Ko chirwere cheLeukemia chirwere chinoshamisa chinokonzerwa nemishonga here? Ngatikurukurei nezve Differentiation Syndrome!

Kana iwe kana mumwe munhu waunoziva ari kurapwa chirwere chakadai seleukemia, unogona kusangana nemigumisiro isingatarisirwi. Nhasi, tichataura nezvemusanganiswa wemigumisiro yakakomba inogona kuitika nemishonga, kunyanya iyo inopihwa kune mhando mbiri dzekenza yeropa. Vanachiremba vanodana iyi Differentiation Syndrome . Nekuti inogona kunge yakakomba, vanachiremba vanowanzo tanga kurapa zviratidzo vasati vazvisimbisa zvechokwadi, izvo zvinogona kuderedza njodzi yezvinetso zvinotyisidzira hupenyu.

Chii chinonzi Differentiation Syndrome?

Muchidimbu, Differentiation Syndrome iboka rezviitiko zvakakomba izvo muviri unosangana nazvo kune mimwe mishonga inoshandiswa kurapa mhando mbiri dzekenza yeropa, dzinoti Acute Promyelocytic Leukemia (APL) uye Acute Myeloid Leukemia (AML) . Zvinoita sekunge mamwe masero mumuviri wedu "anopenga" nemishonga iyi otanga kuburitsa zvinhu zvakawanda panguva imwe chete. Izvi ndizvo zvinokonzera chimwe nechimwe chezviratidzo.

Fungidzira shamwari yako yaonekwa kuti ine APL yotanga kurapwa. Mumazuva mashoma, inotanga kuita fivha, inonetseka kufema, uye yakazvimba zvishoma. Panguva iyoyo, vanachiremba vanofungidzira kuti iyi iDifferential Syndrome.

Ndezvipi zvinhu izvi zvinosiyanisa vanhu?

Mishonga yekurapa inonzi differentiation agents imhando yemishonga inoshandiswa navanachiremba kurapa APL. APL inonyanya kubatwa nemishonga inoita kuti masero akure, kana kuti asiyane . Mishonga iyi inobatsira masero ekenza (blast cell stage) kukura kuita masero machena eropa akagwinya. Ndosaka vanachiremba vachishandisa mishonga iyi ye differentiation pachinzvimbo chekuvapa mishonga yechemotherapy zvakananga.

Kufanana nemimwe mishonga yegomarara, mishonga iyi inobatsira kumisa kana kuderedza kukura kwemasero egomarara. Vanachiremba vanogona kushandisa mishonga iyi vari vega, pamwe chete, kana pamwe chete nechemotherapy. Vanogona kurapa APL zvinobudirira. Zvisinei, vamwe vanhu vane APL vanogona kuva nemigumisiro yakakomba kubva mumishonga iyi.

Ndeipi mishonga inogona kukonzera Differentiation Syndrome?

Dambudziko iri rinogona kuitika nekuda kwezvinhu zvinosiyanisa APL. Mienzaniso inosanganisira:

• All-trans-retinoic acid (ATRA) , iyi imhando yevhitamini A.
• Arsenic Trioxide (ATO) imhando yearsenic.

Uyewo, kune vamwe vanhu vane AML, vanachirembaIsocitrate Dehydrogenase (IDH) inhibitors imhando yemishonga inoshandiswa nechemotherapy. Idzi IDH inhibitors (ivosidenib) uye (enasidenib) dzinogonawo kukonzera Differentiation Syndrome. Kwete izvozvo chete, asiwo FLT3 inhibitors (semuenzaniso (midostaurin) , (gilteritinib) ) dzinogona kukonzera chirwere ichi.

Ndiani angada mishonga inodzivirira chirwere cheIDH?

• Vanhu vane kenza yakadzokazve.
• Vanhu vane kenza yakaoma kurapa.
• Vanhu vane gene mutation chaiyo (IDH1 kana IDH2 mutation).
• Avo vasingakwanise kushivirira mishonga yekurapa kenza yakajairwa.

Ndiani ane mukana mukuru wekuwana Differentiation Syndrome?

Vanhu vazhinji vane APL vane masero machena eropa mashoma (WBC) . Zvisinei, avo vane masero machena eropa akawanda vari panjodzi huru yekubatwa neDifferentiation Syndrome. Muzviitiko izvi, vanachiremba vanowanzo nyora mushonga unonzi Prednisone kana Dexamethasone kuderedza njodzi yechirwere ichi.

Differentiation Syndrome yakajairika zvakadii?

Ichi chirwere chisingawanzoitiki . AML ndiyo mhando yeleukemia inowanikwa zvakanyanya muvanhu vakuru, kunyange zvazvo ichikonzera 1% yekenza dzese. MuUnited States, APL inowanikwa mumunhu mumwe chete pavanhu 250,000.

Kubva kune avo vane AML neAPL:

• Varwere vanosvika 25% veAPL vakagamuchira mishonga yeATRA neATO vakave neDifferentiation Syndrome.
• Dambudziko iri rakataurwa pakati pe14% ne19% yevarwere veAML vanotora mishonga inhibitor yeIDH.

Chii chinokonzera chirwere ichi cheDifferentiation Syndrome?

Vaongorori havasati vaziva kuti sei vamwe vanhu vachipindura kurapwa kweAPL nenzira iyi. Zvidzidzo zvepakutanga zvinoratidza kuti mishonga yegomarara inokonzera kuti masero eleukemia aburitse makemikari akawanda emuviri. Izvi zvinonzi cytokine release syndrome . Kuzvimba uku kusingadzoreki kunokonzera zviratidzo zvakasiyana-siyana, kubva pazvishoma kusvika pazvikuru.

Ndezvipi zviratidzo zveDifferentiation Syndrome?

Munhu ane APL anowanzotanga kuratidza zviratidzo zveDifferentiation Syndrome mukati mevhiki imwe kana maviri mushure mekutanga ATRA uye/kana Arsenic Trioxide. Zvisinei, kana uri kutora mushonga weIDH inhibitor weAML, zvinogona kutora nguva yakati rebei kuti zviratidzo zvionekwe.Inogona kupera (zviratidzo izvi zvinogona kuoneka chero kupi zvako kubva pazuva rimwe kusvika pamwedzi mishanu kusvika mitanhatu mushure mekutanga kushandisa mushonga).

Aya ndiwo zviratidzo zvinonyanya kuonekwa:

• Kukosora .
• Kuunganidzwa kwemvura yakawanda yakakomberedza mwoyo nemapapu (Pleural Effusion) .
• Kukundikana kweitsvo .
• Kuderera kweropa (Hypotension) .
• Okisijeni shoma muropa (Hypoxemia) .
• Kutadza kufema zvakanaka (Dyspnea) .
• Kuzvimba (kuzvimba) kwemaoko, tsoka, nemutsipa.
• Fivha isina chikonzero.
• Kuwedzera uremu pasina chikonzero.

Zvakakosha: Kana uine chimwe chezviratidzo izvi kana kupfuura, hazvirevi kuti une Differentiation Syndrome. Zvisinei, zvakakosha kuzivisa chiremba wako nekukasika kana ukaona chimwe chezviratidzo izvi.

Ndezvipi zvinetso zvinogona kuitika nekuda kweDifferentiation Syndrome?

Dambudziko iri dzimwe nguva rinogona kukonzera mamiriro ezvinhu akakomba. Semuenzaniso:

• Kukundikana kwemoyo .
• Kukundikana kweitsvo .
• Kukundikana kweMapapu .
• Kubuda ropa kubva mumapapu (Pulmonary Exmorrhage) .
• Chirwere chemabayo .
• Sepsis ( hutachiona hwakakomba hunopararira mumuviri wese).

Kana ukaona chimwe chezviratidzo izvi, fonera chiremba wako nekukasika . Kana uchinetseka kufema kana kurwadziwa pachipfuva, fonera 911 (kana nhamba yako yekukurumidzira yemuno) nekukasika . Vanhu vane APL vanowanzo pihwa kurapwa muchipatara kusvika njodzi ye differentiation syndrome yapera.

Differentiation Syndrome inoonekwa sei?

Zvinogona kuoma kuona chirwere ichi kune munhu ane APL, sezvo paine zvimwe zvirwere zvakawanda zvinogona kukonzera zviratidzo zvakafanana. Muzviitiko zvakakomba, vanachiremba vanogona kutanga kurapa zviratidzo nekukurumidza pavanofungidzira kuti vane Differentiation Syndrome, kunyangwe vasati vasimbisa kuti ndiyo chaiyo.

Chiremba wako achakurudzira bvunzo dzakawanda kuti asimbise chirwere chacho uye kuti aone kana zvimwe zvirwere zviriko. Izvi zvinogona kusanganisira:

• Kuverengwa Kweropa Rakazara (CBC) .
• X-ray yechipfuva .
• Echocardiogram (bvunzo inoongorora mashandiro emwoyo).
• Kuongororwa kweCT yechipfuva .
• Bronchoscopy (bvunzo inoshandisa kamera kutarisa mukati memapapu).
• Kumwe kuongororwa kweropa (Bloodwork).

Pane mushonga weDifferentiation Syndrome here?

Kazhinji, vanhu vane acute promyelocytic leukemia (APL) vanogona kupora zvizere kubva ku differentiation syndrome kana vakarapwa nekukasika uye zvakakodzera . APL yava chirwere chinorapika zvakanyanya. Saka hapana chekutya.

Differentiation Syndrome inorapwa sei?

Vanachiremba vanowanzo rapa zviratidzo zve differentiation syndrome nemishonga ye corticosteroid kana glucocorticoid , yakaita se dexamethasone . Muzviitiko zvakakomba, chiremba wako anogonawo kukurudzira kurega kwenguva pfupi kurapwa kwegomarara kusvika zviratidzo zvako zvadzikira.

Vanhu vazhinji vane APL vanorapwa muchipatara kusvika njodzi ye differentiation syndrome yapera. Kana uri munhu anorwara nechirwere che differentiation syndrome uye zvichifungidzirwa kuti chirwere che differentiation syndrome, vanachiremba vako vanogona kusarudza kukuchengeta muchipatara husiku hwese kuti varapwe kana kutariswa. Chikwata chako chekurapa chichabatsira kusimbisa kuongororwa kwako uye kurapa nemazvo chero mamiriro ezvinhu ari kukonzera zviratidzo zvako.

Ndingaitei kuti ndideredze njodzi yangu yekuve neDifferentiation Syndrome?

Hapana chaunogona kuita kuderedza njodzi yako yechirwere ichi. Kana uri kutora chemotherapy kana mimwe mishonga yegomarara, udza chiremba wako nekukurumidza nezve chero zviratidzo zvaunoona . Zvakare, ziva zviratidzo zvekutarisa (sezvatakakurukura pamusoro apa) uye taura nachiremba wako kana uine zvinokunetsa. Ichi ndicho chinhu chakakosha.

Ndeipi tarisiro yeDifferentiation Syndrome?

Maonero ekuti chirwere ichi chinokanganisa kenza anowanzo batsira vanhu vazhinji. Kazhinji, unogona kuramba uchirapwa nemishonga inorwisa kenza, panguva yekurapwa nemishonga iyi kana kuti mushure mekurapwa. Chikwata chako chekurapa chichataura newe nezvesarudzo dzekurapa kwaungaita.

Ndeipi nguva yaunofanira kutsvaga rubatsiro rwechiremba nezveDifferentiation Syndrome?

Kana ukaona zviratidzo zve differentiation syndrome paunenge uchirapwa kenza, fonera chiremba wako nekukasika . Zvingave zvakaoma kwauri kana chiremba wako kuziva kana zviratidzo zvako zvichikonzerwa nekurapwa kenza kana nechimwe chirwere. Kurapwa nekukurumidza kunogona kubatsira kuderedza zviratidzo uye kuderedza njodzi yematambudziko.

Kurapa kenza kunogona kunetsa. Zvisinei, zvinogona kuodza mwoyo kuziva kuti kurapwa kwacho kune migumisiro. Differentiation Syndrome iboka rezviitiko zvinogona kutyisidzira hupenyu hwemurwere pakurapwa kenza yeropa. Zvisinei, inogona kurapwa kana ikaonekwa uye ikarapwa nekukurumidza . Nekuti zviratidzo zvinogona kuwedzera nekukurumidza, vanachiremba vanogona kutanga kukurapa usati wawana mhinduro dzebvunzo dzako kuti une Differentiation Syndrome. Kurapwa nekukurumidza kunogona kubatsira kuderedza zviratidzo zvako uye kukudzosera munzira yekupora.

Mharidzo Yekuenda Nayo Kumba

• Differentiation Syndrome chirwere chakakomba chinogona kuitika nekuda kwemishonga inopihwa yemhando dzeleukemia inonzi APL neAML.
• Zviratidzo zvakaita sefivha, kuoma kufema, uye kuzvimba kwemuviri zvinogona kuitika.
• Kana ukaona zviratidzo izvi, zvakakosha kuzivisa chiremba wako nekukasika .
• Kana chirwere ichi chikaonekwa nekukurumidza uye chikarapwa nemishonga yakaita seDexamethasone, chinogona kurapwa.
• Usavhunduke paunonzwa izvi. Chikwata chako chekurapa chichakubatsira. Chinhu chakakosha ndechekuvazivisa nezvekuchinja kupi zvako, chero zviratidzo.

Differentiation syndrome, leukemia, kurapwa kwekenza, migumisiro yakaipa, APL, AML, ATRA, zviratidzo