Wakambonzwa nezvegomarara iri reropa here? (Acute Promyelocytic Leukemia - APL) Ngatikurukurei zvakadzama!

Wakambonzwa kuneta zvakanyanya kamwe kamwe, kuva nemavanga mashoma, kana kuva nekubuda ropa kakawanda here? Kunyangwe tisinganyatso tarisa zvinhu izvi, muzviitiko zvisingawanzoitiki, zvinogona kuva zviratidzo zvechirwere chakakomba, senge Acute Promyelocytic Leukemia (APL) . Saka, musazvidya mwoyo, nhasi tichataura nezvegomarara iri reropa rinonzi APL nenzira yakajeka uye iri nyore.

Chii chinonzi acute promyelocytic leukemia (APL)?

Zvichitaurwa zviri nyore, APL igomarara reropa risingawanzoitiki . Iri muboka guru remaleukemia anonzi Acute Myeloid Leukemia . Nzvimbo huru inogadzirwa ropa mumuviri wedu ibhonzo . Pano mubhonzo iri, nekuda kwekuchinja kwemajini, ndiko kuti, kushanduka kwemajini , masero machena eropa asina kujairika anotanga kuumbwa. Masero aya asina kujairika anopatsanuka uye anowanda zvisingadzoreki, achipararira mubhonzo rese. Dzimwe nguva vanachiremba vanodana izvi kuti APL leukemia, kana kuti M3-leukemia .

APL chirwere chakakomba. Zviratidzo zvayo zvinogona kungoerekana zvaitika uye nekukurumidza. Kubuda ropa rakawanda chinhu chikuru chine njodzi. Asi pane mashoko akanaka! Nekurapwa kutsva, kusanganisira chemotherapy nemishonga mitsva isiri yechemotherapy, vanachiremba vanokwanisa kudzora APL uye vanowanzoirapa zvachose.

Chirwere ichi chakajairika zvakadii?

APL chirwere chisingawanzoitiki . Semuenzaniso, munyika yakaita seUnited States, vanhu vanosvika zviuru makumi matatu chete ndivo vanoonekwa vaine chirwere ichi gore rega rega. Kazhinji, APL inoonekwa nevanhu vane makore ari pakati pemakumi matatu .

Ndezvipi zviratidzo zveAPL?

Zviratidzo zveAPL zvinoitika kana mupfupa wako usingakwanise kugadzira masero matsvuku eropa ane hutano, masero machena eropa, uye maplatelet sezvakajairika. Kudzikira uku kwemarudzi ese emasero eropa kunonzi pancytopenia . Kana izvi zvikaitika, unogona kuva nezviratidzo zvakakomba zvakaita seanemia , matambudziko ekubuda ropa nekuda kwekugwamba kweropa, uye zvirwere zvinowanzoitika.

Zvimwe zviratidzo zveAPL zvinowanzoonekwa ndeizvi:

• Kunzwa kuneta zvakanyanya uye kuneta nekuda kwekudzikira kwemasero matsvuku eropa (kureva anemia).
• Kutapukirwa kunowanzoitika nekuda kwemasero machena eropa asina simba anorwisa zvirwere. Zvinhu zvakaita sefivha nedzihwa zvinogona kuitika kakawanda.
• Nekuti metabolism yemuviri wako inokurumidza uye simba rinobva muchikafu rinopiswa nekukurumidza,Kuderedza uremu usingazive.

Zviratidzo zvekubuda ropa

Munhu ane APL ane huwandu hushoma hwemaplatelet nezvinhu zvinosunga ropa zvinobatsira kuti ropa rigwambe. Unoziva, maplatelet ndiwo anobatsira kumisa kana kuderedza kubuda ropa. Saka, kana izvi zvikaderera, dambudziko rinotanga.

Heano mamwe ezviratidzo zvekubuda ropa kunokonzerwa neAPL:

• Kubuda ropa kunogona kuitika chero kupi mumuviri. Semuenzaniso, kubuda ropa mumatadza , kubuda ropa mumhino kakawanda, uye, kuvakadzi, kubuda ropa rakawanda panguva yekuenda kumwedzi .
• Ropa rinoungana pasi peganda uye rinokonzera mavanga munzvimbo dzakasiyana-siyana pamuviri . Kunyangwe kukuvara kudiki kunogona kukonzera mavanga makuru.
• Dzimwe nguva kubuda ropa kunogona kuitika muuropi (intracranial hemorrhage) . Kana izvi zvikaitika, ungaomerwa nekufambisa makumbo ako, kurwadziwa nemusoro zvakanyanya, uye ungangoona shanduko. Izvi zvinongoitika nekukurumidza!
• Kana tsvina yako yakasviba kana kuti ine mitsetse yeropa, zvinogona kunge zvichikonzerwa nekubuda ropa mudumbu (gastrointestinal bleeding) .

Chii chinokonzera APL?

Chirwere ichi chinokonzerwa nemajini maviri anodzora kugadzirwa kwemasero edu eropa achibatana kuti aumbe jini risingawanzoitiki rinonzi PML-RARa . Chinonyanya kukosha ndechekuti, kuchinja kwemajini uku hakusi chinhu chaunogara nhaka kubva kuvabereki vako . Kunoitika zvisina tsarukano, zvichireva pasina chikonzero, muhupenyu hwako. Nyanzvi hadzisati dzaziva kuti chii chinokonzera kuchinja kwemajini uku.

Kuchinja uku kunoita kuti masero machena eropa akure asingadzoreki, pachinzvimbo chekukura zvakanaka, uye panzvimbo pezvo ogadzira masero machena eropa asina kukura (promyelocytes) . Masero aya asina kukura anozadza mumongo wemapfupa, achivhara nzvimbo yemasero eropa ane hutano nemaplatelet.

Ndezvipi zvinetso zveAPL?

APL chirwere chinoisa upenyu panjodzi. Izvi zvinodaro nekuti kubuda ropa rakawanda kunogona kukurumidza kuva nengozi. Kana usingakwanise kumisa kubuda ropa kubva kuchekwa kudiki, kana uine ropa rakawanda mutsvina yako kana weti paunoenda kuchimbuzi, kana kana usingakwanise kumisa kubuda ropa kubva mumatadza ako, unofanira kuona chiremba kana kuenda kuchipatara nekukurumidza .

Yeuka: Kana uine kubuda ropa kusingadzoreki, usambozvifuratira. Kurapwa nekukurumidza ndiko kwakakosha.

APL inoonekwa sei?

Vanachiremba vanowanzoita bvunzo dzinoverengeka kuti vaone chirwere ichi.

• Kuverengwa Kweropa Kwakakwana (CBC): APL inokonzera kuumbwa kwemasero machena eropa asina kujairika. Kuongororwa kweCBC kunogona kutarisa mhando dzakasiyana dzemasero eropa uye huwandu hwemaplatelet muropa rako.
• Kusvuta Ropa Panze:Muizvi, ropa rinotorwa roongororwa nemaikorosikopu. Zvadaro, vanoongorora kana paine granules diki dzakawanda mukati memasero machena eropa asina kuibva (promyelocytes), kana kuti pane zvinhu zvakakosha zvinonzi Auer rods . Izvi zvinoonekwa muAPL.
• Kuongororwa kweBone Marrow Biopsy: Muongororo iyi, sampuli diki yebonde rako inotorwa uye masero aro anoongororwa.
• Flow Cytometry: Mubvunzo uyu, vanachiremba vezvirwere vanotsvaga mapatani emapuroteni chaiwo pamusoro pemasero asina kujairika. Mapatani aya anogona kusimbisa APL.
• Kuongororwa kwePolymerase Chain Reaction (PCR): Kuongororwa uku kunogona kuona nemazvo kuvapo kwejini risingawanzoitiki (PML-RARa) rinokonzera APL.
• Cytogenetics: Iyi inoedza shanduko dzakati wandei muma chromosome emasero asina kujairika. Kuwana shanduko idzi ndiyo nzira huru yekusimbisa kuongororwa kweAPL.

Vanachiremba vanoisa APL muboka reAPL serine njodzi shoma kana kuti rine njodzi huru zvichienderana nehuwandu hwemasero machena eropa rako. Vanhu vane APL ine njodzi huru vane mukana wekudzoka kwekenza kana kudzokera kuchirwere zvakare .

APL inorapwa sei?

APL inorapwa nemusanganiswa wemishonga inosiyanisa masero , chemotherapy, uye kurapwa kwakanangana . Kutaura zvazviri, kubva pakawanikwa mishonga iyi muma1980, chirwere ichi, icho chaimbofungidzirwa kuti chinouraya, chave chirwere chinorapika. Iri ibudiriro huru!

Mishonga yekusiyanisa masero mishonga isiri yekurapa nemakemikari inobatsira masero machena asina kujairika, asina kukura, kupatsanurana kuita masero machena eropa akajairwa, akura. Mishonga iyi isiri yekurapa nemakemikari, yakanyorwa pazasi, yakaita kuti pave nekureruka uye kuporesa kwemasero ne95%.

• All-trans-retinoic acid (ATRA) , kana tretinoin (Vesanoid ®) – Iyi imhando yevhitamini A.
• Arsenic trioxide (ATO) – Iyi imhando yearsenic.

Kana chiremba wako achifungidzira kuti une APL, vanogona kutanga kushandisa ATRA kunyangwe mimwe miedzo isati yasimbisa chirwere ichi. Izvi zvinodaro nekuti kutanga kurapwa nekukurumidza kunogona kuderedza njodzi yekubuda ropa kunogona kutyisidzira hupenyu hwako.

Matanho ekurapwa kweAPL

Kurapa kunowanzoitwa muzvikamu zvitatu: Kupinza, Kubatanidza, uye Kuchengetedza. Kurapa kunogona kusiyana zvichienderana nehuwandu hwenjodzi.

• Danho rekutanga (Induction):Chinangwa chikuru chechikamu chino ndechekuuraya masero e leukemia akakwana kuti APL yako irege kupora . Kurerutswa kunoreva kuti hauna zviratidzo uye hapana zviratidzo zve leukemia zvinowanikwa pabvunzo. Izvi zvinoitwa nekushandisa mishonga isiri ye chemotherapy, chemotherapy, uye mishonga yakanangana nayo. Munguva iyi, uchafanirwa kugara muchipatara, kazhinji kwemavhiki mana kusvika matanhatu.
• Chikamu chekubatanidza: Chiremba wako wekenza anogonawo kudana izvi kuti 'kurapa mushure mekurerutsirwa'. Kurapa uku kunochengetedza APL iri mukurerutsirwa uye kunoramba kuchiuraya chero masero e leukemia asara. Uyu ndiwo mushonga mumwe chete waishandiswa muchikamu chekutanga. Kurapa uku kunogona kugara kwemwedzi misere, nekurapwa kwemwedzi miviri yega yega. Unogona kuva nemavhiki mana ekurapwa uchiteverwa nemavhiki mana ekuzorora. Mushonga uyu unogona kupihwa sepiritsi kana sekurapa kwemutsinga (IV) .
• Chikamu chekuchengetedza: Uku kurapwa kuri kuenderera mberi, asi mushonga unopihwa nedosi shoma pane pakutanga uye muchikamu chekudzikamisa. Kurapa uku kwekuchengetedza kunowanzoitwa kwegore rimwe.

Chiremba wako wekenza anogonawo kukupa rubatsiro rwekurapa , sekuwedzerwa ropa, pamwe chete nekurapwa uku.

Matambudziko ekurapwa

Dambudziko rinonyanya kuitika, uye rakakomba, rinonzi differentiation syndrome . Iri iboka remabatiro akasimba emishonga yeAPL. Mabatiro aya anowanzoitika mukati memavhiki matatu ekutanga ekurapwa. Zviratidzo zvinogona kunge zviri zvishoma kana zvakanyanya. Zvimwe zvacho zvinosanganisira:

• Kukosora.
• Mvura yakawandisa yakakomberedza moyo wako nemapapu (pleural effusion) .
• Kukundikana kweitsvo .
• Kuderera kweropa (hypotension) .
• Kuderera kwehuwandu hweokisijeni muropa (hypoxemia) .
• Kutadza kufema zvakanaka (dyspnea) .
• Kuzvimba/ kuzvimba kwemaoko, makumbo, nemutsipa.
• Fivha inouya pasina chikonzero.
• Kuwedzera uremu pasina chikonzero.

Kana ukava nechirwere ichi chekusiyana kwemasero, chiremba wako anogona kumisa kurapwa kwako kwenguva yakati. Vanogonawo kushandisa mimwe mishonga, yakaita sehydroxyurea, kuderedza huwandu hwemasero machena eropa rako.

Munhu ane APL angatarisira chii?

Kazhinji, fungidziro yechirwere ichi yakanaka.Kunyange hazvo mamiriro emunhu wese akasiyana, zvidzidzo zvakaratidza kuti pakati pe90% ne95% yevanhu vane APL vanowana mukana wekuzorora. Zvisinei, APL inogona kudzoka mushure mekurapwa. Vanhu vari pakati pe5% ne10% vanozodzokera kuchirwere, kazhinji mukati memakore matatu ekutanga mushure mekurapwa. Vachazoda kurapwa kwakasiyana kana kumwe.

Mwero wekupona

Nekuti APL chirwere chisingawanzoitiki, zvatinoziva nezvehuwandu hwevanhu vanopona hunobva mukuyedzwa kwekiriniki kunosanganisira varwere vane APL vane njodzi shoma uye vane njodzi huru.

Imwe ongororo inoratidza kuti 99% yevarwere vane APL vari pangozi shoma vanorarama makore mana mushure mekurapwa. Imwe ongororo yevarwere vane APL vari pangozi huru inoratidza kuti 86% vanorarama makore mashanu mushure mekurapwa. Aya ndiwo mhedzisiro yakanaka kwazvo!

Ndinozvitarisira sei?

Nekuti APL inogona kudzoka, zvakakosha kuti uone chiremba wako nenguva (nguva yekutevera nguva yekurapwa) .

Uchaongororwa nachiremba mwedzi wega wega kana miviri yegore rekutanga mushure mekurapwa. Mushure megore rekutanga, uchafanirwa kuona chiremba wako mwedzi mitatu kusvika mina yega yega kwemakore maviri anotevera. Miedzo yakaita seCBC, PCR, uye bone marrow biopsy inogona kuitwa pakushanya uku.

Ndinofanira kuenda kuchipatara riini?

APL inogona kudzoka mushure mekurapwa, uye zviratidzo zvinogona kukurumidza kuipa. Kana wava kupora nekuda kweAPL, enda kuchipatara nekukurumidza kana ukasangana nechimwe chezvinotevera:

• Kana uri kubuda ropa zvisingadzoreki .
• Kana ukangoerekana wazvimba nekurwadziwa mumakumbo ako kana pasi pedumbu .

Pakupedzisira, shoko rinokosha

Acute promyelocytic leukemia (APL) igomarara reropa risingawanzoonekwa sechirwere chinouraya, asi ikozvino rave chirwere chinorapika nekuda kwekurapwa kwepamusoro.

Zvisinei, ichi chirwere chakakomba. Kana chikasaonekwa uye chikarapwa nekukasika, chinogona kuisa hupenyu panjodzi . Saka, kana uine zviratidzo zvakaita sekubuda ropa kusingadzoreki, usambozviregeredza. Chinhu chakakosha kutsvaga mazano echiremba uye kuongororwa nekukurumidza. Usatya, shinga, nekuti ikozvino kune mishonga yakanaka yeizvi!

Leukemia , APL, Kenza yeRopa, Kenza yeRopa, Bone Morrow, Anemia, ATRA, Chemotherapy, Acute Promyelocytic Leukemia, M3-Leukemia, PML-RARa, Kubuda ropa