Kodi mwamvapo za khansa yaikulu ya magazi iyi? (Acute Promyelocytic Leukemia - APL) Tiyeni tikambirane mwatsatanetsatane!

Kodi munayamba mwatopa mwadzidzidzi, mwakhala ndi mabala angapo, kapena mwakhala mukutuluka magazi m'kamwa pafupipafupi? Ngakhale kuti sitisamala kwambiri ndi zinthuzi, nthawi zina, zingakhale zizindikiro za matenda aakulu kwambiri, monga Acute Promyelocytic Leukemia (APL) . Chifukwa chake, musadandaule, lero tikambirana za khansa ya m'magazi yotchedwa APL momveka bwino komanso mosavuta.

Kodi khansa ya m'magazi ya promyelocytic (APL) ndi chiyani?

Mwachidule, APL ndi mtundu wosowa kwambiri wa khansa ya m'magazi . Ndi ya gulu lalikulu la khansa ya m'magazi yotchedwa Acute Myeloid Leukemia . Malo akuluakulu omwe magazi amapangidwa m'thupi lathu ndi mafupa . Pano m'mafupa awa, chifukwa cha kusintha kwa majini, ndiko kuti, kusintha kwa majini , maselo oyera amagazi osazolowereka amayamba kupangidwa. Maselo osazolowereka awa amagawikana ndikuchulukana mosalamulirika, kufalikira m'mafupa onse. Nthawi zina madokotala amatcha khansa ya m'magazi ya APL, kapena M3-leukemia .

Matenda a APL ndi matenda oopsa kwambiri. Zizindikiro zake zimatha kubwera mwadzidzidzi ndikuipiraipira mofulumira. Kutuluka magazi ambiri ndi chinthu chachikulu chomwe chimayambitsa chiopsezo. Koma pali nkhani yabwino! Ndi mankhwala atsopano, kuphatikizapo mankhwala a chemotherapy ndi mankhwala atsopano osagwiritsa ntchito mankhwala a chemotherapy, madokotala amatha kuwongolera APL ndipo nthawi zambiri amachira kwathunthu.

Kodi matendawa ndi ofala bwanji?

Matenda a APL ndi matenda osowa kwambiri. Mwachitsanzo, m'dziko ngati United States, anthu pafupifupi 30,000 okha ndi omwe amapezeka ndi matendawa chaka chilichonse. Nthawi zambiri, matenda a APL amapezeka mwa anthu azaka za m'ma 30 .

Kodi zizindikiro za APL ndi ziti?

Zizindikiro za APL zimachitika pamene mafupa anu akulephera kupanga maselo ofiira a magazi abwinobwino, maselo oyera a magazi, ndi ma platelet mwachibadwa. Kuchepa kumeneku kwa mitundu yonse ya maselo a magazi kumatchedwa pancytopenia . Izi zikachitika, mutha kukhala ndi zizindikiro zazikulu monga kuchepa kwa magazi m'thupi , mavuto otuluka magazi chifukwa cha magazi kuundana , komanso matenda obwerezabwereza.

Zizindikiro zina zodziwika bwino za APL ndi izi:

• Kumva kutopa kwambiri komanso kutopa chifukwa cha kuchepa kwa maselo ofiira a magazi (monga kuchepa kwa magazi m'thupi).
• Matenda obwera chifukwa cha kuchepa kwa maselo oyera m'magazi omwe amalimbana ndi matenda. Zinthu monga malungo ndi chimfine zimatha kuchitika pafupipafupi.
• Chifukwa kagayidwe ka thupi m'thupi lanu kamafulumira ndipo mphamvu yochokera ku chakudya imatenthedwa mwachangu,Kuchepetsa thupi mosadziwa.

Zizindikiro za kutuluka magazi

Munthu amene ali ndi APL amakhala ndi ma platelet ochepa komanso zinthu zotsekereza magazi zomwe zimathandiza kuti magazi aziundana. Mukudziwa, ma platelet ndi omwe amathandiza kuletsa kapena kuchepetsa kutuluka kwa magazi. Choncho, izi zikachepa, vuto limayamba.

Nazi zizindikiro zina za kutuluka magazi chifukwa cha APL:

• Kutuluka magazi m'thupi kungachitike kulikonse m'thupi. Mwachitsanzo, kutuluka magazi m'kamwa , kutuluka magazi m'mphuno pafupipafupi, ndipo mwa akazi, kutuluka magazi ambiri m'mimba .
• Magazi amasonkhana pansi pa khungu ndipo amachititsa mabala m'malo osiyanasiyana pathupi . Ngakhale mabala ang'onoang'ono angayambitse mabala akulu.
• Nthawi zina kutuluka magazi m'magazi kungachitike mkati mwa ubongo (intracranial hemorrhage) . Ngati izi zitachitika, mungakhale ndi vuto losuntha miyendo yanu, mutu wanu umapweteka kwambiri, komanso masomphenya anu amatha kusintha. Izi ndi zadzidzidzi!
• Ngati ndowe yanu ndi yakuda kapena ili ndi mikwingwirima yamagazi, ikhoza kukhala chifukwa cha kutuluka magazi m'mimba (kutuluka magazi m'mimba) .

Kodi chimayambitsa APL ndi chiyani?

Matendawa amayamba chifukwa cha majini awiri omwe amalamulira kupanga maselo athu amagazi pamodzi kuti apange jini yosadziwika bwino yotchedwa PML-RARa . Chofunika kwambiri, kusintha kwa majini kumeneku si chinthu chomwe mumalandira kuchokera kwa makolo anu . Kumachitika mwangozi, popanda chifukwa, nthawi yonse ya moyo wanu. Akatswiri sakudziwabe chomwe chimayambitsa kusintha kwa majini kumeneku.

Kusintha kumeneku kumapangitsa maselo oyera a m'magazi kukula mopanda mphamvu, m'malo mokula bwino, ndipo m'malo mwake amapanga maselo oyera a m'magazi osakhwima (promyelocytes) . Maselo osakhwima awa amadzaza mafuta a m'mafupa, zomwe zimapangitsa kuti pakhale maselo athanzi a m'magazi ndi ma platelet.

Kodi mavuto a APL ndi otani?

APL ndi vuto lomwe lingayambitse imfa. Izi zili choncho chifukwa kutuluka magazi ambiri kumatha kukhala koopsa mwachangu. Ngati simungathe kuletsa kutuluka magazi ngakhale pang'ono, ngati muli ndi magazi ambiri m'chimbudzi chanu kapena mkodzo mukapita kuchimbudzi, kapena ngati simungathe kuletsa kutuluka magazi m'kamwa mwanu, muyenera kuonana ndi dokotala kapena kupita kuchipatala nthawi yomweyo .

Kumbukirani: Ngati muli ndi magazi osalamulirika, musanyalanyaze. Chithandizo chachangu ndichofunika kwambiri.

Kodi matenda a APL amapezedwa bwanji?

Madokotala nthawi zambiri amachita mayeso angapo kuti adziwe matendawa.

• Kuchuluka kwa Magazi Okwanira (CBC): APL imayambitsa maselo oyera a magazi osazolowereka. Kuyeza kwa CBC kungayang'ane mitundu yosiyanasiyana ya maselo a magazi ndi kuchuluka kwa ma platelet mu chitsanzo cha magazi anu.
• Kupaka Magazi Pambali:Mu izi, chitsanzo cha magazi chimatengedwa ndikuyang'aniridwa pogwiritsa ntchito maikulosikopu. Kenako, amafufuza ngati pali tinthu tating'onoting'ono tambiri mkati mwa maselo oyera amagazi osakhwima (ma promyelocytes), kapena ngati pali zinthu zapadera zotchedwa Auer rods . Izi ndi zomwe zimachitika mu APL.
• Kufufuza za Mafupa a M'mafupa: Mu mayesowa, chitsanzo chaching'ono cha mafupa anu chimatengedwa ndipo maselo ake amawunikidwa.
• Flow Cytometry: Mu mayeso awa, akatswiri a matenda amafufuza mapangidwe a mapuloteni enaake pamwamba pa maselo osazolowereka. Mapangidwe awa amatha kutsimikizira APL.
• Mayeso a Polymerase Chain Reaction (PCR): Mayesowa amatha kuzindikira molondola kupezeka kwa jini yosadziwika bwino (PML-RARa) yomwe imayambitsa APL.
• Cytogenetics: Izi zimayesa kusintha kwa ma chromosome a maselo osazolowereka. Kupeza kusintha kumeneku ndiyo njira yayikulu yotsimikizira kupezeka kwa APL.

Madokotala amaika APL ngati chiopsezo chochepa kapena chiopsezo chachikulu kutengera kuchuluka kwa maselo oyera m'magazi mwanu. Anthu omwe ali ndi APL pachiwopsezo chachikulu amakhala ndi chiopsezo chachikulu chokhala ndi khansa yobwerezabwereza kapena kubwereranso .

Kodi APL imachiritsidwa bwanji?

APL imachiritsidwa ndi mankhwala osiyanasiyana , chemotherapy, ndi chithandizo cholunjika . Ndipotu, kuyambira pomwe mankhwala awa adapezeka m'zaka za m'ma 1980, matendawa, omwe kale ankaganiziridwa kuti ndi oopsa, tsopano akhala matenda ochiritsika. Ichi ndi chinthu chabwino kwambiri!

Mankhwala osiyanitsa maselo ndi mankhwala osagwiritsa ntchito chemotherapy omwe amathandiza maselo oyera osakhwima, osakhwima kukhala maselo oyera abwinobwino komanso okhwima. Mankhwala osagwiritsa ntchito chemotherapy awa, omwe atchulidwa pansipa, apangitsa kuti maselowo achepe komanso achire ndi oposa 95%.

• All-trans-retinoic acid (ATRA) , kapena tretinoin (Vesanoid ®) – Iyi ndi mtundu wa vitamini A.
• Arsenic trioxide (ATO) - Iyi ndi mtundu wa arsenic.

Ngati dokotala wanu akukayikira kuti muli ndi APL, angayambe kumwa ATRA ngakhale mayeso ena asanatsimikizire matendawa. Izi zili choncho chifukwa kuyamba chithandizo msanga kungachepetse chiopsezo cha kutuluka magazi omwe angawononge moyo wanu.

Magawo a chithandizo cha APL

Chithandizo nthawi zambiri chimachitika m'magawo atatu: Kuyambitsa, Kuphatikiza, ndi Kusamalira. Chithandizo chingasiyane kutengera kuchuluka kwa chiopsezo.

• Gawo Loyamba (Kuyambitsa):Cholinga chachikulu cha gawoli ndikupha maselo okwanira a leukemia kuti APL yanu ichotsedwe . Kuchotsa kumatanthauza kuti mulibe zizindikiro ndipo palibe zizindikiro za leukemia zomwe zingapezeke pa mayeso. Izi zimachitika pogwiritsa ntchito mankhwala osagwiritsa ntchito chemotherapy, chemotherapy, ndi mankhwala ochizira. Panthawiyi, muyenera kukhala m'chipatala, nthawi zambiri kwa milungu inayi mpaka isanu ndi umodzi.
• Gawo lophatikizana: Dokotala wanu wa khansa angatchulenso kuti 'chithandizo cha pambuyo pa kukhululukidwa'. Chithandizochi chimasunga APL m'chiyembekezo ndipo chimapitiriza kupha maselo ena onse a khansa ya m'magazi. Ichi ndi mankhwala omwewo omwe adagwiritsidwa ntchito mu gawo loyamba. Chithandizochi chingatenge miyezi pafupifupi isanu ndi itatu, ndi chithandizo miyezi iwiri iliyonse. Mutha kukhala ndi milungu inayi ya chithandizo kenako ndi milungu inayi yopuma. Mankhwalawa angaperekedwe ngati piritsi kapena ngati chithandizo cha mtsempha (IV) .
• Gawo losamalira: Uwu ndi chithandizo chopitilira, koma mankhwala amaperekedwa pa mlingo wocheperako kuposa magawo oyamba ndi okhazikika. Chithandizo chosamalira ichi nthawi zambiri chimaperekedwa kwa pafupifupi chaka chimodzi.

Dokotala wanu wa khansa angaperekenso chithandizo chothandizira , monga kuikidwa magazi, pamodzi ndi chithandizochi.

Mavuto a chithandizo

Vuto lofala kwambiri, komanso lalikulu pang'ono, limatchedwa differentiation syndrome . Ili ndi gulu la zotsatirapo zoopsa ku mankhwala a APL. Zotsatirazi nthawi zambiri zimachitika mkati mwa milungu itatu yoyambirira kuyambira pomwe chithandizo chinayamba. Zizindikiro zimatha kukhala zochepa kapena zazikulu. Zina mwa izo ndi izi:

• Chifuwa.
• Madzi ochulukirapo ozungulira mtima ndi mapapo anu (pleural effusion) .
• Kulephera kwa impso .
• Kuthamanga kwa magazi pang'ono (hypotension) .
• Kuchepa kwa mpweya m'magazi (hypoxemia) .
• Kuvuta kupuma (kupuma movutikira) .
• Kutupa/ kutupa kwa manja, miyendo, ndi khosi.
• Malungo omwe amabwera popanda chifukwa.
• Kulemera popanda chifukwa.

Ngati mutakhala ndi vuto losiyanitsa mitundu iyi ya maselo, dokotala wanu angasiye chithandizo chanu kwa kanthawi. Angagwiritsenso ntchito mankhwala ena, monga hydroxyurea, kuti achepetse kuchuluka kwa maselo oyera m'magazi anu.

Kodi munthu amene ali ndi APL angayembekezere chiyani?

Kawirikawiri, zizindikiro za matendawa zimakhala zabwino.Ngakhale kuti vuto la aliyense ndi losiyana, kafukufuku wasonyeza kuti pakati pa 90% ndi 95% ya anthu omwe ali ndi APL amachira msanga. Komabe, APL imatha kubwereranso pambuyo pa chithandizo. Pakati pa 5% ndi 10% ya anthu amabwereranso, nthawi zambiri mkati mwa zaka zitatu zoyambirira pambuyo pa chithandizo. Kenako amafunikira chithandizo china kapena chosiyana.

Ziwerengero za kupulumuka

Popeza APL ndi matenda osowa, zomwe tikudziwa zokhudza kuchuluka kwa anthu omwe amapulumuka zimachokera ku mayeso azachipatala okhudza odwala APL omwe ali pachiwopsezo chochepa komanso omwe ali pachiwopsezo chachikulu.

Kusanthula kwina kukuwonetsa kuti 99% ya odwala APL omwe ali pachiwopsezo chochepa amakhala ndi moyo zaka zinayi atalandira chithandizo. Kusanthula kwina kwa odwala APL omwe ali pachiwopsezo chachikulu kukuwonetsa kuti 86% ali ndi moyo zaka zisanu atalandira chithandizo. Izi ndi zotsatira zabwino kwambiri!

Kodi ndimadzisamalira bwanji?

Popeza APL ikhoza kubwereranso, ndikofunikira kwambiri kuti mukaonane ndi dokotala wanu nthawi yake (nthawi yokumana ndi dokotala wotsatira) .

Mudzapimidwa kuchipatala mwezi uliwonse kapena miyezi iwiri iliyonse chaka choyamba mutalandira chithandizo. Chaka choyamba chitatha, muyenera kuonana ndi dokotala wanu pafupifupi miyezi itatu kapena inayi iliyonse kwa zaka ziwiri zotsatira. Mayeso monga CBC, PCR, ndi bonemorrow biopsy angachitike pa maulendo awa.

Kodi ndiyenera kupita ku chipinda chadzidzidzi liti?

APL ikhoza kubwereranso mukalandira chithandizo, ndipo zizindikiro zake zimatha kukulirakulira mofulumira. Ngati muli ndi mpumulo chifukwa cha APL, pitani kuchipatala mwamsanga ngati mukukumana ndi zotsatirazi:

• Ngati mukutuluka magazi mosalamulirika .
• Ngati mwadzidzidzi muyamba kutupa ndi kupweteka miyendo kapena m'mimba .

Pomaliza, uthenga wofunika

Acute promyelocytic leukemia (APL) ndi khansa ya m'magazi yosowa kwambiri yomwe kale inkaonedwa ngati matenda oopsa, koma tsopano yakhala matenda ochiritsika chifukwa cha mankhwala apamwamba.

Komabe, uwu ukadali matenda oopsa. Ngati sunazindikiridwe ndi kuchiritsidwa mwachangu, ukhoza kukhala pachiwopsezo cha moyo . Chifukwa chake, ngati muli ndi zizindikiro monga kutuluka magazi mosalamulirika, musazinyalanyaze. Chofunika kwambiri ndikupempha upangiri wa dokotala ndikupeza matenda mwachangu momwe mungathere. Musachite mantha, khalani olimba mtima, chifukwa tsopano pali mankhwala abwino a izi!

Khansa ya m'magazi , APL, Khansa ya m'magazi, Khansa ya m'magazi, Bone Morrow, Anemia, ATRA, Chemotherapy, Acute Promyelocytic Leukemia, M3-Leukemia, PML-RARa, Kutuluka magazi