{"id":7997,"date":"2018-10-31T01:53:11","date_gmt":"2018-10-30T18:53:11","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri\/"},"modified":"2018-10-31T01:53:11","modified_gmt":"2018-10-30T18:53:11","slug":"benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri\/","title":{"rendered":"B\u1ec7nh u lympho kh\u00f4ng Hodgkin v\u00e0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><em><strong>Bi\u00ean d\u1ecbch: \u0110\u1eb7ng Th\u1ecb Thanh H\u1ea3i, \u0110\u1eb7ng Th\u1ecb C\u00e1t Vy, Nguy\u1ec5n Th\u1ecb Ng\u1ecdc Th\u01b0.<\/strong><\/em><\/p>\n<h2><strong>T\u1ed5ng quan v\u1ec1 \u0111i\u1ec1u tr\u1ecb<\/strong><\/h2>\n<p>Trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0, th\u00f4ng th\u01b0\u1eddng c\u00e1c b\u00e1c s\u0129 c\u00f3 chuy\u00ean m\u00f4n kh\u00e1c nhau s\u1ebd c\u00f9ng nhau l\u00e0m n\u00ean m\u1ed9t b\u1ea3ng k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb t\u1ed5ng th\u1ec3 k\u1ebft h\u1ee3p c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau cho b\u1ec7nh nh\u00e2n. \u0110\u00e2y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u1ed9i ng\u0169 \u0111a chuy\u00ean khoa. M\u1ed9t \u0111\u1ed9i ng\u0169 ch\u0103m s\u00f3c ung th\u01b0 c\u00f2n bao g\u1ed3m nhi\u1ec1u chuy\u00ean gia ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe trong c\u00e1c l\u0129nh v\u1ef1c kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 tr\u1ee3 l\u00fd b\u00e1c s\u0129 (ng\u00e0nh n\u00e0y kh\u00f4ng c\u00f3 t\u1ea1i Vi\u1ec7t Nam), y t\u00e1, nh\u00e2n vi\u00ean x\u00e3 h\u1ed9i, d\u01b0\u1ee3c s\u0129, nh\u00e2n vi\u00ean t\u01b0 v\u1ea5n, chuy\u00ean vi\u00ean dinh d\u01b0\u1ee1ng v\u00e0 nh\u1eefng ng\u01b0\u1eddi kh\u00e1c.<\/p>\n<p>C\u00f3 4 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u00ednh cho NHL:<\/p>\n<ul>\n<li>H\u00f3a tr\u1ecb.<\/li>\n<li>X\u1ea1 tr\u1ecb.<\/li>\n<li>Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, ch\u1eb3ng h\u1ea1n nh\u01b0 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng, ch\u1ea5t \u1ee9c ch\u1ebf \u0111i\u1ec3m ki\u1ec3m so\u00e1t mi\u1ec5n d\u1ecbch v\u00e0 t\u1ebf b\u00e0o CAR-T.<\/li>\n<li>Li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c m\u1edbi h\u01a1n nh\u1eb1m ng\u0103n ch\u1eb7n m\u1ed9t s\u1ed1 ch\u1ee9c n\u0103ng nh\u1ea5t \u0111\u1ecbnh c\u1ee7a t\u1ebf b\u00e0o u lympho.<\/li>\n<\/ul>\n<p>Th\u00f4ng th\u01b0\u1eddng, b\u1ec7nh nh\u00e2n nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y. \u0110\u00f4i l\u00fac, b\u00e1c s\u0129 v\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc vi\u1ec7c ph\u1eabu thu\u1eadt hay gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c.M\u00f4 t\u1ea3 c\u1ee7a c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb n\u00e0y \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea d\u01b0\u1edbi \u0111\u00e2y. Vi\u1ec7c l\u1ef1a ch\u1ecdn v\u00e0 khuy\u1ebfn ngh\u1ecb \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 sau, bao g\u1ed3m:<\/p>\n<ul>\n<li>Lo\u1ea1i v\u00e0 giai \u0111o\u1ea1n NHL.<\/li>\n<li>Kh\u1ea3 n\u0103ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5.<\/li>\n<li>S\u1ef1 \u01b0a chu\u1ed9ng v\u00e0 s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<p>K\u1ebf ho\u1ea1ch ch\u0103m s\u00f3c \u0111\u00f3 c\u0169ng c\u00f3 th\u1ec3 bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (t\u00e1c d\u1ee5ng ph\u1ee5), \u0111\u00e2y l\u00e0 ph\u1ea7n quan tr\u1ecdng c\u1ee7a vi\u1ec7c ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n ung th\u01b0. C\u00e1c b\u1ec7nh nh\u00e2n n\u00ean d\u00e0nh th\u1eddi gian \u0111\u1ec3 t\u00ecm hi\u1ec3u v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb v\u00e0 h\u00e3y h\u1ecfi ngay n\u1ebfu b\u1ea1n c\u00f3 \u0111i\u1ec1u g\u00ec \u0111\u00f3 ch\u01b0a n\u1eafm r\u00f5. Ngo\u00e0i ra, h\u00e3y n\u00f3i chuy\u1ec7n v\u1edbi b\u00e1c s\u0129 c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c m\u1ee5c ti\u00eau m\u1ed7i l\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u00e0 b\u1ea1n c\u00f3 th\u1ec3 mong \u0111\u1ee3i \u0111i\u1ec1u g\u00ec khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. C\u0169ng n\u00ean t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 vi\u1ec7c \u0111\u01b0a ra c\u00e1c quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h2><strong>Theo d\u00f5i v\u00e0 ch\u1edd \u0111\u1ee3i<\/strong><\/h2>\n<p>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c n\u1ebfu h\u1ecd kh\u1ecfe m\u1ea1nh v\u00e0 b\u1ec7nh kh\u00f4ng g\u00e2y ra b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c v\u1ea5n \u0111\u1ec1 n\u00e0o v\u1edbi c\u00e1c c\u01a1 quan trong c\u01a1 th\u1ec3. \u0110i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ti\u1ebfp c\u1eadn ch\u1edd v\u00e0 theo d\u00f5i hay c\u00f2n g\u1ecdi l\u00e0 theo d\u00f5i ch\u1ee7 \u0111\u1ed9ng. Trong su\u1ed1t qu\u00e1 tr\u00ecnh n\u00e0y, c\u00e1c b\u00e1c s\u0129 s\u1ebd theo d\u00f5i ch\u1eb7t ch\u1ebd m\u1ed9t c\u00e1ch th\u01b0\u1eddng xuy\u00ean t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n qua vi\u1ec7c ki\u1ec3m tra s\u1ee9c kh\u1ecfe, ch\u1ee5p CT ho\u1eb7c l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh kh\u00e1c c\u0169ng nh\u01b0 c\u00e1c x\u00e9t nghi\u1ec7m trong ph\u00f2ng th\u00ed nghi\u1ec7m. S\u1ef1 \u0111i\u1ec1u tr\u1ecb ch\u1ec9 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u n\u1ebfu b\u1ec7nh nh\u00e2n ph\u00e1t tri\u1ec3n c\u00e1c tri\u1ec7u ch\u1ee9ng ho\u1eb7c x\u00e9t nghi\u1ec7m cho th\u1ea5y ung th\u01b0 \u0111ang tr\u1edf n\u00ean t\u1ed3i t\u1ec7 h\u01a1n. \u0110\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm, vi\u1ec7c theo d\u00f5i v\u00e0 ch\u1edd \u0111\u1ee3i kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u01a1 h\u1ed9i s\u1ed1ng c\u00f2n, nh\u01b0ng n\u00ean ch\u0103m s\u00f3c theo d\u00f5i th\u01b0\u1eddng xuy\u00ean v\u00e0 c\u1ea9n th\u1eadn.<\/p>\n<h2><strong>H\u00f3a tr\u1ecb<\/strong><\/h2>\n<p>H\u00f3a tr\u1ecb l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0, th\u01b0\u1eddng s\u1ebd ch\u1ea5m d\u1ee9t kh\u1ea3 n\u0103ng ph\u00e1t tri\u1ec3n v\u00e0 ph\u00e2n chia t\u1ebf b\u00e0o ung th\u01b0. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u00ednh cho NHL. H\u00f3a tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1edfi m\u1ed9t b\u00e1c s\u0129 n\u1ed9i khoa ung th\u01b0, l\u00e0 ng\u01b0\u1eddi chuy\u00ean \u0111i\u1ec1u tr\u1ecb ung th\u01b0 b\u1eb1ng thu\u1ed1c, ho\u1eb7c m\u1ed9t b\u00e1c s\u0129 huy\u1ebft h\u1ecdc, l\u00e0 chuy\u00ean gia \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n v\u1ec1 m\u00e1u. B\u00e1c s\u0129 n\u1ed9i khoa ung th\u01b0 ho\u1eb7c b\u00e1c s\u0129 huy\u1ebft h\u1ecdc th\u01b0\u1eddng l\u00e0 chuy\u00ean gia ung th\u01b0 ch\u00ednh cho nh\u1eefng ng\u01b0\u1eddi m\u1eafc u lympho.H\u00f3a tr\u1ecb li\u1ec7u to\u00e0n th\u00e2n \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o m\u00e1u \u0111\u1ec3 ti\u1ebfp c\u1eadn c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 tr\u00ean kh\u1eafp c\u01a1 th\u1ec3. C\u00e1c c\u00e1ch \u0111i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t th\u00f4ng th\u01b0\u1eddng bao g\u1ed3m \u0111\u1eb7t m\u1ed9t \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch (IV) b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng kim ho\u1eb7c d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng, m\u1ed9t vi\u00ean thu\u1ed1c ho\u1eb7c vi\u00ean d\u1ea1ng nang ch\u1ee9a h\u00f3a ch\u1ea5t \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o c\u01a1 th\u1ec3 b\u1eb1ng \u0111\u01b0\u1eddng mi\u1ec7ng.<\/p>\n<p>M\u1ed9t ch\u1ebf \u0111\u1ed9 h\u00f3a tr\u1ecb li\u1ec7u hay th\u1eddi gian bi\u1ec3u th\u01b0\u1eddng bao g\u1ed3m m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng c\u1ee5 th\u1ec3 chu k\u1ef3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra trong m\u1ed9t kho\u1ea3ng th\u1eddi gian nh\u1ea5t \u0111\u1ecbnh. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c 1 lo\u1ea1i thu\u1ed1c m\u1ed9t l\u1ea7n ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau c\u00f9ng m\u1ed9t l\u00fac. Ph\u00e1c \u0111\u1ed3 h\u00f3a tr\u1ecb \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ee5 thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n v\u00e0 lo\u1ea1i NHL. C\u00e1c k\u1ebft h\u1ee3p h\u00f3a tr\u1ecb li\u1ec7u ph\u1ed5 bi\u1ebfn nh\u1ea5t cho vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u c\u1ee7a NHL ti\u1ebfn tri\u1ec3n nhanh \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 CHOP v\u00e0 ch\u1ee9a 4 lo\u1ea1i thu\u1ed1c:<\/p>\n<ul>\n<li>Cyclophosphamide (Cytoxan, Neosar, \u1edf Vi\u1ec7t Nam l\u00e0 Endoxan).<\/li>\n<li>Doxorubicin (Adriamycin).<\/li>\n<li>Prednisone (nhi\u1ec1u t\u00ean th\u01b0\u01a1ng hi\u1ec7u).<\/li>\n<li>Vincristine (Oncovin, Vincasar, \u1edf Vi\u1ec7t Nam hi\u1ec7n c\u00f3 Vincrans).<\/li>\n<\/ul>\n<p>\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb u lympho t\u1ebf b\u00e0o d\u00f2ng B, vi\u1ec7c th\u00eam kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng rituximab v\u00e0o CHOP s\u1ebd ho\u1ea1t \u0111\u1ed9ng t\u1ed1t h\u01a1n CHOP \u0111\u01a1n \u0111\u1ed9c (xem \u201cLi\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch\u201d b\u00ean d\u01b0\u1edbi). C\u00f3 nh\u1eefng c\u00e1ch k\u1ebft h\u1ee3p ph\u1ed5 bi\u1ebfn kh\u00e1c c\u1ee7a ph\u00e1c \u0111\u1ed3 h\u00f3a tr\u1ecb, bao g\u1ed3m:<\/p>\n<ul>\n<li>BR (bendamustine v\u00e0 rituximab).<\/li>\n<li>C\u00e1c k\u1ebft h\u1ee3p d\u1ef1a tr\u00ean Fludarabine (Fludara, Oforta).<\/li>\n<li>R-CVP (cyclophosphamide, prednisone, rituximab v\u00e0 vincristine).<\/li>\n<\/ul>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a h\u00f3a tr\u1ecb li\u1ec7u ph\u1ee5 thu\u1ed9c v\u00e0o t\u1eebng lo\u1ea1i thu\u1ed1c v\u00e0 li\u1ec1u s\u1eed d\u1ee5ng. C\u00f3 th\u1ec3 bao g\u1ed3m m\u1ec7t m\u1ecfi, thi\u1ebfu m\u00e1u t\u1ea1m th\u1eddi, nguy c\u01a1 nhi\u1ec5m tr\u00f9ng, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n, r\u1ee5ng t\u00f3c, ch\u00e1n \u0103n, ph\u00e1t ban v\u00e0 ti\u00eau ch\u1ea3y. Nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00e0 th\u01b0\u1eddng bi\u1ebfn m\u1ea5t sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb .<\/p>\n<p>H\u00f3a tr\u1ecb c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5 l\u00e2u d\u00e0i, c\u00f2n g\u1ecdi l\u00e0 t\u00e1c d\u1ee5ng mu\u1ed9n. Nh\u1eefng b\u1ec7nh nh\u00e2n u lympho c\u00f3 th\u1ec3 lo l\u1eafng v\u1ec1 vi\u1ec7c li\u1ec7u c\u00e1ch \u0111i\u1ec1u tr\u1ecb c\u1ee7a h\u1ecd c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe t\u00ecnh d\u1ee5c v\u00e0 kh\u1ea3 n\u0103ng sinh s\u1ea3n c\u1ee7a h\u1ecd hay kh\u00f4ng v\u00e0 \u1ea3nh h\u01b0\u1edfng nh\u01b0 th\u1ebf n\u00e0o. H\u00e3y tr\u00f2 chuy\u1ec7n c\u00f9ng v\u1edbi c\u00e1c th\u00e0nh vi\u00ean c\u1ee7a nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u1ec1 c\u00e1c ch\u1ee7 \u0111\u1ec1 n\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 t\u00e1c d\u1ee5ng \u0111i\u1ec1u tr\u1ecb mu\u1ed9n. (\u1ede Vi\u1ec7t Nam, n\u00ean t\u01b0 v\u1ea5n \u1edf b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb c\u1ee7a ch\u00ednh b\u1ea1n th\u1eadt k\u1ef9 v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n n\u00e0y v\u00e0 k\u1ebf ho\u1ea1ch \u0111\u1ec3 qu\u1ea3n l\u00fd ch\u00fang th\u1eadt t\u1ed1t)<\/p>\n<p>T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c \u0111i\u1ec1u c\u01a1 b\u1ea3n c\u1ee7a h\u00f3a tr\u1ecb v\u00e0 chu\u1ea9n b\u1ecb \u0111i\u1ec1u tr\u1ecb. C\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 lu\u00f4n li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1. V\u1eady tr\u00f2 chuy\u1ec7n v\u1edbi b\u00e1c s\u0129 c\u1ee7a b\u1ea1n l\u00e0 c\u00e1ch t\u1ed1t nh\u1ea5t \u0111\u1ec3 t\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea cho b\u1ea1n, m\u1ee5c \u0111\u00edch c\u1ee7a ch\u00fang v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 ti\u1ec1m t\u00e0ng ho\u1eb7c t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 \u0111\u01a1n thu\u1ed1c c\u1ee7a b\u1ea1n b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u01a1 s\u1edf d\u1eef li\u1ec7u thu\u1ed1c c\u00f3 th\u1ec3 t\u00ecm ki\u1ebfm.<\/p>\n<h2><strong>X\u1ea1 tr\u1ecb<\/strong><\/h2>\n<p>X\u1ea1 tr\u1ecb l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c tia X n\u0103ng l\u01b0\u1ee3ng l\u1edbn, electron ho\u1eb7c proton \u0111\u1ec3 ti\u00eau di\u1ec7t c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. M\u1ed9t b\u00e1c s\u0129 chuy\u00ean v\u1ec1 x\u1ea1 tr\u1ecb \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u00e1c s\u0129 chuy\u00ean khoa ung th\u01b0 v\u1ec1 x\u1ea1 tr\u1ecb. X\u1ea1 tr\u1ecb cho NHL th\u01b0\u1eddng l\u00e0 x\u1ea1 tr\u1ecb ch\u00f9m tia ngo\u00e0i, t\u1ee9c l\u00e0 b\u1ee9c x\u1ea1 \u0111\u01b0\u1ee3c \u0111\u01b0a ra t\u1eeb m\u1ed9t m\u00e1y b\u00ean ngo\u00e0i c\u01a1 th\u1ec3.<\/p>\n<p>Ph\u00e1c \u0111\u1ed3 x\u1ea1 tr\u1ecb, hay l\u1ecbch tr\u00ecnh, th\u01b0\u1eddng bao g\u1ed3m m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra trong m\u1ed9t kho\u1ea3ng th\u1eddi gian nh\u1ea5t \u0111\u1ecbnh.<\/p>\n<p>X\u1ea1 tr\u1ecb th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u01b0a ra sau ho\u1eb7c b\u1ed5 sung cho h\u00f3a tr\u1ecb, t\u00f9y thu\u1ed9c v\u00e0o lo\u1ea1i NHL. N\u00f3 th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n u lympho giai \u0111o\u1ea1n c\u00f2n khu tr\u00fa, ngh\u0129a l\u00e0 n\u00f3 ch\u1ec9 li\u00ean quan \u0111\u1ebfn 1 ho\u1eb7c 2 khu v\u1ef1c l\u00e2n c\u1eadn, ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi c\u00f3 h\u1ea1ch b\u1ea1ch huy\u1ebft \u0111\u1eb7c bi\u1ec7t l\u1edbn, th\u01b0\u1eddng \u0111\u01b0\u1eddng k\u00ednh kh\u1ed1i h\u1ea1ch l\u1edbn h\u01a1n 7 &#8211; 10 cm. N\u00f3 c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb \u0111au ho\u1eb7c \u1edf li\u1ec1u r\u1ea5t th\u1ea5p (ch\u1ec9 c\u1ea7n 2 ph\u00e2n li\u1ec1u \u0111i\u1ec1u tr\u1ecb) cho nh\u1eefng b\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n b\u1ec7nh ti\u1ebfn tri\u1ec3n (giai \u0111o\u1ea1n mu\u1ed9n), nh\u1eefng ng\u01b0\u1eddi m\u00e0 tri\u1ec7u ch\u1ee9ng t\u1ea1i ch\u1ed7 c\u00f3 th\u1ec3 thuy\u00ean gi\u1ea3m b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng x\u1ea1 tr\u1ecb.<\/p>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5 chung t\u1eeb x\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 g\u1ed3m m\u1ec7t m\u1ecfi v\u00e0 bu\u1ed3n n\u00f4n. H\u1ea7u h\u1ebft c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 li\u00ean quan \u0111\u1ebfn v\u00f9ng c\u1ee7a c\u01a1 th\u1ec3 ti\u1ebfp nh\u1eadn b\u1ee9c x\u1ea1. Nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 bao g\u1ed3m ph\u1ea3n \u1ee9ng da nh\u1eb9, kh\u00f4 mi\u1ec7ng, r\u1ee5ng t\u00f3c t\u1ea1m th\u1eddi ho\u1eb7c m\u1ea5t nhu \u0111\u1ed9ng ru\u1ed9t. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 x\u1ea1 tr\u1ecb h\u01b0\u1edbng v\u00e0o ng\u1ef1c c\u00f3 th\u1ec3 b\u1ecb vi\u00eam ph\u1ed5i. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 x\u1ea1 tr\u1ecb h\u01b0\u1edbng v\u00e0o x\u01b0\u01a1ng c\u00f3 th\u1ec3 b\u1ecb thi\u1ebfu m\u00e1u. H\u00e3y trao \u0111\u1ed5i b\u00e1c s\u0129 c\u1ee7a b\u1ea1n v\u1ec1 nh\u1eefng g\u00ec b\u1ea1n c\u00f3 th\u1ec3 tr\u00f4ng \u0111\u1ee3i li\u00ean quan \u0111\u1ebfn t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 l\u00e0m th\u1ebf n\u00e0o \u0111\u1ec3 ki\u1ec3m so\u00e1t ch\u00fang.<\/p>\n<p>H\u1ea7u h\u1ebft c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 s\u1ebd bi\u1ebfn m\u1ea5t ngay sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng li\u1ec7u ph\u00e1p x\u1ea1 tr\u1ecb c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng mu\u1ed9n, ch\u1eb3ng h\u1ea1n nh\u01b0 ung th\u01b0 th\u1ee9 ph\u00e1t ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng tim v\u00e0 m\u1ea1ch m\u00e1u n\u1ebfu c\u00e1c c\u01a1 quan n\u00e0y \u1edf trong khu v\u1ef1c b\u1ee9c x\u1ea1. C\u00e1c v\u1ea5n \u0111\u1ec1 t\u00ecnh d\u1ee5c v\u00e0 v\u00f4 sinh c\u00f3 th\u1ec3 x\u1ea3y ra sau khi x\u1ea1 tr\u1ecb v\u00e0o khung ch\u1eadu. Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, h\u00e3y trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 li\u00ean quan \u0111\u1ebfn t\u00ecnh d\u1ee5c v\u00e0 kh\u1ea3 n\u0103ng sinh s\u1ea3n trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ea1n v\u00e0 c\u00e1c s\u1ef1 l\u1ef1a ch\u1ecdn hi\u1ec7n c\u00f3 \u0111\u1ec3 duy tr\u00ec kh\u1ea3 n\u0103ng sinh s\u1ea3n cho c\u1ea3 nam v\u00e0 n\u1eef.<\/p>\n<p>T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c kh\u00e1i ni\u1ec7m c\u01a1 b\u1ea3n v\u1ec1 x\u1ea1 tr\u1ecb.<\/p>\n<h2><strong>Li\u1ec7u ph\u00e1p nh\u1eafm<\/strong><strong> tr\u00fang \u0111\u00edch<\/strong><\/h2>\n<p>Li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u1eafm v\u00e0o c\u00e1c gen, protein ho\u1eb7c m\u00f4i tr\u01b0\u1eddng m\u00f4 c\u1ee5 th\u1ec3 c\u1ee7a kh\u1ed1i u g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 sinh t\u1ed3n c\u1ee7a ung th\u01b0. \u0110\u00e2y l\u00e0 lo\u1ea1i \u0111i\u1ec1u tr\u1ecb ng\u0103n ch\u1eb7n s\u1ef1 t\u0103ng tr\u01b0\u1edfng v\u00e0 l\u00e2y lan c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 c\u1ea3 h\u1ea1n ch\u1ebf t\u1ed5n h\u1ea1i cho c\u00e1c t\u1ebf b\u00e0o kh\u1ecfe m\u1ea1nh.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c kh\u1ed1i u \u0111\u1ec1u c\u00f3 c\u00f9ng m\u1ee5c ti\u00eau. \u0110\u1ec3 t\u00ecm ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 nh\u1ea5t, b\u00e1c s\u0129 c\u00f3 th\u1ec3 l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c gen, protein v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c trong kh\u1ed1i u c\u1ee7a b\u1ea1n. \u0110i\u1ec1u n\u00e0y gi\u00fap c\u00e1c b\u00e1c s\u0129 c\u00f3 c\u00e1ch \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 nh\u1ea5t ph\u00f9 h\u1ee3p h\u01a1n v\u1edbi t\u1eebng b\u1ec7nh nh\u00e2n b\u1ea5t c\u1ee9 khi n\u00e0o c\u00f3 th\u1ec3. Ngo\u00e0i ra, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111ang \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c m\u1ee5c ti\u00eau ph\u00e2n t\u1eed c\u1ee5 th\u1ec3 v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi h\u01b0\u1edbng v\u00e0o ch\u00fang. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c kh\u00e1i ni\u1ec7m c\u01a1 b\u1ea3n v\u1ec1 c\u00e1c li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch.<\/p>\n<h2><strong>Kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng<\/strong><\/h2>\n<p>\u0110\u1ed1i v\u1edbi NHL, kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng l\u00e0 h\u00ecnh th\u1ee9c ch\u00ednh c\u1ee7a li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb. M\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng nh\u1eadn di\u1ec7n v\u00e0 g\u1eafn v\u00e0o m\u1ed9t protein \u0111\u1eb7c hi\u1ec7u v\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c t\u1ebf b\u00e0o kh\u00f4ng c\u00f3 protein \u0111\u00f3. Kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng g\u1ecdi l\u00e0 rituximab \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u lo\u1ea1i NHL t\u1ebf b\u00e0o B kh\u00e1c nhau. Rituximab ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch nh\u1eafm v\u00e0o m\u1ed9t ph\u00e2n t\u1eed g\u1ecdi l\u00e0 CD20 n\u1eb1m tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o B v\u00e0 NHL t\u1ebf b\u00e0o B. Khi kh\u00e1ng th\u1ec3 g\u1eafn v\u00e0o ph\u00e2n t\u1eed n\u00e0y, h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t \u0111\u1ec3 ti\u00eau di\u1ec7t m\u1ed9t s\u1ed1 t\u1ebf b\u00e0o lympho ung th\u01b0 ho\u1eb7c l\u00e0m cho c\u00e1c t\u1ebf b\u00e0o n\u00e0y d\u1ec5 b\u1ecb ph\u00e1 h\u1ee7y b\u1edfi h\u00f3a tr\u1ecb li\u1ec7u h\u01a1n.<\/p>\n<p>M\u1eb7c d\u00f9 kh\u00e1ng th\u1ec3 c\u00f3 th\u1ec3 t\u1ef1 ho\u1ea1t \u0111\u1ed9ng t\u1ed1t nh\u01b0ng \u0111\u00e3 c\u00f3 nghi\u00ean c\u1ee9u cho th\u1ea5y r\u1eb1ng n\u00f3 ho\u1ea1t \u0111\u1ed9ng t\u1ed1t h\u01a1n khi th\u00eam v\u00e0o h\u00f3a tr\u1ecb\u00a0 cho b\u1ec7nh nh\u00e2n v\u1edbi h\u1ea7u h\u1ebft c\u00e1c lo\u1ea1i NHL d\u00f2ng t\u1ebf b\u00e0o B. Rituximab c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh sau khi c\u00f3 s\u1ef1 thuy\u00ean gi\u1ea3m u lympho di\u1ec5n ti\u1ebfn ch\u1eadm \u0111\u1ec3 t\u0103ng th\u1eddi gian \u1ed5n \u0111\u1ecbnh b\u1ec7nh. C\u00f3 2 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1c ch\u1ed1ng l\u1ea1i CD20 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn s\u1eed d\u1ee5ng trong u lympho: obinutuzumab (Gazyva) v\u00e0 ofatumumab (Arzerra).<\/p>\n<p>Brentuximab vedotin l\u00e0 m\u1ed9t lo\u1ea1i kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1c, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ph\u1ee9c h\u1ee3p kh\u00e1ng th\u1ec3-thu\u1ed1c. C\u00e1c ph\u1ee9c h\u1ee3p kh\u00e1ng th\u1ec3-thu\u1ed1c g\u1eafn v\u1edbi c\u00e1c m\u1ee5c ti\u00eau tr\u00ean c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 v\u00e0 sau \u0111\u00f3 gi\u1ea3i ph\u00f3ng m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf h\u00f3a tr\u1ecb ho\u1eb7c c\u00e1c ch\u1ea5t \u0111\u1ed9c kh\u00e1c tr\u1ef1c ti\u1ebfp v\u00e0o kh\u1ed1i u. Vedotin Brentuximab \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t v\u00e0o n\u0103m 2011 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho kh\u00f4ng Hodgkin t\u1ebf b\u00e0o l\u1edbn b\u1ea5t th\u1ee5c s\u1ea3n cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 l\u1ee3i t\u1eeb \u00edt nh\u1ea5t 1 lo\u1ea1i h\u00f3a tr\u1ecb. Thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn cho nh\u1eefng ng\u01b0\u1eddi U Lympho Hodgkin (B\u1ec7nh\u00a0 Hodgkin) m\u00e0 kh\u00f4ng thu \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 \u00a0ho\u1eb7c kh\u00f4ng th\u1ec3 \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c. C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 l\u1ee3i \u00edch c\u1ee7a c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng m\u1edbi h\u01a1n \u0111\u1ed1i v\u1edbi U Lympho \u00e1c t\u00ednh v\u1eabn \u0111ang \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh.<\/p>\n<p>Kh\u00e1ng th\u1ec3 Radilabeled l\u00e0 c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng v\u1edbi c\u00e1c h\u1ea1t ph\u00f3ng x\u1ea1 \u0111\u01b0\u1ee3c g\u1eafn v\u00e0o. C\u00e1c h\u1ea1t \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u00a0sao cho t\u1eadp trung b\u1ee9c x\u1ea1 tr\u1ef1c ti\u1ebfp v\u00e0o c\u00e1c t\u1ebf b\u00e0o u Lympho \u00e1c t\u00ednh. N\u00f3i chung, c\u00e1c kh\u00e1ng th\u1ec3 ph\u00f3ng x\u1ea1 \u0111\u01b0\u1ee3c cho l\u00e0 m\u1ea1nh h\u01a1n c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng th\u01b0\u1eddng l\u1ec7 nh\u01b0ng g\u00e2y h\u1ea1i nhi\u1ec1u h\u01a1n cho t\u1ee7y x\u01b0\u01a1ng. Lo\u1ea1i li\u1ec7u ph\u00e1p n\u00e0y c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch ph\u00f3ng x\u1ea1 (RIT).<\/p>\n<p>H\u00e3y trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ed1i v\u1edbi m\u1ed9t lo\u1ea1i thu\u1ed1c c\u1ee5 th\u1ec3 v\u00e0 c\u00e1ch ki\u1ec3m so\u00e1t ch\u00fang.<\/p>\n<h2><strong>Ch\u1ea5t \u1ee9c ch\u1ebf kinase (c\u1eadp nh\u1eadt th\u00e1ng 10-2018)<\/strong><\/h2>\n<p>Ch\u1ea5t \u1ee9c ch\u1ebf Kinase l\u00e0 lo\u1ea1i li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch kh\u00e1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb NHL. C\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn nh\u1eafm v\u00e0o con \u0111\u01b0\u1eddng phosphoinositide 3-kinase (PI3K).<\/p>\n<p>Copanlisib (Aliquopa) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho d\u1ea1ng nang \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb \u00edt nh\u1ea5t 2 li\u1ec7u ph\u00e1p tr\u01b0\u1edbc \u0111\u00f3. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a copanlisib l\u00e0 t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, ti\u00eau ch\u1ea3y, m\u1ec7t m\u1ecfi, huy\u1ebft \u00e1p cao, s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u th\u1ea5p, bu\u1ed3n n\u00f4n, nhi\u1ec5m tr\u00f9ng ph\u1ed5i v\u00e0 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u th\u1ea5p.<\/p>\n<p>Duvelisib (Copiktra) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho t\u1ebf b\u00e0o nh\u1ecf \u00a0\u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh m\u00e0 ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u1ed5n \u0111\u1ecbnh b\u1edfi \u00edt nh\u1ea5t 2 li\u1ec7u ph\u00e1p tr\u01b0\u1edbc \u0111\u00f3. Li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng Lympho. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a duvelisib l\u00e0 ti\u00eau ch\u1ea3y, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ru\u1ed9t, s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u, ph\u00e1t ban, m\u1ec7t m\u1ecfi, \u0111au, ho, bu\u1ed3n n\u00f4n, nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, vi\u00eam ph\u1ed5i, \u0111au v\u00e0 thi\u1ebfu m\u00e1u.<\/p>\n<h2><strong>Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch<\/strong><\/h2>\n<p>Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, hay c\u00f2n g\u1ecdi l\u00e0 li\u1ec7u ph\u00e1p sinh h\u1ecdc, \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf nh\u1eb1m m\u1ee5c \u0111\u00edch t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng ph\u00f2ng v\u1ec7 t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 \u0111\u1ec3 ch\u1ed1ng l\u1ea1i c\u0103n b\u1ec7nh ung th\u01b0. Ph\u01b0\u01a1ng ph\u00e1p bao g\u1ed3m c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng \u0111\u01b0\u1ee3c n\u00eau \u1edf tr\u00ean v\u00e0 s\u1eed d\u1ee5ng c\u00e1c t\u1ebf b\u00e0o hi\u1ec7u \u1ee9ng v\u00e0 c\u00e1c ph\u00e2n t\u1eed do c\u01a1 th\u1ec3 ho\u1eb7c trong ph\u00f2ng th\u00ed nghi\u1ec7m t\u1ea1o ra \u0111\u1ec3 c\u1ea3i thi\u1ec7n, nh\u1eafm tr\u00fang \u0111\u00edch ho\u1eb7c kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch.<\/p>\n<p>Trong li\u1ec7u ph\u00e1p th\u1ee5 th\u1ec3 kh\u00e1ng nguy\u00ean (CAR) T-cell, m\u1ed9t s\u1ed1 t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c l\u1ea5y ra kh\u1ecfi m\u00e1u ng\u01b0\u1eddi b\u1ec7nh. Sau \u0111\u00f3, c\u00e1c t\u1ebf b\u00e0o \u00a0n\u00e0y \u0111\u01b0\u1ee3c bi\u1ebfn \u0111\u1ed5i trong ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u1ec3 ch\u00fang c\u00f3 c\u00e1c protein \u0111\u1eb7c bi\u1ec7t \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 th\u1ee5 th\u1ec3. C\u00e1c th\u1ee5 th\u1ec3 cho ph\u00e9p c\u00e1c t\u1ebf b\u00e0o T nh\u1eadn ra c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. C\u00e1c t\u1ebf b\u00e0o T \u0111\u01b0\u1ee3c bi\u1ebfn \u0111\u1ed5i s\u1ebd \u0111\u01b0\u1ee3c nu\u00f4i c\u1ea5y v\u1edbi s\u1ed1 l\u01b0\u1ee3ng l\u1edbn trong ph\u00f2ng th\u00ed nghi\u1ec7m v\u00e0 \u0111\u01b0a tr\u1edf l\u1ea1i v\u00e0o c\u01a1 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh. Khi \u0111\u00f3, ch\u00fang s\u1ebd t\u00ecm ki\u1ebfm v\u00e0 ti\u00eau di\u1ec7t c\u00e1c t\u1ebf b\u00e0o ung th\u01b0.<\/p>\n<p>Axicabtagene ciloleucel (Yescarta) l\u00e0 m\u1ed9t li\u1ec7u ph\u00e1p CAR T-cell \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n DLBCL (U Lympho \u00e1c t\u00ednh kh\u00f4ng Hodgkin t\u1ebf b\u00e0o B l\u1edbn lan t\u1ecfa) v\u00e0 \u0111\u00e3 nh\u1eadn \u00edt nh\u1ea5t 2 lo\u1ea1i \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3. Tisagenlecleucel (Kymriah) l\u00e0 m\u1ed9t li\u1ec7u ph\u00e1p CAR T-cell kh\u00e1c \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u lympho B kh\u00e1ng thu\u1ed1c, bao g\u1ed3m DLBCL, sau khi ho\u00e0n t\u1ea5t 2 l\u1ea7n \u0111i\u1ec1u tr\u1ecb to\u00e0n th\u00e2n tr\u01b0\u1edbc \u0111\u00f3 ho\u1eb7c h\u01a1n. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ebf b\u00e0o T kh\u00e1c v\u1eabn \u0111ang \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n v\u00e0 nghi\u00ean c\u1ee9u trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng.<\/p>\n<p>C\u00e1c lo\u1ea1i li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch kh\u00e1c nhau c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng ph\u1ee5 kh\u00e1c nhau. H\u00e3y trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb \u00e1p d\u1ee5ng cho b\u1ea1n. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 c\u00e1c \u0111i\u1ec1u c\u01a1 b\u1ea3n c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch.<\/p>\n<h2><strong>Gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c\/Gh\u00e9p t\u1ee7y<\/strong><\/h2>\n<p>C\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p y khoa trong \u0111\u00f3 t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c t\u1ebf\u00a0 b\u00e0o m\u00e1u ngo\u1ea1i bi\u00ean g\u1ed3m nh\u1eefng t\u1ebf b\u00e0o chuy\u00ean bi\u1ec7t cao g\u1ecdi l\u00e0 t\u1ebf b\u00e0o g\u1ed1c t\u1ea1o m\u00e1u \u0111\u01b0\u1ee3c d\u00f9ng nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb. C\u00e1c t\u1ebf b\u00e0o g\u1ed1c kh\u1ecfe m\u1ea1nh l\u00e0 nh\u1eefng t\u1ebf b\u00e0o t\u1ea1o m\u00e1u m\u1edbi, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u1ea3 t\u1ee7y x\u01b0\u01a1ng v\u00e0 m\u00e1u. Ng\u00e0y nay, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c h\u01a1n l\u00e0 c\u1ea5y t\u1ee7y. \u0110\u00f3 l\u00e0 v\u00ec t\u1ebf b\u00e0o c\u1ea5y gh\u00e9p th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u1ea5y t\u1eeb m\u00e1u ch\u1ee9 kh\u00f4ng ph\u1ea3i t\u1eeb m\u00f4 t\u1ee7y x\u01b0\u01a1ng.<\/p>\n<p>C\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ea5n c\u00f4ng. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng cho nh\u1eefng ng\u01b0\u1eddi u lympho kh\u00f4ng Hodgkin (NHL) \u0111ang ti\u1ebfn tri\u1ec3n ho\u1eb7c t\u00e1i ph\u00e1t. \u0110\u1ed1i v\u1edbi m\u1ed9t v\u00e0i nh\u00f3m NHL nh\u01b0 ung th\u01b0 lympho t\u1ebf b\u00e0o v\u1ecf v\u00e0 1 v\u00e0i lo\u1ea1i U lympho T, b\u00e1c s\u0129 c\u00f3 th\u1ec3 s\u1ebd \u0111\u1ec1 ngh\u1ecb c\u1ea5y t\u1ebf b\u00e0o g\u1ed1c nh\u01b0 l\u00e0 \u0111i\u1ec1u tr\u1ecb b\u01b0\u1edbc 1 \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 t\u00e1i ph\u00e1t. Tr\u01b0\u1edbc khi \u0111\u1ec1 ngh\u1ecb c\u1ea5y gh\u00e9p, b\u00e1c s\u0129 s\u1ebd n\u00f3i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh v\u1ec1 nh\u1eefng nguy c\u01a1 c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y. B\u00e1c s\u0129 c\u0169ng s\u1ebd n\u00f3i v\u1ec1 nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 \u1ea3nh h\u01b0\u1edfng kh\u00e1c nh\u01b0: lo\u1ea1i U lympho \u00e1c t\u00ednh kh\u00f4ng Hodgkin, k\u1ebft qu\u1ea3 c\u1ee7a nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc, tu\u1ed5i t\u00e1c v\u00e0 s\u1ee9c kh\u1ecfe t\u1ed5ng qu\u00e1t c\u1ee7a h\u1ecd. Vi\u1ec7c b\u00e0n lu\u1eadn v\u1edbi b\u00e1c s\u0129 v\u1ec1 m\u1ed9t trung t\u00e2m c\u1ea5y gh\u00e9p c\u00f3 kinh nghi\u1ec7m v\u00e0 nh\u1eefng nguy c\u01a1 c\u0169ng nh\u01b0 l\u1ee3i \u00edch c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng.<\/p>\n<p>C\u00f3 2 lo\u1ea1i c\u1ea5y gh\u00e9p ph\u1ee5 thu\u1ed9c v\u00e0o ngu\u1ed3n thay th\u1ebf t\u1ebf b\u00e0o m\u00e1u g\u1ed1c: D\u1ecb gh\u00e9p (ALLO) v\u00e0 T\u1ef1 gh\u00e9p (AUTO)<\/p>\n<ul>\n<li>ALLO: ph\u01b0\u01a1ng ph\u00e1p c\u1ea5y gh\u00e9p n\u00e0y s\u1eed d\u1ee5ng t\u1eeb t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a m\u1ed9t ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh hi\u1ebfn t\u1eb7ng, l\u00fd t\u01b0\u1edfng nh\u1ea5t l\u00e0 t\u1eeb anh ch\u1ecb em ho\u1eb7c t\u1eeb ng\u01b0\u1eddi t\u01b0\u01a1ng th\u00edch kh\u00f4ng c\u00f3 quan h\u1ec7 huy\u1ebft th\u1ed1ng cung c\u1ea5p. C\u00e1c \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m mi\u1ec5n d\u1ecbch tr\u1ecb li\u1ec7u, ph\u00f3ng x\u1ea1 tr\u1ecb li\u1ec7u ho\u1eb7c h\u00f3a tr\u1ecb li\u1ec7u mi\u1ec5n d\u1ecbch c\u1ed9ng v\u1edbi ho\u1ea1t \u0111\u1ed9ng c\u1ee7a \u201cm\u1ea3nh gh\u00e9p ch\u1ed1ng ung th\u01b0\u201d (graft versus lymphoma) n\u01a1i c\u00e1c t\u1ebf b\u00e0o cho s\u1ebd nh\u1eadn ra v\u00e0 ti\u00eau di\u1ec7t nh\u1eefng t\u1ebf b\u00e0o ung th\u01b0 c\u1ee7a b\u1ec7nh nh\u00e2n. Tuy nhi\u00ean d\u1ecb gh\u00e9p l\u1ea1i mang \u0111\u1ebfn nhi\u1ec1u nguy c\u01a1 h\u01a1n \u0111\u1ed3ng gh\u00e9p nh\u01b0 hi\u1ec7n t\u01b0\u1ee3ng th\u1ea3i lo\u1ea1i khi t\u1ebf b\u00e0o cho l\u00e0m t\u1ed5n th\u01b0\u01a1ng m\u00f4 ho\u1eb7c c\u01a1 quan c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/li>\n<li>AUTO: Gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c t\u1ef1 th\u00e2n l\u00e0 s\u1eed d\u1ee5ng ch\u00ednh t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a b\u1ec7nh nh\u00e2n sau h\u00f3a tr\u1ecb li\u1ec1u cao. Trong ph\u01b0\u01a1ng ph\u00e1p n\u00e0y, m\u1ee5c \u0111\u00edch ch\u00ednh l\u00e0 ti\u00eau di\u1ec7t h\u1ebft t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 trong t\u1ee7y x\u01b0\u01a1ng, m\u00e1u ho\u1eb7c nh\u1eefng ph\u1ea7n kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3 b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng h\u00f3a tr\u1ecb li\u1ec1u cao, mi\u1ec5n d\u1ecbch tr\u1ecb li\u1ec7u v\u00e0\/ho\u1eb7c ph\u00f3ng x\u1ea1 tr\u1ecb li\u1ec7u. Nh\u1eefng t\u1ebf b\u00e0o g\u1ed1c t\u1ef1 th\u00e2n n\u00e0y s\u1ebd tr\u1edf l\u1ea1i c\u01a1 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh khi qu\u00e1 tr\u00ecnh k\u1ebft th\u00fac. Sau \u0111\u00f3 ch\u00fang s\u1ebd l\u00e0m vi\u1ec7c \u0111\u1ec3 t\u1ea1o ra t\u1ee7y x\u01b0\u01a1ng kh\u1ecfe m\u1ea1nh.<\/li>\n<\/ul>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i c\u1ea5y gh\u00e9p, s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c. \u0110\u1ecdc th\u00eam c\u01a1 b\u1ea3n v\u1ec1 c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c v\u00e0 t\u1ee7y x\u01b0\u01a1ng.<\/p>\n<h2><strong>Ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 c\u00e1c<\/strong><strong> tri\u1ec7u ch\u1ee9ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 <\/strong><\/h2>\n<p>U Lympho v\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1eefa tr\u1ecb c\u1ee7a n\u00f3 th\u01b0\u1eddng g\u00e2y ra t\u00e1c d\u1ee5ng ph\u1ee5. Ngo\u00e0i c\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u00f3 xu h\u01b0\u1edbng l\u00e0 ch\u1eadm, ng\u1eebng ho\u1eb7c lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n b\u1ec7nh, m\u1ed9t ph\u1ea7n quan tr\u1ecdng c\u1ee7a vi\u1ec7c ch\u0103m s\u00f3c l\u00e0 l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a t\u00e1c d\u1ee5ng ph\u1ee5. C\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 ho\u1eb7c h\u1ed7 tr\u1ee3, vi\u1ec7c n\u00e0y bao g\u1ed3m h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n v\u1ec1 nh\u1eefng ho\u1ea1t \u0111\u1ed9ng v\u1eadt l\u00fd, c\u1ea3m x\u00fac v\u00e0 nhu c\u1ea7u x\u00e3 h\u1ed9i.<\/p>\n<p>Ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 l\u00e0 t\u1ea5t c\u1ea3 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p t\u1eadp trung v\u00e0o vi\u1ec7c gi\u1ea3m \u0111i tri\u1ec7u ch\u1ee9ng, c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n c\u0169ng nh\u01b0 gia \u0111\u00ecnh h\u1ecd. M\u1ecdi ng\u01b0\u1eddi, b\u1ea5t k\u1ec3 tu\u1ed5i t\u00e1c hay lo\u1ea1i ung th\u01b0 v\u00e0 giai \u0111o\u1ea1n ung th\u01b0 \u0111\u1ec1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y hi\u1ec7u qu\u1ea3 nh\u1ea5t khi \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ung th\u01b0. M\u1ecdi ng\u01b0\u1eddi th\u01b0\u1eddng nh\u1eadn \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00e0 vi\u1ec7c ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f9ng m\u1ed9t l\u00fac. Trong th\u1ef1c t\u1ebf, b\u1ec7nh nh\u00e2n nh\u1eadn c\u1ea3 hai c\u00f9ng m\u1ed9t l\u00fac th\u01b0\u1eddng c\u00f3 \u00edt tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng, ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng t\u1ed1t h\u01a1n, v\u00e0 h\u00e0i l\u00f2ng v\u1edbi k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb h\u01a1n.<\/p>\n<p>Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb gi\u1ea3m nh\u1eb9 c\u00f3 nhi\u1ec1u li\u1ec7u ph\u00e1p kh\u00e1c nhau v\u00e0 th\u01b0\u1eddng bao g\u1ed3m thu\u1ed1c, thay \u0111\u1ed5i dinh d\u01b0\u1ee1ng, k\u1ef9 thu\u1eadt th\u01b0 gi\u00e3n, h\u1ed7 tr\u1ee3 c\u1ea3m x\u00fac v\u00e0 nh\u1eefng li\u1ec7u ph\u00e1p kh\u00e1c. B\u1ea1n c\u0169ng c\u00f3 th\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb gi\u1ea3m nh\u1eb9 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u1ec3 lo\u1ea1i b\u1ecf ung th\u01b0, ch\u1eb3ng h\u1ea1n nh\u01b0 h\u00f3a tr\u1ecb, ph\u1eabu thu\u1eadt ho\u1eb7c x\u1ea1 tr\u1ecb. H\u00e3y trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c m\u1ee5c ti\u00eau c\u1ee7a t\u1eebng ph\u01b0\u01a1ng ph\u00e1p trong k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ea1n.<\/p>\n<p>Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, h\u00e3y trao \u0111\u1ed5i v\u1edbi nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 v\u00e0 c\u00e1c l\u1ef1a ch\u1ecdn ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 c\u1ee7a b\u1ea1n. Trong v\u00e0 sau khi \u0111i\u1ec1u tr\u1ecb, h\u00e3y ch\u1eafc ch\u1eafn th\u00f4ng b\u00e1o cho b\u00e1c s\u0129 ho\u1eb7c m\u1ed9t th\u00e0nh vi\u00ean trong nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u1ec1 nh\u1eefng v\u1ea5n \u0111\u1ec1 b\u1ea1n \u0111ang g\u1eb7p ph\u1ea3i \u0111\u1ec3 c\u00f3 th\u1ec3 gi\u1ea3i quy\u1ebft n\u00f3 nhanh nh\u1ea5t c\u00f3 th\u1ec3. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9.<\/p>\n<h2><strong>S\u1ef1 t<\/strong><strong>huy\u00ean gi\u1ea3m v\u00e0 kh\u1ea3 n\u0103ng t\u00e1i ph\u00e1t<\/strong><\/h2>\n<p>Thuy\u00ean gi\u1ea3m ho\u00e0n to\u00e0n l\u00e0 khi u lympho kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong c\u01a1 th\u1ec3 v\u00e0 kh\u00f4ng c\u00f2n tri\u1ec7u ch\u1ee9ng. \u0110i\u1ec1u n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201ckh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 b\u1ec7nh t\u1eadt\u201d (non evidence of disease) ho\u1eb7c NED. Thuy\u00ean gi\u1ea3m m\u1ed9t ph\u1ea7n l\u00e0 khi U Lympho \u0111\u00e3 tho\u00e1i h\u00f3a h\u01a1n 50% sau qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3 nh\u01b0ng v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n.<\/p>\n<p>Thuy\u00ean gi\u1ea3m c\u00f3 th\u1ec3 l\u00e0 t\u1ea1m th\u1eddi ho\u1eb7c v\u0129nh vi\u1ec5n. S\u1ef1 kh\u00f4ng ch\u1eafc ch\u1eafn n\u00e0y khi\u1ebfn nhi\u1ec1u ng\u01b0\u1eddi lo l\u1eafng r\u1eb1ng ung th\u01b0 s\u1ebd tr\u1edf l\u1ea1i. M\u1eb7c d\u00f9 \u0111a s\u1ed1 s\u1ef1 thuy\u00ean gi\u1ea3m l\u00e0 v\u0129nh vi\u1ec5n, nh\u01b0ng vi\u1ec7c trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 v\u1ec1 kh\u1ea3 n\u0103ng b\u1ec7nh tr\u1edf l\u1ea1i v\u1eabn r\u1ea5t quan tr\u1ecdng. Hi\u1ec3u r\u00f5 v\u1ec1 nh\u1eefng nguy c\u01a1 t\u00e1i ph\u00e1t c\u1ee7a b\u1ec7nh v\u00e0 c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb s\u1ebd gi\u00fap b\u1ea1n c\u1ea3m th\u1ea5y s\u1eb5n s\u00e0ng h\u01a1n n\u1ebfu ung th\u01b0 h\u1ea1ch tr\u1edf l\u1ea1i. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 \u0111\u1ed1i ph\u00f3 v\u1edbi n\u1ed7i s\u1ee3 t\u00e1i ph\u00e1t.<\/p>\n<p>Nh\u01b0 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch trong ph\u1ea7n giai \u0111o\u1ea1n, n\u1ebfu ung th\u01b0 tr\u1edf l\u1ea1i sau khi \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u, n\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ung th\u01b0 t\u00e1i ph\u00e1t. N\u00f3 c\u00f3 th\u1ec3 tr\u1edf l\u1ea1i trong c\u00f9ng m\u1ed9t v\u1ecb tr\u00ed (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u00e1i ph\u00e1t t\u1ea1i ch\u1ed7), g\u1ea7n \u0111\u00f3 (t\u00e1i ph\u00e1t t\u1ea1i v\u00f9ng), ho\u1eb7c \u1edf m\u1ed9t n\u01a1i kh\u00e1c (t\u00e1i ph\u00e1t xa).<\/p>\n<p>Khi \u0111i\u1ec1u n\u00e0y x\u1ea3y ra, m\u1ed9t chu tr\u00ecnh ki\u1ec3m tra m\u1edbi s\u1ebd b\u1eaft \u0111\u1ea7u l\u1ea1i \u0111\u1ec3 t\u00ecm hi\u1ec3u c\u00e0ng nhi\u1ec1u c\u00e0ng t\u1ed1t v\u1ec1 s\u1ef1 t\u00e1i ph\u00e1t. Trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, sinh thi\u1ebft m\u00f4 t\u00e1i ph\u00e1t l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ee9ng minh r\u1eb1ng u lympho kh\u00f4ng thay \u0111\u1ed5i ho\u1eb7c chuy\u1ec3n th\u00e0nh m\u1ed9t d\u1ea1ng kh\u00e1c \u00e1c t\u00ednh h\u01a1n. Sau khi th\u1eed nghi\u1ec7m n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n, b\u1ea1n v\u00e0 b\u00e1c s\u0129 s\u1ebd trao \u0111\u1ed5i v\u1ec1 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb NHL t\u00e1i ph\u00e1t ph\u1ee5 thu\u1ed9c v\u00e0o 3 y\u1ebfu t\u1ed1:<\/p>\n<ul>\n<li>Ung th\u01b0 xu\u1ea5t hi\u1ec7n l\u1ea1i \u1edf \u0111\u00e2u v\u00e0 li\u1ec7u n\u00f3 c\u00f3 chuy\u1ec3n th\u00e0nh m\u1ed9t lo\u1ea1i \u00e1c t\u00ednh h\u01a1n hay kh\u00f4ng.<\/li>\n<li>Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c \u0111\u01b0a ra tr\u01b0\u1edbc \u0111\u00e2y.<\/li>\n<li>S\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<p>Th\u01b0\u1eddng th\u00ec k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb s\u1ebd g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u1edf tr\u00ean, ch\u1eb3ng h\u1ea1n nh\u01b0 h\u00f3a tr\u1ecb, x\u1ea1 tr\u1ecb, li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch, li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch ho\u1eb7c gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c. Tuy nhi\u00ean, nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p ho\u1eb7c \u0111\u01b0a ra \u1edf m\u1ed9t m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau. B\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u1ec1 ngh\u1ecb c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng m\u1edbi \u0111ang nghi\u00ean c\u1ee9u \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb lo\u1ea1i ung th\u01b0 t\u00e1i ph\u00e1t n\u00e0y. Cho d\u00f9 b\u1ea1n ch\u1ecdn ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u tr\u1ecb n\u00e0o, ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 v\u1eabn r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n<p>Nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh ung th\u01b0 t\u00e1i ph\u00e1t th\u01b0\u1eddng tr\u1ea3i qua nh\u1eefng c\u1ea3m x\u00fac nh\u01b0 ho\u00e0i nghi ho\u1eb7c s\u1ee3 h\u00e3i. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch n\u00f3i chuy\u1ec7n v\u1edbi nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u1ec1 nh\u1eefng c\u1ea3m x\u00fac n\u00e0y v\u00e0 h\u1ecfi v\u1ec1 c\u00e1c d\u1ecbch v\u1ee5 h\u1ed7 tr\u1ee3 \u0111\u1ec3 gi\u00fap h\u1ecd \u0111\u1ed1i ph\u00f3. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 \u0111\u1ed1i ph\u00f3 v\u1edbi t\u00e1i ph\u00e1t ung th\u01b0.<\/p>\n<h2><strong>NHL ti\u1ebfn tri\u1ec3n<\/strong><\/h2>\n<p>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n b\u1ecb NHL c\u00f3 th\u1ec3 kh\u00f4ng thuy\u00ean gi\u1ea3m ho\u00e0n to\u00e0n v\u00e0 s\u1ebd c\u00f3 m\u1ed9t l\u01b0\u1ee3ng t\u1ed5n th\u01b0\u01a1ng b\u1ec7nh c\u00f2n t\u1ed3n d\u01b0 v\u00e0 \u1ed5n \u0111\u1ecbnh. Tuy nhi\u00ean ph\u1ea7n t\u1ed3n d\u01b0 \u0111\u00f3 c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n b\u1ea5t ch\u1ea5p s\u1ef1 \u0111i\u1ec1u tr\u1ecb. N\u1ebfu c\u00f3 m\u1ed9t s\u1ef1 t\u1ed3n d\u01b0 \u1ed5n \u0111\u1ecbnh, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n NHL d\u1ea1ng ti\u1ebfn tri\u1ec3n ch\u1eadm c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea9n th\u1eadn trong m\u1ed9t th\u1eddi gian ho\u1eb7c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb duy tr\u00ec b\u1eb1ng kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng ho\u1eb7c c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c. Li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u1ee5c b\u1ed9 c\u0169ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 th\u1ec3 c\u00f3 kho\u1ea3ng ngh\u1ec9 trong \u0111i\u1ec1u tr\u1ecb, \u0111\u00f4i khi k\u00e9o d\u00e0i nhi\u1ec1u n\u0103m. N\u1ebfu u lympho b\u1eaft \u0111\u1ea7u ph\u00e1t tri\u1ec3n ho\u1eb7c lan r\u1ed9ng, \u0111i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh, th\u00ec vi\u1ec7c \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c s\u1ebd b\u1eaft \u0111\u1ea7u l\u1ea1i.<\/p>\n<p>\u0110i\u1ec1u quan tr\u1ecdng ph\u1ea3i hi\u1ec3u r\u1eb1ng m\u1ed9t s\u1ed1 u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng c\u00f3 th\u1ec3 lui b\u1ec7nh ho\u00e0n to\u00e0n. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c theo d\u00f5i m\u1ed9t c\u00e1ch an to\u00e0n n\u1ebfu nh\u01b0 c\u00f2n t\u1ed5n th\u01b0\u01a1ng t\u1ed3n d\u01b0. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 duy tr\u00ec mi\u1ec5n l\u00e0 b\u1ec7nh nh\u00e2n kh\u00f4ng xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 U Lympho kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o m\u00e1u ho\u1eb7c c\u00e1c c\u01a1 quan kh\u00e1c.<\/p>\n<h2><strong>NHL <\/strong><strong>kh\u00e1ng thu\u1ed1c<\/strong><\/h2>\n<p>N\u1ebfu ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n kh\u00f4ng hi\u1ec7u qu\u1ea3 cho NHL ho\u1eb7c U lympho tr\u1edf l\u1ea1i trong v\u00f2ng 6 th\u00e1ng sau khi \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n, \u0111i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 NHL kh\u00e1ng thu\u1ed1c. B\u1ec7nh nh\u00e2n l\u00fac n\u00e0y n\u00ean n\u00f3i chuy\u1ec7n v\u1edbi c\u00e1c b\u00e1c s\u0129 chuy\u00ean gia U lympho \u0111\u1ec3 th\u1ea3o lu\u1eadn v\u1ec1 c\u00e1c l\u1ef1a ch\u1ecdn cho k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t. B\u00ean c\u1ea1nh \u0111\u00f3 vi\u1ec7c tham kh\u1ea3o nh\u1eefng \u00fd ki\u1ebfn kh\u00e1c tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb s\u1ebd l\u00e0m cho b\u1ec7nh nh\u00e2n tho\u1ea3i m\u00e1i h\u01a1n. Cu\u1ed9c th\u1ea3o lu\u1eadn n\u00e0y c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng.<\/p>\n<p>C\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb cho NHL kh\u00e1ng thu\u1ed1c ph\u1ee5 thu\u1ed9c v\u00e0o 4 y\u1ebfu t\u1ed1:<\/p>\n<ul>\n<li>V\u1ecb tr\u00ed c\u1ee7a kh\u1ed1i u.<\/li>\n<li>Lo\u1ea1i u lympho.<\/li>\n<li>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c \u0111\u01b0a ra tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n<li>S\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<p>B\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u01b0a ra nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p nh\u01b0 h\u00f3a tr\u1ecb, mi\u1ec5n d\u1ecbch, c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c ho\u1eb7c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng. Ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 c\u0169ng s\u1ebd r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u00fap gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n<p>\u0110\u1ed1i v\u1edbi h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n, vi\u1ec7c \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n NHL kh\u00e1ng thu\u1ed1c c\u00f3 th\u1ec3 s\u1ebd khi\u1ebfn b\u1ec7nh nh\u00e2n c\u1ea3m th\u1ea5y c\u0103ng th\u1eb3ng v\u00e0 r\u1ea5t kh\u00f3 \u0111\u1ec3 \u0111\u1ed1i m\u1eb7t. Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gia \u0111\u00ecnh \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch k\u1ec3 v\u1edbi c\u00e1c b\u00e1c s\u0129, y t\u00e1, nh\u00e2n vi\u00ean x\u00e3 h\u1ed9i, ho\u1eb7c c\u00e1c th\u00e0nh vi\u00ean kh\u00e1c c\u1ee7a nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u1ec1 nh\u1eefng c\u1ea3m nh\u1eadn c\u1ee7a h\u1ecd. N\u00f3 c\u0169ng c\u00f3 th\u1ec3 h\u1eefu \u00edch \u0111\u1ec3 n\u00f3i chuy\u1ec7n v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00e1c, th\u00f4ng qua m\u1ed9t nh\u00f3m h\u1ed7 tr\u1ee3.<\/p>\n<h2><strong>N\u1ebfu <\/strong><strong>vi\u1ec7c <\/strong><strong>\u0111i\u1ec1u tr\u1ecb kh\u00f4ng hi\u1ec7u qu\u1ea3<\/strong><\/h2>\n<p>Vi\u1ec7c ph\u1ee5c h\u1ed3i sau ung th\u01b0 kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng c\u00f3 th\u1ec3. N\u1ebfu ung th\u01b0 kh\u00f4ng th\u1ec3 ch\u1eefa kh\u1ecfi ho\u1eb7c kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c, b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 giai \u0111o\u1ea1n cu\u1ed1i.<\/p>\n<p>V\u00ec ch\u1ea9n \u0111o\u00e1n n\u00e0y r\u1ea5t kh\u00f3 \u0111\u1ed1i m\u1eb7t n\u00ean m\u1ed9t s\u1ed1 ng\u01b0\u1eddi g\u1ea7n nh\u01b0 kh\u00f4ng th\u1ec3 th\u1ea3o lu\u1eadn v\u1ec1 ung th\u01b0 giai \u0111o\u1ea1n cu\u1ed1i. Tuy nhi\u00ean, nh\u1eefng ng\u01b0\u1eddi NHL giai \u0111o\u1ea1n cu\u1ed1i, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi b\u1ecb u lympho kh\u00f4ng \u1ed5n \u0111\u1ecbnh, c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c s\u1ed1ng trong m\u1ed9t th\u1eddi gian d\u00e0i sau khi ch\u1ea9n \u0111o\u00e1n. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i c\u00f3 c\u00e1c cu\u1ed9c trao \u0111\u1ed5i c\u1edfi m\u1edf v\u00e0 trung th\u1ef1c v\u1edbi b\u00e1c s\u0129 v\u00e0 nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ea1n \u0111\u1ec3 n\u00f3i l\u00ean c\u1ea3m x\u00fac, s\u1edf th\u00edch v\u00e0 nh\u1eefng m\u1ed1i quan t\u00e2m kh\u00e1c. \u0110\u1ed9i ng\u0169 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe lu\u00f4n s\u1eb5n s\u00e0ng tr\u1ee3 gi\u00fap b\u1ea1n. Nhi\u1ec1u th\u00e0nh vi\u00ean trong nh\u00f3m c\u00f3 k\u1ef9 n\u0103ng, kinh nghi\u1ec7m v\u00e0 ki\u1ebfn th\u1ee9c \u0111\u1eb7c bi\u1ec7t \u0111\u1ec3 h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh h\u1ecd. Vi\u1ec7c \u0111\u1ea3m b\u1ea3o cho ng\u01b0\u1eddi b\u1ec7nh tho\u1ea3i m\u00e1i v\u00e0 kh\u00f4ng c\u00f2n c\u1ea3m th\u1ea5y \u0111au \u0111\u1edbn l\u00e0 m\u1ed9t vi\u1ec7c quan tr\u1ecdng.<\/p>\n<p>Nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc ung th\u01b0 giai \u0111o\u1ea1n cu\u1ed1i hay kh\u1ea3 n\u0103ng s\u1ed1ng c\u00f2n d\u01b0\u1edbi 6 th\u00e1ng c\u00f3 th\u1ec3 s\u1ebd mu\u1ed1n xem x\u00e9t v\u1ec1 m\u1ed9t lo\u1ea1i ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 g\u1ecdi l\u00e0 tr\u1ea1m ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t (Hospice). Tr\u1ea1m ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 cung c\u1ea5p ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng t\u1ed1t nh\u1ea5t c\u00f3 th\u1ec3 cho nh\u1eefng ng\u01b0\u1eddi g\u1ea7n cu\u1ed1i \u0111\u1eddi. B\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch trao \u0111\u1ed5i v\u1edbi \u0111\u1ed9i ng\u0169 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe v\u1ec1 c\u00e1c l\u1ef1a ch\u1ecdn, bao g\u1ed3m ch\u0103m s\u00f3c t\u1ea1i nh\u00e0, m\u1ed9t trung t\u00e2m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe \u0111\u1eb7c bi\u1ec7t ho\u1eb7c c\u00e1c \u0111\u1ecba \u0111i\u1ec3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe kh\u00e1c. D\u1ecbch v\u1ee5 ch\u0103m s\u00f3c \u0111i\u1ec1u d\u01b0\u1ee1ng v\u00e0 thi\u1ebft b\u1ecb \u0111\u1eb7c bi\u1ec7t c\u00f3 th\u1ec3 l\u00e0m cho vi\u1ec7c \u1edf nh\u00e0 tr\u1edf th\u00e0nh m\u1ed9t l\u1ef1a ch\u1ecdn kh\u1ea3 thi \u0111\u1ed1i v\u1edbi nhi\u1ec1u gia \u0111\u00ecnh. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 k\u1ebf ho\u1ea1ch ch\u0103m s\u00f3c ung th\u01b0 giai \u0111o\u1ea1n cu\u1ed1i.<\/p>\n<p>Sau c\u00e1i ch\u1ebft c\u1ee7a m\u1ed9t ng\u01b0\u1eddi th\u00e2n y\u00eau, nhi\u1ec1u ng\u01b0\u1eddi c\u1ea7n s\u1ef1 h\u1ed7 tr\u1ee3 \u0111\u1ec3 gi\u00fap h\u1ecd \u0111\u1ed1i ph\u00f3 v\u1edbi s\u1ef1 m\u1ea5t m\u00e1t. T\u00ecm hi\u1ec3u th\u00eam v\u1ec1 \u0111au bu\u1ed3n v\u00e0 m\u1ea5t m\u00e1t.<\/p>\n<p>Ph\u1ea7n ti\u1ebfp theo trong h\u01b0\u1edbng d\u1eabn n\u00e0y l\u00e0 \u201cTh\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng\u201d. N\u00f3 cung c\u1ea5p th\u00eam th\u00f4ng tin v\u1ec1 c\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c t\u1eadp trung v\u00e0o vi\u1ec7c t\u00ecm ki\u1ebfm nh\u1eefng c\u00e1ch t\u1ed1t h\u01a1n \u0111\u1ec3 ch\u0103m s\u00f3c cho nh\u1eefng b\u1ec7nh nh\u00e2n ung th\u01b0. B\u1ea1n c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng menu \u0111\u1ec3 ch\u1ecdn m\u1ed9t ph\u1ea7n kh\u00e1c \u0111\u1ec3 \u0111\u1ecdc trong h\u01b0\u1edbng d\u1eabn n\u00e0y.<\/p>\n<h2><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h2>\n<p><a href=\"https:\/\/www.cancer.net\/cancer-types\/lymphoma-non-hodgkin\/treatment-options\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cancer.net\/cancer-types\/lymphoma-non-hodgkin\/treatment-options<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c n\u1ebfu h\u1ecd kh\u1ecfe m\u1ea1nh v\u00e0 b\u1ec7nh kh\u00f4ng g\u00e2y ra b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c v\u1ea5n \u0111\u1ec1 n\u00e0o v\u1edbi c\u00e1c c\u01a1 quan trong c\u01a1 th\u1ec3.<\/p>\n","protected":false},"author":351,"featured_media":7998,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2460,2955],"tags":[2956],"series":[1802],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>B\u1ec7nh u lympho kh\u00f4ng Hodgkin v\u00e0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c n\u1ebfu h\u1ecd kh\u1ecfe m\u1ea1nh v\u00e0 b\u1ec7nh kh\u00f4ng g\u00e2y ra b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c v\u1ea5n \u0111\u1ec1 n\u00e0o v\u1edbi c\u00e1c c\u01a1 quan trong c\u01a1 th\u1ec3.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/ung-thu\/benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"B\u1ec7nh u lympho kh\u00f4ng Hodgkin v\u00e0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng\" \/>\n<meta property=\"og:description\" content=\"M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n u lympho ti\u1ebfn tri\u1ec3n ch\u1eadm c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c n\u1ebfu h\u1ecd kh\u1ecfe m\u1ea1nh v\u00e0 b\u1ec7nh kh\u00f4ng g\u00e2y ra b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c v\u1ea5n \u0111\u1ec1 n\u00e0o v\u1edbi c\u00e1c c\u01a1 quan trong c\u01a1 th\u1ec3.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n Ung Th\u01b0\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/phan.quyen.1232\" \/>\n<meta property=\"article:published_time\" content=\"2018-10-30T18:53:11+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/10\/benh-u-lympho-khong-hodgkin-va-nhung-phuong-phap-dieu-tri-2.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"660\" \/>\n\t<meta property=\"og:image:height\" content=\"330\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BS. 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