He thisen cancer na tak, Acute Myeloid Leukemia (AML) chungchang hi kan sawi dawn em ni?

Ni reilote hnua a reh loh tur khawsik i nei em? A nih loh leh i chau a, i chau mai mai em ni? A châng chuan, hetiang thil tenau te hian thil lian tak a thup thei a ni. Vawiin hian kan sawi dawn a, natna chi hrang hrang, a pawi deuh a, mahse a fimkhur a pawimawh hle. Chu chu acute myeloid leukemia, a tawi zawngin AML a ni.

AML chu eng nge ni?

A awlsam zawngin Acute Myeloid Leukemia (AML) hi cancer chi khat a ni a, i ruhro leh thisen a nghawng a ni. Natna hmuh tur awm lo mahse na tak a ni. I gene emaw chromosome emaw pakhata mutation avanga lo awm a ni tlangpui. Kum 60 chunglam ah a tam ber a, amaherawhchu, thalai leh naupang te pawh a nghawng thei a ni. AML hi cancer natna a ni a, a darh chak hle a, nunna atana hlauhawm tak a ni. Vanneihthlak takin enkawlna thar a awm avangin mi tam tak chu he natna nen hian an dam rei thei ta a ni.

AML chi hrang hrang a awm em?

Ni e, AML hi subtype hrang hrang engemaw zat a awm. Heng chi hrang hrang hian i thisena cell awm zat a nghawng a ni. Mahse, chi tin hian symptom hrang hrang an nei thei a, enkawlna an dawn dan pawh a inang lo thei bawk.

Doctor-te chuan heng AML subtype te hi microscope hmanga cancer cell te enfiahin an hmuchhuak thin. I chromosome-a inthlak danglamna leh cell thanna controltu gene thenkhata mutations te pawh an zawng bawk.

AML subtype lian ber ber thenkhat chu hetiang hi a ni:

• Myeloid leukemia: Hei hi AML chi khat zingah chuan a tam ber a ni. Thisen var chi khat neutrophils siamtu cell-te cancer angin a lo thang lian a ni.
• Acute monocytic leukemia (AML-M5): Hei hi thisen var chi khat, monocyte an tih siamtu cell-ah a lo thang lian a.
• Acute megakaryocytic leukemia (AMLK): Hei hi thisen zam (red blood cells) emaw, platelets emaw siamtu cell-te cancer a ni.
• Acute promyelocytic leukemia (APL): Hetah hian thisen var puitling lo chi khat, promyelocytes an tih chu a lo thang tha lo va, cancer cell a lo ni ta a ni.

AML hi engtiang chiahin nge a hluar?

AML hi a takah chuan natna tlemte chauh a ni. A vaiin kum tin puitling 100,000 zinga 4 velin he natna hi an vei thin. Tin, kum tin naupang 1,160 velin AML an vei tih hriat a ni bawk.

AML natna lan chhuah dan chu engte nge ni?

A tir lamah chuan AML symptoms hi ni engemaw zat chhunga awm tawh, khawsik na tak emaw, flu emaw i nei ang maiin a lang thei. Mahse AML hi cancer na tak a ni. Chumi awmzia chu, .Rei lo teah symptom thar, langsar zawk i nei tan ang. A hnuah chuan symptoms te chu i hmu thei ang:

• Luak chhuak reng reng.
• Thil chi hrang hrang, awlsam taka hliam, hnar thisen chhuak fo, leh ha i sil laiin i hmui thisen chhuah te.
• Tuar theih loh khawpa hahna hriatna.
• Khua a vawt tih hriatna.
• Khawsik.
• Zan a thawk hah.
• Infection a awm fo a, a nih loh leh infection a awm fo chuan a dam rei hle.
• Lu na.
• Chaw chu a thlum lo.
• Chhan awm lova thinrim.
• Vun dum (pale skin) a ni.
• Thâwk harsa (dyspnea).
• Lymph node a lo hring chhuak.
• Chak lohna neia inhriatna.
• Ruh, hnungzang emaw, pum emaw a na.
• Vunah hian a sen te te (petechiae) a awm thin.
• Hliam dam nan hun a duh thin.

AML awm chhante chu engte nge ni?

Mithiamte chuan AML hi eng nge a thlen tih chiang takin an la hre lo. Mahse kan taksaa gene emaw chromosome emaw thenkhat an inthlak (mutate) a, thisen cell pangngai lo tak tak a lo awm hian he natna hi a lo awm tih an hria a ni. Heng genetic changes te hi a hnuaia mi ang hian a ni thei:

• I dam chhungin thil engemaw takin i DNA a nghawng a.
• Genetic disorder i neih chuan, chu chu thlah kal zelah a lo kal zel a, AML vei theihna a tipung a ni.
• I nu leh pate sperm emaw egg emaw a gene thenkhat a inthlak vang a ni.

Engtin nge genetic changes hian AML a thlen?

Heng genetic changes te hian AML a thlen theih dan hriatthiam nan i ruhro leh thisen cell chungchang tlem tal hriat a tha ang. I ruhro chu i ruh tam zawk lairil a tissue nem, spongy ang maia awm a ni. A siam a ni:

• Stem cells a lo piang chhuak thin. Hengte hi a hnua thisen sen (red blood cells) lo ni ta, oxygen kengtu, natna hrik laka vengtu thisen var leh thisen zam tura puitu platelet te an ni.

A tlangpuiin i ruhro hian production line tha tak angin hna a thawk a, i taksa tana thisen cell leh platelets tling tawk tak a siam a ni. Mahse AML vei mi pakhatah chuan ruhro hian myeloid cell pangngai lo tak tak, myeloid blasts emaw myeloblasts emaw an tih chu a siam tan thin.

Heng myeloid blast cells te hi thisen cell pangngai angin an che lo. Cell pangngai te hian an gene atang hian engtikah nge an inthen darh ang a, engtiang chiahin nge an inthen darh ang tih leh an than chak dan tur thupek an dawng thin. Cell te chu an lo upa tawh chuan ruhro (bone marrow)-a cell thar awm theihna tur hmun siam turin an thi thin. Mahse myeloid blast cells te hian heng instruction te hi an zawm lo. Thunun theih lohvin an inthen a, an thi lo. Myeloid blast cells hian ruhro a luah khat chhunzawm zel avangin thisen cell hrisel tan hmun a awm tawh lo. Hmun a awm loh avangin ruhro hian thisen cell hrisel siam a titawp ta a ni. Thisen hrisel thar a awm loh chuan taksain a thawh that theih nan a mamawh thil a hmu thei lo.

Chubakah, heng myeloid blast cells te hi an inthen chhunzawm zel chuan ruhro atang hian an chhuak a, thisenah an lut ta a ni. Thisenah an awm hnu chuan heng myeloid cells te hi taksa peng dang, i central nervous system, thluak leh ruhro te thlengin an kal a ni.

AML vei theihna tur risk factors te chu engte nge ni?

Mithiamte chuan AML thlentu genetic mutations awm chhan dik tak hre lo mah se, he natna vei theihna tipungtu thil thenkhat (risk factors) an hre chiang hle. (Risk factor kan ngaihtuah hian risk factor neih hian natna hi i kai dawn tihna a ni lo tih hriat reng a pawimawh. ) AML vei theihna tur risk factors te chu:

• Kum: AML vei zinga a chanve vel chu kum 65 aia upa an ni a, an hmuhchhuah hian kum 65 aia upa an ni. Mahse, a hmaa kan sawi tawh ang khan AML hi puitlingah a awm tam ber a, mahse naupangah pawh a awm thei bawk.
• Meizial zuk: Hei hian secondhand smoke hip luh a huam a ni.
• Cancer enkawlna: Chemotherapy leh radiation therapy ang chi thil.
• Chemical carcinogens thenkhat nena hun rei tak awm: Entirna atan benzene leh formaldehyde ang chi thil te hi a ni.
• Nuclear reactor accident emaw atom bomb emaw atanga radiation dose sang tak nena inzawmna.
• Ṭhenkhat chuan rochun genetic disorder an nei.
• Bone marrow natna dang.

Eng genetic disease nge AML vei theihna tipung?

Researcher-te chuan inherited genetic mutations thenkhat chuan AML vei theihna a tipung tih an hmuchhuak. Chung zinga ṭhenkhat chu:

• Down syndrome tih hi a ni
• Ataxia telangiectasia a awm thei
• Li-Fraumeni natna a ni
• Klinefelter natna a ni
• Fanconi thisen tlakchhamna (anemia) a awm
• Wiskott-Aldrich syndrome - Hei hian platelet siamchhuahna a nghawng a ni.
• Bloom syndrome tih hi a ni
• Family Platelet Disorder syndrome - Hei hi platelet kaihhnawih natna a ni bawk.

Eng bone marrow natna nge AML vei theihna tipung?

Mi thenkhat chu myeloproliferative neoplasms, emaw myeloproliferative disorders nei te hian acute myeloid leukemia an nei thei a ni. (Myelo tih awmzia chu ruhro tihna a ni. Proliferative tih awmzia chu thang tam lutuk tihna a ni.) A hnuaia natna nei te pawh hi AML vei theihna a sang zawk a ni:

• Polycythemia vera tih a ni
• Myelofibrosis natna (Myelofibrosis) a awm
• Thrombocytosis a awm thin
• Myelodysplastic natna (Myelodysplastic) natna a ni
• Aplastic thisen tlakchhamna (anemia) a awm

AML avanga harsatna awm thei te chu engte nge ni?

A tir lamah chuan acute myeloid leukemia hian i taksaa thisen sen hrisel, thisen var leh platelet awm zat a nghawng a ni. Thisen cell hrisel leh platelet i neih tlem chuan hetiang dinhmun hi i tawk thei a ni:

• Anemia - chu chu thisen tlakchham tihna a ni.
• Thrombocytopenia - Hei hian platelet a tlakchham tihna a ni.
• Pancytopenia - Hei hian thisen cell leh platelet chi hrang hrang a tlahniam tihna a ni.

Engtin nge AML hi hmuhchhuah a nih? (Diagnosis) tih a ni.

Doctor-te chuan AML hriat theihna atan test eng emaw zat an hmang a, AML chi dik tak hriat nan genetic test an hmang bawk. A hmasa ber chu taksa enfiahna a ni tlangpui. Hei hian hliam, thisen chhuah leh natna hrik awm leh awm loh enfiah a huam a ni. Tin, taksa peng hrang hrang, liver, spleen, leh lymph node-ah te pawh a hring em tih an enfiah bawk.

AML hriat theihna atan eng test nge hman thin?

Heng test zinga pakhat emaw a aia tam emaw i neih a ngai mai thei:

• Thisen chhiar kim (CBC) 1.1.
• Peripheral blood smear - Hei hi thisen sample lak a, microscope hmanga en a ni.
• Bone marrow biopsy - Hemiah hian ruhro sample te tak te lak a ni a, enfiah a ni.
• Spinal tap - Hei hi a chang chuan spinal cord chhehvela tui chhunga cancer cell awm leh awm loh enfiah nan an ti thin.

AML hriat theihna atana hman thin genetic test te chu engte nge ni?

Medical pathologist te chuan AML chi dik tak hriat nan genetic test an nei thin. Chromosome emaw gene thenkhata inthlak danglamna (mutations) an zawng thin. AML chi hi hriat a nih veleh doctor-te tan chuan eng enkawlna nge AML tidam thei ber tih chu a awlsam zawk. Hemi atana test bik tih thin thenkhat chu:

• Immunohistochemistry: Hetah hian cell te chu stain an ni a, microscope hmangin an enfiah thin. Staining method hi cell chhunga chemical awm dan azirin a danglam thin.
• Flow cytometry hmanga tih a ni.
• Karyotype test a ni.
• Fluorescence-in-situ-hybridization (FISH): Hei hian chromosome inthlak danglamna a hriat theih.

AML enkawlna tur engte nge ni?

Enkawlna kawng hrang hrang chu chemotherapy, targeted therapy (monoclonal antibody therapy te pawh tel), allogeneic stem cell transplantation te a ni. Puitling leh naupang tan pawh enkawl dan inang chiah chiah a awm. Enkawlna tum ber chu AML remission kimchang tak neih hi a ni.AML-ah chuan ‘complete cure’ tih awmzia chu test-naah i thisen zat a normal tihna a ni. Tin, doctor-te chuan i ruhro sample chu microscope hmanga an en chuan cancer cell engmah an hmu thei lo tihna a ni bawk.

AML enkawlna atana chemotherapy hman a ni

AML tan hian chemotherapy hi phase pathum a awm a - induction, consolidation, leh maintenance.

Remission induction hmanga enkawl a ni

Hei hi AML tihbo vek theihna tura hmalakna hmasa ber a ni. Enkawlna hi ni engemaw zat a awh tlangpui. Mi thenkhat chuan AML tihbo vek nan hian he enkawlna hmasa ber hi round hnih emaw a aia tam emaw an mamawh mai thei. Doctor-te chuan he enkawlna hmasa ber atan hian a hnuaia chemotherapy damdawi te hi an hmang thei ang:

• Cytarabine (Cytosar-U®) hmanga siam a ni.
• Daunorubicin (Cerubidine®) hmanga siam a ni.
• Idarubicin (Idamycin®) hmanga siam a ni.
• Azacitidine (Vidaza®) hmanga tihdam theih a ni.
• Decitabine (Dacogen®) hmanga siam a ni.
• Glasdegib (Daurismo®) chuan a rawn ti a.
• A rilru a buai em em a, a rilru a hah em em bawk a.

Mithiamte sawi dan chuan heng enkawlna hmasa berte hi:

• Naupang leh tleirawl 60% aia tam an dam chhuak.
• Kum 60 hnuai lam puitling zinga 75% vel chu an dam leh thin.
• Kum 60 chunglam zinga 50% vel chu an dam leh thin.

Consolidation therapy hmanga enkawl a ni

Consolidation therapy hi cancer cell la awm zawng zawng tihhlum nan hman a ni. Hei hian cancer lo kir leh (recurrence) theihna a ti tlem a ni. Mi tam zawk chu cytarabine (Ara-C) emaw HiDAC emaw dose sang tak thla tin ni nga chhung thla thum atanga thla li chhung pek an ni.

Maintenance therapy hmanga enkawl a ni

A tam zawkah chuan AML hi consolidation therapy hmanga tihdam a ni. Mahse, ṭhenkhatah chuan doctor-te chuan chemotherapy dose tlem zawka chhunzawm zel turin an rawt mai thei. Maintenance therapy hi thla tam tak emaw kum tam tak emaw chhung chu a chhunzawm thei a ni. Maintenance therapy atana hman tur chemotherapy damdawi te chu:

• Azacitidine (Vidaza®) hmanga tihdam theih a ni.
• Decitabine (Dacogen®) hmanga siam a ni.
• Midostaurin (Rydapt®) a ni a, a man pawh a tlawm hle.

Targeted therapy hmanga enkawlna

A hming ang bawkin he enkawlna hian cancer cell-a genetic mutations bikte a target a ni. Heng mutations te hi target a nih chuan cancer cell te chu an lo thang lian tawh lo. Monoclonal antibody therapy hi targeted therapy chi khat a ni bawk. Doctor-te chuan AML chemotherapy dawng lo emaw, lo kir leh tawh emaw enkawlna atan targeted therapies an hmang thei a:

• Doctor-te chuan FTL3 gene mutation nei AML vei enkawlna atan chemotherapy damdawi Midostaurin (Rydapt®) emaw Gilteritinib (Xospata®) emaw an hmang thei a ni. He mutation hi AML vei zinga 25% atanga 30% ah hmuh a ni.
• Enasidenib (IDHIFA®) emaw Ivosidenib (Tibsovo®) emaw hmang hian AML vei, an X gene mutation avanga enkawl theih a ni.

Allogeneic stem cell hmanga enkawl a ni

Allogeneic stem cell transplant hian a kaihhnawih emaw, a inzawm lo emaw donor atanga stem cells a hmang thin. Doctor-te chuan heng stem cells te hi bone marrow, peripheral blood, cord blood (nau pian hnua umbilical cord atanga thisen lakkhawm) atang te hian an la thei a ni.

Enkawlna lama harsatna emaw, side effect emaw a awm thei

Cancer enkawlna zawng zawng deuhthaw hian side effect a nei vek. AML-ah chuan stem cell transplantation hian side effect na ber a nei a ni. Chemotherapy hian myelosuppression tih natna a thlen thei a, chu chu i taksaah thisen cell leh platelet awm zat pangngai a hloh tihna a ni. Target therapies-a side effects hi damdawi hman dan azirin a inang lo.

Cancer enkawlna hian nitin nun a nghawng dan tur hriat nan side effects hriatthiam a pawimawh hle. I doctor hi i enkawlna avanga side effects bik hriat tur tha ber a ni. Mi thenkhat chuan palliative care hi an hlawkpui thei a, hei hian side effects te enkawlna kawngah a pui thei a ni.

AML hi a dam kim thei ang em?

Tunah hian allogeneic stem cell transplantation hi acute myeloid leukemia tihdam vek theihna awmchhun a ni. I dinhmun azirin i doctor chuan AML enkawlna hmasa ber atan stem cell transplant a rawt thei ang. A nih loh leh, thla 12 chhunga i AML a lo let leh chuan he enkawlna hi rawt theih a ni. Vanduaithlak takin mi zawng zawng hi stem cell transplant hi an tling vek lo.

AML hi eng prognosis nge ni?

Acute myeloid leukemia prognosis chungchang sawi dawn chuan kawng hnih a awm a. Pakhat chu remission famkim a ni. A dang chu recurrence a ni a, chu chu AML a lo awm leh hunah a ni.

• A pum puiin acute myeloid leukemia vei zinga 50% leh 80% inkar chuan enkawl hnuah an dam kim vek dawn niin an chhut. Naupang leh kum 60 hnuai lam te hi an dam kim theihna a sang zawk. He damna hi thla tam tak emaw, kum tam tak emaw chhung a daih thei a ni.
• Dam chhuak vek zinga 50% vel chuan AML an nei leh ang. Chutiang a nih chuan doctor-te chuan chemotherapy dang emaw, stem cell transplant emaw an rawt thei a ni. Clinical trial-a tel ve turin an rawt thei bawk.

Nang emaw i fa emaw hian AML i vei a nih chuan i beisei theih tur doctor zawt la.

AML vei damchhuah zat hi engzat nge ni?

Acute myeloid leukemia hi natna khirh tak a ni. AML hi subtype engemaw zat a awm avangin prognosis dik tak pek a harsa hle.

Entirnan, naupang kum 15 hnuai lam kum nga chhunga dam rei zat chu 67% a ni. Mahse zirchianna thenkhatah chuan subtype APL nei naupangte kum nga chhunga dam rei zat chu 80% aia tam a ni tih an sawi. Kum hian hmun a chang bawk. A vaiin AML vei puitling 30% chu an hmuhchhuah atanga kum nga hnuah an dam chhuak a ni. AML hi kum 60 leh a chunglam, hriselna lama harsatna dang nei thei te zingah a lo awm tlangpui tih hre reng ang che.

Heng damchhuahna rate hian AML vei pawl lian tak takte thil tawn a tarlang tih hriat reng a pawimawh. He data hian kum 2012 atanga 2018 thlenga damchhuah zat a huam a, tunah chuan AML enkawlna thar zawk, hlawk zawk a awm tawh bawk.

Thil tam tak hian acute myeloid leukemia vei i dam rei tur chu a nghawng a ni. Chumi awmzia chu i damdawi lam chanchin leh hriselna zawng zawng hre chiangtu i doctor-te hi he thil chungchanga hriat tur tha ber an ni tihna a ni.

AML hi ven theih a ni em?

Ni lo, acute myeloid leukemia hi a veng thei lo. Mithiamte chuan AML hi genetic mutations avanga lo awm a ni tih hre mah se, eng thil nge a thlen tih erawh an hre lo. Mahse AML thlen thei risk factors te chu an hre chiang hle. Risk factor i thlak danglam theih thenkhat chu hetiang hi a ni:

• Meizial zuk: Hei hian second-hand smoke a huam tel bawk. Meizial i zuk chuan bansan tum ang che. Meizial zu mi i awmpui emaw, i thawhpui emaw a nih chuan, an zuk laiin an bula hun i hman chu tihtlem tum ang che.
• Hun rei tak chhung cancer thlen thei chemical thenkhat: a bik takin benzene leh formaldehyde te nena inzawmna . Heng carcinogens te hi i thawhpui chuan himna zawng zawng, invenna thawmhnaw hak ang chi te hi la rawh.

Engtin nge ka in enkawl ang? (Mahni inenkawlna) .

Cancer lo kir leh thei nen nun chu thil awlsam a ni lo. Cancer damchhuahna programme-a tel hi i in enkawl theihna kawng khat a ni. Acute myeloid leukemia lo kir leh tur chu i titawp thei lo mai thei. Mahse, eng pawh ni se, a hrisel thei ang bera awm turin hma i la thei a ni. Rawtna thenkhat chu hetiang hi a ni:

• Acute myeloid leukemia enkawlna hian i ei leh in a nghawng thei a ni.Chak taka awm tur chuan ei that a ngai a ni. Chaw ei harsatna i neih chuan nutritionist nen inbia ang che.
• AML enkawlna avanga side effects awm thei hi enkawl a harsa thei hle. A tul chuan i doctor nen palliative care chungchang sawipui rawh.
• Cancer hi a stressful em em a ni. Exercise hian stress i thunun thei a ni. Mahse, exercise program thar, hahthlak tak i tan hmain i doctor nen inbia ang che.
• Cancer hian mahni chauha inhriatna a siam thei che a ni. AML hi natna hmuh tur awm lo tak a ni. I dinhmun chungchang sawi chu i hlauthawng mai thei. Chutiang a nih chuan, support group-a tel chu ngaihtuah rawh.
• Acute myeloid leukemia hian i chau hle thei. Treatment te hian i chakna a tichhe thei a ni. I mamawh ang zat mut hi hre reng ang che.

Engtikah nge Doctor ka hmuh ang?

I dam chhung zawngin i doctor i hmu fo ang a, a bik takin maintenance therapy i dawng a nih chuan. I doctor chuan eng symptom nge i AML lo kir lehna chhinchhiahna ni thei tih a hrilh ang che. Hei hian enkawlna thar emaw, enkawlna dang emaw dawng tura biak hun tur i hriat theih nan a pui ang che.

Doctor hnenah eng zawhna nge ka zawh ang?

AML i neih chuan heng zawhnate hi i inzawt duh mai thei:

• Eng ang AML nge ka neih?
• Ka enkawl dan tur chu engte nge ni?
• Enkawlna hian eng hlauhawmna leh nghawng tha lo nge a neih?
• Engtin nge enkawlna avanga side effects te hi ka enkawl ang?
• Enkawlna hnuah eng follow-up care nge ka mamawh?
• Complication chhinchhiahna awmte chu ka fimkhur tur em ni?
• Clinical trial ka ngaihtuah tur a awm em?

A tawp berah chuan thil hriat reng tur

Acute Myeloid Leukemia (AML) hi cancer hmuh tur awm lo tak a ni a, i ruhro leh thisen a nghawng a ni. AML hian kum 65 chunglam a vei tlangpui a, mahse naupang leh puitling tleirawl te pawh a nghawng thei a ni. Enkawlna thar avang hian tunah chuan enkawl hnua remission-a AML vei tam zawk an awm ta a ni. Cancer hi lo kir leh thei mahse, damdawi lam zirchiangtute chuan AML lo awm leh chu enkawl dan tur an zirchiang chhunzawm zel a ni.

Nang emaw i fa emaw hian acute myeloid leukemia i vei a nih chuan lei nghet tak atanga tuifinriat chiang lo takah paih thla ang maiin i inhria thei. Enkawlna hian hahdamna a thlen ang em tih i ngaihtuah mai thei. Chutiang a nih chuan, chu chhawmdawlna chu eng chen nge a awm ang tih i ngaihtuah mai thei. I doctor-te chuan i rilru put hmang chu an hrethiam a ni. AML harsatna i hmachhawn hunah an awmpui ang che. Chuvangin chak takin awm la, i mamawh tanpuina dawng hreh suh.

` Acute myeloid leukemia, AML, thisen cancer, ruhro, symptoms, chemotherapy, stem cell transplant