Kodi zikutanthauzanji ngati muli ndi acute promyelocytic leukemia (APL) ndipo mumatani?
Mwachidule
Acute promyelocytic khansa ya m'magazi (APL) ndi kachilombo koopsa ka khansa ya m'magazi (AML) , khansa ya magazi. Mwinanso mungamve kuti amatchedwa M3 AML. Ku North America, APL imakhala pafupifupi 10% mwa milandu yonse ya AML. Ku Italy ndi madera a South America, APL ingaimire ochulukirapo 65%.
Amapezeka mofanana pakati pa amai ndi abambo, ndipo zaka zapakati pa msinkhu ndi zaka 40.
Ngakhale zili zofanana ndi njira zina za subtypes, APL ndi yosiyana ndipo ili ndi dongosolo lachithandizo kwambiri. Zotsatira za chithandizo cha APL ndi zabwino kwambiri, ndipo zimaonedwa kuti ndi mankhwala opatsirana kwambiri a khansa ya m'magazi. Machilombo ochiza matenda ali ochuluka kwambiri kuposa 90%.
Genetics ndi Acute Promyelocytic Leukemia (APL)
Chibadwa chosinthika kapena kusintha kwachibadwa kawirikawiri m'DNA ya maselo a khansa ya m'magazi ndikutumiza pakati pa chromosomes 15 ndi 17. Izi zikutanthauza kuti gawo la chromosome 15 limatha, ndipo limasintha ndi gawo la chromosome 17. Kusinthika uku kumabweretsa kupanga puloteni yomwe imayambitsa kukula kwa maselo a magazi kuti 'amangirire' pa promyelocytic siteji, pamene maselo oyera a mthupi ali aang'ono kwambiri ndipo ali aang'ono.
Kodi Promyelocytes Ndi Chiyani?
Promyelocytes ndi maselo omwe amapezeka mu mzere wa mtundu uwu wa maselo oyera, ndi "makanda" omwe amakhala myeloblasts kapena opweteka, ndipo akuluakulu amakhala mayelocytes omwe amatchedwa neutrophils, eosinophils, basophils, ndi monocytes.
Maselo a Promyelocytic a m'magazi akhoza kuyerekezedwa ndi achinyamata. Amawoneka ngati achikulire, koma sangathe kupeza ntchito, kulipira ngongole, kuyendetsa galimoto, kapena kuchita ntchito tsiku ndi tsiku la anthu okhwima. Momwemonso, maselo a magazi a promyelocytic ndi osalimbikitsidwa kwambiri kugwira ntchito za maselo oyera a thupi loyera.
Zizindikiro ndi Zizindikiro
Odwala omwe ali ndi APL amasonyeza zizindikiro zambiri monga mitundu ina ya mitsempha yambiri yoopsa ya m'magazi (AML). Zambiri mwa zizindikiro za khansa ya m'magazi zimachokera ku maselo a khansa "kutulutsa" fupa la fupa ndikusokoneza kupanga maselo ofiira a magazi, maselo oyera ndi maselo. Zizindikiro ndi zizindikirozi zikuphatikizapo:
- Kukhala ndi mphamvu zochepa, kapena kutopa nthawi zonse
- Kumamva kupuma pang'ono pochita zinthu zowonongeka
- Khungu lenileni
- Malungo osadziwika
- Kuchulukitsa nthawi ya machiritso ya mabala ndi makutu
- Mafupa kapena ziwalo za Achy
- Zovuta "kumenyana" ndi matenda
Kuwonjezera pa zizindikiro za AML, odwala APL amasonyezanso zizindikiritso zina . Nthawi zambiri:
- Khalani ndi vuto lalikulu la kutaya mwazi monga kupweteka, nosebleeds, magazi mu mkodzo kapena kayendedwe kake. Atsikana ndi amayi omwe ali ndi APL amatha kuona nthawi ya kumwezi yolemera kwambiri.
- Pa nthawi yomweyo, nthawi zambiri pamakhala magazi osadziwika bwino.
Zizindikiro za khansa ya m'magazi zikhoza kukhala zosavuta kwambiri, ndipo zikhoza kukhala zizindikiro za zina, zomwe sizili ndi khansa. Ngati mumakhudzidwa ndi thanzi lanu, kapena thanzi la wokondedwa wanu, nthawi zonse ndi bwino kupeza uphungu kwa dokotala.
Chithandizo
Mankhwala a acute promyelocytic leukemia (APL) ndi osiyana kwambiri ndi a mitundu ina ya khansa ya m'magazi, kotero kuzindikiritsa bwino ndikofunika.
Odwala ambiri a APL amachiritsidwa kale ndi mankhwala osokoneza bongo (ATRA), mawonekedwe apadera a vitamini A. ATRA mankhwalawa ndi amodzi chifukwa amachititsa kuti maselo a promyelocytic a m'magazi akule bwino, monga momwe maphunziro apamwamba amachitira achinyamata. Kuyerekezera ndi udindo wamkulu (chabwino, nthawi zina). Gawo ili la mankhwala limatchulidwa kuti "kulowetsa."
Ngakhale ATRA ikhoza kupeza odwala APL kuti akhululuke mwa kukankhira maselo onse a m'magazi kukhala okhwima, sangathe kuchiza kasupe. Zotsatira zake, zotsatira za nthawi yaitali za mankhwala zimakula bwino pamene madokotala akuwonjezera mankhwala othandizira .
Chinthu ichi cha chithandizo chimatchedwanso "kugwirizanitsa."
Pambuyo pa chemotherapy, anthu nthawi zambiri amapitirizabe ku ATRA kwa chaka chimodzi, nthawi zina kuphatikizapo mankhwala ena. Gawo lomaliza la chithandizo limatchedwa "kusamalira."
Ngati khansa ya m'magazi isayankhe ATRA ndi chemotherapy, kapena ikabwerera, APL imatha kuchitidwa ndi arsenic trioxide (ATO).
Kuthamangitsani
Kuchiza kwa APL kumapindulitsa nthawi zambiri.
Kulimbana ndi Kuthandizidwa
Ngakhale kuti acute promyelocytic khansa ya m'magazi imakhala ndi mbiri yabwino, makamaka poyerekeza ndi khansa ya m'magazi, "kupita kumeneko" kungakhale kovuta ndi kukhetsa. Pitani kwa achibale ndi abwenzi . Osadandaula za kusowa thandizo ndi kulandira chithandizo pa gawo ili m'moyo wanu. Mungazidabwe kuti zimangokuthandizani bwanji, pamene ena amathandiza, koma zimabweretsa chimwemwe kwa iwo. Onani malangizo awa pa kuthana ndi khansa ya m'magazi ndi lymphoma .
Tengani nthawi yophunzira za kupulumuka. Pamene chithandizo cha khansa chimathera, mmalo mokondwerera, anthu ambiri amavutika maganizo. Zotsatira zosautsa za mankhwala ndi nthawi yomwe mumagwiritsa ntchito pamaganizo opatsirana kwambiri a khansa zingakuchititseni kudzifunsa ngati mudzamva bwino. Pemphani thandizo, ndipo musangomva "zatsopano". Pali zambiri zomwe zingatheke kuthandizira odwala matenda a khansa. Ndipo musaiwale kuti nthawi zina zabwino zimabwera kuchokera ku khansa. Zofufuza zimatiuza kuti khansa imasintha anthu m'njira zabwino osati zoipa.
Zotsatira
American Cancer Society. Kuchiza kwa acute promyelocytic (M3) khansa ya m'magazi. Kusinthidwa 02/22/16. http://www.cancer.org/cancer/leukemia-acutemyeloidaml/detailedguide/leukemia-acute-myeloid-myelogenous-treating-m3-leukemia
Jurcic, J., Soignet, S., Maslak, P. Kuzindikira ndi Chithandizo cha Acute Promyelocytic Leukemia. Malipoti Otsutsa Masiku Ano 2007. 9: 337-344.
Lemons, R., Keller, S., Gietzen, D., Dufner, J, Rebentisch, M., Feusner, J., Eilender, D. Acute Promyelocytic Leukemia Journal ya Matenda a Hematology / Oncology 1995. 17: 198- 210.
Sanz, M. Chithandizo cha Acute Promyelocytic Leukemia. American Society of Hematology 2006. 147- 155.
Wiernik, P., Gallagher, R., Tallman, M. "Acute Promyelocytic Leukemia" ku Wiernik, P., Goldman, J., Dutcher, J., Kyle, R. (eds.) (2003) Magazi- 4th ed. New York: Cambridge University Press.