Cia peb kawm txog tus kab mob leukemia uas tsis tshua muaj uas tshwm sim hauv cov ntshav? (Large Granular Lymphocytic Leukemia - LGL)

Koj puas tau hnov ​​txog ib hom kab mob leukemia txawv txawv, tab sis tsis tshua muaj uas tshwm sim hauv cov ntshav? Tej zaum koj tau hnov ​​txog ib tug phooj ywg uas muaj nws. Los yog tej zaum koj nyuam qhuav hnov ​​txog nws thiab xav paub txog nws. Hnub no peb yuav tham txog ib hom kab mob leukemia uas tsis tshua muaj, tab sis tseem ceeb heev. Nws hu ua Large Granular Lymphocytic Leukemia (LGL). Lub npe yuav zoo li ntev me ntsis, tab sis cia peb ua kom yooj yim.

LGL txhais li cas tiag?

Hais yooj yim xwb, LGL yog ib hom kab mob leukemia uas loj hlob qeeb hauv lub cev, mob ntev (txhais tau tias nws kav ntev). Nws cuam tshuam rau ib hom qe ntshav dawb tshwj xeeb hauv peb cov ntshav. Peb hu cov qe no ua lymphocytes . Koj puas paub tias lymphocytes yog cov feem tseem ceeb ntawm peb lub cev tiv thaiv kab mob. Lawv zoo li cov tub rog hauv peb pab tub rog. Lawv yog cov uas tawm tsam cov kab mob xws li cov kab mob uas nkag mus rau hauv peb lub cev, thiab lawv yog cov uas tsim cov tshuaj tiv thaiv kab mob uas tiv thaiv peb ntawm cov kab mob.

Yog li, hauv LGL, qhov tshwm sim yog tias cov hlwb lymphocyte no, tshwj xeeb tshaj yog ob hom hlwb hu ua Cytotoxic T cells lossis Natural Killer cells (NK cells), hloov pauv tsis zoo li qub rau qee qhov laj thawj thiab pib faib thiab nce ntxiv yam tsis tuaj yeem tswj tau. Cov hlwb tsis zoo no hu ua LGL cells.

Tus mob no, hu ua LGL, feem ntau loj hlob qeeb heev. Yog vim li ntawd nws thiaj hu ua mob leukemia ntev. Nws feem ntau tshwm sim rau cov neeg hnub nyoog tshaj 60 xyoo. Cov kws kho mob tuaj yeem kho LGL. Tab sis qee zaum tus mob tuaj yeem rov qab los, thiab nws tuaj yeem yog teeb meem kev noj qab haus huv mus sij hawm ntev.

Muaj ob hom LGL tseem ceeb:

Muaj ob hom mob LGL no tau txheeb xyuas lawm. Lawv yog:

1. T-cell large granular lymphocytic leukemia (T-LGL)

2. Kev mob qog ntshav ntawm cov qe ntshav NK (CLPD-NK)

Hauv ob qho tib si, raws li tau hais ua ntej lawm, qhov tshwm sim yog tias cov qe ntshav T lossis cov qe ntshav NK dhau los ua qhov tsis zoo.

Qhov xwm txheej no cuam tshuam li cas rau peb lub cev?

Tej zaum koj yuav xav paub tias tus kab mob hu ua LGL no muaj feem cuam tshuam li cas rau peb lub cev. Zoo, vim qhov no yog ib hom Chronic Lymphocytic Leukemia, cov qe ntshav LGL uas tsis zoo no mus rau hauv cov pob txha thiab cuam tshuam rau kev tsim cov qe ntshav ib txwm muaj. Nws zoo li ib tsob nroj phem tuaj thiab noj ib tsob nroj zoo.

Qhov no tuaj yeem ua rau muaj ob qho teeb meem tseem ceeb:

• Neutropenia : Qhov no yog qhov txo qis ntawm cov granulocytes hauv peb lub cev.Kev txo qis ntawm cov qe ntshav dawb (granulocytes) (hom qe ntshav dawb uas feem ntau pom). Thaum cov qe ntshav dawb no txo ​​qis, peb lub cev lub peev xwm los tawm tsam kab mob, lossis kev tiv thaiv kab mob, txo qis. Qhov no ua rau muaj kev pheej hmoo ntawm kev kis kab mob ntau zaus.
• Kab mob ntshav tsis txaus : Tej zaum koj twb tau hnov ​​txog qhov no lawm. Kab mob ntshav tsis txaus yog thaum lub cev poob cov qe ntshav liab uas noj qab nyob zoo. Qhov mob no tuaj yeem tshwm sim vim tias cov qe ntshav LGL kuj cuam tshuam rau kev tsim cov qe ntshav liab. Thaum muaj kab mob ntshav tsis txaus, koj yuav xav tias nkees thiab nkees heev.

Leej twg yuav muaj feem kis tau tus kab mob no tshaj?

LGL yog ib yam kab mob tsis tshua muaj . Yog koj saib thoob plaws ntiaj teb, tus mob no tsuas muaj li ib ntawm ib lab tus neeg xwb. Qhov ntawd txhais tau tias nyob rau hauv lub tebchaws zoo li Sri Lanka, cov neeg mob no yuav muaj tsawg heev. Feem ntau, thaum kuaj pom tus kab mob no, cov neeg mob muaj hnub nyoog 60 xyoo.

Cov tsos mob yog dab tsi? Peb nkag siab qhov no li cas?

Nov yog qhov xav tsis thoob me ntsis. Ib txhia neeg uas muaj LGL tuaj yeem nyob tau ntau xyoo yam tsis muaj tsos mob . Ib txoj kev tshawb fawb pom tias kwv yees li ib feem peb ntawm cov neeg uas muaj LGL tsis muaj tsos mob li thaum lawv raug kuaj pom. Lawv tsuas pom tias lawv muaj nws thaum kev kuaj ntshav rau lwm qhov laj thawj qhia tias muaj cov qe ntshav liab tsawg lossis cov qe ntshav dawb hu ua neutrophils tsawg.

Txawm li cas los xij, muaj qee cov cim qhia uas cov neeg uas muaj cov tsos mob yuav pom:

• Qaug zog thiab nkees heev : Qhov no yog cov tsos mob feem ntau ntawm LGL. Feem ntau, qhov no yog vim muaj cov ntshav tsis txaus uas tau hais los saum toj no.
• Kub taub hau ntau zaus thiab rov qab muaj kab mob : Cov kab mob bacterial tuaj yeem ua rau kub taub hau. Qhov no yog vim lub cev tiv thaiv kab mob tsis muaj zog.
• Splenomegaly: Qhov no yog qhov loj ntawm lub po, uas yog ib lub cev hauv peb lub cev. Qhov no tuaj yeem tshwm sim los ntawm kev kis kab mob thiab qee hom ntshav tsis txaus.

Nco ntsoov tias, tsuas yog muaj cov tsos mob no xwb tsis tau txhais hais tias koj muaj LGL. Lawv kuj tuaj yeem yog cov tsos mob ntawm ntau lwm yam kab mob. Yog li, yog tias koj tab tom ntsib ib yam dab tsi zoo li no, nws yog qhov zoo tshaj plaws mus ntsib kws kho mob kom tau txais kev qhia.

Puas muaj lwm yam mob uas cuam tshuam nrog LGL?

Yog lawm, ntau tus neeg uas muaj LGL tau pom tias muaj lwm yam kab mob autoimmune . Uas yog, cov mob uas peb lub cev tiv thaiv kab mob tawm tsam peb cov hlwb noj qab haus huv. Ntawm cov no, mob rheumatoid arthritis yog qhov feem ntau.

Tsis tas li ntawd xwb, muaj ntau yam mob uas yuav cuam tshuam nrog LGL:

• Kab mob ntshav tsis txaus : Peb tau tham txog qhov no ua ntej lawm. Ib txhia neeg muaj kab mob ntshav tsis txaus hnyav thiab xav tau kev hloov ntshav kom tswj tau lawv cov qe ntshav liab. Ib txhia neeg uas muaj LGLIb hom mob ntshav tsis txaus hu ua hemolytic anemia kuj tuaj yeem tshwm sim. Hauv qhov no, es tsis txhob txo cov qe ntshav liab tsim tawm, cov qe ntshav liab uas twb muaj lawm raug rhuav tshem.
• Lymphocytosis : Qhov no yog kev nce ntxiv ntawm cov qe ntshav dawb hu ua lymphocytes hauv cov ntshav. Qhov kev nce ntxiv ntawm cov lymphocytes no feem ntau pom muaj nyob rau hauv cov neeg uas muaj lymphocytic leukemias, lymphomas, lossis kev kis kab mob viral.

Qhov ua rau LGL muaj tseeb yog dab tsi?

Qhov no yog ib yam dab tsi uas cov kws kho mob tseem tsis tau nkag siab tag nrho. Tseem tsis tau paub meej tias yog vim li cas LGL thiaj ua rau muaj. Txawm li cas los xij, lawv ntseeg tias muaj kev sib txuas ntawm tus mob leukemia no thiab kev ua haujlwm ntawm peb lub cev tiv thaiv kab mob, cov kab mob autoimmune, thiab lwm yam mob qog noj ntshav.

• Kwv yees li ntawm 30% ntawm cov neeg uas muaj LGL muaj lwm yam kab mob autoimmune, xws li mob caj dab rheumatoid.
• Lwm 25% txog 30% tej zaum yuav muaj lwm hom lymphoma lossis lwm hom mob qog noj ntshav.
• Tsis tas li ntawd xwb, ntau tus neeg uas muaj LGL muaj kev hloov pauv hauv lawv cov noob caj noob ces. Tshwj xeeb, muaj kev hloov pauv hauv ob lub noob caj noob ces hu ua STAT3 thiab STAT5B . Ob lub noob caj noob ces no ua lub luag haujlwm tseem ceeb hauv kev tiv thaiv kab mob ntawm cov hlwb thiab txoj kev uas cov hlwb faib thiab loj hlob.

Cov kws kho mob kuaj mob li cas?

Cov kws kho mob feem ntau siv cov kev kuaj ntshav thiab kev tshuaj ntsuam caj ces los kuaj mob LGL. Nov yog qee qhov kev kuaj uas feem ntau ua:

• Kev suav cov ntshav tag nrho (CBC) nrog rau qhov sib txawv : Qhov no suav txhua hom qe ntshav hauv koj cov ntshav, tshwj xeeb tshaj yog pes tsawg hom qe ntshav dawb uas koj muaj.
• Kev kuaj ntshav ntawm cov hlab ntsha sab nraud : Qhov no suav nrog kev saib cov qauv ntshav hauv qab lub tshuab tsom iav thiab suav cov lej ntawm cov hlwb LGL hauv cov ntshav.
• Kev ntsuas cov kab mob ntshav ntws (Flow cytometry ): Qhov no yog kev kuaj hauv chav kuaj uas siv los tshuaj xyuas cov yam ntxwv ntawm cov hlwb. Kev kuaj no feem ntau siv los txheeb xyuas thiab faib cov hom kab mob leukemia.
• Kev kuaj mob immunophenotyping : Qhov no suav nrog kev coj cov ntshav lossis cov qauv nqaij thiab kuaj xyuas lawv rau cov cim tshwj xeeb ntawm qhov chaw ntawm cov cell. Cov cim no tuaj yeem siv los txheeb xyuas qee hom kab mob.
• Kev tshuaj xyuas kev hloov pauv ntawm cov noob caj noob ces ntawm T-cell receptor (TCR) : Qhov no siv cov ntshav lossis cov pob txha thiab nrhiav seb puas muaj teeb meem nrog cov noob caj noob ces uas tswj cov noob caj noob ces ntawm T-cell ua haujlwm li cas.
• Kev kuaj noob caj noob ces : Koj tuaj yeem kuaj xyuas seb puas muaj kev hloov pauv hauv cov noob STAT3 thiab STAT5B uas tau hais ua ntej.

Ntxiv rau cov kev ntsuam xyuas no, kev tiv thaiv kab mob tsis zooTej kev kuaj mob lwm yam, xws li kev kuaj pob txha, yuav ua tau los txiav txim seb puas muaj lwm yam mob xws li kev tiv thaiv kab mob tsis zoo, mob rheumatoid arthritis, myelodysplasia , thiab myeloid mutations . Tej zaum yuav kuaj xyuas cov theem immunoglobulin thiab cov theem monoclonal protein .

Yuav kho LGL li cas?

Xav hais tias koj muaj T-LGL lossis CLPD-NK leukemia, tab sis koj tsis muaj tsos mob dab tsi li . Yog li ntawd, koj tus kws kho mob yuav pom zoo kom siv txoj kev hu ua "watchful waiting." Qhov no suav nrog kev saib xyuas koj txoj kev noj qab haus huv tas li. Feem ntau, koj yuav kuaj ntshav txhua ob peb lub hlis kom pom tias cov tsos mob puas tshwm sim.

Rau cov neeg uas muaj cov tsos mob, kev kho mob tiv thaiv kab mob thiab tshuaj steroids yuav muab tau. Cov kws kho mob yuav pib ib qho kev kho mob tom qab lwm qhov, lossis lawv yuav pib kho mob qis qis. Vim tias LGL yog ib yam kab mob tsis tshua muaj, feem ntau cov neeg nrhiav tus kws kho mob uas tshwj xeeb hauv cov kab mob no.

Peb puas tsis tuaj yeem txo qhov tshwm sim ntawm tus kab mob no?

Tu siab kawg li, peb ua tsis tau li ntawd. Cov kws kho mob tseem tsis tau paub meej tias yog vim li cas thiaj ua rau muaj qhov teeb meem no. Yog li ntawd, nws nyuaj rau hais tias yuav tiv thaiv nws li cas. Txawm li cas los xij, tau pom tias cov neeg uas muaj cov kab mob autoimmune muaj feem yuav mob no ntau dua. Yog li ntawd, yog tias koj muaj ib qho ntawm cov kab mob autoimmune no, nws yog ib lub tswv yim zoo los nug koj tus kws kho mob yog tias koj yuav tsum txhawj xeeb txog LGL.

LGL puas yog ib yam kab mob uas ua rau tuag taus?

Feem ntau, LGL yog ib yam kab mob ntev, tsis yog kev tuag tam sim ntawd . Kwv yees li 75% ntawm cov neeg uas muaj T-LGL leukemia thiab CLPD-LGL leukemia muaj sia nyob tsib xyoos tom qab kuaj pom. Txawm li cas los xij, kwv yees li 10% ntawm cov neeg uas muaj cov hom leukemia no tuag los ntawm cov kab mob loj uas tuaj yeem tshwm sim ua ib qho teeb meem ntawm leukemia. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum tiv thaiv koj tus kheej ntawm cov kab mob.

Kuv yuav saib xyuas kuv tus kheej li cas? Kuv yuav ua li cas nrog tus mob no?

Yog koj muaj LGL, tej zaum koj yuav tsis muaj tsos mob dab tsi li. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum saib xyuas koj txoj kev noj qab haus huv tag nrho, suav nrog kev mus kuaj mob tsis tu ncua . Txawm koj muaj tsos mob lossis tsis muaj, cov lus qhia no yuav pab tau:

• Noj zaub mov zoo : Noj ntau cov nqaij ntshiv, ntses, txiv hmab txiv ntoo, zaub, thiab cov nplej tag nrho.
• Kev tawm dag zog tsis tu ncua : Xaiv ib qho kev tawm dag zog uas zoo thiab haum rau koj.
• Pw tsaug zog zoo : Kev so kom txaus yog qhov tseem ceeb heev.
• Tswj kev ntxhov siab.Ua tej yam uas ua rau koj zoo siab, xav, ua yoga.
• Tiv thaiv koj lub cev tiv thaiv kab mob : Nug koj tus kws kho mob txog kev txhaj tshuaj tiv thaiv kab mob thiab lwm yam uas koj ua tau los tiv thaiv kev kis kab mob. Txawm tias tej yam yooj yim xws li ntxuav koj txhais tes nrog xab npum thiab nyob deb ntawm cov chaw muaj neeg coob coob kuj tuaj yeem pab tau.

Puas ua tau kom nyob tau lub neej li qub nrog tus mob no?

Feem ntau, cov neeg uas tau kho mob LGL feem ntau ua neej nyob li qub . Lawv tuaj yeem ua neej nyob ntev npaum li ib tus neeg uas tsis muaj mob. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qee tus neeg uas muaj LGL tej zaum yuav muaj cov kab mob ntshav loj uas cuam tshuam rau lawv lub neej zoo.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj muaj cov tsos mob uas qhia tias koj tus mob yuav hnyav zuj zus, koj yuav tsum mus ntsib koj tus kws kho mob. Yog tias koj twb tau txais kev kho mob rau cov tsos mob lawm, koj yuav tsum qhia rau koj tus kws kho mob txog txhua yam kev hloov pauv uas koj pom hauv koj lub cev (piv txwv li, cov tsos mob zuj zus tuaj).

Cov lus nug tseem ceeb uas yuav nug tus kws kho mob yog dab tsi?

Vim LGL yog ib yam kab mob uas tsis tshua muaj, nws yog ib qho ib txwm muaj ntau cov lus nug txog nws. Nov yog qee cov lus nug uas peb vam tias yuav pab koj kawm ntxiv txog LGL:

• Kuv muaj hom LGL twg?
• Cov kev kho mob rau qhov no yog dab tsi?
• Kuv puas yuav tsum tau ntau tshaj ib qho kev kho mob?
• Kuv xav tias zoo heev tam sim no. Kuv puas yuav muaj cov tsos mob?
• Kuv muaj lwm yam mob. LGL puas yuav ua rau lawv mob hnyav dua?

Tsis txhob ntshai nug cov lus nug zoo li no. Koj tus kws kho mob yeej npaj txhij pab koj. Lawv cog lus tias yuav piav qhia txhua yam rau koj kom koj nkag siab.

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Kab mob leukemia lymphocytic loj (LGL) yog ib hom mob qog ntshav uas tsis tshua muaj thiab cuam tshuam rau koj cov qe ntshav dawb. Txawm tias koj muaj tus mob no los xij, koj yuav tsis pom muaj kev hloov pauv hauv koj lub cev uas yuav yog cov tsos mob ntawm LGL. Qee zaum, cov tsos mob yuav tsis tshwm sim rau ntau xyoo.

Cov kws kho mob tsis tuaj yeem kho qhov mob no kom zoo tag nrho. Txawm li cas los xij, muaj kev kho mob uas tuaj yeem pab tswj nws cov tsos mob. Nws yog ib qho ib txwm muaj uas yuav xav tsis thoob thiab ntshai thaum koj hnov ​​​​​​tias koj muaj tus kab mob uas kho tsis tau . Koj cov kws kho mob yuav nkag siab tias vim li cas koj thiaj xav li ntawd.

Lawv yuav zoo siab piav qhia rau koj txog yam koj ua tau los saib xyuas koj txoj kev noj qab haus huv tam sim no, thiab yam koj yuav tsum xav txog yog tias muaj cov tsos mob tshwm sim. Kev paub txog yam koj yuav tsum xav txog yav tom ntej yuav ua rau koj muaj kev ntseeg siab thiab lub zog los nyob nrog LGL. Yog li, tham nrog koj tus kws kho mob txog txhua lo lus nug uas koj muaj. Nrhiav kev qhia. Qhov ntawd yog qhov zoo tshaj plaws uas koj ua tau thaum lub sijhawm zoo li no.

`Kab mob ntshav dawb LGL, mob qog ntshav hauv cov ntshav, cov qe ntshav dawb, cov qe ntshav dawb lymphocytes, cov qe ntshav dawb tsis muaj zog (neutropenia), cov ntshav tsis txaus (anemia), lub cev tiv thaiv kab mob