CCTV International 20031October 24th 1 17:07
1, Professor Lu Daopei was born in a medical family and was the director of Peking University Institute of Hematology. Since 1950s, he has been engaged in clinical and experimental research on hematological diseases. He is one of the founders of China's research on coagulopathy. He built the Peking University Institute of Hematology into the largest bone marrow center in China, and its transplantation effect is at the leading level in the world. He vigorously promoted the rapid development of hematopoietic stem cell transplantation in China. It plays a connecting role in the clinical research of leukemia. After years of overseas study experience and nearly half a century's medical career, Lu Daopei has accumulated more than 230 papers in Chinese and English, and achieved fruitful medical results. 1996 was awarded the title of academician of China Academy of Engineering, which is not only a rare honor, but also a brand-new milestone. (Left)
2. Chen Huan, deputy chief physician of Institute of Hematology, Beijing People's Hospital, has been mainly engaged in clinical research of leukemia chemotherapy and hematopoietic stem cell transplantation in recent ten years. Completed hematopoietic stem cell transplantation 100 cases, including incompatible bone marrow transplantation and unrelated bone marrow transplantation, and participated in many clinical research projects of hematology institute. He has some basic theory and clinical experience in hematopoietic stem cell transplantation and published more than ten academic papers. (right)
Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about leukemia.
Recently, Professor Hu Yamei, a famous medical expert on childhood leukemia, an academician of China Academy of Engineering and honorary president of Children's Hospital, called for the cause of leukemia to be related to environmental factors. The paint used to decorate the room contains some harmful substances. If children inhale paint when it volatilizes, leukemia may occur. Today is165438+1October 20th, which is also the World Children's Day. This day was jointly organized by China Interior Decoration Society, Indoor Environmental Monitoring Center and China Children's Health Disease Prevention and Guidance Center. The investigation on indoor environmental pollution monitoring of urban children with leukemia was officially launched. The activity will carry out free indoor environmental pollution monitoring for urban children with leukemia under 14 years old nationwide, focusing on the environmental factors that cause leukemia. Children with leukemia all over the country can check the testing units and register through China Indoor Environment Network (www.cietc.com).
Moderator: Let's watch a movie: Today is a very special day for Zhang. Academician Lu Daopei, a famous hematologist in China who saved her life 40 years ago, personally visited her home. The arrival of the old academician made Zhang particularly excited. Forty years ago, Zhang worked as a nurse in a hospital in Pinggu, Beijing. At that time, she took a lot of anti-inflammatory drugs (synthetic drugs) because of her cold. Results A few days later, I found the mouth and nose bleeding, and went to the hospital for examination and diagnosis as severe aplastic anemia. This was undoubtedly a bolt from the blue for her who was only 22 years old at that time. However, the same young doctor Lu Daopei gave her constant encouragement. He decided to treat Zhang with bone marrow transplantation. At that time, no one in Asia had used this method, but Lu Daopei saw hope from a large number of successful experiments. After intense preparation and careful surgery, he successfully completed the first allogeneic bone marrow transplant in Asia and the fourth in the world, and Zhang was reborn. This successful operation, like a morning star, announced the beginning of hematopoietic stem cell transplantation in China. Forty years later, Zhang has become a grandmother. Whenever she recalls the thrilling race against time 40 years ago, she will be filled with emotion.
Zhang: It was Dr. Lu who gave me a second life.
Moderator: What is the relationship between aplastic anemia and leukemia?
Lu Daopei: Aplastic anemia and leukemia are both bone marrow diseases, which can lead to thrombocytopenia, anemia and normal leukopenia. Aplastic anemia is bone marrow failure and leukemia is malignant proliferation of bone marrow cells. Leukemia, also known as hematological tumor disease, contains leukemia cells in the body and causes some symptoms and hemogram changes. The incidence of leukemia is rising gradually. Statistics 20 years ago showed that there were about 4-5 patients per100000 people, but now it is far more than that. Leukemia accounts for the first place in the incidence of tumor in adolescents.
Chen Huan: There are many reasons for the increase of the incidence rate, including environmental pollution, radiation and the increase of chemical products. Another factor that cannot be ignored is that drugs are closely related to the occurrence of leukemia. When we ask about the medical history of leukemia patients at work, we find that many leukemia patients have taken painkillers, which is also a problem worthy of attention by both doctors and patients.
Host: Let's watch a movie:
Patient A: I felt very heavy when I learned that I had leukemia, and I felt that I was definitely finished.
Patient B: I was in a bad mood after learning that I was leukemia, and my parents were also in a heavy mood.
Patient C: After being diagnosed, I almost collapsed. 1999, I am 3 1 year old, and my limited knowledge only knows that this is a terrible disease.
Patient C's family: I felt very heavy at that time. The child was only 2 years old at that time, and it was even worse.
Chen Huan: We have come into contact with a large number of patients in similar situations in our daily work, and we are very sorry. However, with the continuous development of medicine, there are many new drugs, and I believe leukemia can still be cured step by step.
Moderator: What is the classification of leukemia?
Lu Daopei: Leukemia can be divided into acute leukemia, chronic leukemia and subacute leukemia according to the course of disease. According to the cell source, it can be divided into lymphocytic leukemia and aqueous leukemia. Broadly speaking, other tumors in the blood system, such as multiple myeloma, belong to the category of leukemia. Acute leukemia is more acute. Without reasonable treatment, the patient's life will not exceed half a year. Subacute leukemia usually lasts about a year and a half if it is not given reasonable treatment. Chronic leukemia has a long course of disease.
Moderator: What are the specific clinical symptoms of leukemia?
Chen Huan: It can manifest as fever, bleeding and fatigue.
Lu Daopei: Leukemia may sometimes be confused with many diseases. The uncontrolled proliferation of blood cancer cells can infiltrate everywhere with blood flow, such as gingival infiltration, hepatosplenomegaly, meningeal infiltration and so on. Other symptoms include bleeding caused by thrombocytopenia and infection and fever caused by normal leukopenia.
Moderator: What is the current treatment for leukemia?
Lu Daopei: In the treatment of leukemia, we should focus on radical cure, but we should relieve it first. The treatment of leukemia, especially radical treatment, can be divided into three aspects: 1, drug therapy 2, hematopoietic stem cell transplantation (including bone marrow transplantation and cord blood transplantation) 3, immunotherapy.
Moderator: What are the aspects of medication?
Lu Daopei: Chemotherapy is the most important drug treatment. Chemotherapy has certain toxicity, but it has developed rapidly in recent decades, especially for the treatment of acute leukemia in children. In addition to chemotherapy, there are some targeted treatments. For example, promyelocytic leukemia was once a very dangerous disease. At present, arsenic sulfide can be used in our hospital, and patients can relieve their illness by 65,438+0,000%. After combined treatment, patients can survive for more than 95% for a long time.
Moderator: Let's look at the situation of a patient who has received this treatment:
Patient: I took the medicine for about a month, and then I took intensive treatment, first once every half month, then once every month, until once every six months, and finally once every three years. The doctor told me that there was no problem and I didn't need chemotherapy, so I was liberated. Since then, I have had a bone marrow transplant every six months and a blood test every month. I have been doing this for two years and have fully recovered.
Lu Daopei: The treatment of this patient is a radical treatment. The patient is receiving simple chemotherapy. Of course, the so-called simple chemotherapy is also a combination of several chemotherapy drugs. He has lived 15 years, and there are many patients who have lived longer than him.
Moderator: What should we do when drugs and chemotherapy don't work?
Chen Huan: The dependence of many leukemias on drugs and chemotherapy is not obvious. At present, hematopoietic stem cell transplantation (including bone marrow transplantation) is still an important treatment for leukemia.
Lu Daopei: Hematopoietic stem cell transplantation includes bone marrow transplantation and cord blood transplantation. It means that patients receive high-dose chemotherapy or even radiotherapy first, and then after the bone marrow cells of patients are removed, normal hematopoietic stem cells are inoculated into patients, so that the diseased cells are replaced, which is equivalent to rebuilding hematopoietic and immune functions, and can also remove the residual leukemia cells in the body. Although the number of hematopoietic stem cells planted is very small, hematopoietic stem cells can be continuously replicated, multiplied and differentiated in the body. Hematopoietic stem cell transplantation can treat leukemia and severe aplastic anemia.
Moderator: Let's look at a patient who has received a mother's hematopoietic stem cell transplant:
Patient: I want to thank my mother for giving me a second life. My mother was 50 years old when she gave me hematopoietic stem cells. I am very moved to donate hematopoietic stem cells to me at such an old age. I had a bone marrow transplant in 1992, and the effect was very good. Now my mental state and physical state are very good.
Chen Huan: Usually, before transplantation, patients must undergo a rigorous physical examination to evaluate the condition of various organs of the patients.
Moderator: Does donating hematopoietic stem cells have an impact on the donor's health?
Lu Daopei: Donating hematopoietic stem cells has no effect on donors. Basically, the so-called impact is similar to blood donation, and there is basically no big impact.
Moderator: Let's watch a video:
Wife of Patient C: After the transplant was decided, both his sisters had an examination. At first, they thought it was nothing, because their three brothers and sisters looked alike. But then I heard that he had a rare locus in Asia, and then he matched the umbilical cord blood. Coincidentally, there are nine suitable ones, and they all say that we are lucky.
Lu Daopei: Our first choice in choosing hematopoietic stem cell donors is those who are related by blood and have the same matching. This probability is often relatively small. Secondly, we choose donors who are not related by blood and have the same matching. This volunteer who has registered hematopoietic stem cells can donate or transplant unrelated umbilical cord blood. Umbilical cord blood is actually placental blood, rich in hematopoietic stem cells, and the matching requirements are not strict.
Moderator: Let's take a look at this film again:
Wife of Patient C: At first, I thought there was no hope for bone marrow matching, so I chose cord blood matching. Later, Dr. Lu said that I could, and that two pieces of cord blood could be put together. Finally, under the explanation of experts, we decided to do it.
Patient C: My physical condition has basically reached 60% of my physical quality before I got sick. I think I'm content to get my life back. I feel that I have earned everything in my present state.
Lu Daopei: This is the first successful double cord blood transplantation in the world. Because he was very heavy (95kg at that time), one cord blood was not enough, so he used double cord blood. The operation was a great success.
Moderator: Please introduce hematopoietic stem cell transplantation as a whole.
Lu Daopei: If the patient's physical condition permits, we should transplant the patient and try not to let the patient relapse, so the chance of recurrence is much smaller, though not absolute. First of all, we should choose consanguineous matching and consanguineous single-generation transplantation, such as father-son mutual transplantation. There is also umbilical cord blood transplantation. Umbilical cord blood is a gift to the world when a newborn is born. With this kind of cord blood, we keep it in the cord blood bank, and people who need it can use it.
Moderator: Let's listen to these patients who have overcome leukemia:
Patient A: My experience with this disease is not to be afraid. The more I am afraid of illness, the more I bully you, which further weakens my mental state.
Patient C: I think I should have a firm and strong desire to survive after suffering from this disease. Only good cooperation with doctors can cure the disease.
Wife of Patient C: I think family members should also have a good attitude. In any case, they should have a good mental outlook to face patients.
Lu Daopei: Leukemia is not an incurable disease. We can treat leukemia in various ways, and more and more patients can be cured.
Moderator: Will the patient relapse after treatment?
Chen Huan: Recurrence is possible. Chemotherapy, second transplantation and immunotherapy can also be performed after recurrence. Some patients can be relieved.
Lu Daopei: We have a relapsed patient who is doing well after immunotherapy. The development of immunotherapy is very early, but the development speed is relatively slow. We have various immunotherapy to control diseases.
Moderator: Ms. Song from Liaoning, 30 years old. In July this year, I was diagnosed with M6 leukemia with persistent high fever and severe oral ulcer. How to treat it? Can I have a bone marrow transplant?
Lu Daopei: Specific patients should be analyzed. After the patient goes to the hospital for examination, the results of the examination can be analyzed to know whether it meets the transplant conditions. Not everyone is suitable for transplantation. In principle, we transplant the patient after the initial remission, but if there is no remission, we can also transplant.
Moderator: Mr. Chen from Sichuan, 40 years old. My wife received a bone marrow transplant two years ago. After more than two years of recovery, bone marrow and blood indexes are normal, but menstruation has never come. Hormone therapy or traditional Chinese medicine mediation can be used, but are you afraid of affecting your condition? Ask an expert to recommend a good method.
Chen Huan: After bone marrow transplantation, the endocrine function of many patients, including lesbians, will be affected, so some female patients will have abnormal menstruation. If they have children or have little impact on their lives, I don't think it is necessary to take any treatment measures. If estrogen therapy affects their quality of life, it is also possible.
Moderator: Mr. Sun, Shandong, 3 1 year-old, I suffer from myelodysplastic syndrome stage 2 complicated with hepatitis B, is it suitable for bone marrow transplantation?
Lu Daopei: We are very careful about hepatitis B now. Bone marrow transplantation can't cure hepatitis B. Patients should treat hepatitis B first. Otherwise, patients with recurrent hepatitis after bone marrow transplantation have low resistance. If hepatitis recurs seriously, it will not get better.