Thisen cancer CML (Chronic Myeloid Leukemia) an tih chungchang hi a awlsam zawngin i zir ang u.

Mi tam tak chuan "cancer" tih thumal hi kan hlau hle. Thil awmze nei tak a ni. Mahse tunlai hian medical science a lo thang chak em avangin cancer chi thenkhat nen chuan pangngai taka nun theih a ni ta. Vawiin hian chutiang thisen cancer chi khat chungchang kan sawi dawn a ni. Chu chu CML a ni a, chu chu Chronic Myeloid Leukemia tihna a ni. He hming hi thisen test pangngai hnuah i hre tawh mai thei. Chuvangin, hlau lovin chipchiar takin sawi ila.

Okay, chuti a nih chuan he CML hi eng nge ni?

A awlsam zawngin CML hi kan thisen cancer a ni. Kan ruh chhunga ruhro (bone marrow) atang hian a intan thin. Bone marrow hi kan taksa mamawh cell chi hrang hrang, red blood cells, white blood cells, leh platelets tia koh siamna factory ang a ni. CML-ah chuan heng bone marrow cell-a myeloid stem cell-te hi thil dik lo a awm a, thunun theih lohvin an inthen darh a, an pung chho ta a ni.

Hei hi `chronic myelogenous leukemia` emaw `chronic granulocytic leukemia` emaw an ti bawk.

Mahse hetah hian thu pawimawh ber leh tha ber chu tunlai enkawlna hmasawn tak tak hmang hian CML vei tam zawk chuan dam rei zawng pangngai an hmang thei tih hi a ni . Chumi awmzia chu thihna thlen thei natna ni lovin, damdawi hmanga thunun theih, natna khirh tak a lo ni ta tihna a ni.

He CML hi engtiang chiahin nge a kal chak?

"Chronic" tih thumal hi "hun rei tak chhung" tihna a ni. Tin, chutiang chu he natna hi a ni. CML hi natna tlanglawn tak a ni. A châng chuan kum tam tak chhung chu natna lan chhuahna nei lovin a awm thei bawk. Mi tam tak chuan accident-in an nei tih an hrechhuak a, chu chu chhan dang avanga thisen test an tih chuan an thisen cell count-ah thil dik lo a awm tih an hmuchhuak a ni.

Mahse enkawl loh chuan hei hi kum thum atanga kum li chhungin nunna atana hlauhawm tak a ni thei. Chuvang chuan natna hriatchhuah a, enkawl tan hmasak a pawimawh hle.

CML vei mi pakhatin eng symptom nge a neih theih ang?

Vawi tam tak chu a tir lamah chuan symptom lian tham a awm lo thei. Mahse, hun kal zelah a lan chhuah dan tlangpui thenkhat a awm. Hengte hi thil pangngai anga kan ngaih leh kan ngaihthah fo thin a ni.

Engvangin nge CML hi a lo thang lian? Hrilhfiahna a ni em?

He zawhna hi mi tam takin an neih a ni. Hetah hian hriatthiam tur pawimawh ber chu CML hi thlahtute atanga lo chhuak natna a ni lo tih hi a ni . Chumi awmzia chu naupangte chuan an nu leh pate an neih vang mai maiin an nei lo tihna a ni. Tin, rochun thil a ni lo.

Awle, tunah chuan hei hi engtin nge a thawh tih i en ang u. A awlsam zawngin hetiang hi a ni:

1. Kan stem cells genes ah hian inthlak danglamna a awm a, gene thar, added `BCR-ABL` tih chu a lo piang ta a ni.

2. This new gene gives new instructions to stem cells to make an unusual form of an enzyme called `tyrosine kinase`.

3. Heng enzyme te hi light "on" leh "off" switch on ang maiin ngaihtuah rawh. Hengte hi cell inthen darh dan control tu chu an ni.

4. Mahse chu `tyrosine kinase` enzyme siam danglam chuan "off" switch a nei lo. A "on" reng a ni.

5. "Off" switch a awm loh avangin ruhro chhunga stem cell te hian thunun theih loha inthen darh, inthen leh pung turin signal an dawng chhunzawm zel a.

6. Chumi avang chuan thisen var puitling lo (`blast` an tih bawk) tam tak a lo piang tan a.

7. Hun a kal zel a, heng cell pangngai lote hian ruhro (bone marrow) chu an luah khat ta vek a. Tichuan ruhro hian thisen sen hrisel, thisen var leh platelet siam theihna a hloh ta a ni. Chumi avang chuan a chunga kan sawi tak symptoms te hi a lo lang tan ta a ni.

Hei hi a hlauhawmna leh harsatna awm thei te

Risk factors te pawh a awm thei

CML vei theihna tur risk factor hriat chhuah awmchhun chu radiation level sang tak tak nena inzawmna a ni . Mahse, hei hi a tlem hle. Nun pangngaia kan tawn radiation level (entir nan, X-ray lak atanga) hian a thlen lo.

Harsatna awm thei te

CML hian harsatna lian tak pahnih a thlen thei a, chungte chu:

• Anemia: Thisen sen (red blood cell) hrisel tak tak siam chhuah a tlahniam a, chu chuan taksain oxygen a mamawh zat a ti tlem a, hahdamna leh vun rawng a siam thin.
• Splenomegaly: Thisen cell pangngai lo tam tak chu spleen-ah hian a pungkhawm a, chu chuan a ti hring chhuak thin. Hei hian chaw ei tlem hnuah pawh pum a ti na thei a, a pum a ti na thei bawk.

Tin, zirchianna thenkhatah chuan CML vei te hian cancer chi dang (second cancers) vei theihna chance tlem an nei sang thei tih an hmuchhuak bawk.

Doctor-te hian engtin nge CML hi an hriat theih?

I doctor chuan thisen test awlsam tak hmangin hei hi a ringhlel mai thei. Amaherawhchu, he natna hi finfiah tur chuan genes inthlak danglamna zawng chhuak tur special test neih a ngai a ni.

CML hi eng phase nge awm?

Cancer dang ang lo takin CML hi "stage 1, 2, 3, 4"-ah dah a ni lo. Chu ai chuan "phases" tiin an classified zawk a ni. Hei hi thisen leh ruhro chhunga thisen var (`blast`) puitling lo awm zat atanga teh a ni.

• Chronic Phase: Hei hi a hmasa ber a ni. Thisen leh ruhroah hian `blasts` cell 10% aia tlem a awm a. CML vei hmuhchhuah zinga 80-90% chu hetiang dinhmunah hian an awm mek a ni. Heng mite hian symptoms an nei thei a, an nei lo thei bawk.
• Accelerated Phase: He phase ah hian `blasts` cells hi 10% leh 19% inkar ah a pung thin. Symptoms chu a langsar zual tan thin.
• Blast Phase emaw Blast Crisis: Hei hi a na ber leh nunna atana hlauhawm ber a ni. `blasts` cells hi 20% emaw a aia tam emaw a pung a ni. Chauhna nasa tak, khawsik, leh taksa rihna tlahniam te ang chi natna lanchhuahna te chu a na hle.
• Resistant CML: Hei hi CML enkawlna dawng lo emaw, enkawl hnua lo lang leh emaw hming an vuah a ni.

CML enkawl dan tur chu engte nge ni?

Hetah hian CML chungchang thu lawmawm a lo lang a, tunlai hian he natna hi enkawlna tha tak tak a awm tawh a ni.

Enkawlna ber chu damdawi chi khat Tyrosine Kinase Inhibitors (TKIs) tih a ni. Hengte hi damdawi, pill anga ei thin te an ni.

A hmaa kan sawi tawh enzyme danglam tak, "on" switch ang maia thawk kha i hre reng em? Chu chu heng damdawi te hian an target a ni. TKI te hian an tih chu chu enzyme "off" switch nei lo chu hnathawh tir an titawp thin. An block thin. Tichuan chutiang thunun theih loha inthen darh CML cell te chuan inthen theihna signal an hmu lo va, rei vak lo hnuah chuan chu cell te chu an thi ta a ni.

Heng TKI te hian CML vei te nunah danglamna nasa tak a thlen a ni. Heng damdawi te hi a lo chhuah hma hian CML vei hmuhchhuah zinga 20% vel chauh chu kum 5 chhung an dam a ni. Mahse vawiinah chuan TKI te nen chuan chu percentage chu 90% aia tam a ni ta.

Heng damdawi te hi dam chhung atan ei a ni fo. TKI chi hrang hrang hman tlanglawn tak tak thenkhat chu:

• Imatinib a ni
• Dasatinib a ni
• Nilotinib a ni
• Bosutinib a ni
• Ponatinib a ni

TKI hian side effect a nei em?

Ni e, damdawi dang ang bawkin side effect a awm thei. Mahse enkawl theih an ni tlangpui. A hman tlanglawn berte chu:

• Pum a na
• Chau lutuk
• Kawthalo
• Muscle a rawn inher chhuak
• Edema a awm
• A châng chuan, thin (liver) chhiatna leh thisen cell count hniam ang chi thil a thleng thei bawk.

I doctor chuan heng side effects te hi a sawipui ang che a, enkawl dan tur a pui ang che.

CML hi tihdam theih vek a ni em?

Hetih lai hian CML "dam" theihna awmchhun chu allogeneic stem cell transplant hmanga tihdam a ni. Hei hian mi hrisel tak atanga damlo chhunga stem cells transplant a huam a ni. Mahse, hei hi enkawlna buaithlak tak leh risky tak a ni. Chuvangin, TKIs dawng lo damlo tan chauh tih a ni tlangpui.

CML nena nun hi eng ang nge a nih a, a hmalam hun tur chu eng nge ni?

CML hi enkawlna nen remission -ah a kal chuan symptoms i nei tawh lo va, test-ah pawh natna chhinchhiahna hmuh tur a awm tawh lo. Hei hian nun pangngai i hmang thei tihna a ni. Mahse natna thunun nan damdawi i ei chhunzawm a ngai dawn a ni. Tin, i enkawlnain a thawh that leh that loh enfiah nan thisen test turin doctor i pan fo a ngai bawk ang.

Enkawlna awm lo Remission (TFR) 1.1.

Hei hi CML enkawlna lama hmasawnna thar ber leh beisei awm ber a ni. Hei hian a awmzia chu damlo thenkhat, TKIs hun engemaw chen ei tawh, an natna control tha tak tawhte chuan tunah chuan an doctor enkawlna hnuaiah damdawi an ei tawh lo thei tawh tihna a ni. Damdawi an chawlhsan hnuah pawh natna hi a lo let leh tawh lo. Mahse hei hi mi zawng zawng tan thil theih a ni lo. Chumi atan chuan qualification thenkhat i tlin a ngai a ni.

Doctor zawh tur zawhna pawimawh

CML i nei tih i hriat chuan i rilruah zawhna tam tak a awm hi thil pangngai a ni. Hlau suh, heng thilte hi i doctor hnenah zawt rawh.

• CML eng stage nge ka neih?
• Eng enkawlna kawng nge ka neih?
• Enkawl lai hian engtin nge ka awm ang? A side effects te chu engte nge ni?
• Enkawlna ka dawn lai hian ka hna hi ka chhunzawm thei ang em?
• Enkawlna hi a hlawhtling em tih hriat nan engzat nge thisen test ka mamawh?
• Ka natna hi remission-a a kal theihna chance engzat nge awm?
• Ka dinhmun atan hian stem cell transplant hi a tha em?
• Enkawlna senso enkawl dan tur chungchangah tute nge ka biak theih ang?