Tiyeni tiphunzire za khansa ya m'magazi yomwe imapezeka m'magazi? (Large Granular Lymphocytic Leukemia - LGL)

Kodi munamvapo za mtundu wachilendo, koma wosowa kwambiri wa khansa ya m'magazi womwe umayamba m'magazi? Mwina munamvapo za mnzanu amene ali ndi khansa imeneyi. Kapena mwina mwangomvapo za khansayo ndipo munadabwa nayo. Lero tikambirana za khansa imodzi yosowa kwambiri, koma yofunika kwambiri. Imatchedwa Large Granular Lymphocytic Leukemia (LGL). Dzinali lingamveke lalitali pang'ono, koma tiyeni tiisunge mosavuta.

Kodi LGL imatanthauza chiyani kwenikweni?

Mwachidule, LGL ndi mtundu wa khansa ya m'magazi yomwe imakula pang'onopang'ono m'thupi, yosatha (kutanthauza kuti imatenga nthawi yayitali). Imakhudza mtundu wapadera wa maselo oyera m'magazi mwathu. Timatcha maselo awa kuti ma lymphocyte . Kodi mukudziwa kuti ma lymphocyte ndi mbali zofunika kwambiri za chitetezo chathu chamthupi. Ali ngati asilikali m'gulu lathu lankhondo. Ndiwo omwe amalimbana ndi majeremusi ngati mavairasi omwe amalowa m'thupi mwathu, ndipo ndi omwe amapanga ma antibodies omwe amatiteteza ku matenda.

Kotero, mu LGL, chomwe chimachitika ndichakuti maselo otchedwa lymphocyte, makamaka mitundu iwiri ya maselo otchedwa Cytotoxic T cells kapena Natural Killer cells (NK cells), amasintha mosazolowereka pazifukwa zina ndipo amayamba kugawikana ndikuchulukana mosalamulirika. Maselo osazolowereka awa amatchedwa maselo a LGL.

Matendawa, otchedwa LGL, nthawi zambiri amakula pang'onopang'ono. Ndicho chifukwa chake amatchedwa khansa yosatha ya m'magazi. Amafala kwambiri mwa anthu azaka zopitirira 60. Madokotala amatha kuchiza matenda a LGL. Koma nthawi zina matendawa amatha kubwereranso, ndipo akhoza kukhala vuto la thanzi kwa nthawi yayitali.

Pali mitundu iwiri ikuluikulu ya LGL:

Mitundu iwiri ikuluikulu ya vuto la LGL yadziwika. Ndi iyi:

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

2. Matenda a lymphoproliferative osatha a maselo a NK (CLPD-NK)

M'zochitika zonsezi, monga tafotokozera kale, chomwe chimachitika ndichakuti maselo a T kapena maselo a NK amakhala osazolowereka.

Kodi vutoli limakhudza bwanji matupi athu?

Mwina mukudabwa kuti matendawa otchedwa LGL amakhudza bwanji matupi athu. Popeza uwu ndi mtundu wa Chronic Lymphocytic Leukemia, maselo osazolowereka a LGL amapita ku mafupa ndikusokoneza kupanga maselo abwinobwino a magazi kumeneko. Zili ngati chomera choipa chomwe chimabwera ndikutenga chomera chabwino.

Izi zingayambitse mavuto awiri akuluakulu:

• Neutropenia : Ichi ndi kuchepa kwa chiwerengero cha ma granulocytes m'thupi lathu.Kuchepa kwa chiwerengero cha maselo oyera a m'magazi (granulocytes) (mtundu wofala kwambiri wa maselo oyera a m'magazi). Maselo amenewa akachepa, mphamvu ya thupi lathu yolimbana ndi matenda, kapena chitetezo chamthupi, imachepa. Izi zimawonjezera chiopsezo cha matenda opatsirana pafupipafupi.
• Kuchepa kwa magazi m'thupi : Mwina munamvapo izi. Kuchepa kwa magazi m'thupi ndi pamene thupi limataya kuchuluka kwa maselo ofiira athanzi. Vutoli limatha kuchitika chifukwa maselo a LGL amakhudzanso kupanga maselo ofiira amagazi. Kuchepa kwa magazi m'thupi kukakula, mumamva kutopa komanso kutopa kwambiri.

Ndani amene ali ndi mwayi waukulu wopeza matendawa?

Matenda a LGL ndi matenda osowa kwambiri . Mukayang'ana padziko lonse lapansi, matendawa amapezeka mwa anthu pafupifupi mmodzi pa anthu miliyoni. Izi zikutanthauza kuti m'dziko ngati Sri Lanka, odwalawa akhoza kukhala ochepa kwambiri. Nthawi zambiri, matendawa akapezeka, odwala amakhala ndi zaka zoposa 60.

Kodi zizindikiro zake ndi ziti? Kodi tikumvetsa bwanji izi?

Izi ndi zodabwitsa pang'ono. Anthu ena omwe ali ndi LGL amatha kukhala zaka zambiri osawonetsa zizindikiro zilizonse . Kafukufuku wina adapeza kuti pafupifupi gawo limodzi mwa magawo atatu a anthu omwe ali ndi LGL analibe zizindikiro zilizonse atapezeka ndi matendawa. Anangopeza kuti ali ndi matendawa pamene mayeso a magazi pazifukwa zina adawonetsa kuchuluka kochepa kwambiri kwa maselo ofiira amagazi kapena kuchuluka kochepa kwa maselo oyera amagazi otchedwa neutrophils.

Komabe, pali zizindikiro zina zomwe anthu omwe ali ndi vuto la matenda a shuga angazindikire:

• Kutopa kwambiri ndi kutopa : Ichi ndi chizindikiro chofala kwambiri cha LGL. Nthawi zambiri, izi zimachitika chifukwa cha kuchepa kwa magazi m'thupi komwe kwatchulidwa pamwambapa.
• Malungo obwerezabwereza komanso matenda obwerezabwereza : Matenda oyambitsidwa ndi mabakiteriya angayambitse malungo. Izi zimachitika chifukwa cha kufooka kwa chitetezo chamthupi.
• Splenomegaly: Uku ndi kukula kwa ndulu, chiwalo chomwe chili m'thupi lathu. Izi zitha kuchitika chifukwa cha matenda ndi mitundu ina ya kuchepa kwa magazi m'thupi.

Kumbukirani, kungokhala ndi zizindikiro izi sikutanthauza kuti muli ndi matenda a LGL. Izi zitha kukhalanso zizindikiro za matenda ena ambiri. Chifukwa chake, ngati mukukumana ndi vuto ngati ili, chinthu chabwino kuchita ndikuwonana ndi dokotala ndikupeza upangiri.

Kodi pali zinthu zina zomwe zimagwirizana ndi LGL?

Inde, anthu ambiri omwe ali ndi LGL apezeka kuti ali ndi matenda ena odziteteza okha . Izi zikutanthauza kuti, matenda omwe chitetezo cha mthupi lathu chimaukira maselo athu athanzi. Pakati pa izi, nyamakazi ndiyo yofala kwambiri.

Kuphatikiza apo, zinthu zina zingapo zitha kugwirizanitsidwa ndi LGL:

• Kuchepa kwa magazi m'thupi : Takambirana kale za izi. Anthu ena amakhala ndi vuto la kuchepa kwa magazi m'thupi kwambiri ndipo amafunika kuikidwa magazi kuti akhalebe ndi maselo ofiira a m'magazi. Anthu ena omwe ali ndi matenda a LGLMtundu wa kuchepa kwa magazi wotchedwa hemolytic anemia ungayambenso. Pankhaniyi, m'malo mochepetsa kupanga maselo ofiira a magazi, maselo ofiira omwe alipo amawonongeka.
• Lymphocytosis : Uku ndi kuwonjezeka kwa maselo oyera a m'magazi otchedwa lymphocytes m'magazi. Kuwonjezeka kwa ma lymphocytes kumeneku nthawi zambiri kumawoneka mwa anthu omwe ali ndi lymphocytic leukemias, lymphomas, kapena matenda opatsirana ndi mavairasi.

Kodi chifukwa chenicheni cha LGL ndi chiyani?

Ichi ndi chinthu chomwe madokotala sakumvetsabe mokwanira. Chifukwa chenicheni cha LGL sichinadziwikebe. Komabe, amakhulupirira kuti pali mgwirizano pakati pa vutoli la khansa ya m'magazi ndi momwe chitetezo chathu chamthupi chimagwirira ntchito, matenda odziteteza ku matenda ena, ndi mitundu ina ya khansa.

• Pafupifupi 30% ya anthu omwe ali ndi LGL ali ndi matenda ena odziteteza okha, monga nyamakazi.
• Ena 25% mpaka 30% akhoza kukhala ndi mtundu wina wa lymphoma kapena khansa ya mtundu wina.
• Komanso, anthu ambiri omwe ali ndi LGL ali ndi kusintha kwa majini awo. Makamaka, pali kusintha kwa majini awiri otchedwa STAT3 ndi STAT5B . Majini awiriwa amachita ntchito yofunika kwambiri pa chitetezo cha maselo komanso momwe maselo amagawikira ndikuchulukira.

Kodi madokotala amazindikira bwanji matendawa?

Madokotala amagwiritsa ntchito makamaka mayeso a magazi ndi majini kuti adziwe matenda a LGL. Nazi zina mwa mayeso omwe amachitidwa nthawi zambiri:

• Kuchuluka kwa magazi (CBC) ndi kusiyana : Izi zimawerengera mitundu yonse ya maselo m'magazi anu, makamaka kuchuluka kwa maselo oyera amagazi omwe muli nawo.
• Kuyeza magazi m'magazi : Izi zimaphatikizapo kuyang'ana magazi pogwiritsa ntchito maikulosikopu ndikuwerengera kuchuluka kwa maselo a LGL m'magazi.
• Kuyeza kwa kayendedwe ka magazi: Iyi ndi njira yoyezera magazi yomwe imagwiritsidwa ntchito pofufuza makhalidwe a maselo. Nthawi zambiri njira iyi imagwiritsidwa ntchito kuzindikira ndi kugawa mitundu ya khansa ya m'magazi.
• Kuyesa kwa Immunophenotyping : Izi zimaphatikizapo kutenga zitsanzo za magazi kapena minofu ndikuwunika zizindikiro zinazake pamwamba pa maselo. Zizindikirozi zingagwiritsidwe ntchito kuzindikira mitundu ina ya matenda.
• Kusanthula kwa kukonzanso majini a T-cell receptor (TCR) : Izi zimatenga chitsanzo cha magazi kapena fupa la m'mafupa ndikuyang'ana mavuto aliwonse ndi majini omwe amalamulira momwe maselo a T amagwirira ntchito.
• Kuyesa majini : Muthanso kuyesa kusintha kwa majini a STAT3 ndi STAT5B omwe atchulidwa kale.

Kuwonjezera pa mayeso awa, chitetezo chamthupi cha m'thupiMayeso ena, monga kuyezetsa mafupa, angachitike kuti athetse matenda ena monga kusowa kwa chitetezo chamthupi, nyamakazi, myelodysplasia , ndi kusintha kwa myeloid . Kuchuluka kwa immunoglobulin ndi kuchuluka kwa mapuloteni a monoclonal kungayang'anitsidwenso.

Kodi LGL imachiritsidwa bwanji?

Tiyerekeze kuti muli ndi khansa ya m'magazi ya T-LGL kapena CLPD-NK, koma mulibe zizindikiro zilizonse . Ngati zili choncho, dokotala wanu angakulangizeni njira yotchedwa "watcherful waiting." Izi zimaphatikizapo kuyang'anira thanzi lanu nthawi zonse. Nthawi zambiri, mudzayesedwa magazi miyezi ingapo iliyonse kuti muwone ngati zizindikirozo zikuyamba.

Kwa iwo omwe ali ndi zizindikiro, chithandizo choletsa chitetezo chamthupi ndi ma steroids angapatsidwe. Madokotala angayambe chithandizo chimodzi ndi chimodzi, kapena angayambe chithandizo chocheperako. Popeza LGL ndi matenda osowa, anthu ambiri amafunafuna dokotala yemwe ndi katswiri wa matendawa.

Kodi sitingathe kuchepetsa kuchuluka kwa matendawa?

Mwatsoka, ayi, sitingathe. Madokotala sakudziwabe chomwe chimayambitsa vutoli. Chifukwa chake, n'zovuta kunena momwe angapewere. Komabe, zapezeka kuti anthu omwe ali ndi matenda a autoimmune ali pachiwopsezo chachikulu chotenga vutoli. Chifukwa chake, ngati muli ndi matenda a autoimmune awa, ndi bwino kufunsa dokotala wanu ngati muyenera kuda nkhawa ndi LGL.

Kodi LGL ndi matenda oopsa?

Nthawi zambiri, matenda a LGL ndi matenda osatha, osati imfa yadzidzidzi . Pafupifupi 75% ya anthu omwe ali ndi khansa ya m'magazi ya T-LGL ndi khansa ya m'magazi ya CLPD-LGL amakhala ndi moyo kwa zaka zisanu atapezeka ndi matendawa. Komabe, pafupifupi 10% ya anthu omwe ali ndi khansa ya m'magazi yamtunduwu amafa chifukwa cha matenda akuluakulu omwe angachitike chifukwa cha khansa ya m'magazi. Chifukwa chake, ndikofunikira kwambiri kudziteteza ku matenda.

Kodi ndimadzisamalira bwanji? Kodi ndimakhala bwanji ndi vutoli?

Ngati muli ndi matenda a LGL, mwina simungakhale ndi zizindikiro zilizonse. Komabe, ndikofunikira kusamalira thanzi lanu lonse, kuphatikizapo kupita kukayezetsa nthawi zonse . Kaya muli ndi zizindikiro kapena ayi, malangizo awa angathandize:

• Idyani zakudya zabwino : Idyani nyama yopanda mafuta ambiri, nsomba, zipatso, ndiwo zamasamba, ndi tirigu wonse.
• Kuchita masewera olimbitsa thupi nthawi zonse : Sankhani masewera olimbitsa thupi omwe amakusangalatsani komanso oyenera.
• Gonani bwino : Kupuma mokwanira n'kofunika kwambiri.
• Sinthani kupsinjika maganizo.Chitani zinthu zomwe zimakusangalatsani, sinkhasinkhani, chitani yoga.
• Tetezani chitetezo chanu cha mthupi : Funsani dokotala wanu za katemera ndi zinthu zina zomwe mungachite kuti mupewe matenda. Ngakhale zinthu zosavuta monga kusamba m'manja ndi sopo komanso kupewa malo odzaza anthu zingathandize.

Kodi n'zotheka kukhala ndi moyo wabwinobwino ndi vutoli?

Kawirikawiri, anthu omwe amalandira chithandizo cha matenda a shuga nthawi zambiri amakhala ndi moyo wabwinobwino . Amatha kukhala ndi moyo wautali ngati munthu wopanda matendawa. Komabe, ndikofunikira kukumbukira kuti anthu ena omwe ali ndi matenda a shuga akhoza kukhala kale ndi matenda oopsa a magazi omwe amakhudza moyo wawo.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati mukupeza zizindikiro zomwe zikusonyeza kuti vuto lanu likuipiraipira, muyenera kuonana ndi dokotala wanu. Ngati muli kale ndi chithandizo cha zizindikiro, muyeneranso kuuza dokotala wanu za kusintha kulikonse komwe mukuona m'thupi lanu (monga zizindikiro zikuipiraipira).

Kodi ndi mafunso otani ofunika kufunsa dokotala?

Popeza matenda a LGL ndi osowa kwambiri, ndi zachilendo kukhala ndi mafunso ambiri okhudza matendawa. Nazi mafunso ena omwe tikukhulupirira kuti akuthandizani kudziwa zambiri za matenda a LGL:

• Kodi ndili ndi mtundu wanji wa LGL?
• Kodi mankhwala ochizira izi ndi otani?
• Kodi ndikufunika chithandizo choposa chimodzi?
• Ndikumva bwino tsopano. Kodi ndidzakhala ndi zizindikiro?
• Ndili ndi matenda ena. Kodi LGL idzawapangitsa kukhala ovuta kwambiri?

Musamaope kufunsa mafunso ngati awa. Dokotala wanu alipo kuti akuthandizeni. Iwo ndi odzipereka kufotokoza chilichonse m'njira yomwe mungamvetse.

Pomaliza, zinthu zoti muzikumbukira

Large granular lymphocytic leukemia (LGL) ndi khansa ya m'magazi yosowa kwambiri yomwe imakhudza maselo oyera a m'magazi. Ngakhale mutakhala ndi vutoli, simungazindikire kusintha kulikonse m'thupi lanu komwe kungakhale zizindikiro za LGL. Nthawi zina, zizindikiro sizingawonekere kwa zaka zambiri.

Madokotala sangathe kuchiza vutoli kwathunthu. Komabe, pali mankhwala omwe angathandize kuchepetsa zizindikiro zake. Ndizachibadwa kudabwa komanso kuchita mantha mukamva kuti muli ndi matenda osachiritsika . Madokotala anu adzamvetsa chifukwa chake mukumva choncho.

Adzasangalala kukufotokozerani zomwe mungachite kuti musamale thanzi lanu tsopano, komanso zomwe mungayembekezere ngati zizindikiro zitayamba. Kudziwa zomwe mungayembekezere mtsogolo kudzakupatsani chidaliro komanso mphamvu zambiri kuti mukhale ndi LGL. Chifukwa chake, lankhulani ndi dokotala wanu za mafunso onse omwe muli nawo. Dziwani zambiri. Ndicho chinthu chabwino kwambiri chomwe mungachite panthawi ngati iyi.

'Matenda a khansa ya m'magazi a LGL, khansa ya m'magazi, maselo oyera amagazi, ma lymphocyte, neutropenia, kuchepa kwa magazi, chitetezo chamthupi