Types/leukemia/patient/adult-all-treatment-pdq

Chithandizo cha Akuluakulu Acute Lymphoblastic Leukemia Treatment (?) - Patient Version

Zambiri Zokhudza Matenda Aakulu Aakulu A m'magazi

MFUNDO ZOFUNIKA

• Khansa ya m'magazi ya akulu (ALL) ndi mtundu wa khansa momwe mafupa amapangira ma lymphocyte ambiri (mtundu wa maselo oyera amwazi).

• Khansa ya m'magazi ingakhudze maselo ofiira ofiira, maselo oyera amwazi, ndi ma platelet.

• Chemotherapy yam'mbuyomu komanso kutulutsa ma radiation kumawonjezera chiopsezo chotenga ZONSE.

• Zizindikiro za achikulire ZONSE zimaphatikizapo kutentha thupi, kumva kutopa, kuvulaza kapena kutuluka magazi mosavuta.

• Kuyesa komwe kumayesa magazi ndi mafupa amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira wamkulu ONSE.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Khansa ya m'magazi ya akulu (ALL) ndi mtundu wa khansa momwe mafupa amapangira ma lymphocyte ambiri (mtundu wa maselo oyera amwazi).

Akuluakulu pachimake lymphoblastic khansa ya m'magazi (ZONSE; amatchedwanso pachimake lymphocytic khansa ya m'magazi) ndi khansa ya m'magazi ndi m'mafupa. Khansa yamtunduwu imakula msanga ngati singalandire chithandizo.

Thupi la fupa. Fupa limapangidwa ndi fupa lophatikizana, fupa la siponji, ndi mafupa. Fupa lokwanira limapanga gawo lakunja la fupa. Mafupa a siponji amapezeka makamaka kumapeto kwa mafupa ndipo amakhala ndi mafuta ofiira. Mafupa a mafupa amapezeka pakatikati pa mafupa ambiri ndipo amakhala ndi mitsempha yambiri yamagazi. Pali mitundu iwiri ya mafupa: ofiira ndi achikasu. Mafupa ofiira amakhala ndimaselo amwazi omwe amatha kukhala maselo ofiira, maselo oyera amwazi, kapena ma platelet. Mafupa achikasu amapangidwa makamaka ndi mafuta.

Khansa ya m'magazi ingakhudze maselo ofiira ofiira, maselo oyera amwazi, ndi ma platelet.

Nthawi zambiri, mafupa amapanga magazi am'magazi (maselo osakhwima) omwe amakhala maselo amwazi okhwima pakapita nthawi. Selo loyambira magazi limatha kukhala khungu la myeloid kapena tsinde la lymphoid.

Selo loyambira la myeloid limakhala amodzi mwamitundu itatu yamaselo okhazikika amwazi:

• Maselo ofiira ofiira omwe amanyamula mpweya ndi zinthu zina kumatumba onse amthupi.

• Mipata yomwe imapanga magazi kuundana kuti magazi asiye kutuluka.

• Ma granulocytes (maselo oyera amwazi) omwe amalimbana ndi matenda komanso matenda.

Selo la tsinde la lymphoid limakhala khungu la lymphoblast kenako imodzi mwamitundu itatu yama lymphocyte (maselo oyera amwazi):

• Ma lymphocyte B omwe amapanga ma antibodies kuti athandizire kulimbana ndi matenda.

• Ma lymphocyte a T omwe amathandiza ma lymphocyte a B kupanga ma antibodies omwe amathandiza kulimbana ndi matenda.

• Maselo opha achilengedwe omwe amalimbana ndi ma khansa ndi ma virus.

Kukula kwa maselo amwazi. Selo loyambira magazi limadutsa masitepe angapo kuti likhale khungu lofiira, platelet, kapena khungu loyera.

MU ZONSE, maselo ochuluka kwambiri amadzimadzi amakhala ma lymphoblasts, B lymphocytes, kapena T lymphocyte. Maselowa amatchedwanso maselo a leukemia. Maselo a leukemia sangathe kulimbana ndi matenda bwino. Komanso, kuchuluka kwa maselo a leukemia kumawonjezeka m'magazi ndi m'mafupa, pamakhala malo ochepa okhala ndi magazi oyera oyera, maselo ofiira, ndi ma platelets. Izi zitha kuyambitsa matenda, kuchepa kwa magazi, komanso magazi osavuta. Khansara imatha kufalikira kumtunda wamanjenje (ubongo ndi msana).

Chidulechi ndi cha achikulire a khansa ya m'magazi. Onani zowerengera zotsatirazi za kuti mumve zambiri za mitundu ina ya khansa ya m'magazi:

• Kuchiza Kwachangu kwa Lymphoblastic Leukemia Treatment.

• Chithandizo Chachikulu cha Myeloid Leukemia.

• Ubwana Wopweteka Myeloid Leukemia / Other Myeloid Malignancies Chithandizo.

• Kuchiza Kwachilendo kwa Lymphocytic Leukemia.

• Chithandizo Chachangu cha Leukemia.

• Chithandizo cha Khansa Ya m'magazi.

Chemotherapy yam'mbuyomu komanso kutulutsa ma radiation kumawonjezera chiopsezo chotenga ZONSE.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo. Zomwe zingakhale pachiwopsezo kwa ONSE ndi izi:

• Kukhala wamwamuna.

• Kukhala mzungu.

• Kukhala wamkulu kuposa 70.

• Chithandizo cham'mbuyomu ndi chemotherapy kapena radiation radiation.

• Kuwonetsedwa pama radiation yayikulu m'chilengedwe (monga radiation ya nyukiliya).

• Kukhala ndi zovuta zina zamtundu, monga Down syndrome.

Zizindikiro za achikulire ZONSE zimaphatikizapo kutentha thupi, kumva kutopa, kuvulaza kapena kutuluka magazi mosavuta.

Zizindikiro zoyambirira za ONSE zitha kukhala chimfine kapena matenda ena wamba. Funsani dokotala ngati muli ndi izi:

• Kufooka kapena kumva kutopa.

• Kutentha thupi kapena thukuta usiku.

• Kuvulaza kosavuta kapena kutuluka magazi.

• Petechiae (malo athyathyathya, osinkhasinkha pansi pa khungu, amayamba chifukwa chamagazi).

• Kupuma pang'ono.

• Kuchepetsa thupi kapena kusowa kwa njala.

• Kupweteka m'mafupa kapena m'mimba.

• Zowawa kapena kumva kwodzaza pansi pa nthiti.

• Ziphuphu zopanda pake m'khosi, pansi pamimba, m'mimba, kapena kubuula.

• Kukhala ndi matenda ambiri.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha khansa ya m'magazi yayikulu yam'magazi kapena zinthu zina.

Kuyesa komwe kumayesa magazi ndi mafupa amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira wamkulu ONSE.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikilo zaumoyo, kuphatikiza kuwunika ngati pali matenda, monga matenda kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kuwerengera kwathunthu kwa magazi (CBC) mosiyanasiyana: Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira ndi ma platelet.

• Chiwerengero ndi mtundu wama cell oyera.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

Kuwerengera kwathunthu kwa magazi (CBC). Magazi amatengedwa polowetsa singano mumtsempha ndikuloleza magazi kuti alowe mu chubu. Sampulo yamwazi imatumizidwa ku labotale ndipo maselo ofiira amwazi, maselo oyera amwazi, ndi ma platelet amawerengedwa. CBC imagwiritsidwa ntchito kuyesa, kuzindikira, ndikuwunika zochitika zosiyanasiyana.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

• Peripheral blood smear: Njira yomwe magazi amayang'aniridwa kuti aphulitse maselo, kuchuluka kwake ndi mitundu yama cell oyera, kuchuluka kwa ma platelets, komanso kusintha kwa mawonekedwe am'magazi.

• Kulakalaka kwa mafuta m'mafupa ndi biopsy: Kuchotsa mafupa, magazi, ndi kachigawo kakang'ono ka fupa poika singano yopanda kanthu m'chiuno kapena m'chifuwa. Katswiri wazachipatala amawona mafupa, magazi, ndi mafupa pansi pa microscope kuti ayang'ane maselo abwinobwino.

Kukhumba kwamfupa ndi mafupa. Gawo laling'ono la khungu litachita dzanzi, singano ya m'mafupa imalowetsedwa m'fupa la m'chiuno la wodwalayo. Zitsanzo zamagazi, mafupa, ndi mafupa amachotsedwa kuti zikaunikidwe ndi microscope.

Mayesero otsatirawa atha kuchitika pamitundu yamagazi kapena ya m'mafupa omwe achotsedwa:

• Kusanthula kwa cytogenetic: Kuyesa kwa labotale komwe ma chromosomes am'magazi am'magazi kapena m'mafupa amawerengedwa ndikuwunika ngati pali kusintha kulikonse, monga kusweka, kusowa, kukonzedwanso, kapena ma chromosomes owonjezera. Kusintha kwa ma chromosomes ena kungakhale chizindikiro cha khansa. Mwachitsanzo, ku Philadelphia chromosome-positive YONSE, gawo limodzi la chromosome limasintha malo ndi gawo lina la chromosome ina. Izi zimatchedwa "chromosome ya ku Philadelphia." Kusanthula kwa cytogenetic kumagwiritsidwa ntchito kuthandizira kuzindikira khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

Chromosome ya ku Philadelphia. Chidutswa cha chromosome 9 ndi chidutswa cha chromosome 22 chimachoka ndikugulitsa malo. Gulu la BCR-ABL limapangidwa pa chromosome 22 pomwe chidutswa cha chromosome 9 chimamangirira. Chromosome yosinthidwa 22 imatchedwa chromosome ya Philadelphia.

• Immunophenotyping: Kuyesa kwa labotale komwe kumagwiritsa ntchito ma antibodies kuti azindikire maselo a khansa kutengera mitundu ya ma antigen kapena zolembera zomwe zili pamwamba pamaselo. Kuyesaku kumagwiritsidwa ntchito kuthandizira kuzindikira mitundu ina ya khansa ya m'magazi. Mwachitsanzo, kafukufuku wa cytochemistry atha kuyesa ma cell mwa nyemba pogwiritsa ntchito mankhwala (utoto) kuti asinthe zina ndi zina. Mankhwala amatha kusintha mtundu wamtundu umodzi wa leukemia koma osasintha mtundu wina wa leukemia.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Zaka za wodwalayo.

• Kaya khansara yafalikira ku ubongo kapena msana.

• Kaya pali majini ena, kuphatikizapo chromosome ya ku Philadelphia.

• Kaya khansa idathandizidwapo kale kapena yabwereranso (kubwerera).

Magawo a Akuluakulu Acute Lymphoblastic Leukemia

MFUNDO ZOFUNIKA

• Wonse wamkulu atapezeka, amayesedwa kuti adziwe ngati khansara yafalikira m'kati mwa ubongo (ubongo ndi msana) kapena mbali zina za thupi.

• Palibe njira yokhazikika ya achikulire ONSE.

Wonse wamkulu atapezeka, amayesedwa kuti adziwe ngati khansara yafalikira m'kati mwa ubongo (ubongo ndi msana) kapena mbali zina za thupi.

Kukula kapena kufalikira kwa khansa nthawi zambiri kumafotokozedwa ngati magawo. Ndikofunika kudziwa ngati khansa ya m'magazi yafalikira kunja kwa magazi ndi mafupa kuti mukonzekere chithandizo. Mayesero ndi njira zotsatirazi zitha kugwiritsidwa ntchito kuti mudziwe ngati leukemia yafalikira:

• X-ray pachifuwa : X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikupita mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi.

• Lumbar puncture: Njira yogwiritsira ntchito nyemba ya cerebrospinal fluid (CSF) kuchokera kumtunda wa msana. Izi zimachitika poika singano pakati pa mafupa awiri mumsana ndi CSF mozungulira msana ndikuchotsa madzi. Chitsanzo cha CSF chimayang'aniridwa ndi microscope ngati pali zizindikiro zakuti maselo a leukemia afalikira kuubongo ndi msana. Njirayi imatchedwanso LP kapena tapu ya msana.

Lumbar kuboola. Wodwala amagona pamalo okuta patebulo. Dera laling'ono kumunsi kumapeto kwake, dzenje la msana (singano yayitali, yopyapyala) imalowetsedwa m'munsi mwa msana kuti muchotse madzi amadzimadzi (CSF, omwe akuwonetsedwa ndi buluu). Timadzimadzi timatumizidwa ku labotale kukayezetsa.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zam'mimba, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo za malo amkati mwa thupi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

Palibe njira yokhazikika ya achikulire ONSE.

Matendawa amafotokozedwa ngati osachiritsidwa, okhululukidwa, kapena obwereza.

Munthu wamkulu wosachiritsidwa ONSE

ZONSE zatulutsidwa kumene ndipo sizinathandizidwe kupatula kuthana ndi zizindikilo monga malungo, magazi, kapena kupweteka.

• Kuwerengera kwathunthu kwa magazi kumakhala kwachilendo.

• Maselo opitilira 5% am'mafupa amaphulika (ma cell a leukemia).

• Pali zizindikiro za khansa ya m'magazi.

Akuluakulu onse atakhululukidwa

ZONSE zathandizidwa.

• Kuwerengera kwathunthu kwa magazi ndikwabwino.

• Maselo 5% kapena ochepera m'mafupa amaphulika (maselo a leukemia).

• Palibe zisonyezo za khansa ya m'magazi kupatula m'mafupa.

Okhalanso Omwe Amakhala Ndi Khansa Ya m'magazi Yaakulu Akuluakulu

Matenda a khansa ya lymphoblastic leukemia (ALL) ndi khansa yomwe yabwereranso (yabwerera) itatha. ZONSE zikhoza kubwerera m'magazi, m'mafupa, kapena ziwalo zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi achikulire ONSE.
• Chithandizo cha achikulire ONSE nthawi zambiri chimakhala ndi magawo awiri.
• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Chemotherapy

• Thandizo la radiation

• Chemotherapy yokhala ndi tsinde

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chitetezo chamatenda

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Chithandizo cha akulu pachimake lymphoblastic khansa ya m'magazi chingayambitse mavuto.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi achikulire ONSE.

Pali mitundu yosiyanasiyana ya mankhwala kwa odwala omwe ali ndi khansa ya m'magazi (ALL). Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Chithandizo cha achikulire ONSE nthawi zambiri chimakhala ndi magawo awiri.

Chithandizo cha akulu ZONSE chikuchitika m'magulu:

• Thandizo lothandizira: Iyi ndi gawo loyamba la chithandizo. Cholinga ndikupha ma cell a leukemia m'magazi ndi m'mafupa. Izi zimayika khansa ya m'magazi kuti ikhululukidwe.

• Thandizo la Post-remission: Ili ndiye gawo lachiwiri la chithandizo. Imayamba kamodzi khansa ya m'magazi itakhululukidwa. Cholinga chothandizira kukhululukidwa ndi kupha maselo amtundu wa leukemia omwe sangakhale otakataka koma atha kuyambiranso ndikuyambiranso. Gawoli limatchedwanso kuchotsera kupitiriza chithandizo.

Chithandizo chotchedwa central nervous system (CNS) prophylaxis therapy nthawi zambiri chimaperekedwa panthawi iliyonse yamankhwala. Chifukwa mulingo woyenera wa chemotherapy mwina sungafikire maselo a leukemia mu CNS (ubongo ndi msana), maselo a leukemia amatha kubisala mu CNS. Chemotherapy yokhazikika yomwe imaperekedwa muyezo waukulu, intrathecal chemotherapy, ndi mankhwala a radiation kuubongo amatha kufikira ma cell a leukemia mu CNS. Mankhwalawa amaperekedwa kuti aphe ma cell a leukemia ndikuchepetsa mwayi womwe khansa ya m'magazi ingabwererenso (kubwerera).

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika mu cerebrospinal fluid (intrathecal chemotherapy), chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa. Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.

Intrathecal chemotherapy itha kugwiritsidwa ntchito pochiza wamkulu ZONSE zomwe zafalikira, kapena kufalikira, kuubongo ndi msana. Mukagwiritsidwa ntchito pochepetsa mwayi ma cell a leukemia adzafalikira kuubongo ndi msana, amatchedwa CNS prophylaxis.

Mankhwala otchedwa intrathecal chemotherapy. Mankhwala a anticancer amalowetsedwa mu intrathecal space, omwe ndi malo omwe amakhala ndi cerebrospinal fluid (CSF, yowonetsedwa ndi buluu). Pali njira ziwiri zochitira izi. Njira imodzi, yomwe ikuwonetsedwa kumtunda kwa chiwerengerocho, ndi kuyika mankhwalawo mu dziwe la Ommaya (chidebe chowoneka ngati dome chomwe chimayikidwa pansi pamutu pochita opareshoni; imagwira mankhwalawo akamadutsa chubu kakang'ono kupita muubongo ). Njira ina, yomwe ikuwonetsedwa kumapeto kwa chiwerengerocho, ndikulowetsa mankhwalawo mu CSF m'munsi mwa msana, pambuyo poti dera laling'ono kumunsi kwanjenjemera.

Onani Mankhwala Ovomerezeka a Acute Lymphoblastic Leukemia kuti mumve zambiri.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwalawa amaperekera zimadalira mtundu wa khansa. Chithandizo cha radiation chakunja chitha kugwiritsidwa ntchito kuchiza wamkulu ZONSE zomwe zafalikira, kapena zomwe zingafalikire, kuubongo ndi msana. Mukagwiritsidwa ntchito motere, amatchedwa central nervous system (CNS) malo opangira mankhwala kapena CNS prophylaxis. Thandizo la radiation lakunja litha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

Chemotherapy yokhala ndi tsinde

Chemotherapy imaperekedwa kuti iphe ma cell a khansa. Maselo athanzi, kuphatikiza maselo opanga magazi, nawonso amawonongedwa ndi chithandizo cha khansa. Kuika timitengo tating'onoting'ono ndi chithandizo m'malo mwa maselo omwe amapanga magazi. Maselo otchedwa stem cells (maselo a magazi osakhwima) amachotsedwa m'magazi kapena m'mafupa a wodwalayo kapena woperekayo ndipo amaundana ndi kusungidwa. Wodwalayo akamaliza chemotherapy, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Onani Mankhwala Ovomerezeka a Acute Lymphoblastic Leukemia kuti mumve zambiri.

Kupanga khungu la tsinde. (Gawo 1): Magazi amatengedwa mumtambo wa woperekayo. Wodwala kapena wina akhoza kukhala woperekayo. Magazi amayenda kudzera pamakina omwe amachotsa maselowo. Kenako magaziwo amabwezera woperekayo kudzera mumitsempha ya mkono wina. (Gawo 2): Wodwalayo amalandila chemotherapy kuti aphe maselo omwe amapanga magazi. Wodwala atha kulandira chithandizo cha radiation (chosawonetsedwa). (Gawo 3): Wodwalayo amalandila maselo am'magazi kudzera mu catheter yoyikidwa mumtsuko wamagazi pachifuwa.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Thandizo la monoclonal antibody ndi tyrosine kinase inhibitor therapy ndi mitundu ya mankhwala omwe amagwiritsidwa ntchito pochiza akuluakulu ONSE.

Thandizo la monoclonal antibody ndi khansa yomwe imagwiritsa ntchito ma antibodies opangidwa mu labotore, kuchokera ku mtundu umodzi wamatenda amthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Blinatumomab ndi inotuzumab ozogamicin ndi ma anti-monoclonal antibodies omwe amagwiritsidwa ntchito ndimatumba am'magazi am'magazi kuti athandize achikulire ONSE.

Thandizo la Tyrosine kinase inhibitor limatseka ma enzyme, tyrosine kinase, omwe amachititsa kuti maselo amadzipangire kukhala maselo oyera amwazi (kuphulika) kuposa momwe thupi limafunira. Imatinib mesylate (Gleevec), dasatinib, ndi nilotinib ndi tyrosine kinase inhibitors omwe amagwiritsidwa ntchito pochiza akulu ONSE.

Onani Mankhwala Ovomerezeka a Acute Lymphoblastic Leukemia kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

Mankhwala a CAR T-cell ndi mtundu wa immunotherapy womwe umasintha ma T cell (mtundu wama chitetezo amthupi) kuti athe kuwononga mapuloteni ena omwe ali pamwamba pa maselo a khansa. Maselo a T amachotsedwa kwa wodwalayo ndipo ma receptors ena apadera amawonjezedwa pamwamba pa labotore. Maselo osinthidwa amatchedwa chimeric antigen receptor (CAR) T maselo. Maselo a CAR T amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amachulukana m'magazi a wodwalayo ndikuukira ma cell a khansa. Chithandizo cha CAR T-cell chikuwerengedwa pochiza akuluakulu ZONSE zomwe zabwereranso (kubwerera).

Chithandizo cha CAR T-cell. Mtundu wa chithandizo momwe ma T cell a wodwala (mtundu wa chitetezo chamthupi) amasinthidwa mu labotore kotero amamangiriridwa ndi ma cell a khansa ndikuwapha. Magazi ochokera mumthambo wadzanja la wodwalayo amayenda kudzera mu chubu kupita kumakina a apheresis (osawonetsedwa), omwe amachotsa maselo oyera, kuphatikiza ma T, ndikutumiza magazi otsalawo kwa wodwalayo. Kenako, jini la cholandirira chapadera lotchedwa chimeric antigen receptor (CAR) imalowetsedwa m'maselo a T mu labotale. Maselo a CAR T mamiliyoni amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amatha kumangiriza antigen pamaselo a khansa ndikuwapha.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Chithandizo cha akulu pachimake lymphoblastic khansa ya m'magazi chingayambitse mavuto.

Kuti mumve zambiri zamankhwala oyambilira omwe amayamba mukalandira chithandizo cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Zotsatira zakumapeto kwa chithandizo cha ONSE zitha kuphatikizira chiwopsezo cha khansa yachiwiri (mitundu yatsopano ya khansa). Mayeso omwe akutsatiridwa pafupipafupi ndiofunikira kwambiri kwa omwe apulumuka kwanthawi yayitali.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Njira Zothandizira Kuchiza Khansa Yaikulu Yaikulu Ya m'magazi

M'chigawo chino

• Munthu Wosadwala Wachilendo Wopanda Khansa ya m'magazi

• Akuluakulu Acute Lymphoblastic Leukemia mu Kukhululukidwa

• Okhalanso Omwe Amakhala Ndi Khansa Ya m'magazi Yaakulu Akuluakulu

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Munthu Wosadwala Wachilendo Wopanda Khansa ya m'magazi

Chithandizo chamankhwala cha akulu acety lymphoblastic leukemia (ZONSE) panthawi yoperekera chikhululukiro chimaphatikizapo izi:

• Kuphatikiza chemotherapy.

• Mankhwala a Tyrosine kinase inhibitor okhala ndi imatinib mesylate, mwa odwala ena. Ena mwa odwalawa adzalandiranso chemotherapy.

• Chithandizo chothandizira kuphatikiza maantibayotiki ndi maselo ofiira amwazi ndi kuikidwa magazi.

• CNS prophylaxis therapy kuphatikiza chemotherapy (intrathecal ndi / kapena systemic) yokhala ndi kapena yopanda poizoniyu kupita kuubongo.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Akuluakulu Acute Lymphoblastic Leukemia mu Kukhululukidwa

Chithandizo choyenera cha achikulire ONSE munthawi ya kuchotsera pambuyo pake chimaphatikizapo izi:

• Chemotherapy.

• Mankhwala a Tyrosine kinase inhibitor okhala ndi imatinib, nilotinib, kapena dasatinib.

• Chemotherapy yokhala ndi tsinde.

• CNS prophylaxis therapy kuphatikiza chemotherapy (intrathecal ndi / kapena systemic) yokhala ndi kapena yopanda poizoniyu kupita kuubongo.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Okhalanso Omwe Amakhala Ndi Khansa Ya m'magazi Yaakulu Akuluakulu

Chithandizo choyenera cha achikulire omwe abwereranso ZONSE zitha kuphatikizira izi:

• Kuphatikiza kwa chemotherapy kutsatiridwa ndi kuphatika kwa tsinde.

• Thandizo la monoclonal antibody (blinatumomab kapena inotuzumab ozogamicin) lotsatiridwa ndi kuphatika kwa cell cell.

• Mankhwala ochepetsa cheza ochepetsa mphamvu ngati mankhwala ochepetsa nkhawa kuti athetse vuto ndikukhala ndi moyo wabwino.

• Mankhwala a Tyrosine kinase inhibitor okhala ndi dasatinib kwa odwala ena.

Zina mwazithandizo zomwe zikuwerengedwa m'mayesero azachipatala kwa akulu omwe abwereranso ZONSE ndi izi:

• Kuyesedwa kwachipatala koika ma cell pogwiritsa ntchito maselo am'mitsempha.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala.

• Kuyesedwa kwachipatala kwa mankhwala a chimeric antigen receptor (CAR) T-cell.

• Kuyesedwa kwachipatala kwa mankhwala atsopano a anticancer.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe Zambiri Zokhudza Matenda Aakulu Aakulu A m'magazi

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudzana ndi khansa yayikulu ya khansa ya m'magazi, onani izi:

• Tsamba la Khansa ya m'magazi

• Mankhwala Ovomerezeka a Acute Lymphoblastic Leukemia

• Kusandulika Kwamaselo Opangira Magazi

• Njira Zochizira Khansa

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira