Shi Shurong Consultation Appointment: What is the difference between slow granules (CMML) and chronic myeloid leukemia?

Chronic myelomonocytic leukemia (CMML) is a clinically rare blood disease. Its clinical manifestations, survival time, and blood routine tests are diverse. Most of them develop after 60 years of age, CMML has obvious pathological hematopoiesis, and the hematopoietic function is mostly poor. Director Shi Shurong’s WeChat consultation platform: Similarities between zkxk9999 and chronic myeloid leukemia: CMML can be divided into chronic phase, accelerated phase, and acute phase. The patients in the chronic phase are relatively stable, asymptomatic, or have only low fever and fatigue, and rarely have enlarged liver and spleen lymph nodes, which is very similar to chronic myeloid leukemia. At the same time, many patients with chronic myeloid leukemia have myeloproliferative characteristics, the same is true of “slow granulocytes”. Differences: ① The slow-grained single is not only characterized by myeloproliferative characteristics, but also accompanied by morbid bone marrow hematopoiesis, which often occurs due to abnormal bone marrow hyperplasia and thrombocytopenia, manifested as fatigue, palpitations, paleness, low fever, infection or bleeding. ② The characteristic of myeloproliferative hyperplasia is abnormal mononuclear cell hyperplasia, especially when the disease progresses rapidly after entering the accelerated phase. At this time, the mononuclear cell can be significantly increased, the condition is extremely serious, and most of them die from bleeding, infection or dirty before the acute change Organ failure. ③The main treatment of slow-grain monotherapy is mainly chemotherapy. On the basis of chemotherapy, it cooperates with traditional Chinese medicine syndrome differentiation treatment to reduce side effects and relieve pain. The doctor said that the median survival time of CMML patients is about 20 months, and about 15-20% of them progress to acute myeloid leukemia; the survival time may be related to the proportion of bone marrow blasts. But the prognosis will also be significantly different due to the heterogeneity of the disease. More patient communication assistance can follow the WeChat public account: Slow Grain Patient Association

Shi Shurong medical words: Why do you have chronic myeloid leukemia? What should be paid attention to in treatment?

Patients with chronic myeloid leukemia and their families have a question: why do they have chronic myeloid leukemia? It is generally believed that the incidence of chronic granules is related to these factors: ionizing radiation, chemical pollution, and genetic factors. However, in the same living environment, only a few people have been diagnosed with chronic granules. What is the pathogenesis of this group of people? Director Shi Shurong consulted WeChat zkxk9999 slow granulogenesis: non-genetic, mostly chromosomal variation. In previous research, it has been found that chronic myeloid leukemia is caused by the translocation and exchange of the 9th and 22nd pair of chromosome end gene loci in humans. The formation of a new bcr-abl fusion gene, encoded into a specific protein, a tyrosine kinase, which leads to disease, causing a rapid rise in white blood cells and splenomegaly. The cause of the chromosomal mutation is not yet clear, but what can be determined is that it has nothing to do with inheritance. Based on the pathogenesis of slow granules, the curative effect of targeted drugs is “gratifying”. Targeting drugs for fusion genes of slow granule patients, namely tyrosine kinase inhibitors, have a clear effect and a significant effect, allowing the quality of life and survival of slow granule patients. The period has been significantly extended. However, during the treatment period, due to individual differences, it is necessary to constantly adjust the medication plan according to the patient’s condition, medication response and efficacy. Therefore, patients with slow-grain must carefully review and monitor in order to pass the medication to make the fusion gene The expression reached the expected goal, and even received withdrawal. In addition, some patients with slow-grained drugs have had various degrees of side effects during the treatment, which may even affect the final efficacy. Therefore, it is recommended that slow-grain patients can intervene in traditional Chinese medicine to increase the effectiveness and reduce toxicity! For more knowledge about chronic myeloid leukemia disease or patient help, you can pay attention to WeChat public number: mbxb120

Shi Shurong’s Medical Talk: Instructions for Slow-grain Patients: Requirements for Taking Different Targeted Drugs!

Compared with other types of leukemia, chronic myelogenous leukemia is “more docile”. Most patients can control their condition by taking medicine only, and they can even return to normal living conditions! Director Shi Shurong’s WeChat signal zkxk9999 However, in the course of treatment, medication compliance is often a key factor influencing the curative effect. For this reason, patients with slow-grained medication must obey the arrangement. First of all, the requirements for taking different targeted drugs ① Imatinib taking this drug may cause nausea and vomiting, which is caused by the stimulation of the gastrointestinal mucosa by the drug, especially when it is taken on an empty stomach. Therefore, when taking imatinib, you can take it with food at the same time to avoid the occurrence of nausea. Specific methods: take medicine during meals, drink a large glass of water, and take a rest two hours after taking the medicine. If nausea and vomiting are serious, you can take some antiemetic drugs. ② Nilotinib needs to be taken on an empty stomach to obtain a stable blood drug concentration. Fat in food can promote the absorption of nilotinib. In order to avoid fluctuations in the absorption rate and blood concentration of nilotinib caused by different fat content in the diet, fasting: one hour before or two hours after a meal At the same time, because nilotinib needs to be taken twice a day, the medication time needs to be coordinated with the meal plan. ③ Dasatinib diet has no effect on the absorption of dasatinib, so there is no need to pay attention to the coordination of meals with Dasatinib. Secondly, the medication time should be fixed as much as possible to reduce the occurrence of adverse reactions, and at the same time, ensure a certain blood drug concentration. Furthermore, do not eat foods that affect the efficacy, such as grapefruit and grapefruit. Finally, in addition to the above factors, slow-grain patients also need to regularly review and monitor the condition. Adjust the treatment plan in time when the disease is resistant or the gene has not been converted, to prevent the condition from accelerating the rapid change and deterioration. If the disease has progressed in an unfavorable direction, it is necessary to receive combined treatment in time to achieve rapid remission and stabilize the condition. For more knowledge about chronic myeloid leukemia disease or patient help, please pay attention to WeChat public account: mbxb120

Shi Shurong’s medical remarks: Is chronic myeloid leukemia better if blood routine is normal?

Now, many patients with chronic myeloid leukemia know that to have a better effect, they need to be reviewed regularly to monitor their condition. But there are also some patients who only check the blood routine during the re-examination. So, if the blood routine is normal, can the medicine be stopped? Director Shi Shurong’s micro-signal zkxk9999 patient’s question: In February last year, because of abdominal distension and chest pain, went to the hospital to confirm the diagnosis of chronic myeloid leukemia. After taking Gleevec, the skin still showed red rash after taking the medicine for half a year, itchy, and then stopped the medicine and changed to Chinese medicine. Up to now, the blood routine values ​​are basically normal, and the body does not have any discomfort symptoms. Has the disease improved? Hematologist: Chronic myeloid leukemia is a type of hematological malignancy. Most patients require long-term medication and monitor the effect of treatment at the same time, but it is only a review of blood routine, which is not enough to monitor chronic myelopathy. Patients also need to do fusion genes on a regular basis. Quantitative monitoring is the effective monitoring of the disease. In addition, for slow-grain patients, long-term and sufficient targeted drug therapy to promote the fusion gene to become negative is the best treatment. The therapeutic effect of Chinese medicine on blood diseases is worthy of affirmation. It can be treated with integrated Chinese and Western medicine. After the condition is really improved and stabilized, consider taking targeted drugs. It is very dangerous to stop taking targeted drugs suddenly during slow-grain treatment like this, and it is easy to delay the treatment of the disease. In summary, patients with chronic myeloid leukemia not only need to check the blood routine, but also need to do quantitative monitoring of fusion genes. For slow-grain patients with relatively large side effects of targeted drugs, they should cooperate with traditional Chinese medicine as soon as possible to increase the effectiveness and reduce toxicity. For more knowledge about chronic myeloid leukemia disease or patient help, please pay attention to WeChat public account: mbxb120

What does Shi Shurong think: How to treat traditional Chinese medicine in chronic phase of chronic granule patients?

Chronic myeloid leukemia is a malignant tumor that affects the blood and bone marrow. In clinical practice, chronic myeloid leukemia is divided into three stages according to the rapid increase of peripheral blood leukocytes and the number of bone marrow cancer cells and the severity of symptoms. Chronic stage , Acceleration and rapid changes. Among them, the treatment of chronic phase is the most critical. Director Shi Shurong’s micro-signal xueyeke999 The chronic phase of this disease patient is relatively long, including chronic early or sub-clinical stage (current yin and yang imbalance, evil poison deep) and chronic stable period (current yang heat into evil, qi and yin injury) can be There are two types. The following will introduce the Chinese medicine treatment of chronic myeloid leukemia to everyone in detail: ①The initial appearance of chronic granules: poisonous evil invades the marrow, yin deficiency and fire vigorous symptoms: mostly manifested as pale and frivolous, five upset fever, low fever night sweats, upset and palpitations, anorexia , Subcostal syndrome, thin body, pale red tongue, thin white fur, fine pulse. Treatment principle: clearing the marrow and toxic heat, nourishing kidney and yin. In this type of treatment, detoxification is the first, heat-clearing and anti-cancer drugs are used together, followed by nourishing kidney and yin, Shaozuo and gastric blood circulation products, and using Qi-enhancing drugs with caution. ②After several months and years: poisoned bone marrow, qi and dark consumption, poisoning and stasis symptom: dizziness, shortness of breath, weakness in movement, spontaneous sweating and night sweats, soft waist and legs, insomnia, spleen discomfort, loose stools, pale tongue The moss is white and the pulse is thin and weak. Treatment principles: nourishing yin and benefiting qi, detoxifying, dissipating stasis. This type of treatment is mainly focused on corrective treatment, supplemented by detoxification, and blood circulation drugs should be added as appropriate, but it should not be broken. The treatment of chronic myeloid leukemia with traditional Chinese medicine has advantages in the chronic phase. Its treatment principle emphasizes the overall concept, considers and analyzes the etiology and pathology, pays attention to syndrome differentiation and treatment, personalized treatment, reflects one person, one symptom, one law, corrects evil, cures both symptoms and symptoms . Through the treatment of traditional Chinese medicine, it can control the development of the disease, relieve symptoms, improve the quality of life of the patient, protect the bone marrow’s hematopoietic function, enhance the patient’s immune mechanism, avoid the occurrence of infection and bleeding symptoms, and achieve the purpose of prolonging the life of patients with chronic myeloid leukemia. For more knowledge about chronic myeloid leukemia disease or patient help, please pay attention to WeChat public account: mbxb120

Chronic myeloid leukemia can be treated and controlled, and patient self-management is very important! Shi Shurong consultation appointment

Chronic myeloid leukemia was once considered an “incurable disease”, but with the development of modern medicine, especially the widespread use of targeted drugs in the clinic, chronic myeloid leukemia has become a “controllable and controllable” chronic disease, and even Some patients can live and work normally. Director Shi Shurong’s WeChat account xueyeke999 However, even if the quality of life is greatly improved, patients should not be taken lightly, and we must pay attention to “self-management” in life! Regarding the self-management of slow-grain patients, hematologists believe that: First of all, patients should have some understanding of “slow granules”; slow-grain granules are not like acute leukemia, which can make patients face “life and death choices” in a short time. It can be cured, but the patient should not be too lax. Only timely and effective treatment can make the condition controllable. ◆ Second, it is necessary to carry out regular review, especially blood routine and fusion gene monitoring. If the symptoms are not relieved, it is regarded as “healing”. This requires the patient to consciously pay attention to it; the blood routine of patients with slow grains can be normal, but at this time Also, pay attention to the results of monitoring the fusion gene. It is not normal blood routine, and the body has no symptoms, it means healed! ◆ Thirdly, it is necessary to take medicine regularly. The key to the controllability of slow-grain patients is that patients who take the wrong medicine, miss the medicine, and do not take it according to the time may affect the treatment effect and even give up their previous achievements. Chronic myeloid leukemia can already be treated as a chronic disease. The long-term self-management of the patient is particularly important. During treatment, it is necessary to adhere to regular medication, regular review, and follow the doctor’s advice. I also hope that patients will not be overly afraid of slow grains and have confidence in their own treatment and return to normal life. Welcome to pay attention to the WeChat public account of Chronic Disease Patients Association: mbxb120

Director Shi Shurong explained: three types of drugs used to treat chronic myeloid leukemia!

Just diagnosed with chronic myeloid leukemia, patients often listen to the doctor’s advice in the treatment of medication, and for the patient, whether it is the condition or the medication, they are in a very confused state. I don’t know how to choose? In fact, slow-grain patients have a little more knowledge about the disease, which is helpful for later treatment and monitoring of efficacy. Director Shi Shurong WeChat xueyeke999 Today, we will give you a summary of the types of chronic myeloid leukemia treatment drugs: the first category: hydroxyurea and interferon Some slow-grained “elderly” people are familiar with these two drugs. Before imatinib and other drugs were used in clinical treatment, hydroxyurea and interferon were the “main force” for the treatment of chronic myeloid leukemia. At present, some patients with poor economic conditions are also using these two drugs. This drug is mainly used for cell-reducing effect, and the price is relatively low; however, patients need long-term medication, which may have an impact on patients who need to consider fertility problems. At the same time, the drug has greater toxic and side effects during medication. The second category: TKI preparation tyrosine kinase inhibitors, such as the first-generation drugs imatinib, the second-generation drugs nilotinib and dasatinib, is currently the main clinical treatment of chronic myeloid leukemia. The advantage is that through the use of drugs, the survival time of most patients with chronic myeloid leukemia can be extended, and the quality of life has also been greatly improved; the disadvantage is that drug resistance is unavoidable, there are certain side effects, the cost is too high, and it is difficult for ordinary families to support long-term medication. The third category: the application of traditional Chinese medicine and traditional Chinese medicine in the treatment of chronic myeloid leukemia, its purpose is not to correct the phenomenon of chromosomes, gene mutations and other phenomena, its role is to: ① reduce toxicity and increase efficiency, for adverse reactions that may occur during medication Regulate, improve, improve patient survival treatment, consolidate the efficacy; ② adjust body immunity, promote the balance and repair of the body’s self-immune mechanism, increase the inhibition of leukemia cells, reduce the risk of drug resistance and gene mutation. The above is a summary of commonly used drugs for chronic myeloid leukemia. Which drug treatment to choose depends on the patient’s condition. At the same time, during the medication, pay attention to regular review and monitoring of the therapeutic effect in order to adjust the treatment medication plan in time to reduce adverse reactions. happened! Welcome to pay attention to the WeChat public account of Chronic Disease Patients Association: mbxb120

Farewell: can all patients with chronic myeloid leukemia control the disease, can they stop the drug?

Chronic myeloid leukemia was once considered an “incurable disease”. With the development of modern medicine, especially the emergence of targeted drugs, chronic myeloid leukemia has changed from an incurable disease to a treatable and controllable chronic disease. & nbsp. Chronic myeloid leukemia, also known as “slow granuloma”, is a malignant clonal disease in which bone marrow hematopoietic stem cells proliferate abnormally due to gene rearrangement and produce large numbers of abnormal granulocytes. Worldwide, patients with chronic myeloid leukemia are about 1.2 million to 1.5 million. In China, the annual incidence of chronic myeloid leukemia is about 1 / 100,000 to 2 / 100,000, accounting for 15% of adult leukemia, the median age of onset is 45-50 years, and there are more male patients than female patients. & nbsp. Currently, the most extensive treatment for chronic myeloid leukemia is tyrosine kinase inhibitor therapy. The main drugs are first-generation imatinib mesylate, second-generation nilotinib, and dasatinib and many more. & nbsp. Data show that after treatment with tyrosine kinase inhibitors, 50% of patients can achieve deep remission, and about 50% of patients can achieve drug withdrawal and achieve clinical cure or no treatment remission. Although tyrosine kinase inhibitors can effectively control chronic myeloid leukemia, they can’t achieve the purpose of cure. & nbsp. Slow granules can be used as a chronic disease for long-term self-management. In order to prevent the occurrence of drug resistance and intolerance in the course of medication, close monitoring and compliance with the doctor’s orders are the key to the patient’s best efficacy. & nbsp. However, the treatment of chronic myeloid leukemia is expensive, and it takes between 100,000 and 150,000 yuan a year to take the medicine alone. At the same time, taking medicine will also bring certain side effects such as diarrhea, rash and bone pain. & nbsp. The threshold for patients with slow-grain withdrawal is very high, and they need to be closely monitored after withdrawal. Once there are signs of relapse, they need to re-take the medicine. Therefore, an experienced specialist must initiate and monitor the withdrawal process. Professor Zhou Jianfeng made an analogy, just like driving, you must obey the traffic rules, otherwise it is very dangerous. & nbsp. The degree of treatment remission of patients with slow-grain can be divided into four depths: complete hematological response, complete cytogenetic response, main molecular response and deep molecular response. Every time it reaches a certain level, the white blood cells in the patient’s body will drop by an order of magnitude. Only when it reaches a stable fourth depth can it be possible to try to stop the drug. “If you want to achieve the withdrawal condition, you must standardize treatment and monitoring from the beginning.”

Shi Shurong explained: chronic myeloid leukemia can also be “curable and controllable” like a chronic disease!

At present, chronic myeloid leukemia has changed from “incurable disease” to “chronic disease” through treatment medication and standard monitoring during treatment. The patient’s survival time and quality of life have been significantly improved, but these are dependent on the disease condition. Early recognition, diagnosis and standardized treatment. Director Shi Shurong’s micro-signal xueyeke999 can make chronic granules become “chronic disease” leukemia through standard treatment. Can it be cured? Information obtained from film and television works or expert opinions decades ago was incurable. With the progress of society and the improvement of diagnosis and treatment, there are more and more long-term surviving leukemia patients, especially chronic myeloid leukemia patients. The molecular targeted drugs for chronic myeloid leukemia include the first-generation drugs imatinib, the second-generation drugs nilotinib, dasatinib, etc. Imatinib can achieve disease remission and long-term survival in nearly 90% of patients, but still Some patients relapse because of drug resistance, and need to take medicine for a lifetime without interruption. A large number of clinical trials at home and abroad have proved that nilotinib is more effective and stronger than imatinib, which can overcome the resistance of imatinib and enable patients to achieve molecular remission earlier, faster and deeper. Some patients can stop the medicine to achieve cure. It should be emphasized that in the process of slow-grain therapy, expert monitoring is indispensable to remind experts, although slow-grain leukemia can be treated and controlled as a “chronic disease”. But patients with slow-grain should be aware that they cannot stop the drug without authorization, otherwise it may accelerate the development of the disease. It is necessary to pay attention to monitoring organ functions and genetic changes when taking medicine. Therefore, it should be emphasized that slow-grain patients must standardize treatment, regularly monitor and follow up. [For more disease knowledge, follow the WeChat public account: Slow Grain Patient Association] Welcome to follow Shi Shurong to consult and reserve an official account to learn more: zzb753