Koj puas tau hnov ​​txog tus mob qog ntshav loj no? (Acute Promyelocytic Leukemia - APL) Cia peb tham kom meej!

Koj puas tau muaj ib zaug koj xav tias koj nkees heev tam sim ntawd, muaj ob peb qhov mob, lossis muaj cov pos hniav los ntshav ntau zaus? Txawm hais tias peb tsis tau ua tib zoo saib xyuas cov no, qee zaum, lawv yuav yog cov cim qhia txog tus mob hnyav dua, xws li Acute Promyelocytic Leukemia (APL) . Yog li, tsis txhob txhawj, hnub no peb yuav tham txog tus mob qog ntshav no hu ua APL hauv txoj kev yooj yim thiab meej.

Kab mob leukemia promyelocytic loj heev (APL) yog dab tsi?

Hais yooj yim xwb, APL yog ib hom mob qog ntshav uas tsis tshua muaj . Nws yeej yog ib pawg loj ntawm cov kab mob leukemia hu ua Acute Myeloid Leukemia . Qhov chaw tseem ceeb uas peb lub cev tsim cov ntshav yog cov pob txha . Hauv cov pob txha no, vim muaj kev hloov pauv caj ces, uas yog, kev hloov pauv caj ces , cov qe ntshav dawb tsis zoo pib tsim. Cov qe ntshav tsis zoo no faib thiab loj hlob sai yam tsis muaj kev tswj hwm thiab kis mus thoob plaws hauv cov pob txha. Qee zaum cov kws kho mob hu qhov no ua APL leukemia, lossis M3-leukemia .

APL yog ib qho mob hnyav heev. Nws cov tsos mob tuaj yeem tshwm sim sai sai thiab hnyav zuj zus sai. Kev los ntshav ntau dhau yog ib qho tseem ceeb uas ua rau muaj kev pheej hmoo. Tab sis muaj xov xwm zoo! Nrog rau kev kho mob tshiab, suav nrog kev kho mob chemotherapy thiab cov tshuaj tshiab uas tsis yog chemotherapy, cov kws kho mob muaj peev xwm tswj tau APL thiab feem ntau kho nws kom zoo.

Kab mob no feem ntau tshwm sim li cas?

APL yeej yog ib yam kab mob tsis tshua muaj . Piv txwv li, nyob rau hauv lub tebchaws zoo li Tebchaws Meskas, tsuas muaj li ntawm 30,000 tus neeg raug kuaj pom tias muaj tus kab mob no txhua xyoo. Feem ntau, APL raug kuaj pom tias muaj rau cov neeg hnub nyoog 30 xyoo .

Cov tsos mob ntawm APL yog dab tsi?

Cov tsos mob ntawm APL tshwm sim thaum koj cov pob txha tsis tuaj yeem tsim cov qe ntshav liab , cov qe ntshav dawb, thiab cov platelets zoo li qub. Qhov kev txo qis ntawm tag nrho cov qe ntshav no hu ua pancytopenia . Thaum qhov no tshwm sim, koj tuaj yeem tsim cov tsos mob hnyav xws li anemia , teeb meem los ntshav vim yog cov ntshav txhaws , thiab mob ntau zaus.

Lwm cov tsos mob ntawm APL feem ntau yog:

• Xav tias nkees thiab qaug zog heev vim yog cov qe ntshav liab txo qis (piv txwv li, ntshav tsis txaus).
• Kev kis kab mob ntau zaus vim muaj cov qe ntshav dawb tsawg uas tawm tsam kab mob. Tej yam xws li kub taub hau thiab mob khaub thuas tuaj yeem tshwm sim ntau zaus.
• Vim tias koj lub cev lub cev ua haujlwm sai dua thiab lub zog los ntawm cov khoom noj raug hlawv sai,Kev poob phaus yam tsis tau npaj tseg.

Cov tsos mob ntawm kev los ntshav

Ib tug neeg uas muaj APL muaj cov platelets tsawg thiab cov yam ntxwv ua rau cov ntshav txhaws uas pab kom cov ntshav txhaws. Koj paub, cov platelets yog cov uas pab nres lossis txo cov ntshav ntws. Yog li, thaum cov no tsawg, qhov teeb meem pib.

Nov yog qee cov tsos mob ntawm kev los ntshav los ntawm APL:

• Kev los ntshav tuaj yeem tshwm sim nyob rau txhua qhov chaw hauv lub cev. Piv txwv li, cov pos hniav los ntshav , cov ntshav ntswg ntau zaus, thiab, rau cov poj niam, cov ntshav hli ntau heev .
• Ntshav sib sau ua ke hauv qab daim tawv nqaij thiab ua rau muaj kev mob ntawm ntau qhov chaw ntawm lub cev . Txawm tias yog qhov txiav me me los kuj tuaj yeem ua rau muaj kev mob loj.
• Qee zaum yuav muaj kev los ntshav hauv lub hlwb (intracranial hemorrhage) . Yog tias qhov no tshwm sim, koj yuav muaj teeb meem txav koj ob txhais ceg, mob taub hau hnyav, thiab tej zaum yuav muaj kev hloov pauv hauv koj qhov kev pom. Qhov no yog xwm txheej ceev!
• Yog tias koj cov quav dub los yog muaj cov ntshav ntws, nws yuav yog vim muaj kev los ntshav hauv lub cev zom zaub mov (kev los ntshav ntawm txoj hnyuv) .

Dab tsi ua rau APL?

Kab mob no yog tshwm sim los ntawm ob lub noob caj noob ces uas tswj kev tsim cov qe ntshav los ua ke los ua ib lub noob caj noob ces tsis zoo hu ua PML-RARa . Qhov tseem ceeb, qhov kev hloov pauv caj noob ces no tsis yog ib yam dab tsi uas koj tau txais los ntawm koj niam koj txiv . Nws tshwm sim yam tsis muaj laj thawj, txhais tau tias tsis muaj laj thawj, thaum koj tseem muaj sia nyob. Cov kws tshaj lij tseem tsis tau paub meej tias dab tsi ua rau muaj qhov kev hloov pauv caj noob ces no.

Qhov kev hloov pauv no ua rau cov qe ntshav dawb loj hlob tsis zoo, es tsis loj hlob zoo, thiab hloov chaw tsim cov qe ntshav dawb tsis tau loj hlob zoo (promyelocytes) . Cov qe ntshav tsis tau loj hlob no puv cov pob txha, ua rau muaj qhov chaw rau cov qe ntshav thiab cov ntshav platelets noj qab haus huv.

Cov teeb meem ntawm APL yog dab tsi?

APL yog ib qho mob uas txaus ntshai rau lub neej. Qhov no yog vim tias kev los ntshav ntau dhau uas tshwm sim tuaj yeem ua rau muaj kev phom sij sai. Yog tias koj tsis tuaj yeem tso tseg kev los ntshav txawm tias yog qhov txiav me me, yog tias koj muaj ntshav ntau hauv koj cov quav lossis zis thaum koj mus rau chav dej, lossis yog tias koj tsis tuaj yeem tso tseg kev los ntshav ntawm koj cov pos hniav, koj yuav tsum mus ntsib kws kho mob lossis mus rau chav kho mob ceev hauv tsev kho mob tam sim ntawd .

Nco ntsoov: Yog tias koj los ntshav uas tsis tuaj yeem tswj tau, tsis txhob quav ntsej txog nws. Kev kho mob sai yog qhov tseem ceeb.

Yuav kuaj mob APL li cas?

Feem ntau cov kws kho mob ua ntau yam kev kuaj mob los kuaj mob no.

• Kev suav cov ntshav tag nrho (CBC): APL ua rau cov qe ntshav dawb tsis zoo li qub. Kev kuaj CBC tuaj yeem saib cov qe ntshav sib txawv thiab cov platelets hauv koj cov ntshav.
• Kev Ntsuas Ntshav Peripheral:Hauv qhov no, cov ntshav yuav raug coj mus kuaj hauv qab lub tshuab kuaj mob me me. Tom qab ntawd, lawv saib seb puas muaj ntau cov granules me me hauv cov qe ntshav dawb uas tsis tau loj hlob (promyelocytes), lossis seb puas muaj cov khoom tshwj xeeb hu ua Auer rods . Cov no yog cov yam ntxwv ntawm APL.
• Kev Kuaj Mob Pob Txha: Hauv qhov kev kuaj no, yuav muab ib qho qauv me me ntawm koj cov pob txha thiab kuaj nws cov hlwb.
• Flow Cytometry: Hauv qhov kev kuaj no, cov kws kho mob nrhiav cov qauv ntawm cov protein tshwj xeeb rau ntawm qhov chaw ntawm cov hlwb tsis zoo. Cov qauv no tuaj yeem lees paub APL.
• Kev kuaj Polymerase Chain Reaction (PCR): Qhov kev kuaj no tuaj yeem ntes tau qhov muaj cov noob caj noob ces tsis zoo (PML-RARa) uas ua rau APL.
• Cytogenetics: Qhov no kuaj rau cov kev hloov pauv tshwj xeeb hauv cov chromosomes ntawm cov hlwb tsis zoo. Kev nrhiav cov kev hloov pauv no yog txoj hauv kev tseem ceeb los paub meej tias tus kab mob APL yog dab tsi.

Cov kws kho mob faib APL ua qhov muaj kev pheej hmoo tsawg lossis muaj kev pheej hmoo siab raws li koj cov qe ntshav dawb suav. Cov neeg uas muaj APL muaj kev pheej hmoo siab yuav muaj mob qog noj ntshav rov qab los yog rov qab mob dua .

Yuav kho tus kab mob APL li cas?

APL raug kho nrog kev sib xyaw ua ke ntawm cov neeg sawv cev sib txawv ntawm cov hlwb , tshuaj kho mob qog noj ntshav, thiab kev kho mob tsom mus rau ib qho. Qhov tseeb, txij li thaum pom cov kev kho mob no hauv xyoo 1980, tus kab mob no, uas yav dhau los xav tias yuav ua rau tuag taus, tam sim no tau dhau los ua tus kab mob kho tau. Qhov no yog ib qho kev ua tiav zoo heev!

Cov tshuaj sib txawv ntawm cov hlwb yog cov tshuaj uas tsis yog tshuaj kho mob uas pab cov qe ntshav dawb uas tsis zoo li qub, tsis tau loj hlob zoo li qub thiab loj hlob zoo li qub. Cov tshuaj uas tsis yog tshuaj kho mob no, uas teev hauv qab no, tau ua rau muaj kev zam txim thiab kho tau ntau dua 95%.

• All-trans-retinoic acid (ATRA) , los yog tretinoin (Vesanoid ®) - Qhov no yog ib hom vitamin A.
• Arsenic trioxide (ATO) - Qhov no yog ib hom arsenic.

Yog koj tus kws kho mob xav tias koj muaj APL, lawv yuav pib koj siv ATRA txawm tias ua ntej lwm cov kev kuaj mob lees paub tus kab mob. Qhov no yog vim tias kev pib kho mob thaum ntxov tuaj yeem txo qhov kev pheej hmoo ntawm kev los ntshav uas hem txoj sia.

Cov theem ntawm kev kho mob APL

Feem ntau kev kho mob ua peb theem: Kev pib kho, Kev sib sau ua ke, thiab Kev txij nkawm. Kev kho mob yuav txawv nyob ntawm qib kev pheej hmoo.

• Theem Pib (Kev Pib):Lub hom phiaj tseem ceeb ntawm theem no yog tua cov qe ntshav dawb kom txaus kom koj tus APL rov qab zoo . Kev rov qab zoo txhais tau tias koj tsis muaj tsos mob thiab tsis muaj tsos mob ntawm tus kab mob leukemia pom ntawm kev kuaj mob. Qhov no ua tiav los ntawm kev siv cov tshuaj uas tsis yog chemotherapy, chemotherapy, thiab kev kho mob tshwj xeeb. Thaum lub sijhawm no, koj yuav tsum nyob hauv tsev kho mob, feem ntau yog plaub txog rau lub lis piam.
• Theem Kev Sib Koom Ua Ke: Koj tus kws kho mob qog nqaij hlav kuj tseem yuav hu qhov no tias 'kev kho mob tom qab kev zam txim'. Kev kho mob no ua rau APL nyob hauv kev zam txim thiab txuas ntxiv tua cov hlwb leukemia uas tseem tshuav. Qhov no yog tib yam tshuaj uas tau siv rau theem pib. Kev kho mob no tuaj yeem kav ntev li yim lub hlis, nrog rau kev kho mob txhua ob lub hlis. Koj tuaj yeem muaj plaub lub lis piam ntawm kev kho mob ua raws li plaub lub lis piam so. Cov tshuaj no tuaj yeem muab ua tshuaj lossis ua kev kho mob intravenous (IV) .
• Theem kev kho mob tas mus li: Qhov no yog kev kho mob tas mus li, tab sis cov tshuaj raug muab rau ntawm qhov koob tshuaj qis dua li thaum pib thiab theem kev ruaj khov. Kev kho mob tas mus li no feem ntau yog muab rau li ib xyoos.

Koj tus kws kho mob qog nqaij hlav kuj tseem yuav muab kev kho mob txhawb nqa , xws li kev hloov ntshav, nrog rau kev kho mob no.

Cov teeb meem ntawm kev kho mob

Qhov teeb meem feem ntau thiab loj me ntsis, hu ua kev sib txawv ntawm cov kab mob . Qhov no yog ib pawg ntawm cov kev tsis haum tshuaj loj rau cov tshuaj APL. Cov kev tsis haum tshuaj no feem ntau tshwm sim hauv peb lub lis piam thawj zaug ntawm kev pib kho mob. Cov tsos mob tuaj yeem tsis hnyav lossis hnyav. Qee qhov ntawm lawv suav nrog:

• Hnoos.
• Muaj kua dej ntau ntxiv nyob ib puag ncig koj lub plawv thiab lub ntsws (pleural effusion) .
• Kev ua haujlwm tsis zoo ntawm lub raum .
• Ntshav siab qis (hypotension) .
• Cov pa oxygen hauv cov ntshav tsawg dua (hypoxemia) .
• Ua pa nyuaj (ua tsis taus pa) .
• O / o ntawm koj txhais tes, ceg, thiab caj dab.
• Kub taub hau uas los tsis muaj laj thawj.
• Qhov hnyav nce tsis muaj laj thawj.

Yog koj muaj tus mob sib txawv no, koj tus kws kho mob yuav tsum tsis txhob kho koj ib pliag. Lawv kuj tseem yuav siv lwm yam tshuaj, xws li hydroxyurea, los txo koj cov qe ntshav dawb.

Ib tug neeg uas muaj APL yuav xav tau dab tsi?

Feem ntau hais lus, qhov kev kwv yees ntawm tus kab mob yog qhov zoo.Txawm hais tias txhua tus neeg qhov teeb meem txawv, kev tshawb fawb tau qhia tias ntawm 90% thiab 95% ntawm cov neeg uas muaj APL mus rau hauv kev zam txim. Txawm li cas los xij, APL tuaj yeem rov qab los tom qab kev kho mob. Ntawm 5% thiab 10% ntawm cov neeg yuav muaj kev rov qab los, feem ntau hauv peb xyoos thawj zaug tom qab kev kho mob. Tom qab ntawd lawv yuav xav tau kev kho mob ntxiv lossis kev kho mob sib txawv.

Cov nqi ciaj sia

Vim tias APL yog ib yam kab mob tsis tshua muaj, qhov peb paub txog cov feem pua ​​​​​​ntawm kev ciaj sia yog los ntawm kev sim tshuaj uas muaj cov neeg mob APL uas muaj kev pheej hmoo tsawg thiab cov neeg mob APL uas muaj kev pheej hmoo siab.

Muaj ib qho kev tshuaj xyuas qhia tau tias 99% ntawm cov neeg mob APL uas muaj kev pheej hmoo tsawg tseem muaj sia nyob plaub xyoos tom qab kev kho mob. Lwm qhov kev tshuaj xyuas ntawm cov neeg mob APL uas muaj kev pheej hmoo siab qhia tau tias 86% tseem muaj sia nyob tsib xyoos tom qab kev kho mob. Cov no yog cov txiaj ntsig zoo tiag tiag!

Kuv yuav saib xyuas kuv tus kheej li cas?

Vim tias APL tuaj yeem rov tshwm sim dua, nws yog ib qho tseem ceeb heev uas koj mus ntsib koj tus kws kho mob raws sijhawm (kev teem caij ua raws li) .

Koj yuav tau mus kuaj mob txhua hli lossis ob hlis rau thawj xyoo tom qab kev kho mob. Tom qab thawj xyoo, koj yuav tsum mus ntsib koj tus kws kho mob txog txhua peb mus rau plaub lub hlis rau ob xyoos tom ntej. Kev kuaj xws li CBC, PCR, thiab kev kuaj pob txha yuav ua tau thaum mus ntsib no.

Kuv yuav tsum mus rau chav kho mob ceev thaum twg?

APL tuaj yeem rov tshwm sim tom qab kho mob, thiab cov tsos mob tuaj yeem hnyav zuj zus sai. Yog tias koj tau zoo los ntawm APL, mus rau chav kho mob ceev tam sim ntawd yog tias koj muaj ib qho ntawm cov hauv qab no:

• Yog tias koj los ntshav tsis tu ncua .
• Yog tias koj cia li o tuaj nrog mob hauv koj ob txhais ceg lossis lub plab qis .

Thaum kawg, ib zaj lus tseem ceeb

Kab mob leukemia promyelocytic (APL) yog ib hom mob qog ntshav tsawg tsawg uas yav dhau los suav tias yog ib yam kab mob uas ua rau tuag taus, tab sis tam sim no tau dhau los ua ib yam kab mob uas kho tau zoo vim muaj kev kho mob siab heev.

Txawm li cas los xij, qhov no tseem yog ib qho kab mob loj heev. Yog tias tsis kuaj pom thiab kho sai sai, nws tuaj yeem ua rau tuag taus . Yog li ntawd, yog tias koj muaj cov tsos mob zoo li ntshav tsis tuaj yeem tswj tau, tsis txhob tsis quav ntsej nws. Qhov tseem ceeb tshaj plaws yog nrhiav kev pab kho mob thiab kuaj mob sai li sai tau. Tsis txhob ntshai, ua siab loj, vim tias tam sim no muaj kev kho mob zoo rau qhov no!

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