Acute Myeloid Leukemia (AML): chii zvazviri, zviratidzo uye kurapwa

Zvemukati

• Zviratidzo zvikuru
• Kuongororwa uye kupatsanurwa
• Kurapwa kunoitwa sei
• 1. Chemotherapy
• 2. Radiotherapy
• 3. Kupfupa kwemongo wemapfupa
• 4. Target therapy uye immunotherapy
• 5. Mota T-Cell gene kurapa

Acute myeloid leukemia, inozivikanwawo se AML, mhando yekenza inobata masero eropa uye inotanga mumongo wemapfupa, inova nhengo inoitisa kugadzirwa kwemasero eropa. Rudzi rwecancer rwune mukana wakakura wekurapa kana ruchionekwa padanho rekutanga, kana kuchinge kusisina metastasis uye chinokonzeresa zviratidzo sekuderedza uremu uye kuzvimba kwendimi nedumbu, semuenzaniso.

Acute myeloid leukemia inokura nekukurumidza uye inogona kuitika muvanhu veese mazera, zvisinei inowanzoitika muvakuru, semasero ekenza anoungana mumongo wemapfupa uye anosunungurwa muropa, kwaanoendeswa kune dzimwe nhengo. , spleen kana yepakati tsinga system, kwavanoramba vachikura nekukura.

Kurapa kweacute myeloid leukemia kunogona kuitwa kuchipatara checancer uye chakanyanya kwazvo mumwedzi miviri yekutanga, uye rinenge gore rimwezve rekurapa rinodiwa kuti chirwere chirapike.

Zviratidzo zvikuru

Zviratidzo zvakajairika zveacute myeloid leukemia zvinosanganisira:

• Kupererwa neropa, kunozivikanwa nekuderera kwehuwandu hwehemoglobin;
• Kunzwa kushaya simba uye general malaise;
• Pallor uye nemusoro izvo zvinokonzerwa neanemia;
• Kakawanda kubuda ropa kunoonekwa nekureruka kwemhino kubuda ropa uye kuwedzera kuenda kumwedzi;
• Kuitika kwemavanga makuru kunyangwe muzvirovi zvidiki;
• Kurasikirwa kwechido uye kurasikirwa nekurema pasina chikonzero chakajeka;
• Dzimba dzakazvimba uye dzinorwadza, kunyanya mumutsipa nekugomera;
• Kakawanda zvirwere;
• Kurwadziwa mumapfupa nemajoini;
• Kupindwa nechando;
• Kufema kwekufema uye kukosora;
• Kuwedzeredza ziya ziya usiku, rinosvika pakunyorovesa hembe dzako;
• Kusuruvara kwepamuviri kunokonzerwa nekuzvimba kwechiropa uye spleen.

Acute myeloid leukemia rudzi rwekenza yeropa iyo inowanzo bata vanhu vakuru uye kuongororwa kwayo kunogona kuitwa mushure mekuongororwa kweropa, lumbar puncture uye bone marrow biopsy.

Kuongororwa uye kupatsanurwa

Kuongororwa kweacute myeloid leukemia kunoenderana nezviratidzo zvinounzwa nemunhu uye mhedzisiro yebvunzo, senge kuwanda kweropa, kuongorora kwemongo wemapfupa uye mamorekuru uye immunohistochemical bvunzo. Kuburikidza nekuverenga kweropa, zvinokwanisika kucherechedza kuderera kwehuwandu hwesero chena reropa, kuvapo kwekutenderera masero machena eropa uye yakaderera masero matsvuku eropa nemaplatelet. Kuti usimbise kuongororwa, zvakakosha kuti iyo myelogram iitwe, mairi iyo inogadzirwa kubva pakubaya uye kuunganidzwa kwesampula yemongo, inoongororwa murabhoritari. Nzwisisa kuti myelogram inogadzirwa sei.

Kuziva rudzi rweacute myeloid leukemia, zvakakosha kuti molekyuli uye immunohistochemical test zviitwe kuti zvionekwe hunhu hwemasero anowanikwa muropa anozivikanwa nechirwere, ruzivo urwu ruchikosha kuona kufungidzira kwechirwere uye kwe chiremba kuratidza kurapwa kwakakodzera kwazvo.

Kana imwe nguva rudzi rwe AML rukazivikanwa, chiremba anogona kuona fungidziro uye nekumisikidza mikana yekurapa. AML inogona kuiswa mune mamwe madiki, ayo ari:

Kurapwa kunoitwa sei

Kurapa kweacute myeloid leukemia (AML) inoda kuratidzirwa neoncologist kana hematologist uye inogona kuitwa kuburikidza nemaitiro akati wandei, senge chemotherapy, mishonga kana bone marrow kuisirwa.

1. Chemotherapy

Kurapa kweacute myeloid leukemia kunotanga nemhando yekemotherapy inonzi induction, iyo inotarisira kuregererwa negomarara, izvi zvinoreva kudzikisa maseru ane chirwere kudzamara asingawanikwe mukuongororwa kweropa kana muiyo myelogram, kunova kuongororwa kweropa rakaunganidzwa. zvakananga kubva kumongo wemapfupa.

Rudzi urwu rwekurapa runoratidzwa nahematologist, rinoitwa mukiriniki yekunze kwechipatara uye inoitwa nekuisa mishonga yakanangana netsinga, kuburikidza nekateti yakaiswa kurudyi rwechipfuva inonzi port-a-cath kana nekupinda mutsinga yeruoko.

Muzviitiko zvakawanda zveacute myeloid leukemia, chiremba anokurudzira kuti munhu wacho agamuchire seti yemishonga yakasiyana-siyana, inonzi maprotocol, ayo anonyanya kubva mukushandiswa kwemishonga yakadai sa cytarabine uye idarubicin, semuenzaniso. Ma protocols anoitwa muzvikamu, nemazuva ekurapwa kwakanyanya uye nemazuva mashoma ekuzorora, ayo anotendera kuti muviri wemunhu upore, uye huwandu hwenguva dzinofanirwa kuitwa zvinoenderana nekuomarara kweAML.

Mimwe yemishonga yakajairika yekurapa iyi leukemia, inogona kuve:

Chiremba anogona zvakare kukurudzira kushandiswa kwecorticosteroids, senge prednisone kana dexamethasone, sechikamu cheprotocol yekurapa yeacute myeloid leukemia. Imwe ongororo iri kugadzirwa kuitira kuti mishonga mitsva yakaita se capecitabine, lomustine uye guadecitabine inoshandiswawo kurapa chirwere ichi.

Uye zvakare, mushure mekuregererwa kwechirwere nekemotherapy, chiremba anogona kuratidza mhando nyowani yekurapa, inonzi kusimbisa, iyo inoshanda kuona kuti maseru ekenza abviswa mumuviri. Iko kusimbiswa kunogona kuitwa kuburikidza neepamusoro-dose chemotherapy uye yemapfupa kuisirwa.

Kurapa kweacute myeloid leukemia nekemotherapy kunoderedza huwandu hwesero jena reropa muropa, anova maseru ekudzivirira emuviri, uye munhu ane hutachiona hwakadzika, zvoita kuti vabatwe nehutachiona. Naizvozvo, mune dzimwe nguva, munhu wacho anoda kuiswa muchipatara panguva yekurapwa uye anoda kushandisa mishonga inorwisa mabhakitiriya, mishonga inorwisa utachiona uye mishonga yekudzivirira fungus kudzivirira hutachiona kubva. Uye zvakadaro, zvakajairika kuti zvimwe zviratidzo zvioneke, senge kurasikirwa nevhudzi, kuzvimba kwemuviri uye ganda rine mavara. Dzidza nezve mamwe mhedzisiro yemakemikari.

2. Radiotherapy

Radiotherapy rudzi rwemushonga unoshandisa muchina unoburitsa mwaranzi mumuviri kuuraya maseru egomarara, zvisinei, kurapwa uku hakusi kushandiswa zvakanyanya kweacute myeloid leukemia uye kunongoshandiswa mune izvo chirwere chakapararira kune dzimwe nhengo, senge uropi uye testis, kushandiswa pamberi pekupfekedzwa kwemongo kana kubvisa marwadzo munzvimbo yemapfupa inopindwa neleukemia.

Asati atanga iwo maradhiotherapy, chiremba anoita chirongwa, achitarisa mifananidzo yeiyo computed tomography kuitira kuti nzvimbo chaiyo mairi ma radiation inofanira kusvikwa mumuviri inotsanangurwa uyezve, mamaki anogadzirwa paganda, nepeni chaiyo, kuratidza chinzvimbo chakakodzera pamushini we radiotherapy uye kuitira kuti zvikamu zvese zvigare zviri munzvimbo yakatarwa.

Kunge chemotherapy, rudzi urwu rwekurapa runogona kukonzeresa mhedzisiro, senge kuneta, kurasikirwa nechido, kusvotwa, huro uye ganda rinoshanduka zvakafanana nekupiswa nezuva. Dzidza zvakawanda nezve kuchengetwa kunofanirwa kutorwa panguva ye radiotherapy.

3. Kupfupa kwemongo wemapfupa

Bone marrow kuisirwa rudzi rwekuwedzerwa ropa kunoitwa kubva kune hematopoietic stem maseru anotorwa akananga kubva kumongo wemapfupa weanopa anoenderana, kungave kuburikidza nekuvhiya kweropa kubva muhudyu kana kuburikidza neapheresis, unova muchina unopatsanura masero emidzi yeropa kuburikidza ne catheter mutsinga.

Rudzi urwu rwekuchinjisa runowanzoitwa mushure mekuwandisa madhiragi ekemotherapy kana radiotherapy mishonga yaitwa uye chete mushure mekunge masero ekenza asati aonekwa mumiedzo. Kune mhando dzinoverengeka dzekupinza, senge autologous uye allogeneic, uye chiratidzo chinoitwa nahematologist zvinoenderana nehunhu hweacute myeloid leukemia. Ona zvimwe nezve maitirwo emongo wemapfupa uye nemhando dzakasiyana.

4. Target therapy uye immunotherapy

Targeted therapy ndiyo mhando yekurapa iyo inoshandisa zvinodhaka zvinorwisa maseru anorwara neleukemia ane chaiwo maitiro ekuchinja, zvichikonzera mashoma mhedzisiro pane chemotherapy. Mimwe yemishonga iyi inoshandiswa ndeiyi:

• FLT3 inhibitors: yakaratidzirwa kune vanhu vane acute myeloid leukemia nekuchinja kwemajiniFLT3 uye mimwe yemishonga iyi midostaurin uye gilteritinib, haisati yatenderwa kuti ishandiswe muBrazil;
• HDI inhibitors: inokurudzirwa nachiremba kuti ishandiswe mune vanhu vane leukemia ine gene mutationIDH1 kanaIDH2, izvo zvinodzivirira kumera kwakakodzera kwemasero eropa. HDI inhibitors, senge enasidenib uye ivosidenib, inogona kubatsira maseru eukemia akura kuita akajairwa masero eropa.

Uye zvakare, mimwe mishonga inoshanda pane mamwe majeni ari kushandiswawo sevadziviriri veBCL-2 geni, senge venetoclax, semuenzaniso. Nekudaro, mimwe mishonga yemazuva ano inoenderana nekubatsira immune system kurwisa maseru eecemia, anozivikanwa seununotherapy, anokurudzirwawo zvikuru nemahematologist.

MaMonoclonal antibodies ndiwo immunotherapy madhiragi akagadzirwa semapuroteni ezvirwere zvemuviri anoita nekuzvinamatira kumadziro ema AML maseru uye nekuzoaparadza. Iyo gemtuzumab mishonga ndiyo iyi mhando yemishonga inokurudzirwa zvikuru navanachiremba kuti varape rudzi urwu rweleukemia.

5. Mota T-Cell gene kurapa

Gene kurapa uchishandisa nzira yeCar T-Cell inzira yekurapa kune vanhu vane acute myeloid leukemia iyo inosanganisira kubvisa masero kubva kuzvirwere zvemuviri, anozivikanwa seT masero, kubva mumuviri wemunhu uye wozoatumira ku laboratori. Murabhoritari, aya maseru anoshandurwa uye zvinhu zvinodaidzwa kuti maCAR zvinounzwa kuitira kuti vakwanise kurwisa maseru egomarara.

Mushure mekurapwa murabhoritari, maT seli anotsiviwa mumunhu ane leukemia kuitira kuti, agadziriswe, aparadze masero anorwara nekenza. Rudzi urwu rwekurapa rwuchiri kuongororwa uye haruwanikwe neSUS. Tarisa uone zvakawanda nezvekuti Car T-Cell kurapa kunoitwa sei uye chii chinogona kurapwa.

Onawo vhidhiyo pamaitiro ekuderedza mhedzisiro yekurapwa nekenza.