Kei te ngenge tonu tāu tamaiti, kei te kikorangi tōna kiri, kei te pāngia rānei e te kirika? I ētahi wā he tohu noa iho ēnei. Engari i ētahi wā, he tohu pea ēnei mea iti mō tētahi mate kino i roto i te tinana. I tēnei rā ka kōrero tātou mō tētahi momo mate pukupuku toto e tino kitea ana i waenga i ngā tamariki nohinohi, engari ka pāngia hoki ngā pakeke. Ko tōna ingoa ko te Acute Lymphoblastic Leukemia, arā, ko te (ALL) te whakarapopototanga. Kaua e manukanuka, ka kōrerohia e tātou ngā mea katoa i roto i ngā kupu māmā.
He aha te tikanga o te KATOA?
Ko te Acute Lymphoblastic Leukemia (ALL) he momo mate pukupuku e puta ana i roto i ō tātou toto. Kei roto i ō tātou toto ngā toto whero, ngā toto mā, me ngā pereti toto. Ko tētahi momo toto mā e kiia ana ko ngā lymphocytes. Pērā i te ope taua o tō tātou whenua, ka tiakina tātou e ēnei pūtau mā te whawhai ki ngā mate me ngā huakita e uru mai ana ki roto i ō tātou tinana.
Ka hangaia ēnei pūtau lymphocyte i roto i te hinu wheua i roto i ō tātou wheua. I ētahi wā, nā te whakarerekētanga ira i roto i ēnei pūtau lymphocyte, ka tīmata rātou ki te huri hei pūtau matepukupuku kaua ki ngā pūtau hauora. Ka wehewehea, ka whakanuia teretia ēnei pūtau matepukupuku me te kore e taea te whakahaere, ka panaia ngā pūtau hauora. Ka kiia noa tēnei ko te ALL.
Kāore ēnei pūtau matepukupuku e noho noa i roto i te hinu wheua. Ka taea e rātou te haere i roto i te toto, ka horapa (metastasize) puta noa i te tinana.
Engari ko te mea nui, ahakoa he mate kino, he mate ka taea te whakaora katoa mēnā ka tika te maimoatanga. He tino teitei te auau whakaora, inā koa i waenga i ngā tamariki nohinohi.
He aha ngā momo matua o te KATOA?
Ina kōrero tātou mō ngā lymphocytes, e rua ngā momo matua o aua pūtau: ko ngā pūtau B me ngā pūtau T. Ka puta katoa ngā mate pukupuku mai i ēnei momo pūtau e rua.
| Momo mate pukupuku | He whakamārama māmā |
|---|---|
| Pūtau-B KATOA (Pūtau-B KATOA) | Koinei te momo tino noa. E 85% o te ALL i roto i ngā tamariki, ā, e 75%-80% o te ALL i roto i ngā pakeke. Ko ngā pūtau-B te momo pūtau e hanga ana i ngā paturopi hei ārai i ngā iroriki i roto i tō tātou tinana. |
| Pūtau-T KATOA (Pūtau-T KATOA) | He ahua onge tēnei. Tata ki te 25% o ngā pakeke me te 12%-15% o ngā tamariki ka pāngia e tēnei momo mate. Ko ngā pūtau-T te momo pūtau e patu tika ana i ngā iroriki me te āwhina i ētahi atu pūtau o te pūnaha ārai mate. |
Haunga ēnei momo e rua, kei reira anō tētahi momo tino onge e kiia nei ko te Natural Killer ALL. Mā tō tākuta e whakahaere ngā whakamātautau e tika ana kia kitea ai te momo e pāngia ana koe, e tō tamaiti rānei.
He aha ngā tohu e kitea ana e tātou?
Ina puta te ALL, ka mimiti haere ngā pūtau toto hauora o te tinana, ka puta ai ngā momo tohu. Ka puta ohorere mai ēnei tohu, ka puta mārire rānei.
He mea nui: Ki te pāngia koe e ēnei tohu, ehara i te mea kei a koe te KATOA. Heoi, ki te mea kei a koe ēnei tohu mō te neke atu i te rua wiki, he mea nui kia toro atu koe ki te tākuta mō ētahi tohutohu.
| Tohu | He aha te tikanga o tēnā? |
|---|---|
| Te ngenge tonu me te kiri mā | Nā te hekenga o ngā toto whero i roto i te tinana (anemia), ahakoa te mahi i ngā mahi iti nei, ka taea tonu te hoha, ā, ka āhua mā te tinana. |
| Te pāngia e te mate pinepine | I te hekenga o ngā pūtau toto ma hauora, ka heke te kaha o te tinana ki te whawhai ki ngā mate (ārai mate). Nō reira, ka puta pinepine ngā mate pēnei i te kirika me te makariri. |
| Te toto me te maru | I te mea ka heke te nui o ngā pereti toto e āwhina ana ki te toto totoka, ka puta he ira kikorangi nui ki te tinana i te toto o te ihu, te toto o ngā kapia, tae noa ki ngā whara iti. Tērā pea ka nui te toto o te wahine i te wā o te paheketanga. |
| Ngā ira whero i runga i te kiri (petechiae) | Ka puta ngā ira whero iti ki te kiri me te mea nei i werohia ki te pine, nā te toto mai i ngā uaua toto tino angiangi i raro i te kiri. |
| Mamae wheua me ngā hononga | I te mea ka whakakīia te hinu wheua e ngā pūtau matepukupuku, ka pā te mamae nui ki ngā wheua me ngā hononga. |
| Ngā kōpū lymph pupuhi | Ka pupuhi pea ngā puku (ngā pona) i ngā wāhi pēnei i te kaki, ngā kēkē, me te uma, kāore he mamae. |
| Ētahi atu āhuatanga | Tērā pea ka kitea anō ngā tohu pēnei i te kore hiahia kai, te ngaronga taumaha, te werawera i te pō, me te uaua ki te manawa. |
He aha i puta ai tēnei mate? He aha ngā āhuatanga mōrearea?
Kāore he take kotahi mō ngā mate pukupuku katoa. Ko te take matua, e ai ki tā tātou i kōrero ai i mua ake nei, ko ngā whakarerekētanga ira e puta ana i te wā e hangaia ana ngā pūtau toto. I roto i ngā tamariki nohinohi, ka puta pea ēnei whakarerekētanga i mua i te whānautanga.
Heoi, kua tautuhia he maha ngā āhuatanga e whakanui ake ai i te mōrearea o te whakawhanaketanga o tēnei mate.
- Tau: Ko te mōrearea nui rawa atu i waenga i ngā tamariki kei raro iho i te 15 tau te pakeke, inā koa ko te hunga i waenga i te 2-5 tau te pakeke, me ngā pakeke neke atu i te 50 tau te pakeke.
- Ētahi mate ira: Ko te hunga whai mate ira, pērā i te Down syndrome, he nui ake te tūponotanga ki te whakawhanake i te ALL.
- Te pānga ki te irahiko: Mā te pānga ki ngā taumata teitei o te irahiko, hei tauira, mēnā kua whiwhi koe i te rongoā irahiko mō tētahi atu mate pukupuku i mua, ka nui ake pea tō tūponotanga.
- Ētahi huaketo: E whakaponohia ana hoki ka piki ake te mōrearea e ētahi mate huaketo, pērā i te huaketo Epstein-Barr.
- Te whakamahi tupeka: I roto i ngā pakeke, ko te pānga ki ngā matū whakaputa mate pukupuku pēnei i te whakamahi tupeka he take anō pea.
Me pēhea te tātaritanga tika a te tākuta i tēnei mate?
Ina haere koe ki te kite i tētahi tākuta me ngā tohu i whakahuatia ake nei e koe, ka pātai tuatahi ia i tētahi pātai taipitopito mō ō tohu. Kātahi ka whakahaerehia e ia he whakamātautau tinana, ā, ka whakahau i ētahi whakamātautau hei whakaū i te mate.
- Ngā whakamātautau toto:Ka taea e te whakamātautau Tatau Toto Katoa (FBC) te kite i ngā rerekētanga o te maha o ngā pūtau i roto i te toto.
- Kohikohi wheua wheua: Koinei te whakamātautau matua hei whakaū i te mate. Ka tangohia he tauira iti o te wheua wheua mai i tētahi wāhi pēnei i te wheua hope i raro i te rongoā whakamoe, ā, ka tirohia i raro i te karuārai. Mā tēnei ka taea te whakatau mēnā kei reira ngā pūtau matepukupuku, ā, mēnā kei reira, he aha te momo.
- Ngā whakamātautau whakaahua: Tērā pea ka mahia ngā karapa CT me ngā karapa PET hei tirotiro mēnā kua horapa te matepukupuku ki ētahi atu wāhanga o te tinana, hei tauira, ki te kōhao o te uma.
- Te pokanga tuaiwi/te pokanga lumbar: Mēnā he ruarua kei te horapa ngā pūtau matepukupuku ki te roro, ki te taurakira rānei, ka tangohia he iti o te wai tuaiwi mai i te tuaiwi ka whakamatautauria.
He aha ngā maimoatanga mō te ALL?
He maha ngā maimoatanga mō te KATOA. Mā tō tākuta e whakatau te mahere maimoatanga pai rawa atu māu i runga i ngā āhuatanga maha, tae atu ki tō tau, te momo mate, me ngā tohu ira i roto i ō pūtau matepukupuku.
Maimoatanga matua: Te rongoā matū
He rongoā kaha te chemotherapy e patu ana i ngā pūtau matepukupuku. Koinei te maimoatanga matua mō te KATOA. Ka tukuna tēnei maimoatanga i roto i ētahi wāhanga, mai i ētahi marama ki te rua ki te toru tau te roa.
| Ngā wāhanga maimoatanga | He aha te mea e tupu ana? |
|---|---|
| 1. Wāhanga tīmatanga (Whakaoho Murunga) | E 4-6 wiki te roa o tēnei. Ko te whāinga matua ko te whakangaro i te maha o ngā pūtau matepukupuku i te wā e taea ai. I tēnei wā, he maha ngā wā me noho koe ki te hōhipera. |
| 2. Te rongoā i te pūnaha io (te rongoā e arohia ana e te CNS) | Ka tukuna tēnei maimoatanga hei ārai i te horapa o ngā pūtau matepukupuku ki te roro me te taurakira, hei whakangaro rānei i a rātou mēnā kua horapa. He maha ngā wā ka mahia tēnei i te wāhanga tuatahi. |
| 3. Wāhanga whakakotahi | Kia memeha haere te mate, ka tīmata tēnei wāhanga ki te whakangaro i ngā pūtau matepukupuku e toe ana. Ka noho koe ki te hōhipera mō ētahi rā i ia wiki, mō ētahi marama, ā, ka whiwhi koe i ngā rongoā werohanga ā-uaua (IV). |
| 4. Wāhanga tiaki | Koinei te wāhanga whakamutunga, te wāhanga roa rawa hoki. E rua ki te toru tau te roa. Ko te whāinga i konei he ārai i te hokinga mai o te mate. I te nuinga o te wā, ka hoatuhia ngā rongoā ā-waha me ngā rongoā ā-uaua ki te whare hauora. Kāore he take ki te haere pinepine ki te hōhipera. |
Ētahi atu maimoatanga
- Te rongoā arotahi: Kei roto i tēnei ko te hoatu rongoā hei whakaeke i ngā huringa ira motuhake e kitea ana i roto i ngā pūtau matepukupuku anake. Hei tauira, he tino whai hua tēnei maimoatanga mō te hunga he huringa ira e kiia nei ko te ira o Philadelphia.
- Whakaora Ārai Mate: Kei roto i tēnei ko te whakaoho i tō tātou ake pūnaha ārai mate ki te whakangaro i ngā pūtau matepukupuku. Ko te whakaora pūtau CAR-T he tikanga maimoatanga hou e taka ana ki raro i tēnei kāwai.
- Whakaora irahiko: Ka taea te whakamahi i te rongoā irahiko mēnā kāore te mate pukupuku e pai ki te rongoā chemotherapy, mēnā rānei ka hoki mai te mate.
- Te whakawhitinga wheua wheua: Mena kāore ētahi atu maimoatanga e angitu, he tino teitei rānei te mōrearea o te hokinga mai o te mate, ka tukuna pea koe ki tētahi tangata hauora mō te whakawhitinga wheua wheua.
He aha ngā tūponotanga ka ora ai tēnei mate?
Koinei te pātai nui rawa atu kei roto i te hinengaro o te katoa. He mate pukupuku a ALL e tino pai ana te urupare ki te maimoatanga.
He tino whai hua ngā hua mō ngā tamariki. 98% o ngā tamariki e whiwhi ana i te maimoatanga tika ka ora katoa te mate. Ko te ōrau ora i muri i te 5 tau i muri i te rongoā o te mate he teitei ki te 90%.
He iti iho tēnei ōrau i waenga i ngā pakeke. Ko te reiti oranga 5-tau mō ngā pakeke kei waenga i te 30% - 40%.
Engari he mea nui kia mārama he tatauranga noa iho ēnei. He rerekē rawa te urupare a te tangata ki te maimoatanga. Nō reira kaua e mataku i ēnei tau. Ko te tākuta anake e rongoā ana i a koe ka taea te hoatu i ngā mōhiohio pai rawa atu mō tō āhua, mō tō tamaiti rānei.
He mea noa te whakaaro kei te pakaru tō ao ina kitea he mate pukupuku tōu. Ina koa mēnā ko tāu tamaiti. Engari kia maumahara, he mate ngāwari ake te rongoā mō NGĀ MEA KATOA i ngā momo mate pukupuku maha atu. Whakawhirinaki ki tō tīma hauora. Ka noho tahi rātou me koe i tēnei haerenga, ka whakarato i ngā tautoko me ngā whakamārama katoa e hiahiatia ana e koe.
Karere Tangohia ki te Kāinga
- Ko te Acute Lymphoblastic Leukemia (ALL) he mate pukupuku e puta ana i roto i ngā lymphocytes, he momo toto ma.
- Ahakoa he mea noa tēnei mate i waenga i ngā tamariki nohinohi, ka taea e te tangata o ngā tau katoa te pāngia e te mate.
- Ki te pāngia koe e ngā tohu pēnei i te ngenge tonu, te kiri mā, te mate pinepine, te kikorangi o te tinana, me te mamae o te wheua mō ngā wiki e rua neke atu, rapua tonutia he tohutohu hauora.
- Ahakoa he mate kino te ALL, ka taea te whakaora katoa mā roto i ngā maimoatanga pēnei i te chemotherapy. He tino teitei te auau whakaora, inā koa i waenga i ngā tamariki.
- Ka roa pea te tukanga maimoatanga, ka hoha hoki, engari kaua e wehi, whakawhirinaki ki ō tākuta, ā, whaia rawatia ā rātou tohutohu.
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