Mitundu / khansa ya m'magazi / wodwala / mwana-aml-chithandizo-pdq

Childhood Acute Myeloid Leukemia / Other Myeloid Malignancies Treatment (®) -Patient Version

Zambiri Zokhudza Matenda Aakulu a Myeloid Leukemia ndi Ma Myeloid Malignancies

MFUNDO ZOFUNIKA

• Ubwana pachimake myeloid khansa ya m'magazi (AML) ndi mtundu wa khansa momwe mafupa amapanga kuchuluka kwa maselo osadziwika amwazi.

• Khansa ya m'magazi ndi matenda ena am'magazi ndi m'mafupa amatha kukhudza maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Matenda ena a myeloid amatha kukhudza magazi ndi mafupa.

• Zovuta zachilendo myelopoiesis (TAM)

• Khansa yapadera ya khansa ya m'magazi (APL)

• Khansa ya myelomonocytic khansa ya m'magazi (JMML)

• Matenda a myelogenous khansa ya m'magazi (CML)

• Myelodysplastic syndromes (MDS)

• AML kapena MDS imatha kuchitika atalandira chithandizo ndi mankhwala ena a chemotherapy komanso / kapena radiation radiation.

• Zowopsa zaubwana AML, APL, JMML, CML, ndi MDS ndizofanana.

• Zizindikiro za ubwana AML, APL, JMML, CML, kapena MDS zimaphatikizapo malungo, kumva kutopa, komanso kutuluka mwazi mosavuta kapena kuvulala.

• Mayeso omwe amafufuza magazi ndi mafupa amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira ubwana wa AML, TAM, APL, JMML, CML, ndi MDS.

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

Ubwana pachimake myeloid khansa ya m'magazi (AML) ndi mtundu wa khansa momwe mafupa amapanga kuchuluka kwa maselo osadziwika amwazi.

Ubwana pachimake myeloid khansa ya m'magazi (AML) ndi khansa yamagazi ndi mafupa. AML amatchedwanso pachimake myelogenous khansa ya m'magazi, pachimake myeloblastic khansa ya m'magazi, pachimake granulocytic khansa ya m'magazi, ndi pachimake nonlymphocytic khansa ya m'magazi. Khansa yomwe imakhala yovuta nthawi zambiri imakula msanga ngati singalandire chithandizo. Khansa yomwe imakhalapo nthawi zambiri imakula pang'onopang'ono.

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 ndi matenda ena am'magazi ndi m'mafupa amatha kukhudza maselo 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 la tsinde la lymphoid limasanduka khungu loyera la magazi.

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

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

• Maselo oyera amagazi omwe amalimbana ndi matenda komanso matenda.

• Mipata yomwe imapanga magazi kuundana kuti magazi asiye kutuluka.

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

Mu AML, maselo a myeloid nthawi zambiri amakhala mtundu wa maselo oyera amtundu wamtundu wotchedwa myeloblasts (kapena myeloid blast). Ma myeloblasts, kapena maselo a leukemia, mu AML ndi achilendo ndipo samakhala maselo oyera oyera athanzi. Maselo a khansa ya m'magazi amatha kukhazikika m'magazi ndi m'mafupa chifukwa pamakhala malo ochepa okhala ndi magazi oyera oyera, maselo ofiira, ndi ma platelets. Izi zikachitika, matenda, kuchepa magazi m'thupi, kapena kutuluka mwazi kosavuta kumatha kuchitika.

Maselo a leukemia amatha kufalikira kunja kwa magazi kupita mbali zina za thupi, kuphatikiza dongosolo lamanjenje (ubongo ndi msana), khungu, ndi nkhama. Nthawi zina maselo a leukemia amapanga chotupa cholimba chotchedwa granulocytic sarcoma kapena chloroma.

Matenda ena a myeloid amatha kukhudza magazi ndi mafupa.

Zovuta zachilendo myelopoiesis (TAM)

TAM ndimatenda am'mafupa omwe amatha kukhala ndi ana akhanda omwe ali ndi Down syndrome. Nthawi zambiri zimangopita zokha m'miyezi itatu yoyambirira yamoyo. Makanda omwe ali ndi TAM ali ndi mwayi wochulukirapo wokhala ndi AML asanakwanitse zaka zitatu. TAM imadziwikanso kuti matenda osakhalitsa a myeloproliferative kapena khansa ya m'magazi yaposachedwa.

Khansa yapadera ya khansa ya m'magazi (APL)

APL ndi mtundu wa AML. Mu APL, mitundu ina ya chromosome 15 imasintha malo ndi majini ena pa chromosome 17 ndipo jini losazolowereka lotchedwa PML-RARA limapangidwa. Jini ya PML-RARA imatumiza uthenga womwe umaletsa ma promyelocyte (mtundu wamaselo oyera amwazi) kuti usakhwime. Ma promyelocyte (ma cell a leukemia) amatha kumangika m'magazi ndi m'mafupa chifukwa chake pamakhala malo ochepera maselo oyera oyera, maselo ofiira, ndi ma platelets. Mavuto otaya magazi kwambiri komanso magazi oundana amathanso kutha. Ili ndi vuto lalikulu lathanzi lomwe limafunikira chithandizo mwachangu.

Khansa ya myelomonocytic khansa ya m'magazi (JMML)

JMML ndi khansa yosawerengeka yaubwana yomwe imakonda kwambiri ana azaka pafupifupi 2 ndipo imakonda anyamata. Mu JMML, maselo am'magazi ambiri a myeloid amakhala ma myelocytes ndi monocytes (mitundu iwiri yama cell oyera). Ena mwa maselo am'magazi am'magazi samasanduka maselo oyera oyera. Maselo osakhwima, otchedwa blast, amalephera kugwira ntchito yawo wamba. Popita nthawi, ma myelocyte, ma monocyte, ndi kuphulika kumadzaza maselo ofiira am'magazi m'mapfupa. Izi zikachitika, matenda, kuchepa magazi m'thupi, kapena kutuluka mwazi kosavuta kumatha kuchitika.

Matenda a myelogenous khansa ya m'magazi (CML)

CML nthawi zambiri imayamba mu selo loyambirira la myeloid magazi akasintha. Gawo la majini, lomwe limaphatikizapo mtundu wa ABL, pa chromosome 9 amasintha malo ndi gawo la majini pa chromosome 22, lomwe lili ndi jini la BCR. Izi zimapanga chromosome yayifupi kwambiri 22 (yotchedwa chromosome ya ku Philadelphia) komanso chromosome yayitali kwambiri 9. Jini yachilendo ya BCR-ABL imapangidwa pa chromosome 22. Jini ya BCR-ABL imauza ma cell amwazi kuti apange protein yambiri yotchedwa tyrosine kinase. Tyrosine kinase amachititsa kuti maselo oyera oyera ambiri (ma cell a leukemia) apangidwe m'mafupa. Maselo a leukemia amatha kukhazikika m'magazi ndi m'mafupa chifukwa pamakhala malo ochepa okhala ndi magazi oyera oyera, maselo ofiira, ndi ma platelets. Izi zikachitika, matenda, kuchepa magazi m'thupi, kapena kutuluka mwazi kosavuta kumatha kuchitika. CML imapezeka kawirikawiri mwa ana.

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.

Myelodysplastic syndromes (MDS)

MDS imachitika kawirikawiri mwa ana kuposa achikulire. Mu MDS, mafupa amapanga maselo ofiira ochepa, maselo oyera, ndi ma platelets. Maselo a magazi awa sangakhwime ndikulowa m'magazi. Mtundu wa MDS umadalira mtundu wa khungu lamagazi lomwe lakhudzidwa.

Chithandizo cha MDS chimadalira kuchepa kwa kuchuluka kwa maselo ofiira, maselo oyera a magazi, kapena ma platelets. Popita nthawi, MDS imatha kukhala AML.

Chidule ichi ndi zaubwana AML, TAM, ubwana APL, JMML, CML yaubwana, ndi MDS yaubwana. Onani chidule cha matenda a khansa ya m'magazi aubwana pachimake kuti mumve zambiri za chithandizo cha khansa ya khansa ya m'magazi ya ana.

AML kapena MDS imatha kuchitika atalandira chithandizo ndi mankhwala ena a chemotherapy komanso / kapena radiation radiation.

Kuchiza khansa ndi mankhwala ena a chemotherapy komanso / kapena radiation kungayambitse AML (t-AML) kapena MDS (t-MDS) yokhudzana ndi mankhwala. Kuopsa kwa matenda a myeloid okhudzana ndi mankhwalawa kumadalira kuchuluka kwa mankhwala a chemotherapy omwe amagwiritsidwa ntchito komanso kuchuluka kwa radiation ndi gawo la chithandizo. Odwala ena amakhalanso ndi chiopsezo chotengera t-AML ndi t-MDS. Matenda okhudzana ndi mankhwalawa amapezeka mkati mwa zaka 7 atalandira chithandizo, koma amapezeka kawirikawiri mwa ana.

Zowopsa zaubwana AML, APL, JMML, CML, ndi MDS ndizofanana.

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 wa mwana wanu ngati mukuganiza kuti mwana wanu akhoza kukhala pachiwopsezo. Izi ndi zina zitha kuwonjezera chiopsezo cha ubwana wa AML, APL, JMML, CML, ndi MDS:

• Kukhala ndi mchimwene kapena mlongo, makamaka mapasa, ndi khansa ya m'magazi.

• Kukhala ku Puerto Rico.

• Kutulutsa utsi wa fodya kapena mowa usanabadwe.

• Kukhala ndi mbiri yakale ya kuchepa kwa magazi m'thupi.

• Kukhala ndi mbiri yaumwini kapena yabanja ya MDS.

• Kukhala ndi mbiri yabanja ya AML.

• Chithandizo cham'mbuyomu ndi chemotherapy kapena radiation radiation.

• Kuwonetsedwa ndi ma radiation kapena mankhwala monga benzene.

• Kukhala ndi ma syndromes ena kapena zovuta zobadwa nazo, monga:

• Matenda a Down.

• Kuchepa kwa magazi m'thupi.

• Kuchepa kwa magazi kwa Fanconi.

• Mtundu wa Neurofibromatosis 1.

• Matenda a Noonan.

• Matenda a Shwachman-Diamond.

• Matenda a Li-Fraumeni.

Zizindikiro za ubwana AML, APL, JMML, CML, kapena MDS zimaphatikizapo malungo, kumva kutopa, komanso kutuluka mwazi mosavuta kapena kuvulala.

Zizindikiro ndi zizindikilozi zimatha kuyambitsidwa ndi ubwana wa AML, APL, JMML, CML, kapena MDS kapena zina. Funsani dokotala ngati mwana wanu ali ndi izi:

• Malungo kapena alibe matenda.

• Kutuluka thukuta usiku.

• Kupuma pang'ono.

• Kufooka kapena kumva kutopa.

• Kuvulaza kosavuta kapena kutuluka magazi.

• Petechiae (malo athyathyathya, osinkhasinkha pansi pa khungu chifukwa cha magazi)

• Kupweteka m'mafupa kapena mafupa.

• Zowawa kapena kumva kwodzaza pansi pa nthiti.

• Ziphuphu zopanda pake m'khosi, pansi, m'mimba, m'mimba, kapena mbali zina za thupi. Ali mwana AML, zotupazi, zotchedwa khansa ya m'magazi

• cutis, akhoza kukhala wabuluu kapena wofiirira.

• Ziphuphu zopanda pake zomwe nthawi zina zimakhala mozungulira maso. Izi, zomwe zimatchedwa ma chloroma, nthawi zina zimawoneka muubwana wa AML ndipo zimatha kukhala zobiriwira.

• Kutupa kofanana ndi chikanga.

Zizindikiro za TAM zitha kukhala izi:

• Kutupa thupi lonse.

• Kupuma pang'ono.

• Kuvuta kupuma.

• Kufooka kapena kumva kutopa.

• Kutuluka magazi kwambiri, ngakhale kuchokera pocheka pang'ono.

• Petechiae (malo athyathyathya, osinkhasinkha pansi pa khungu chifukwa cha magazi)

• Ululu pansipa nthiti.

• Ziphuphu pakhungu.

• Jaundice (chikasu chachikopa ndi azungu amaso).

• Mutu, kuvutika kuwona, ndi chisokonezo.

Nthawi zina TAM siyimayambitsa zizindikiro zilizonse ndipo imapezeka pambuyo poyesa magazi nthawi zonse.

Mayeso omwe amafufuza magazi ndi mafupa amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira ubwana wa AML, TAM, APL, JMML, CML, ndi MDS. Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuyang'ana ngati pali matenda, monga zotupa 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.

• 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.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Zamoyo zomwe zingachitike ndi izi:

• 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.

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

• Chotupa chotupa : Chidziwitso cha chloroma chitha kuchitika.

• Lymph node biopsy: Kuchotsa zonse kapena gawo la mwanabele.

• 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.

• 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. Kusanthula kwa cytogenetic kumagwiritsidwa ntchito kuthandizira kuzindikira khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

Mayeso otsatirawa ndi mtundu wa kusanthula kwa cytogenetic:

• FISH (fluorescence in situ hybridization): Kuyesa kwa labotale komwe kumayang'ana ndikuwerengera majini kapena ma chromosomes m'maselo ndi minofu. Zidutswa za DNA zomwe zimakhala ndi utoto wa fulorosenti zimapangidwa mu labotale ndikuwonjezeredwa muzitsanzo zamaselo a wodwalayo. Zidutswa za DNA zoterezi zikalumikizana ndi majini kapena madera ena a chromosomes mchitsanzo, zimawala zikawonedwa ndi microscope ya fulorosenti. Kuyesa kwa FISH kumagwiritsidwa ntchito kuthandizira kuzindikira khansa ndikuthandizira kukonzekera mankhwala.

• Kuyesedwa kwa ma molekyulu : Kuyesa kwa labotale kuti muwone ngati majini, mapuloteni, kapena mamolekyulu ena mumwazi kapena m'mafupa. Kuyesedwa kwama molekyulu kumawunikiranso zosintha zina mu jini kapena chromosome zomwe zingayambitse kapena kusokoneza mwayi wopanga AML. Mayeso am'magulu atha kugwiritsidwa ntchito kuthandizira kukonzekera chithandizo chamankhwala, kudziwa momwe mankhwala akugwirira ntchito, kapena kudziwitsa ena.

• 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.

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

Kulosera (mwayi wochira) ndi njira zamankhwala zaubwana wa AML zimadalira izi:

• Zaka za mwana khansa itapezeka.

• Mtundu kapena mtundu wamwana.

• Kaya mwanayo ndi wonenepa kwambiri.

• Chiwerengero cha maselo oyera m'magazi atazindikira.

• Kaya AML idachitika atalandira chithandizo cha khansa cham'mbuyomu.

• Mtundu wa AML.

• Kaya pali ma chromosome kapena majini omwe amasintha m'maselo a leukemia.

• Kaya mwanayo ali ndi matenda a Down syndrome. Ana ambiri omwe ali ndi AML ndi Down syndrome amatha kuchiritsidwa ndi khansa ya m'magazi.

• Kaya khansa ya m'magazi ili mkati mwa ubongo (ubongo ndi msana).

• Khansa ya m'magazi imayankha mwachangu mankhwala.

• Kaya AML ipezeka kumene (osachiritsidwa) kapena yabwereranso pambuyo poti mwalandira chithandizo.

• Kutalika kwa nthawi kuyambira pomwe chithandizo chatha, kwa AML yomwe yabwerezedwanso.

Kulosera kwaubwana APL kumadalira izi:

• Chiwerengero cha maselo oyera m'magazi atazindikira.

• Kaya pali ma chromosome kapena majini omwe amasintha m'maselo a leukemia.

• Kaya APL yapezeka kumene (sanalandire chithandizo) kapena yabwereranso atalandira chithandizo.

Njira zakudziwitsira ndi chithandizo cha JMML zimadalira izi:

• Zaka za mwana khansa itapezeka.

• Mtundu wa jini womwe wakhudzidwa komanso kuchuluka kwa majini omwe asintha.

• Ndi ma monocyte angati (mtundu wa maselo oyera amwazi) omwe ali m'magazi.

• Kuchuluka kwa hemoglobin m'magazi.

• Kaya JMML yatulutsidwa kumene (osachiritsidwa) kapena yabwereranso atalandira chithandizo.

Njira zakudziwitsira ndi chithandizo cha ubwana wa CML zimadalira izi:

• Zakhala nthawi yayitali bwanji kuchokera pomwe wodwalayo adapezeka.

• Ndi maselo angati akuphulika omwe ali m'magazi.

• Kaya ndi momwe kuphulika kwamaselo kumatuluka m'magazi ndi m'mafupa mankhwala atayamba.

• Kaya CML ipezeka kumene (osachiritsidwa) kapena yabwereranso pambuyo poti mwalandira chithandizo.

Njira zodziwitsira ndi chithandizo cha MDS zimadalira izi:

• Kaya MDS idayambitsidwa ndimankhwala am'mbuyomu.

• Kutsika kwake kwa maselo ofiira amwazi, maselo oyera amwazi, kapena ma platelet.

• Kaya MDS ipezeka kumene (osachiritsidwa) kapena yabwerezedwanso pambuyo poti mwalandira chithandizo.

Magawo Aubwana Pachimake cha Myeloid Leukemia ndi Ma Myeloid Malignancies

MFUNDO ZOFUNIKA

• Kamodzi ubwana pachimake myeloid leukemia (AML) wapezeka, amayesedwa kuti apeze ngati khansara yafalikira mbali zina za thupi.

• Palibe njira yokhazikika ya AML yaubwana, khansa yaukali ya promyelocytic leukemia (APL), khansa ya myelomonocytic leukemia (JMML), khansa ya myelogenous leukemia (CML), kapena myelodysplastic syndromes (MDS).

• AML obwerezabwereza abwerera atachiritsidwa.

Kamodzi ubwana pachimake myeloid leukemia (AML) wapezeka, amayesedwa kuti apeze ngati khansara yafalikira mbali zina za thupi.

Mayesero ndi njira zotsatirazi zitha kugwiritsidwa ntchito kudziwa ngati leukemia yafalikira kuchokera m'magazi kupita mbali zina za thupi:

• 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.

• Kutupa kwa machende, thumba losunga mazira, kapena khungu: Kuchotsa maselo kapena ziphuphu m'matumbo, thumba losunga mazira, kapena khungu kuti athe kuwonedwa ndi microscope kuti aone ngati ali ndi khansa. Izi zimachitika pokhapokha ngati pamakhala mayeso achilengedwe.

Palibe njira yokhazikika ya AML yaubwana, khansa yaukali ya promyelocytic leukemia (APL), khansa ya myelomonocytic leukemia (JMML), khansa ya myelogenous leukemia (CML), kapena myelodysplastic syndromes (MDS).

Kukula kapena kufalikira kwa khansa nthawi zambiri kumafotokozedwa ngati magawo. M'malo mwa magawo, chithandizo cha ubwana wa AML, ubwana APL, JMML, CML yaubwana, ndi MDS zimakhazikitsidwa ndi chimodzi kapena zingapo zotsatirazi:

• Mtundu wa matenda kapena mtundu wa AML.

• Kaya khansa ya m'magazi yafalikira kunja kwa magazi ndi mafupa.

• Kaya matendawa amapezeka kumene, ali okhululukidwa, kapena amabwereranso.

AML omwe angopezedwa kumene ali mwana

Matenda a AML omwe angopezedwa kumene sanalandire chithandizo kupatula kuthana ndi zizindikilo monga malungo, magazi, kapena kupweteka, ndipo chimodzi mwazotsatira zimapezeka:

• Maselo opitilira 20% am'mafupa amaphulika (ma cell a leukemia).

kapena

• Maselo ochepera 20% am'mafupa amaphulika ndipo pali kusintha kwina mu chromosome.

Ubwana AML mu chikhululukiro

Muubwana AML mu chikhululukiro, matendawa adathandizidwa ndipo zotsatirazi zimapezeka:

• Kuwerengera kwathunthu kwamagazi ndikwabwino.

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

• Palibe zisonyezo za khansa ya m'magazi muubongo, msana, kapena ziwalo zina za thupi.

AML obwerezabwereza abwerera atachiritsidwa.

Nthawi zambiri ubwana wa AML, khansara imatha kubwereranso m'magazi ndi m'mafupa kapena mbali zina za thupi, monga dongosolo lamanjenje (ubongo ndi msana).

Khansa yaukadaulo ya AML, khansa siyankha mankhwala.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi AML, TAM, APL, JMML, CML, ndi MDS.

• Chithandizo chimakonzedwa ndi gulu la othandizira azaumoyo omwe ndi akatswiri pochiza khansa ya m'magazi ya ana ndi matenda ena amwazi.

• Chithandizo cha ubwana pachimake cha myeloid khansa ya m'magazi chingayambitse mavuto.

• Chithandizo cha ubwana wa AML nthawi zambiri chimakhala ndi magawo awiri.

• Mitundu isanu ndi iwiri yothandizidwa moyenera imagwiritsidwa ntchito paubwana AML, TAM, ubwana APL, JMML, CML yaubwana, ndi MDS.

• Chemotherapy

• Thandizo la radiation

• Kupanga khungu la tsinde

• Chithandizo chofuna

• Mankhwala ena

• Kudikira kudikira

• Chithandizo chothandizira

• 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.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi AML, TAM, APL, JMML, CML, ndi MDS.

Pali mitundu yosiyanasiyana ya chithandizo kwa ana omwe ali ndi vuto la myeloid leukemia (AML), myelopoiesis wosakhalitsa (TAM), leukemia (APL), juvenile myelomonocytic leukemia (JMML), chronic myelogenous leukemia (CML), ndi myelodysplastic syndromes (MDS) . 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.

Chifukwa AML ndi zovuta zina za myeloid ndizochepa mwa ana, kutenga nawo mbali pakuyesa kwamankhwala kuyenera kuganiziridwa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambebe kulandira chithandizo.

Chithandizo chimakonzedwa ndi gulu la othandizira azaumoyo omwe ndi akatswiri pochiza khansa ya m'magazi ya ana ndi matenda ena amwazi.

Chithandizo chidzayang'aniridwa ndi oncologist wa ana, dokotala yemwe amadziwika bwino pochiza ana omwe ali ndi khansa. Ocologist wa ana amagwira ntchito ndi ena othandizira zaumoyo omwe ndi akatswiri pochiza ana omwe ali ndi khansa ya m'magazi komanso omwe amakhazikika m'malo ena azamankhwala. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Katswiri wa zachipatala.

• Katswiri wazachipatala.

• Dokotala wa ana.

• Wofufuza oncologist.

• Katswiri wa zamagulu.

• Neuropathologist.

• Neuroradiologist.

• Katswiri wa namwino wa ana.

• Wogwira ntchito.

• Katswiri wokonzanso.

• Katswiri wa zamaganizo.

Chithandizo cha ubwana pachimake cha myeloid khansa ya m'magazi chingayambitse mavuto.

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

Mayeso omwe akutsatiridwa pafupipafupi ndiofunikira kwambiri. Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Zotsatira zakumapeto kwa chithandizo cha khansa zitha kuphatikizira izi:

• Mavuto athupi.

• Kusintha kwa malingaliro, malingaliro, kuganiza, kuphunzira, kapena kukumbukira.

• Khansa yachiwiri (mitundu yatsopano ya khansa).

Zotsatira zina mochedwa zimatha kuthandizidwa kapena kuwongoleredwa. Ndikofunika kuti makolo a ana omwe amalandira chithandizo cha AML kapena matenda ena amwaziwo azilankhula ndi madotolo a ana awo zamomwe angathandizire mwana wawo khansa. (Onani chidule cha pa Zotsatira Zotsiriza za Chithandizo cha Khansa ya Ana kuti mumve zambiri).

Chithandizo cha ubwana wa AML nthawi zambiri chimakhala ndi magawo awiri.

Chithandizo cha ubwana wa AML chimachitika magawo:

• Mankhwala othandizira: Ili ndiye gawo loyamba la chithandizo. Cholinga ndikupha ma cell a leukemia m'magazi ndi m'mafupa. Izi zimayika khansa ya m'magazi kuti ikhululukidwe.

• Kuphatikiza / kukulitsa chithandizo: Ili ndiye gawo lachiwiri la chithandizo. Imayamba kamodzi khansa ya m'magazi itakhululukidwa. Cholinga cha mankhwalawa ndikupha maselo amtundu wa leukemia omwe abisala ndipo mwina sangakhale otakataka koma atha kuyambiranso ndikuyambiranso.

Chithandizo chotchedwa central nervous system (CNS) prophylaxis therapy chingaperekedwe panthawi yothandizira. Chifukwa mulingo woyenera wa chemotherapy mwina sungafikire maselo a leukemia mu CNS (ubongo ndi msana), maselo a leukemia amatha kubisala mu CNS. Intrathecal chemotherapy imatha kufikira ma cell a leukemia mu CNS. Amaperekedwa kuti aphe ma cell a leukemia ndikuchepetsa mwayi kuti leukemia ibwererenso (kubwerera).

Mitundu isanu ndi iwiri yothandizidwa moyenera imagwiritsidwa ntchito paubwana AML, TAM, ubwana APL, JMML, CML yaubwana, ndi MDS.

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 opitilira chemotherapy.

Momwe chemotherapy imaperekedwa imadalira mtundu wa khansa yomwe ikuchitidwa. Mu AML, chemotherapy yoperekedwa pakamwa, mtsempha, kapena m'madzi amadzimadzi amagwiritsidwa ntchito.

Mu AML, maselo a leukemia amatha kufalikira kuubongo komanso / kapena msana. Chemotherapy yoperekedwa pakamwa kapena m'mitsempha yothandizira AML silingadutse chotchinga cha magazi ndi ubongo kuti ilowe mumadzi ozungulira ubongo ndi msana. M'malo mwake, chemotherapy imalowetsedwa m'malo amadzimadzi kupha ma cell a leukemia omwe atha kufalikira pamenepo (intrathecal chemotherapy).

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 Myeloid 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 yomwe ikuthandizidwa. Muubwana wa AML, mankhwala amtundu wakunja amatha kugwiritsidwa ntchito pochiza chloroma yomwe siyankha chemotherapy.

Kupanga khungu la tsinde

Chemotherapy imaperekedwa kuti iphe ma cell a khansa kapena ma cell ena achilendo. 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 ndikusungidwa. Wodwalayo akamaliza chemotherapy, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

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. Mitundu yamankhwala omwe akhudzidwa ndi awa:

• Thandizo la Tyrosine kinase inhibitor: Mankhwala a Tyrosine kinase inhibitor (TKI) amaletsa zizindikilo zofunika kuti zotupa zikule. Ma TKIs amaletsa enzyme (tyrosine kinase) yomwe imapangitsa kuti maselo am'magazi akhale maselo oyera amwazi (kuphulika) kuposa momwe thupi limafunira. Ma TKI amatha kugwiritsidwa ntchito ndi mankhwala a chemotherapy monga adjuvant therapy (mankhwala omwe amaperekedwa atalandira chithandizo choyambirira, kuti athetse chiopsezo kuti khansa ibwererenso).

• Imatinib, dasatinib, ndi nilotinib ndi mitundu ya ma TKI omwe amagwiritsidwa ntchito pochizira ubwana wa CML.

• Sorafenib ndi trametinib akuwerengedwa pochiza khansa ya m'magazi yaubwana.

• Thandizo la monoclonal antibody: Thandizo la monoclonal antibody limagwiritsa ntchito ma antibodies opangidwa mu labotale, kuchokera ku mtundu umodzi wamthupi. 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.

• Gemtuzumab ndi mtundu wa anti-monoclonal antibody womwe umalumikizidwa ndi mankhwala a chemotherapy. Amagwiritsidwa ntchito pochiza AML.

Selinexor ndi mankhwala omwe amaphunzitsidwa kuti athetse vuto la ubwana wa AML.

Onani Mankhwala Ovomerezeka a Leukemia kuti mumve zambiri.

Mankhwala ena

Lenalidomide itha kugwiritsidwa ntchito pochepetsa kufunika kwa kuthiridwa magazi kwa odwala omwe ali ndi myelodysplastic syndromes omwe amayamba chifukwa cha kusintha kwina kwa chromosome. Ikuwerengedwanso pochiza ana omwe amabwera mobwerezabwereza komanso osokoneza bongo AML.

Arsenic trioxide ndi all-trans retinoic acid (ATRA) ndi mankhwala omwe amapha mitundu ina yama cell a leukemia, amaletsa ma cell a leukemia kuti asagawanike, kapena amathandizira ma cell a leukemia kukula m'maselo oyera. Izi mankhwala ntchito pa matenda a pachimake promyelocytic khansa ya m'magazi.

Onani Mankhwala Ovomerezeka a Acute Myeloid Leukemia kuti mumve zambiri.

Kudikira kudikira

Kuyembekezera mwachidwi kumayang'anitsitsa matenda a wodwalayo osamupatsa chithandizo chilichonse mpaka zizindikilo kapena zizindikiritso zikuwoneka kapena kusintha. Nthawi zina amagwiritsidwa ntchito pochiza MDS kapena myelopoiesis (TAM) wosakhalitsa.

Chithandizo chothandizira

Thandizo lothandizira limaperekedwa kuti muchepetse mavuto omwe amabwera chifukwa cha matendawa kapena chithandizo chake. Odwala onse omwe ali ndi khansa ya m'magazi amalandila chithandizo chothandizira. Chithandizo chothandizira chitha kukhala ndi izi:

• Thandizo lothana ndi magazi: Njira yoperekera maselo ofiira ofiira, maselo oyera, kapena ma platelet m'malo mwa maselo amwazi omwe awonongedwa ndi matenda kapena chithandizo cha khansa. Magazi atha kuperekedwa kuchokera kwa munthu wina kapena atha kutenga kuchokera kwa wodwalayo koyambirira ndikusungidwa mpaka kukafunika.

• Mankhwala, monga maantibayotiki kapena othandizira antifungal.

• Leukapheresis: Njira yomwe makina apadera amagwiritsidwira ntchito kuchotsa ma cell oyera m'magazi. Magazi amatengedwa kuchokera kwa wodwalayo ndikuwayika kupatukana ndi maselo amwazi omwe amachotsedwa. Magazi otsalawo kenako amawabwezera m'magazi a wodwalayo. Leukapheresis imagwiritsidwa ntchito pochiza odwala omwe ali ndi kuchuluka kwama cell oyera oyera.

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 biotherapy.

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.

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 matenda a mwana wanu asintha kapena ngati khansa yabwereranso (kubwerera). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Njira Zothandizira Achinyamata Pachimake cha Myeloid Leukemia

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

Chithandizo cha ana omwe atangopezeka kumene ali ndi myeloid leukemia (AML) panthawi yophunzirira atha kuphatikizira izi:

• Kuphatikiza chemotherapy.

• Chithandizo chojambulidwa ndi antioclonal antibody (gemtuzumab).

• Njira yapakati yamanjenje yoteteza mankhwala ndi intrathecal chemotherapy.

• Thandizo la radiation, kwa odwala omwe ali ndi granulocytic sarcoma (chloroma) ngati chemotherapy sagwira ntchito.

• Kuphatikizira kwa cell, kwa odwala omwe ali ndi AML yokhudzana ndi mankhwala.

Chithandizo cha ubwana wa AML panthawi yachikhululukiro (kuphatikiza / kuphatikiza mankhwala) kumadalira mtundu wa AML ndipo ungaphatikizepo izi:

• Kuphatikiza chemotherapy.

• Chemotherapy yamphamvu kwambiri yotsatiridwa ndi kusanjidwa kwa maselo pogwiritsa ntchito maselo am'magazi ochokera kwa wopereka.

Chithandizo cha vuto la ubwana wa AML chingaphatikizepo izi:

• Mankhwala a Lenalidomide.

• Kuyesedwa kwachipatala kwa chemotherapy ndi mankhwala omwe amalimbana nawo (selinexor).

• Njira yatsopano yophatikizira chemotherapy.

Kuchiza kwa ubwana wa AML wobwereza kungaphatikizepo izi:

• Kuphatikiza chemotherapy.

• Kuphatikiza kwa chemotherapy ndi kuponyera ma cell a stem, kwa odwala omwe akhululukidwa kwathunthu.

• Kuika kwachiwiri kwa cell, kwa odwala omwe matenda awo adabweranso pambuyo pokhazikitsa koyamba.

• Kuyesedwa kwachipatala kwa chemotherapy ndi mankhwala omwe amalimbana nawo (selinexor).

Njira Zothandizira Kuchiza Kwachilendo Kwa Myelopoiesis kapena Ana omwe ali ndi Down Syndrome ndi AML

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

Myelopoiesis yanthawi yayitali (TAM) nthawi zambiri imapita yokha. Kwa TAM yomwe siyimatha yokha kapena imayambitsa mavuto ena azaumoyo, chithandizo chitha kuphatikizira izi:

• Thandizo lothandizira, kuphatikizapo mankhwala opatsirana kapena leukapheresis.

• Chemotherapy.

Chithandizo cha acute myeloid leukemia (AML) mwa ana azaka 4 kapena kupitilira apo omwe ali ndi Down syndrome atha kukhala awa:

• Kuphatikiza kwa chemotherapy komanso chapakati pa mitsempha yothandizira ndi mankhwala a intrathecal chemotherapy.

• Kuyesedwa kwachipatala kwa chemotherapy regimen yatsopano yomwe imadalira momwe mwana amayankhira chemotherapy yoyamba.

Chithandizo cha AML kwa ana opitilira zaka 4 omwe ali ndi Down syndrome atha kukhala ofanana ndi chithandizo cha ana opanda Down syndrome.

Njira Zothandizira Kuchiza Khansa Yaikulu Ya Achinyamata a Promyelocytic

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

Chithandizo cha matenda a khansa ya promyelocytic khansa ya m'magazi (APL) ingaphatikizepo izi:

• All-trans retinoic acid (ATRA) kuphatikiza chemotherapy.

• Thandizo la Arsenic trioxide.

• Kuyesedwa kwachipatala kwa ATRA ndi arsenic trioxide therapy kapena chemotherapy.

Chithandizo cha ubwana wa APL panthawi yachikhululukiro (kuphatikiza / kulimbikitsa mankhwala) atha kuphatikizira izi:

• All-trans retinoic acid (ATRA) kuphatikiza chemotherapy.

Chithandizo cha kubwerezabwereza kwaubwana APL chingaphatikizepo izi:

• Thandizo la Arsenic trioxide.

• All-trans retinoic acid therapy (ATRA) kuphatikiza chemotherapy.

• Chithandizo chojambulidwa ndi antioclonal antibody (gemtuzumab).

• Kupanga ma cell pogwiritsa ntchito maselo am'magazi kuchokera kwa wodwala kapena woperekayo.

Njira Zothandizira Achinyamata a Myelomonocytic Leukemia

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

Chithandizo cha achinyamata myelomonocytic leukemia (JMML) chingaphatikizepo izi:

• Kuphatikiza kwa chemotherapy kutsatiridwa ndi kuphatika kwa tsinde. Ngati JMML ibwereranso pambuyo pothandizidwa ndi tsinde, kubzala kwachiwiri kungachitike.

Chithandizo cha JMML chaubwana kapena chosabwereza chingaphatikizepo izi:

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala omwe ali ndi tyrosine kinase inhibitor (trametinib).

Njira Zothandizira Kuchiza Matenda a Mwana Wamthupi Wanga

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

Chithandizo cha khansa ya myelogenous leukemia (CML) itha kukhala ndi izi:

• Chithandizo choyenera ndi tyrosine kinase inhibitor (imatinib, dasatinib, kapena nilotinib).

Chithandizo cha CML chosokoneza kapena chobwerezabwereza cha ana chingaphatikizepo izi:

• Chithandizo choyenera ndi tyrosine kinase inhibitor (dasatinib kapena nilotinib).

• Kupanga maselo okuthandizani pogwiritsa ntchito maselo am'magazi ochokera kwa wopereka.

Njira Zothandizira Kuchiza Kwaubwana Myelodysplastic Syndromes

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

Chithandizo cha ubwana wa myelodysplastic syndromes (MDS) chingaphatikizepo izi:

• Kupanga maselo okuthandizani pogwiritsa ntchito maselo am'magazi ochokera kwa wopereka.

• Thandizo lothandizira, kuphatikizapo mankhwala opatsirana ndi maantibayotiki.

• Thandizo la Lenalidomide, la odwala omwe amasintha majini ena.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala.

Ngati MDS idzakhala ya myeloid leukemia (AML), chithandizo chimakhala chimodzimodzi ndi chithandizo cha AML yomwe yangotuluka kumene.

Kuti mudziwe Zambiri Zokhudza Ubwana Wa Myeloid Leukemia ndi Ma Myeloid Malignancies

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza ubwana wa myeloid leukemia ndi matenda ena a myeloid, onani izi:

• Mankhwala Ovomerezeka a Acute Myeloid Leukemia

• Mankhwala Ovomerezeka a Myeloproliferative Neoplasms

• Kusandulika Kwamaselo Opangira Magazi

• Njira Zochizira Khansa

Kuti mumve zambiri za khansa yaubwana ndi zina zothandiza za khansa, onani izi:

• Za Khansa

• Khansa Za Ana

• Cure Search for Cancer ya Ana Tulukani Chodzikanira

• Zotsatira Zochedwetsa Khansa Yaana

• Achinyamata ndi Achinyamata Achikulire ndi Khansa

• Ana omwe ali ndi khansa: Upangiri wa Makolo

• Khansa mwa Ana ndi Achinyamata

• Kusinthana

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira