbeviɣidɔ sesẽ ate ŋu agblẽ nu le wò ahɔhɔ̃ kple lãmekawo ƒe dɔwɔwɔ ŋu . Ne edzɔ alea la, àte ŋu akpɔ dzesiwo abe ŋkuɖoɖonudzi kple susu tsɔtsɔ ɖo nu ŋu asesẽ na wò ene.

Nukatae dɔléle sia ƒomevi dzɔna?

Atikeŋutinunyalawo menya nusi tututu hea AMOL vɛ haɖe o. Gake wosusu be domenyiŋusẽfianu ƒe tɔtrɔ , alo lãmenugbagbeviwo ƒe DNA ƒe tɔtrɔ gbɔe wòtso. Tɔtrɔ siawoe nana lãmenugbagbevi si le lãmesẽ me va zua kansa.

Numekulawo kpɔe be le ame aɖewo siwo ŋu AMoL le gome la, domenyiŋusẽfianu ƒe dɔléle aɖe si woyɔna be domenyiŋusẽfianu ƒe tɔtrɔ ɖe ɖoɖo nu li. Esia fia be domenyiŋusẽfianu ɖeka ƒe akpa aɖe gbãna eye wòléna ɖe domenyiŋusẽfianu bubu ŋu. Woyɔa esia be domenyiŋusẽfianu ƒe tɔtrɔ . Dɔléle sia ate ŋu ana lãmenugbagbevi aɖe nadzudzɔ tsitsi abe monocyte ene eye wòazu kansa lãmenugbagbevi. Bu eŋu abe nane si gblẽ ene.

Wogale numekuku wɔm tso domenyiŋusẽfianu ƒe tɔtrɔ siawo ŋu kokoko. Domenyiŋusẽfianu si le megbe na kansa gɔmesese akpe ɖe eŋutinunyalawo ŋu woato atikewɔmɔnu nyuitɔwo vɛ be woatsɔ awɔ avu kplii.

Nukawoe nye nusiwo ate ŋu ana woaxɔ dɔléle sia?

Nu geɖe li siwo ate ŋu ana afɔku si le Acute Monocytic Leukemia xɔxɔ me nadzi ɖe edzi. Wo dometɔ aɖewoe nye esi:

• Sigaretnono kple atamanono si wozãna tsã . Ne mènoa atama o hã la, afɔku le ame siwo noa atama gbɔ nɔnɔ hã.
• Ne èxɔ kansa ƒe atike va yi, le kpɔɖeŋu me, atikewɔmɔnu kple keklẽŋusẽdɔdamɔnu.
• Dɔlékui siwo hea kansa vɛ , abe atikewo abe benzene kple formaldehyde (siwo woate ŋu akpɔ le dɔwɔƒe kple amadede aɖewo me) ene zazã ɣeyiɣi didi.
• Kekeli ƒe keklẽ le nukliaʋawɔnu ƒe afɔku alo atɔmik bɔmb megbe.
• Ne domenyiŋusẽfianu ƒe dɔléle aɖe le ŋuwò si wotsɔna tsoa dzidzimewo me la, le kpɔɖeŋu me , Li-Fraumeni ƒe dɔléle .
• Ne dɔléle siwo do ƒome kple ƒumeŋuɖui, abe myeloproliferative neoplasms ene, le ŋuwò .

Gake ele vevie be nàɖo ŋku edzi be afɔku aɖe ƒe amesinɔnɔ mefia be kansa axɔ wò godoo o . Gake anyo wu sã be nàƒo asa na afɔku siwo dzi nàte ŋu aɖu, abe atamanono manɔmee ene.

Nukawoe nye kuxi siwo ate ŋu ado tso dɔléle sia me?

Ne AMoL le ŋuwò la, lãmenugbagbevi siwo mesɔ o ate ŋu aƒo ƒu ɖe wò ƒumeŋuɖui me . Abe alesi nènyae ene la, ƒumeŋuɖui mee wowɔa ʋumenugbagbeviwo le. Eyata ne kansadɔlékui siawo tsi la, wotsia ʋumenugbagbevi siwo le lãmesẽ me la nu ƒu. Esia ate ŋu ana ʋumenugbagbevi dzĩwo, ʋumenugbagbevi ɣiwo, kple ʋumenugbagbevi dzĩwo dzi naɖe akpɔtɔ, si ate ŋu ahe kuxi vovovowo vɛ. Le kpɔɖeŋu me:

• Ʋusɔgbɔdɔ : Nɔnɔme si tsoa ʋumenugbagbevi dzĩwo ƒe ɖiɖi gbɔ. Esia ate ŋu ana ɖeɖi nate ame ŋu eye wòazu ɣie.
• Neutropenia : Neutrophils, si nye ʋumenugbagbevi ɣi ƒomevi aɖe, si dzi ɖena kpɔtɔna, si wɔnɛ be dɔlékuiwo xɔxɔ ƒe afɔkua dzina ɖe edzi.
• Thrombocytopenia : Ʋumenugbagbeviɣidɔ ƒe ɖiɖi, si kpena ɖe ʋu ŋu. Esia ate ŋu ana ʋu nadzi ɖe edzi le abi sue aɖe gɔ̃ hã me.

Aleke nèwɔna dea dzesi dɔléle sia?

Ðɔktawo zãa dodokpɔ vovovowo tsɔ dea dzesi AML. Xexeame ƒe Lãmesẽ Habɔbɔ gblɔ be wobua ame be AML le eŋu ne woƒe ʋumenugbagbevi 20% alo esi wu nenema nye lãmenugbagbevi siwo mesɔ o, siwo metsi o. Azɔ hã, ele be lãmenugbagbevi mawo siwo mesɔ o ƒe 80% kple edzivɔ nanye monocytes alo monocyte precursors.

Wò ɖɔkta axɔ ʋu, alo lãmenugbagbevi, tsi, alo ƒumeŋuɖui ƒe kpɔɖeŋu. Wodoa nusiawo kpɔna ŋutɔŋutɔ le dodokpɔxɔ me.

Esiawoe nye dodokpɔ siwo wozãna tsɔ dea dzesi AMOL:

• Ʋudodokpɔ : Ʋudodo blibo (CBC ) ate ŋu aɖe AMoL ƒe dzesiwo afia, abe ʋumenugbagbevi ɣiwo ƒe dzidziɖedzi ene. Ʋu si woɖena le lãme na ame ate ŋu alé ŋku ɖe lãmenugbagbevi siwo mesɔ o ŋu.
• Bone marrow biopsy : Le dodokpɔ sia gome la, wò ɖɔkta ɖea lãkusi alo tsi aɖe tso wò ƒu me (zi geɖe la, wò akɔtaƒu). Emegbe wodoa kpɔɖeŋua kpɔna le nusuekpɔmɔ̃ me be woakpɔe ɖa be kansa lãmenugbagbeviwo le wo me hã. Esia ate ŋu ave ame vie, gake ele vevie hafi woate ŋu anya dɔlélea.
• Spinal tap : Be ɖɔktaa nakpɔe ɖa be kansa lãmenugbagbeviwo kaka ɖe ahɔhɔ̃a alo lãmeka siwo le titina hã la, eɖea wò aklã me tsi ƒe kpɔɖeŋu hedonɛ kpɔna.
• Dɔlélenutsiŋutete ƒe nɔnɔme ƒe wɔwɔme: Dodokpɔ sia dia protein tɔxɛ aɖewo le lãmenugbagbeviwo ƒe anyime. Protein siawo kpena ɖe ame ŋu wòdea dzesi lãmenugbagbeviwo be wonye AMoL lãmenugbagbeviwo.
• Cytogenic analysis : Kukuɖenuŋu sia ƒomevi léa ŋku ɖe ʋuʋu alo tɔtrɔ yeye le domenyiŋusẽfianu siwo le lãmenugbagbevi siwo do ƒome kple AMoL me ŋu.

Nukae nye esia ƒe atikewɔwɔ?

Taɖodzinu vevitɔ si le atikewɔwɔ ŋue nye be woana kansa la nagbɔdzɔ . Eyae nye be, va ɖo afi si kansa lãmenugbagbeviwo maganɔ wò ƒumeŋuɖui alo ʋu me o. Gake mele be woatɔtɔ esia kple atike aɖe o . Atikewɔwɔ nye nɔnɔme si me kansa la nu yi keŋkeŋ eye megatrɔ gbɔ o.

Atikewo zazã

Atike vevitɔ si wozãna na ʋumenugbagbeviɣidɔ sesẽe nye atikewɔmɔnu . Esia ate ŋu alɔ afɔɖeɖe siwo gbɔna ɖe eme:

• Induction therapy : Atikewɔwɔ sia zãa atike siwo wozãna tsɔ daa dɔe tsɔ dea AMoL me be wòaɖe asi le eŋu. Zi geɖe la, atikewɔwɔa nyea ɣeyiɣi geɖe siwo xɔa ŋkeke geɖe, eye wòhiãna be woagava srãe kpɔ ake.
• Consolidation therapy : Le atikewɔwɔ sia me la, àyi edzi anɔ chemo si sɔ gbɔ wu xɔm be wòawu kansa lãmenugbagbevi ɖesiaɖe si susɔ. Esia aɖe mɔnukpɔkpɔ si li be kansadɔlékuiawo natrɔ ava la dzi akpɔtɔ. Zi geɖe la, atikewɔwɔa xɔa ɣleti etɔ̃ va ɖo ene, eye wòxɔa ŋkeke ʋɛ aɖewo.
• Beléle na dɔdamɔnu : Le atike si naa ame ƒe lãme sẽ megbe la, àte ŋu ahiã be nàzã atike si ƒe agbɔsɔsɔme le sue ɣleti geɖe alo ƒe geɖe gɔ̃ hã.

Atikewɔwɔ si ŋu woɖo taɖodzinu ɖo

Dɔdamɔnu sia tɔa ŋku nugbagbeviwo ƒe tɔtrɔ alo tɔtrɔ tɔxɛ siwo vaa kansa lãmenugbagbeviwo me. Ne atikewɔmɔnu mewɔ dɔ o la, ɖewohĩ ahiã be nàzã atike si woɖo taɖodzinu na . Alo, ne domenyiŋusẽfianu ƒe tɔtrɔ aɖe koŋ le kansa lãmenugbagbeviwo me la, woate ŋu ana atike si woɖo taɖodzinu na wò si wɔa dɔ ɖe tɔtrɔ ma ŋu.

Lãmenugbagbeviwo dodo na ame

Mɔ ɖeka kolia si dzi woato ada ʋumenugbagbeviɣidɔ sesẽ si nye monocytic leukemia keŋkeŋ enye allogeneic stem cell transplant . Esia ate ŋu ahiã ne èyi ɖe tsɔtsɔke me vɔ. Alo, ne kansa la gatrɔ va le wò yiyi ɖe dɔlélea nu vɔ megbe la, woate ŋu awɔ dɔ sia dodo na ame bubu. Le dɔ sia wɔwɔ me la, ɖɔkta tsɔa lãmenugbagbevi siwo tso nunala aɖe gbɔ ɖɔlia wò ŋutɔ wò lãmenugbagbeviwo. Zi geɖe la, ʋudola la nyea ʋu si sɔ kplikplikpli. Alo, ate ŋu anye nunala si medo ƒome kplii o le dukɔa alo dukɔwo dome ŋkɔwo ŋɔŋlɔ ƒe agbalẽ me.

Gake menye amesiamee ate ŋu ado lãmenugbagbeviwo na ame bubu o. Ate ŋu ahe nugbegblẽ le ame ŋu vevie hã vɛ. Ne wò ɖɔkta kafui la, woaɖe viɖe kple kuxi siwo le eme la me na wò.

Dɔdamɔnu dodokpɔwo

Dɔdamɔnu dodokpɔ nye numekuku si doa atike yeyewo ƒe dedienɔnɔ kple woƒe dɔwɔwɔ kpɔna. Le dɔléle si wokpɔ le ŋuwò nu la, esia ate ŋu anye atike nyuitɔ kekeake na wò. Bia wò ɖɔkta nenye be ele be nàkpɔ gome le dɔdamɔnu dodokpɔ aɖe me.

Aleke nènɔa agbe kple nɔnɔme sia? / Mɔnukpɔkpɔ kawoe li be woahaya?

Zi geɖe la, mɔkpɔkpɔ na amesi ŋu acute monocytic leukemia (AMoL) le la sɔ kple amesi ŋu acute myeloid leukemia (AML) le. Ame siwo ade 3 le 10 ɖesiaɖe me siwo ŋu AMoL le gakpɔtɔ le agbe le ƒe atɔ̃ megbe tso esime wokpɔ dɔlélea .

Gake ele vevie be míaɖo ŋku edzi be xexlẽme siawo meɖea atikewɔwɔ yeyewo fiana o. Dɔdamɔnu yeyewo le mɔ ɖem na amewo be woanɔ agbe didi wu kple AMoL. Azɔ hã, wò nyagblɔɖi , alo mɔnukpɔkpɔ si li be nàhaya, nɔ te ɖe nu geɖe dzi. Le kpɔɖeŋu me:

• Ƒe : Ame siwo mexɔ ƒe 65 haɖe o la ate ŋu ahaya tso AMoL me wu.
• Ʋumenugbagbevi ɣiwo ƒe xexlẽme : Mɔnukpɔkpɔ sua amesiwo ƒe ʋumenugbagbevi ɣiwo ƒe xexlẽme mede o la si be woahaya.
• Alesi wowɔa nui ɖe atikewɔwɔ ŋu : Ne wokpɔ dɔlélea ƒe tsɔtsɔke le atikewɔmɔnu gbãtɔ (induction chemotherapy) megbe la, mɔnukpɔkpɔ si li be woahaya la lolo ŋutɔ.

Aleke nèléa be na ɖokuiwòe?

Agbenɔnɔ kple ʋumenugbagbeviɣidɔ ate ŋu anye nuteɖeamedzi . Ne èle dɔlélea ƒe tsɔtsɔke me gɔ̃ hã la, ɖewohĩ ahiã kokoko be nànɔ te ɖe vɔvɔ̃ be kansa la atrɔ ava gbɔ. Ðewohĩ ahiã be nànɔ te ɖe kansa dada ƒe nugbegblẽ le ame ŋu ɣeyiɣi didi hã ŋu. Mɔ nyuitɔ si dzi nàto akpɔ ɖokuiwò dzie nye be nàwɔ nunɔamesi siwo katã le asiwò la ŋudɔ . Esiawo ate ŋu anye:

• Kansa ƒe agbetsitsi ƒe ɖoɖowo : Kadodo kple ame bubu siwo ŋu kansa le ate ŋu ana kpekpeɖeŋu si nèhiã la wò eye wòakpe ɖe ŋuwò nàse le ɖokuiwò me be menye ye ɖeka koe o.
• Palliative care : Palliative care kpena ɖe ŋuwò nèkpɔa kansa ƒe dzesiwo kple kansa dada ƒe nugbegblẽ le ame ŋu gbɔ. Nuka kee nèɖagblɔ ɖi o, esia nye dɔwɔnu vevi aɖe.
• Atikewɔwɔ : Ame geɖe siwo ŋu kansa le la tsia dzimaɖi kple blanuiléle. Àte ŋu axɔ kpekpeɖeŋu ne èdo go kple susumedɔléle ŋuti aɖaŋuɖola si wɔa dɔ kple amesiwo tsi agbe le kansa me. Aɖaŋuɖola ate ŋu akpe ɖe ŋuwò nàɖu gbesiagbe nuteɖeamedzi siwo dona tso kansadɔ si wokpɔna me dzi.

Ɣekaɣie wòhiã be nàyi ɖɔkta gbɔ?

Ahiã be nàyi ɖɔkta gbɔ edziedzi be nàlé ŋku ɖe alesi nèwɔa nui ɖe atikewɔwɔ ŋui ŋu. Woana nànya ne tɔtrɔ aɖewo le wò ŋutilã me si ate ŋu afia be kansa la le tɔtrɔm. Ƒo nu kple wò ɖɔkta evɔ màlé naneke ɖe te o .

Nya kawoe wòle be nàbia ɖɔktaa?

Nya aɖewo siwo nàte ŋu abia wò ɖɔktae nye esi:

• Atikewɔwɔ kae hiãm?
• Nu gbegblẽ kawoe wòle be makpɔ mɔ na, ​​eye aleke mawɔ akpɔ wo gbɔe?
• Ðe wòhiã be makpɔ gome le dɔdamɔnu dodokpɔ aɖe mea?
• Zi nenie wòahiã be mava hena ɣeyiɣi siwo woawɔ be makplɔe ɖo?
• Nu kawoe li siwo ate ŋu akpe ɖe ŋunye?

Mlɔeba la, nu siwo dzi wòle be woaɖo ŋkui

Ne èva nya be ʋumenugbagbeviɣidɔ sesẽ (AMoL) le ye alo viwò ŋu la, ate ŋu awɔ nuku na wò ŋutɔ. Ʋumekansa nye nɔnɔme sesẽwo, eye atikewɔwɔawo ate ŋu asesẽ. Anɔ eme be àdze ŋgɔ atikewɔwɔ zi geɖe le ŋkeke, kwasiɖa, kple ɣleti siwo gbɔna me.

Gake ele vevie be nàɖo ŋku esia dzi: Dɔdamɔnu siawo le kpekpem ɖe amewo ŋu be woanɔ agbe didi wu tsã . Le ame aɖewo gome la, atikeawo ate ŋu aɖe kansa la ɖa keŋkeŋ gɔ̃ hã. Bia wò ɖɔkta be nukae nàte ŋu akpɔ mɔ na hã. Ƒo nu tso atikewɔmɔnu ɖesiaɖe ƒe viɖe kple kuxiwo ŋu na wo. Woate ŋu akpe ɖe ŋuwò nànɔ te ɖe nusi gbɔna dzɔdzɔ ge la nu.

Ðo ŋku esia dzi: Menye wò ɖeka koe le mɔzɔzɔ sia me o. Ðɔktawo, ƒometɔwo, kple xɔlɔ̃wo katã le afima be yewoakpe ɖe ŋuwò. Nɔ anyi sesĩe!

` Acute monocytic leukemia, AMoL, ʋumenugbagbeviɣidɔ, ʋumenugbagbeviɣidɔ ƒe dzesiwo, atikewɔmɔnu, ƒumeŋuɖui dodo na ame, kansa dada