Koj tus me nyuam puas nkees tas li, muaj daim tawv nqaij xiav, lossis kub taub hau tas li? Qee zaum cov no tsuas yog cov tsos mob ib txwm muaj xwb. Tab sis qee zaum, cov me nyuam no tuaj yeem yog ib qho cim qhia txog ib qho mob hnyav hauv lub cev. Hnub no peb yuav tham txog ib hom mob qog ntshav uas feem ntau tshwm sim ntawm cov menyuam yaus, tab sis kuj tuaj yeem cuam tshuam rau cov neeg laus. Nws lub npe yog Acute Lymphoblastic Leukemia, lossis (ALL) luv luv. Tsis txhob txhawj, peb yuav tham txog txhua yam hauv cov lus yooj yim.
Hais yooj yim xwb, ALL txhais li cas?
Kab mob qog ntshav Lymphoblastic Leukemia (ALL) yog ib hom mob qog ntshav uas tshwm sim hauv peb cov ntshav. Peb cov ntshav muaj cov qe ntshav liab, cov qe ntshav dawb, thiab cov platelets. Ib hom qe ntshav dawb hu ua lymphocytes. Ib yam li peb lub teb chaws cov tub rog, cov qe ntshav no tiv thaiv peb los ntawm kev tawm tsam cov kab mob thiab cov kab mob uas nkag mus rau hauv peb lub cev.
Cov qe ntshav dawb no yog tsim tawm hauv cov pob txha hauv peb cov pob txha. Qee zaum, vim muaj kev hloov pauv caj ces hauv cov qe ntshav dawb no, lawv pib ua cov qe ntshav dawb es tsis yog cov qe ntshav dawb noj qab nyob zoo. Cov qe ntshav dawb no faib thiab loj hlob sai sai yam tsis muaj kev tswj hwm, ua rau cov qe ntshav dawb tsis muaj zog. Qhov no tsuas yog hu ua ALL.
Cov qog nqaij hlav no tsis yog nyob hauv cov pob txha xwb. Lawv tuaj yeem mus ncig hauv cov ntshav thiab kis mus rau thoob plaws lub cev.
Tiamsis qhov tseem ceeb tshaj plaws yog TXHUA, txawm hais tias yog ib qho mob hnyav, yog ib qho mob uas kho tau tag nrho nrog kev kho mob kom zoo. Tus nqi kho tau zoo heev, tshwj xeeb tshaj yog rau cov menyuam yaus.
Cov hom tseem ceeb ntawm ALL yog dab tsi?
Thaum peb tham txog cov lymphocytes, muaj ob hom tseem ceeb ntawm lawv: B cell thiab T cell. TXHUA yam mob qog noj ntshav tshwm sim los ntawm ob hom cell no.
| Hom mob qog noj ntshav | Piav qhia yooj yim |
|---|---|
| B-cell TXHUA (B-cell TXHUA) | Qhov no yog hom mob uas feem ntau muaj. Nws suav txog li 85% ntawm ALL hauv cov menyuam yaus thiab 75%-80% ntawm ALL hauv cov neeg laus. Cov qe ntshav B yog hom qe ntshav uas tsim cov tshuaj tiv thaiv kab mob hauv peb lub cev. |
| T-cell TXHUA (T-cell TXHUA) | Qhov no tsis tshua muaj. Kwv yees li 25% ntawm cov neeg laus thiab 12% -15% ntawm cov menyuam yaus muaj hom kab mob no. Cov qe ntshav T yog hom qe ntshav uas tua cov kab mob thiab pab lwm cov qe ntshav hauv lub cev tiv thaiv kab mob. |
Ntxiv rau ob hom no, kuj tseem muaj ib hom kab mob uas tsis tshua muaj hu ua Natural Killer ALL. Koj tus kws kho mob yuav ua cov kev kuaj mob tsim nyog kom paub tseeb tias koj lossis koj tus menyuam muaj hom kab mob twg.
Peb pom cov tsos mob li cas?
Thaum ALL tshwm sim, cov qe ntshav dawb hauv lub cev yuav tsis muaj zog lawm, ua rau muaj ntau yam tsos mob. Cov tsos mob no tuaj yeem tshwm sim sai sai lossis maj mam tshwm sim.
Tseem Ceeb: Muaj cov tsos mob no tsis tau txhais hais tias koj muaj TXHUA YAM. Txawm li cas los xij, yog tias koj muaj cov tsos mob no ntau tshaj ob lub lis piam, nws yog ib qho tseem ceeb uas yuav tsum mus ntsib kws kho mob kom tau txais kev qhia.
| Cov tsos mob | Qhov ntawd txhais li cas? |
|---|---|
| Kev qaug zog thiab ntsej muag daj ntseg tas li | Vim yog cov qe ntshav liab hauv lub cev txo qis (anemia), txawm tias ua tej haujlwm me me los kuj ua rau nkees, thiab lub cev yuav zoo li dawb paug. |
| Mob ntau zaus | Thaum cov qe ntshav dawb noj qab haus huv txo qis, lub cev lub peev xwm los tawm tsam kab mob (kev tiv thaiv kab mob) txo qis. Yog li ntawd, cov kab mob xws li kub taub hau thiab mob khaub thuas tuaj yeem tshwm sim ntau zaus. |
| Kev ntshav thiab mob nqaij | Vim tias cov platelets uas pab kom cov ntshav txhaws tsawg zuj zus, qhov ntswg los ntshav, cov pos hniav los ntshav, thiab txawm tias raug mob me me kuj tuaj yeem ua rau muaj cov pob xiav loj ntawm lub cev. Cov poj niam yuav los ntshav ntau thaum lub sijhawm muaj hli. |
| Cov pob liab ntawm daim tawv nqaij (petechiae) | Cov pob me me liab tshwm sim rau ntawm daim tawv nqaij zoo li raug ib tug koob chob, vim yog los ntshav los ntawm cov hlab ntsha me me hauv qab daim tawv nqaij. |
| Mob pob txha thiab pob qij txha | Thaum cov qe ntshav qog noj ntshav puv cov pob txha, qhov mob hnyav tuaj yeem tshwm sim rau hauv cov pob txha thiab cov pob qij txha. |
| Cov qog ntshav o | Cov pob (nodules) nyob rau hauv cov chaw xws li caj dab, qhov tso, thiab qhov ncauj tsev menyuam tuaj yeem o tuaj yam tsis mob. |
| Lwm yam nta | Kuj tseem yuav pom cov tsos mob xws li tsis xav noj mov, poob phaus, tawm hws hmo ntuj, thiab ua pa nyuaj. |
Vim li cas tus kab mob no thiaj tshwm sim? Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi?
Tsis muaj ib qho ua rau mob qog noj ntshav TAG NRHO. Qhov ua rau tseem ceeb, raws li peb tau tham ua ntej, yog kev hloov pauv ntawm cov noob caj noob ces uas tshwm sim thaum lub sijhawm tsim cov qe ntshav. Rau cov menyuam yaus, cov kev hloov pauv no yuav tshwm sim ua ntej lawv yug los.
Txawm li cas los xij, muaj ntau yam uas tau txheeb xyuas tias ua rau muaj kev pheej hmoo ntawm kev mob no.
- Hnub nyoog: Qhov kev pheej hmoo siab tshaj plaws ntawm cov menyuam yaus hnub nyoog qis dua 15 xyoos, tshwj xeeb tshaj yog cov neeg hnub nyoog ntawm 2-5 xyoos, thiab cov neeg laus hnub nyoog tshaj 50 xyoo.
- Qee yam kab mob caj ces: Cov neeg uas muaj qee yam kab mob caj ces, xws li Down syndrome, muaj feem yuav mob ALL ntau dua me ntsis.
- Kev raug hluav taws xob: Kev raug hluav taws xob ntau heev, piv txwv li, yog tias koj tau kho hluav taws xob rau lwm yam mob qog noj ntshav yav dhau los, yuav ua rau koj muaj kev pheej hmoo ntau ntxiv.
- Qee cov kab mob: Qee cov kab mob viral, xws li tus kab mob Epstein-Barr, kuj ntseeg tias yuav ua rau muaj kev pheej hmoo ntxiv.
- Kev siv luam yeeb: Ntawm cov neeg laus, kev raug cov carcinogens xws li kev siv luam yeeb kuj tseem yuav yog ib qho tseem ceeb.
Tus kws kho mob yuav kuaj mob no li cas kom meej?
Thaum koj mus ntsib kws kho mob uas muaj cov tsos mob uas koj tau hais los saum toj no, nws yuav xub nug koj txog koj cov tsos mob kom meej. Tom qab ntawd nws yuav kuaj koj lub cev thiab xaj ntau zaus kom paub tseeb tias koj muaj mob.
- Kev kuaj ntshav:Kev kuaj ntshav tag nrho (FBC) niaj hnub tuaj yeem nrhiav pom qhov txawv txav ntawm tus lej ntawm cov qe ntshav hauv cov ntshav.
- Kev kuaj mob pob txha: Qhov no yog qhov kev kuaj tseem ceeb uas siv los xyuas kom meej tias muaj mob. Yuav muab ib qho qauv me me ntawm cov pob txha los ntawm ib qho chaw xws li pob txha ntawm lub duav thiab siv tshuaj loog los kuaj hauv lub tshuab microscope. Qhov no tuaj yeem txiav txim siab seb puas muaj cov hlwb qog nqaij hlav thiab, yog tias muaj, hom twg.
- Kev kuaj duab: Kev luam theej duab CT thiab PET scans yuav ua tau los saib seb tus mob qog noj ntshav puas tau kis mus rau lwm qhov ntawm lub cev, piv txwv li, mus rau hauv lub hauv siab.
- Kev tho qhov txha nraub qaum/Kev tho qhov nraub qaum: Yog tias muaj kev tsis ntseeg tias cov qog nqaij hlav tau kis mus rau lub hlwb lossis cov hlab ntsha hauv qab, yuav muab me me ntawm cov kua hauv qab ntawm tus txha nraub qaum thiab kuaj.
Cov kev kho mob rau ALL yog dab tsi?
Muaj ntau txoj kev kho mob rau ALL. Koj tus kws kho mob yuav txiav txim siab txoj kev kho mob zoo tshaj plaws rau koj raws li ntau yam, suav nrog koj lub hnub nyoog, hom kab mob, thiab cov cim qhia txog caj ces hauv koj cov hlwb qog noj ntshav.
Kev kho mob tseem ceeb: Kev kho mob qog noj ntshav
Kev kho mob qog noj ntshav yog ib yam tshuaj muaj zog uas tua cov hlwb qog noj ntshav. Nws yog kev kho mob tseem ceeb rau TXHUA TUS. Kev kho mob no muaj ntau theem, kav ntev li ob peb lub hlis mus txog ob txog peb xyoos.
| Cov theem kho mob | Muaj dab tsi tshwm sim? |
|---|---|
| 1. Theem pib (Kev ua kom rov zoo siab) | Qhov no yuav siv sijhawm li 4-6 lub lis piam. Lub hom phiaj tseem ceeb yog rhuav tshem cov hlwb qog noj ntshav kom ntau li ntau tau sai li sai tau. Thaum lub sijhawm no, koj yuav tsum tau nyob hauv tsev kho mob ntau zaus. |
| 2. Kev kho mob ntawm lub paj hlwb (CNS-directed therapy) | Kev kho mob no yog muab los tiv thaiv cov qog nqaij hlav kom tsis txhob kis mus rau lub hlwb thiab tus txha caj qaum, lossis kom rhuav tshem lawv yog tias lawv tau kis mus. Qhov no feem ntau ua tiav rau theem thawj zaug. |
| 3. Theem kev sib koom ua ke | Tom qab tus kab mob zoo lawm, theem no yuav pib rhuav tshem cov hlwb qog nqaij hlav uas tseem tshuav. Koj yuav raug pw hauv tsev kho mob ob peb hnub txhua ob peb lub lis piam rau ob peb lub hlis thiab yuav tau txais cov tshuaj txhaj rau hauv cov hlab ntsha (IV). |
| 4. Theem txij nkawm | Qhov no yog theem kawg thiab ntev tshaj plaws. Nws siv sijhawm li 2-3 xyoos. Lub hom phiaj ntawm no yog los tiv thaiv tus kab mob kom tsis txhob rov qab los. Feem ntau, cov tshuaj noj thiab cov tshuaj txhaj rau hauv cov hlab ntsha raug muab rau ntawm lub tsev kho mob. Tsis tas yuav mus rau tsev kho mob ntau zaus. |
Lwm yam kev kho mob
- Kev kho mob rau lub hom phiaj: Qhov no suav nrog kev muab cov tshuaj uas tawm tsam cov kev hloov pauv tshwj xeeb uas pom tsuas yog nyob rau hauv cov hlwb qog noj ntshav. Piv txwv li, kev kho mob no muaj txiaj ntsig zoo rau cov neeg uas muaj kev hloov pauv caj ces hu ua Philadelphia chromosome.
- Kev Kho Mob Tiv Thaiv Kab Mob: Qhov no suav nrog kev txhawb nqa peb lub cev tiv thaiv kab mob kom rhuav tshem cov hlwb qog noj ntshav. Kev kho mob CAR-T cell yog ib txoj kev kho mob niaj hnub uas poob rau hauv pawg no.
- Kev Kho Mob Hluav Taws Xob: Kev kho mob hluav taws xob yuav siv tau rau hauv cov rooj plaub uas mob qog noj ntshav tsis teb rau kev kho mob chemotherapy lossis thaum tus kab mob rov qab los.
- Kev hloov pob txha: Yog tias lwm yam kev kho mob tsis ua tiav lossis muaj kev pheej hmoo ntawm kev rov qab los ntawm tus kab mob siab heev, koj yuav raug xa mus rau kev hloov pob txha los ntawm ib tus neeg noj qab haus huv.
Muaj feem yuav kho tau tus kab mob no li cas?
Qhov no yog lo lus nug loj tshaj plaws uas txhua tus neeg xav txog. TXHUA yog ib hom mob qog noj ntshav uas teb tau zoo heev rau kev kho mob.
Rau cov menyuam yaus, cov txiaj ntsig zoo heev. 98% ntawm cov menyuam yaus uas tau txais kev kho mob zoo tau zoo tag nrho. Tus nqi ciaj sia tom qab 5 xyoos tom qab tus kab mob kho tau zoo yog siab txog 90%.
Feem pua no qis dua me ntsis ntawm cov neeg laus. Tus nqi ciaj sia nyob 5 xyoos rau cov neeg laus yog ntawm 30% - 40%.
Tiam sis nws yog ib qho tseem ceeb uas yuav tsum nkag siab tias cov no tsuas yog cov ntaub ntawv suav xwb. Txoj kev uas ib tug neeg teb rau kev kho mob tuaj yeem txawv ntawm lwm tus. Yog li ntawd, tsis txhob ntshai cov lej no. Tsuas yog tus kws kho mob uas kho koj thiaj li muab tau cov ntaub ntawv zoo tshaj plaws txog koj lossis koj tus menyuam tus mob.
Nws yog ib qho ib txwm muaj uas koj yuav xav tias koj lub neej yuav tawg thaum koj raug kuaj pom tias muaj mob qog noj ntshav. Tshwj xeeb tshaj yog tias nws yog koj tus menyuam. Tab sis nco ntsoov, TXHUA yam yog ib yam kab mob uas kho tau zoo dua li ntau hom mob qog noj ntshav. Ntseeg koj pab neeg kho mob. Lawv yuav nrog koj nyob hauv txoj kev no, muab txhua yam kev txhawb nqa thiab kev piav qhia uas koj xav tau.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob qog ntshav Acute Lymphoblastic Leukemia (ALL) yog ib yam mob qog ntshav uas tshwm sim hauv cov lymphocytes, ib hom qe ntshav dawb.
- Txawm hais tias tus kab mob no feem ntau tshwm sim ntawm cov menyuam yaus, nws tuaj yeem tshwm sim rau txhua tus neeg txawm tias muaj hnub nyoog li cas los xij.
- Yog tias koj muaj cov tsos mob xws li qaug zog tas li, ntsej muag dawb paug, mob ntau zaus, lub cev xiav, thiab mob pob txha ntev tshaj ob lub lis piam, nrhiav kev pab kho mob tam sim ntawd.
- Txawm hais tias ALL yog ib yam kab mob loj heev los, nws kho tau tag nrho los ntawm kev siv tshuaj kho mob xws li chemotherapy. Feem pua ntawm kev kho mob yog siab heev, tshwj xeeb tshaj yog rau cov menyuam yaus.
- Cov txheej txheem kho mob yuav siv sijhawm ntev thiab nkees, tab sis tsis txhob ntshai nws, ntseeg koj cov kws kho mob, thiab ua raws li lawv cov lus qhia kom meej.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus