Bɔku pan wi kin fred di wɔd "kansa." Na tin we rili kɔmɔn. Bɔt tide, bikɔs mɛrɛsin sayɛns dɔn go bifo, i dɔn bi pɔsibul fɔ liv nɔmal wan wit sɔm kayn kansa. Tide, wi go tɔk bɔt wan pan dɛn kayn blɔd kansa dɛn de. Dat na CML, we tinap fɔ Chronic Myeloid Leukemia. Yu go dɔn yɛri dis nem afta yu dɔn du blɔd tɛst ɔltɛm. So, lɛ wi tɔk bɔt am ditayli ɛn nɔ fred.
Okay, so wetin na dis CML?
Fɔ tɔk am simpul wan, CML na kansa we de na wi blɔd. I de stat na di bon mכro we de insay wi bon dεm. Di bon mɛro tan lɛk faktri we de mek di kayn sɛl dɛn we wi bɔdi nid we dɛn kɔl rɛd blɔd sɛl, wayt blɔd sɛl, ɛn pletlɛt. insay CML, sכmtin de go rכng wit di mayloid stεm sεl dεm na dεn bon mכro sεl dεm ya, εn dεn kin bigin fכ sheb εn mכltipכl we dεn nכ kin kכntro.
dis dεn kכl am bak `krכnik maylojεnik lukimiya` כ `krכnik granulosaytik lukimiya`.
Bɔt di nyus we impɔtant ɛn we bɛtɛ pas ɔl na ya na dat, wit di advans tritmɛnt dɛn tide, bɔku pipul dɛn we gɛt CML kin liv nɔmal layf . Dis min se instead fɔ bi sik we de kil pɔsin, i dɔn bi wan sik we nɔ de mɛn we pɔsin kin kɔntrol wit mɛrɛsin.
Aw kwik dis CML de go bifo?
Di wɔd "krɔnik" min "lɔng tɛm." Ɛn na so dis sik tan. CML na wan sik we kin rili bɔku. Sɔmtɛm e kin de fɔ lɔng lɔng tɛm ɛn nɔr kin gɛt ɛni sayn. Bɔku pipul dɛn kin no se dɛn gɛt am bay aksidɛnt, we dɛn du blɔd tɛst fɔ ɔda rizin sho se dɛn blɔd sɛl nɔ de wok fayn.
Bɔt if dɛn nɔ trit dis, dis kin bi sik we go mek i day insay tri to 4 ia. So, i rili impɔtant fɔ no di sik ɛn bigin fɔ trit am kwik.
Us sayn dɛm wae pɔrsin wae gɛt CML kin gɛt?
Bɔrku tɛm, nɔr kin gɛt ɛni big sayn fɔ de na di fɔs stej. Bɔt sɔm kɔmɔn sayn dɛn de we kin apin as tɛm de go. Bɔku tɛm, dɛn tin ya na tin dɛn we wi kin tink se na nɔmal tin ɛn wi nɔ kin pe atɛnshɔn to.
| Di sayn we de sho se di sik de | Wan simpul ɛksplen |
|---|---|
| I kin taya ɔltɛm ɛn wi kin wik | Ɔltɛm yu kin fil taya, ilɛksɛf yu slip fayn ɛn nɔ du ɛni wok. |
| I nɔ izi fɔ blo (Dyspnea) . | Fɔ fɔdɔm we yu de waka fɔ shɔt tɛm ɔ we yu de klaym stej. |
| Fiva we nɔ gɛt ɛni rizin | Fɔ fil wam we yu nɔ gɛt ɛni ɔda sik. |
| Nayt swet dɛn | Swet na nɛt te di sheet dɛn wet, pan ɔl we di rum kol. |
| We yu de lɔs yu wet fɔ natin | Fɔ lɔs yu wet wantɛm wantɛm we yu nɔ de it ɔ ɛksesaiz. |
| Swel ɔ nɔ kin fil fayn na di ɔp pat na di lɛft pat na di bɛlɛ | dis kin bi fכ di swεla we di splin de swel, we de na dis pat pan di bכdi. |
| Fɔ fil ful ivin afta yu dɔn it smɔl | Splin we dɔn swel kin prɛs pan di bɛlɛ, ɛn mek yu fil ful ivin afta yu dɔn it smɔl. |
Wetin mek CML de divɛlɔp? Yu tink se na frɔm dɛn gret gret granpa dɛn?
Dis kwɛstyɔn na sɔntin we bɔku pipul dɛn gɛt. Di impɔtant tin fɔ ɔndastand ya na dat CML nɔto sik we pɔsin kin gɛt frɔm in mama ɛn papa . Dis min se pikin dɛn nɔ kin gɛt am jɔs bikɔs dɛn mama ɛn papa bin gɛt am. Ɛn i nɔto sɔntin we pɔsin kin gɛt frɔm wi gret gret granpa dɛn.
CML de apin we chenj (mכteshכn) de apin na di jin dεm na wi sεl dεm, dat na di stεm sεl dεm na di bon mכro, insay wi layf. dis dεn kכl am `akwyayz mכtεshכn`.
Okay, naw mek wi si aw dis de wok. Fɔ tɔk am simpul wan, i tan lɛk dis:
1. chenj de apin na di jin dεm na wi stεm sεl dεm, εn wan nyu, ad jin we dεn kכl `BCR-ABL` de fכm.
2. This new gene gives new instructions to stem cells to make an unusual form of an enzyme called `tyrosine kinase`.
3. Tink se dεn εnzym dεm ya lεk di "on" εn "off" swich dεm we de on layt. Dis na di tin dɛn we de kɔntrol di we aw di sɛl dɛn de sheb.
4. bכt dat abnכmal fכm `tyrosine kinase` εnzym nכ gεt "כf" switch. I de "on" ɔltɛm.
5. biכs nכ "off" switch de, di stεm sεl dεm na di bon mכro de kכntinyu fכ gεt signal fכ divayd, divayd, εn mכltiply we dεn nכ de kכntro.
6. as a rizulta, bכku nכmba fכ di wayt bכdi sεl dεm we nכ machכ (dεn kכl dεm bak `blast`) de bigin fכ fכm.
7. As tεm de go, dεn abnכmal sεl dεm ya de fulכp di bon mכro. Dɔn di bon mɛro nɔ kin ebul fɔ mek wɛlbɔdi rɛd blɔd sɛl, wayt blɔd sɛl, ɛn pletlɛt. Dis kin mek di sayn dɛn we wi dɔn tɔk bɔt kin bigin fɔ sho.
Di risk dɛm ɛn di prɔblɛm dɛm wae kin kam wit dis
Di tin dɛn we kin mek pɔsin gɛt prɔblɛm
di onli risk fכs we dεn no fכ divεlכp CML na fכ εkspos to rili hεy lεvεl dεm fכ rεdyushכn . Bɔt, dis nɔ kin apin so ɔltɛm. di lεvεl dεm fכ rεdyushכn we wi kin mit na nכmal layf (fכ egzampl, frכm we wi gεt εks-ray) nכ kin mek i apin.
Sɔm prɔblɛm dɛn we kin apin
CML kin mek tu men prɔblɛm dɛn:
- Anemia: Na di rεd bכdi sεl dεm we de mek di bכdi de dכn, we de rεdכks di כksijεn we di bכdi nid, we de mek i taya εn i de bεlε.
- Splenomegaly: Bɔku bɔku blɔd sɛl dɛn we nɔ de na di bɔdi kin gɛda na di splin, ɛn dis kin mek i swel. Dis kin mek yu bɛlɛ nɔ fil fayn ɛn fil se yu ful-ɔp ivin afta yu it smɔl.
Apat frɔm dat, sɔm stɔdi dɛn dɔn sho se pipul dɛn we gɛt CML kin gɛt smɔl chans fɔ gɛt ɔda kayn kansa (sɛkɔn kansa).
Aw dɔktɔ dɛn kin no se pɔsin gɛt CML?
Yu dɔktɔ kin sɔprayz dis wit wan simpul blɔd tɛst. Bɔt fɔ mek dɛn no di sik, dɛn nid fɔ du spɛshal tɛst dɛn we de luk fɔ chenj dɛn na di jin dɛn.
| Tɛst | Wetin yu si pan dis? |
|---|---|
| Kɔmplit Blɔd Kɔnt (CBC) . | Dɛn kin chɛk fɔ si if di wayt blɔd sɛl dɛn tu bɔku ɔ di rɛd blɔd sɛl dɛn tu smɔl. |
| Bone Marrow Aspirashon/Bayopsi we yu de du | dεn tek sכm sכm sεmpl fכ bon mכro εn tεst fכ si if di jεnεtik mכtεshכn we dεn kכl `BCR-ABL` de. |
| CT Skan (Kɔmpyut Tomografi Skan) . | chɛk fɔ si if di kansa dɔn spre to ɔda pat dɛn na di bɔdi (e.g. splin, liva). |
| Ultrasound Skan we dɛn kin du | Dɛn kin yuz dis tɛst fɔ si if di splin big pas aw i kin bi. |
Wetin na di faz dɛm fɔ CML?
difrεnt lεk כda kεnsar dεm, dεn nכ de klas CML as "stej 1, 2, 3, 4." Bifo dat, dɛn kin klas am as "faz dɛm." dis de sho bay di nכmba fכ di wayt bכdi sεl dεm we nכ machכ (`blast`) na di bכdi εn bon mכro.
- Kronik Faz: Dis na di fɔs stej. lεs dan 10% pan di `blast` sεl dεm de na di bכdi εn bon mכro. 80-90% pan di pipul dεm we dεn no se dεn gεt CML de na dis stej. Dɛn pipul ya kin gɛt ɔr nɔr kin gɛt sɔm kayn sik.
- aksεlεrayt Faz: insay dis fεz, di nכmba fכ di `blast` sεl dεm de inkrεs to bitwin 10% εn 19%. Di sayn dɛm kin bigin fɔ notis mɔr.
- Blast Faz ɔ Blast Krays: Dis na di faz we kin rili bad ɛn we kin mek pɔsin in layf de pan denja. di nכmba fכ di `blast` sεl dεm de inkrεs bay 20% כ mכr. Di sayn dɛm lɛk fɔ taya pasmak, fiva, ɛn fɔ lɛf fɔ it bɔku bɔku it kin rili bad.
- Resistant CML: Dis na di nem we dɛn gi CML we nɔ de ansa to tritmɛnt ɔ we de kam bak afta tritmɛnt.
Wetin na di tritmɛnt dɛm fɔ CML?
Dis na di say we di gud nyus bɔt CML kin kam insay.Tide, tritmɛnt dɛn de we rili fayn fɔ dis sik.
Di men tritmɛnt na wan klas ɔf drɔgs we dɛn kɔl Tyrosine Kinase Inhibitors (TKIs) . Dis na mɛrɛsin dɛn we dɛn kin tek as pils.
yu mεmba di כnusual εnzym we wi bin tכk bכt we de akt lεk "on" switch? Na dat dɛn drɔgs ya de target. wetin TKI dεn de du na dεn de stכp da εnzym de we nכ gεt "off" switch fכ wok. Dɛn kin blok am. afta dat dεn CML sεl dεm we de divayd we dεn nכ de kכntro nכ de gεt di signal fכ divayd, εn afta sכm tεm dεn sεl dεm de day.
Dɛn TKI ya dɔn mek big difrɛns na di layf fɔ di wan dɛn we gɛt CML. Bifo dɛn drɔgs ya kam, na lɛk 20% pan di pipul dɛn we dɛn no se gɛt CML bin de liv fɔ 5 ia. Bɔt tide, wit TKI, da pasɛnt de dɔn go ɔp to pas 90%.
Bɔku tɛm, dɛn kin tek dɛn mɛrɛsin ya fɔ ɔl dɛn layf. Sɔm pan di kayn TKI dɛn we dɛn kin yuz na:
- Imatinib we gɛt di sik
- Dasatinib we dɛn kɔl Dasatinib
- Nilotinib we gɛt di sik
- Bosutinib we gɛt di sik
- Ponatinib we dɛn kɔl Ponatinib
Yu tink se TKI dɛn gɛt sayd ɛfɛkt?
Yɛs, lɛk ɛni mɛrɛsin, sayd ɛfɛkt dɛn kin de. Bɔt bɔku tɛm dɛn kin ebul fɔ kɔntrol dɛn. Di wan dɛn we bɔku pipul dɛn kin gɛt na:
- Bɛlɛ de at
- We pɔsin taya
- Rɔnbɛlɛ
- Mɔsul dɛn we de rɔl
- Ɛdima
- Sɔntɛnde, tin dɛn lɛk fɔ pwɛl di liva ɛn fɔ lɛ di blɔd sɛl nɔ bɔku kin apin.
Yu dɔktɔ go tɔk to yu bɔt dɛn sayd ɛfɛkt ya ɛn ɛp yu fɔ kɔntrol dɛn.
Yu tink se CML kin wɛl ɔltogɛda?
na dis tεm, di כnli we fכ "kכl" CML na wit wan allojenik stεm sεl transplant . Dis involv fɔ transplant stem sɛl dɛn frɔm pɔsin we gɛt wɛlbɔdi to di pɔsin. Bɔt dis na tritmɛnt we rili kɔmpleks ɛn we gɛt prɔblɛm. So, dɛn kin du am fɔ di wan dɛn nɔmɔ we nɔ de ansa to TKI.
Aw i tan lɛk fɔ liv wit CML ɛn wetin na di lukin-grɔn?
We CML go insay rεmishכn wit tritmεnt, yu nכ de gεt simptom dεm igen εn dεn nכ kin no sayn fכ di sik pan tεst. Dis min se yu kin liv nɔmal layf. Bɔt yu go nid fɔ kɔntinyu fɔ tek mɛrɛsin fɔ kɔntrol di sik. Yu go nid bak fɔ go to yu dɔktɔ ɔltɛm fɔ mek dɛn go chɛk yu blɔd fɔ chɛk aw yu tritmɛnt de wok fayn.
Tritmɛnt-Fri Rimishɔn (TFR) .
Dis na di las ɛn prɔmis divɛlɔpmɛnt pan CML tritmɛnt. Dis min se sɔm pasɛnt dɛn we dɔn de tek TKI fɔ sɔm tɛm ɛn we dɛn dɔn kɔntrol dɛn sik fayn fayn wan kin stɔp naw fɔ tek di mɛrɛsin ɔnda dɛn dɔktɔ in sɔpɔtishɔn. Ivin afta dɛn dɔn stɔp di mɛrɛsin, di sik nɔ dɔn kam bak. Bɔt dis nɔ pɔsibul fɔ ɔlman. Yu fɔ mit sɔm kwalifayeshɔn dɛn fɔ am.
Di tin we impɔtant pas ɔl na, nɔ ɛva stɔp fɔ tek yu mɛrɛsin fɔ ɛni rizin we yu nɔ tɔk to yu dɔktɔ. Dat kin rili denja.
Impɔtant kwɛstyɔn dɛn fɔ aks yu dɔktɔ
We yu kam fɔ no se yu gɛt CML, i nɔmal fɔ gɛt bɔku kwɛstyɔn dɛn na yu maynd. Nɔr frayd, aks yu dɔktɔ bɔt dɛn tin ya.
- Us stej na CML a gɛt?
- Us tritmɛnt opshɔn dɛn a gɛt?
- Aw a go fil we dɛn de trit mi? Wetin na di bad tin dɛn we kin apin to pɔsin?
- A kin kɔntinyu fɔ du mi wok we a de gɛt tritmɛnt?
- Aw ɔltɛm a nid fɔ du blɔd tɛst fɔ si if di tritmɛnt dɔn wok fayn?
- Wetin na di chans fɔ mek mi sik go insay rɛmishɔn?
- Yu tink se stem sɛl transplant fayn fɔ mi kɔndishɔn?
- Udat a kin tɔk to bɔt aw fɔ manej di kɔst fɔ tritmɛnt?
Mɛsej we dɛn kin kɛr go na os
- CML na wan blɔd kansa we de gro sloslo. I nɔto tin we pɔsin kin gɛt frɔm in mama ɛn papa.
- Tide di tritmɛnt dɛm wae dɛn kin tɔk bɔt, wae dɛn kɔl TKI, kin rili woke, wae de alaw bɔrku pipul dɛm wae gɛt CML fɔ liv nɔrmal, lɔng layf.
- Wae yu dɔn no se yu gɛt dis sik, nɔr panik ɛn fala yu dɔktɔ in instrɔkshɔn ɛksaktɔli.
- I impɔtant fɔ tek mɛrɛsin di rayt tɛm ɛn go na klinik fɔ chɛk-ap di rayt tɛm.
- Nɔ ɛva stɔp ɔ chenj di tritmɛnt if yu dɔktɔ nɔ gri fɔ du dat.
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