ʻO Leukemia Lymphocytic maʻi mau (CLL)

Anter

• He aha ka leukemia lymphocytic mau (CLL)?
• He aha nā hōʻailona o CLL?
• He aha ka lāʻau no CLL?
• ʻO Chemotherapy
• Pāhawewe
• Nā therapies pahuhopu
• ʻO ka iwi pūpū a i ʻole ke kahe ʻana o ke koko
• Hoʻopili ke koko
• ʻOki kino
• Pehea e ʻike ʻia ai ka CLL?
• Helu piha ke koko (CBC) me ka ʻokoʻa o ke aʻa koko keʻokeʻo (WBC)
• Hōʻike Immunoglobulin
• Biopsy iwi ʻōiwi
• CT scan
• Kahe cytometry a me ka cytochemistry
• ʻO ka hoʻāʻo ʻana o Genomic a me nā molekole
• He aha ka helu ola no ka poʻe me CLL?
• Pehea ka CLL e hoʻokumu ai?
• He aha ke kumu o CLL, a aia kekahi kumu pilikia no kēia maʻi?
• Aia kekahi mau pilikia i hiki ke mālama ʻia?
• He aha ka nānā wā lōʻihi no CLL?

Nā kiʻi Getty

He aha ka leukemia lymphocytic mau (CLL)?

ʻO ka leukemia kahi ʻano o ka maʻi ʻaʻai e pili ana i nā hunaola kanaka a me nā ʻāpana hana koko. Nui a hewahewa nā ʻano maʻi leukemia, e pili ana kēlā me kēia ʻano i nā selā o ke koko. ʻO ka leukemia lymphocytic mau, a i ʻole CLL, e hoʻopili ai i nā lymphocytes.

ʻO Lymphocytes kahi ʻano o ke keʻokeʻo koko keʻokeʻo (WBC). Hoʻopili ka CLL i nā lymphocytes B, i kapa ʻia hoʻi nā pūnaʻi B.

Kūpuni nā pūnaewele B maʻamau i kou koko a kōkua i kou kino e hakakā i ka maʻi. ʻAʻole hakakā nā hunaola B i nā maʻi e like me nā hunaola B maʻamau. Ke piʻi mālie nei ka nui o nā hunaola B maʻi ʻaʻai, hoʻopuni lākou i nā lymphocytes maʻamau.

ʻO CLL ka ʻano leukemia maʻamau i nā mākua. Ua kuhi ka National Cancer Institute (NCI) he 21,040 mau hihia hou e kū nei i United States ma 2020.

He aha nā hōʻailona o CLL?

ʻAʻohe o kekahi poʻe me CLL i loaʻa kekahi mau ʻōuli, a ʻike wale ʻia ko lākou maʻi ʻaʻai i loko o kahi hoʻokolohua koko maʻamau.

Inā loaʻa iā ʻoe nā hōʻailona, ​​hoʻohui pū lākou:

• luhi
• fiva
• nā maʻi pinepine a maʻi paha
• ka wehewehe kaumaha a i ʻole manaʻo ʻole ʻia
• puhū pō
• haʻalulu
• pehu lymph node

I ka wā o kahi hoʻokolohua kino, ʻike paha kāu kauka ua hoʻonui ʻia kou spleen, ate, a i ʻole lymph nodes. Hiki i kēia mau hōʻailona ke hoʻolaha ʻia ka maʻi ʻaʻai i kēia mau kino. Hana pinepine kēia i nā hihia holomua o CLL.

Inā kū kēia iā ʻoe, ʻike paha ʻoe i nā puʻupuʻu ʻeha ma kou ʻāʻī a i ʻole ke ʻano o ka piha a i ʻole ka pehu ʻana i kou ʻōpū.

He aha ka lāʻau no CLL?

Inā loaʻa iā CLL ka mea haʻahaʻa, hiki i kāu kauka ke ʻōlelo iā ʻoe e kali wale a nānā no nā hōʻailona hou. ʻAʻole pōʻino paha kāu maʻi a koi paha i ka lāʻau no nā makahiki. ʻAʻole koi kekahi poʻe i ka lāʻau.

I kekahi mau hihia o ka CLL makaʻu haʻahaʻa, hiki i kāu kauka ke koi aku i ka mālama ʻana. ʻO kahi laʻana, koi paha lākou i ka lāʻau lapaʻau inā loaʻa iā ʻoe:

• nā maʻi kūmau, hoʻomau hou
• hela ke koko haʻahaʻa
• ka luhi a i ʻole ka weluwelu po
• pūnana lymph ʻeha

Inā loaʻa iā CLL waena a i ʻole pilikia kiʻekiʻe, e aʻoaʻo paha kāu kauka iā ʻoe e hoʻomaka koke i ka lāʻau.

Ma lalo iho nei kekahi mau lāʻau lapaʻau e koi ai kāu kauka.

ʻO Chemotherapy

ʻO Chemotherapy ka lapaʻau nui no CLL. Pili ia i ka hoʻohana ʻana i nā lāʻau e hoʻomake i nā hunaola maʻi ʻaʻai. Kaukaʻi ʻia i nā lāʻau pono a kāu kauka i kau ai, hiki iā ʻoe ke lawe iā lākou me ka huhū a waha paha.

Pāhawewe

I kēia kaʻina hana, hoʻohana ʻia nā hunaahi kaha nui a i ʻole nalu e pepehi i nā hunaola maʻi ʻaʻai. ʻAʻole hoʻohana pinepine ʻia ka pāhawewe no CLL, akā inā he ʻeha kou, pehu nā lymph node, hiki i ka radiation therapy ke hōʻemi iā lākou a hoʻomaha i kou ʻeha.

Nā therapies pahuhopu

Nānā nā therapies pahuhopu i nā genes kikoʻī, nā protein, a i ʻole nā ​​ʻaʻa e kōkua i ke ola ʻana o nā hunaola maʻi ʻino. Hiki i kēia ke hoʻopili:

• monoclonal antibodies, i hoʻopili i nā protein
• nā kinase e hiki ai ke hoʻopau i nā hunaola maʻi ʻaʻai e ka pale ʻana i kekahi mau kinase enzyme

ʻO ka iwi pūpū a i ʻole ke kahe ʻana o ke koko

Inā loaʻa iā CLL ka makaʻu kiʻekiʻe, hiki i kēia lāʻau ke koho. Hoʻopili ia i ka lawe ʻana i nā hunaola iwi mai ka iwi iwi a i ʻole ke koko o kahi mea hāʻawi - he lālā ʻohana ka mea maʻamau - a transplanting iā lākou i kou kino e kōkua i ka hoʻokumu ʻana i ka momona iwi maikaʻi.

Hoʻopili ke koko

Inā haʻahaʻa kāu helu o ke kelepona, pono ʻoe e loaʻa i nā transfusions koko ma o ka laina intravenous (IV) e hoʻonui iā lākou.

ʻOki kino

I kekahi mau hihia, hiki i kāu kauka ke koi aku i ke ʻoki e wehe i ka spleen inā ua hoʻonui ʻia ma muli o CLL.

Pehea e ʻike ʻia ai ka CLL?

Inā kānalua kāu kauka he CLL kāu, hiki iā lākou ke hoʻohana i nā hoʻokolohua like ʻole e hōʻoia i ka ʻike. ʻO kahi laʻana, e kauoha paha lākou i hoʻokahi a ʻoi paha o nā hoʻokolohua aʻe.

Helu piha ke koko (CBC) me ka ʻokoʻa o ke aʻa koko keʻokeʻo (WBC)

Hiki i kāu kauka ke hoʻohana i kēia hoʻokolohua koko e ana i ka helu o nā ʻano ʻokoʻa o nā hunaola i loko o kou koko, me nā ʻano WBC like ʻole.

Inā he CLL kāu, e ʻoi aku kou nui o nā lymphocytes ma mua o ka maʻamau.

Hōʻike Immunoglobulin

Hiki i kāu kauka ke hoʻohana i kēia hoʻokolohua koko e aʻo inā loaʻa iā ʻoe nā mea ʻawaʻawa lawa e hakakā ai i nā maʻi.

Biopsy iwi ʻōiwi

I kēia kaʻina hana, hoʻokomo kāu kauka i kahi nila me kahi Tube kūikawā i loko o kou iwi ākea a i ʻole ka umauma e kiʻi i kahi laʻana o kou iwi iwi no ka hoʻāʻo ʻana.

CT scan

Hiki i kāu kauka ke hoʻohana i nā kiʻi i hana ʻia e ka CT scan e nānā ai no nā pehu lymph pehu i kou umauma a i ʻole kou ʻōpū.

Kahe cytometry a me ka cytochemistry

Me kēia mau hoʻāʻo, hoʻohana ʻia nā kemika a i ʻole nā ​​kala e ʻike ai i nā hōʻailona ma nā hunaola maʻi ʻaʻai e kōkua e hoʻoholo i ke ʻano o ka leukemia. ʻO kahi laʻana koko ka mea e pono ai no kēia mau hoʻāʻo.

ʻO ka hoʻāʻo ʻana o Genomic a me nā molekole

Nānā kēia mau hoʻāʻo i nā gen, nā protein, a me nā hoʻololi chromosome i kū hoʻokahi i kekahi ʻano leukemia. Kōkua pū lākou i ka hoʻoholo ʻana i ka wikiwiki e holomua ai ka maʻi a kōkua i kāu kauka e koho i nā koho lapaʻau e hoʻohana ai.

ʻO ka hoʻāʻo genetika e ʻike i nā loli a i ʻole ka hoʻololi ʻana e hiki ke hoʻopili i ka fluorescence in situ hybridization (FISH) a me ka polymerase chain reaction.

He aha ka helu ola no ka poʻe me CLL?

ʻO ka helu ola 5 mau makahiki no ka poʻe ʻAmelika me CLL he 86.1 pakeneka, e like me ka NCI. Kuhi pū ʻia ʻo ia ma kahi o CLL e hopena i ka make ʻana o 4,060 ma United States i 2020.

ʻOi aku ka haʻahaʻa o nā helu ola no ka poʻe ʻelemakule me ke ʻano.

Pehea ka CLL e hoʻokumu ai?

Inā hoʻoholo kāu kauka he CLL kāu, e kauoha lākou i nā hoʻokolohua hou aku e ana i ka nui o ka maʻi. Kōkua kēia i kāu kauka e hoʻokaʻawale i ka pae o ka maʻi ʻaʻai, nāna e alakaʻi i kāu papa lāʻau.

No ke kau ʻana i kāu CLL, e kauoha paha kāu kauka i nā hoʻokolohua koko e loaʻa ai ka helu o kou koko ʻulaʻula (RBC) a me ka helu lymphocyte koko kikoʻī. E nānā paha lākou inā ua hoʻonui ʻia kou mau lymph node, spleen, a i ʻole ke akepaʻa.

Ma lalo o ka ʻōnaehana Rai o ka hoʻohālikelike ʻana, hoʻokumu ʻia ʻo CLL mai ka 0 a i ka 4. ʻO Rai ke kahua 0 CLL ka mea liʻiliʻi loa, ʻoiai ʻo Rai pae 4 ka mea kiʻekiʻe loa.

No nā kumu lapaʻau, hoʻuluulu ʻia nā pae i nā pae o ka makaʻu. ʻO Rai pae 0 ka haʻahaʻa haʻahaʻa, Rai pae 1 a me 2 i waena pōpilikia, a me Rai pae 3 a me 4 i kiʻekiʻe kamepiula, wehewehe i ka American Cancer Society.

Eia kekahi mau hōʻailona CLL maʻamau i kēlā me kēia pae:

• Kahua 0: nā pae kiʻekiʻe o nā lymphocytes
• Kahua 1: nā pae kiʻekiʻe o nā lymphocytes; hoʻonui ʻia nā lymph node
• Kahua 2: nā pae kiʻekiʻe o nā lymphocytes; hoʻonui ʻia paha nā puka lymph; hoʻonui ākea; hoʻonui ʻia ke ake
• pae 3: nā pae kiʻekiʻe o nā lymphocytes; anemia; hoʻonui ʻia paha nā pūnana lymph, spleen, a i ʻole ke akepaʻa
• pae 4: nā pae kiʻekiʻe o nā lymphocytes; hoʻonui ʻia paha nā aka lymph, spleen, a me ke akepaʻa paha; hiki ke anemia; nā pae haʻahaʻa o nā platelet

He aha ke kumu o CLL, a aia kekahi kumu pilikia no kēia maʻi?

ʻAʻole ʻike maopopo ka poʻe loea i ke kumu o CLL. Eia nō naʻe, aia kekahi mau mea pilikia e hoʻonui i ka likelike o ke kanaka i ka hoʻomohala ʻana iā CLL.

Eia kekahi mau mea pilikia i hiki ke hāpai i ka likelike o ke kanaka e hoʻomohala iā CLL:

• Makahiki. ʻAʻole ʻike iki ʻia ʻo CLL i ka poʻe ma lalo o 40 mau makahiki. ʻO ka hapa nui o nā hihia CLL ʻike ʻia i ka poʻe ma mua o 50 mau makahiki. ʻO ka makahiki maʻamau o ka poʻe i ʻike ʻia me CLL he 71.
• Moekolohe Hoʻopili ia i nā kāne hou aʻe ma mua o nā wahine.
• Lāhui. ʻOi aku ka maʻamau i nā poʻe kūʻauhau Lūkia a me ʻEulopa a ʻaʻole loaʻa iki i ka poʻe Hikina Hema a me ko ʻAsia Hikina Hema.
• ʻO ka lymphocytosis B-cell Monoclonal. Aia kahi makaʻu liʻiliʻi e hiki ai i kēia ʻano, ke kumu o ke kiʻekiʻe ma mua o nā pae maʻamau o nā lymphocytes, ke lilo i CLL.
• Kaiapuni. ʻO ka US Department of Veterans Affairs kahi i hōʻike ʻia me Agent Orange, kahi mea kaua i hoʻohana ʻia i ka wā o ke Kaua Vietnam, ma ke ʻano he pilikia no CLL.
• Mōʻaukala ʻohana. ʻO ka poʻe i loaʻa ka ʻohana pili loa me ka hōʻailona CLL i ʻoi aku ka nui o ka makaʻu no CLL.

Aia kekahi mau pilikia i hiki ke mālama ʻia?

Hoʻonawaliwali ʻo Chemotherapy i kāu ʻōnaehana pale, waiho iā ʻoe i nā mea ʻoi loa i nā maʻi. Hiki paha iā ʻoe ke hoʻomohala i nā pae maʻamau o nā antibodies a me nā helu o ke kahe o ke koko i ka manawa o ka chemotherapy.

ʻO nā hopena ʻē aʻe o ka chemotherapy e komo pū:

• luhi
• poho lauoho
• ʻeha nā waha
• nalo ʻai ʻole
• nausea a me ka luaʻi

I kekahi mau hihia, hiki i ka chemotherapy ke kōkua i ka ulu ʻana o nā maʻi ʻē aʻe.

Hiki i ka radiation, transfusions koko, a me ka iwi o ka iwi a i ʻole ke koko transipher cell stem transplants ke hoʻopili i nā hopena ʻaoʻao.

No ka hoʻoponopono ʻana i nā hopena ʻaoʻao kikoʻī, hiki i kāu kauka ke kauoha:

• IV immunoglobulin
• Corticosteroids
• ka hoʻoneʻe ʻāpala
• ka lāʻau lapaʻau rituximab

E kamaʻilio me kāu kauka e pili ana i nā hopena i manaʻo ʻia o kāu lapaʻau. Hiki iā lākou ke haʻi iā ʻoe i nā hōʻailona a me nā hopena ʻē aʻe e koi ai i ka olakino.

He aha ka nānā wā lōʻihi no CLL?

Hoʻololi ka nui o nā helu ola no CLL. ʻO kou mau makahiki, moekolohe, nā chromosome abnormalities, a me nā ʻano maʻi ʻaʻa ʻoi e hiki ke hoʻopili i kāu kuana lōʻihi. ʻAʻole ola iki ka maʻi, akā ʻo ka hapa nui o ka poʻe e ola nei no nā makahiki he nui me CLL.

E noi i kāu kauka e pili ana i kāu hihia kikoʻī. Hiki iā lākou ke kōkua iā ʻoe e hoʻomaopopo i ka lōʻihi o kāu maʻi ʻaʻai. Hiki iā lākou ke kūkākūkā i kāu koho koho a me ka nānā lōʻihi.