What is leukemia? - Danilo Allegra and Dania Puggioni

Kaj je levkemija? - Danilo Allegra in Dania Puggioni

Translator: Nika Kotnik Reviewer: Matej Divjak

Despite advances in medicine,

Kljub napredku v medicini,

cancer remains one of the most frightening diagnoses patients can receive.

ostaja rak ena najbolj strašljivih diagnoz, ki jih lahko prejme pacient.

What makes it so difficult to cure is that it's not one illness,

Težko ga je ozdraviti, ker ni ena bolezen,

but a family of over 100 diseases occurring in different types of cells.

ampak družina več kot 100 bolezni, ki se pojavijo v različnih tipih celic.

And one type of cancer has the unfortunate distinction

In ena vrsta raka se pomembno razlikuje

of afflicting children more than any other type.

v tem, da prizadene otroke bolj kot katerakoli druga vrsta.

This is leukemia,

To je levkemija,

a cancer that begins in stem cells found in the bone marrow.

rak, ki se začne v izvornih celicah kostnega mozga.

A stem cell is a bit like an infant,

Izvorna celica je na nek način kot dojenček,

undeveloped but possessing great potential.

nerazvita, a z velikim potencialom.

Many stem cells specialize and become cells of organs,

Veliko izvornih celic se specializira, in postanejo celice organov,

like the liver, brain and heart.

kot so jetra, možgani in srce.

But in some tissues,

A v nekaterih tkivih,

they can continue to divide into new stem cells throughout development,

se lahko še naprej delijo v nove izvorne celice skozi razvoj

and into adulthood in order to frequently generate new cells

in v odraslost, da lahko nastajajo nove celice,

and keep up with the body's needs.

ki dohajajo potrebe telesa.

One example is the bone marrow,

En primer je kostni mozeg,

where stem cells differentiate into many types of blood cells.

kjer se izvorne celice diferencirajo v veliko različnih vrst krvnih celic.

That includes red blood cells,

To vključuje rdeče krvničke,

which carry oxygen from the lungs to all tissues,

ki prenašajo kisik od pljuč k tkivom,

platelets, which help stop bleeding by sticking to damaged blood vessels,

trombociti, ki pomagajo ustaviti krvavitev z lepljenjem na poškodovane žile,

and white blood cells,

in bele krvničke,

which patrol the body, destroying potentially harmful invaders.

ki varujejo telo z uničevanjem potencialno nevarnih vsiljivcev.

Every once in a while,

Vsake toliko časa,

something goes wrong during a stem cell's specialization process

gre pri procesu specializacije izvorne celice nekaj narobe

and harmful mutations occur in the cell's DNA.

in pride do škodljivih mutacij v celični DNA.

Cells with compromised DNA are supposed to self-destruct,

Celice s poškodovano DNA naj bi se samouničile,

but some damaged cells ignore this order,

a nekatere poškodovane celice ignorirajo ta ukaz,

replicating uncontrollably, even as they lose their original function.

se množijo nenadzorovano, tudi ko izgubijo svojo prvotno vlogo.

These are what we know as cancer cells.

Te so znane kot rakaste celice.

It is not yet clear why leukemia is the most common childhood cancer,

Ni še čisto jasno, zakaj je levkemija najbolj pogost otroški rak,

but one contributing factor may be

a eden izmed vzrokov je lahko,

that leukemias are often caused by just one or two DNA modifications,

da levkemije pogosto povzroča le ena ali dve DNK spremembi,

while most cancers require many of them,

medtem ko jih večina rakov zahteva več,

allowing leukemias to arise faster than other types of cancer.

kar dovoli levkemijam, da nastanejo hitreje kot druge vrst rakov.

Moreover, some DNA alterations can occur in white blood cells

Nekatere DNK spremembe lahko nastanejo v belih krvničkah

during fetal development,

med fetalnim razvojem,

further increasing the risk of early leukemia.

kar še bolj poveča tveganje zgodnje levkemije.

But though it affects more children than any other cancer,

A čeprav prizadene več otrok kot katerakoli druga vrsta raka,

adults constitute the majority of leukemia patients overall.

odrasli predstavljajo večino pacientov z levkemijo.

Once leukemia strikes, the damaged cells reproduce in the blood and the bone marrow

Ko levkemija udari, se poškodovane celice množijo v krvi in kostnem mozgu,

until they take up all available space and resources.

dokler ne zavzamejo vsega razpoložljivega prostora in virov.

When the bone marrow can no longer produce

Ko kostni mozeg ne more več proizvajati

the required amount of functional cells,

potrebne količine delujočih celic,

the blood becomes depleted.

kri postane pomanjkljiva.

The lack of red blood cells

Pomanjkanje rdečih krvničk pomeni, da mišice ne dobijo dovolj kisika,

means that muscles don't get enough oxygen,

the reduced number of platelets is not sufficient to repair wounds,

zmanjšano število trombocitov ni zadosti za popravilo rane

and the dearth of functional white blood cells impairs the immune system,

in pomanjkanje funkcionalnih belih krvničk poškoduje imunski sistem,

increasing the risk of infections.

kar poveča tveganje za infekcije.

To restore the normal function of the blood,

Da bi obnovili normalno funkcijo krvi,

leukemic cells have to be eliminated.

je treba odstraniti levkemične celice.

But because leukemias are not solid tumors,

Zato ker levkemije niso solidni tumorji,

they can't be removed surgically.

jih ne moremo odstraniti kirurško.

Instead, the cells are killed inside the body using various treatments

Namesto tega, celice ubijemo znotraj telesa z različnimi zdravljenji,

that include chemotherapy,

med katerimi je tudi kemoterapija,

a combination of drugs that destroys quickly multiplying cells.

kombinacija zdravil, ki uničuje hitro množeče se celice.

Unfortunately, this has the side effect of killing healthy cells,

Na žalost ima to stranski učinek ubijanja zdravih celic,

such as those found in hair follicles or intestines.

kot so tiste v lasnih foliklih ali črevesju.

And in some cases, the dosage required is so high

In v nekaterih primerih so potrebni odmerki tako veliki,

that it kills all cells in the bone marrow,

da ubijejo vse celice v kostnem mozgu,

including stem cells.

tudi izvorne celice.

When this happens, the body is no longer able to create new blood cells on its own.

Ko se to zgodi, telo ne more več samo proizvajati novih krvnih celic.

Fortunately, outside help can come in the form of stem cells

Na srečo, lahko pride pomoč od zunaj v obliki izvornih celic

from the bone marrow of a donor.

iz kostnega mozga darovalca.

Once transplanted into the patient,

Ko so enkrat presajene v pacienta,

they rapidly repopulate the bone marrow and the blood.

se hitro namnožijo v kostnem mozgu in v krvi.

However, bone marrow transplants are a complicated process

A presaditev kostnega mozga je zapleten proces,

requiring antigen compatibility between the donor and recipient

ki zahteva ujemanje antigenov med darovalcem in prejemnikom,

to keep the transplanted cells from from attacking the patient's own cells

da presajene celice ne bi napadle pacientovih lastnih celic

as foreign bodies.

kot tuja telesa.

Unlike with blood transplants,

Za razliko od transfuzij krvi,

there are thousands of HLA types,

je tu na tisoče HLA tipov

and even siblings and close relatives may not have compatible bone marrow.

in celo bratje in sestre ter sorodniki morda nimajo ujemajočega kostnega mozga.

If this is the case, the search is expanded to a database

V tem primeru se iskanje razširi na bazo podatkov,

containing the genetic makeup of millions of voluntary bone marrow donors.

ki vsebuje genetske strukture milijone prostovoljnih darovalcev kostnega mozga.

The more potential donors there are,

Več kot je potencialnih darovalcev,

the more patients lives can be saved through successful transplants.

več pacientov lahko rešimo z uspešno presaditvijo.

Leukemia may be a frightening disease, but there is strength and hope in numbers.

Levkemija je morda strašljiva bolezen, a tu je moč in upanje v množini.