Chronic Lymphocytic Leukemia (CLL) tih hi i hre tawh em? Chipchiar takin sawi ila!

A châng chuan i chau hle mai em? A nih loh leh khawsik i nei fo em? I kawr, i kawrfual, i kawrfual-ah emaw, i kawrfual emaw-a awm ang maia hriat theih, lump te te i nei em? Hengte hi Chronic Lymphocytic Leukemia, a tawi zawngin CLL chhinchhiahna a ni thei. Mahse lungngai suh, a chhan chu heng symptoms zawng zawng neih hian he natna hi i nei tihna a ni lo. Mahse hetiang thil hi fimkhur a pawimawh hle. Chuvangin vawiin hian CLL chungchang hi awlsam takin han sawi ila, okay?

Chronic lymphocytic leukemia (CLL) tih hi eng nge ni? A awlsam zawngin...

Chronic lymphocytic leukemia (CLL) hi thisen cancer chi khat a ni a . Puitling zingah chuan leukemia chi khat a ni ber. Thisen cell te hi ruhro (bone marrow) ah a lo piang chhuak thin a. Hetiang dinhmun hi ruhroa thisen var hrisel chi khat lymphocytes te chu a danglam a, chu chu an inthlak a, cancer an nih tihna a ni. Heng cancer cell te hi thunun theih lohvin an pung a, thisen cell hrisel leh platelet te chu an tikhawlo a, chu chuan thisen a tikhawlo thei a ni.

CLL hi kum 65 chunglam ah a thleng tam ber a, mahse, a chang chuan kum 30 hnuai lam ah a thleng thei a, chubakah, mi thenkhat chuan CLL hi symptoms nei lovin an nei thei bawk Mi tam tak chuan he natna hi natna dang an neih leh neih loh thisen test an neih hian emaw, kum tin damdawi lam enfiahna pangngai an neih laiin emaw an hre chhuak thin.

Tunah hian CLL hi damdawi a la awm lo. Mahse chu chu ngaihtuahawm a ni lo. Kum sawm kalta chhung khan doctor-te chuan CLL control thei leh remission-a dah thei damdawi thar an siam chhuak a ni . Heng enkawlnate hian CLL vei te chu an dam rei thei hle.

CLL chi hrang hrangte chu engte nge ni?

Kan taksaah hian thisen var chi hnih a awm a, chungte chu lymphocyte an ti a. CLL hi heng chi hnih zinga pakhat chauh hian a lo piang thei a ni.

• B-lymphocytes (B-cells): Hengte hi antibodies siamtu cell an ni a, chu chu protein chi khat, natna hrik, bacteria, virus, cancer cell thlengin a hrechhuak a, a do thei a ni.
• T-lymphocytes (T-cells): Hengte hian kan taksaa immune system-in a chhân lêtna chu a thunun a ni. Tin, cell pangngai lo, cancer cell ang chi te pawh an hmuchhuak a, an tichhia bawk.

CLL chi khat hman tlanglawn ber chu B-cell CLL a ni . T-cells tichhe thei natna nena inzawm a awm a, chu chu T-cell prolymphocytic leukemia (PLL) an ti a ni. Mahse, PLL vei te hian B- cell CLL vei te aiin symptoms an nei rang zawk .

He natna hi engtiang chiahin nge CLL tia koh a nih?

Dik tak chuan chronic lymphocytic leukemia (CLL) hi puitling zingah chuan leukemia chi khat a ni. United States-ah chuan he natna hian mi 100,000 zinga 5 vel a vei a ni. American Cancer Society chuan kum 2023 chhung ringawt pawh hian CLL vei thar 18,700 vel an awm dawn niin an chhut. Hei hi a dik zawnga thlir chuan kum 2023 chhung hian lung cancer (cancer awm tam ber zinga mi) vei thar 238,000 chuang an awm beisei a ni a, chuvangin, CLL hi chutiang chuan a awm lo niin a lang mai thei a, mahse leukemia chi khat a ni.

CLL natna lan chhuah dan chu engte nge ni?

Kan sawi tawh ang khan mi thenkhat chuan CLL hi symptoms nei lovin an nei thei . Thla tam tak emaw, kum tam tak emaw pawh a ngai thei a, symptoms a lan theih nan. A lan chhuah dan tlangpui chu:

• Chauhna: CLL hian i thisen sen (red blood cells) a nghawng thei a, thisen tlakchhamna (anemia) a thlen thei. Chauhna hi thisen tlakchhamna (anemia) chhinchhiahna tlanglawn tak a ni.
• Fever: Khawsik hi natna hrik kai tihna a ni. CLL hian thisen var hrisel tak takte a nghawng avangin natna hrik i kai tam zawk.
• Kawng, kawr, kawr, emaw, pum chhunga lymph node hring (swollen) a awm.
• Zan a thawk hah.
• Sawifiah loha taksa rihna tlahniam.
• I ruh hnuaia natna emaw, i taksa pum a khat tih hriatna: CLL hian i liver emaw i spleen emaw a nghawng thei. Heng taksa peng hrang hrangah hian cancer cells an awm khawm chuan an lo hring chhuak thei a ni.

Engvangin nge CLL hi a lo awm? Risk factors te chu engte nge ni?

Chronic lymphocytic leukemia (CLL) hi kan dam chhunga kan chromosome leh gene-a mutations, a nih loh leh inthlak danglamna thenkhat a awm hian a lo awm thin. Mahse, damdawi lam zirchiangtute chuan heng inthlak danglamna thlentu hi eng nge ni tih an la hre chiang lo. Mahse, a nghawng thei tur risk factor engemaw zat an hmuchhuak a:

• Chhungkaw chanchin: Zirchianna atanga a lan dan chuan i chhungte hnai tak pakhat, chu chu i nu, i pa, i unau emaw, i fate emaw chuan CLL a neih chuan CLL vei theihna i neih theihna chu a let hnih atanga a let liin a pung thei a ni.
• Kum: A vaiin damlote hi CLL vei an nih chuan kum 71 vel an ni.
• Sex: Mipa hian CLL an nei tam zawk.
• Agent Orange nena inzawmna: Research atanga a lan dan chuan Vietnam War laia chemical hman thin Agent Orange leh CLL te hi inzawmna a awm tih hmuhchhuah a ni.
• Monoclonal B-cell lymphocytosis atanga lo chhuak a ni.Hetiang dinhmunah hian i thisenah hian a tlangpui aia tam B-cell chi khat i nei tam zawk a ni. Hetiang dinhmun hi i neih chuan CLL vei theihna chance tlem i nei a ni.

CLL avanga harsatna awm thei te chu engte nge ni?

CLL hian i thisen sen, thisen var leh platelet te a nghawng a ni. Ngaihtuah teh, thisen sen (red blood cells) hian taksa pum puiah oxygen a phur a. Thisen var (white blood cell) hian natna lakah min venghim a. Platelets hian thisen zam a pui thin. Chuvangin, heng thisen cell hrisel leh platelet te hi i hloh chuan harsatna i nei thei a, chungte chu:

• Lymphoma: CLL vei zinga 2% leh 10% inkar chuan cancer chi khat lymphoma an tih chu an nei thei a.
• Skin cancer, lung cancer, emaw colon cancer: CLL hian i immune system a tichak lo va, cancer cells te pawh tiamin invaders lakah a veng thei lo. Hei hian cancer chi dang i vei theihna a tipung thei a ni.
• Anemia: Taksa pum puia oxygen phur thei tur thisen sen (red blood cells) a awm loh chuan thisen tlakchhamna (anemia) a lo awm thei.
• Thrombocytopenia: CLL hian i platelet supply a nghawng thei a ni. Hei hian thisen a chhuah tir thei a ni.
• Infection tam: Thisen var hrisel tha tawk lo chuan bacteria, fungal, viral infection i nei tam zawk.
• Autoimmune natna: CLL vei thenkhat chuan autoimmune hemolytic anemia ang chi natna an nei thei.

Engtin nge CLL hi hmuhchhuah a nih?

Doctor i pan hunah i symptoms te a zawt ang che. Tichuan, taksa enfiahna an nei ang a, test thenkhat an order thei a, chungte chu:

• Complete blood count (CBC) leh differential: He test hian i thisena thisen sen, thisen var leh platelet awm zat a teh a ni. Tin, i thisen sen (red blood cells)-a hemoglobin (oxygen kengtu protein) awm zat a enfiah bawk.
• Peripheral blood smear: Medical laboratory technician chuan i thisen cell te chu microscope hmangin a enfiah a, cancer cell a awm leh awm loh a enfiah thin.
• Flow cytometry: He lab test hian i thisen cell chungchang a hriat belh theih a ni. CLL ah chuan i thisen var ah CLL cell a awm em tih chiang taka hriat nan hman a ni.
• Genetic test hrang hrang: 1.1.Doctor-te chuan i chromosome leh genes te enfiah nan fluorescent in situ hybridization (FISH) leh immunoglobulin heavy chain (IGHV) ang chi test an hmang thin. Heng chromosome leh gene-a inthlak danglamna awmte hriatthiamna hian doctor-te chu CLL enkawl dan tur ngaihtuah turin a pui a ni.

CLL stage hrang hrang

Doctor-te chuan cancer stage chu enkawl dan tur ruahmanna siamin, a hmalam hun tur an sawi lawk thin. CLL stage siamna atana hmanraw lian pahnih a awm a, chungte chu Rai staging system leh Binet staging system te an ni.

A châng chuan heng stage-te hi number leh letter-a i chhiar hian tlem chuan i hlauthawng a, i rilru a hah hle thei bawk. "Hetiang hian ka natna hi formula-ah sawi a ni em?" Chu chu Doctor ten an hrethiam. Thu sawi i hriat chian loh chuan, emaw, i tana phurrit a nih chuan, i doctor hnenah he stage system hi i dinhmunah engtin nge a hman tih sawifiah turin hrilh rawh.

Rai staging system a ni

Hetiang method hian CLL hi a na zual theihna tur leh enkawl a ngai dawn leh dawn loh a zirin a thliar hrang a:

• Risk hniam (hmanlai Rai stage 0 tia hriat thin): Lymphocytosis (lymphocyte tamna) i nei a, thisen leh/ emaw ruhroah thisen var pangngai lo tak tak a awm bawk.
• Intermediate risk (hmanlai chuan Rai stage I emaw stage II emaw tia hriat thin): Lymphocytosis i nei a, lymph nodes a hring a, i spleen leh/ emaw liver a lian bawk.
• High risk (hmanlai chuan Rai Stage III tia hriat thin): Anemia emaw thrombocytopenia (platelet count hniam) i nei a.

Binet staging system hmanga siam a ni

Hetiang tih dan hi i thisen cell leh platelet zat a zirin a ni a, chubakah i taksaa lymph node hring awm zat a zirin a ni:

• Stage A: Thisen tlakchhamna (thisen sen zat hniam) emaw, platelet hniam emaw i nei lo. Mahse, i taksa hmun hnih tal chu lymph node a hring chhuak a ni. Entirnan, i kawr leh i kawr chhungah lymph node a hring chhuak thei.
• Stage B: Taksa hmun thum-ah lymph node a hring a, a nih loh leh thin emaw, ril emaw a hring emaw a ni. Mahse, thisen tlakchhamna a awm lo va, platelet level pawh a normal.
• Stage C: I taksa hmun thum emaw a aia tam emaw ah thisen tlakchhamna (anemia) i nei a, lymph node a hring (ssllen lymph nodes) i nei bawk.

CLL hi engtin nge enkawl a nih?

Enkawl dan tur chu i natna lan chhuah dan leh test result a zirin a ni. Entirnan, CLL hmasa ber i neih chuan i doctor chuan "watchful waiting/active surveillance" tih a rawt thei ang."Monitoring" tih method hmangin i kal thei bawk. Hei hian enkawl tan lovin i hriselna tlangpui, natna lan chhuah dan leh test result uluk taka enfiah a huam a ni.

Genetic test result hian enkawlna chungchanga thutlukna siam pawh a nghawng thei bawk. Entîr nân, genetic change ṭhenkhat chuan i dinhmun chu a chhe thuai thei a, a nih loh leh standard CLL treatment-te chuan beisei angin hna a thawk ṭha lo thei bawk.

CLL enkawlna hman tlanglawn ber chu targeted therapy leh chemotherapy te hi a ni . A chang chuan CLL symptoms tihziaawm nan radiation therapy an hmang thin. Heng enkawlna tin hian side effect hrang hrang a thlen thei a ni. I doctor chuan i enkawlna a hlawkna te, a side effect te, leh hun rei tak chhunga harsatna awm thei te chu chiang takin a hrilhfiah ang che.

Targeted therapy hmanga enkawlna

He enkawlna hian cancer cells target-in hna a thawk a ni. Chronic lymphocytic leukemia-ah chuan he enkawlna hian cancer natna vei thisen var (white blood cells) lo thang lian zel chu a titawp a ni. Target therapies thenkhat chuan cancer cell te chu cell hrisel te tichhe lovin an that thin. Chumi atana hman tur damdawi thenkhat chu:

• Bruton’s tyrosine kinase (BTK) inhibitor therapy: He enkawlna hian B-cells te thisen var tam zawk siam tura puitu enzyme pakhat a block a ni. Entirnan: ibrutinib (Imbruvica®) , acalabrutinib (Calquence®) , leh zanubrutinib (Brukinsa ®) te hi a ni.
• BCL2 inhibitor therapy: Damdawi venetoclax (Venclexta®) hian leukemia cell-a awm protein BCL2 an tih chu a block a, chutah chuan CLL cells pawh a tel a ni. He enkawlna hian leukemia cell te a that thei a, cancer dona damdawi dang lakah pawh a sensitive zawk thei bawk.
• Monoclonal antibody therapy: Hei hi immunotherapy chi khat a ni. Monoclonal antibodies hi laboratory-a siam antibody chi khat a ni. Cancer cell thanna an titawp emaw, cancer cell an that emaw a ni. Entirnan: rituximab (Rituxan®) leh obinutuzumab (Gazyva®) .

Chemotherapy hmanga enkawl a ni

I doctor chuan chronic lymphocytic leukemia enkawlna ber atan chemotherapy a hmang thei ang. CLL atana chemotherapy damdawi hman tlanglawn tak tak thenkhat chu:

• A rilru a buai em em a, a rilru a hah em em bawk a.
• Chlorambucil (Chlorambucil - Leukeran®) tih a ni a, a man hi a to hle.
• Cyclophosphamide (Cytoxan®) hmanga siam a ni.
• A rilru a buai em em a, a rilru a hah em em bawk a.

Immunotherapy hmanga enkawl a ni

He enkawlna hian i taksa hriselna a siam that emaw, a tichak emaw a, cancer cell tihchhiat emaw, an than chakna tikhawtlai emaw a pui a ni.

Chemotherapy dawng lo, CLL lo kir leh (recurrent) emaw, a na zual zel emaw tan chuan doctor-te chuan immunotherapy damdawi lenalidomide (Revlimid®) an hmang thei a ni.

Medical researcher-te chuan CLL vei, standard treatment dawng lote tan chimeric antigen receptor (CAR-T) therapy an zirchiang mek bawk.

CLL hmang hian eng chen nge i dam theih ang?

Chronic lymphocytic leukemia (CLL) hi a tlangpuiin zawi zawiin a kal zel a. CLL nen hian kum tam tak chhung chu symptoms i neih hmain i nung thei a ni. Symptoms a lo lan hnu chuan doctor-te chuan CLL chu remission-a dah thei enkawlna \ha tak tak an nei ta a ni . He CLL atanga remission hi kum engemaw zat a awm tlangpui a, chu chu natna a lo let leh hmain a ni. Mahse, i doctor chuan CLL chu remission-a dah leh thei tur enkawlna dang a rawt thei ang. CLL hi tihdam theih a ni lova, mahse he natna vei te hian dam rei tak, puitling an dam thei a ni.

National Cancer Institute chuan CLL vei zinga 87.9% chu an hmuhchhuah atanga kum nga hnuah an dam niin an chhut. Mahse, heng damchhuah zat ngaihtuah hian hengte hi CLL vei pawl lian tak takte thil tawn atanga chhut a ni tih hriat reng a pawimawh. Heng damchhuahna rate hi thil tam takin a nghawng thei a, chung zingah chuan i hriselna tlangpui te, i natna hriat chhuah huna i natna dinhmun te, leh i natnain enkawlna a dawn dan te a nghawng thei a ni. Zawhna i neih chuan i dinhmun a zirin i doctor hnenah eng nge i beisei tur tih zawt la.

CLL end-stage-ah eng nge thleng?

"End-stage" tih hian CLL natna control emaw tihtawp emaw kawngah enkawlna a hlawk tawh lo tihna a ni. Chutih hunah chuan nunna atana hlauhawm natna hrik emaw, thisen chhuah thunun theih loh emaw, doctor-te’n an tihdam theih loh emaw i nei thei a ni.

Hetiang dinhmun hi ven theih a ni em?

Tunah hian CLL ven dan tur hriat a la awm lo.

CLL nena khawsak hi eng ang nge ni?

I dinhmunah a innghat. CLL i nei thei a, symptoms engmah nei lovin i nei thei bawk. Symptoms i neih chuan tihziaawmna tur leh natna enkawl dan tur enkawlna a awm. Mahse, natna chu a bo vek dawn lo.

CLL nena i awm chhunga i tanpui thei tur rawtna thenkhat chu hetiang hi a ni:

• Hri kai laka invenna tur:CLL vei te hian hri kai an vei theihna a sang hle. Infection thenkhat chu nunna atana hlauhawm tak a ni thei. I doctor hnenah eng vaccine nge i tan a tha tih zawt rawh.
• I hriselna tlangpui ngaihven rawh: Vun cancer, lung cancer, emaw, colon cancer emaw i vei theihna a sang hle thei. I doctor hnenah cancer screening test chungchang zawt rawh.
• Stress enkawl: CLL vei tam tak chuan remission leh relapse cycle an paltlang thin. Natna a zual zel chuan lungkhamna leh hlauhna i nei thei. Chutiang a nih chuan, i rilru hahna tihtlem nâna ṭanpui thei program emaw, service emaw chungchâng i doctor hnênah zawt rawh.
• Ei leh in hrisel ei: CLL symptom thenkhat chuan ei duhna a ti tlahniam thei. Nutritionist hnen atanga thurawn lak chungchangah doctor nen inbia ang che. I ei duhna a tha a nih chuan ei leh in inthlau tak ei tum la, chutah chuan protein tha lo, whole grains, thei leh thlai, leh thau hrisel te a tel a ni. Hei hian i hriselna zawng zawng a tichangtlung thei a ni.
• Exercise: Exercise hian stress i control thei a, i hlim reng bawk.
• Hahdam takin la rawh: CLL hian i chau hle thei. I mamawh nia i hriat hunah chawlh la rawh.
• Beisei tur hre rawh: Hriatna chu thiltihtheihna a ni. I dinhmun chu a zual zel mai thei tih chhinchhiahna doctor hnenah zawt rawh. Chutiang a nih chuan i doctor chuan i CLL enkawlna tha zawka pui thei tur enkawlna dang a rawn rawt thei ang.

Doctor hnenah eng zawhna nge ka zawh ang?

Heng zawhnate hi i zawt duh mai thei:

• Eng ang chronic lymphocytic leukemia nge ka neih?
• Symptoms ka nei lo. Engtikah nge enkawlna ka tan ang?
• Eng enkawlna kawng nge ka neih?
• Chatuan atan enkawlna ka lak a ngai dawn em ni?
• Enkawlna hian ka dinhmun hi remission-ah a dah dawn em ni?

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Chronic lymphocytic leukemia (CLL) hi leukemia chi khat a ni a, puitlingah a tam ber. Hetiang dinhmun hi kum tam tak chhung chu engmah chhinchhiahna nei lovin i nei thei a ni. CLL i neih chuan enkawl tan nghal a ngai lo mai thei. Doctor-te chuan an tidam kim thei lo nain, CLL symptoms tihziaawm thei leh natna chu remission-a dah thei damdawi a awm . CLL vei thenkhat chu kum tam tak an dam.

CLL ang natna khirh tak nena nun hi thil awlsam a ni lo. Remission leh recurrence cycle engemaw zat i paltlang thei bawk. Cycle tin chhung hian eng nge thleng dawn tih i ngaihtuah mai thei. I doctor-te chuan natna khirh tak nena nun chu eng ang nge tih an hrethiam. Zawhna i neih apiang chu lawm takin an chhang ang a, an theih ang angin an pui ang che. Chuvangin, i doctor hnenah i ngaihtuahnate sawipui chu hlau ngai suh.

` Leukemia, CLL, thisen cancer, natna lan chhuah dan, enkawl dan, lymphocytes, dam lehna