Kodi khansa ya m'magazi ndi matenda achilendo omwe amayamba chifukwa cha mankhwala? Tiyeni tikambirane za Differentiation Syndrome!

Pamene inu kapena munthu amene mumamudziwa akulandira chithandizo cha matenda monga khansa ya m'magazi, mungakumane ndi zotsatirapo zosayembekezereka. Lero, tikambirana za kuphatikiza kwa zotsatirapo zazikulu zomwe zingachitike ndi mankhwala, makamaka omwe amaperekedwa pa mitundu iwiri ya khansa ya m'magazi. Madokotala amatcha izi Differentiation Syndrome . Chifukwa zimatha kukhala zoopsa kwambiri, madokotala nthawi zambiri amayamba kuchiza zizindikiro asanatsimikizire motsimikiza, zomwe zingachepetse chiopsezo cha zovuta zomwe zingawononge moyo.

Kodi Differentiation Syndrome ndi chiyani?

Mwachidule, Differentiation Syndrome ndi gulu la zotsatirapo zoopsa zomwe thupi limakhala nazo ku mankhwala ena omwe amagwiritsidwa ntchito pochiza mitundu iwiri ya khansa ya m'magazi, yomwe ndi Acute Promyelocytic Leukemia (APL) ndi Acute Myeloid Leukemia (AML) . Zili ngati maselo ena m'thupi lathu "amasokonezeka" ndi mankhwalawa ndikuyamba kutulutsa zinthu zambiri nthawi imodzi. Ichi ndi chomwe chimayambitsa chizindikiro chilichonse.

Tangoganizani kuti mnzanu wapezeka ndi APL ndipo wayamba kulandira chithandizo. Patangopita masiku ochepa, wayamba kutentha thupi, wavutika kupuma, ndipo watupa pang'ono. Pamenepo, madokotala akukayikira kuti iyi ndi Differentiation Syndrome.

Kodi Zosiyanasiyanazi ndi ziti?

Mankhwala osiyanitsa ndi mtundu wa mankhwala omwe madokotala amagwiritsa ntchito pochiza APL. APL ndi yovuta kwambiri kuposa mitundu ina ya AML ku mankhwala omwe amachititsa kuti maselo akhwime, kapena kusiyanitsa . Mankhwalawa amathandiza maselo a khansa (blast cell stage) kukhala maselo oyera athanzi komanso abwinobwino. Ichi ndichifukwa chake madokotala amagwiritsa ntchito mankhwala osiyanitsa awa m'malo mowapatsa mankhwala a chemotherapy mwachindunji.

Monga mankhwala ena a khansa, mankhwalawa amathandiza kuletsa kapena kuchepetsa kukula kwa maselo a khansa. Madokotala angagwiritse ntchito mankhwala osiyanitsa awa okha, pamodzi, kapena pamodzi ndi chemotherapy. Angathe kuchiza APL bwino. Komabe, anthu ena omwe ali ndi APL akhoza kukhala ndi zotsatirapo zoyipa kwambiri chifukwa cha mankhwalawa.

Ndi mankhwala ati omwe angayambitse Differentiation Syndrome?

Vutoli lingachitike chifukwa cha zinthu zosiyanasiyana zomwe zimaperekedwa ku APL. Zitsanzo zake ndi izi:

• All-trans-retinoic acid (ATRA) , iyi ndi mtundu wa vitamini A.
• Arsenic Trioxide (ATO) ndi mtundu wa arsenic.

Komanso, kwa anthu ena omwe ali ndi AML, madokotalaMankhwala oletsa Isocitrate Dehydrogenase (IDH) ndi gulu la mankhwala a chemotherapy omwe amagwiritsidwa ntchito. Mankhwala oletsa IDH awa (ivosidenib) ndi (enasidenib) angayambitsenso Differentiation Syndrome. Sikuti zokhazo, komanso mankhwala oletsa FLT3 (monga (midostaurin) , (gilteritinib) ) angayambitse vutoli.

Ndani angafunike zoletsa za IDH?

• Anthu omwe khansa yawo yabwereranso.
• Anthu omwe ali ndi khansa omwe ndi ovuta kuchiza.
• Anthu omwe ali ndi kusintha kwa majini (IDH1 kapena IDH2 mutation).
• Anthu omwe sangathe kupirira chithandizo chamankhwala chokhazikika cha chemotherapy.

Ndani amene ali ndi mwayi waukulu wopeza Differentiation Syndrome?

Anthu ambiri omwe ali ndi APL amakhala ndi kuchuluka kochepa kwa maselo oyera m'magazi (WBC) . Komabe, omwe ali ndi kuchuluka kwakukulu kwa maselo oyera m'magazi amakhala pachiwopsezo chachikulu chotenga matenda a Differentiation Syndrome. Pazochitika izi, madokotala nthawi zambiri amalemba mankhwala otchedwa Prednisone kapena Dexamethasone kuti achepetse chiopsezo cha matendawa.

Kodi Differentiation Syndrome ndi yofala bwanji?

Imeneyi ndi vuto losowa kwambiri. AML ndi mtundu wofala kwambiri wa khansa ya m'magazi mwa akuluakulu, ngakhale kuti ndi imodzi mwa khansa zonse. Ku United States, APL imapezeka mwa munthu m'modzi mwa anthu 250,000.

Kuchokera kwa iwo omwe ali ndi AML ndi APL:

• Pafupifupi 25% ya odwala a APL omwe adalandira mankhwala a ATRA ndi ATO ali ndi matenda a Differentiation Syndrome.
• Vutoli lanenedwa pakati pa 14% ndi 19% ya odwala a AML omwe amatenga zoletsa za IDH.

Kodi n’chiyani chimayambitsa matenda a Differentiation Syndrome amenewa?

Ofufuza sakudziwabe chifukwa chake anthu ena amayankha chithandizo cha APL motere. Kafukufuku woyambirira akusonyeza kuti mankhwala a khansa amachititsa maselo a leukemia kutulutsa mwadzidzidzi mankhwala ambiri a chitetezo chamthupi. Izi zimatchedwa cytokine release syndrome . Kutupa kosalamulirika kumeneku kumayambitsa zizindikiro zosiyanasiyana, kuyambira pang'ono mpaka zazikulu.

Kodi zizindikiro za Differentiation Syndrome ndi ziti?

Munthu amene ali ndi APL nthawi zambiri amayamba kukhala ndi zizindikiro za Differentiation Syndrome mkati mwa sabata imodzi kapena ziwiri atayamba kugwiritsa ntchito ATRA ndi/kapena Arsenic Trioxide. Komabe, ngati mukumwa mankhwala oletsa IDH a AML, zingatenge nthawi yayitali kuti zizindikiro ziwonekere.Zitha kutha (zizindikirozi zimatha kuonekera kuyambira tsiku limodzi mpaka miyezi isanu mpaka isanu ndi umodzi mutayamba kugwiritsa ntchito mankhwala).

Zizindikiro zomwe zimawonedwa kwambiri ndi izi:

• Chifuwa .
• Madzi ochulukirapo ozungulira mtima ndi mapapo anu (Pleural Effusion) .
• Kulephera kwa Impso .
• Kuthamanga kwa magazi pang'ono (Hypotension) .
• Mpweya wochepa m'magazi (Hypoxemia) .
• Kuvuta kupuma (Dyspnea) .
• Kutupa (kutupa) kwa manja, mapazi, ndi khosi.
• Malungo popanda chifukwa.
• Kulemera popanda chifukwa.

Chofunika: Ngati muli ndi chimodzi mwa zizindikiro izi, sizikutanthauza kuti muli ndi Differentiation Syndrome. Komabe, ndikofunikira kudziwitsa dokotala wanu nthawi yomweyo ngati muwona chimodzi mwa zizindikirozi.

Kodi mavuto omwe angakhalepo chifukwa cha Differentiation Syndrome ndi ati?

Vutoli nthawi zina lingayambitse mavuto aakulu kwambiri. Mwachitsanzo:

• Kulephera kwa Mtima .
• Kulephera kwa Impso .
• Kulephera kwa Mapapo .
• Kutuluka magazi m'mapapo (Pulmonary Hemorrhage) .
• Chibayo .
• Sepsis ( matenda oopsa omwe amafalikira m'thupi lonse).

Ngati mukukumana ndi zizindikiro izi, imbani dokotala wanu nthawi yomweyo . Ngati mukuvutika kupuma kapena kupweteka pachifuwa, imbani 911 (kapena nambala yanu yadzidzidzi yapafupi) nthawi yomweyo . Anthu omwe ali ndi APL nthawi zambiri amathandizidwa kuchipatala mpaka chiopsezo cha differentiation syndrome chitapita.

Kodi matenda a Differentiation Syndrome amapezedwa bwanji?

Zingakhale zovuta kupeza vutoli mwa munthu amene ali ndi APL, chifukwa pali matenda ena ambiri omwe angayambitse zizindikiro zofanana. Pa milandu yoopsa, madokotala angayambe kuchiza zizindikirozo akangoganiza kuti ali ndi Differentiation Syndrome, ngakhale asanatsimikizire kuti ndi yoyenera.

Dokotala wanu adzakulangizani mayeso angapo kuti atsimikizire vutoli ndikuchotsa matenda ena. Izi zingaphatikizepo:

• Kuchuluka kwa Magazi Onse (CBC) .
• X-ray ya pachifuwa .
• Echocardiogram (kuyesa komwe kumayesa momwe mtima umagwirira ntchito).
• Kujambula pachifuwa kwa CT scan .
• Bronchoscopy (kuyeza komwe kumagwiritsa ntchito kamera kuti ione mkati mwa mapapo).
• Mayeso ena a magazi (Kuyesa magazi).

Kodi pali mankhwala a Differentiation Syndrome?

Nthawi zambiri, anthu omwe ali ndi vuto la acute promyelocytic leukemia (APL) amatha kuchira kwathunthu ku differentiation syndrome ngati atalandira chithandizo mwachangu komanso moyenera . APL tsopano ndi matenda ochiritsika kwambiri. Choncho palibe choopa.

Kodi Differentiation Syndrome imachiritsidwa bwanji?

Madokotala nthawi zambiri amachiritsa zizindikiro za differentiation syndrome ndi mankhwala a corticosteroid kapena glucocorticoid , monga dexamethasone . Pa milandu yoopsa, dokotala wanu angakulangizeninso kuti musiye chithandizo cha khansa kwakanthawi mpaka zizindikiro zanu zitatha.

Anthu ambiri omwe ali ndi APL amalandira chithandizo kuchipatala mpaka chiopsezo cha differentiation syndrome chitachepa. Ngati muli kunja kwa chipatala ndipo mukukayikira kuti differentiation syndrome, madokotala anu angasankhe kukusungani m'chipatala usiku wonse kuti akuthandizeni kapena akuwoneni. Gulu lanu lachipatala lidzakuthandizani kutsimikizira kuti mwapezeka ndi matendawa ndikuchiza moyenera matenda aliwonse omwe akukuyambitsani zizindikiro.

Kodi ndingatani kuti ndichepetse chiopsezo changa chotenga matenda a Differentiation Syndrome?

Palibe chomwe mungachite kuti muchepetse chiopsezo chanu cha matendawa. Ngati mukumwa mankhwala a chemotherapy kapena mankhwala ena a khansa, uzani dokotala wanu nthawi yomweyo za zizindikiro zilizonse zomwe mukukumana nazo . Komanso, dziwani zizindikiro zomwe muyenera kuziyang'anira (monga tafotokozera pamwambapa) ndipo lankhulani ndi dokotala wanu ngati muli ndi nkhawa iliyonse. Ichi ndiye chinthu chofunikira kwambiri.

Kodi chiyembekezo cha Differentiation Syndrome ndi chiyani?

Chiyembekezo cha matenda a differentiation nthawi zambiri chimakhala chabwino kwa anthu ambiri. Nthawi zambiri, mutha kupitiriza kulandira chithandizo cha khansa, kaya panthawi ya chithandizo ndi ma steroids kapena mutatha. Gulu lanu lachipatala lidzakambirana nanu za njira zomwe mungasankhire chithandizo.

Kodi ndi liti pamene muyenera kupeza upangiri wa dokotala wa Differentiation Syndrome?

Ngati mukuona zizindikiro zilizonse za matenda a khansa pamene mukulandira chithandizo cha khansa, imbani dokotala nthawi yomweyo . Zingakhale zovuta kwa inu kapena dokotala wanu kudziwa ngati zizindikiro zanu zayamba chifukwa cha chithandizo cha khansa kapena chifukwa cha vuto lina. Kulandira chithandizo msanga kungathandize kuchepetsa zizindikiro ndikuchepetsa chiopsezo cha mavuto.

Chithandizo cha khansa chingakhale chovuta. Komabe, zingakhale zokhumudwitsa kudziwa kuti chithandizocho chili ndi zotsatirapo zake. Differentiation Syndrome ndi gulu la zochita zomwe zingawopseze moyo chifukwa cha mankhwala a khansa ya m'magazi. Komabe, imatha kuchiritsidwa ngati yapezeka ndikuchiritsidwa msanga . Chifukwa zizindikiro zimatha kuipiraipira mwachangu, madokotala angayambe kukuthandizani zotsatira zanu zisanatsimikizire kuti muli ndi Differentiation Syndrome. Chithandizo chamankhwala msanga chingathandize kuchepetsa zizindikiro zanu ndikukubwezeretsani panjira yochira.

Uthenga Wopita Nawo Kunyumba

• Matenda a Differentiation Syndrome ndi vuto lalikulu lomwe lingachitike chifukwa cha mankhwala ena omwe amaperekedwa kwa mitundu ya khansa yotchedwa APL ndi AML.
• Zizindikiro monga malungo, kupuma movutikira, komanso kutupa kwa thupi kungachitike.
• Ngati muwona zizindikiro izi, ndikofunikira kudziwitsa dokotala wanu nthawi yomweyo .
• Ngati matendawa atapezeka msanga ndikuchiritsidwa ndi mankhwala monga Dexamethasone, nthawi zambiri amatha kuchiritsidwa.
• Musachite mantha mukamva izi. Gulu lanu lachipatala lidzakuthandizani. Chofunika kwambiri ndikuwauza za kusintha kulikonse, zizindikiro zilizonse.

Matenda a Kusiyanitsa, khansa ya m'magazi, chithandizo cha khansa, zotsatira zake zoyipa, APL, AML, ATRA, zizindikiro