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Lefuemia e sa foleng ea Lymphoid, eo hape e tsejoang e le LLC kapa lefu le sa foleng la kankere ea mali, ke mofuta oa kankere ea mali e khetholloang ke keketseho ea li-lymphocyte tse holileng maling, ho kenyelletsa keketseho ea lisele tsa mmele, ho theola boima ba 'mele le mokhathala o feteletseng. .

LLC hangata e fumanoa e le lilemo li 65, hobane lefu lena le na le phetoho e liehang, 'me hangata matšoao a hlokomeloa ha lefu lena le se le le mothating o tsoetseng pele. Ka lebaka la ho lieha ho hlaha ha matšoao, lefu lena hangata le tsejoa nakong ea liteko tsa mali tse tloahelehileng, haholo-holo palo ea mali, moo keketseho ea palo ea li-lymphocyte e ka tsejoang.

Li-lymphocyte ka har'a smear ea mali

Matšoao a LLC

LLC e qala ho feta likhoeli kapa lilemo, ka hona, matšoao a hlaha hanyane ka hanyane, mme lefu lena le tsejoa hangata ha le se le le boemong bo tsoetseng pele. Matšoao a bontšang LLC ke:


  • Likokoana-hloko tse eketsehileng le li-lymph nodes;
  • Mokhathala;
  • Phefumoloho e khutšoanyane nakong ea boikoetliso;
  • Ho atolosoa ha spleen, eo hape e bitsoang splenomegaly;
  • Hepatomegaly, e leng ho holisa sebete;
  • Matšoao a iphetang a letlalo, moroto le matšoafo;
  • Ho fokotsa boima ba 'mele.

Kaha lefu lena ha le hlahise matšoao mokhatlong oa lona oa pele, LLC e ka tsejoa kamora ho etsa liteko tse tloaelehileng, moo keketseho ea palo ea li-lymphocyte le leukocyte e ka bonoang tekong ea mali.

Mokhoa oa ho hlahloba o etsoa joang

Ho fumanoa ha Leukemia ea Chronic Lymphoid ho etsoa ka tlhahlobo ea lisele tsa mali ka lebaka la palo e felletseng ea mali, e entsoeng ka tlhahlobo ea sampole ea mali. Palo e felletseng ea mali ea LLC ho a khonahala ho tseba leukocytosis, hangata e kaholimo ho lisele tse 25,000 / mm³ tsa mali, le lymphocytosis e phehellang, hangata e kaholimo ho li-lymphocyte tse 5000 / mm³ tsa mali. Ho phaella moo, bakuli ba bang ba na le phokolo ea mali le thrombocytopenia, e leng ho fokotseha ha palo ea liplatelete maling. Bona hore na litekanyetso tsa litšupiso tsa lisele tse tšoeu tsa mali ke eng.


Leha e se e holile, li-lymphocyte tse teng maling a phelisang li nyane ebile lia fokola, ka hona, nakong ea ho etsa mali smear li ka petsoha mme tsa hlahisa meriti ea nyutlelie, eo hape e bitsoang meriti ea Gumprecht, eo le eona e nkoang e felletse ho hlahlojoa.

Le ha palo ea mali e lekane ho phethela tlhahlobo ea lefu le sa foleng la lymphocytic leukemia, liteko tsa immunophenotyping lia hlokahala ho khetholla boteng ba matšoao a netefatsang hore ke leukemia e amanang le ho ata ha li-lymphocyte tsa mofuta oa B le hore e sa foleng. Ho itšireletsa mafung ho nkoa e le tekanyetso ea khauta ea boitsebiso eseng feela bakeng sa LLC empa le bakeng sa mefuta e meng ea kankere ea mali.

Maemong a mang, ngaka e ka kopa myelogram, e leng tlhahlobo e etsoang ho sekaseka lisele tse teng mokong oa masapo, eo tabeng ea LLC e nang le li-lymphocyte tse fetang 30% tse holileng tsebong. Tlhatlhobo ena, leha ho le joalo, ha e koptjoe haholo ho fumana lefu lena, empa ho netefatsa ho iphetola ha lintho, mokhoa oa ho kenella oa li-lymphocyte le ho hlalosa ponelopele. Utloisisa hore na myelogram e etsoa joang.


Phekolo ea LLC

Kalafo ea LLC e etsoa ho latela sethaleng sa lefu lena:

  • Kotsi e tlase: moo ho fumanoang feela leukocytosis le lymphocytosis, ntle le matšoao a mang. Kahoo, ngaka e felehetsa mokuli mme ha ho hlokahale ho etsa kalafo;
  • Kotsi ea lipakeng: moo lymphocytosis, ho atolosoa ha li-lymph node le sebete kapa splenomegaly ho netefalitsoeng, ho hloka hore ho lateloe bongaka ho lekola phetoho ea lefu lena le kalafo ka chemo kapa radiotherapy;
  • Kotsi e kholo: moo ho khetholloang matšoao a CLL, ntle le khaello ea mali le thrombocytopenia, mme kalafo e lokela ho qalisoa hanghang. Kalafo e khothalelitsoeng ka ho fetesisa ntlheng ena ke ho kenyelletsa 'moko oa masapo, hape ho hlokahala hore o etsoe chemo le radiotherapy.

Hang ha keketseho ea bongata ba li-lymphocyte maling a pheripherali e tsejoa, ho bohlokoa hore ngaka e hlahlobe boemo ba mokuli ka kakaretso e le hore tlhahlobo ea CLL e netefatsoe le kalafo e ka qalisoa le ts'oaetso ea lefu e ka qojoa.

Ka bobeli radiotherapy le chemotherapy li ka fokolisa haholo ebile tsa kena-kenana le boleng ba motho ba bophelo. Kahoo, hoa khahlisa ho ba le phepo e nepahetseng le e leka-lekaneng ho tiisa maikutlo a boiketlo le ho kokobetsa matšoao a amanang le mefuta ena ea kalafo. Sheba video e latelang ka lijo tse ntle ho fokotsa litla-morao tsa chemotherapy:

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