He thisen cancer na tak hi i hre tawh em? (Acute Promyelocytic Leukemia - APL) Chipchiar takin i sawi dawn nia!

I chau hle tawh em, i hliam tlemte i nei tawh em, a nih loh leh i hmui thisen chhuak fo tawh ngai em? Heng thilte hi kan ngaihven vak lo nain, a tlem berah chuan natna khirh zawk, Acute Promyelocytic Leukemia (APL) ang chi chhinchhiahna a ni thei. Chuvangin, lungngai suh, vawiinah hian he thisen cancer APL an tih hi chiang tak leh awlsam takin kan sawi dawn a ni.

Acute promyelocytic leukemia (APL) tih hi eng nge ni?

A awlsam zawngin sawi ila, APL hi thisen cancer chi khat, a awm lo hle a ni . A nihna takah chuan leukemia pawl lian tak Acute Myeloid Leukemia an tih zingah a tel a ni. Kan taksaa thisen siamna hmun ber chu ruhro hi a ni . Hetah hian he ruhroah hian, genetic change, chu chu genetic mutation vangin, thisen var pangngai lo tak tak a lo piang tan thin. Heng cell pangngai lote hi thunun theih lohvin an inthen darh a, an pung a, ruhro (bone marrow) zawng zawngah an darh vek a ni. A châng chuan doctor-te chuan hei hi APL leukemia, a nih loh leh M3-leukemia .

APL hi natna khirh tak a ni. A natna lan chhuah dan chu a lo lang nghal thei a, a zual nghal vat thei bawk. Thisen chhuah tam lutuk hi risk factor lian tak a ni. Mahse, chanchin lawmawm a awm! Enkawlna thar, chemotherapy leh non-chemotherapy damdawi thar te nen chuan doctor-te chuan APL hi an control thei a, a tam zawkah chuan an tidam vek a ni.

He natna hi engtiang chiahin nge a hluar?

APL hi a takah chuan natna hmuh tur awm lo tak a ni . Entirnan, United States ang ramah chuan kum tin mi 30,000 vel chauh he natna hi an vei tih hmuhchhuah a ni. A tam zawkah chuan APL hi kum 30 hnuai lam atanga hmuhchhuah a ni .

APL natna lan chhuah dan chu engte nge ni?

APL symptoms hi i ruhro hian red blood cells , white blood cells, leh platelets te chu a pangngai angin a siam thei lo a nih chuan a lo lang thin. Hetiang thisen cell chi hrang hrang tihtlem hi pancytopenia an ti a . Chutiang a nih chuan, thisen zam vanga thisen chhuah harsatna , leh natna tam tak te ang chi natna khirh tak tak i nei thei a ni.

APL symptoms langsar dangte chu:

• Thisen sen (i.e. anemia) tlahniam avanga chau lutuk leh chau lutuk anga inhriatna.
• Natna dotu thisen var (white blood cells) tlem avanga natna kai fo thin. Khawsik leh khawsik ang chi thil hi a thleng fo thei.
• I taksa metabolism a chak a, ei tur atanga chakna lo chhuak chu a kang chak em em a, .Tum loh vanga taksa rihna tihtlem.

Thisen chhuahna symptoms a awm

APL vei chuan thisen zam tura puitu platelet leh thisen zam (blood clotting factors) a nei tlem hle. I hria em, platelet hi thisen chhuah tihtawp emaw tihtlem emaw puitu a ni. Chuvangin, hengte hi a hniam chuan buaina a intan thin.

APL vanga thisen chhuak chhinchhiahna thenkhat chu hetiang hi a ni:

• Taksa khawi hmunah pawh thisen a chhuak thei. Entirnan, hmui thisen chhuak , hnar thisen chhuak fo , leh, hmeichhiaah chuan, thlasik laiin thisen chhuak nasa tak .
• Thisen hi vun hnuaiah a awm khawm a , taksa hmun hrang hrangah hliam a siam thin . Cut tlemte pawh hian hliam lian tak a thlen thei.
• A châng chuan thluak chhungah thisen a chhuak thei (intracranial hemorrhage) . Chutiang a nih chuan i ke ruhte chet harsa i ti thei a, lu na nasa tak i nei thei a, i mit hmuh danah pawh danglamna i nei thei bawk. Hei hi emergency a ni!
• I bawlhhlawh a dum emaw, thisen chhuak a awm emaw a nih chuan digestive system-a thisen chhuak (gastrointestinal bleeding) vang pawh a ni thei .

Eng thilin nge APL hi a thlen?

He natna hi kan thisen cell siamna control tu gene pahnih inzawmkhawma gene danglam tak PML-RARa tih atanga lo awm a ni. Pawimawh tak chu, he genetic mutation hi i nu leh pate hnen atanga i rochun thil a ni lo . Random takin a thleng a, chhan awm lovin, i dam chhungin a thleng thin. Mithiamte chuan he genetic change hi eng thil nge a thlen tih chiang takin an la hre lo.

He mutation hian thisen varte chu thunun theih lohvin a tipung a, a lo thanglian tha lo va, chu ai chuan thisen var puitling lo (promyelocytes) a siam ta zawk a ni. Heng cell puitling lote hian ruhro chu an luah khat a, thisen cell hrisel leh platelet awmna hmun chu an tikhawtlai a ni.

APL hian eng harsatna nge a thlen?

APL hi nunna atana hlauhawm tak a ni. Hei hi a chhan chu thisen chhuah tam lutuk hi a hlauhawm thuai theih vang a ni. I hliam tenau tak atanga thisen chhuak i tihtawp theih loh chuan, toilet i kal laiin i bawlhhlawh emaw, i zun emaw-ah thisen tam tak i awm a nih chuan, emaw, i hmui atanga thisen chhuak i tihtawp theih loh chuan doctor pan nghal tur a ni emaw, damdawi in emergency room-ah emaw kal nghal tur a ni

Hriat reng tur: Thunun theih loh thisen chhuak i neih chuan ngaihthah ngai suh. Enkawlna rang tak neih hi a pawimawh hle.

Engtin nge APL hi hmuhchhuah a nih?

Doctor ten he natna hi hriat chian nan test eng emaw zat an nei tlangpui.

• Complete Blood Count (CBC): APL hian thisen var pangngai lo tak tak a siam a. CBC test hian thisen cell chi hrang hrang leh i thisen sample pakhata platelet awm zat a en thei a.
• Peripheral Blood Smear hmanga tihfai: 1.1.Hetah hian thisen sample lak a ni a, microscope hmangin enfiah a ni. Tichuan, chu thisen var puitling lo (promyelocytes) chhungah chuan granule te tak te tam tak a awm em tih an en a, a nih loh leh Auer rods tia koh thil bik a awm em tih an en bawk. Hengte hi APL ziarang a ni.
• Bone Marrow Biopsy: He test-ah hian i ruhro sample tlemte lak a ni a, a cell te chu enfiah a ni.
• Flow Cytometry: He test-ah hian pathologist-te chuan cell pangngai lo chunglama protein bikte pattern an zawng thin. Heng pattern te hian APL hi a nemnghet thei a ni.
• Polymerase Chain Reaction (PCR) test: He test hian APL thlentu gene pangngai (PML-RARa) awm leh awm loh dik takin a hmu thei a ni.
• Cytogenetics: Hei hian cell pangngai lo chromosome- a inthlak danglamna chiang tak a test thin. Heng inthlak danglamna te hi hmuh chhuah hi APL hmuhchhuah dan finfiahna ber a ni.

Doctor-te chuan APL hi i thisen var cell count a zirin low-risk emaw high-risk emaw tiin an classified a. High-risk APL vei te hi cancer lo lang leh emaw, a lo lang leh emaw an tam zawk .

APL hi engtin nge enkawl a nih?

APL hi differentiation agents , chemotherapy, leh targeted therapy hmanga enkawl a ni. Dik tak chuan kum 1980 chho vela heng damdawi chi hrang hrang hmuhchhuah a nih atang khan he natna, a hmaa thihna thlen thei tura ngaih thin kha tunah chuan dam theih natna a lo ni ta a ni. Hei hi hlawhtlinna ropui tak a ni!

Cell differentiation drugs hi chemotherapy ni lo damdawi a ni a, thisen var pangngai lo, puitling lote chu thisen var pangngai, puitling takah an inthlak danglam thei a ni. Heng non-chemotherapy damdawi, a hnuaia tarlan te hian 95% aia tam remission leh cure rates an nei tawh a ni.

• All-trans-retinoic acid (ATRA) , emaw tretinoin (Vesanoid ®) – Hei hi vitamin A chi khat a ni.
• Arsenic trioxide (ATO) – Hei hi arsenic chi khat a ni.

I doctor chuan APL i vei nia a rinhlelh chuan test dangin natna a finfiah hma pawhin ATRA hmangin an tan tir thei che a ni. Hei hi a chhan chu enkawlna hmasa ber tan chuan nunna atana hlauhawm thisen chhuah theihna a tihziaawm theih vang a ni.

APL enkawlna stage hrang hrang

Enkawlna hi a tlangpuiin phase thum-ah tih a ni a, chungte chu Induction, Consolidation, leh Maintenance te an ni. Risk level a zirin enkawl dan pawh a inang lo thei.

• A bul tanna (Induction): 1.1.He phase tum ber chu i APL remission-a dah theihna tur leukemia cells tling tawk tihhlum hi a ni . Remission tih awmzia chu symptom i nei lo tihna a ni a, test-ah pawh leukemia chhinchhiahna hmuh tur a awm lo. Hei hi chemotherapy ni lo damdawi, chemotherapy, leh targeted therapies hmanga tih a ni. Hemi chhung hian damdawi inah i awm a ngai dawn a, a tlangpuiin kar li atanga kar ruk chhung i awm a ngai dawn a ni.
• Consolidation phase: I oncologist pawhin hei hi ‘post-remission therapy’ a ti thei bawk. He enkawlna hian APL chu remission-ah a dah a, leukemia cell la awm zawng zawng chu a that chhunzawm zel bawk. Hei hi a tir lama hman thin damdawi tho kha a ni. He enkawlna hi thla riat vel a daih thei a, thla hnih danah enkawl a ni. Kar li chhung enkawlna i nei thei a, chumi hnuah kar li chawlh i nei thei bawk. He damdawi hi pill angin emaw, intravenous (IV) treatment angin emaw pek theih a ni .
• Maintenance phase: Hei hi enkawlna kalpui mek a ni a, mahse damdawi hi initial leh stabilization phase aiin a dose hniam zawkin pek a ni. He maintenance treatment hi kum khat vel pek thin a ni tlangpui.

I oncologist chuan he enkawlna rual hian thisen pek ang chi supportive therapy , a pe thei bawk.

Enkawlna avanga harsatna awm thei

Harsatna awm tam ber, leh a nasat deuh deuh chu differentiation syndrome an ti a. Hei hi APL damdawi ei avanga natna khirh tak tak nei pawl a ni. Heng reaction te hi enkawl tan tirh atanga kar thum chhungin a thleng tlangpui. Symptoms hi a na lo emaw, na tak emaw pawh a ni thei. Chung zinga ṭhenkhat chu:

• Khuh.
• I thinlung leh i lung chhehvela tui tam zawk (pleural effusion) .
• Renal failure a awm thin .
• Thisen sang hniam (hypotension) .
• Thisenah oxygen level tlahniam (hypoxemia) .
• Thâwk harsa (dyspnea) .
• I kut, ke, leh kawr a hring/ inflammation .
• Chhan awm lova lo thleng thin khawsik.
• Chhan awm lovin taksa rihna a pung.

He differentiation syndrome hi i neih chuan i doctor chuan i enkawlna chu hun engemaw chen a titawp thei a ni. I thisen var zat tihhniam nan damdawi dang, hydroxyurea ang chi te pawh an hmang thei bawk.

APL vei hian eng nge a beisei theih ang?

A tlangpuiin natna hi a hmalam hun tur (prognosis) a tha hle.. Mi zawng zawng dinhmun hi inang lo mah se, zirchianna atanga a lan dan chuan APL vei zinga 90% leh 95% inkar chu remission-ah an kal thin. Amaherawhchu, APL hi enkawl hnuah a rawn let leh thei a ni. Mi 5% leh 10% inkar chuan natna hi a lo lang leh ang a, a tlangpuiin enkawl hnu kum thum chhungin a lo lang leh ang. Chumi hnuah chuan enkawlna dang emaw, a danglam emaw an mamawh dawn a ni.

Damchhuak zat

APL hi natna hlauhawm tak a nih avangin damchhuahna rate chungchanga kan hriat hi APL risk hniam leh risk sang tak nei te clinical trial atanga lo chhuak a ni.

Analysis pakhatah chuan low-risk APL vei zinga 99% chu enkawl an nih hnu kum li hnuah an la dam tih a tarlang. High-risk APL vei te zirchianna dang pakhatah chuan 86% chu enkawl an nih hnu kum nga chhungin an la dam tih hmuhchhuah a ni. Hengte hi result tha tak a ni tak zet!

Engtin nge ka in enkawl ang?

APL hi a lo lang leh thei a, chuvangin a hun taka doctor i hmuh a pawimawh hle (follow-up appointment) .

Enkawl zawh kum khatna atan thla hnih emaw thla hnih emaw danah medical check-up i nei ang. Kum khatna hnuah chuan kum hnih chhung chu thla thum atanga thla li danah vel doctor i pan a ngai dawn a ni. Heng tlawhnaah hian CBC, PCR, leh bone marrow biopsy ang chi test te pawh tih theih a ni.

Engtikah nge emergency room-ah ka kal ang?

APL hi enkawl hnuah a lo lang leh thei a, a natna lan chhuah dan pawh a zual thuai thei bawk. APL atanga remission i neih chuan a hnuaia mi hi i tawn chuan emergency room-ah kal nghal rawh :

• Thunun theih loh khawpa thisen chhuak i nih chuan .
• I ke emaw i pum hnuai lam emaw natna nen a hring chhuak nghal a nih chuan .

A tawp berah chuan thuchah pawimawh tak

Acute promyelocytic leukemia (APL) hi thisen cancer hmuh tur awm lo tak a ni a, hmân laiin natna hlauhawm tak anga ngaih a ni a, mahse tunah chuan enkawlna hmasawn tak tak avangin tihdam theih a ni ta a ni.

Mahse, hei hi natna khirh tak a la ni reng a ni. Hriatchhuah leh enkawl vat a nih loh chuan nunna atana hlauhawm tak a ni thei . Chuvangin, thunun theih loh thisen chhuak ang chi symptom i neih chuan ngaihthah ngai suh. A pawimawh ber chu doctor thurawn la a, a rang thei ang bera diagnosis neih hi a ni. Hlau suh, huai takin awm rawh, a chhan chu tunah chuan hei hi enkawl dan tha tak tak a awm tawh!

` Leukemia, APL, Thisen Cancer, Thisen Cancer, Bone Marrow, Anemia, ATRA, Chemotherapy, Acute Promyelocytic Leukemia, M3-Leukemia, PML-RARa, Thisen chhuak