Nukae Nye Leptomeningeal Dɔléle? Mina míaƒo nu tso eŋu!

Esesẽna be nàgblɔ vɔvɔ̃ kple dzimaɖitsitsi si nèsena le ɖokuiwò me ne èva nya be kansa le ye ŋu la ɖe nya me. Ne èle avu wɔm kple kansa la, mí katã míese be ate ŋu akaka ɖe ŋutilã ƒe akpa bubuwo. Egbea, míele nu ƒom tso mɔ ɖeka si dzi kansa ate ŋu ato akpɔ ŋusẽ ɖe míaƒe ahɔhɔ̃, lãkusi siwo ƒo xlã míaƒe akɔta, kple míaƒe ahɔhɔ̃mekawo dzi ŋu. Ðɔktawo yɔa esia be Leptomeningeal Disease , si woyɔna ɣeaɖewoɣi be LMD alo LM .

Kpuie ko la, nukae nye Leptomeningeal Disease?

Enyo, mina míagbã esia vie. Lãmetsi tsɛ etɔ̃e li siwo kpɔa míaƒe ahɔhɔ̃ kple aklã ta. Míeyɔa esiawo be meninges. Woyɔa lãkusi tsɛ eve siwo le lãkusi siawo me be leptomeninges . Abe agbalẽ ƒe akpawo ene la, lãkusi siawo kpɔa míaƒe lãmekawo ƒe akpa vevi eve siawo ta.

Eyome, tsi tɔxɛ aɖe li si sina yia míaƒe ahɔhɔ̃ me kple míaƒe aklã me. Woyɔa esia be ahɔhɔ̃mekawo ƒe tsi (CSF) . Lãmetsi sia naa nunyiame ahɔhɔ̃ kple aklã, ekpɔa eta, eye wòɖea gbeɖuɖɔwo ɖa.

Fifia, leptomeningeal disease (LMD) nye esime kansa si le ŋutilã ƒe teƒe bubu, abe no me dɔdzẽ alo lãkusi me dɔdzẽ ene, kaka eye wòge ɖe leptomeningeal membrane mawo siwo ŋu míeƒo nu tsoe kple ahɔhɔ̃mekawo ƒe tsi (CSF) me. Ema fia be kansa lãmenugbagbeviwo dzea tsia dzi le tsi sia me, abe gbeɖuɖɔ siwo le tsia me ene. Wobua esia be enye kansa ƒomevi aɖe si nu sẽ ŋutɔ.

Aleke gbegbee leptomeningeal dɔléle (LMD) bɔe?

Le nyateƒe me la, leptomeningeal disease (LMD) mebɔ nenema gbegbe o. Gake esi wowɔ ŋgɔyiyi le atikewɔmɔnu siwo ana amewo te ŋu nɔa agbe didi wu kple kansa ta la, eva le bɔbɔm. Le mama dedie nu la, LMD dzɔna le kansadɔnɔ siwo ade 5% me .

Wokpɔa LMD ƒe nɔnɔme sia zi geɖe le amesiwo ŋu kansa ƒomevi siwo gbɔna le ŋu:

• No me dɔdzẽ: No me dɔdzẽe nye no me dɔdzẽ ƒomevi si bɔ wu si do ƒome kple LMD. Edzea nyɔnu siwo ŋu no me dɔdzẽ le ƒe 3% va ɖo 5% dzi . Numekukuwo ɖee fia be nyɔnu siwo ŋu no me dɔdzẽ ƒomevi si woyɔna be ``Triple negative breast cancer'' kple subtype ``Lobular breast cancer'' le la le afɔku gã me be woaxɔ LMD.
• Aklã me dɔdzẽ: Aɖuɖɔtoe me dɔdzẽ si menye lãmenugbagbevi suewo o (NSCLC) kple lãmenugbagbevi suewo me dɔdzẽ (SCLC) siaa ate ŋu akaka ɖe leptomeninges kple ahɔhɔ̃mekawo me tsi me. Ðɔktawo bu akɔnta be amesiwo ŋu NSCLC le dometɔ 4% va ɖo 7% xɔa LMD. Agbɔsɔsɔ sia dzina ɖe edzi va ɖoa amesiwo ŋu SCLC le ƒe 11% lɔƒo .
• Melanoma: Esia nye ŋutigbalẽ me kansa ƒomevi sesẽ aɖe. Ame siwo ŋu melanoma le la dometɔ siwo ade 5%LMD ate ŋu adze egɔme.
• Acute lymphocytic leukemia (ALL): Esia nye ʋu me kansa. Ame siwo ŋu ALL le ƒe 1% va ɖo 10% ate ŋu axɔ LMD.
• Non-Hodgkin’s lymphoma (NHL): Esia hã nye kansa si le ʋukawo me. Ame siwo ŋu NHL le ƒe 5% va ɖo 10% ate ŋu axɔ NHL.

Vovototo kae le ahɔhɔ̃ me dɔlékuiwo ƒe kaka kple leptomeningeal disease (LMD) dome?

Esiawo evea siaa dzɔna ne kansa la kaka, gake vovototo sue aɖe le wo dome.

Ahɔhɔ̃ me dɔlékuiwo ƒe kaka nye ne kansa lãmenugbagbeviwo zɔ mɔ yi ahɔhɔ̃mekawo me tẽ eye wowɔa dɔdzẽ le afima.

Gake leptomeningeal disease (LMD) nye ne kansa lãmenugbagbeviwo zɔ mɔ yi ahɔhɔ̃mekawo me tsi (CSF) kple leptomeningeal membranes siwo ƒo xlã ahɔhɔ̃ kple aklã me . Le afisia la, kansa lãmenugbagbeviwo ate ŋu anɔ tsia dzi alo anɔ kakam ɖe lãkusiawo ƒe anyime.

Ɣeaɖewoɣi la, nɔnɔme siawo evea siaa ate ŋu adzɔ ɖekae, alo woate ŋu adzɔ ɖe vovo.

Nukae nye dɔléle sia ƒe dzesiwo?

Dzesi geɖe ate ŋu anɔ leptomeningeal disease (LMD) ŋu, elabena egblẽa nu le ahɔhɔ̃ kple aklã, si nye míaƒe lãmekawo katã ŋu. Gake dzesi siwo bɔ wu dometɔ aɖewoe nye esi:

• Taɖuame: Esiae nye dzesi vevitɔ si ame akpa gãtɔ kpɔna. Mele abe taɖuame si sɔ ene o, ate ŋu asẽ vie, eye ɣeaɖewoɣi la, egavloe ɖe edzi le ŋdi me.
• Aɖuɖɔtoe kple aɖuɖɔtoe: Aɖuɖɔtoe kple aɖuɖɔ ate ŋu adzɔ, vevietɔ le ŋdi me.
• Tɔtrɔ le azɔlizɔzɔ ŋu: Ðewohĩ àse le ɖokuiwò me be yemegate ŋu le ye ɖokui dzi ɖum o eye nèle klitsaklitsa dzi ne èle zɔzɔm.
• Tosese ƒe dɔmawɔmawɔ nyuie: Tosese ƒe dɔmawɔmawɔ nyuie ate ŋu adzɔ kpata, eye àte ŋu adze gbeɖiɖi vovovowo sese gɔme le wò towo me.
• Nukpɔkpɔ ƒe kuxiwo: Nukpɔkpɔ eve kple nukpɔkpɔ si me mekɔ o ate ŋu adzɔ.
• Alɔ̃madɔmadɔ : Ate ŋu adzɔ be ame ƒe susu nabu kpata eye wòaʋuʋu.
• Tɔtɔ kple tɔtrɔ le ame ƒe susu, seselelãme, alo nuwɔna me: Ate ŋu asesẽ be wò susu nanɔ nu ŋu, ŋkuɖoɖonudzi ƒe dɔmawɔmawɔ nyuie, dzikudodo, kple dzimaɖitsitsi ate ŋu adzɔ.
• Akɔta kple afɔveve: Vevesese ate ŋu adzɔ le akɔta kple afɔwo to.
• Afɔwo alo akɔta ƒe ʋuʋu alo gbɔdzɔgbɔdzɔ: Wò afɔwo ate ŋu ase le wo ɖokui me be yevuvu eye agbe mele wo ŋu o.
• Kuxi siwo le aɖuɖɔtoe alo aɖuɖɔtoe me: Ate ŋu asesẽ be woaɖu aɖuɖɔ kple aɖuɖɔ dzi.
• Ahɔhɔ̃mekawo ƒe kuxi yeye bubuwo: Tsɔ kpe ɖe esia ŋu la, ahɔhɔ̃mekawo ƒe dzesi yeyewo ate ŋu ado, abe nuƒoƒo sesẽ kple mo ƒe akpa aɖe ƒe ʋuʋu ene.

Nu vevitɔe nye be ne kansa le ŋuwò la, gblɔe na wò ɖɔkta enumake ne dzesi yeye aɖewo abe esiawo ene dze ŋuwò.

Nukatae leptomeningeal dɔléle (LMD) dzɔna?

Kpuie ko la, LMD dzɔna ne kansa lãmenugbagbeviwo do le afisi kansa nɔ gbã le ŋutilã me (e.g., no, lãkusi), zɔ mɔ to ʋukawo alo ʋukawo me, eye woge ɖe ahɔhɔ̃mekawo ƒe tsi (CSF) kple leptomeninges siwo ŋu míeƒo nu tsoe va yi la me. Esia ɖe alesi gbegbe kansa la kaka ɖoe fia.

Zi geɖe la, ahɔhɔ̃mekawo me tsi (CSF) dzɔna le míaƒe ahɔhɔ̃ me, emegbe ezɔna ƒoa xlã ahɔhɔ̃a kple aklã me, eye wògagena ɖe ʋukawo me. Esia dzɔna le tsatsam me. Gake ne kansa lãmenugbagbeviwo ge ɖe CSF sia me la, woate ŋu ado kplamatse tsi sia ƒe sisi nyuie. Emegbe CSF ate ŋu aƒo ƒu, si ana nyaƒoɖeamenu si le ahɔhɔ̃a me nadzi ɖe edzi. Esia tae dzesi geɖe dzena ɖo. Azɔ hã, ne kansa lãmenugbagbeviwo kaka ɖe leptomeningeal membranes me la, woate ŋu agblẽ nu le membrane mawo kple lãmeka siwo do ƒome kpli wo ŋu.

Aleke ɖɔktawo wɔna dea dzesi esia?

Ne èsusu be LMD le ye ŋu la, ɖɔktawo awɔ dodokpɔ vevi eve:

1. MRI scan (Magnetic Resonance Imaging - MRI): Wowɔa wò ahɔhɔ̃ kple/alo wò aklã ƒe MRI scan be woatsɔ akpɔe ɖa be kansa lãmenugbagbeviwo kaka ɖe leptomeninges me eye woxe mɔ na CSF ƒe sisi hã.

2. Lumbar puncture / Spinal Tap: In this test , wotsɔa aŋe tsɛ aɖe dea wò akɔta ƒe akpa si le anyime, eye wokpɔa egbɔ be yemagblẽ nu le wò aklã ŋu o, be woaɖe ahɔhɔ̃meka me tsi (CSF) sue aɖe ɖa. Emegbe wodoa kpɔɖeŋua kpɔna le dodokpɔxɔ aɖe me be woakpɔe ɖa be kansadɔlékui aɖewo li hã.

Ɣeaɖewoɣi la, ne kansa lãmenugbagbeviwo ƒe kaka menya kpɔna dzea sii bɔbɔe o (nusuekpɔmɔ̃) la, ɖewohĩ womakpɔe le MRI-mɔ̃ dzi o. Le nɔnɔme mawo me la, dɔlélea didi ate ŋu asesẽ vie. Esia tae wòle vevie be nàgblɔ wò dzesiwo na wò ɖɔkta pɛpɛpɛ.

Ðe atike blibo aɖe li na esia?

Nublanuitɔe la, fifia la, womekpɔ atike aɖeke na leptomeningeal disease (LMD) o. Esi wònye kansa sesẽ aɖe si bɔ ta la, atikewɔwɔ ƒe taɖodzinu vevitɔwoe nye be woaɖu kansa ƒe kaka dzi, aɖe dzesiawo dzi akpɔtɔ eye wòakpe ɖe ŋuwò nànɔ agbe bɔbɔe alesi nàte ŋui, eye nàlé agbenɔnɔ ƒe nyonyome me ɖe asi.

Atikewɔwɔ ƒe tiatia nɔ te ɖe nusiwo nye kansa ƒomevi si nɔ ŋuwò le gɔmedzedzea me, afisi kansa la kaka ɖo, kple wò lãmesẽ bliboa dzi. Dɔdamɔnu siwo wozãna wu dometɔ aɖewoe nye:

• Kekelidɔdamɔnu: Wotsɔa keklẽŋusẽdɔdamɔnu na ahɔhɔ̃a alo aklã ƒe akpa siwo ŋu wògblẽ nu le. Esia ateŋu aɖe dzesi aɖewo dzi akpɔtɔ (e.g., vevesese, lãmekawo ƒe gbɔdzɔgbɔdzɔ) eye wòana lãmeka aɖewo ƒe dɔwɔwɔ nanyo ɖe edzi.
• Atikewo zazã:Wona atikewo be woatsɔ awu kansa lãmenugbagbeviwo. Woate ŋu ano atike siawo abe atikekui ene, ado wo abe atike si wodona ɖe ʋuka me ene, alo woado wo ɖe ahɔhɔ̃meka me tsi (CSF) me tẽ ɣeaɖewoɣi. Woyɔa esia be ``Intrathecal chemotherapy.'' Wowɔa esia to mɔ̃ sue aɖe si wotsɔ de ahɔhɔ̃a me si woyɔna be ``ventricular access device.''

Ðe mɔ aɖewo li siwo dzi woato aɖe esia ƒe dzɔdzɔ dzi akpɔtɔa?

Le nyateƒe me la, mɔ aɖeke meli si dzi woato axe mɔ ɖe LMD ƒe dzɔdzɔ nu fifia o, elabena edzɔna le kansa si le ŋutilãa me xoxo ƒe kaka ta.

Ɣeyiɣi didi kae nàte ŋu anɔ agbe kple dɔléle sia?

Menya be nya sia nye nya sesẽ aɖe si woabia. LMD nye kansa ƒe akpa si de ŋgɔ wu. Esia fia be ne nɔnɔme sia do mo ɖa la, dɔnɔa nɔa kansa ƒe akpa si nu sẽ wu la me.

Le mamã dedie nu la, dɔnɔ siwo wowɔ atike na ate ŋu akpɔ mɔ be yewoanɔ agbe ɣleti etɔ̃ va ɖo ade le dɔlélea kpɔkpɔ vɔ megbe . Le amesiwo mexɔa atike o gome la, ɣeyiɣi sia ate ŋu anɔ abe ɣleti ɖeka ene.

Ke hã, esia ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Enɔ te ɖe nu geɖe dzi, abe kansa ƒomevi si le ŋuwò kple alesi wò ŋutilã wɔa nui ne wowɔ atike nɛ ene. Wò ɖɔktae nye ame nyuitɔ kekeake si ana nyatakaka wò tso esia ŋu.

Aleke malé be na ɖokuinye? Ðe wòle be mabu beléle na ame tsitsiwo ŋua?

Ne LMD le ŋuwò la, ele vevie be nàse wò nɔnɔmea gɔme nyuie. LMD nye kansa ƒe kuxi si wua ame, si womate ŋu ada o. Bia wò ɖɔkta nusi nàkpɔ mɔ na le wò nɔnɔmea nu. To mɔ sia dzi la, àte ŋu akpɔ wò dzesiawo gbɔ, anɔ dziɖeɖi me alesi nàte ŋui, eye nàtsɔ nusiwo le vevie na wò aɖo nɔƒe gbãtɔ.

Esiawo menye nu bɔbɔe siwo ŋu nàƒo nu tsoe o, eɖanye na wò alo wò ɖɔkta o. Gake wole vevie ŋutɔ. Wò ɖɔkta ate ŋu akpe ɖe ŋuwò nàse nusi le dzɔdzɔm ɖe wò ŋutilã dzi kple nusi ate ŋu adzɔ le etsɔme gɔme. Ate ŋu akpe ɖe ŋuwò hã be nàbu wò tiatiawɔblɔɖe ŋu eye ne ehiã la, wòaɖo wò ɖe kpekpeɖeŋunadɔwɔƒewo.

Ame tsitsiwo dzikpɔƒe nye subɔsubɔdɔ si kpena ɖe amesiwo ŋu dɔléle siwo xea mɔ na woƒe agbenɔnɔ, siwo wua ame le ŋu be woanɔ woƒe ŋkeke mamlɛawo me le dziɖeɖi me, le bubu me, le woƒe ŋusẽ te, eye woanɔ agbe nyuie. Ne míele avu wɔm kple dɔléle sesẽ aɖe la, míaƒe ɣeyiɣi kple ŋusẽ akpa gãtɔ nɔa atikewɔwɔ ŋu. Ne wole ame tsitsiwo dzi kpɔkpɔ ŋu bum la, alesi woazã ɣeyiɣi susɔea ŋue woƒe susu nɔa, ke menye dɔlélea ŋutɔ ŋu o. Ne èƒo nu kple wò ɖɔkta tso alesi LMD akpɔ ŋusẽ ɖe wò agbe dzii, atike siwo li na wò kansa ƒomevi, kple nusiwo nàkpɔ mɔ na tso atikewɔwɔ mawo me ŋu la, àte ŋu awɔ nyametsotso si anyo na wò.

Ne LMD le ŋuwò la, ke ɖewohĩ èle agbe kple kansa sesẽ aɖe si kaka ɖe wò ŋutilã katã me togbɔ be wowɔ atike nɛ hã. Ne èva nya be kuxi sesẽ aɖe si womate ŋu ada o le ye ŋu la, àte ŋu awɔ nuku, ado dziku, eye vɔvɔ̃ naɖo ye. Ðewohĩ àbia ɖokuiwò be, “Nukatae nusia le dzɔdzɔm ɖe dzinye?” Menye wò ɖeka koe le nɔnɔme sia me o. Bia wò ɖɔkta be wòakpe ɖe ye ŋu. Wose nu si me tom nèle la gɔme, eye woakpe ɖe ŋuwò le mɔ ɖesiaɖe si woate ŋui nu.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

• Leptomeningeal disease (LMD) nye kansa ƒe kaka ɖe lãkusi siwo tsyɔ ahɔhɔ̃ kple aklã me kple ahɔhɔ̃mekawo me.
• Esia nye nɔnɔme sesẽ aɖe si womate ŋu ada o.
• Ahɔhɔ̃mekawo ƒe dzesiwo abe taɖuame, ʋuʋudedi, azɔlizɔzɔ sesẽ, nukpɔkpɔ/sesese ƒe kuxiwo, kple tɔtɔ ate ŋu ado mo ɖa.
• Wotoa MRI-dɔdamɔnu kple akɔta ƒe dodo dzi dea dzesi dɔlélea.
• Taɖodzinu si le atikewɔwɔ ŋue nye be woaɖu dzesiawo dzi eye woalé agbenɔnɔ ƒe nyonyome me ɖe asi.
• Mègavɔ̃ be yeaƒo nu kple wò ɖɔkta gaglãa tso wò nɔnɔmea, wò etsɔme, kple tiatia siwo nàwɔ abe ame tsitsiwo dzi kpɔkpɔ ene ŋu o. Na kpekpeɖeŋu si mia kple wò ƒomea miehiã be miate ŋu ato ɣeyiɣi sesẽ sia me.

` Leptomeningeal Dɔléle, Kansa, Ahɔhɔ̃, Aklã, Ahɔhɔ̃meka, Dzesiwo, Kansa ƒe Kaka