Experts explain the three major misunderstandings of slow granule treatment

Experts explain the three major misunderstandings of slow granule treatment

September 21, 2015 Source: Xinhuanet

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Zhu Huanling, deputy director and chief physician of the Department of Hematology, West China Hospital, recently accepted an interview with Xinhua.com, through TKI drug treatments such as imatinib (such as Gleevec), it is now possible to manage chronic granules like managing chronic diseases, but for slow-granulation treatment. There are still some misunderstandings.

If the symptoms improve, it does not mean that the medicine can be broken.

It is known that slow granules are caused by genetic mutations, leading to bone marrow hyperplasia, resulting in a malignant tumor caused by a large number of abnormal granulocytes. "The premise of achieving functional cure in patients with chronic granules is to take regular medication, regular monitoring, and standardized management of chronic diseases." Zhu Huanling reminded: "Like high blood pressure patients should take antihypertensive drugs on time, regular blood pressure measurement, slow granule patients Hematology, bone marrow cytogenetics and molecular biology examinations should be conducted at the critical time points of the 3rd, 6th, 12th and 18th months to understand the treatment effect and facilitate the doctor according to the condition. Development and adjustment of treatment methods."

"After taking the medicine for a period of time, a small number of patients may think that the symptoms have been controlled, or reduce or stop taking the medicine for reasons such as medical expenses. Although it may not be reflected in the blood examination in the short term, it is actually unable to reduce the disease. Genes, even in the case of long-term low-dose drugs, can lead to drug resistance.” Zhu Huanling said that TKI drugs can inhibit cancer cells to levels that are almost undetectable, but current treatment methods cannot completely eliminate pathogenic cells. Taking the medicine on time and regular inspections can control the increase of pathogenic cells, so that doctors can find out if there is any signs of deterioration."

Slow-particle patients can't wait until they feel bad symptoms and see a doctor. "The ultimate goal of treatment is to enable patients with chronic granules to survive for a long period of time. If the symptoms recur and the abnormal cells rise very high, then the treatment will be very passive. In addition, although TKI medication will treat patients The 8-year survival rate has increased to 85%, but this also means that there is still a 15% risk. We certainly hope to maintain the health of each patient through standardized management." Zhu Huanling said.

Can you want your baby not to stop taking medicine at any time?

Reproductive health and smart baby is the expectation of every parent. "Slow-granule patients can be pregnant, but only if the patient achieves better molecular biological remission." Zhu Huanling said, "The general recommendation is that patients maintain MR 4.5 levels (BCR-ABL <0.0032%) for more than 2 years, or Maintain MMR3.0 for at least 2 years. Female patients can stop using TKI drugs during pregnancy and pregnancy, switch to interferon and other treatment methods, and re-use TKI drugs after the end of lactation period."

Zhu Huanling suggested that patients with chronic granules who are preparing to become pregnant should communicate with their doctors in time, otherwise they may threaten their own health and their children's health. "Not long ago, there was a female patient in the hospital who insisted on the child when the condition was not well controlled. The patient could only passively stop taking the drug. At the time of production, the pregnant woman was already very ill, the white blood cell value was always rising, and the disease was blocked. The blood vessels, the eyes are almost invisible, it is a great risk to give birth to the child." Speaking of this story, Zhu Huanling still feels scared.

In order to help patients with chronic granules to learn more about disease, Huaxi Hospital holds a patient education program every quarter. More than 100 patients actively participated and asked questions. Zhu Huanling also introduced that nearly 400 patients in the hospital spontaneously established QQ groups, exchanged experiences and organized offline activities, and also pulled doctors into the group and took time to answer questions from patients. “Many patients have higher levels of education and health awareness, and they have more and more accurate understanding of slow granules.” Zhu Huanling said

Malignant tumors do not mean that they can't get back to normal work

Due to the lack of understanding of chronic granules in the society, many patients were rejected by the original work unit after the disease was well controlled. Zhu Huanling also experienced similar situations.

"My patients include doctors, civil servants, and teachers with graduating classes. If the patients recover well, they can do the job well under the conditions of regular work and normal diet." Zhu Huanling said that although the slow grain is A malignant tumor, but as long as the patient achieves a functional cure, they will not be found to have a disease if they do not pass a very sensitive test.

"With TKI drugs, slow granules can already be managed as chronic diseases. Slow-granular patients are also social people. If they can return to work after getting effective treatment, they can be with friends and colleagues, for themselves, their families and society. Zhu Huanling appealed, "I hope that the society and the family should identify, care for, accept these slow-granular patients and treat them as ordinary people. At the same time, patients with chronic granules should have confidence and believe that they can achieve functionality under standardized treatment. Heal and return to normal work and life."

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