Ko e ngaahi meʻa ʻoku totonu ke ke ʻilo fekauʻaki mo e Kanisā Kan (Lōsemi)

Ko e hā ʻa e Lösemi?

Ko e lösemi ko ha kanisā ʻoku tupu mei he tuʻunga ʻoku ʻikai totonu mo e ʻikai ke fakaleleʻi ʻo e tupulaki ʻo e ngaahi selo toto ʻi he huhuʻa ʻo e hui, ʻa ia ʻe lava ke hoko ʻi he ngaahi kulupu taʻu kotoa pē, ka ʻoku lahi ange hono maʻu ʻi he fanau mo e kakai matuʻotuʻa ʻi he taʻu 50 ʻi ʻolunga. ʻOku lahi ange ʻa e faingamalie ʻo e moʻui lelei ʻi he ngaahi meʻa kuo vave ke ʻiloʻi ai ʻa e mahaki. Ko ia ai, ʻoku mahuʻinga lahi ke ʻiloʻi vave ʻa e ngaahi fakaʻilonga ʻo e lösemi pea kamata vave ʻa e faitoʻo.

ʻOku tupu ʻa e lösemi ʻi he taimi ʻoku ʻikai ke lava ʻo fakaʻosi lelei ʻa e tupulaki ʻo e ngaahi selo tupu mei he huhuʻa ʻo e hui, pea ʻoku nau tupulaki vave mo e ʻikai ke fakaleleʻi. ʻOku kamata ʻi he huhuʻa ʻo e hui pea ʻe lava ke holo ki he sino kotoa. ʻI he huhuʻa ʻo e hui ʻoku faʻu ai ʻa e ngaahi selo toto kulokula (alyuvar), ngaahi selo toto hinehina (akyuvar), mo e ngaahi selo fakapī (trombosit). ʻOku mahuʻinga lahi ʻa e ngaahi selo toto hinehina ʻi he tauhi ʻo e sino mei he ngaahi mahaki fakainfectious mo e ngaahi selo ʻoku fie hoko ko e kanisā.

ʻOku lava ke faʻu ʻa e ngaahi selo hinehina ʻikai ngata ai ʻi he huhuʻa ʻo e hui, ka ʻi he ngaahi sino kehe hange ko e ngaahi konga lenifi, spleen mo e thymus. Kapau ʻe ʻikai ke faitoʻo ʻa e lösemi, ʻe faingataʻa hono tauhi. ʻOku faifai mālie ʻa e lösemi ʻoku tupu mei he tupulaki lahi ʻo e ngaahi akyuvar kuo maʻu moʻui, ka ʻoku vave mo lahi ange ʻa e ngaahi fakaʻilonga ʻi he ngaahi tuʻunga ʻoku lahi ʻa e akyuvar ʻoku ʻikai ke maʻu moʻui, pea ʻe lava ke hoko ʻi he uike pe māhina siʻi pē.

Ko e hā e ngaahi Fa'ahinga Lösemi?

ʻOku vahevahe ʻa e lösemi ʻi he ongo kulupu lahi ʻe ua ʻi hono vave pe mālie ʻo e tupu: akuté (vave) mo e kroniké (faifai mālie). ʻOku vave mo lahi ʻa e tupulaki ʻo e selo mo e fakaʻilonga ʻi he akuté, kae faifai mālie mo ʻikai ke ʻilo vave ʻa e kroniké pea lava ke hoko ʻi he ngaahi taʻu lahi.

ʻOku toe vahevahe ʻa e kulupu takitaha ʻi he fa'ahinga ʻo e selo toto hinehina ʻoku tupulaki ʻikai totonu:

• Kapu mei he ngaahi selo myeloid, ʻoku ui ko e “lösemi myeloid”,

• Kapu mei he ngaahi lenfosití, ʻoku ui ko e “lösemi lenfoblastik (pe lenfositik)”.

ʻOku toe ʻi ai ʻa e ngaahi fa'ahinga lösemi siʻi ange (hange ko e: lösemi juvenil myelomonositik, lösemi selo huluhulu).

Ko e fa'ahinga lösemi lahi taha ʻe fā ko ʻeni:

1. Lösemi Lenfoblastik Akuté (ALL)

Ko e fa'ahinga lösemi lahi taha ʻi he fanau, ka ʻe lava ke hoko foki ʻi he kakai matuʻotuʻa. ʻOku tupulaki ʻikai totonu ʻa e ngaahi selo hinehina ʻoku tupu mei he lenfosití. ʻOku kehekehe ʻa e tuʻunga moʻui lelei ʻo e ALL ʻi he fanau mo e kakai matuʻotuʻa ʻi he taʻu, moʻui lelei lahi, mo e tali ki he faitoʻo.

2. Lösemi Myeloid Akuté (AML)

ʻOku tupu mei he tupulaki ʻikai totonu ʻo e ngaahi selo myeloid ʻoku ʻikai ke maʻu moʻui. ʻOku lahi hono maʻu ʻi he kakai lalahi mo e kakai matuʻotuʻa. ʻOku kei hoko atu ʻa e ngaahi ola lelei ʻo e faitoʻo AML ʻi he ngaahi founga fakafaitoʻo foʻou.

3. Lösemi Lenfositik Kroniké (KLL)

ʻOku lahi hono maʻu ʻi he kakai matuʻotuʻa, tautefito ki he taʻu 60 ʻi ʻolunga. ʻI he fa'ahinga ko ʻeni, ʻoku tupulaki ʻa e ngaahi lenfosití kuo maʻu moʻui ka ʻikai ke ngaue lelei, pea ʻoku nau fakalalahi ʻi he huhuʻa ʻo e hui mo e ngaahi sino kehe, ʻoku ne fakalalahi ʻa e faingataʻa ʻo e ngaue lelei ʻo e ngaahi sino ko ʻeni.

4. Lösemi Myeloid Kroniké (KML)

ʻOku lahi hono maʻu ʻi he kakai ʻi he vahaʻa taʻu 25-60. ʻOku tupulaki ʻikai totonu ʻa e ngaahi selo myeloid. ʻOku toe lelei ange ʻa e ola mo e moʻui lelei ʻi he ngaahi meʻa faitoʻo molekulā foʻou ʻoku fakafou ʻi he ngaahi selo, ʻoku ne fakalahi ʻa e tuʻunga moʻui lelei.

Ko e hā e ngaahi Fakaʻilonga ʻo e Lösemi?

ʻOku fakahā ʻa e ngaahi fakaʻilonga lösemi hange ko e ngaahi mahaki huhuʻa ʻo e hui kehe, pea ʻoku kau ai:

• Fie mālōlō, kulokula, vave ke fiemaʻu mālōlō, mole lelea (ko e ʻuhinga ʻi he mole toto)

• Mahaki fakainfectious lahi (ko e mālohi siʻi ʻo e sisitemi tauʻi mahaki)

• Totongi ʻikai ʻamanaki ʻi he ihu, ngutu, pe lalo ʻi he kili, ngaahi kulokula mo e ngaahi fanga kiʻi fasi (peteşi)

• Mole fie kai, mole mamafa, fakamālohi pō

• Mahaki fakainfectious ʻoku maʻu ʻi he mafana lahi mo e taimi loloa

• Fakamanava mo e mamahi ʻo e hui mo e ngaahi hui

• Fakalalahi ʻo e ngaahi konga lenifi ʻi he ua, lalo ʻa e nima pe vae

• Fakalalahi ʻo e kili pe konga ʻo e konga konga

Lösemi ʻi he Fanau: Fakaʻilonga mo e Fakaʻilonga

ʻOku kau ʻa e lösemi ʻi he ngaahi kanisā lahi taha ʻi he fanau, tautefito ki he fanau ʻi he vahaʻa taʻu 2-10. ʻI he ngaahi māhina kamata ʻo e pepe, ʻoku mole vave ʻa e ngaahi koloa malu mei he susu ʻo e faʻe pea kamata ke langa hake ʻa e sisitemi tauʻi mahaki. ʻI he taimi ko ʻeni, ʻoku lava ke fakalahi ʻa e faingataʻa ʻo e lösemi ʻe he ngaahi mahaki fakavaila, ngaahi tuʻunga genetic, mo e mole ʻo e vitamin D.

Ngāueʻaki ʻa e ngaahi fakaʻilonga lahi ʻi he fanau:

• Kulokula lahi ʻi he kili

• Mole mamafa, fie kai siʻi

• Mahaki mafana loloa pe toe hoko

• Fasi mo e fakalalahi ʻi he sino

• Fakalalahi mo e mamahi ʻi he konga konga

• Fakamanava mo e mamahi ʻo e hui pe ngaahi hui

ʻI he hoko atu ʻo e mahaki, ʻe lava ke hoko ʻa e ngaahi fakaʻilonga toe hange ko e fakamanava, puke, mo e ngaahi fakaʻilonga neurological ʻi he holo ʻo e ngaahi selo kanisā ki he sisitemi neva pe ngaahi sino kehe.

Ko e hā e ngaahi Meʻa Fakatuʻutamaki ʻi he Lösemi?

ʻOku maʻu ʻa e lösemi ʻi ha tuʻunga mahuʻinga ʻi he ngaahi kanisā ʻi māmani, pea ʻoku lahi ange hono maʻu ʻi he tangata ʻi he fefine. ʻOku kehekehe ʻa e ngaahi meʻa fakatuʻutamaki ʻi he ngaahi fa'ahinga lösemi kehekehe:

Lösemi Lenfoblastik Akuté (ALL)

ʻEven though ʻoku ʻikai ke mahino lelei ʻa e ngaahi ʻuhinga kotoa, ʻoku lava ke fakalahi ʻa e fakatuʻutamaki ʻe he radiation lahi, ngaahi kemikale (hange ko e: benzen), faitoʻo kemoterapi kuo hili, ngaahi mahaki fakavaila (HTLV-1, Epstein–Barr virus), ngaahi mahaki genetic (Down syndrome, Fanconi anemia).

Lösemi Myeloid Akuté (AML)

ʻOku kau ʻi he ngaahi meʻa fakatuʻutamaki ʻo e AML ʻa e ngaahi liliu genetic, tuʻunga taʻu, inu sigareti, ngaahi mahaki toto pe faitoʻo kemoterapi kuo hili, mo e Down syndrome.

Lösemi Lenfositik Kroniké (KLL)

ʻOku ʻikai ke mahino lelei ʻa e ʻuhinga ʻo e KLL. Ka ʻoku fakalahi ʻa e fakatuʻutamaki ʻe he taʻu lahi, tangata, ngaahi kemikale, mo e ngaahi talanoa famili ʻo e KLL.

Lösemi Myeloid Kroniké (KML)

ʻOku kau ʻa e KML ʻi ha liliu genetic ʻoku maʻu ʻi he moʻui (ʻikai ko e foha). ʻOku lahi hono maʻu ʻa e liliu genetic ko e “Philadelphia chromosome” ʻi he KML, pea ʻoku ne fakalahi ʻa e tupulaki ʻikai totonu ʻo e ngaahi selo ʻi he huhuʻa ʻo e hui.

Fakatokanga ʻo e Lösemi

Ko e taumuʻa ʻo e fakatokanga lösemi ko e ʻiloʻi totonu ʻo e maʻu, fa'ahinga, mo e holo ʻo e mahaki. ʻOku kau ʻa e ngaahi sitepu lalahi ʻi he fakatokanga:

• Talanoa fakalahi mo e sivi sino: Kulokula, fakalalahi ʻo e lenifi pe sino, liliu ʻo e kili ʻoku vakaiʻi.

• Sivi toto: Fakaʻilonga toto kotoa, biochemistry, ngaue ʻo e ate, mo e sivi fakapī.

• Fakamatala toto ʻi tuʻa: Fakaʻilonga ʻo e ngaahi selo ʻikai totonu ʻi he toto.

• Biopsy/aspiration huhuʻa ʻo e hui: ʻI he fakatokanga totonu, tautefito ki he akuté, ʻoku toʻo ha sample mei he huhuʻa ʻo e hui ke vakaiʻi ʻi lalo microscope.

• Sivi genetic mo molekulā: Tautefito ki he KML, ʻoku vakaiʻi ʻa e Philadelphia chromosome mo e liliu BCR-ABL.

ʻOku fai lahi ʻa e biopsy huhuʻa ʻo e hui ʻi he hui ʻo e vae pea vakaiʻi ʻi he ngaahi labotale fakapitoa.

Ko e hā e ngaahi Founga Faitoʻo Lösemi?

ʻOku fiemaʻu ke fakalangilangi ʻa e fa'ahinga lösemi mo e tuʻunga moʻui lelei ʻo e mahaki ʻi hono fokotuʻu ʻo e palani faitoʻo, pea ko ha timi poto ʻi he ngaahi mahaki toto mo e onkoloji ʻoku totonu ke fai ai. ʻI he ngaahi ʻaho ni, ko e ngaahi founga faitoʻo lahi ʻo e lösemi ko ʻeni:

Kemoterapi

ʻOku taumuʻa ke toʻo ʻa e ngaahi selo ʻikai totonu ʻaki ha ngaahi meʻa kemoterapi kehekehe. ʻOku fakangofua ʻa e ngaahi meʻa ʻe ngaueʻaki ʻi he fa'ahinga lösemi mo e tuʻunga fakapitoa ʻo e mahaki.

Raitioterapi

ʻOku taumuʻa ke toʻo ʻa e ngaahi selo lösemi ʻaki ha ngaahi huhuʻa mālohi. ʻOku ngaueʻaki ʻa e raitioterapi ʻi he ngaahi meʻa fili, pea toe ngaueʻaki ʻi he teuteu ki he toʻo selo tupu.

Faitoʻo Fakafaitoʻo mo Molekulā

ʻOku mahuʻinga ʻa e ngaahi meʻa faitoʻo foʻou (immunotherapy, biological agents, molecular targeted therapies) ʻi he ngaahi lösemi kehekehe ke fakalahi ʻa e mālohi ʻo e sisitemi tauʻi mahaki pe ke taumuʻa ki he ngaahi selo kanisā. Ko e fakatātā, ko e tyrosine kinase inhibitors ki he KML ʻoku ne liliu lahi ʻa e faitoʻo ʻo e mahaki ko ʻeni pea siʻi ange ʻa e ngaahi ngaahi kovi ʻi he kemoterapi.

Toʻo Selo Tupu (Huhuʻa ʻo e Hui)

Ko e founga ko ʻeni ʻoku toʻo katoatoa ai ʻa e hikuʻanga kōsimasi pea fakatāutaha mo e ngaahi selo ʻakau moʻui lelei, ko e taha ia ʻo e ngaahi founga fakafaitoʻo ʻoku mahuʻinga taha pea ʻoku fai ia ki he kau mahaki ʻoku totonu. ʻI he taimi ʻo e ngāueʻaki pea mo hono toki mui, ʻe lava ke hoko ha ngaahi ngaahi konga kovi. ʻOku totonu ke tokanga ki he ngaahi palopalema ʻoku fesili mo e polokalama maluʻi (hange ko e GVHD), ngaahi palopalema ki he ngaahi sino totonu mo e faingataʻa ʻo e mahaki. Ko ia ai, ʻoku totonu ke fai ʻa e tohi hikuʻanga kōsimasi ʻi he ngaahi senta ʻoku maʻu ai e poto lahi.

Ngaahi Faitoʻo Tokoni

Ke fakasiʻisiʻi ʻa e faingataʻa ʻo e ʻikai ke maʻu ha toto, faingataʻa ʻo e mahaki mo e tafe toto ʻoku hoko ʻi he kemoterapi mo e ngaahi faitoʻo kehe, ʻoku fiemaʻu ke fai ha tohi toto, ngaahi faitoʻo maluʻi mei he mahaki, kapau ʻoku fiemaʻu ko e ngaahi faitoʻo fakapuna mo e ngaahi faitoʻo tokoni kehe.

Ko e ngaahi founga faitoʻo fakaonopooni ʻoku ne fakatupulaki lahi ʻa e ngaahi tuʻunga moʻui ʻo e kau mahaki leukemia ʻi he ngaahi taʻu fakamuimui. Ko e fakatātā, ʻi he taʻu 1970, ko e tuʻunga moʻui ki he taʻu 5 naʻe ʻi he 30% pē, ka ʻi he ngaahi fakamatala ʻo e ʻaho ni, ʻaki ha faitoʻo totonu mo e vave ʻo e ʻilo, kuo ne toe lahi hake ʻi he 60%.

Kau mai, kapau ʻe ʻilo vave ʻa e ngaahi fakaʻilonga pea fai vave ha ʻalu ki ha fale moʻui, ʻe tokoni lahi ia ki ho moʻui lelei mo e founga ʻo e mahaki.

Ngaahi Fehuʻi ʻOku Fai Laumālie

1. ʻOku mafola ʻa e leukemia?

ʻIkai, ʻoku ʻikai mafola ʻa e leukemia. ʻOku tupu ia mei he ngaahi liliu genetic, ngaahi meʻa ʻi he ʻatakai mo e ngaahi faingataʻa fakataautaha pea ʻoku ʻikai fetuʻutaki mei ha taha ki ha taha.

2. Ko e hā e meʻa totonu ʻoku fakatupu ai ʻa e leukemia?

ʻOku ʻikai ʻiloa lahi e meʻa totonu ʻoku fakatupu ai ʻa e leukemia. Ka ʻoku lava ke fakalahi ʻe he ngaahi meʻa genetic, ngaahi kemikale, radiation mo e ngaahi vailasi kehe ʻa e faingataʻa.

3. ʻOku lava ke faitoʻo ʻa e leukemia?

ʻOku lava ke puleʻi pe toʻo katoatoa ʻa e ngaahi faingataʻa leukemia lahi, tautefito ki he ʻilo vave mo e faitoʻo totonu. ʻOku fakangatangata ʻa e faingamālie ʻo e faitoʻo ʻi he taʻu ʻo e mahaki, tuʻunga moʻui lahi pea mo e faingataʻa ʻo e leukemia.

4. ʻOku toe moʻui feʻefeka ʻa e kau maʻu leukemia?

ʻOku fakangatangata ʻa e taimi moʻui ʻi he leukemia ʻi he faingataʻa ʻo e mahaki, taimi ʻilo, tali ki he faitoʻo mo e ngaahi koloa moʻui fakataautaha. ʻI he ngaahi faitoʻo lelei ʻo e ʻaho ni, ʻoku lava ke moʻui lahi.

5. Ko e hā ʻoku lahi ai ʻa e leukemia ʻi he fanau?

ʻOku lava ke fakatupulaki ʻa e faingataʻa ʻo e leukemia ʻi he fanau ʻi he ngaahi koloa genetic mo e ngaahi koloa maluʻi pea mo e ngaahi meʻa ʻi he ʻatakai. Ka ʻoku ʻikai ke ʻiloa lahi e meʻa totonu ʻi he fanau lahi.

6. ʻOku totonu ki he kakai kotoa ʻa e tohi hikuʻanga kōsimasi?

ʻIkai, ʻoku ʻikai totonu ke fai ʻa e tohi hikuʻanga kōsimasi ki he kakai kotoa. ʻOku fakangatangata ʻa e totonu ʻi he taʻu ʻo e mahaki, tuʻunga moʻui lahi, faingataʻa ʻo e mahaki pea mo e ngaahi meʻa fakafaitoʻo kehe ʻe vakaiʻi ʻe he kau nimoni.

7. Ko e hā e ngaahi mahaki ʻe toe fakafeangai mo e ngaahi fakaʻilonga ʻo e leukemia?

ʻOku lava ke fakafeangai ʻa e leukemia mo e ngaahi mahaki hange ko e ngaahi mahaki fakapuna, ngaahi faingataʻa ʻikai ke maʻu ha toto mo e ngaahi mahaki toto kehe. ʻOku fiemaʻu ke fai ha sivi toto mo e ngaahi sivi lalahi ke fakapapauʻi.

8. ʻOku lava ke maluʻi mei he leukemia?

ʻOku ʻikai lava ke maluʻi katoatoa, ka ʻoku tokoni ʻa e taʻe inu sigareti, taʻe ngāue mo e ngaahi kemikale kovi, moʻui lelei mo e sivi moʻui tuʻuloa ke ʻilo vave ʻa e mahaki.

9. ʻOku toe faingataʻa ange ki he mahaki fakapuna ʻa e kau maʻu leukemia?

ʻIo, ʻoku uesia ʻa e hikuʻanga kōsimasi mo e polokalama maluʻi. Ko ia ai, ʻoku totonu ke tokanga ki he maʻa, taʻe ʻalu ki he ngaahi feituʻu tokolahi mo e ngaahi feituʻu ʻoku ʻi ai e mahaki, pea kapau ʻoku fiemaʻu ke fai ha ngaahi maluʻi.

10. ʻOku mole ʻa e fulufulu ʻi he leukemia?

ʻOku lava ke mole ʻa e fulufulu ʻi he taimi ʻo e faitoʻo ʻaki ha ngaahi faitoʻo (tautefito kemoterapi). Ko e konga kovi ko ʻeni ʻoku taimi nounou pē pea ʻe toe tupu hake ʻa e fulufulu hili hono fakaʻosi ʻo e faitoʻo.

11. ʻOku hoko ʻa e leukemia mei he ngaahi matuʻa?

ʻOku ʻikai hoko ʻa e leukemia mei he ngaahi matuʻa ʻi he ngaahi mahaki lahi. Ka ʻoku lava ke fakalahi ʻa e faingataʻa ʻe he ngaahi genetic syndrome ke hoko ʻa e leukemia.

12. Ko e hā e ngaahi meʻa totonu ke tokanga ki ai ʻi he taimi ʻo e faitoʻo leukemia?

ʻOku totonu ke maluʻi mei he mahaki fakapuna, muimui ki he ngaahi fakahinohino ʻa e nimoni, fai ha sivi tuʻuloa pea fakahā ki he timi moʻui ʻi he ngaahi konga kovi.

Ngaahi Ngaahi Konga Fakamālie

• Kautaha Moʻui ʻo Māmani (WHO): Leukemia

• Kautaha Puleʻanga ʻAmelika ki he Puleʻi mo e Maluʻi ʻo e Mahaki (CDC): Leukemia Patient Facts

• Kautaha Kanisā ʻo ʻAmelika: Leukemia Overview

• Kautaha Hematology ʻo ʻIulope: Leukemia Guidelines

• Cancer Research UK: Leukemia Types and Treatments