Kua rongo koe i tēnei mate pukupuku toto kino? (Acute Promyelocytic Leukemia - APL) Me kōrero taipitopito tātou!

Kua pāngia koe e te ngenge rawa, he marō ētahi, he toto pinepine rānei ō kapia? Ahakoa kāore mātou e aro nui ana ki ēnei mea, i ētahi wā onge, he tohu pea ēnei mō tētahi mate kino ake, pērā i te Acute Promyelocytic Leukemia (APL) . Nō reira, kaua e manukanuka, i tēnei rā ka kōrerohia e mātou tēnei mate pukupuku toto e kiia nei ko te APL i roto i te huarahi mārama, ngāwari hoki.

He aha te mate toto promyelocytic acute (APL)?

He kupu ngāwari noa iho, he momo matepukupuku toto tino onge te APL . Nō tētahi rōpū nui o ngā mate toto toto e kiia nei ko te Acute Myeloid Leukemia . Ko te wāhi matua e hangaia ai te toto i roto i tō tātou tinana ko te hinu wheua . I konei i roto i tēnei hinu wheua, nā te huringa ira, arā, he whakarerekētanga ira , ka tīmata te hanga o ngā pūtau toto ma rerekē. Ka wehea, ka whakanuia hoki ēnei pūtau rerekē, ka horapa puta noa i te hinu wheua. I ētahi wā ka kiia tēnei e ngā tākuta ko te APL leukemia, ko te M3-leukemia rānei.

He mate kino te APL. Ka puta ohorere mai ōna tohu, ā, ka tere te kino haere. He take nui te toto nui . Engari he rongo pai tēnei! Mā ngā maimoatanga hou, tae atu ki te chemotherapy me ngā rongoā hou kāore i te chemotherapy, ka taea e ngā tākuta te whakahaere i te APL, ā, he maha ngā wā ka ora katoa.

He pēhea te noa o tēnei mate?

He mate tino onge te APL. Hei tauira, i tētahi whenua pērā i te Hononga o Amerika, tata ki te 30,000 noa iho ngā tāngata e kitea ana tēnei mate i ia tau. I te nuinga o te wā, ka kitea te APL i roto i te hunga kei roto i ō rātou tau 30 .

He aha ngā tohu o te APL?

Ka puta ngā tohumate APL ina kore e taea e tō hinu wheua te hanga i ngā toto whero hauora, ngā toto mā, me ngā pereti toto pērā i te tikanga. Ko te whakahekenga o ēnei momo toto katoa e kiia ana ko te pancytopenia . Ina tupu tēnei, ka taea e koe te whakawhanake i ngā tohumate kino pērā i te anemia , ngā raruraru toto nā te toto e totohu ana , me ngā mate maha.

Ko ētahi atu tohu APL noa ko:

• Te tino ngenge me te ngenge rawa nā te hekenga o ngā toto whero (arā, te anemia).
• Ngā mate pāwera maha nā te iti o ngā toto toto mā e whawhai ana ki te mate. Ka puta pinepine pea ngā mea pēnei i te kirika me te makariri.
• Nā te mea ka tere ake te pākia o te tinana, ā, ka tere te tahuna o te pūngao mai i te kai,Te whakahekenga taumaha koretake.

Ngā tohu toto

He iti te maha o ngā pereti toto me ngā mea e whakapakeke ana i te toto o te tangata whai APL. E mōhio ana koe, ko ngā pereti toto te mea e āwhina ana ki te aukati, ki te whakaiti rānei i te toto. Nō reira, ina iti ēnei, ka tīmata te raruraru.

Anei ētahi tohu o te toto e puta mai ana i te APL:

• Ka taea te toto i ngā wāhi katoa o te tinana. Hei tauira, te toto o ngā kapia , te toto pinepine o te ihu , ā, mō ngā wāhine, te toto nui o te paheketanga .
• Ka kohia te toto i raro i te kiri, ā, ka puta he marutanga ki ngā wāhi rerekē o te tinana . Ahakoa he motu iti, ka puta he marutanga nui.
• I ētahi wā ka puta te toto i roto i te roro (te toto i roto i te angaanga) . Mēnā ka puta tēnei, ka uaua pea te neke i ō ringaringa me ō waewae, ka pāngia koe e te mamae nui, ā, ka rerekē pea ō tirohanga. He āhuatanga ohorere tēnei!
• Mena he mangu tō tūtae, he toto rānei kei roto, tera pea nā te toto i roto i te pūnaha nakunaku (toto i roto i te puku) .

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He aha ngā take o te APL?

E rua ngā ira e whakahaere ana i te hanga o ngā pūtau toto e huihui ana hei hanga i tētahi ira rerekē e kiia nei ko te PML-RARa . He mea nui, ehara tēnei whakarerekētanga ira i te mea i riro mai i ō mātua . Ka puta noa mai, arā, kāore he take, i roto i tō oranga. Kāore anō ngā tohunga kia tino mōhio he aha te take o tēnei whakarerekētanga ira.

Nā tēnei whakarerekētanga ira ka tipu haere ngā pūtau toto mā, kaua e whanake tika, ā, ka puta ko ngā pūtau toto mā kāore anō kia pakari (promyelocytes) . Ka whakakīia e ēnei pūtau kāore anō kia pakari te hinu wheua, ka kapi te wāhi mō ngā pūtau toto hauora me ngā pereti toto.

He aha ngā raruraru o te APL?

He mate morearea te APL. Nā te mea ka tere te noho morearea o te toto nui e puta ana. Ki te kore e taea e koe te aukati i te toto mai i tētahi motu iti noa iho, ki te nui te toto i roto i tō tūtae, i tō mimi rānei ina haere koe ki te wharepaku, ki te kore rānei e taea e koe te aukati i te toto mai i ō kapia, me toro atu koe ki te tākuta, me haere rānei ki te rūma whawhati tata o te hōhipera .

Kia maumahara: Ki te kore e taea te whakahaere i te toto, kaua rawa e warewarehia. Ko te mea nui ko te maimoatanga tere.

Me pēhea te tautuhi i te APL?

He maha ngā whakamātautau ka mahia e ngā tākuta hei tautuhi i tēnei mate.

• Tatau Toto Katoa (CBC): Ka puta he toto toto ma rerekē i te APL. Ka taea e te whakamātautau CBC te tirotiro i ngā momo toto rerekē me te maha o ngā pereti toto i roto i tētahi tauira o tō toto.
• Te Pane Toto Āpiti:I roto i tēnei, ka tangohia he tauira toto, ka tirohia i raro i te karuārai. Kātahi ka tirohia mēnā he maha ngā pūmua iti kei roto i aua pūtau toto mā kāore anō kia pakari (promyelocytes), mēnā rānei he mea motuhake e kiia nei ko ngā tokotoko Auer . Koinei ngā āhuatanga o te APL.
• Kohikohi i te Huka Wheua: I tēnei whakamātautau, ka tangohia he tauira iti o tō hinu wheua, ā, ka tirohia ōna pūtau.
• Te Ine Rere: I roto i tēnei whakamātautau, ka rapu ngā tākuta mate i ngā tauira o ngā pūmua motuhake i runga i te mata o ngā pūtau rerekē. Ka taea e ēnei tauira te whakaū i te APL.
• Whakamātautau Polymerase Chain Reaction (PCR): Ka taea e tēnei whakamātautau te kite tika i te aroaro o te ira rerekē (PML-RARa) e hua ai te APL.
• Cytogenetics: Ka whakamātautauhia ngā huringa motuhake o ngā chromosomes o ngā pūtau rerekē. Ko te kimi i ēnei huringa te huarahi matua ki te whakaū i te tautuhi i te APL.

Ka whakarōpūhia e ngā tākuta te APL hei iti te mōrearea, hei nui rānei te mōrearea i runga i te maha o ngā pūtau toto mā. Ko te hunga he nui te mōrearea o te APL ka nui ake te tūponotanga ka hoki anō te mate pukupuku, ka hoki anō rānei .

Me pēhea te rongoā mō te APL?

Ka rongoatia te APL mā te whakakotahitanga o ngā rongoā rerekētanga , te chemotherapy, me te rongoā arotahi . Inaa, mai i te kitenga o ēnei maimoatanga i te tekau tau atu i 1980, ko tēnei mate, i whakaarohia i mua he mate whakamate, kua riro hei mate ka taea te rongoā. He whakatutukitanga nui tēnei!

Ko ngā rongoā wehewehe pūtau he rongoā kore-chemotherapy e āwhina ana i ngā pūtau toto ma rerekē, kāore i te pakari te wehewehe hei pūtau toto ma noa, kua pakari. Ko ēnei rongoā kore-chemotherapy, kua whakarārangihia i raro nei, kua hua ake i te neke atu i te 95% te maha o ngā mate me ngā reiti whakaora.

• Ko te waikawa katoa-trans-retinoic (ATRA) , ko te tretinoin rānei (Vesanoid ®) – He momo huaora A tēnei.
• Te toru o te waikura ārsenika (ATO) – He momo ārsenika tēnei.

Ki te whakapae tō tākuta kei a koe te APL, ka tīmata pea rātou i te ATRA i mua i te whakaūnga o te mate e ētahi atu whakamātautau. Nā te mea ka taea e te tīmatanga wawe o te maimoatanga te whakaiti i te tūponotanga o te toto e morearea ana ki te ora.

Ngā wāhanga o te maimoatanga APL

E toru ngā wāhanga o te maimoatanga: Te Whakaoho, te Whakakotahi, me te Tiaki. Ka rerekē pea te maimoatanga i runga i te taumata o te mōrearea.

• Wāhanga tīmatanga (Whakaurunga):Ko te whāinga matua o tēnei wāhanga ko te patu i ngā pūtau leukemia kia nui ai te whakaora i tō APL. Ko te tikanga o te whakaora, kāore he tohu, ā, kāore he tohu o te leukemia e kitea i roto i ngā whakamātautau. Ka mahia tēnei mā te whakamahi i ngā rongoā kore-chemotherapy, te chemotherapy, me ngā maimoatanga kua tohua. I roto i tēnei wā, me noho koe ki te hōhipera, mō te whā ki te ono wiki te nuinga.
• Wāhanga Whakakotahi: Ka taea hoki e tō tākuta mate pukupuku te kī ko te 'whakaora muri i te murunga'. Mā tēnei maimoatanga ka noho tonu te APL ki te murunga, ā, ka haere tonu te patu i ngā pūtau leukemia e toe ana. Koinei te rongoā kotahi i whakamahia i te wāhanga tuatahi. Ka roa pea tēnei maimoatanga mō te waru marama, me ngā maimoatanga i ia rua marama. Tērā pea e whā wiki te roa o te maimoatanga, ā, ka whai muri ko te whā wiki te okiokinga. Ka taea te hoatu i tēnei rongoā hei pire, hei maimoatanga ā-uaua rānei (IV) .
• Wāhanga Tiaki: He maimoatanga tonu tēnei, engari he iti iho te horopeta e hoatu ana i te rongoā i tērā i ngā wāhanga tīmatanga me ngā wāhanga whakau. Ko te tikanga ka hoatu tēnei maimoatanga tiaki mō te tau pea.

I te taha o tēnei maimoatanga, ka tukuna pea e tō tākuta matepukupuku he rongoā tautoko , pērā i te whakawhiti toto.

Ngā raruraru o te maimoatanga

Ko te raruraru tino noa, ā, he āhua kino hoki, ko te mate rerekētanga . He rōpū tauhohenga kino tēnei ki ngā rongoā APL. I te nuinga o te wā ka puta ēnei tauhohenga i roto i ngā wiki tuatahi e toru o te tīmatanga o te maimoatanga. Ka taea e ngā tohu te ngawari, te kino rānei. Ko ētahi o ēnei ko:

• Maremare.
• He wai nui atu i te taha o tō ngākau me ō pukahukahu (te rerenga wai i roto i te pleura) .
• Te ngoikore o te whatukuhu .
• Te toto toto iti (te toto toto iti) .
• Te hekenga o te taumata hāora i roto i te toto (hypoxemia) .
• Te uaua ki te manawa (dyspnea) .
• Te pupuhi/ te mumura o ō ringaringa, o ō waewae, me tō kaki.
• Te kirika e puta mai ana, kāore he take.
• Te pikinga o te taumaha me te kore take.

Ki te pāngia koe e tēnei mate rerekētanga, ka mutu pea tō maimoatanga e tō tākuta mō tētahi wā. Tērā pea ka whakamahia e rātou ētahi atu rongoā, pērā i te hydroxyurea, hei whakaiti i te maha o ngā toto toto mā.

He aha ngā mea ka taea e te tangata whai APL te tumanako?

I te nuinga o te wā, he pai te matapae mō te mate.Ahakoa he rerekē te āhua o te katoa, kua whakaatuhia e ngā rangahau kei waenganui i te 90% me te 95% o te hunga whai APL ka hoki whakamuri. Heoi, ka taea e te APL te hoki mai i muri i te maimoatanga. I waenganui i te 5% me te 10% o te hunga ka hoki anō ki te mate, i roto i ngā tau tuatahi e toru i muri i te maimoatanga. Kātahi ka hiahia rātou ki tētahi atu maimoatanga, ki tētahi atu maimoatanga rerekē rānei.

Ngā reiti oranga

Nā te mea he mate onge te APL, ko tā tātou e mōhio ana mō ngā reiti oranga i ahu mai i ngā whakamātautau haumanu e uru ana ki ngā tūroro APL iti te mōrearea me ngā tūroro morearea nui.

E whakaatu ana tētahi tātaritanga e 99% o ngā tūroro APL iti-morearea e ora tonu ana i muri i ngā tau e whā i te maimoatanga. E whakaatu ana tētahi atu tātaritanga o ngā tūroro APL nui-morearea e 86% e ora tonu ana i muri i ngā tau e rima i te maimoatanga. He tino pai ngā hua!

Me pēhea taku tiaki i ahau anō?

Nā te mea ka hoki anō te APL, he mea nui kia kite koe i tō tākuta i te wā tika (ngā whakaritenga whai muri) .

Ka tirotirohia koe e tō hauora i ia marama, i ia rua rānei marama mō te tau tuatahi i muri i te maimoatanga. I muri i te tau tuatahi, me toro atu koe ki tō tākuta i ia toru ki te whā marama mō ngā tau e rua e whai ake nei. Tērā pea ka mahia ngā whakamātautau pēnei i te CBC, te PCR, me te koiora wheua i ēnei haerenga.

Āhea ahau me haere ki te rūma whawhati tata?

Ka taea e te APL te hoki mai anō i muri i te maimoatanga, ā, ka tere te kino haere o ngā tohu. Mena kei te heke tō mate mai i te APL, haere tonu ki te rūma whawhati tata mena ka pāngia koe e tētahi o ēnei e whai ake nei:

• Mena kei te totohu koe me te kore e taea te whakahaere .
• Ki te puta whakarere mai he pupuhi me te mamae i ō waewae, i tō puku raro rānei .

Hei whakamutunga, he karere nui

Ko te mate pukupuku toto onge te mate pūkahukahu promyelocytic acute (APL) i whakaarohia i mua he mate whakamate, engari kua taea te whakaora nā ngā maimoatanga matatau.

Heoi anō, he mate kino tonu tēnei. Ki te kore e kitea wawetia, e rongoatia rānei, ka mate pea . Nō reira, ki te pā mai ngā tohu pēnei i te toto e kore e taea te whakahaere, kaua rawa e warewaretia. Ko te mea nui ko te rapu tohutohu hauora me te tiki tātaritanga i te wā e taea ai. Kaua e mataku, kia maia, nā te mea kei reira ngā maimoatanga pai mō tēnei!