He raruraru toto anō tōu? Me kōrero tātou mō te CMML (Chronic Myelomonocytic Leukemia)!

Kua rongo kē koe i tētahi mate e kiia nei ko te `CMML`, ko te Chronic Myelomonocytic Leukemia rānei? Kāore pea. Nā te mea he momo matepukupuku toto onge. Engari he mea tino nui kia mōhio tātou ki tēnei. Nā te mea ka pā ki te hanga toto o tō tātou tinana. Me kōrero ngāwari tātou mō tēnei, i roto i tētahi huarahi e mārama ai koe.

He aha te CMML? Kia mārama tātou!

Ki te kī ngāwari, ko tō hinu wheua – te wāhanga hautai i roto i ō wheua – te mea e hanga ana i te toto. Ko te tangata whai CMML he nui rawa te whakaputanga o tētahi momo toto mā e kiia nei ko ngā monocytes . Ka āraihia e ēnei monocytes rerekē ngā toto whero hauora, ngā pereti toto , me ētahi atu toto mā hauora e hiahiatia ana e tātou. Whakaarohia he rite ki ngā taru i roto i te māra e āraihia ana ngā rākau hauora.

E whakarōpūtia ana tēnei mate e ngā tākuta hei Myeloproliferative neoplasm/Myelodysplastic syndrome (MPN/ MDS ). Ahakoa te āhua nei he huinga kupu uaua tēnei, ko tōna tikanga ko:

• Te mate toto myeloproliferative (MPN): Koinei te wā e nui rawa ai te hanga o te momo toto kotahi e tō hinu wheua. Ina nui rawa te hanga o te momo kotahi, ka whakararuraruhia te taurite o te toto, ā, kāore te toto e mahi tika.
• Te mate Myelodysplastic (MDS): He āhuatanga tēnei e rerekē ai, e hē ai te āhua o ngā pūtau toto e hangaia ana e tō hinu wheua. Ina koa, kaua ki ngā pūtau toto hauora, kua pakari, ka puta ake he pūtau kāore anō kia pakari e kiia nei ko ngā pūtau pahū.

I ētahi wā ka tino puhoi te tipu o te CMML. Engari i ētahi wā ka tere ake, ka kino ake hoki. Ma tō tākuta koe e whakamārama ki ngā maimoatanga ka taea te whakahaere i tōna tipu.

He aha ngā tohu o te CMML? Kei a koe anō ēnei?

Kāore ngā tohu o te CMML e kitea tonutia ana. I ētahi wā, ko te whakamātautau toto te tohu tuatahi. Ahakoa ka puta mai ngā tohu, ka puta mārire tonu. Tirohia mēnā e mōhio ana koe ki ēnei tohu:

• Te ngenge me te ngoikore i ngā wā katoa: Nā te hekenga o ngā toto whero, arā, te anemia , tēnei.
• Ngā mate me ngā mate pāwera pinepine:Nā te hekenga o ngā pūtau toto mā tēnei, e kiia nei ko te neutropenia.
• Te toto pinepine o te ihu, te kikorangi ahakoa he maru iti noa: Nā te hekenga o ngā pereti toto tēnei, e kiia nei ko te thrombocytopenia.
• Splenomegaly : He whakanuinga o te whēkau, kei te taha maui o runga o tō puku.
• Hepatomegaly : Te whakanui ake i te ate.
• Te whakahekenga taumaha kāore i te whakamāramatia.
• Te werawera o te pō.
• Mamae wheua.
• Te kirika.

Kia maumahara, ehara i te katoa he CMML kei a rātou. Engari ki te mau tonu ēnei tohu, he pai ake te toro atu ki te tākuta.

He take motuhake kei te pūtake o te CMML?

Kāore anō kia tino mōhiotia e ngā kairangahau te pūtake o te CMML. Heoi, kua kitea e rātou ētahi whakarerekētanga ira e pā ana ki te mate. Mena kua tātaritatia koe he CMML, tera pea he neke atu i te kotahi ō whakarerekētanga ira. Ko ētahi o ngā whakarerekētanga ira e tino kitea ana ko:

• `TET2`
• `SRSF2`
• `ASXL1`
• `RAS` (koinei te mea tino noa)

Mā tō tākuta koe e kōrero atu mō tēnei ira.

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te CMML?

He maha ngā āhuatanga mōrearea ka pā ki te whanaketanga o te CMML:

• Tau: Ka piki ake te mōrearea o te pāngia e tēnei mate i a koe e pakeke haere ana. Ko te tau toharite mō te tātaritanga kei waenganui i te 73 me te 75 tau te pakeke. Ko te tikanga ko te haurua o te hunga kua tātaritatia ki te mate he iti ake i tērā, ā, ko te haurua he pakeke ake.
• Ira Tangata: He nui ake te kitea o te CMML i roto i ngā tāne i ngā wāhine.
• Maimoatanga mate pukupuku o mua: Tata ki te kotahi i roto i te tekau o ngā tāngata kua pāngia e te CMML kua whiwhi kē i te rongoā chemotherapy, i te irahiko rānei mō te mate pukupuku. Engari ka hoatu noa ēnei maimoatanga e ngā tākuta mēnā he nui ake ngā painga o te maimoatanga i te mōrearea o te pāngia e te mate pukupuku ā muri ake nei.

He aha atu ngā raruraru ka puta i tēnei āhuatanga?

Tata ki te rua i roto i te tekau o ngā tāngata whai CMML ka pāngia e tētahi atu mate pukupuku toto kino e kiia nei ko te acute myeloid leukemia (AML). Kōrero ki tō tākuta mō tō mōrearea ki te whakawhanake i te AML i runga i tō tātaritanga me ngā āhuatanga mōrearea.

Me pēhea te tautuhi a ngā tākuta i te CMML?

Ka pātai tō tākuta mō ō tohumate, ka tangohia hoki tō hītori hauora. Kātahi ka whakahaerehia e rātou ētahi whakamātautau hei tirotiro i ō toto. Kei roto pea i ēnei whakamātautau:

• Te tatau toto katoa (CBC): Mena he nui rawa te maha o ngā monocyte (monocytosis), he tohu pea tēnei nō te CMML.
• Te whakamātautau toto ā-taha: Mena ka puta he āhua koretake, he āhua pakari rānei ngā monocyte (ngā pūtau pupuhi) ina tirohia i raro i te karuārai, he tohu pea tēnei nō te CMML.
• Kohikohi ira wheua: I ētahi wā, me tango e te tākuta tētahi tauira iti o te hinu wheua ka whakamātautau i roto i te taiwhanga kia kitea ai mēnā he monocytes rerekē kei roto.
• Whakamātautau ira: Ka rapua hoki e ngā tākuta ngā whakarerekētanga ira e pā ana ki ētahi atu mate pukupuku toto. Mā tēnei ka taea e rātou te whakakore i ētahi atu mate he rite ngā tohu me ngā hua o te whakamātautau toto.

He aha ngā wāhanga o te CMML?

Ka whakatauhia e ngā tākuta te horapa o te CMML, te kaha rānei (te whakatau i te taumata o te mate pukupuku), i runga i te maha o ngā pūtau pupuhi i roto i tō toto me tō hinu wheua. Ko ēnei wāhanga e rua:

• CMML-1: He iti iho i te 4 o roto i te 100 pūtau i roto i tō toto he pūtau pahū. He iti iho i te 9 o roto i te 100 pūtau i roto i tō hinu wheua he pūtau pahū.
• CMML-2: I waenganui i te 5 me te 19 o roto i te 100 pūtau o roto i tō toto he pūtau pahū. I waenganui i te 10 me te 19 o roto i te 100 pūtau o roto i tō hinu wheua he pūtau pahū.

I tēnei wā ka whakatau tō tākuta ko tēhea te maimoatanga e tino tika ana, e tino whai hua ana hoki māu.

He aha ngā maimoatanga mō te CMML?

Tuatahi, me rongoā pea koe kia mōhio ai kei a koe he nui ngā pūtau toto hauora. Kei roto pea i tēnei ko te rongoā hei whakanui ake i te maha o ngā pūtau toto, te whakawhiti toto auau rānei. Tērā pea he wāhanga tēnei o te tiaki mamae hei whakahaere i ngā tohumate.

Ko ētahi atu maimoatanga e aro tika ana ki te CMML ko:

• Te whakawhitinga pūtau take allogeneic: Koinei anake te maimoatanga ka taea te whakaora katoa i te CMML. Heoi, kāore e pai mō te katoa. Ka taea hoki e ia te whakaputa raruraru morearea pērā i te mate graft-versus-host.
• Te rongoā matū: Ka aukati ngā rongoā rongoā matū i te tipu kore whakahaere o ngā monocyte. Ka āwhina tēnei ki te whakaora i ngā tohu. Ka whakamahia ngā rongoā pēnei i te Hydroxyurea me ngā Hypomethylating agents (HMA).
• Ngā whakamātautau haumanu:Ki te kore e āwhina ētahi atu maimoatanga, ka tūtohu pea tō tākuta kia whai wāhi koe ki tētahi whakamātautau haumanu. Kei te tirotirohia e ngā whakamātautau haumanu te whai huatanga o ngā maimoatanga hou (hei tauira, te rongoā arotahi, te rongoā ārai mate) mō te CMML.

Āhea ahau me kite i te tākuta?

Me toro atu koe ki tō tākuta i ia wā (kotahi i te marama ki te ono marama). He mea nui kia mau tonu koe ki ēnei wā whakarite. I roto i ēnei wā whakarite, ka pātai tō tākuta mō ō tohumate, ka whakamātautau toto, ka tirotiro i te pai o te mahi a tō maimoatanga, ā, ka mahi i ngā whakarerekētanga e tika ana.

I tēnei wā, ki te pāngia koe e ngā pānga kino ohorere mai i tō maimoatanga , kōrero tonu atu ki tō tākuta . Mā tō tākuta koe e kī atu ki ngā tohu hei tūpato māu, i runga i te maimoatanga e whiwhi ana koe.

He aha tāu e tumanako ai ina noho tahi koe me tēnei mate?

Ko te roanga o te oranga mō te tangata kua tāpaetia ki te CMML he tata ki te kotahi ki te toru tau. Anō, ko te "waenga" he uara waenga. Ko te tikanga tēnei he poto ake te roanga o te oranga mō te haurua o te taupori, ā, he roa ake te haurua. Heoi, he maha ngā āhuatanga e whakatau ana i tō matapae. Kei roto i ēnei ko:

• Ngā hua o te whakamātautau toto: Ka taea e te maha o ngā pūtau toto te whakaatu i ngā tohu mō tō matapae. He mea nui te maha o ngā monocyte, ngā pūtau blast, me ngā platelet. He mea nui anō hoki te taumata o tō hemoglobin ka tirohia e tō tākuta.
• Ngā whakarerekētanga ira: Ko ētahi whakarerekētanga ira, hei tauira he whakarerekētanga ira i roto i te ira `ASXL1`, e pā ana ki te āhua kino ake o te putanga mai.
• Te auau o ngā whakawhiti toto: Ki te kore koe e hiahia ki ngā whakawhiti toto auau hei whakaora i ō pūtau toto, he pai te nuinga o te wā ka puta he hua pai.

Ko tō matapae ka whakawhirinaki anō ki te pikinga o tō mate ki te `AML` (acute myeloid leukemia). He nui ake te tūponotanga ka puta tēnei mena kei a koe te `CMML-2`.

He aha taku e taea ai kia noho ora, kia kaha hoki?

Mena kei a koe te CMML, ko tētahi o ngā mea pai rawa atu ka taea e koe ko te tango i te kawenga mō tō hauora i ngā huarahi katoa e taea ana . I tēnei wā, he mea nui kia kai i ngā kai totika me te moe nui. He mea nui anō hoki te taurite i waenga i te noho kaha me te okioki nui. He huarahi pai te hono atu ki ētahi atu e ora ana me te mate pukupuku ki te whawhai ki ngā kare ā-roto o te mokemoke. Kōrero ki tētahi kaiwhakaora hinengaro he wheako ki te mahi me ngā tūroro mate pukupuku.

Ka taea e te mate pukupuku te whakapouri i te tangata, engari kia maumahara, kei a koe tonu te mana whakahaere o tōu ao.Ā, he maimoatanga anō hei āwhina i a koe.

Ehara i te mea ngāwari te noho me te CMML. Ka whakawhirinaki tō putanga ki ngā āhuatanga maha e motuhake ana ki a koe. Pātai atu ki tō tākuta kia whakamārama mai he aha ēnei āhuatanga me te pānga ki tō matapae. Kia mārama ki ō whiringa maimoatanga kia mōhio ai koe ka tutuki i te tiaki e whiriwhiria e koe ō whāinga.

Ko te karere tino nui hei kawe ki te kāinga

He mate kino te CMML. Engari ki te mōhio koe ki tēnei mate, ki te mahi tahi me tō tākuta, ki te whiwhi maimoatanga tika, ā, ki te hanga huringa pai mō te noho, ka taea e koe te ngana ki te noho pai me tēnei mate. Kaua e mutu te tumanako. Kei reira tō whānau, ō hoa, me ō tākuta hei āwhina i a koe. Kāore koe i te mokemoke. Ki te mea he pātai, he āwangawanga rānei āu, kaua e wehi ki te pātai ki tō tākuta. Nāu te tika.

` CMML, Leukemia Myelomonocytic Mau tonu, Matepukupuku Toto, Huango Wheua, Monocyte, Ngā Tohu, Te Maimoatanga