{"id":8533,"date":"2020-05-23T07:40:08","date_gmt":"2020-05-23T00:40:08","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/hoi-chung-phong-thich-cytokine-sau-lieu-phap-mien-dich\/"},"modified":"2020-05-23T07:40:08","modified_gmt":"2020-05-23T00:40:08","slug":"hoi-chung-phong-thich-cytokine-sau-lieu-phap-mien-dich","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/hoi-chung-phong-thich-cytokine-sau-lieu-phap-mien-dich\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine sau li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch"},"content":{"rendered":"<h2><strong>H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine l\u00e0 g\u00ec?<\/strong><\/h2>\n<p>H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine (CRS) l\u00e0 m\u1ed9t t\u1eadp h\u1ee3p c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p li\u00ean quan \u0111\u1ebfn t\u1ebf b\u00e0o T. H\u1ed9i ch\u1ee9ng x\u1ea3y ra khi c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t v\u00e0 gi\u1ea3i ph\u00f3ng m\u1ed9t l\u01b0\u1ee3ng l\u1edbn cytokine v\u00e0o c\u01a1 th\u1ec3. Cytokine l\u00e0 c\u00e1c protein nh\u1ecf \u0111\u00f3ng vai tr\u00f2 l\u00e0 s\u1ee9 gi\u1ea3 c\u1ee7a t\u1ebf b\u00e0o \u0111\u1ec3 gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. Tuy nhi\u00ean, n\u1ed3ng \u0111\u1ed9 cytokine cao c\u00f3 th\u1ec3 g\u00e2y t\u0103ng ho\u1ea1t \u0111\u1ed9ng vi\u00eam to\u00e0n c\u01a1 th\u1ec3. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i v\u00e0 can thi\u1ec7p v\u00e0o m\u1ed9t s\u1ed1 ch\u1ee9c n\u0103ng c\u01a1 th\u1ec3. Trong tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng, CRS c\u00f3 th\u1ec3 g\u00e2y suy t\u1ea1ng v\u00e0 th\u1eadm ch\u00ed t\u1eed vong.<\/p>\n<p>CRS th\u01b0\u1eddng ph\u00e1t sinh trong v\u00f2ng 3-14 ng\u00e0y sau \u0111i\u1ec1u tr\u1ecb b\u1eb1ng li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch d\u1ef1a tr\u00ean t\u1ebf b\u00e0o T. N\u00f3 th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u v\u1edbi tri\u1ec7u ch\u1ee9ng s\u1ed1t v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng c\u00fam nh\u01b0ng c\u00f3 th\u1ec3 x\u1ea5u \u0111i nhanh ch\u00f3ng v\u00e0 g\u00e2y ra b\u1ec7nh nghi\u00eam tr\u1ecdng.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb CRS bao g\u1ed3m theo d\u00f5i v\u00e0 ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 \u0111\u1ec3 ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t v\u00e0 thu\u1ed1c \u0111\u1ec3 gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch (thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch).<\/p>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 s\u1ebd \u0111\u01b0\u1ee3c theo d\u00f5i trong kho\u1ea3ng m\u1ed9t th\u00e1ng sau khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng c\u1ea3i thi\u1ec7n trong v\u00f2ng 1-2 tu\u1ea7n. H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 v\u1ea5n \u0111\u1ec1 l\u00e2u d\u00e0i t\u1eeb h\u1ed9i ch\u1ee9ng gi\u1ea3i ph\u00f3ng cytokine.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-33504 size-full\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2020\/05\/hoi-chung-phong-thich-cytokine-sau-lieu-phap-mien-dich.jpg\" alt=\"H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine sau li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch\" width=\"660\" height=\"330\" \/><\/p>\n<h2><strong>Tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine<\/strong><\/h2>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a CRS \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c trong c\u01a1 th\u1ec3. C\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng l\u00ean nhi\u1ec1u c\u01a1 quan. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, CRS c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng bi\u1ebfn \u0111\u1ed5i \u0111e d\u1ecda t\u00ednh m\u1ea1ng l\u00ean ch\u1ee9c n\u0103ng tim, ph\u1ed5i, th\u1eadn, gan v\u00e0 n\u00e3o.<\/p>\n<p>Nhi\u1ec1u tri\u1ec7u ch\u1ee9ng CRS c\u00f3 th\u1ec3 c\u00f3 nguy\u00ean nh\u00e2n kh\u00e1c. Nhi\u1ec5m \u0111\u1ed9c th\u1ea7n kinh v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch c\u00f3 th\u1ec3 x\u1ea3y ra khi c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng CRS. \u0110\u1ed9i ng\u0169 ch\u0103m s\u00f3c s\u1ebd th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 theo d\u00f5i c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u1ec3 l\u00ean k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t.<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"506\"><strong>C\u01a1 quan b\u1ecb \u1ea3nh h\u01b0\u1edfng<\/strong><\/td>\n<td width=\"727\"><strong>Tri\u1ec7u ch\u1ee9ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"506\">T\u1ed5ng tr\u1ea1ng<\/td>\n<td width=\"727\">S\u1ed1t, \u1edbn l\u1ea1nh, m\u1ec7t m\u1ecfi, y\u1ebfu, ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n, n\u00f4n, ti\u00eau ch\u1ea3y, nh\u1ee9c \u0111\u1ea7u, \u0111au kh\u1edbp ho\u1eb7c c\u01a1, ph\u00e1t ban da<\/td>\n<\/tr>\n<tr>\n<td width=\"506\">Tim v\u00e0 m\u1ea1ch m\u00e1u<\/td>\n<td width=\"727\">H\u1ea1 huy\u1ebft \u00e1p, nh\u1ecbp tim t\u0103ng, nh\u1ecbp tim kh\u00f4ng \u0111\u1ec1u, gi\u1ea3m ch\u1ee9c n\u0103ng tim, ph\u00f9<\/td>\n<\/tr>\n<tr>\n<td width=\"506\">N\u00e3o v\u00e0 h\u1ec7 th\u1ea7n kinh<\/td>\n<td width=\"727\">Nh\u1ee9c \u0111\u1ea7u, l\u00fa l\u1eabn, ch\u00f3ng m\u1eb7t, co gi\u1eadt, \u1ea3o gi\u00e1c, gi\u1ea3m kh\u1ea3 n\u0103ng ph\u1ed1i h\u1ee3p, v\u1ea5n \u0111\u1ec1 v\u1ec1 ng\u00f4n ng\u1eef ho\u1eb7c nu\u1ed1t, run, v\u1ea5n \u0111\u1ec1 ki\u1ec3m so\u00e1t c\u1eed \u0111\u1ed9ng<\/td>\n<\/tr>\n<tr>\n<td width=\"506\">Ph\u1ed5i<\/td>\n<td width=\"727\">Ho, kh\u00f3 th\u1edf, gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i, gi\u1ea3m n\u1ed3ng \u0111\u1ed9 oxy<\/td>\n<\/tr>\n<tr>\n<td width=\"506\">Thay \u0111\u1ed5i c\u00e1c marker<\/td>\n<td width=\"727\">Gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn ho\u1eb7c gan, t\u0103ng n\u1ed3ng \u0111\u1ed9 cytokine trong m\u00e1u, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, r\u1ed1i lo\u1ea1n \u0111\u00f4ng c\u1ea7m m\u00e1u<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><strong>Nguy\u00ean nh\u00e2n c\u1ee7a H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine<\/strong><\/h2>\n<p>H\u1ed9i ch\u1ee9ng gi\u1ea3i ph\u00f3ng Cytokine x\u1ea3y ra sau khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch k\u00edch ho\u1ea1t c\u00e1c t\u1ebf b\u00e0o T \u0111\u1ec3 ch\u1ed1ng ung th\u01b0. Nh\u1eefng li\u1ec7u ph\u00e1p n\u00e0y k\u00edch ho\u1ea1t m\u1ed9t ph\u1ea3n \u1ee9ng vi\u00eam mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c do s\u1ef1 gi\u1ea3i ph\u00f3ng c\u00e1c cytokine.<\/p>\n<p>Trong ung th\u01b0 \u1edf tr\u1ebb em, li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn CRS bao g\u1ed3m blinatumomab v\u00e0 tisagnlecleucel.<\/p>\n<p>Blinatumomab (Blincyto\u00ae) l\u00e0 m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng k\u00edch th\u00edch t\u1ebf b\u00e0o T nh\u1ecb hi\u1ec7u (bispecific T-cell engager BiTE). Thu\u1ed1c n\u00e0y ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch l\u00e0m cho c\u00e1c t\u1ebf b\u00e0o T nh\u1eafm \u0111\u1ebfn m\u1ed9t protein c\u00f3 t\u00ean CD19 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean m\u1ed9t s\u1ed1 lo\u1ea1i t\u1ebf b\u00e0o ung th\u01b0 b\u1ea1ch c\u1ea7u.<\/p>\n<p>Tisagenlecleucel (Kymriah\u00ae) l\u00e0 m\u1ed9t li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch t\u1ebf b\u00e0o T CAR. N\u00f3 ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch d\u00f9ng k\u1ef9 thu\u1eadt \u0111\u1ec3 cho t\u1ebf b\u00e0o T c\u00f3 c\u00e1c th\u1ee5 th\u1ec3 \u0111\u1eb7c bi\u1ec7t g\u1ecdi l\u00e0 th\u1ee5 th\u1ec3 kh\u00e1ng nguy\u00ean chimeric (CAR). Nh\u1eefng th\u1ee5 th\u1ec3 n\u00e0y gi\u00fap c\u00e1c t\u1ebf b\u00e0o T nh\u1eadn bi\u1ebft v\u00e0 t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o ung th\u01b0.<\/p>\n<p>Hi\u1ec7n nay, li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch t\u1ebf b\u00e0o CAR trong ung th\u01b0 nhi th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t \u1edf tr\u1ebb em m\u1eafc b\u1ec7nh b\u1ea1ch c\u1ea7u\u00a0 c\u1ea5p d\u00f2ng lympho t\u00e1i ph\u00e1t ho\u1eb7c kh\u00e1ng tr\u1ecb (ALL).<\/p>\n<h2><strong>\u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine<\/strong><\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb CRS bao g\u1ed3m theo d\u00f5i v\u00e0 x\u00e9t nghi\u1ec7m, \u0111i\u1ec1u tr\u1ecb c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee5 th\u1ec3 v\u00e0 thu\u1ed1c \u0111\u1ec3 gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch. \u0110\u1ed9i ng\u0169 ch\u0103m s\u00f3c s\u1ebd theo d\u00f5i c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u suy t\u1ea1ng. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 n\u1eb7ng ho\u1eb7c m\u1ee9c \u0111\u1ed9 c\u1ee7a h\u1ed9i ch\u1ee9ng gi\u1ea3i ph\u00f3ng cytokine. Tr\u1ebb em m\u1eafc ung th\u01b0 c\u00e0ng r\u1ed9ng c\u00f3 nguy c\u01a1 m\u1eafc CRS n\u1eb7ng h\u01a1n.<\/p>\n<p><strong>Theo d\u00f5i tri\u1ec7u ch\u1ee9ng v\u00e0 x\u00e9t nghi\u1ec7m<\/strong><\/p>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 m\u1eafc CRS n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong nh\u1eefng tu\u1ea7n \u0111\u1ea7u ti\u00ean sau khi \u0111i\u1ec1u tr\u1ecb mi\u1ec5n d\u1ecbch.<\/p>\n<p>Theo d\u00f5i CRS bao g\u1ed3m:<\/p>\n<ul>\n<li>Th\u00e2n nhi\u1ec7t<\/li>\n<li>Nh\u1ecbp th\u1edf<\/li>\n<li>Huy\u1ebft \u00e1p<\/li>\n<li>Nhi\u0323p tim<\/li>\n<li>Oxy m\u00e1u<\/li>\n<li>Kh\u00e1m th\u1ea7n kinh \u0111\u1ec3 theo d\u00f5i nh\u1eefng thay \u0111\u1ed5i trong ch\u1ee9c n\u0103ng n\u00e3o v\u00e0 h\u1ec7 th\u1ea7n kinh<\/li>\n<li>C\u00e1c x\u00e9t nghi\u1ec7m nh\u01b0 c\u00f4ng th\u1ee9c m\u00e1u, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, c\u00e1c ch\u1ec9 s\u1ed1 v\u1ec1 ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 gan, cytokine v\u00e0 c\u00e1c marker kh\u00e1c c\u1ee7a ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch v\u00e0 nhi\u1ec5m tr\u00f9ng<\/li>\n<\/ul>\n<p><strong>Ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n<p>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c trong m\u00f4i tr\u01b0\u1eddng ICU.<\/p>\n<p>Ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 bao g\u1ed3m:<\/p>\n<ul>\n<li>Truy\u1ec1n d\u1ecbch nu\u00f4i d\u01b0\u1ee1ng<\/li>\n<li>H\u1ed7 tr\u1ee3 oxy ho\u1eb7c m\u00e1y th\u1edf<\/li>\n<li>Thu\u1ed1c \u0111i\u1ec1u h\u00f2a huy\u1ebft \u00e1p<\/li>\n<li>Thu\u1ed1c h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng tim<\/li>\n<li>Truy\u1ec1n m\u00e1u<\/li>\n<li>Thu\u1ed1c ho\u1eb7c l\u1ecdc m\u00e1u \u0111\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng th\u1eadn<\/li>\n<\/ul>\n<p><strong>Ph\u00f2ng ch\u1ed1ng co gi\u1eadt. <\/strong><\/p>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 b\u1ecb \u1ea3nh h\u01b0\u1edfng n\u00e3o v\u00e0 h\u1ec7 th\u1ea7n kinh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t lo\u1ea1i thu\u1ed1c nh\u01b0 levetiracetam (Keppra\u00ae) \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba co gi\u1eadt c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch.<\/p>\n<p><strong>Thu\u1ed1c l\u00e0m gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch<\/strong><\/p>\n<p>B\u1ec7nh nh\u00e2n b\u1ecb CRS n\u1eb7ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1ed1ng l\u1ea1i ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch. Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y bao g\u1ed3m c\u00e1c li\u1ec7u ph\u00e1p tr\u00fang \u0111\u00edch \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u00e1c cytokine c\u1ee5 th\u1ec3, c\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch n\u00f3i chung.<\/p>\n<p>M\u1ed9t cytokine ph\u1ed5 bi\u1ebfn l\u00e0 interleukin-6 (IL-6). C\u00e1c lo\u1ea1i thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 can thi\u1ec7p v\u00e0o IL-6 l\u00e0 tocilizumab v\u00e0 siltuximab.<\/p>\n<p>Corticosteroid nh\u01b0 methylprednisolone ho\u1eb7c dexamethasone c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap gi\u1ea3m ph\u1ea3n \u1ee9ng vi\u00eam v\u00e0 mi\u1ec5n d\u1ecbch; n\u00f3 kh\u00f4ng nh\u1eafm \u0111\u00edch v\u00e0o c\u00e1c cytokine c\u1ee5 th\u1ec3 m\u00e0 ch\u1ec9 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch n\u00f3i chung.<\/p>\n<p>B\u1edfi v\u00ec thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch c\u00f3 kh\u1ea3 n\u0103ng can thi\u1ec7p v\u00e0o t\u00e1c d\u1ee5ng ch\u1ed1ng ung th\u01b0 c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch v\u00e0 c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c, n\u00ean nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y kh\u00f4ng ph\u1ea3i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p>Nh\u00f3m ch\u0103m s\u00f3c s\u1ebd c\u00e2n nh\u1eafc l\u1ee3i \u00edch v\u00e0 r\u1ee7i ro ti\u1ec1m \u1ea9n trong vi\u1ec7c quy\u1ebft \u0111\u1ecbnh k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t.<\/p>\n<p>H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch. B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1eadp trung v\u00e0o vi\u1ec7c \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng c\u01a1 quan.<\/p>\n<p>B\u00e1c s\u0129 c\u00f3 th\u1ec3 gi\u00fap b\u1ea1n hi\u1ec3u h\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch cytokine v\u00e0 bi\u1ebft li\u1ec7u con b\u1ea1n c\u00f3 nguy c\u01a1 hay kh\u00f4ng. Lu\u00f4n lu\u00f4n n\u00f3i chuy\u1ec7n v\u1edbi nh\u00f3m ch\u0103m s\u00f3c c\u1ee7a b\u1ea1n v\u1ec1 b\u1ea5t k\u1ef3 m\u1ed1i quan t\u00e2m v\u1ec1 s\u1ee9c kh\u1ecfe n\u00e0o v\u00e0 b\u00e1o c\u00e1o nh\u1eefng thay \u0111\u1ed5i x\u1ea3y ra trong ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p class=\"simple-title\"><a href=\"https:\/\/together.stjude.org\/en-us\/diagnosis-treatment\/side-effects\/cytokine-release-syndrome-crs.html\" target=\"_blank\" rel=\"noopener\">Cytokine Release Syndrome (CRS) After Immunotherapy<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine (CRS) l\u00e0 t\u1eadp h\u1ee3p c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p li\u00ean quan \u0111\u1ebfn t\u1ebf b\u00e0o T<\/p>\n","protected":false},"author":469,"featured_media":6848,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3239],"tags":[2624],"series":[2108],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine sau li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch - D\u1ef1 \u00e1n Ung Th\u01b0<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng ph\u00f3ng th\u00edch Cytokine (CRS) l\u00e0 t\u1eadp h\u1ee3p c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p li\u00ean quan \u0111\u1ebfn t\u1ebf b\u00e0o T\" \/>\n<meta name=\"robots\" content=\"index, follow, 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