Leukemia ma aha cudur halis ah, laakiin dad badan. Cilmi-baadhayaashu waxay bilaabayaan inay fahmaan sida xitaa hal nooc, nooc gaar ah ee leukemia uu leeyahay nooc hoosaad ah oo ku kala duwan siyaabo muhiim ah.
Afar nooc oo astaamo ah oo leetemia ah waxay ku saleysan yihiin haddii uu yahay mid aad u ba'an ama daba-dheer, iyo mellitamiin ama lymphocytic leukemias, iyo qeybaha ugu waaweyn waa sida soo socota:
- Cudurka Myeloid ee Xanuunka ah (ama Miyelomous) Leukemia (CML)
- Lymphocytic (ama lymphoblastic) leukemia (ALL)
- Lymphocytic leukemia (CLL)
Ku saabsan AML
Cudurka 'myelogenous leukemia' waa kansarka lafaha lafaha - lafdhabarta lafaha, halkaas oo unugyada dhiiga la sameeyo - sidoo kale waa kansarka dhiigga.
AML waxaa loo tixgeliyaa "leukemia" degdeg ah maxaa yeelay waxay si degdeg ah u socotaa. Qaybta maskaxeed ee magacu waxay ka timaaddaa unugyada myeloid - oo ah unugyo unugyada caadi ahaan ku soo baxa noocyada kala duwan ee unugyada dhiigga ee qaangaarka ah, sida unugyada dhiigga cas, unugyada dhiigga cad iyo qajaarka.
AML wuxuu leeyahay noocyo badan oo ka mid ah: Cudurka 'myelogenous leukemia' ayaa sidoo kale loo yaqaannaa 'myeloid leukemia', 'leukemia', 'leukemia leukemia', 'leukemia granulocytic leukemia' iyo 'nonelphocytic leukemia'.
AML waxay saameyn kartaa dadka da 'kasta. Hay'adda Caafimaadka ee Caalamiga ah ee 2012 ee GLOBOCAN ayaa soo jeedisay in 352,000 oo qof oo adduunka ah ay qabaan AML, cudurkuna wuxuu noqdaa mid ka sii ballaadhan sida dadka da'da ah.
Calaamadaha iyo astaamaha AML waxaa ka mid ah:
- Qandho
- Xanuunka lafaha
- Lethargy iyo daal
- Neefsasho gaabis ah
- Maqaarka cirridka
- Caabuqyo joogto ah
- Nabaro fudud
- Dhiig-bax aan caadi ahayn, sida nuucyada soo noqnoqda iyo dhiig-baxa cirridka
Subtypes
Qeybinta AML ee ku saleysan muuqaalka dhirta ee unugyada kansarka, ama qaabdhismeed, ayaa lagu kordhiyaa helitaan cusub oo ku saabsan isbeddelada hidde-galka ama isbeddellada ku lug leh qaababka kala duwan ee caansaankan.
Cilmi-baareyaasha ku jira Hay'ada Wellcome Trust Sanger Institute iyo wada-shaqeeyayaashu waxay dhawaan ku darsadeen saldhig aqooneed, oo ka warbixinaya isbeddellada hidda-guurka oo gacan ka geysta qaabeynta fahamka AML- oo sii fekeraya fikradda AML ee ka mid ah halxirid mid ka mid ah ugu yaraan 11 nooc oo kala duwan oo hidde ah malignancy , oo leh kala duwanaansho oo kaa caawin karta sharaxaad ka duwan waqtiyada badbaadada ee bukaanka dhalinyarada ee AML.
Cilmi-baadhayaashu waxay daabaceen daraasad ku saabsan genetics ee AML ee bishii June 2016 ee "New Journal Journal of Medicine", iyo khubaradu waxay rumeysan yihiin in natiijooyinkani ay kor u qaadi karaan tijaabooyinka bukaan-socodka iyo saameynta sida habka bukaan-socodka leh AML loo ogaado loona daweeyo mustaqbalka.
Daraasadda NEJM
Cilmi-baadhayaashu waxay bartay 1.540 bukaan oo qaba AML kuwaas oo lagu qoray tijaabooyinka bukaan-socodka. Waxay falanqeynayeen in ka badan 100 gen oo loo yaqaan 'leukemia' iyada oo ujeedadu tahay in la aqoonsado "mawduucyada hidde" ka dambeeya horumarinta cudurka.
Waxay ogaadeen in bukaanada qaba AML loo kala qaybin karo ugu yaraan 11 kooxood oo waaweyn, mid kasta oo leh kala duwanaansho isbeddel ah oo isbeddel ah iyo astaamo kala duwan. Sida laga soo xigtay daraasaddan, bukaanjiifka badankood waxay lahaayeen isbeddel isku mid ah oo isbeddelada hidda-socodka ah ee keenaya leetemia, taas oo laga yaabo inay ka caawiso sharaxaadda sababta ay AML u muujinayso isbeddelka noocaas ah ee sicirka nolosha
Saameynta
Aqoonta hiddo-wanaaga ee leetemia-da bukaanku waxay hagaajin kartaa kartida lagu saadaaliyo in daaweyntu hadda waxtarkeeda ay wax ku ool laheyd. Macluumaadka noocan ah waxaa loo isticmaali karaa in la sameeyo tijaabooyinka cusub ee daaweynta si loo horumariyo daaweynta ugu fiican ee nooc kasta oo AML ah; iyo ugu dambeyntii, baaritaano dheeri ah ee hidda-socodka ah ee AML ee lagu ogaado cudurka ayaa noqon kara mid caadi ah.
Sannadka 2008 Qaybta Caafimaadka ee Caalamiga ah (WHO), saynisyahanku wuxuu mar hore bilaabay qiyaasida dadka waaweyn ee AML "kooxo molecular", oo ay ku jiraan isbeddellada hidde-galka gaarka ah ama dhaawacyada koromosoomyada oo lagu tilmaamay sida soo socota: t (15; 17), t (8; ), (16) -t (16) -t (16; 16), t (6; 9), khudbada (3) -t (3; 3), gene-fusion-fusion, iyo ku-meelgaar ahaan, CEBPA ama isbeddelada NPM1.
Si kastaba ha noqotee, sida lagu muujiyey daraasadda NEJM ee dhowaan, qiyaasaha nafaqa-yada ee WHO si fiican uma shaqeynayaan tiro badan oo ah AML. Daraasaddan, 736 bukaan oo qaba AML, ama 48 boqolkiiba, laguma kala saari karin iyadoo lagu saleynayo kooxo ka tirsan Qeybaha Caafimaadka ee WHO, inkastoo 96 boqolkiiba bukaannada ay sameeyeen, waxaa loo yaqaanay isbeddelka wadista - isbeddelada hidde-galka ee hoos yimaada malignancy
Helitaanka genen cusub ee leukemia, isbeddelada wadista badan ee bukaanku, iyo qaababka isku dhafan ee isku dhafan ayaa keeney in baarayaashu ay dib u qiimeeyaan qoondaynta caadiga ah ee AML tan iyo bilawgii.
Qiimeynta AML iyo Qeybinta, Iyadoo lagu saleynayo Isku Beddelka Jeermiska
Sidaa daraadeed, cilmi-baarayaashu waxay dib ugu noqdeen guddi-dejinta si ay isku dayaan inay horumariyaan nidaam cusub si ay u kala saaraan AML oo ka dhigaysa isticmaalka macluumaadka soo baxaya.
Qeybaha kala duwan ee la aqbali karo ee AML waxay adeegsanayaan nooca WHO - oo ay ku jiraan noocyada loo yaqaan 'cytogenetic lesions' - tusaale ahaan t (15; 17) - iyadoo leh NPM1, FLT3ITD, iyo CEBP, sida kor ku xusan.
Marka la eego daraasaddan cusub, qorayaashu waxay ku taliyeen in, muddada gaaban, TP53, SRSF2, ASXL1, DNMT3A, iyo IDH2 waa in loo tixgeliyaa in lagu daro tilmaamo qadarin ah sababtoo ah waxay yihiin kuwo caadi ah oo saameyn xoog leh ku leh natiijooyinka kiliinikada.
Qiimaynta AML, qiimeynta "gen genetic-factor factor" RUNX1, ASXL1, iyo MLLPTD marka la ogaado cudurka ayaa tilmaamaya bukaannada "kooxda chromatin-spliceosome." Tani waxay ahayd kooxda labaad ee ugu weyn ee bukaannada AML ee daraasadda, Qeybaha WHO ee AML, laf dhabarta oo keliya ayaa qeexaya kooxdan.
Isticmaalka nidaamkan la soo jeediyey, 1.236 oo ka mid ah 1.540 bukaan oo leh mutarjumin darawalnimo ayaa lagu kala saari karaa hal koox hoosaad, 56 bukaannana waafajiyey shuruudaha laba ama in ka badan. Wadar ahaan 166 bukaan oo leh isbeddelka wadaha ayaa weli ah mid aan la cayimin.
Taariikhda Nidaamka Nooca Qaybinta
AML looma dhicin sida kansarrada kale ee badankood. Aragtida qof leh AML waxay ku xiran tahay macluumaadka kale, sida noocyada kala duwan ee lagu ogaado baaritaanka sheybaarka, iyo weliba da'da bukaanka, iyo natiijooyinka baaritaanka shaybaarka kale.
Astaamaha AML waxay la xiriiri karaan aragtida qofka bukaanka ah iyo daaweynta ugu fiican. Tusaale ahaan, noocyada 'APL' ee noocaas ah ee 'promyelocytic leukemia' (APL) ayaa badanaaba loola dhaqmaa iyadoo la adeegsanayo daawooyin ka duwan kuwa loo isticmaalo noocyada kale ee AML.
Laba ka mid ah nidaamyada ugu muhiimsan ee loo isticmaalay in lagu cadeeyo AML hoos-u-dhigga hoosta ayaa ah kala soocida Faransiis-Mareykan-British (FAB) iyo qoondeynta cusub ee Caafimaadka Adduunka (WHO).
Qeybta Faransiiska-American-British (FAB) ee qoondaynta AML
Sanadkii 1970-yadii, khabiiro Faransiis ah, Ameerikan, iyo Ingiriisi ah ayaa u kala qaybiyay AML iyagoo hoosta M0 illaa M7, oo ku salaysan nooca unugyada kaas oo leukemia horumarinayso iyo sida ay kor ugu kacdo unugyada. Tani waxay ku saleysneyd sida ay unugyada leukemia u ekaadeen bakteeriyada ka dib markii marxalad la geliyo.
Magaca FAB magaca hoose
M0 Maqnaanshaha 'myeloblastic bacterial leukemia'
M1 Cudurka macaan ee 'myeloblastic lumma' oo leh waxyar aan ka yareyn
M2 Cudurka macaan ee myeloblastic ee leh korriin
M3 Cudurka 'Promyelocytic Leukemia' (APL)
M4 Cudurka 'myelomonocytic' leukemia
M4 eos Cudurka 'myelomonocytic leukemia' oo leh eosinophilia
M5 Cudurka 'leukemia' oo macluul ah
M6 Cudurka 'viral leukemia'
M7 Mucaarad-ku-dareen-celin megakaryoblastic ah
Subtypes M0 ilaa M5 dhamaantood waxay ku bilaabmaan qaabab aan qaangaar ahayn ee unugyada dhiigga cad. M6 AML waxay ku bilaabataa qaabab aad u liidata unugyada dhiigga cas, halka M7 AML ay ku bilaabmayso noocyo aan qasan lahayn oo unugyada unugyada sameeya.
Hay'adda Caafimaadka Adduunka (WHO) ee qoondaynta AML
Nidaamka u dejinta FAB waa mid waxtar leh, waxaana inta badan loo isticmaalaa kooxo AML ah oo hoosta ku yaalla, hase yeeshee aqoonta la hormariyay ee la xidhiidha saadaasha iyo aragtida noocyada kala duwan ee AML, iyo qaar ka mid ah horumarkaasi waxay ka muuqdaan nidaamka 2008 Ururka Caafimaadka Adduunka (WHO).
Nidaamka WHO wuxuu u qaybiyaa AML kooxo dhowr ah:
AML leh cillado hidde ah oo qaarkood
- AML leh tarjumaad u dhexeeya koromosom 8 iyo 21
- AML leh tarjumid ama rogid ku saabsan koromosoom 16
- AML leh tarjumaad u dhexeeya koromosoomyada 9 iyo 11
- APL (M3) oo ay weheliso tarjumaad u dhexeeya koromosoomyada 15 iyo 17
- AML leh tarjumaad u dhexeeya koromosoomyada 6 iyo 9
- AML leh tarjubaan ama soo noqoshada chromosome 3
- AML (megakaryoblastic) oo ay weheliso tarjumaad u dhexeeya koromosoomyada 1 iyo 22
AML leh isbeddellada la xiriirta myelodysplasia
AML la xiriirta kiimiko hore ama shucaac
AML oo aan si kale loo cayimin (AML) oo aan ku dhicin mid ka mid ah kooxaha kor ku xusan, sidaas darteedna waxaa loo cayimay waxyaabo badan oo la mid ah waxa loo sameeyey nidaamka FAB):
- AML leh kala-duwanaansho yar (M0)
- AML iyadoon korin (M1)
- AML leh korriin (M2)
- Cudurka 'myelomonocytic leukemia' (M4)
- Astaamaha lafdhabarta ah (M5)
- Cudurka 'viral leukemia' (M6)
- Cudurka 'leukemia' (Acute Megacaryoblastic Leukemia) (M7)
- Cudurka 'basophilic leukemia'
- Panmielosis xanuun leh fibrosis
Sambabada sambabada (oo loo yaqaan 'sarcoma granulocytic' ama 'chloroma')
Cudurka Myeloid ee la xariira Down syndrome
Iskudhin iyo biphenotypic acute leukemias :
Kuwani waa leukemias leh lymphocytic iyo sifooyinka mawduuca labadaba. Mararka qaarkood waxay ku magacawday DHAMAAN calaamadaha maaddada 'myeloid', AML leh calaamadaha lafdhaha, ama lakab-xummo daran.
Qeybta sare ee WHO waxaa laga soo qaatay Ururka Kansarka Maraykanka.
Ilaha:
Papaemmanuil E, Gerstung M, iyo al. Qoondaynta genomic iyo saadaalinta cudurka kansarka ee 'myeloid leukemia'. N Engl J Med . 2016; 374 (23): 2209-21.
Wellcome Trust Sayniska. Cudurka 'myeloid leukemia' ayaa ah ugu yaraan 11 cudur oo kala duwan. Laga heley June 2016.
Society Cancer Society. Sidee laysku gardarrada 'myeloid leukemia'? Laga heley June 2016.