Hom / mob rwj / neeg mob / menyuam-aml-kho-pdq

Thaum Ntxov Hlawv Mob Hlwb Mob Hlwb Nyau / Lwm Yam Mob Myeloid Malignancies (®) –Patient Version

Cov Lus Qhia Txog Hais Txog Cov Menyuam Muaj Mob Me Mob Hlwb Hlwb Qha Ntshav Tsis Zoo thiab Lwm Yam Tshuaj Myeloid Malignancies

QHOV TSEEM CEEB

• Cov me nyuam mob ntshav sib luag (AML) yog ib hom mob cancer uas tus hlwb pob txha ua rau cov ntshav muaj ntshav ntau.

• Kab mob ntshav thiab lwm yam kab mob ntawm cov ntshav thiab cov pob txha pob txha tuaj yeem cuam tshuam rau cov ntshav liab, cov qe ntshav dawb, thiab cov qe ntshav.

• Lwm yam kab mob myeloid tuaj yeem cuam tshuam rau cov ntshav thiab pob txha pob txha.

• Qho txawv txav myelopoiesis (TAM)

• Mob ntsws mob ntshav siab (APL)

• Kab mob ntshav siab mob myelomonocytic (JMML)

• Mob ntsws mob myelogenous ntev (CML)

• Cov Myelodysplastic syndromes (MDS)

• AML lossis MDS tuaj yeem tshwm sim tom qab kho qee yam tshuaj khomob thiab / lossis kev kho hluav taws xob.

• Cov kev pheej hmoo txaus ntshai rau thaum yau AML, APL, JMML, CML, thiab MDS zoo sib xws.

• Cov tsos mob thiab tsos mob ntawm cov menyuam yaus AML, APL, JMML, CML, lossis MDS suav nrog ua npaws, nkees, thiab yooj yim los ntshav lossis doog.

• Kev ntsuam xyuas uas kuaj cov ntshav thiab pob txha pob txha yog siv los kuaj (nrhiav) thiab kuaj mob thaum yau AML, TAM, APL, JMML, CML, thiab MDS.

• Qee yam cuam tshuam txog kev raug (mob rov qab) thiab txoj kev kho.

Cov me nyuam mob ntshav sib luag (AML) yog ib hom mob cancer uas tus hlwb pob txha ua rau cov ntshav muaj ntshav ntau.

Cov me nyuam mob ntshav sib luag (AML) yog mob qog noj ntshav thiab mob hlwb pob txha. AML tseem tseem hu ua mob myelogenous leukemia, mob myeloblastic leukemia, mob ntshav siab ntau, thiab cov ntshav tsis sib luag. Kab mob khees xaws uas mob hnyav feem ntau muaj ntau dua sai sai yog tias tsis kho. Mob qog noj ntshav uas mob nyhav feem ntau mob qeeb zuj zus.

Anatomy ntawm pob txha. Lub pob txha ua los ntawm cov pob txha sib dhos, pob txha hno, thiab pob txha pob txha. Cov pob txha sib xyaw ua rau cov txheej txheem sab nrauv ntawm pob txha. Daim tawv pob txha muaj nyob hauv qhov kawg ntawm cov pob txha thiab muaj cov hlwb liab. Hlwb Pob Txha yog nyob hauv plawv feem ntau ntawm cov pob txha thiab muaj ntau cov hlab ntshav. Muaj ob hom pob txha pob txha: liab thiab daj. Cov hlwb liab muaj cov qe ntshav liab uas tuaj yeem dhau los ua cov ntshav liab, cov qe ntshav dawb, lossis qe ua ntshav khov. Cov roj ntsha daj ua cov rog feem ntau.

Kab mob ntshav thiab lwm yam kab mob ntawm cov ntshav thiab cov pob txha pob txha tuaj yeem cuam tshuam rau cov ntshav liab, cov qe ntshav dawb, thiab cov qe ntshav.

Feem ntau, cov hlwb pob txha ua rau cov qe ntshav (cov qe ntshav tsis txaus) ua cov qe ntshav thaum lub sijhawm dhau los. Cov qe ntshav ntshav yuav dhau los ua myeloid qia cell los yog lymphoid qia cell. Cov lymphoid qia cell ua cov qe ntshav dawb.

Myeloid qia cell dhau los ua ib qho ntawm peb hom qe ntshav loj:

• Cov ntshav liab uas xa cov pa oxygen thiab lwm yam tshuaj rau txhua qhov nqaij ntawm lub cev.

• Cov qe ntshav dawb uas tawm tsam kev kis mob thiab kab mob.

• Platelets uas ua rau cov ntshav txhaws txhaws kom los ntshav.

Kev loj hlob ntawm cov ntshav. Cov qe ntshav muaj hla ntau kauj ruam dhau los ua lub qe ntshav liab, ntshav tawm, lossis qe ntshav dawb.

Hauv AML, cov qe ntshav myeloid feem ntau yog ib hom qe ntshav dawb tsis paub qab hau hu ua myeloblasts (lossis myeloid blast). Cov myeloblasts, lossis cov qe ntshav mob ntshav hauv ntshav, hauv AML yog qhov txawv txav thiab tsis dhau los ua cov qe ntshav dawb. Cov qe ntshav muaj zog tuaj yeem tsim tsa hauv cov ntshav thiab pob txha pob txha txhawm rau kom tsis muaj chaw txaus rau cov ntshav qog dawb, qe ntshav liab thiab ntshav khov. Thaum qhov no tshwm sim, kev kis mob, ua kom ntshav khov, lossis ntshav tau yooj yim.

Cov qe ntshav mob tau nthuav tawm sab nraud cov ntshav mus rau lwm qhov ntawm lub cev, suav nrog cov hlab ntsha hauv nruab nrab (lub hlwb thiab tus txha caj qaum), tawv, thiab cov pos hniav. Qee zaum cov qe ntshav qog ntshav tsim cov qog ua pob hu ua granulocytic sarcoma lossis chloroma.

Lwm yam kab mob myeloid tuaj yeem cuam tshuam rau cov ntshav thiab pob txha pob txha.

Qho txawv txav myelopoiesis (TAM)

TAM yog ib qho kev cuam tshuam ntawm cov hlwb pob txha uas tuaj yeem tshwm sim hauv cov menyuam tshiab uas muaj Down syndrome. Nws feem ntau ploj nws tus kheej hauv thawj 3 lub hlis ntawm lub neej. Cov menyuam mosliab uas tau TAM muaj feem ntau zog los tsim tus kabmob AML uantej muaj 3 xyoos. TAM tseem tseem hu ua kev hloov pauv myeloproliferative tsis xis nyob lossis mob qog nqaij hlav hauv lub cev.

Mob ntsws mob ntshav siab (APL)

APL yog subtype ntawm AML. Hauv APL, qee cov caj ces ntawm chromosome 15 hloov chaw nrog qee cov caj ces ntawm chromosome 17 thiab muaj qhov txawv txav hu ua PML-RARA. Lub PML-RARA gene xa xov uas nres promyelocytes (ib hom qe ntshav dawb) los ntawm kev paub tab. Cov qog ntshav (promyelocytes) (cov ntshav muaj ntshav roj) tuaj yeem tsim cov ntshav thiab pob txha pob txha kom thiaj li muaj tsawg dua cov ntshav dawb, qe ntshav liab, thiab qe ntshav. Cov teeb meem nrog ntshav khov thiab ntshav khov kuj yuav tshwm sim. Nov yog ib qho teeb meem mob loj uas xav tau kev kho mob kom sai li sai tau.

Kab mob ntshav siab mob myelomonocytic (JMML)

JMML yog tus mob cancer rau menyuam yaus uas feem ntau tshwm sim rau cov menyuam yaus hnub nyoog 2 xyoos thiab feem ntau yog menyuam yaus. Hauv JMML, ntau cov myeloid ntshav qia hlwb ua myelocytes thiab monocytes (ob hom qe ntshav dawb). Qee cov myeloid qia ua ntshav no yeej tsis dhau los ua cov qe ntshav dawb. Cov qog ua ntshav no, hu ua blasts, tsis tuaj yeem ua lawv cov haujlwm li ib txwm. Sij hawm dhau mus, cov mob hu ua myelocytes, monocytes, thiab lub cev tawg tau tawm ntawm cov ntshav liab thiab ntshav hauv lub hlwb pob txha. Thaum qhov no tshwm sim, kev kis mob, ua kom ntshav khov, lossis ntshav tau yooj yim.

Mob ntsws mob myelogenous ntev (CML)

CML pib tshwm sim thaum ntxov ntawm cov keeb ntshav myeloid thaum muaj qee yam kev pauv hloov gene. Ib feem ntawm cov noob, uas suav nrog ABL caj ces, ntawm chromosome 9 pauv qhov chaw nrog ib ntu ntawm cov noob ntawm chromosome 22, uas muaj BCR caj ces. Qhov no ua rau lub chromosome luv luv 22 (hu ua Philadelphia chromosome) thiab lub chromosome ntev heev 9. Qhov tsis txaus ntseeg BCR-ABL yog tsim los ntawm cov chromosome 22. Cov noob BCR-ABL qhia cov ntshav cov ntshav ntau dhau ntawm cov protein hu ua tyrosine. kinase. Tyrosine kinase ua rau cov qe ntshav dawb ntau dhau (cov qe ntshav muaj ntshav) tuaj mus ua cov hlwb pob txha. Cov qe ntshav muaj zog tuaj yeem tsim tsa hauv cov ntshav thiab pob txha pob txha txhawm rau kom tsis muaj chaw txaus rau cov ntshav qog dawb, qe ntshav liab thiab ntshav khov. Thaum qhov no tshwm sim, kev kis mob, ua kom ntshav khov, lossis ntshav tau yooj yim. CML tsis tshua muaj rau menyuam yaus.

Philadelphia chromosome. Ib daig ntawm cov chromosome 9 thiab ib daim ntawm cov chromosome 22 tawg tawm thiab cov chaw lag luam. BCR-ABL gene yog tsim nyob rau ntawm chromosome 22 qhov twg daim ntawm chromosome 9 txuas. Lub hloov pauv chromosome 22 yog hu ua Philadelphia chromosome.

Cov Myelodysplastic syndromes (MDS)

MDS tshwm sim muaj tsawg dua rau cov menyuam yaus dua li cov neeg laus. Hauv MDS, hlwb pob txha ua rau cov qe ntshav liab tsawg, qe ntshav dawb, thiab cov qe ua kom ntshav khov. Cov qe ntshav no yuav tsis loj thiab nkag rau hauv cov ntshav. Hom MDS nyob ntawm hom ntshav ntshav uas muaj kev cuam tshuam.

Qhov kev kho rau MDS nyob ntawm seb cov qe ntshav liab tsawg, qe ntshav dawb, lossis ntshav muaj ntshav tsawg. Ua haujlwm mus ntev, MDS yuav dhau los ua AML.

Cov ntsiab lus no yog hais txog menyuam yaus AML, TAM, menyuam yaus APL, JMML, menyuam yaus CML, thiab MDS thaum yau. Saib Cov Ntawv Qhia Txog Kev Loj Hlob Lymphoblastic Kev Kho Mob Ntshav Qab Zib Thaum Menyuam Yaus rau cov lus qhia txog kev kho mob menyuam yaus mob qog ntshav.

AML lossis MDS tuaj yeem tshwm sim tom qab kho qee yam tshuaj khomob thiab / lossis kev kho hluav taws xob.

Kev kho mob qog noj ntshav nrog qee cov tshuaj khomob thiab / lossis kho hluav taws xob yuav ua rau cov tshuaj AML (t-AML) lossis ntsig txog MDS (t-MDS). Txoj kev pheej hmoo ntawm cov kab mob ntsig txog kev kho tus mob myeloid nyob ntawm tag nrho cov koob tshuaj ntawm cov tshuaj kho siv thiab qhov ntsuas hluav taws xob thiab thaj chaw kho mob. Qee tus neeg mob tseem muaj feem yuav raug tus mob t-AML thiab t-MDS. Cov kab mob ntsig txog kev kho mob feem ntau tshwm sim hauv 7 xyoo tom qab kho, tab sis tsis tshua muaj rau cov menyuam yaus.

Cov kev pheej hmoo txaus ntshai rau thaum yau AML, APL, JMML, CML, thiab MDS zoo sib xws.

Txhua yam uas ua rau koj muaj feem yuav kis tus mob yog hu ua kev pheej hmoo. Muaj qhov muaj feem yuav tsis txhais tau tias koj yuav muaj mob qog noj ntshav; tsis muaj yam txaus ntshai tsis txhais tau tias koj yuav tsis muaj mob qog noj ntshav. Tham nrog koj tus menyuam tus kws kho mob yog tias koj xav tias koj tus menyuam raug pheej hmoo. Cov no thiab lwm yam yuav ua rau muaj kev pheej hmoo ntawm menyuam yaus AML, APL, JMML, CML, thiab MDS:

• Muaj ib tug nus-kwv lossis tus muam, tshwj xeeb tshaj yog menyuam ntxaib, mob ruas ntshav.

• Ua Neeg Mev.

• Raug raug luam yeeb lossis haus luam yeeb ua ntej yug.

• Muaj tus kheej keeb kwm kev mob ntshav tsis txaus.

• Muaj tus kheej lossis tsev neeg keeb kwm ntawm MDS.

• Muaj tsev neeg muaj keeb kwm ntawm AML.

• Yav dhau los kev kho mob nrog kev kho mob lossis tshuaj tua hluav taws xob.

• Raug rau cov hluav taws xob ionizing lossis tshuaj lom neeg zoo li benzene.

• Muaj qee yam kev mob hlwb lossis kev mob sib cais, xws li:

• Mob ntsws qis.

• Aplastic anemia.

• Fanconi anemia.

• Neurofibromatosis hom 1.

• Noonan syndrome.

• Shwachman-Diamond syndrome.

• Li-Fraumeni syndrome.

Cov tsos mob thiab tsos mob ntawm cov menyuam yaus AML, APL, JMML, CML, lossis MDS suav nrog ua npaws, nkees, thiab yooj yim los ntshav lossis doog.

Cov no thiab lwm yam cim thiab tsos mob tuaj yeem yog vim menyuam yaus AML, APL, JMML, CML, lossis MDS lossis lwm yam mob. Nrog kws kho mob tham yog tias koj tus menyuam muaj tej yam hauv qab no:

• Ua npaws nrog lossis tsis kis mob.

• Hmo ntuj tawm hws.

• Ua tsis taus pa.

• Tsis muaj zog los yog nkees.

• Ua kom doog ntshav yooj yim lossis los ntshav.

• Petechiae (tiaj, taw me ntsis hauv qab daim tawv nqaij los ntawm los ntshav).

• Mob hauv cov pob txha lossis pob qij txha.

• Mob los yog hnov ​​tag nrho hauv qab cov tav.

• Kev mob nyob hauv lub caj dab, tsis txaus ntseeg, plab, puab tais, lossis lwm qhov ntawm lub cev. Hauv thaum yau AML, cov qog no, hu ua mob ntsws

• cutis, tej zaum yuav xiav lossis liab doog.

• Kev mob ib ce uas qee zaum ib ncig ntawm lub qhov muag. Cov qog no, hu ua chloromas, qee zaum pom ntawm menyuam yaus AML thiab tej zaum yuav xiav-ntsuab.

• Daim tawv nqaij zoo li khaus.

Cov cim thiab cov tsos mob ntawm TAM yuav suav nrog cov hauv qab no:

• O o thoob plaws lub cev.

• Ua tsis taus pa.

• Teeb meem ua pa.

• Tsis muaj zog los yog nkees.

• Los ntshav ntau, txawm los ntawm kev txiav me me.

• Petechiae (tiaj, taw me ntsis hauv qab daim tawv nqaij los ntawm los ntshav).

• Mob hauv qab cov nqaj

• Cov tawv nqaij ua pob.

• Qhov muag daj (daj tawv nqaij tawv thiab ntsiab muag dawb).

• Mob taub hau, teeb meem pom, thiab tsis meej pem.

Qee zaum TAM tsis raug mob dab tsi thiab raug kuaj tom qab kuaj ntshav tas li.

Kev ntsuam xyuas uas kuaj cov ntshav thiab pob txha pob txha yog siv los kuaj (nrhiav) thiab kuaj mob thaum yau AML, TAM, APL, JMML, CML, thiab MDS. Cov ntawv xeem thiab txheej txheem hauv qab no yuav raug siv:

• Kev kuaj lub cev thiab keeb kwm: Kev tshuaj xyuas lub cev los kuaj cov cim ntawm kev noj qab haus huv, suav nrog kuaj lub cim ntawm tus kab mob, xws li cov qog lossis lwm yam uas zoo li txawv txawv. Cov keeb kwm ntawm tus neeg mob txoj kev noj qab haus huv thiab cov kab mob yav dhau los thiab kev kho mob tseem yuav raug coj los siv.
• Ua kom tiav cov ntshav suav (CBC) nrog kev sib txawv: Ib txoj kev ua uas coj los ntsuas thiab kuaj xyuas cov hauv qab no:

• Tus lej ntawm cov ntshav liab thiab cov qe ntshav.

• Tus lej thiab hom ntshav dawb.

• Cov ntshav hemoglobin (cov protein uas nqa oxygen) hauv cov ntshav liab.

• Feem ntawm cov ntshav ua tau los ntawm cov ntshav liab.

Ua kom tiav cov ntshav suav (CBC). Ntshav yog sau los ntawm kev ntxig ib rab koob rau hauv cov leeg thiab pub cov ntshav tuaj rau hauv lub raj. Cov ntshav ntsuas raug xa mus rau chav kuaj thiab ntshav liab, ntshav dawb, thiab cov ntshav khov yog suav. Lub CBC yog siv los ntsuas rau, ntsuas mob, thiab saib xyuas ntau yam mob.

Kev tshawb fawb hauv ntshav cov ntshav: Tus txheej txheem tso ntshav kuaj ntsuas los ntsuas cov khoom tshuaj uas tso rau hauv ntshav los ntawm cov plab hnyuv siab raum thiab cov nqaij hauv lub cev. Ib qho txawv (ntau dua lossis qis dua qub) ntawm cov tshuaj yuav ua rau lub cim ntawm tus kabmob.

• Xoo Xaim: Xoos hluav taws xob ntawm cov plab hnyuv siab raum thiab pob txha hauv hauv siab. Qhov xoo hluav taws xob yog ib hom kev tawm dag zog ntawm lub zog uas tuaj yeem nkag mus hauv lub cev thiab mus rau zaj duab xis, ua duab ntawm thaj chaw hauv lub cev.

• Tso me nyuam tawm: tshem tawm cov nqaij los yog nqaij kom lawv tuaj yeem saib nyob rau hauv lub tshuab tsom kab ntsig los ntawm tus kws kho mob kuaj seb puas muaj mob qog nqaij hlav. Tej zaum yuav raug txiav li cov nram no:

• Mob pob txha rau txoj kev cia siab thiab kuaj me me: Tshem tawm cov pob txha pob txha, ntshav, thiab ib qho me me ntawm pob txha los ntawm ntxig rab koob hollow rau hauv lub duav lossis lub qog.

Nqaij pob txha txhaws thiab nqus xyoob. Tom qab qhov chaw me me ntawm daim tawv nqaij loog, xoos pob txha pob txha tau tso rau hauv tus menyuam pob txha pob txha. Cov hnoos qeev ntshav, pob txha, thiab pob txha pob txha tau raug tshem tawm mus kuaj hauv lub tshuab tsom.

• Tumor biopsy: Kev tso ib qho kuab tshuaj ntawm lub chloroma tuaj yeem ua.

• Lymph node biopsy: Qhov tshem tawm tag nrho lossis ib feem ntawm cov qog ntshav.

• Immunophenotyping: Kev sim tshuaj uas siv tshuaj tiv thaiv kab mob ntawm cov qog nqaij hlav cancer ua raws li hom antigens lossis cim rau ntawm cov kem hlwb. Kev kuaj ntshav no yog siv los pab txheeb xyuas qee hom ntshav qab zib.

• Kev tshuaj ntsuam Cytogenetic: Kev sim tshuaj uas cov chromosomes ntawm cov hlwb hauv ib qho qauv ntawm cov ntshav lossis pob txha txhawm rau suav thiab txheeb xyuas rau txhua qhov hloov pauv, xws li tawg, ploj, rov kho dua, lossis ntxiv rau cov xoos xoos. Kev hloov qee yam chromosomes yuav yog mob qog nqaij hlav. Cytogenetic tsom xam yog siv los pab ntsuas mob qog noj ntshav, npaj kev kho mob, lossis pom tias kev kho mob ua haujlwm tau zoo npaum li cas.

Kev sim hauv qab no yog ib hom kev tshawb xyuas cytogenetic:

• FISH (fluorescence hauv situ hybridization): Lub chaw sim siv los saib thiab suav cov noob lossis cov keeb yoog nyob hauv cov hlwb thiab cov ntaub so ntswg. Cov qog ntawm DNA uas muaj cov xim fluorescent yog tsim nyob rau hauv chav kuaj thiab ntxiv rau ib qho qauv ntawm tus neeg mob lub hlwb lossis cov nqaij. Thaum cov dyed pieces ntawm DNA txuas rau qee cov caj ces lossis thaj chaw ntawm cov chromosomes hauv qhov qauv, lawv taws thaum saib hauv qab lub tshuab tsom fluorescent. Kev ntsuas FISH yog siv los pab ntsuas mob qog nqaij hlav thiab pab npaj kho mob.

• Kev kuaj mlecular: Kev sim ntsuas los kuaj qee cov noob, protein, lossis lwmyam qauv lwg me hauv cov ntshav los yog pob txha caj qaum. Cov kev sim tshuaj molecular tseem kuaj xyuas qee yam kev hloov pauv hauv cov gene lossis chromosome uas tej zaum yuav ua rau lossis cuam tshuam txoj kev muaj peev xwm ntawm AML. Kev kuaj ib qho qauv ntawm cov tshuaj molecular yuav raug siv los pab npaj phiaj xwm kho mob, tshuaj xyuas seb puas kho tau tus mob zoo, lossis ua kom raug kev kwv yees.

• Lumbar puncture: Tus txheej txheem siv los sau cov qauv ntawm cerebrospinal kua (CSF) los ntawm pob txha caj qaum. Qhov no yog ua los ntawm kev tso ib rab koob ntawm ob pob txha hauv tus nqaj qaum thiab nkag rau hauv CSF puag ncig tus txha nraub qaum thiab hle qhov hnoos qeev. Qhov piv txwv ntawm CSF raug kuaj hauv lub tshuab tsom rau cov cim qhia tias cov qe ntshav mob tau kis mus rau lub hlwb thiab tus txha caj qaum. Qhov txheej txheem no tseem hu ua LP lossis txha caj qaum.

Lumbar puncture. Tus neeg mob pw hauv ib qho chaw curled ntawm lub rooj. Tom qab thaj chaw me me ntawm sab nraub qaum yog numbed, koob koob txha nqaj (ntev dua, nyias koob) tau ntxig rau hauv qhov qis ntawm qhov txha caj qaum kom tshem tawm cov cerebrospinal kua (CSF, qhia hauv xiav). Cov kua dej yuav xa mus rau qhov chaw kuaj sim.

Qee yam cuam tshuam txog kev raug (mob rov qab) thiab txoj kev kho.

Qhov raug (sij hawm rov qab los) thiab kev xaiv kho mob rau menyuam yaus AML nyob ntawm seb:

• Lub hnub nyoog ntawm tus menyuam thaum kuaj mob qog noj ntshav.

• Haiv neeg lossis pawg neeg ntawm tus menyuam.

• Seb tus menyuam puas hnyav dhau.

• Cov naj npawb ntawm cov qe ntshav dawb hauv cov ntshav thaum kuaj pom.

• Seb AML puas tshwm sim tom qab kev kho mob qog noj ntshav dhau los.

• Lub subtype ntawm AML.

• Txawm hais tias muaj qee yam chromosome lossis cov noob hloov hauv cov qe ntshav muaj ntshav.

• Seb tus menyuam puas muaj mob syndrome. Yuav luag txhua tus menyuam yaus mob AML thiab Down mob ntsws tuaj yeem kho tau lawv tus mob ruas.

• Seb puas yuav mob leukemia nyob hauv nruab nrab lub paj hlwb (lub hlwb thiab tus txha caj qaum).

• Yuav sai npaum li cas cov roj ntsha tiv thaiv tau txais kev kho mob.

• Seb AML puas yog nyuam qhuav raug kuaj (tsis kho mob) lossis tau rov muaj dua tom qab kho tas.

• Lub sijhawm ntev npaum li cas txij li kev kho mob tas, rau AML uas tau rov muaj dua.

Kev soj ntsuam rau menyuam yaus APL nyob ntawm cov hauv qab no:

• Cov naj npawb ntawm cov qe ntshav dawb hauv cov ntshav thaum kuaj pom.

• Txawm hais tias muaj qee yam chromosome lossis cov noob hloov hauv cov qe ntshav muaj ntshav.

• Seb APL puas tau raug kuaj tshiab (tsis raug kho mob) lossis tau rov muaj dua tom qab kho tas.

Qhov ntsuas thiab kev kho mob rau JMML nyob ntawm cov hauv qab no:

• Lub hnub nyoog ntawm tus menyuam thaum kuaj mob qog noj ntshav.

• Hom noob cuam tshuam thiab tus naj npawb ntawm cov muaj hloov.

• Muaj pes tsawg lub monocytes (ib hom qe ntshav dawb) muaj nyob hauv cov ntshav.

• Ntau npaum li cas hemoglobin nyob rau hauv cov ntshav.

• Seb JMML puas nyuam qhuav raug kuaj (tsis kho) lossis rov muaj dua tom qab kho tas.

Qhov raug thiab txoj kev kho mob rau me nyuam CML yog nyob ntawm cov hauv qab no:

• Ntev npaum li cas nws tau raug kuaj txij li thaum tus neeg mob kuaj pom.

• Muaj pes tsawg lub qe ntshav nyob hauv cov ntshav.

• Txawm hais tias thiab tag nrho cov paj hlwb tawg ploj ntawm cov ntshav thiab pob txha pob txha tom qab kev kho pib tau pib li cas.

• Txawm hais tias CML tau nyuam qhuav raug kuaj mob (tsis raug kho) lossis tau rov muaj dua tom qab kho tas.

Kev sojntsuam thiab txoj kev kho rau MDS yog nce raws li hauv qab no:

• Seb MDS puas yog tsim los ntawm kev kho mob qog noj ntshav dhau los.

• Cov qe ntshav liab liab, qe ntshav dawb, lossis ntshav khov yog tsawg npaum li cas.

• Txawm hais tias MDS tau raug kuaj tshiab (tsis kho) lossis tau rov muaj dua tom qab kho tas.

Theem ntawm Menyuam yaus Mob Hliav Mob Hlwb Hlav Ntshav Qab Txhawj thiab Lwm Yam Tshuaj Myeloid Malignancies

QHOV TSEEM CEEB

• Thaum kuaj pom tus mob myeloid leukemia zoo (AML) lawm, muaj kev ntsuam xyuas kom paub seb puas muaj mob cancer kis mus rau lwm qhov hauv lub cev.

• Tsis muaj cov qauv txheej txheem rau cov menyuam yaus hnub nyoog AML, menyuam yaus mob sai ua kom muaj ntshav txhaws kabmob (APL), kabmob ntshav myelomonocytic leukemia (JMML), menyuam mob myelogenous leukemia (CML), lossis myelodysplastic syndromes (MDS).

• Rov qab tshwm sim thaum yau AML tau rov qab los tom qab nws tau kho nws.

Thaum kuaj pom tus mob myeloid leukemia zoo (AML) lawm, muaj kev ntsuam xyuas kom paub seb puas muaj mob cancer kis mus rau lwm qhov hauv lub cev.

Cov kev tshuaj ntsuam thiab cov txheej txheem hauv qab no yuav raug siv los txiav txim seb puas yuav ua kom ntshav qog ntshav tau kis mus rau lwm qhov ntawm lub cev:

• Lumbar puncture: Tus txheej txheem siv los sau cov qauv ntawm cerebrospinal kua (CSF) los ntawm pob txha caj qaum. Qhov no yog ua los ntawm kev tso ib rab koob ntawm ob pob txha hauv tus nqaj qaum thiab nkag rau hauv CSF puag ncig tus txha nraub qaum thiab hle qhov hnoos qeev. Qhov piv txwv ntawm CSF raug kuaj hauv lub tshuab tsom rau cov cim qhia tias cov qe ntshav mob tau kis mus rau lub hlwb thiab tus txha caj qaum. Qhov txheej txheem no tseem hu ua LP lossis txha caj qaum.

• Txo cov noob qes, zes qe menyuam, lossis daim tawv nqaij: tshem tawm cov qog lossis cov nqaij mos tawm los ntawm cov noob qes, zes qe menyuam, lossis daim tawv nqaij kom lawv tuaj yeem pom nyob rau hauv lub tshuab tsom kab ntsig kom kuaj seb puas muaj mob qog nqaij hlav. Qhov no ua tau yog tias muaj qee yam tsis txawv txog cov noob qes, zes qe menyuam, lossis daim tawv nqaij pom thaum kuaj lub cev.

Tsis muaj cov qauv txheej txheem rau cov menyuam yaus hnub nyoog AML, menyuam yaus mob sai ua kom muaj ntshav txhaws kabmob (APL), kabmob ntshav myelomonocytic leukemia (JMML), menyuam mob myelogenous leukemia (CML), lossis myelodysplastic syndromes (MDS).

Li cas los yog kis mob qog nqaij hlav feem ntau piav raws theem. Hloov ntawm cov theem, kev kho mob thaum menyuam yaus AML, menyuam yaus APL, JMML, menyuam yaus CML, thiab MDS ua raws ib lossis ntau yam hauv qab no:

• Hom mob lossis qhov quav ntawm AML.

• Seb puas muaj mob ntshav sib kis tau rau sab nraud cov ntshav thiab pob txha pob txha.

• Seb puas yog tus kabmob nyuam qhuav raug kuaj tshiab, hauv kev tshem tawm, lossis rov ua dua tshiab.

Cov nyuam qhuav nyuam qhuav tuag los kuaj tshiab hu ua AML

Cov kab mob tshiab rau thaum nyuam qhuav pib noj tshuaj AML tsis tau kho tshwj tsis yog ua rau txo cov tsos mob xws li kub taub hau, los ntshav, lossis mob, thiab ib qho ntawm cov hauv qab no yog pom:

• Ntau tshaj 20% ntawm cov keeb hauv cov hlwb pob txha yog cov khoom tawg (hlwb hlav).

lossis

• Tsawg dua 20% ntawm cov keeb hauv cov pob txha pob txha tawg thiab muaj qee qhov hloov pauv hauv cov chromosome.

Thaum yau AML nyob rau hauv kev zam txim

Hauv thaum yau AML nyob rau hauv kev tshem tawm, tus kab mob tau raug kho thiab cov hauv qab no pom:

• Tiav ntshav suav tag nrho yuav luag zoo li qub.

• Tsawg dua li 5% ntawm cov qe ntshav hauv cov pob txha txha yog cov khoom tawg (cov ntshav muaj roj).

• Tsis muaj cov cim qhia lossis tsos mob tshwm sim ntawm leukemia nyob rau hauv lub hlwb, tus txha caj qaum, lossis lwm qhov ntawm lub cev.

Rov qab tshwm sim thaum yau AML tau rov qab los tom qab nws tau kho nws.

Hauv kev rov qab ua menyuam yaus AML, mob qog ntshav yuav rov qab los ntawm cov ntshav thiab mob pob txha lossis lwm qhov hauv lub cev, xws li lub hauv nruab nrab cov hlab ntsha hlwb (lub hlwb thiab tus txha nqaj qaum).

Hauv refractory thaum yau AML, mob cancer tsis teb rau kev kho mob.

Txoj Kev Kho Mob Cov Tswv Yim

QHOV TSEEM CEEB

• Muaj ntau hom kev kho mob rau menyuam yaus uas muaj AML, TAM, APL, JMML, CML, thiab MDS.

• Txoj kev kho yog npaj los ntawm pab pawg saib xyuas kev noj qab haus huv uas yog tus kws tshaj lij hauv kev kho cov menyuam yaus mob ntshav nce hlwb thiab lwm yam kab mob ntawm cov ntshav.

• Txoj kev kho rau cov mob suam ntshav myeloid hnyav tuaj yeem ua rau muaj kev phiv tshuaj.

• Kev kho mob thaum yau AML feem ntau muaj ob theem.

• Xya hom qauv kev kho mob no tau siv rau cov menyuam yaus AML, TAM, menyuam yaus APL, JMML, menyuam yaus CML, thiab MDS.

• Kws khomob

• Kev siv hluav taws xob

• Qia cell hloov

• Cov hom phiaj kho

• Lwm txoj kev kho tshuaj

• Xyuam xim tos

• Kev pab tu

• Cov hom kev kho mob tshiab tau raug sim hauv qhov kev sim kho mob.

• Kev Txhaj Tshuaj Tiv Thaiv

• Cov neeg mob yuav xav txog kev sim kho mob.

• Cov neeg mob tuaj yeem nkag mus kuaj mob ua ntej, sijhawm, lossis tom qab pib kho mob qog noj ntshav.

• Tej zaum yuav tau ua raws li kev ntsuam xyuas.

Muaj ntau hom kev kho mob rau menyuam yaus uas muaj AML, TAM, APL, JMML, CML, thiab MDS.

Muaj ntau hom kev kho mob muaj rau cov menyuam yaus tus mob myeloid leukemia (AML), mob qog mob ntshav tsis huv (TAM), mob ntshav siab (ntshav qab zib) (Myelodysplastic syndromes) (MDS). Cov. Qee qhov kev kho mob yog tus qauv (cov kev kho mob tam sim no), thiab qee qhov raug sim hauv kev kuaj mob. Kev kho mob hauv tsev kho mob yog txoj kev tshawb nrhiav uas pab txhawm rau txhim kho kev kho mob tam sim no lossis tau txais cov ntaub ntawv ntawm kev kho mob tshiab rau cov neeg mob cancer. Thaum kuaj pom tias cov kev kho tshiab zoo dua li kev kho mob, cov kev kho mob tshiab tuaj yeem dhau los ua cov qauv kev kho mob.

Vim tias AML thiab lwm yam kev mob myeloid tsis tshua muaj rau cov menyuam yaus, kev koom nrog kev sim tshuaj yuav tsum tau coj los xav. Qee qhov kev sim tshuaj sim tsuas yog qhib rau cov neeg mob uas tseem tsis tau pib kho.

Txoj kev kho yog npaj los ntawm pab pawg saib xyuas kev noj qab haus huv uas yog tus kws tshaj lij hauv kev kho cov menyuam yaus mob ntshav nce hlwb thiab lwm yam kab mob ntawm cov ntshav.

Kev kho yuav raug saib xyuas los ntawm tus kws kho menyuam yaus, kws kho mob tshwj xeeb hauv kev kho menyuam yaus mob qog noj ntshav. Tus kws kho menyuam yaus ua haujlwm nrog lwm tus kws saib xyuas kev noj qab haus huv uas yog tus kws tshaj lij hauv kev kho cov menyuam yaus mob ntshav cev thiab tus kws paub tshwj xeeb hauv qee thaj chaw tshuaj. Cov no yuav suav nrog cov kws tshwj xeeb hauv qab no:

• Kws kho mob hlwb.

• Hematologist.

• Kws tshuaj oncologist.

• Kws phais neeg mob hlwb.

• Kws phais hluav taws xob oncologist.

• Neurologist.

• Tus Tshuaj Neuropathologist.

• Neuroradiologist.

• Kws saib xyuas neeg mob tshwj xeeb.

• Neeg ua hauj lwm pab neeg.

• Cov kws tshaj lij fab kev peem tsheej.

• Kws tshuaj sab laj.

Txoj kev kho rau cov mob suam ntshav myeloid hnyav tuaj yeem ua rau muaj kev phiv tshuaj.

Yog xav paub txog cov kev mob tshwm sim uas pib thaum kho mob cancer, mus saib peb Nplooj Ntawv Sab Npab.

Kev tshuaj xyuas tas li niaj zaus yog ib qho tseem ceeb heev. Cov kev mob tshwm sim los ntawm kev kho mob cancer uas pib tom qab kho thiab txuas ntxiv rau lub hlis lossis xyoo yog hu ua kev mob lig. Kev lig dhau los ntawm kev kho mob cancer tej zaum yuav muaj cov hauv qab no:

• Lub cev muaj teeb meem.

• Hloov pauv hauv txoj kev xav, kev xav, kev xav, kev kawm, lossis kev nco.

• Kab mob qog zaum ob (hom qog nqaij hlav tshiab).

Qee qhov cuam tshuam tom qab tuaj yeem kho lossis tswj tau. Nws yog ib qho tseem ceeb uas cov niam txiv ntawm cov menyuam uas tau txais kev kho mob AML lossis lwm tus mob ntshav tham nrog lawv tus menyuam tus kws kho mob txog cov teebmeem kev kho mob cancer tuaj yeem muaj rau lawv tus menyuam. (Saib cov ntsiab lus hais txog Cov Kev Kho Mob Npaws Sij Hawm Rau Kev Mob Hlwb Me Nyuam Me kom paub ntau ntxiv).

Kev kho mob thaum yau AML feem ntau muaj ob theem.

Kev kho mob thaum me nyuam yaus AML tau ua hauv theem:

• Kev kho mob Induction: Qhov no yog thawj theem ntawm kev kho mob. Lub hom phiaj yog tua cov hlwb mob ntshav hauv cov ntshav thiab hlwb pob txha. Qhov no tso qhov leukemia rau hauv kev zam txim.

• Kev pom zoo / siv tshuaj kho ntxiv: Nov yog theem thib ob ntawm kev kho. Nws pib thaum lub ntshav ntuag ntshav hauv kev kho mob. Lub hom phiaj ntawm txoj kev kho yog tua cov qog ntshav uas tseem tshuav uas tau zais thiab tsis tuaj yeem siv tau tab sis tuaj yeem pib rov ua dua thiab ua kom rov huam dua.

Kev kho mob hu ua central nervous system (CNS) prophylaxis txoj kev kho yuav muab rau lub sijhawm induction theem ntawm kev kho. Vim tias cov tshuaj muaj kuab tshuaj zoo ib yam yuav tsis ncav cuag cov qog ntshav hauv CNS (lub hlwb thiab tus txha caj qaum), cov qog ntshav ntawm kab mob tuaj yeem nkaum hauv CNS. Intrathecal kev kho mob tshuaj muaj peev xwm mus cuag cov ntshav qog ntshav hauv CNS. Nws muab rau tua cov ntshav ntawm cov ntshav leukemia thiab txo qhov muaj feem ua rau leukemia rov zoo li (rov qab los).

Xya hom qauv kev kho mob no tau siv rau cov menyuam yaus AML, TAM, menyuam yaus APL, JMML, menyuam yaus CML, thiab MDS.

Kws khomob

Kev siv tshuaj kho mob yog kev kho mob cancer uas siv cov tshuaj los txwv kev loj hlob ntawm cov qog nqaij hlav cancer, los ntawm kev tua cov qog lossis txwv tsis pub faib. Thaum cov tshuaj tua kab mob noj los ntawm qhov ncauj lossis txhaj rau hauv txoj hlab ntshav lossis leeg, cov tshuaj nkag mus rau cov ntshav thiab tuaj yeem mus txog rau cov qog nqaij hlav ntshav thoob plaws lub cev (kev kho mob tshuaj tua kabmob). Thaum cov kws kho mob tso tshuaj ncaj qha rau cov kua tshuaj tua kab mob hlwb (tshuaj pleev ib ce rau ib leeg), ib qho khoom hauv nruab nrog cev, lossis lub cev lub cev xws li lub plab zom mov, cov tshuaj feem ntau cuam tshuam rau cov qog nqaij hlav cancer hauv thaj chaw (thaj av kho mob). Kev sib xyaw ua ke ntawm kev siv tshuaj kho yog kho siv ntau dua ib txoj kev siv tshuaj kho mob.

Txoj hauv kev siv tshuaj khomob yog muab raws li hom tshuaj khomob kho. Hauv AML, kev siv tshuaj kho mob muab los ntawm qhov ncauj, leeg ntshav, lossis mus rau hauv cov kua dej ua kua dej cerebrospinal.

Hauv AML, cov qe ntshav mob qog yuav kis mus rau lub hlwb thiab / lossis tus txha nqaj qaum. Kws tshuaj muab los ntawm qhov ncauj lossis leeg txhawm rau kho AML tej zaum yuav hla tsis tau cov ntshav ntawm lub hlwb kom nkag mus rau hauv cov kua dej uas nyob ib ncig ntawm lub hlwb thiab tus txha caj qaum. Hloov chaw, kev siv tshuaj kho mob yog txhaj rau qhov chaw muaj kua dej txhawm rau tua cov ntshav mob leukemia uas yuav kis tau rau ntawd (kev siv tshuaj kho mob).

Intrathecal kev siv tshuaj kho mob. Cov tshuaj anticancer tau txhaj rau hauv qhov chaw intrathecal, uas yog qhov chaw khaws cov tshuaj cerebrospinal kua (CSF, qhia xiav). Muaj ob txoj hauv kev los ua qhov no. Ib txoj kev, qhia nyob rau sab kawg nkaus ntawm daim duab, yog txhaj cov tshuaj mus rau hauv Ommaya lub taub dej (lub thawv uas muaj cov dome uas tau tso rau hauv tawv taub hau thaum phais mob; nws tuav cov tshuaj thaum lawv ntws los ntawm lub raj me me rau hauv lub hlwb. )). Lwm txoj kev, qhia nyob rau hauv qab seem ntawm daim duab, yog kom txhaj cov tshuaj ncaj qha rau hauv CSF hauv ntu qis ntawm pob txha caj qaum, tom qab thaj chaw me me ntawm sab nraub qaum yog loog.

Mus Saib Cov Tshuaj Pom Zoo rau Mob Tus Mob Hlav Ntshav Qab Zib Rau lus qhia ntxiv.

Kev siv hluav taws xob

Kev xoo hluav taws xob yog kev kho mob cancer uas siv hluav taws xob xoo hluav taws xob loj lossis lwm yam hluav taws xob tua ntau los tua cov qog nqaij hlav cancer lossis ua kom lawv loj tuaj. Muaj ob txoj kev kho hluav taws xob:

• Kev siv hluav taws xob sab nraud siv lub tshuab sab nraud lub cev xa hluav taws xob mus rau cov kabmob.

• Kev kho hluav taws xob sab hauv yog siv cov tshuaj pleev hluav taws xob kaw hauv cov koob, noob, xov hlau, lossis cov paws menyuam uas tso ncaj qha mus rau lossis ze ntawm cov qog nqaij hlav cancer.

Txoj hauv kev siv hluav taws xob kho yog muab nyob ntawm hom mob cancer kho. Hauv thaum yau AML, kev siv hluav taws xob sab nraud yuav siv los kho cov tshuaj chloroma uas tsis teb rau kev kho mob.

Qia cell hloov

Kev siv tshuaj kho mob yog muab rau tua cov qog nqaij hlav cancer lossis lwm cov qe ntshav tsis zoo. Cov kab mob noj qab haus huv, suav nrog cov qe tsim cov ntshav, kuj raug rhuav tshem los ntawm kev kho mob qog noj ntshav. Kev hloov ntawm qia yog qhov kev kho mob los hloov cov qe tsim cov qe ntshav. Cov qia hlwb (cov qe ntshav tsis txaus) raug tshem tawm los ntawm cov ntshav lossis pob txha mob ntawm tus neeg mob lossis tus neeg pub ntshav thiab raug khov thiab khaws cia. Tom qab tus neeg mob ua tiav kev kho mob tshuaj, cov qia hlwb raug thaws thiab muab rov qab rau tus neeg mob los ntawm kev hla tshuaj. Cov qog ntshav qog ua kom loj hlob mus rau (thiab txum tim) lub cev cov ntshav.

Qia cell hloov. (Kauj Ruam 1): Ntshav tau txais los ntawm cov leeg ntshav hauv caj npab ntawm tus neeg pub ntshav. Tus neeg mob lossis lwm tus tuaj yeem ua tus pub. Cov ntshav ntws dhau los ntawm lub tshuab uas tshem cov qia. Tom qab ntawd cov ntshav xa rov qab rau tus neeg pub ntshav los ntawm txoj hlab ntsha hauv lwm sab caj npab. (Kauj Ruam 2): Tus neeg mob tau txais tshuaj kho mob los tua cov qe tsim cov ntshav. Tus neeg mob yuav tau txais kev kho mob hluav taws xob (tsis qhia). (Kauj Ruam 3): Tus neeg mob tau txais cov qia hlwb los ntawm txoj raj tso rau hauv cov hlab ntshav hauv siab.

Cov hom phiaj kho

Cov hom phiaj kho yog ib hom kev kho mob uas siv tshuaj los yog lwm yam tshuaj los txheeb xyuas thiab tua cov qe ntshav tshwj xeeb tsis yog ua mob rau cov leeg zoo li qub. Cov hom kev kho mob suav nrog cov hauv qab no:

• Kev Kho Mob Tyrosine kinase: Txoj kev kho Tyrosine kinase inhibitor (TKI) kev kho kom pom cov cim xav tau rau cov qog loj tuaj. TKIs thaiv cov enzyme (tyrosine kinase) uas ua rau cov qia hlwb ua cov qe ntshav dawb ntau dua (cov khoom tawg) dua li lub cev xav tau. TKI yuav raug siv nrog kev siv tshuaj kho mob raws li kev kho mob (kev kho mob tom qab kho thawj zaug, txo qis kev pheej hmoo tias mob cancer yuav rov qab los).

• Imatinib, dasatinib, thiab nilotinib yog TKI uas yog siv los kho CML thaum yau.

• Sorafenib thiab trametinib tau kawm hauv kev kho mob rau cov menyuam yaus mob qog ntshav.

• Kev Kho Mob Monoclonal: Cov txheej txheem tiv thaiv kab mob monoclonal siv cov tshuaj tiv thaiv kab mob hauv chav kuaj, los ntawm ib hom kab mob tiv thaiv kab mob ntawm tes. Cov tshuaj tiv thaiv no tuaj yeem txheeb xyuas cov tshuaj ntawm qog nqaij hlav cancer lossis cov khoom qub uas tuaj yeem pab ua kom cov cell mob qog noj ntshav. Cov tshuaj tiv thaiv txuas rau cov tshuaj thiab tua cov qog nqaij hlav cancer, thaiv lawv qhov kev loj hlob, lossis txwv tsis pub kis mus rau lwm qhov. Cov kab mob monoclonal yog muab los ntawm kev lis ntshav. Lawv yuav raug siv nyob ib leeg lossis nqa tshuaj, co toxins, lossis khoom siv hluav taws xob ncaj qha mus rau qog nqaij hlav cancer.

• Gemtuzumab yog ib hom monoclonal antibody uas txuas nrog rau kev siv tshuaj kho mob. Nws yog siv hauv kev kho mob ntawm AML.

Selinexor yog cov hom phiaj kho tshuaj uas tau kawm txog kev kho kom rov zoo lossis rov qab muaj zog thaum yau AML.

Saib Cov Tshuaj Tso Cai Pom Kev Leukemia xav paub ntxiv.

Lwm txoj kev kho tshuaj

Lenalidomide tuaj yeem siv los txo qis qhov kev xav hloov ntshav hauv cov neeg mob uas muaj myelodysplastic syndromes tshwm sim los ntawm kev hloov pauv tshwj xeeb. Nws tseem tseem tau kawm txog kev kho mob menyuam yaus nrog kev rov ua dua thiab refractory AML.

Arsenic trioxide thiab txhua yam kev hloov cov kab mob retinoic acid (ATRA) yog cov tshuaj uas tua qee yam kab mob ntshav leukemia, nres cov ntshav ntawm leukemia los ntawm kev faib, lossis pab cov qe ntshav leukemia los ua qe ntshav dawb. Cov tshuaj no yog siv rau hauv kev kho mob ntawm tus mob sai promyelocytic.

Mus Saib Cov Tshuaj Pom Zoo rau Mob Tus Mob Hlav Ntshav Qab Zib Rau lus qhia ntxiv.

Xyuam xim tos

Kev tos kom ceev faj yog saib xyuas tus neeg mob kom zoo tsis tas kho mob kom txog thaum muaj cov tsos mob tshwm sim los yog hloov. Qee lub sij hawm nws tau siv los kho MDS lossis hloov pauv myelopoiesis (TAM).

Kev pab tu

Kev pab tu yog muab rau txo cov teeb meem tshwm sim los ntawm tus kabmob lossis nws txoj kev kho. Txhua tus neeg mob qog ntshav tau txais kev pab kho mob kom zoo. Kev saib xyuas mob siab yuav suav nrog cov hauv qab no:

• Txoj kev kho ntshav ntxiv: Ib txoj kev muab cov qe ntshav liab, qe ntshav dawb, lossis qe ntshav los hloov cov qe ntshav ua puas tsuaj los ntawm kev kho tus mob Cov ntshav yuav tau muab los ntawm lwm tus neeg lossis nws tuaj yeem nqa los ntawm tus neeg mob ua ntej thiab khaws cia kom txog thaum xav tau.

• Siv tshuaj kho mob, xws li tshuaj tua kab mob los yog cov tshuaj tua kab mob.

• Leukapheresis: Ib txoj kev ua nyob hauv lub tshuab tshwj xeeb yog siv los tshem cov qe ntshav dawb hauv cov ntshav. Ntshav tau tawm los ntawm tus neeg mob thiab tso los ntawm cov ntshav sib cais uas cov qe ntshav dawb raug tshem tawm. Qhov seem ntawm cov ntshav ces rov qab mus rau tus neeg mob cov ntshav. Leukapheresis yog siv los kho cov neeg mob ntshav dawb ntau ntawm cov ntshav.

Cov hom kev kho mob tshiab tau raug sim hauv qhov kev sim kho mob.

Tshooj lus kawg piav txog kev kho mob uas tau kawm hauv kev sim tshuaj. Nws yuav tsis hais txog txhua txoj kev kho tshiab tau kawm. Cov ntaub ntawv hais txog kev sim kho mob muaj nyob rau ntawm NCI lub vev xaib.

Kev Txhaj Tshuaj Tiv Thaiv

Kev Siv Tshuaj Tiv Thaiv yog ib txoj kev kho mob uas siv tus neeg mob lub cev tiv thaiv kab mob cancer. Cov tshuaj uas tsim los ntawm lub cev lossis tsim hauv chav siv tshuaj yog siv los txhawb, ncaj qha, lossis rov kho lub cev lub cev los tiv thaiv tus mob qog nqaij hlav. Hom kev kho mob cancer no tseem hu ua kev siv tshuaj lom neeg los yog kev kho tsiaj.

Cov neeg mob yuav xav txog kev sim kho mob.

Txog qee tus neeg mob, koom nrog kev sim kho mob yuav yog txoj kev xaiv zoo tshaj plaws. Cov chaw kuaj mob yog ib feem ntawm cov txheej txheem tshawb mob qog noj ntshav. Cov chaw kho mob tau sim ua kom pom tias kev kho mob qog noj ntshav tshiab muaj kev nyab xeeb thiab zoo dua lossis zoo dua cov qauv tshuaj.

Ntau yam ntawm cov qauv kev kho mob qog noj ntshav niaj hnub no yog los ntawm cov kev tshawb fawb kab mob thaum ntxov. Cov neeg mob uas koom nrog kev sim kho mob tuaj yeem tau txais cov qauv kev kho mob lossis ua thawj zaug tau txais kev kho mob tshiab.

Cov neeg mob uas koom nrog kev sim kho mob kuj pab txhim kho txoj kev kho mob qog nqaij hlav yav tom ntej. Txawm hais tias kev sim tshuaj sim tsis ua rau muaj kev kho mob tshiab, lawv feem ntau teb cov lus nug tseem ceeb thiab pab txav kev tshawb fawb tom ntej.

Cov neeg mob tuaj yeem nkag mus kuaj mob ua ntej, sijhawm, lossis tom qab pib kho mob qog noj ntshav. Qee qhov kev sim tshuaj tsuas yog suav nrog cov neeg mob uas tseem tsis tau txais kev kho mob. Lwm txoj kev sim sim cov kev kho mob rau cov neeg mob uas mob qog noj qab tsis tau zoo dua. Kuj tseem muaj cov kev sim tshuaj kuaj mob uas sim txoj kev tshiab los txwv qog noj ntshav kom tsis txhob mob ntxiv (rov qab los) lossis txo kev phiv los ntawm kev kho mob qog noj.

Cov chaw kuaj mob tau tshwm sim nyob rau ntau lub tebchaws. Cov ntaub ntawv hais txog kev sim kho mob uas tau txhawb nqa los ntawm NCI tuaj yeem nrhiav pom ntawm NCI cov chaw kuaj mob tshawb nrhiav lub vev xaib. Cov chaw kuaj mob txhawb nqa los ntawm lwm cov koomhaum tuaj yeem nrhiav pom ntawm ClinicalTrials.gov lub vev xaib.

Tej zaum yuav tau ua raws li kev ntsuam xyuas.

Qee qhov kev ntsuas mob uas tau ntsuas los kuaj mob qog noj ntshav lossis kom pom tias theem mob cancer yuav rov qab ua dua. Qee qhov kev ntsuas yuav rov ua qhov qub txhawm rau kom pom tias qhov kev kho mob ua haujlwm li cas. Cov kev txiav txim siab hais txog seb puas yuav txuas ntxiv, hloov, lossis tsum tsis mus kho yuav ua raws cov txiaj ntsig ntawm cov kev ntsuas no.

Qee qhov kev sim yuav txuas ntxiv ua ib zaug dhau ib zaug tom qab kho tas. Qhov tshwm sim ntawm cov kev sim no tuaj yeem qhia tau yog tias koj tus menyuam tus mob tau hloov lossis yog tus kabmob tau mob ntxiv (rov qab los). Qee qhov kev ntsuas no qee zaum hu ua kev kuaj mob rov qab lossis mus kuaj mob.

Cov Kev Xaiv Kho rau Cov Menyuam Yaus Kho Mob Hlav Hlwb Mob Hlwb Hlav Tawm Taug Qha

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev kho mob ntawm cov kab mob nyuam qhuav pib muaj tus mob myeloid leukemia (AML) thaum lub sijhawm induction theem yuav suav nrog cov hauv qab no:

• Kev sib xyaw nrog kev kho tshuaj.

• Kev kho hom phiaj nrog lub monoclonal antibody (gemtuzumab).

• Nruab nrab lub paj hlwb prophylaxis kev kho mob nrog kev siv tshuaj khomob intrathecal.

• Kev siv hluav taws xob kho, rau cov neeg mob uas muaj cov tshuaj tua kab mob (granulocytic sarcoma) (chloroma) yog tias siv tshuaj tua kab mob tsis ua haujlwm.

• Kev hloov pauv qia rau, rau cov neeg mob uas muaj kev kho mob ntsig txog AML.

Kev kho mob thaum yau AML thaum lub sijhawm kev kho dua (kev kho mob / sib zog ua kom zoo dua qub) nyob ntawm subtype ntawm AML thiab tej zaum yuav suav nrog cov hauv qab no:

• Kev sib xyaw nrog kev kho tshuaj.

• Kev siv tshuaj ntau ntxiv los ntawm kev hloov cov kab mob ntshav los ntawm kev siv cov qe ntshav los ntawm tus neeg pub.

Kev kho mob ntawm refractory thaum yau AML yuav suav nrog cov hauv qab no:

• Lenalidomide txoj kev kho.

• Kev sim tshuaj khomob thiab tshuaj kho mob lub hom phiaj (selinexor).

• Ib qho kev sib txuas nrog cov tshuaj tua hluav taws xob tshiab.

Kev kho mob rau cov menyuam yaus thaum muaj sijhawm AML yuav suav nrog cov hauv qab no:

• Kev sib xyaw nrog kev kho tshuaj.

• Kev sib txuas ua ke ntawm cov tshuaj khomob thiab lub cev hloov pauv rau cov neeg mob, uas tau rov qab ua tiav zaum ob.

• Qhov thib ob qia cell hloov, rau cov neeg mob uas nws cov kab mob rov qab los tom qab thawj lub qog cell hloov ntshav.

• Kev sim tshuaj khomob thiab tshuaj kho mob lub hom phiaj (selinexor).

Cov Kev Kho Mob Rau Cov Neeg Mob Qog Tsis Zoo Myelopoiesis lossis Cov Menyuam Muaj Mob Hlwb Hlav thiab AML

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev hloov mus rau lwm qhov tsis meej myelopoiesis (TAM) feem ntau yuav ploj mus ntawm nws tus kheej. Rau TAM uas tsis ploj mus ntawm nws tus kheej lossis ua rau lwm cov teeb meem kev noj qab haus huv, kev kho mob yuav suav nrog cov hauv qab no:

• Pab tu, suav nrog kev hloov ntshav kho lossis ntshav tawv nqaij txhawb.

• Kws khomob.

Kev kho mob ntawm cov mob myeloid tawv nqaij dawb (AML) rau cov menyuam yaus hnub nyoog 4 xyoos lossis qis dua uas muaj Down syndrome yuav suav nrog cov hauv qab no:

• Kev kho tshuaj sib xyaw nrog rau kev kho lub hauv nruab nrog lub paj hlwb txoj kev kho mob hlwb nrog rau kev siv tshuaj kho kom zoo.

• Kev sim tshuaj ntawm kev muab tshuaj tua kab mob tshiab yog nyob ntawm seb tus menyuam teb li cas thaum pib cov tshuaj khomob.

Kev kho mob ntawm AML rau cov menyuam yaus hnub nyoog qis dua 4 xyoos uas muaj mob syndrome yuav zoo ib yam li kev kho mob rau cov menyuam yaus uas tsis muaj tus mob syndrome.

Cov Kev Xaiv Kho rau Menyuam Yaus Kho Mob Hlwb Hlwb Qha Ntshav Caws Tsis Zoo

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev kho mob rau cov me nyuam uas nyuam qhuav soj ntsuam tus mob ntshav liab (promoelocytic leukemia) (APL) kuj yuav suav nrog:

• All-trans retinoic acid (ATRA) ntxiv rau kev siv tshuaj kho.

• Arsenic trioxide kev kho.

• Kev sim tshuaj ATRA thiab arsenic trioxide kho nrog lossis tsis muaj tshuaj lom.

Kev kho ntawm menyuam yaus APL thaum lub sijhawm daws dua (kev kho ua ke / sib zog ua kom zoo) tuaj yeem suav cov hauv qab no:

• All-trans retinoic acid (ATRA) ntxiv rau kev siv tshuaj kho.

Kev kho kom rov zoo li qub thaum menyuam yaus APL yuav suav nrog cov hauv qab no:

• Arsenic trioxide kev kho.

• All-trans retinoic acid kho (ATRA) ntxiv rau kev siv tshuaj kho.

• Kev kho hom phiaj nrog lub monoclonal antibody (gemtuzumab).

• Kev hloov pauv ntawm qog siv cov qe ntshav los ntawm tus neeg mob lossis tus neeg muab nyiaj.

Cov Lus Qhia Txog Kev Kho Mob Rau Cov Menyuam Yaus Tshuaj Myelomonocytic Leukemia

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev kho mob rau cov hluas ntshav myelomonocytic leukemia (JMML) yuav suav nrog cov hauv qab no:

• Kev siv tshuaj sib txuas ua ke nrog kev hloov ntawm qia. Yog tias JMML rov ua haujlwm dua tom qab hloov qia ntawm tes, yuav hloov kho qia ntawm tes ib zaug kom tiav.

Kev kho mob ntawm refractory lossis txuas hnub nyoog JMML tuaj yeem suav nrog cov hauv qab no:

• Kev sim tshuaj mob rau cov hom phiaj kho nrog tus mob tyrosine kinase inhibitor (trametinib).

Cov Kev Xaiv Kho rau Menyuam Yaus Mob Hlwb Mob Hlwb Hlwb Ntev

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev kho rau cov mob ntsws myelogenous mob ntshav dawb (CML) yuav suav nrog cov hauv qab no:

• Cov hom phiaj kho nrog tus mob tyrosine kinase inhibitor (imatinib, dasatinib, lossis nilotinib).

Kev kho mob ntawm refractory lossis rov ua dua thaum yau CML yuav suav nrog cov hauv qab no:

• Cov hom phiaj kho nrog tus mob tyrosine kinase inhibitor (dasatinib lossis nilotinib).

• Kev hloov ntawm qog siv ntshav qia los ntawm tus neeg pub ntshav.

Cov Txheej Txheem Kho Rau Cov Menyuam Yaus Myelodysplastic Syndromes

Yog xav paub txog cov kev kho mob uas teev rau hauv qab no, saib hauv Cov Lus Qhia Kev Xaiv Kev Xaiv.

Kev kho cov kab mob myelodysplastic syndromes (MDS) yuav suav nrog cov hauv qab no:

• Kev hloov ntawm qog siv ntshav qia los ntawm tus neeg pub ntshav.

• Kev pab tu, nrog rau kev hloov ntshav thiab tshuaj tua kab mob.

• Lenalidomide txoj kev kho, rau cov neeg mob uas muaj qee yam hloov pauv noob.

• Ib qho kev sim kho mob rau cov hom phiaj kho.

Yog tias MDS dhau los ua mob myeloid leukemia (AML), txoj kev kho yuav zoo ib yam li kev kho rau cov tshuaj AML tshiab.

Kom Kawm paub ntau ntxiv Txog Menyuam Yaus Acute Myeloid Leukemia thiab Lwm Yam Myeloid Malignancies

Yog xav paub ntau ntxiv los ntawm National Cancer Institute txog thaum yau mob myeloid leukemia thiab lwm yam mob myeloid, pom cov hauv qab no:

• Tshuaj Pom Zoo rau Mob Ntshav Siab Mob Hlwb Ntshav Dawb Ntshav Qab Zib

• Cov Tshuaj Tau Pom Zoo rau Myeloproliferative Neoplasms

• Ntshav-Ua Rau Lub Cev Hloov Pauv

• Hom Kab Mob Kuaj Mob Cancer

Yog xav paub ntau ntxiv txog kev mob qog noj ntshav thaum tseem yau thiab lwm yam kev qhia txog mob qog noj ntshav, saib cov hauv qab no:

• Txog Mob Cancer

• Kev Menyuam Kab Menyuam Kiag

• CureSearch rau Cov Menyuam Txoj Kev Mob Cancer

• Qhov Zoo Los Ntawm Txoj Kev Kho Mob Kheev Me Menyuam Thaum Ntxov

• Cov Hluas thiab Cov Hluas Hluas Muaj Mob Cancer

• Cov Menyuam Muaj Mob Cancer: Cov Lus Qhia rau Niam Txiv

• Mob Cancer rau Cov Menyuam thiab Cov Hluas

• Qib

• Kev Muaj Mob Cancer

• Cov Lus Nug Yuav Nug Koj Tus Kws Kho Mob txog Kab Mob Cancer

• Rau Cov Muaj Txoj Sia Nyob thiab Cov Saib Xyuas