2013年12月29日 星期日

誤認感冒發燒 竟罹白血病 (2013/12/30 蘋果日報)

慢性淋巴性白血病患增5成


氣溫驟降使不少人感冒、發燒,這些看似平常小病痛,卻有可能是慢性淋巴性白血病的症狀,台北榮總內科部血液腫瘤科醫師蕭樑材表示,許多慢性淋巴性白血病患者,初期都是疲累、感冒、發燒,健檢時才意外發現罹病,據資料顯示,近5年來確診人數增5成,推測跟人口老化、環境汙染等有關。

蕭樑材醫師表示,慢性淋巴性白血病是白血病的其中一種,病患大多為60~70歲老年人,但由於病程發展緩慢,初期症狀不明顯,大多只會感到疲累、感冒、發燒,因此不易發現,多數人可能罹病5~10年後,某次進行健檢時才意外確診,此時病況已屬中晚期,治療時會考慮患者的年齡與病況決定藥物,如果年紀很大、生理條件不佳,會採用溫和的口服化療藥物,若尚屬壯年、生理條件佳,則除化療外會再搭配標靶藥物,無疾病惡化存活期可延長至52個月

先了解】症狀易被輕忽

因白血球數量異常增加,患者常會疲累、有時發燒,症狀常被輕忽,所以約6成是健檢才意外發現,部分患者則會出現體重驟降、嚴重貧血等,此時才會有警覺心而就醫

多數為老年人

白血病分急性、慢性骨髓性白血病與急性、慢性淋巴性白血病4種,其中慢性淋巴性白血病患多為60~70歲老年人,推測與疾病發展慢,及接觸輻射、化學藥劑如清潔劑有關。 

這樣做】標靶藥效果好

據國外研究顯示,以無疾病惡化存活期比較,單用化療藥治療平均為33個月,化療搭配標靶可延長至52個月,但化療藥有健保給付、標靶藥物須每月自費5萬元,實際仍要醫師評估後選擇適合治療方式

免疫差防感染

免疫力差是慢性淋巴性白血病患的特色,因此平時日常生活需防範感染,建議流感、肺炎疫苗皆要施打,流感流行期間也要少出入公共場所,或是戴口罩再外出,另外,生活作息也要規律

【醫師說】

化療搭標靶藥和單用化療藥,其實整體存活期差不多,但前者能給患者更好生活品質,但藥費也較昂貴

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