Magungunan cutar sankarar myeloid na yau da kullum (CML) yana daya daga cikin manyan nau'i hudu na cutar sankarar bargo . Sauran uku sune cutar cutar sankarar myeloid mai tsanani, m cutar kututtukan lymphoblastic mai tsanani, da cutar ciwon sankarar lymphocytic na kullum.
Ko da kuwa irin nau'in, dukkanin leukemias farawa a cikin sel cikin jini a cikin kasusuwa. Kowane irin cutar sankarar bargo yana samun sunansa daga yadda ciwon daji ke ci gaba da girma (ciwon daji yana ci gaba da sauri, ci gaba yana cigaba da hankali) da kuma irin kwayoyin jini wanda daga cikinsu ne ya fara girma.
CML ne mai cutar sankarar bargo , yana nufin ya cigaba da girma da ci gaban sannu a hankali. CML kuma mai cutar sankarar rigakafi ne , yana nufin shi yana farawa a jikin jini marar tsarki wanda aka sani da kwayoyin myeloid.
Mene ne ke kawo CML?
Wasu canje-canje a cikin DNA na iya haifar da ƙwayar kasusuwan kasusuwa don zama cutar sankarar bargo. Mutanen da ke da CML suna da Philadelphia chromosome , wanda ya ƙunshi nauyin jini na BCR-ABL. Hanyoyin BCR-ABL na haifar da jinin jini don yayi girma a cikin wani abu mara kyau, hanyar da ba a kula ba, haifar da cutar sankarar bargo.
Wanda ke samun CML?
CML zai iya faruwa a kowane zamani, amma ya fi kowa a cikin tsofaffi a cikin shekaru 50, wanda ke lissafin kimanin kashi 70 na duk lokuta. Kareem Abdul-Jabbar daya daga cikin shahararren dan Amurka wanda ke da CML.
Yaya Kayan Kayan CML yake?
CML yana da inganci. A Amurka a shekara ta 2017, kimanin mutane 8,950 ne zasu faru kuma kimanin mutane 1,080 zasu mutu daga wannan cuta.
Cutar cututtuka
Saboda CML yana ciwon ciwon daji mai saurin, mutane da yawa basu da alamun bayyanar cutar idan aka fara gano su.
A gaskiya, har zuwa kashi 40 zuwa 50 na marasa lafiya ba su da wata alamar wariyar launin fata, kuma suna karbar ganewar asali bayan aikin jini na yau da kullum ya gano wani abu maras kyau.
CML na iya haifar da bayyanar cututtuka yayin da yake cigaba da lokaci, duk da haka. Idan aka ba wannan halin da ake ciki, ana iya bayyana jerin "bayyanar cututtuka" mafi kyau kamar haka:
- Babu bayyanar cututtuka (kimanin kashi 50 cikin dari na mutane a ganewar asali)
- Babban gajiya ko gajiya
- Rashin rauni
- Fever
- Sumi dare
- Baceccen asarar rashin lafiya
- Pain ko fullness a cikin ƙananan hagu na hagu, ƙarƙashin haƙarƙarin.
Sakamakon karshe a cikin lissafi ya kasance ne saboda wani karami mai girma, wanda ake kira splenomegaly, wanda yake a cikin 46 zuwa 76 bisa dari na waɗanda ke tare da CML. Irin wannan ƙaddamar da ƙwarƙwarar zai iya haifar da raunin sarari ga sauran kwayoyin a yankin, kamar ciki, wanda zai iya taimakawa wajen jin dadi sosai lokacin cin abinci.
Rashin gajiya da gajiya da wasu mutane da ke ciki na CML zasu iya bunkasa daga hanyoyi masu yawa. Wata tushen rauni da gajiya shi ne anemia, wanda ke nufin jiki ba shi da isasshen kwayoyin jinin jinin da ke dauke da oxygen zuwa kyallen takarda. Abun ciki zai iya sa ka ji kamar ba za ka iya yin amfani da kanka ko amfani da tsokoki kamar yadda ya saba ba.
Sanin asali
Kwararku zai dauki tarihin lafiyarku kuma kuyi nazari na jiki, kamar sauran gwajin don rashin lafiya.
Spleen Size
Yin la'akari da girman yatsun ka shine muhimmin ɓangare na gwaji na jiki. Ba'a ji jin dadi a kowane lokaci ba, amma ana iya gano lambun girma a gefen hagu na ƙananan ciki, a ƙarƙashin gefen hagu.
Kwangwaki yakan tanadar da jini kuma ya rushe tsohuwar jini. A CML, ana iya yalwata ƙuƙwalwa saboda dukan ƙarin jinin jinin da ke zaune a jikin.
Labaran Lab
Ana buƙatar gwaje-gwaje na laboratory. Ana ɗaukar jinin daga jikin da yake cikin hannu, kuma ana amfani da hawan nama ta hanyar hanyar da ake kira ɓawon fata da kasusuwan kwayar halitta. Ana aikawa da samfurori a cikin wani lab kuma mai ilimin likita ya bincika su a ƙarƙashin microscope kuma yayi wasu gwaje-gwaje, yana nema don ganowa da kara bayyana sassan cutar sankarar bargo, idan akwai.
Kwayoyin jini da yawa da nau'ikan ƙananan sunadarai a cikin jini na iya nuna alamar CML.
A cikin kasusuwa na kasusuwa, lokacin da yawancin kwayoyin jini ke kasancewa wanda ake sa ran, ana nuna cewa jinin ya zama hypercellular. Kullun da aka yanka a cikin CML shine sau da yawa hypercellular a CML saboda yana cike da kwayoyin cutar sankarar bargo.
Gene Tests
Za a kuma gwada gwaje-gwajen Gene don nemo "chromosome Philadelphia" da / ko kuma BCR-ABL. Ana amfani da wannan gwajin don tabbatar da ganewar asali na CML. Idan baku da Philadelphia chromosome ko janar BCR-ABL, to ba ku da CML.
Gwaje-gwajen Hoto
Binciken, ko gwaje-gwaje na hoto, ba a buƙatar don gano CML ba. Duk da haka, ana iya yin su a matsayin ɓangare na aikinka, a wasu lokuta; Alal misali, don bincikar wasu alamomi ko kuma ganin idan akwai yalwataccen mahaifa ko hanta.
Harkokin CML
Cases na CML za a iya ƙirƙirar su cikin kungiyoyi daban-daban daban-daban da ake kira phases. Wannan lokaci yana dogara ne akan adadin kwayoyin jini marar tsabta, ko blasts, cewa kuna da jini da ƙashin jini. Sanin lokaci na CML zai iya taimaka maka ka fahimci yadda rashin lafiyarka zai shafe ka a nan gaba.
Hanyar Farar
Wannan shine karo na farko na CML. A wannan lokaci, kun riga kun sami yawan ƙwayoyin jinin jini a cikin jini da / ko ɓawon jini. Duk da haka, wadannan kwayoyin jini marar tsabta, ko hargitsi, sun kasance ƙasa da kashi 10 cikin 100 na sel a cikin jini da / ko kogon kasusuwa.
Yawancin lokaci, a cikin lokaci mai mahimmanci, babu alamun bayyanar, amma za'a iya samun wasu cikakken hagu na ciki. Tsarinka na rigakafi yana cike da kyau sosai a cikin lokaci na yau da kullum, don haka har yanzu kana da ikon yin yaki mai kyau game da cututtuka. Mutum na iya kasancewa a cikin lokaci na yau da kullum kamar gajeren watanni kadan idan dai yawancin shekaru.
Ƙara Phase
A lokacin da aka haɓaka, adadin ƙwayoyin ƙwayar jini a cikin jini da / ko kullun kasusuwan ya fi girma a lokacin lokaci na yaduwa kuma kwayoyin cutar sankarar barkewa suna haifar da bayyanar cututtuka waɗanda zasu iya haɗa da zazzabi, asarar nauyi, rashin jin yunwa, da karar girma.
Yawan adadin jinin jini yana da girma fiye da al'ada kuma zaka iya samun canje-canje a cikin ƙididdigar jini, irin su babban adadin basophils ko adadi kaɗan na platelets.
Akwai sharuɗɗan ma'auni daban-daban da aka yi amfani da su a yau wanda ya ƙayyade tsawon lokaci. Cibiyar WHO (Hukumar Lafiya ta Duniya) Ta'addanci ta bayyana lokacin da aka kara da kasancewa a gaban dukkanin waɗannan abubuwa masu zuwa:
- Rahoton 10 zuwa 19 cikin jini da / ko kututtukan kasusuwa
- Fiye da kashi 20 cikin dari na basophils a cikin jini
- Ra'ayin platinci mai ƙananan ko ƙananan wanda bai danganta da magani ba
- Ƙara yawan yaduwa da ƙwayar jinin jini duk da lura
- Sabuwar tsarin canji ko maye gurbi
Blast Phase
Wannan ma an kira shi "rikicin tashin hankali," tun da yake shine mataki na uku da na ƙarshe kuma yana da yiwuwar zama barazanar rai. Yawan ƙwayoyin ƙuƙwalwa a cikin jini da / ko ɓawon kasusuwa sun zama mafi girma kuma waɗannan rukuni suna yadawa a waje da jini da / ko kututtukan kashi zuwa wasu nau'ukan. Kwayar cututtuka sunfi yawa a lokacin blast, wanda zai iya hada da cututtuka, zub da jini, ciwo na ciki, da kuma ciwo na nama.
CML a cikin rukuni na lokaci zai iya bayyana kamar kamuwa da cutar sankarar bargo fiye da cutar sankarar bargo. A lokacin haɗari, ƙwayoyin CML za su iya nuna hali kamar AML (mikiyoid cutar sankarar bargo) ko fiye da DUK (ƙananan cutar sankarar lymphoblastic).
Ƙaddamarwar WHO game da ɓarna na zamani shine mafi girma fiye da kashi 20 cikin dari a cikin jini ko ƙashin kashi. Bayanin rajista na kasa da kasa na ƙasashen waje ya fi kashi 30 cikin dari a cikin jini da / ko kasusuwan kasusuwa. Dukansu ma'anonin sun hada da kasancewar ƙwayoyin ƙuƙwalwa a waje da jini ko ƙashin jini.
Faɗakarwa
Lokacin ƙoƙarin ganin hangen nesa, lokaci na CML yana da muhimmanci, amma ba haka ba ne kawai.
Akwai wasu abubuwa da dama waɗanda aka nuna su daidaita tare da haɗarinka a matsayin haƙuri na mutum, ciki har da shekarunka, girman girman ka, da jini. Bisa ga irin waɗannan abubuwa, mutum zai iya fada cikin ɗaya daga cikin uku: low, matsakaici, ko babban haɗari.
Mutanen da suke cikin wannan hadarin sun fi dacewa su amsa irin wannan hanyar zuwa magani. Mutanen da ke cikin ƙananan haɗari suna amsa mafi kyau ga magani. Duk da haka, waɗannan rukuni sune kayan aikin, ba cikakkun alamun.
CML Jiyya
Duk jiyya yana da hadarin gaske da kuma amfani, kuma shawarar da za a bi da CML na daya ne da aka yi ta hanyar yin maganin likita da haƙuri da kuma kimantawa da mutumin da yake fama da cutar da kuma lafiyarsa. Ba kowane mutum tare da CML ya karbi duk maganin CML da aka tattauna a kasa ba.
Tyrosine Kinase Inhibitor Far
Maganin maganin tyrosine kinase yana da nau'i na farfadowa. Mene ne manufa? Wannan rukuni na kwayoyi suna kama da nauyin gina jiki na BCR-ABL wanda ke taimakawa kwayoyin CML girma.
Wadannan kwayoyi sun hana gina jiki na BCR-ABL daga aikawa da sakonni da ke haifar da ƙwayoyin CML da yawa. Wadannan kwayoyi sun zo cikin nau'i na kwayoyin da za a iya haɗiye su.
Far | Bayani |
Imatinib | Shin magoya bayan tyrosine kinase da FDA ta amince don magance CML; amince a shekarar 2001. |
Dasatinib | An amince don magance CML a shekara ta 2006. |
Nilotinib | An fara amincewa da CML a 2007. |
Bosutinib | An amince da shi don biyan CML a shekarar 2012, amma an amince da shi ne kawai ga waɗanda aka magance su tare da wani mai hana dancin tyrosine kinase wanda ya daina aiki ko ya haifar da mummunar tasiri. |
Ponatinib | An amince da shi don bi da CML a shekarar 2012 amma an yarda da shi kawai ga marasa lafiya da maye gurbin T315I ko CML wanda ke da tsayayya ko rashin tsayayya ga wasu maƙaryata tyrosine kinase. |
Immunotherapy
Interferon abu ne da tsarin tsarin rigakafi ya sa. Harkokin PEG (mai zumunci) interferon yana da nau'in maganin miyagun ƙwayoyi.
Ba a amfani da Interferon a matsayin magunguna na farko na CML ba, amma ga wasu marasa lafiya, wannan yana iya zama wani zaɓi lokacin da basu iya jure wa maganin tyranine kinase. Interferon wani ruwa ne wanda aka allura a karkashin fata ko cikin tsoka da allura.
Chemotherapy
Omacetaxine wata sabuwar kwayar cutar shan magani ne wanda aka amince da CML a shekara ta 2012, a cikin marasa lafiya da juriya da / ko rashin haƙuri ga maɓallin tyrosine kinase biyu ko fiye. Tsayawa shine lokacin da CML ba ta amsa maganin ba. Rashin hankali shine lokacin da aka magance magani tare da miyagun ƙwayoyi saboda mummunar sakamako mai tsanani.
Ana bada Omacetaxine a matsayin ruwa wanda aka allura a karkashin fata tare da allura. Wasu ƙwayoyin cutar shan-jijila zasu iya yin inji a cikin wani ɓoye ko za a iya ba su a matsayin kwaya don haɗiye.
Hematopoietic Cell Transplant (HCT)
Kafin magunguna na tyrosine kin inganci, an dauke wannan a matsayin maganin zabi na CML, amma halayen maganin HCT shine maganin rikitarwa kuma zai iya haifar da sakamako mai tsanani. Saboda haka, bazai zama kyakkyawar zafin maganin kowane mai haƙuri tare da CML, kuma yawancin cibiyoyin kulawa a yau sunyi la'akari da wannan zaɓin magani don marasa lafiya marasa lafiya fiye da shekaru 65.
Yayi amfani da kwayar cutar ta farko don halakar da kwayoyin halitta guda biyu da ƙwayoyin CML a cikin kututture. Hanyar HCT wata hanya ce ta maye gurbin kwayoyin da aka lalata a cikin kututtukan ka da sababbin kwayoyin jini.
Jarabawa na Gidan Gida: Magunguna
Sabbin magunguna suna ci gaba da bincike. Ƙaramar gwaji na sababbin hanyoyin kwantar da hankali na iya zama wani zaɓi ga wasu marasa lafiya. Kuna iya tambayi magungunan ku idan akwai wata gwaji na gwaji wanda za ku iya shiga tare da kuma ko sun yi imanin cewa za ku kasance dan takara mai kyau don irin wannan gwaji.
Kalma Daga
Ga mutumin da ke tare da CML, ƙwarewar za ta iya dogara ne akan abubuwan kamar shekaru, lokaci na CML, yawan fashewar jini ko ƙashin kasusuwan, girman girman ƙwayar cuta, da kuma lafiyar jiki.
Tare da gabatar da kwayoyi da ake kira magunguna tyrosine kinase farawa a shekara ta 2001, mutane da yawa tare da CML sunyi kyau sosai, kuma ana iya kiyaye cutar a cikin lokaci na tsawon shekaru.
Duk da haka, akwai kalubale da yawa: yana da wuya a hango koyo, tun daga farkon, wanda marasa lafiya da CML zasu iya samun mummunan sakamako. Bugu da ƙari, yawancin marasa lafiya suna buƙatar CML ta bi da su ba tare da iyaka ba, kuma cututtuka ba su da wata tasiri. Saboda haka, yayin da ci gaba ya kasance muhimmi a cikin 'yan shekarun nan, har yanzu akwai damar ci gaba.
> Sources:
> Cibiyar Cancer ta Kasa. Magungunan cutar sankarar bargo.
> Sintina PA, Kantarjian HM, Cortes JE. Sanin asali da jiyya na cutar cutar sankarar bargo a shekarar 2015. Mayo Clin Proc . 201 5; 90 (10): 1440-54.
> Faderl S, Talpaz M, Estrov Z, O'Brien S, Kurzrock R, Kantarjian HM. Ilmin halitta na cutar cutar sankarar myeloid na kullum. N Engl J Med . 1999; 341 (3): 164-172.