Qhov Tseem Ceeb - MDS vs Leukemia
MDS thiab leukemia yog vim qhov txawv txav ntawm cov pob txha pob txha. Leukemia tuaj yeem txhais tau tias yog qhov sib txuam ntawm qhov txawv txav ntawm cov qe ntshav dawb monoclonal hauv cov pob txha. Myelodysplastic syndromes los yog MDS hais txog cov txheej txheem ntawm cov pob txha pob txha uas tshwm sim vim qhov tsis xws luag hauv cov qia hlwb. Leukemia yog ib hom mob malignancy, tab sis myelodysplasia yog ib qho mob ua ntej uas tuaj yeem ua rau muaj kev hloov pauv tsis zoo. Qhov no yog qhov txawv ntawm MDS thiab leukemia.
MDS yog dab tsi?
Myelodysplastic syndromes (MDS) piav qhia txog cov txheej txheem ntawm cov pob txha pob txha uas tshwm sim vim muaj qhov tsis xws luag hauv cov qia hlwb. Cov yam ntxwv ntawm cov kab mob no yog qhov ua rau cov pob txha pob txha tsis ua haujlwm nrog ob qho tib si qhov ntau thiab qhov zoo ntawm cov kab mob myeloid (xws li cov qe ntshav liab, cov qe ntshav dawb, thiab platelets). Somatic taw tes hloov pauv hauv cov noob xws li TP53 thiab E2H2 tau ntseeg tias yog qhov ua rau muaj tus mob no.
Tshuaj Kho Mob
MDS feem ntau pom ntawm cov neeg laus. Feem ntau pom tshwm sim yog,
- Anemia
- ntshav vim pancytopenia
- Neutropenia
- monocytosis
- Thrombocytopenia
Cov yam ntxwv no tuaj yeem pom ntawm tus kheej lossis ua ke nrog ib leeg.
Txawm hais tias muaj pancytopenia, cov pob txha pob txha qhia tau tias muaj cellularity. Dyserythropoiesis yog ib qho teeb meem tshwm sim. Granulocyte precursors thiab megakaryocytes muaj qhov txawv txav morphology.
Daim duab 01: Myelodysplasia
WHO Classification of MDS
| Kab mob | Marrow Blasts (%) | Kev nthuav qhia kho mob | Cytogenic Abnormalities (%) |
| Refractory anemia | <5 | Anemia | 25 |
| Refractory anemia nrog lub nplhaib sideroblasts | <5 | Anemia, > 15% ringed sideroblasts nyob rau hauv lub hlwb liab precursors | 5-20 |
| MDS nrog cais del | <5 | Anemia, ib txwm platelets | 100 |
| Refractory cytopenia nrog multilineage dysplasia | <5 | Bicytopnenia lossis pancytopenia | 50 |
| Refractory anemia nrog ntau tshaj blasts-1 | 5-9 | Cytopenia nrog peripheral ntshav blasts (<5%) | 30-50 |
| Refractory anemia nrog ntau tshaj blasts-1 | 10-19 | Cytopenia nrog peripheral ntshav blasts | 50-70 |
| Myelodysplastic syndrome, unclassified | <5 | Neutropenia thiab thrombocytopenia | 50 |
Kev tshawb nrhiav
Kev kuaj ntshav thiab cov pob txha hlwb tau los ntawm kev kuaj ntshav thiab kuaj pob txha pob txha
Kev tswj hwm
Cov neeg mob nrog <5% ntawm cov pob txha tawg hauv pob txha tau txais kev tswj hwm kev saib xyuas uas suav nrog,
- Red cell thiab platelets transfusions
- Tshuaj tiv thaiv kab mob
Yog tias feem pua ntawm cov pob txha tawg yog >5% kev tswj hwm yog los ntawm cov txheej txheem hauv qab no,
- Txhawb kev saib xyuas kom txo qis kev pheej hmoo kis lwm yam teeb meem
- Tshuaj khomob
- Kev tswj hwm ntawm lenalidomide
- pob txha pob txha hloov
Leukemia yog dab tsi?
Leukemia tuaj yeem txhais tau tias yog qhov sib txuam ntawm cov qog ntshav dawb monoclonal txawv txav hauv cov pob txha pob txha. Qhov no ua rau cov pob txha tsis ua haujlwm ua rau mob ntshav qab zib, neutropenia, thiab thrombocytopenia. Feem ntau, qhov feem pua ntawm cov hlwb tawg hauv cov pob txha neeg laus yog tsawg dua 5%. Tab sis nyob rau hauv cov pob txha leukemic, qhov kev faib ua feem ntau tshaj 20%.
Type of Leukemia
Muaj 4 hom kab mob leukemia li,
- Acute myeloid leukemia (AML)
- Tus mob lymphoblastic leukemia (TAG NRHO)
- Chronic myeloid leukemia (AML)
- Chronic lymphocytic leukemia (CLL)
Cov kab mob no tsis tshua muaj tshwm sim thiab qhov tshwm sim txhua xyoo yog 10/1000000. Feem ntau, leukemia tuaj yeem tshwm sim txhua lub hnub nyoog. Tab sis TAG NRHO feem ntau pom hauv cov menyuam yaus thaum CLL nquag tshwm sim hauv cov neeg laus. Cov kab mob etiological ua rau mob leukemia muaj xws li hluav taws xob, kab mob, cov kab mob cytotoxic, kev tiv thaiv kab mob thiab cov caj ces. Kev kuaj mob ntawm tus kab mob tuaj yeem ua tiav los ntawm kev kuaj xyuas cov kab mob ntawm cov ntshav peripheral thiab cov pob txha pob txha. Rau kev faib tawm thiab kev soj ntsuam, kev tiv thaiv kab mob, cytogenetics, thiab molecular noob caj noob ces yog qhov tseem ceeb.
mob leukemia
Qhov tshwm sim ntawm tus mob leukemia nce ntxiv nrog rau hnub nyoog dhau los. Lub hnub nyoog nruab nrab ntawm kev nthuav qhia rau mob myeloblastic leukemia yog 65 xyoo. Mob leukemia tej zaum yuav tshwm sim de novo los yog vim ua ntej cytotoxic chemotherapy los yog myelodysplasia. Mob lymphoblastic leukemia muaj hnub nyoog qis dua qhov kev nthuav qhia. Nws yog qhov mob hnyav tshaj plaws hauv menyuam yaus.
Kev Kho Mob Ntawm Txhua Tus
- Ua tsis taus pa thiab qaug zog
- Kab mob
- Headache/confuse
- pob txha
- YHepatosplenomegaly/lymphadenopathy
x
Kev kho mob ntawm AML
- Gum hypertrophy
- Ntxhais tawv nqaij tawv
- qaug zog thiab ua tsis taus pa
- Kab mob
- YHepatosplenomegaly
- YLymphadenopathy
- Testicular o
x
Kev tshawb nrhiav
Rau Kev Pom Zoo Txog Kev Tshawb Fawb
- ntshav suav - Platelets thiab hemoglobin feem ntau qis; Cov ntshav dawb suav ib txwm sawv.
- Ntshav Zaj duab xis - Kab mob ntawm tus kab mob tuaj yeem txheeb xyuas tau los ntawm kev soj ntsuam cov hlwb tawg. Auer rods tuaj yeem pom hauv AML.
- pob txha pob txha aspiration - Txo erythropoiesis, txo megakaryocytes, thiab nce cellularity yog cov cim los nrhiav.
- lub hauv siab X-ray
- Cerebrospinal kua tshuaj
- Txoj kev sib txuas profile
Kev Npaj Kho Mob
- Serum urate thiab daim siab biochemistry
- Electrocardiography/echocardiogram
- HLA type
- Kuaj HBV xwm txheej
Kev tswj hwm
Tsis kho mob leukemia feem ntau tuag taus. Tab sis nrog kev kho mob palliative, lub neej ntev tuaj yeem txuas ntxiv. Qee zaum kev kho mob tuaj yeem ua tiav. Kev ua tsis tiav tuaj yeem yog vim muaj tus kab mob rov qab los yog vim muaj teeb meem ntawm kev kho mob lossis vim qhov tsis zoo ntawm tus kab mob. Nyob rau hauv tag nrho, remission induction tuaj yeem ua tiav nrog kev sib xyaw ua ke ntawm kev kho mob ntawm Vincristine. Rau cov neeg mob uas muaj kev pheej hmoo siab, kev hloov pauv ntawm cov qia cell tuaj yeem ua tau.
Chronic Myeloid Leukemia
CML yog ib tug tswv cuab ntawm tsev neeg ntawm myeloproliferative neoplasms uas tsuas yog tshwm sim rau cov neeg laus. Nws yog txhais los ntawm lub xub ntiag ntawm Philadelphia chromosome thiab muaj kev kawm qeeb qeeb dua li mob qog noj ntshav.
Tshuaj Kho Mob
- Symptomatic anemia
- mob plab tsis xis nyob
- poob qis
- Headache
- YLymphadenopathy
x
Kev tshawb nrhiav
- ntshav suav - Hemoglobin qis lossis ib txwm muaj. Platelets yog qis, zoo li qub lossis tsa. WBC tau tsa.
- Kev muaj tus paub tab myeloid precursors hauv ntshav zaj duab xis
- Kev nce cellularity nrog nce myeloid precursors hauv pob txha pob txha aspirate.
Kev tswj hwm
Thawj kab tshuaj hauv kev kho mob ntawm CML yog Imatinib (Glivec), uas yog tyrosine kinase inhibitor. Kev kho kab thib ob suav nrog kev kho tshuaj nrog hydroxyurea, alpha interferon, thiab kev hloov pauv ntawm cov qia cell.
Chronic Lymphocytic Leukemia
CLL yog cov kab mob leukemia uas feem ntau tshwm sim thaum laus. Nws yog tshwm sim los ntawm clonal expansion ntawm me B lymphocytes.
Tshuaj Kho Mob
- Asymptomatic lymphocytosis
- YLymphadenopathy
- Marrow tsis ua haujlwm
- YHepatosplenomegaly
- B-symptoms
Daim duab 02: Cov tsos mob ntawm Leukemia
Kev tshawb nrhiav
- Cov qe ntshav dawb siab heev tuaj yeem pom hauv cov ntshav suav
- Smudge cells tuaj yeem pom hauv cov ntshav zaj duab xis
Kev tswj hwm
Kev kho yog muab rau cov teeb meem organomegaly, ntu hemolytic, thiab pob txha pob txha. Rituximab ua ke nrog Fludarabine thiab cyclophosphamide qhia cov lus teb zoo heev.
Dab tsi zoo sib xws ntawm MDS thiab Leukemia?
- Ob leeg yog cov kab mob hematological uas yog vim qhov txawv txav ntawm cov pob txha pob txha.
- Kev kuaj ntshav thiab kuaj cov pob txha pob txha tau ua tiav rau kev kuaj mob ntawm ob qho xwm txheej
Qhov txawv ntawm MDS thiab Leukemia yog dab tsi?
MDS vs Leukemia |
|
| Myelodysplastic syndromes piav qhia txog cov txheej txheem ntawm cov pob txha pob txha uas tshwm sim los ntawm qhov tsis xws luag hauv cov qia hlwb. | Leukemia tuaj yeem txhais tau tias yog qhov sib txuam ntawm cov qog ntshav dawb monoclonal txawv txav hauv cov pob txha pob txha. |
| Type | |
| Ntawm no yog qhov mob ua ntej uas muaj peev xwm ntawm kev hloov pauv tsis zoo. | Qhov no yog qhov phem. |
| Qhov no feem ntau pom ntawm cov neeg laus. | Qhov no tuaj yeem pom hauv txhua pawg hnub nyoog tab sis cov neeg laus raug cuam tshuam los ntawm tus mob no ntau dua li cov menyuam yaus. |
| Tshuaj Kho Mob | |
|
Qhov chaw kho mob ntau yam yog, · Anemia · los ntshav vim pancytopenia · Neutropenia · Monocytosis · Thrombocytopenia |
Ntau zaus pom cov tsos mob ntawm leukemia yog, · Gum hypertrophy · Violaceous skin deposits · Npuag thiab ua tsis taus pa · mob taub hau/tsis meej pem · Kab mob · mob pob txha · ntshav thiab nqaij tawv · Hepatosplenomegaly · Testicular o · Lymphadenopathy |
| Kev tswj hwm | |
|
Cov neeg mob nrog <5% ntawm cov pob txha tawg hauv pob txha tau txais kev tswj hwm kev saib xyuas uas suav nrog, · Red cell thiab platelets transfusions · Tshuaj tua kab mob rau tus kab mob Yog tias feem pua ntawm cov pob txha tawg yog >5% kev tswj hwm yog los ntawm cov txheej txheem hauv qab no, · Txhawb kev saib xyuas kom txo qis kev pheej hmoo kis lwm yam teeb meem · Chemotherapy · Kev tswj hwm ntawm lenalidomide pob txha pob txha hloov |
Kev tswj hwm nws txawv raws li hom kab mob leukemia uas tus neeg mob muaj. Tshuaj kho mob ua lub luag haujlwm tseem ceeb hauv kev kho mob leukemia. |
Summary – MDS vs Leukemia
Myelodysplastic syndromes (MDS) piav qhia txog cov txheej txheem ntawm cov pob txha pob txha uas tau txais los ntawm qhov tsis xws luag hauv cov qia hlwb thaum Leukemia yog qhov sib txuam ntawm qhov txawv txav ntawm cov qe ntshav dawb monoclonal hauv cov pob txha. Myelodysplasia yog ib qho mob ua ntej uas tuaj yeem ua rau muaj kev hloov pauv tsis zoo tab sis leukemia yog qhov mob hnyav. Qhov no yog qhov txawv ntawm MDS thiab leukemia.
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Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li cov ntawv sau tseg. Thov download PDF version ntawm no Qhov txawv Ntawm MDS thiab Leukemia
