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huangrens · 3 years ago

Text

SITTING IN THE CORNER CRYING BC THIS IS SO FREAKING ADORABLE

# TRUTH OR DARE? - l.dh

↳ Truth. Would you be my fake girlfriend for 2 weeks? Dare. Be my fake girlfriend for 2 weeks.

pairing: Lee Donghyuck x reader

genre: fluff, crack, angst, friends to lovers! AU, roadtrip! AU, fake dating! AU

warnings: mentions of mental breakdowns, swearing, lots of food, mentions of violence, but no actual action of it, more to be added if found

word count: 18.1k words

a/n: hey this is my 5th time changing the a/n because just as i thought the fic would be over, it isnt. but hey!! its finally done right? anyways, please please pleasssee tolerate the messy writing my mind was in so many places when writing this fic. In the beginning, i had a completely different plot, but it eventually evolved to how it is now so i know it's gonna be messy at some parts (the beginning <3)

also note that i know Haechan has siblings, but I didn't want to assume things about them or anyhting, so i made my own oc as his little sister

series masterlist

prologue.

"Truth or dare?"

"Excuse me?"

You stare confusedly into the eyes of Lee Donghyuck, who is staring at you with dead serious, almost intimidating eyes. Not very intimidating to you anymore the moment you feel a sudden laugh tickling at your throat, letting it out.

"What even, Haechan?" You snort, taking a book from your cart to place it to it's rightful place on the shelf. On days like these, working part-time at a library didn't seem so bad, it would usually be ruined by a child just flinging their book anywhere, and literally everywhere.

"Please," His voice grow desperate, "just answer."

Donghyuck has made a big mistake by promising his family he would get a girlfriend by the time he would see them next. How dumb his past self was to really make such a big promise?

Also, who wouldn't want him? He's hot, nice, and definitely a girl's type, no?

Wrong. He is hot, but his personality doesn't scream nice. He's more of a mischievous than nice. He pranked Huang Renjun a lot, like that time he sprayed cheese in his nose.

This time, a real laugh bubbles from your stomach at the sight of him pleading with his hands clasped together. He's never been one to do such thing.

"Why, is this a survey? Oh my god don't tell me you have an assignment undone, break just started!"

Donghyuck huffs, shaking his head. "Y/n, just answer, please."

You take another book from the cart, shoving it to Donghyuck's chest as you gesture to a high shelf. He takes the hint and places the novel into place as you put another back on another shelf. "Why? You better not pull anything suspicious."

"I promise. No fishy business."

You shrug, "Truth."

"Would you be my fake girlfriend for 2 weeks?"

No fishy business for sure. He makes it even fishier with using fake girlfriend instead of just girlfriend, but it would be fishy either way so why not go all out?

What were you expecting anyway?

You slap a thick book to Donghyuck's shoulder, before pushing it into his chest and instructing him to put it on another high shelf. "What the fuck? That's the fishiest business I've ever heard!"

Donghyuck repeats his action of placing a book in it's place, before he turns back to you with an exasperated look, "Look, just for fourteen days, okay? I promised them the next time I see my family I would come with a girlfriend. A serious one."

Serious? Serious?? Why make it fake, when he has to make it serious?!

"And you think I'm the one for the job?! Have you ever seen me in a relationship? Hell, a fake one??"

"No, but you're the best chance I have."

You shake your head once more and pet Donghyuck's bicep with a sigh, "Try Renjun or something."

Baffled, he watches as you trudge to another shelf and continue putting books in their places.

"He just got a girlfriend though!"

Fake dating, huh? You've never thought anything of it, never thought it would come to you. But, unexpected comes in the form of Lee Donghyuck if you've learned enough from your friends. Oh, especially Renjun. Who would have thought about cheesing your own friend's nose?

But fake dating? What's the big deal anyway? This had to be a joke, or a dare or something.

But as you see Lee Donghyuck walking through the doors of the diner you work at, you decide he's really desperate. Or maybe really hungry.

You narrow your eyes at Donghyuck as he approaches the counter, settling himself on one of the high seats. The diner is empty today, it usually is at hours like these. He's the first customer to come in 2 hours.

"What do you want?" You mutter as you raise your eyebrow suspiciously at him, your pen and notepad settled to the side.

"For you to be my girlfriend." Girlfriend? What happened to fake girlfriend?

You sigh, and walk back to your previous seat by the coffeemaker, "Why do you have to do this whenever I'm working?"

"I don't just come whenever you're working," Donghyuck counters, "these are the only places I know where to find you."

"How desperate are you?"

"Very."

Your scowl finally cracks into a small smirk, observing Donghyuck's clasped hands he pulls to his chest. His lips are pursed awkwardly into a thin line, eyes wide in anticipation. You've never seen him in such a state since Renjun decided to get him back for cheesing his nose. He's desperate, alright.

"What's in it for me?"

"A hot boyfriend,"

"I'm having second thoughts."

The boy in front of you springs up, surprise written all over his expressions, "And I can help do your homework?"

At this, you grow interested. You have your hands a bit full with 2 part-time jobs, and not to mention your procrastination and laziness? Homework in the hands of Lee Donghyuck doesn't sound too bad. He's smart, you know this very well after doing a group project with him.

"...you've got to help out in the library once in a while too. Ms. Lee is running out of students to recruit and makes me do everything. Help a bit in the library and I might just consider it."

A relieved smile curls Donghyuck's lips up, and his eyes sparkle. Finally, a light to end his misery.

You point your pen to a booth at the corner, gesturing to him to go there, "My shift ends in 10 minutes, we'll discuss more about it later."

Donghyuck scurries to the booth, flopping himself on the seats, and pulls out his notebook from his backpack. You wonder if he's prepared, because he sits there patiently, doodling on his notebook, as if he knew you were going to tell him you'd consider it.

And turns out he's really prepared. Whatever he was doodling before was actually agreement points, whatever you had said before to him. You gaze over the piece of paper, filled with doodles at the corners and in large letters, 'CONTRACT'. "Contract? What are we, in a stupid movie?"

Donghyuck shakes his head casually, knocking the far end of the table, nodding his head towards it, "No. Sit down first." You follow as he says, sitting in front of him with curious eyes following every move he makes.

The boy in front of you quickly notes a few things into the page, taking no time to messily scribble down words, before he flips the notebook to your side. He taps the page with his pencil, pointing at the numbers 1, 2, and 3 he had written.

1. We do not tell any of our friends, or family.

2. Hang out at least twice a week or we would be sus.

Did he seriously just write 'sus'? What kind of contract is this? You shake your thoughts off and continue reading.

3. We do this for 2 weeks, and 2 weeks only.

Now that you really think of it, 14 days is a long time to fake something.

"Okay, these all seem reasonable,"

Donghyuck instantly flashes a smile, before he reaches his hand out to take his notebook back. It is however, stopped, with your hand swatting it away. Before he could even question your actions, you had already stolen his pencil and scribbled your own terms on the notebook.

4. Boyfriend car privileges <3

You turn back the notebook with a smug, victorious smile playing at your lips.

Donghyuck's eyes instantly narrow at only condition you wrote down, "So I'm supposed to drive you... where, exactly?"

"Anywhere," You answer simply with a shrug, picking at the tiny broken pieces of the tip of the pencil you held. It's warm, strangely, despite you only using it for a few mere seconds. "At my beck and call."

Donghyuck shrugs, thinking nothing of the condition. If that was the only thing you wanted out of the relationship, other than the library job, then it's a definite steal.

He turns the notebook shut, sneakily taking the pencil between your fingers into his hold, signing the tiny space in the corner, right next to your name where you had also signed, before he tosses it into the depths of his bag.

He then sticks his hand out, eyes glistening almost mischievously as he urges you to take it, "Deal?"

Cautiously, you stick your hand out and slip it in his, tightening holds with each other as he awaits for your response.

"What about feelings? Isn't that like one of the major factors of a relationship?"

Your response is a shrug, and a lopsided smile as Donghyuck swings your hands side-to-side. "If we fall, we fall. Make it more realistic, am I right?"

At that, you shake your hand in his, nodding. Yeah, realistic.

After all, 14 days isn't enough for one to fall completely in love, right?

i. day one.

It's a bit strange, though. Not a single word from Donghyuck after the signing of the contracts, which in your opinion, was ridiculous to have if he was literally going to not reply to your questions.

Sure, it's only been 2 days since you've seen him , which isn't that long since you don't see him that much, but you still would like your questions to be answered by now.

Like the exact reason why he needs to fake date. He only said it was for his family. You would like to know the story bit by bit to understand it. It also sounds funny so that would be a bonus.

Just as you roll the book cart full of children's books and different novels into the fairy tales section, and search for an empty spot, you find a book falling through and tumbling in front of your feet.

Ugh, children these days, knocking over books for no reason.

Only, it wasn't a child. Something quite similar, actually.

The face of your fake boyfriend sticks through the tiny hole he had created on the shelf, eyes all aglow upon the sight of you.

"What the fuck—"

"—Oh hey,"

Speaking of the devil you were just thinking of, there your said fake boyfriend is, peeking through the tiny hole he caused by knocking over a book. For someone who is supposed to be acting as your boyfriend, you can’t say he’s doing a great job. At all.

“Hey, I have a lot of questions, so you better answer them now, Lee Haechan.”

His face is gone from the hole, and instead he appears right next to you, nodding at your request. “Alright, shoot,”

It shocks you how he seems so natural and relaxed in such a situation, as if he didn’t have anything to make clear, or some little details he would be making sure to be right when you get to his house tomorrow as you agreed right after the contract.

“First of all, are you not gonna make any specific details? Like I don’t know, how we met, why we dated, none of that?”

Donghyuck only shrugs, reaching out for the book he had knocked over by your feet, before he places it back to its rightful place. “I don’t think my family would pry that much into our relationship.”

What a respectful family. Last time you dated someone their family wanted to know every single little detail of how you came to be. You reach out for the pile of book placed on top of the shelf, and seeing as they didn’t belong in the children’s books section, you start to move the cart.

You decide to continue on with your questions as Donghyuck follows along behind you, “Uhm, okay. Well, what about-”

A sudden grasp at your hand startles you instantly, and you almost jump in surprise at how unexpected it was. To your utter surprise, when you trail your eyes back down to see what had touched your hand, you find Donghyuck’s fingers by your own, bringing them close to his to intertwine them together.

“What the fuck are you doing?!” You mutter, attempting to pull your hand back from his hold. Donghyuck simply keeps your hand in his hold, tugging you along with the cart to follow him.

“I’m spreading the word, Y/n.” He responds simply, squeezing your hand softly. “Today is day one, alright?”

Who is there to spread the word to?!

You whip your head left to right, searching for a single person looking your way. Not a single pair of eyes. What on earth was he talking about?

You find out hours later that Renjun and his girlfriend had only had a single glimpse towards your hands, and had even gotten it on camera when he was filming a library video for his YouTube channel, and being the menace of a best friend, he would go straight to Donghyuck’s mother and show him everything.

And apparently his whole audience knows now. The friend who cheesed Huang Renjun’s nose is now in a relationship. Not that big of news, but they still worry for you and hope you don’t get cheesed in the nose when you’re asleep.

You appreciate their wishes, and truly hope nothing happens to your nose whenever you’re around Donghyuck.

ii. day four.

It’s been another three days since you’ve seen Donghyuck, and you’re starting to think he doesn’t want to do this thing anymore. Why ghosts their girlfriend for a full 3 days? But then again, you’re not really dating.

Either way, it still confuses the hell out of you.

You think this as you place yet another plate of chicken nuggets and fries on the table of a customer, offering the woman a smile. She smiles back, and thanks you, before turning back to her work on her laptop. Strange, you would’ve thought people go to cafes for working, or a McDonalds for chicken nuggets and fries.

Just as you turn around, a certain figure catches your figure again. It’s him, your fake boyfriend, a smile playing on his lips as he stares at you with his head resting on his palms. With squinted eyes, you approach his booth cautiously.

Once you reach his table, you pull out your notepad and pen, “What can I get for you today?”

“I think it’s what I can do for you,”

At this, you place your pen and notepad back into your pocket, “Alright, what is it this time?”

“What,” Donghyuck tilts his head and bats his beady eyes up at you, “I can’t even visit my girlfriend?”

“Not when she’s working, Haechan. Now what do you want?”

Donghyuck laughs airily, shaking his head in protest against your words, “You’re not working when you only have 10 minutes left of work.”

With a check to your watch, you’re surprised he remembers when you get off work, you only told him once.

“Yes, yes. I know. I’m a great boyfriend for remembering!”

Just as you turn around to leave, a tug at your wrist halts you in your way, before Donghyuck’s voice resonates before you, “Just letting you know, after your shift ends I'm taking you to my house.”

"I'm sorry, you're what??"

Donghyuck quickly lets go of your wrist, before coughing awkwardly at your very astonished expression that's evident all over you. Your voice has risen, drastically, eyes wide almost in terror, and your pen his pointed very dangerously close to his face. Now that it's so close to his face, he notices the small pen ink blotches splattered on your fingers.

Hard worker. He respects that.

"I need to babysit my little sister, and she wants to meet you," Donghyuck breathes out. After an nudge of his head to the other seat across him, he finds you sliding in with a very confused face. "after my aunt spilled the beans to everyone."

"Okay but, I'm literally not ready. Like, at all." You gesture to your outfit, which consist literally of just your normal wear, plus a dirty apron.

"Oh, I'm sure it's fine! They don't judge clothes, they only judge personality."

And, how compatible you two are, might you add. You get along quite well, but you're sure that if you're under the pressure of having to act as a family's beloved son's lover, you have to act like you love him. Which you frankly don't.

"What if I have a bad personality impression on them? What then??"

Donghyuck sighs and taps his fingers on the table as he leans back in his seat, shrugging as if the answer was right there, evident, and that you were just blind. You might just be blind because you don't see what's so obvious.

"Why do you think I asked you? Because you have the personality that my family would like, and I would enjoy too,"

You think that's complete baloney, because you've only met in gatherings or a project, or maybe through Lee Jeno, but that's literally it. How could he possibly know you that well?

"Feeling, Y/n. I can feel it in my gut."

"That sounds very untrustworthy."

Donghyuck glances at his watch, before looking back up at you and tapping on it, "You've got five minutes to get ready,"

Gosh, the audacity Lee Donghyuck has.

As much as you didn't want to, you said yes to his proposal. Heck, there's even a contract!

You have to do it, ready or not.

Not ready is what you are, no idea of what's to come. What if they instantly notice and start suspecting? What if they don't even like you? Gosh, who makes plans 10 minutes before it's in action?

You wonder this as you pull up in front of Donghyuck's house, your eyes glued to every single detail of it.

Your mind seems to picture smoke and a red light emitting from the front door, as if the door to your immense doom. You honestly seriously believe it's the path to your misery.

"What the fuck, this is crazy." Your hands cradle your head into your arms, before you start rocking back and forth in the passenger's seat, "Why did I even agree to this? Y/n you are crazy, Haechan you are insane to think I can pull this off!"

Your fake boyfriend brushes off the last part, instead turning his car engine off and patting at your back. You think of it as some small action of comfort, before he speaks.

"Right, just another thing, don't call me Haechan. Just use my normal name, okay? My family would catch on instantly if you called me Haechan,"

"You're making this rule now?!"

A small pang of guilt hits Donghyuck, but he simply shrugs and opens his door, exiting his car with words you didn't quite catch. Donghyuck himself doesn't catch it, but that's practically irrelevant now.

He helps you out from the passenger's seat, before locking his car. The small beeps it makes cause the people inside his humble abode realize it's his car, it's him, arrived, with a girl. A girl they assume is his girlfriend, but who really isn't.

As you approach the door, the evil door to your doom, you can see a small shadow of footsteps by the ground, your nervousness and anticipation catching all in your throat you can barely breathe.

When the door opens, it reveals a little girl, a little over 9, smile bright, and you can't help but think she looks a lot like Donghyuck. With her sunkissed skin and smile so precious, she runs up to your classmate, before throwing herself into his arms.

"Hyuckie! I missed you so much!"

Donghyuck giggles along and jumps up and down in the air with her in his arms, looking incredibly alike it amazes you. "I missed you too, pretty girl!"

Oh, how cute.

The little girls squeals stops as she notices you smiling and watching them intently by his car, before she starts violently smacking at her brother's back with a surprised face.

"Oh my god, oh my god, oh my god, is that her?!"

For a second there, for a mere second, you're scared, terrified, nervous of what her first impression of you is. Though, it completely washes away once you see the little girl's smile widen, if it was even possible, and gape at you with sparkling eyes.

Just a second later, when you raise your hand to wave at her, her smile falls and it's like her face has become a tomato. The little girl ends up shying away from your gaze, hiding into Donghyuck's chest.

You simply laugh at how adorable she seemed, so very enthusiastic but instantly shy just a second later. You wonder how long it would take you to get close to her.

"Hey- Minnie, what's wrong? I thought you wanted to her? Are you scared? Does she scare you?"

You can't help but chuckle at the way Donghyuck calls you scary, and apparently, neither can his little sister. She giggles and shakes her head, shying away once again when she glances your way.

"So," you mumble, breaking their small conversation, "how long are we gonna be here?"

"Uh," Donghyuck checks his phone, as he stands up with his little sister in his other arm. You can't help but stare right at her in adoration as she tries not to stare back at you. "until 6, that's what mom says,"

Your fake boyfriend slips his phone back into his back pocket, before turning back to Sungmin, his sister, if you remember correctly. You can't really remember when your nerves where taking over you. Or when Donghyuck goes on and on about his family. It didn't help with your nerves at all.

"Are you ready to have the best time ever?"

The little girl throws her hands up with a big smile, "Heck yeah!!!"

You've never had a little sister, or brother, no younger sibling. You were the youngest. Your older sister and brother are fairly busy with work, and now that you watch Donghyuck and his sister, you think of meeting back up with them sometime.

You want to talk to Sungmin, or Minnie, as she liked being called, but you don't think you can. With her being so shy in front of you, and with you being ever so shy and awkward as well, you don't think you're gonna talk that much.

And you think that says a lot because she's Lee Donghyuck's sister for fucks sake. The moment she opened her mouth you were surprised with how much she loved to chat. Much like her brother.

After 30 minutes, you learn that she's very productive, academically thriving, and very sociable. The childhood you've always wanted. Donghyuck's parents know how to raise a child alright.

It's not until 40 minutes into babysitting, when Donghyuck excuses himself to go to the bathroom, when Sungmin finally approaches you.

Your heart swells as she shuffles shyly next to you, her eyes fliting to you ever so often.

"D-do you want something to drink?"

Manners, you love it.

"Sure! Do you want a drink too? How about we go get those drinks together?"

It takes all your confidence to actually invite her into a conversation, but you're so very glad you do, because one moment she's not even looking at you, and the next she's beaming up at you and nodding enthusiastically.

With your hand in hers, Sungmin leads you to the kitchen, excitedly giggling as she goes straight to the cupboard to get a few cups. She thankfully acknowledges her own brother, bringing out 3 cups, as you take out the apple juice sitting in the fridge.

And while you pour the juices into the cups, you glance at the girl next to you, who waits patiently for you to finish filling up each cup. You pass her a cup, grabbing one for yourself.

"So, Minnie," You almost feel giddy calling her by her nickname, such a cute nickname. "what are your hobbies?"

Minnie gulps the last of her apple juice, before placing her cup on the counter and wiping politely at her lips, "I like to sing!"

The enthusiasm that she radiates makes you equally as excited when talking to her, her previously quiet voice now exclaiming, filling you with joy.

"Oh, and I like to take pictures. Mom gave me this camera for my birthday and ever since I've been taking pictures of everything,"

She then lists all the things she's seen and taken a picture of, going from little bugs, to animals, to the little details she finds in her home. It's amazing how passionate she is about it, and you take a mental note to ask to see her pictures one day.

You can listen to her hours on end, nonstop, because she's just too precious not to stop. A few moments later, you find your chin on your palm with an adoring smile on your face.

Once Sungmin is finished with her passionate rant about her camera, with her head held high in the air with pride, she blinks up at you. Once, twice, thrice, and you wonder what's got her like that.

"You're really pretty,"

One moment your head is on your palms, the next it's slipping and banging against the counter. As instinct, you slap your hand on your forehead, which, expectedly, brings more pain. "Ouch..."

You have to say though, it was worth slipping your head and eating shit, because Sungmin is now laughing the most you've seen her laugh, the most happy she's been since you came.

Albeit that, she still slaps a hand to her mouth just a few moments later, a look of terror flooding through her face. It worries you for a hot second before she breaks into a smile.

You soon realize, as you look over your shoulder, that Donghyuck stands there, his hands on his hips as he looks sternly at Sungmin. The exact same smile breaks his pursed lips, and you truly think they are twins of different age.

"Mom's on the phone and wants to talk to you, Minnie," Donghyuck gestures to the living room, where the home phone stays. Sungmin instantly dashes to the living room with fast scurries, and quiet snickers.

"So," Your attention adverts from the running girl, to her brother, who approaches you and takes the glass of apple juice. "I'm assuming you get along?"

You pick up your own glass of apple juice, nodding as you rub at the pain on your forehead. You know it's bound to bruise.

"She's full of passion. And she's a lot like you," You say in between sips. "just a little less of a riot."

Donghyuck accepts. If anything, he thinks the same thing.

Just as you put down your cold cup of apple juice, Donghyuck notices the small amount of juice by the corner of your lips.

"Anyways-" your words, they seem to flush down your throat, and hitch right back up. All because of the way Donghyuck wipes at the left over apple juice by your lip.

Donghyuck thinks nothing of it. Not when he's already trudging out the kitchen and beckoning you to do the same with Sungmin yells about wanting to watch a Christmas movie.

You don't feel like thinking anything of it, you don't want to.

But your heart beats in your ears and flips.

Strange.

iii. day 5.

So far, you have to say things are going uphill, unlike you expected. You had met the rest of Donghyuck's family last night when they came back home, and you were surprised at how easygoing they were. They liked you, and you find that surprising. They even asked you to stay a few more hours.

To say you were shocked was an understatement, you were positive you were gonna get caught. Even Donghyuck was surprised at how happy they when they met you.

Donghyuck was right, you were someone they enjoyed being around and they were people you loved spending time with.

You wonder if his family was with close to his past lovers.

Donghyuck is fairly good at doing his part of the job, pretending to be your beloved boyfriend in front of his family, and driving you to places. You requested to go get tacos before going home yesterday. It was nice.

And he even got up early in the morning today just to drive you to the library because Han Jisung couldn't do his morning shift today. Something about Felix Lee breaking his favorite air fryer.

So here you are, in the quiet library once again, picking up the few mythical books a few middle schoolers had left on the tables. Donghyuck chose to stay too, instead of whatever he does in the morning, claiming he also had to do his other part of the deal.

Ms. Lee is much more delighted now. Or biased. Or maybe just desperate for volunteers.

You're still on the shit nonetheless, storing books back to their rightful places yet once again. It gets boring once in a while, but you occasionally see books you haven't seen in months, or a new one. Not that you would read them, it's just nice to see people reading different books.

Just as you place the next romance novels back to their places, it gets pushed and knocks over instantly, falling to your feet. It's a very familiar scene, and becomes even more vivid when you look up to see Donghyuck peeking through the hole.

"Why do you always do that?"

"That was only the second time, Y/n,"

You crouch down to grab the book once again, and lift it back up to position it over the space. "Why do I have the feeling you're gonna do it again?"

Donghyuck's face disappears, and so you replace it with the book, before you hear him trudge back to your side of the shelves. "Uh so," He starts, picking up a book from the cart. He flips through the book's pages mindlessly, playing around with it almost nervously.

"My sister really likes you, and wants you to stay over for a while."

That was quick, and so very unexpected.

"Why do you always do these things out of pocket?" You ask. Like day one, when he suddenly held you hand and 'spread the word'. Or in the diner, saying you had to babysit Sungmin with him. Always surprising.

At least he's never boring, right?

"You have a lot of questions."

"You're just very confusing, Haechan."

That name, it's weird to say it. You spent all day yesterday calling him 'Donghyuck' and 'Hyuck', Haechan is almost unfamiliar.

"So, you're okay with it?"

You shrug, "I mean it's what I'm supposed to do, right? Act like your girlfriend. I pulled it off last night, I'm pretty sure I can do it again,"

However, you aren't so sure just hours later. In Donghyuck's car once again. You left right away, seeming as Minnie really wanted you to come over so she could show you her photo collection.

She fell asleep before she could remember yesterday, so hearing the news of you coming over, she got very excited.

"Holy fuck I was wrong. I'm not sure, Haechan, I'm not sure!"

"Remember," Your fake boyfriend says as he pulls up in front of the house. He unbuckles his seatbelt, before he faces you. His gaze is stern, and you're sure he's about to reassure you.

But alas, he is Lee Donghyuck. "Donghyuck, Hyuck, or some petname."

What were you expecting, anyways?

It managed to calm you nerves a little, neutralize them with some annoyance, but it seems to all pile back up as you stand in front of the frightening door of Donghyuck's house once again.

His arm slides around your waist, and you can feel the warmth seeping through the fabric of your shirt and leave goosebumps along your skin. It's a bit reassuring to you for a moment, warm and firm, before you remember that it's just an act.

Before you know it, the door has swung open and appears Sungmin with a oversized blue apron hanging from her shoulders.

The moment she realizes it's you at the door, her smile grows and eyes seem to have all the stars in the skies caught in her eyes. Your nerves melt, and so does your heart, and if it were possible, you would've melted right there as well.

"Mom, they're here!" But instead, Sungmin reaches out instantly and tugs you into the house, completely ignoring her own brother, who stands dumbfounded by the door. "And just in time, too!"

When you enter the living room, the aroma of sweet baked goods fills the air. You sit down and decide to settle down on the couch as Sungmin had instructed, smiling warmly at the drastic change from shy to hyped in just a night.

Donghyuck walks into the kitchen, greeting loudly, and a smile is stretched on Mrs. Lee's face instantly, as she turns around to grab her son's face to place a lingering peck on his cheek. You smile at the sight.

He then walks into the living room, catching sight of you on the couch, where Sungmin had pushed you on. He trudges right to you and sits by your side, arm slinging around your shoulders.

At this particular action, you grow surprised. And as Donghyuck's mother joins you lot in front of the TV, you realize. You realize that it's not just Sungmin, the 9 year old, but it's his mother and grandmother too.

You'd have to act much more... lovey dovey to actually fool them.

It's almost embarrassing to act like so with Donghyuck, but the way he's moving so calmly and expertly, you like to think you're a good job at fooling them.

It's almost embarrassing to act like so with Donghyuck, but the way he's moving so calmly and expertly, you like to think you're doing a good job at fooling them. At one point Donghyuck placed a quick peck on your forehead before dashing to get a cup of water, and you really hope you didn’t look too affected by it.

Fortunately, Sungmin was too ecstatic to show you her photo collection to even notice. She's filled the previously empty spot that was reserved for Donghyuck with herself, her photo journal on his lap.

"This was when we went to the beach, there were a lot of crabs around. There was one with a pretty shell so dad brought it home, we didn't know where was a crab inside until we got home, so we named him frankie."

Usually, when you hears the adventures of your friends, you would grow jealous and a bit sad that you didn't get to come. But when it was Sungmin telling the stories and pointing at the pictures she took, it was like you were on the trip as well. It's probably her great photography skills.

"And we found so many sea urchins on the island too! Hyuckie almost got stung by one,"

"Okay, first of all," Your head instantly whips to the left, where Donghyuck stands there with his hands on his hips. Funny, it's like every time you were with Sungmin he'd be lurking around the corner with his hands glued to his hips.

He raises a hand to the air, pointing sternly at Sungmin, "The tide was strong. I could barely run away from it. And second, you're in my seat."

Sungmin's lips pull to a frown, and she slumps in the seat as if it were hers forever, "I want to sit next to Y/n!"

"She's my girlfriend, Minnie."

"She's my new best friend!"

"Yeah! I’m her new best friend!"

Donghyuck shifts his gaze from his sister to you, betrayal laced in his eyes, “Babe!"

Donghyuck's future girlfriend sure is lucky, because how often do you grow so close with your significant other's family? How often is it that your significant other's sister is so comfortable with you after meeting you? How often is it that their parents don't even hesitate to make you feel like home and practically adore you more than their own child?

Day 5 and you're already jealous of Donghyuck's future girlfriend.

iv. day 7.

It might be the way you're already so used to Donghyuck asking you to come after just after 2 days, or how you're already getting ready the moment he walks through the diner entrance, but Donghyuck feels a bit peachy about it.

Very peachy, actually, because he never uses the word peachy.

Your deal has been going pretty smoothly for the past week, he'd help out in the library, drive you to the diner, and back to your place, and it's not like his company is bad either. He has good music taste, there's not a moment in his car where you're not bopping or singing along.

Donghyuck also has a nice voice, you notice, incredible vocals.

You've been hanging out with Donghyuck's family everyday so far, you picked up his grandmother from her house so she could spend time with her grandchildren (plus you, of course).

And Donghyuck's family is so fun, and genuine, and you don't know how they're so easy going, you think it's in the blood or something.

Donghyuck pulls up in front of the front porch of his house, unbuckling his seatbelt. He turns to look at you, and to his utter surprise you're not jittering and running your mouth about how nervous you feel.

Instead, you're getting your stuff and fixing your hair, a relaxed smile on your lips.

As if you can feel Donghyuck's stare, you turn to look at him, with an amused smirk on his face.

"What?"

"Nothing," Donghyuck chuckles with a shake of his head, "you're not nervous anymore?"

You shrug with a smile, opening your door, "Not when I'm with you, baby!"

For some apparent reason, Donghyuck's heart jumps. Jump so suddenly that his breath hitches in his throat and he almost feels lightheaded.

Woah, when did a simple petname get him so worked up?

Was it even the petname? Or the way you're already so used to being with him and his family? Donghyuck doesn't know, but he knows for a fact that he has to take a few moments to calm down.

However, he doesn't really get to calm down when he exits his car, because before him is the sight of his little siter jumping into your arms, and swinging around as you spin with her in your hold.

And the thumping of his heart doesn't seem to slow down when you call out his name and reach your hand out for him to hold.

When Donghyuck finds his lips pursing and his gaze very shyly staying on you as you light up and greet his family, and his fingers squeezing yours unintentionally, he knows he's screwed. For sure.

No, no, that's total baloney! He wasn't even feeling like this for the past week, why is he feeling like this now? He can't lie to himself, at least not his heart that thumps in his ears. No, they are the worst a lying.

They seem to get at least 10 times faster, 10 times louder, when he raises his arm for you to sit next to him, and you flop down and squeeze to his side instantly, all while you argue with Sungmin that there is one butt, and two cheeks.

"Nuh-uh! Captain Jaemin told me it was two butts!"

Who even listens to their scout mentor?

"Then Captain Jaemin was mistaken! It's clearly one butt, right Hyuck?"

It was, after all, Donghyuck's fault the argument had started in the first place, after mumbling how his 'one butt' hurt after falling on his ass.

But surprisingly, Donghyuck doesn't look all too well, not at all immersed in the argument as he usually would be. Instead, he's staring at you with wide eyes, lips still pursed very awkwardly.

He might just look absolutely adorable.

"W-wha..."

Both you and Sungmin stare at him weirdly, slight worry covering your gazes. It scares him how alike the two of you are.

"Hey, you feeling okay?" No, not really. With your hands pressing against his face, squishing his cheeks? His lips are gone form their awkward line, instead pressed outwards, so very close to your own face. Just one lean, and he could kiss-

Donghyuck pulls away abruptly, hands grabbing yours and taking them away from his face. Now that's super strange.

He stuttered, and became embarrassed? Did you perhaps break Lee Donghyuck?

Most likely, Donghyuck thinks, because his mind, his heart, his whole body isn't working as it usually should. He's not chatting the day away, or teasing the shit out of you, he doesn't think he can come to do it.

The last time he felt like this was 10th grade, when he had a crush on—

And then it hits him.

He has a crush on you?!

Your fake boyfriend stands up very quickly, letting go of your hands quickly, before he walks off without even looking at you, "I need to go to the bathroom!"

As he slams the door to the bathroom, Sungmin huffs out in confusion, turning back to her grandmother, "He hasn't been like this since the... tenth grade.... huh."

For a 9 year old, Sungmin sure is super observative. Bright smile and bright eyes set on you and all, observing your genuinely worried gaze on the bathroom door. It's right under your noses, fools!

v. night 7.

No no no no, this isn't good. This is not good. He can't have feelings for you! That's kind of ironic, because he's the one who asked to fake it. And he's the one falling just a week later? What is he gonna do? He'd never had a crush this bad since the tenth grade! That was years ago! What's he supposed to do now, confess?

So much for more natural when realizing feelings. This is the most unnatural he's felt in literally forever. Especially when he's in his own house, with his own family, that's not something to be unnatural about.

And just as he expected, Sungmin is onto him and has his grandmother right on his track as well.

Why would he act so uncomfortable and such around you? You're already dating, so there has to be something you're not telling them.

But alas, they can't follow him around all day. Both Minnie, and grandma have a bed time.

Unlucky for Donghyuck, you stayed over, with some convincing (read: bribing with ice cream) of getting Ryujin from your dorm to drop off a duffle bag with your clothes, you're set just for a night.

You thought it would be fun, spending time with your 'boyfriend' and his family, it was a night evening indeed.

But something just won't let you sleep. Was it the couch? No, you've fallen asleep countless of times while watching a Harry Potter movie, and it can't be the ticking of the clock, you've mastered blurring that out years ago when you had exams.

What was making you so restless?

(not so) Coincidentally, Donghyuck can't seem to sleep either. For very obvious reasons, of course.

He decides to clear his head a little, choosing to go to the kitchen and maybe have a little snack. Worked every time back in high school when he had mental breakdowns every 5 seconds.

What he didn't want was to see you in the kitchen, chugging a glass of water.

Donghyuck panics, though he doesn't show it, he's screaming in the inside and already turning to walk away. However, you notice him before he's able to.

"Oh, hi Haechan,"

His heart leaps. Now it isn't even just nicknames that shake his heartstrings, it's just anything you call him. When did this even start?!

"H-hey."

That's all you say. The only thing you do is greet him, pat him by the back, and exit the kitchen.

A small urge causes Donghyuck's arm to jump up, and wrap around your stomach, before he's dragging you back in front of him. He's inches away from you, you can see and point out every little detail about him, like the mole near his eye you never noticed he had.

And Donghyuck can see so much more of you up close, your eyelashes that brush against your skin with every slow, sleepy blink. And how your lips are just a tiny bit puffier than usual, or your skin he ought to caress, perhaps even kiss.

Before he can even do too much, Donghyuck quickly steps away, instead wrapping his fingers around your wrist so you don't go back to the living room.

"I-I, uh,"

Quick, think of something!

"You want a few midnight snacks with me?"

And minutes later, you find yourself on the floor, an ice cream sandwich in your hands. It was Donghyuck's specialty, as he claimed.

"Alright," Donghyuck says as he slides next to you on the floor, his own ice cream sandwich in his hands. It's not that special, or complicated, just a huge bunch of ice cream slapped between 2 slices or bread. But it had love, another thing Donghyuck claimed for it to posses. "you ready?"

"I was born ready." You say as you yawn. Perhaps the sight caused yet another jump at Donghyuck's heart.

Donghyuck takes a bite first, a big one, into the ice cream sandwich. He doesn’t have much of a reaction, just a close of his eyes and wipe at the corner of his lips. One glance to you, and you follow along, taking a big bite as well.

It’s not all that amazing, or extravagant, but you do have to say, it’s very delicious.

It’s enough for you to take another bite, and another, and another, until you’re halfway through the sandwich.

“Is good?” Donghyuck mumbles through a mouthful of ice cream. You reply simply with a nod and a hum, finding your mouth too full to properly respond with actual words. A smile graces itself on Donghyuck’s face at your response, happy to hear that you like it. Okay, maybe you looked funny (read: cute) with your filled cheeks.

He finds you even more adorable when you wince, fanning your mouth with a sour expression. “Ah! C-cold!”

Very cute. Who fans their mouth when it’s cold?

Donghyuck can’t help but chuckle at you, and you can’t help but glare at him when he does. He laughs even more at your glare on him, finding you very funny with your puffy cheeks and narrowed eyes.

And frankly, he doesn’t look too bad in such dim lighting. The only source of light is the small lava lamp on the corner of the kitchen counter, one of Minnie’s science projects, you assume.

FInally, when the cold numbness of your lips and mouth is gone, you elbow Donghyuck’s side, the corner of your lips curling down very visibly. “I was in pain! Your girlfriend is in pain, and you laugh at her?!”

Donghyuck can’t count how many times you’ve made his heart skip today. There goes another skip.

He knows, you know, that nobody is around, it’s the dead of night, nobody would be awake, and yet, you don’t put the ‘fake’ label.

You should, you really should, or Donghyuck might just believe it and do things he would regret in the future.

Things like staring at you so genuinely that you are fooled at it as well, and grab your hand when you slap his leg again, or pull you closer to stop you.

Man, he’s done all those things. He’s screwed for sure.

You’re all too close, for the second time tonight. Donghyuck finds more things then he did before, every single little detail about you, the surprise laced in your gaze when he stares intently at you, your mouth agape in such shock, and hey, even the ice cream stuck to the corner of your lips.

The ice cream stuck to your… lips. Your lips that Donghyuck keeps his gaze on, your lips that he gets closer to, your lips that seem so alluring to him.

You don’t know what Donghyuck is doing, and frankly, you don’t really care. You’re shocked, so very shocked, but at the same time… you’re not so shocked. There’s another emotion surging through your body. It’s very effective, causing your heart to beat so much faster, your hand freezing at the touch he leaves on it. It’s a little bit…. Happy? Why are you feeling happy? This is no time to feel anything but sleepiness and full. Not full of happiness!

And strangely, you don’t feel all that bad when Donghyuck lenas closer to you, you don’t feel anything but the urge to lean in as well, and close your eyes, and have the urge to feel his lips brushing against yours.

As much as you wanted it, the moment they press against yours, it feels so unfamiliar, so foreign. It’s a new place you are unaware of, tasting like ice cream with the slight scent of pine. It’s a new place you want to explore.

Darn Donghyuck and his perfume collection, making you feel all sorts of ways.

For a hot moment there your mind is gone, completely oblivious to the fact that this is all supposed to be fake. All just an act in front of his family. Well, here you are, kissing in his kitchen with nobody around.

His lips are soft, so incredibly soft, and gentle, as they caress against yours. They fit almost perfectly between yours, and floods an urge for more.

Donghyuck’s ice cream sandwich is abandoned, on his lap, his hands finding their places on your jaw instead. Fingertips slightly cold from the treat, but they still hold a small amount of warmth that is pulling you in, feeling like sun rays on a nice sunny day.

Who would have thought kissing Lee Donghyuck would’ve been so nice?

And who would’ve thought the both of you would catch the tiniest bit (read: a whole lot) of feelings before day 14?

vi. day 8.

Oh how Sungmin enjoyed this. It’s been a while since she’s seen this sight.

Who wouldn’t love the idea of seeing their brother all jittery and flustered every 2 minutes? And just because of a little crush!

Sungmin approves, she very much approves. You’re a nice person, she possibly loves you and how caring and nice and pretty and funny and kind hearted you are. Maybe that's just in her eyes, but that’s not the point.

The point is how Donghyuck sees you with his eyes. Sungmin suspects with flying hearts all around you and an illuminating light from behind you, because he sure acts like he sees every good thing in the world when he sees you.

Apparently, you’re not too good at faking a relationship and acting. At least, not after that night. Sungmin knows there’s something between you two, she knows it’s not a real relationship. If it was, then Donghyuck wouldn’t be acting so unnatural and aware of his surroundings in his own house.

And he would definitely not be avoiding any question or mention of your relationship.

“Hyuckie you’re being very weird.”

“Yeah? Well, you’re weird too, Minnie.” Donghyuck shoots back childishly at his sister. It’s ridiculous to counter back with such a witty comment to a literal 9 year old. And he looks even more ridiculous with pancakes shoved in his mouth, as he spins on one of the high chairs.

Sungmin decides to not push on her brother, for it would end up with an argument she would very much win and leave her brother all petty. Instead, she walks over to you, eating your own plate of pancakes next to Donghyuck’s dear grandmother while you two watch a TV show.

“Hi Y/n,” She says as she jumps next to you on the couch. Sungmin then reaches out to grab a pancake from your plate, bringing it up to her lips instantly. You don’t comment about it, not when Sungmin leans onto you and gets comfortable on your shoulder. It’s far too endearing to comment about. “Good morning,”

There’s a nice silence after that, only the clanking of dishes in the sink that Donghyuck chooses to wash, and the quiet dialogue of the people on the TV. You were so surprised when you found out Donghyuck’s grandmother enjoyed watching Dance Moms, but you see why she enjoys it. Dramatic mothers fighting and little girls wanting to be on top of a pyramid made of picture tapes to a mirror. Very entertaining.

“Do you know why Donghyuck is being so weird?”

The sudden question, and the very obvious answer sitting on your mind causes all your movement to stop. Yeah, you’d rather not tell a 9 year old that her brother is being weird because he kissed someone he wasn't supposed to.

“W-what?”

“I know there’s something going on, I can tell.”

The way the words flow out of Sungmin so naturally, as she eats her (your previous) pancake is honestly a bit intimidating to you.

Maybe you should tell her.

Wait, what?! No! Don’t tell your fake boyfriend’s little sister who, might you add, is 9! That’s a crazy idea!

“You’re very smart.”

God, why did you say that?!

“So, what is it, big sis?”

The urge to tell Sungmin is growing, with her big doe eyes, small anticipated smile, hell, how she called you big sis?!

“Sisters tell sisters everything, right sis?”

She’s clever, very clever.

Your chewing slows down, and at that point you can’t even look Sungmin straight in the eye. You look to your side instead, because you know if you even glanced at her anticipated expression, she’d notice the small curl of your lips, and you’d spill the beans instantly.

You’re shocked as you find not only is Sungmin looking at you with expectant eyes, but so is her grandmother, a slight smirk on her lips. Now she knows there’s something wrong. 14 days is not that long, and you’re spilling at day 8?

“Okay, fine.” You’re not that good at keeping lies, anyway. “But you can’t tell Donghyuck I told you, okay?”

You glance at Sungmin, and then her grandmother, “Both of you, please. He’d get so mad.”

“Mad, shmad!” Sungmin exclaims, slapping the rest of her pancake back on your plate. “You’re both acting so weird! What is it? Did you guys break a coffee table?!”

If that was here assumption, you wonder what her reaction to the real lie would be.

Extremely shocked, apparently, jaw dropping and eyes widening. Did she really think you broke a coffee table?

“You guys what?!”

“Shhh!” You instantly bring Sungmin closer to you and press a finger to your lips, shaking your head as you glance to the kitchen. Donghyuck hasn’t noticed, you’re definitely glad he doesn’t. Thank god he has Michael Jackson booming through the kitchen.

“Wha—why?! He could’ve just come without one!”

“I don’t know! He said something about a promise, or something??”

Sungmin grabs your hand placed on her shoulder, holding it with both her her small hands. In the span of a second, her shocked and upset face turns upside down, and she shakes your hand.

“Wait no, this is good!”

It is?

“It is!!” Sungmin’s certain it is. He’s finally found his true love.

Not really what’s going on with the both of you, but she’s still young so it’s understandable.

“He likes you! And I think you like him, too! You guys can date and he can fulfill his promise, this is so easy!”

No, not really. Again, she's still young, so she wouldn’t know the fear and immense anxiety that comes with conffesing. And problems it can cause. Gosh, how much easier it would be if you did what Sungmin said.

It would be great to date Donghyuck, but you don’t feel that way about him. No, last night was just a spur of the moment. Last night, where he made you an ice cream sandwich, a great ice cream sandwich. Last night, where he looked so good under the moonlight and streetlamp and fridge light. Last night where you very much wanted your lips to meet so badly. Last night where you caught feelings.

“Oh my god I do like him!”

You don’t hear Sungmin’s next words, you don’t hear anything. You frankly can’t focus on anything but your beloved fake boyfriend drying the plates. Dear god he looks extremely boyfriend material.

Donghyuck looks up, and catches your eyes. This obviously catches you off guard, but he remains calm, winking at you with a very exaggerated lip bite. Man, anything he does has you going crazy.

You’re screwed.

vii. day 10.

How long has it been since the last time Donghyuck’s seen you? 2 days, 10 hours, and 10 seconds. 11, now. That's what Donghyuck knows.

Strange, you’d usually be at the library or the diner you work at. Just where are you?

Donghyuck strolls back into the entrance of the library, hands on his hips with a very determined expression. He was planning to hang out with you as he worked on this one thing professor Kim assigned to do over break, but you’re nowhere to be found.

He could’ve just done it by himself, focused and ready to go, but strangely he thinks that he won’t be ready if he’s constantly thinking of you and where you might be.

But on the other hand, if you were with him he’d be nothing but staring at you, wondering what you’re thinking about. Overall, you’ll distract him. He’d feel a lot better if you were by his side, though.

He spots Renjun and his significant other, filming yet another library vlog. THis time, they’re reviewing old children’s books, pointing out each detail.

And just as Donghyuck’s about to go up to them and ask where you might be, you come right beside them, passing a few more old, dusty books with smiles. You then take the books they had previously reviewed, putting them in the cart to put them back into their respective places.

Donghyuck is shocked, and feels a pit growing in his stomach. Is it because they’re practically using you? Or maybe he was jealous of you spending time with them and not him. Either way, the feeling makes him decide to storm up to them very dramatically, stomping his worn out sneakers on the carpet.

“Hey, you!”

You’re even more surprised than he was before, you swear he was gonna sleep in until 1 pm like he usually does.

“Hyuck?”

Your wide, bright eyes staring up at him makes him almost physically melt right there on the spot, if it weren’t for Renjun saying the same thing.

“Are you forcing my girlfriend to work for you? You and your-your vlog??”

Wow, what a simp.

“No—”

“—Actually, Hyuck,” you interrupt before Renjun’s girlfriend could spit back any thing that would cause a petty little argument between them, reaching out to grab Donghyuck’s hm which is currently pointing at the camera set up on the desk. “I offered to help them, dumbo, if you’re pointing fingers, point at me!”

And if he’s looking ways or feeling things, it’s always gonna be you.

Donghyuck’s arm relaxes, flopping to his side as he pouts at you. “I’m not gonna point at you!”

“But you—”

“—No buts, Y/n! Come on, ditch Renjun for your dear boyfriend, won’t you?”

Well, how are you supposed to turn that down? Hands clasping yours, tightening ever so softly as he stares at you expectantly.

“Well, I wouldn’t mind”

“-Right! Thought so.” Donghyuck smiles almost instantly, reaching right up to his eyes. He looks nice. WIth his brown hoodie and messy hair, and a backpack slung over his shoulder. God, he looks really boyfriend material again. Can he stop being so boyfriend material?

“Bye Renjun and viewers! Come on babe,”

Donghyuck proceeds to drag you all the way to the other side of the library, a much more isolated area. You recognize the shelves as the very ones Donghyuck first asked you to fake date, with a simple game of truth or dare.

He decides to sit on the table right in front of the shelves, pulling his laptops out. You have nothing to do, but just stick with your fake boyfriend and simply accompany him.

You didn’t even bring your phone, you left if charging after you found you forgot to do so last night. Now your only source of entertainment is Donghyuick, and the many books around you.

As much as reading TINTIN comics sounds interesting, you find staring at Donghyuck much more entertaining, counting each omole over and over again. It doesn’t bore you, you don’t think it could ever bore you with how beautiful they look.

Donghyuck finds as he glances at you, that you are staring straight at him with your head in your palm. At first, his heart skips. It jumps around and back to its original spot, before he can actually stop it.

After recovering, he finally asks you, “What are you doing?”

“Watching you.”

“Why?”

You shrug, and lean back on your seat, ”I have nothing to do.”

Sudden guilt washes over Donghyuck as he realizes that he didn’t even think of what you would do except wait for him and accompany him, his stomach dropping just a little.

“Oh, right. You can go help Renjun if you want then,”

To Donghyuck’s surprise, you simply shake your head with a chuckle, “No, I’ll stay with you. I want to.”

Not only do your words cause his heart to stutter, but yours as well. You didn’t mean for it to come out that way, but in a way you kind of did.

“Right, okay,”

Though, just about 10 minutes after, you feel bored. Extremely bored. As much as staring at Donghyuck was entertaining before, it’s not too fun when you’ve been doing it for what seems like hours on end, you’ve been counting each one of his moles 8 times already.

Donghyuck doesn’t comment when you suddenly get up and head over to a bookshelf, and he doesn’t question why you’ve decided to sit on a bean bag instead of next to him. As long as you’re in sight he’ll be focusing.

It’s strange how he thought if you would be with him you’d be distracting him even if you weren’t even doing anything, and yet you’re here and he’s never been so focused when doing an assignment. Maybe it was your comforting presence, or the fact that he knows you’re here and not anywhere else. Or something. But he likes it. He should ask you to accompany him more in the future.

Around an hour later, Donghyuck finds his rough draft of his essay finished, and his body is very sore and stiff. Like really stiff. He stands up, starting to stretch his arms out. Just as he yawns, he also finds that he’s trying to find you.

And as he looks at your spot by the green bean bag you were on previously, he notices how the TINTIN comic is set to the side, and you’re sleeping peacefully on the bean bag. You look incredibly peaceful, so comfortable on the old bean bag, hugging your arms to your chest.

Just a second later, Donghyuck notices how you shiver, just for a mere moment, but he catches it nonetheless.

He then suddenly remembers of the blankets Mrs. Lee keeps by the librarian’s desk, for when she’s feeling extra chilly or one of the children asks for one. He decides to head there instantly, thinking of nothing but to get you some warmth. It’s the least he could do, after he dragged to accompany him.

Soon, Donghyuck finds a larger dinosaur print blanket among the smaller ones, before he takes it out of the cabinet of blankets to bring it over to you. As he ventures back to you, he finds that you have shifted on the bean bag, this time with your cheek completely pressed to the cushion, your lips slightly parted.

Wow, you look incredibly comfortable.

Opening and dusting off the blanket, Donghyuck flaps it over your body, and ever so carefully let's it settle over your legs and some of your arm. Despite it being the largest blanket from the cabinet, it’s still not big enough to fit you fully.

Donghyuck, the impulsive little menace he is, decides to whip off his hoodie, and to not be too much of a menace. If anything, quite the opposite. Instead of wearing it himself, he drapes his warm, thick hoodie over your arms, patting it straight.

Seeing you up close, all snug in your sleep, with his hoodie keeping you warm, it causes something to stir in Donghyuck. Something so foreign, but feels like home. Something he could fear, but instead, he welcomes it with a full heart. His full heart, full of love, for you.

Slowly, Donghyuck leans down, places a hand on your shoulder to steady himself, and presses the softest, most love filled kiss to your forehead.

Oh, how he wants to trail more along your cheeks and nose, how he longs to hear you laugh and tell him to stop like that one time he accidentally brushed his fingers by the bare skin of your back, how he wants you to feel how he's feeling right now.

He presses one last kiss to your cheek, before heading back to his seat to work. He’s cold, but who cares? When you look so snug, he already feels a rush of warmth surging through his body.

viii. night 10.

How are you supposed to react when you wake up with your fake boyfriend’s warm ass hoodie around you after you very vividly remember clearly not falling asleep with it? And a dino print blanket over your legs? How are you not supposed to physically melt into your spot when he says that you should use it for the rest of the day? How are you not supposed to be affected when he claims he’s not cold and still shivers just a second later? How??

Apparently, you can’t. According to the footage Renjun showed you.

God, you look stupid in love with your staring at Donghyuck with his hoodie clutched to your chest. And the way you physically almost gasp when he threads his fingers with yours. So stupid!

Now it’s all you can think of, even when Donghyuck and his parents left 2 hours ago to go somewhere, you couldn’t remember. Now you’re stuck here, at home, with Sungmin by your side, asking every 5 minutes about your crush on your fake boyfriend.

“So are you guys going to get married now?”

At this, you snort, shaking your head, “You know better, Minnie. We aren’t even dating!”

“Yeah,” Sungmin shrugs, “I do know better. But you guys should at least start dating, right?”

“Oh please, we don’t even know if Donghyuck likes me!”

Sungmin shifts in your arms, causing you to glance to yoru left to see what she’s up to. She looks up at you with the most deadpanned expression she’s ever had on, and that’s very deadpanned. There was a time her mother switched salt for sugar when making cookies, so this was very bad then.

“He gave you his hoodie. His favorite Michael Jackson hoodie. He likes you very much, Y/n!”

She does have a point. Michael Jackson is someone very special to him, and to carelessly give it to someone who was simply cold? Maybe he likes you a little.

“And he was so jealous when Renjun stole you away from him yesterday.”

Wait a minute, how did she know about that? Renjun is a careful, and quite the slow editor, so the video won’t be out for the next week.

“How do you know about that?”

Sungmin reaches out for another cookie from the cookie jar, the safe batch made with sugar, and note salt, and giggles at your very surprised tone, “I was there, dummy!”

“What, so you watched Donghyuck make me accompany him? And you saw me sleep?”

“And when he gave you the dino blanket and hoodie.” She adds on, “I was just in the children’s section, did you not notice me?”

“No?? I didn’t??”

Sungmin shrugs and laughs breathlessly, wiping at the crumbs at the corner of her lips, “Well, should I tell you about the kiss he left on your forehead when he gave you the blankets?”

Now that, you had no memory of. But just thinking of it has you jumping in surprise, turning to Sungmin in surprise. “He did what?!”

You bake him cookies, a few hours later, for some reason.

Apology cookies for using his beloved Michael Jackon hoodie? Or for falling asleep when you were supposed to be with him? You don’t know, but you want to apologize for some reason.

Maybe you didn’t even want to apologize, and you just wanted to make him cookies. If so, you wouldn’t admit it out loud.

Nonetheless, you have cookies ready, cooled on the cooling tray, ready to be eaten. And the last batch is finished right on time, just as Donghyuck’s car pulls up into the garage.

Your (unfortunately,) fake boyfriend walks through the doors, announcing a very dramatic greeting to nobody in particular, before he walks into the living room.

“Mom and dad asked me to drop them off at Jaemin’s mom’s house after shopping so it’s just me.”

Quickly, you take your plate of what you thought was your prettiest cookies onto a plate, holding it tight in your grasp nervously. This was so impulsive, random, and you don’t even know if the cookies taste the slightest bit good.

Donghyuck finds himself inhaling the beautiful scent of freshly baked goods, and he spins on his heel to head to the source of the gracious smell. He is very surprised at the sight of you moving a couple of cookies around on a plate, even more surprised when you stick the plate out towards him just a second later.

“S-sorry…?” You mumble through an awkward smile.

“For… what?”

“I mean,” you shake your head, shutting your eyes in hopes of erasing your embarrassment. “for using your kitchen ingredients?”

Not what you were sorry for, but you apologized, right?

“Sungmin wanted some cookies, so I made her some.” Lies, but Donghyuck buys it very easily, eyeing the plate full of cookies in your hands. “You could have some too, if you’d like. Maybe with some ice cream?”

God, why did you say that?! Now you’ve reminded you both of the night you kissed, and make yourself grow even more awkward.

“Or maybe not, ice cream, you know?”

You might think you’re being embarrassing, awkward, weird even. But to Donghyuck, you look absolutely stunning. Have you always looked so pretty up close? Perhaps it was the new expression on your face that he’s never seen before. Well, whatever it is, it's making him go crazy.

“Milk could work too, or some—”

The rest of your sentence hitches in your throat as Donghyuck pulls you forward, his grasp tight on your wrist, and his warm lips land on your cheek for just a mere second, before the sensation is gone.

“Ice cream would be great,” He mumbles with a chuckle, before he pulls you to the freezer.

If you could, you’d land a big kiss on his lips as he makes an ice cream cookie sandwich. But, you’re too immersed in how delicious the combination is to even bother to.

ix. day 11.

Three days left. You’re not so sure how to feel about it. Relieved? Disappointed? You’ve never felt so many feelings at once, and you’re scared of it, which adds yet another emotion in the pile of mixed ones. And for that, you want to beat Donghyuck up as he pulls you closer just as you say something about wanting to get up for a glass of water.

“Nooo, don’t leave!”

“Donghyuck, I don’t think I can even physically leave.” At least not with his arms and legs trapping you against him. Mentally, though, you don’t really want to. His presence is far too warm and comforting for you to want to leave, but your thirst for water is causing you to want to leave.

“Just for a second please, do you really want your girlfriend to die of thirst?!”

There you go again, calling yourself his girlfriend even if nobody is home. Donghyuck’s parents and Sungmin have gone out shopping for her birthday coming up soon, and apparently she didn’t want you to come. Something about surprising you with her pretty outfits. Or it could be something about getting with Donghyuck, and it could be confirmed as she threw a wink at you and finger guns as she closed the door behind her.

“Just a few more minutes please,”

You give in eventually. It’s not like you could actually get him to let go. And it’s not like you really wanted to let go either. You’ve gone longer without water, right? Exam week is a bitch when you forget to bring a water bottle with you to the library.

Donghyuck’s embrace is warm, you’re shocked at how warm it can be. His heartbeat is your favorite song, and the sight of him smiling lightly into his sleep is much better than your favorite movie. And the sensation of his fingers running lightly against your back feels almost heavenly, and you’re sure to combust of adoration when he pulls you closer and complains about it being cold despite the AC being off.

It feels all too real.

Just the thought of what you two are doing is fake, that it’s going to come to an end in just 2 days, is almost haunting to you. What’s going to happen to the both of you after this?

The question is itching in your throat, right on the tip of your tongue, but you can’t get yourself to say it. You were simply scared of what’s to come.

You should probably ask.

You’re about to ask. Your mouth is open, your heart ready for the response, and you sit up. But the moment you sit up, Donghyuck doesn’t even ask, and flops right on top of you.

“A few more minutes, I swear.”

And a few minutes later, your confidence has faded away, and all you can do is nervously play with Donghyuck’s hoodie strings.

x. day 12.

God, this feels surreal.

You wonder if you get to have another chance to be Donghyuck after this, friends or not. You don’t know if you can even be his friend after tomorrow. It would’ve been fine even if you had realized your feelings, but the kiss is messing with your head seriously.

Now what are you going to do? Go back to knowing Donghyuck as just the guy who sprayed half a can of cheese into Renjun’s nose? Possibly, but there would be no way Donghyuck would go back to knowing you as that one girl from Math who works at the library and diner.

It would take you at least like, what, 2 years to get over him? Last time you tried to get over a guy it took about 2 months, and that was just from a small crush you developed when Lee Felix was your project partner for 2 weeks. How are you supposed to face him after tomorrow?

You can’t. You know you can’t. At least without remembering the kiss every 2 minutes when he starts speaking and you start staring at his lips And his other habit where he traces out what he’s saying? He’s developed a habit of writing it on your knee after how often you would sit next to him the past 2 weeks. Man, just a little tap of his fingers on your knee and you are melting.

And that’s what you’re currently thinking, of how you could melt any second now with Donghyuck’s hand tapping against your knee. You stare at it as he talks to his sister, watching as he scribbles out words and crosses them out casually, a smile itching on your face.

You think he’s saying something to you, and you’re very certain he was, as he pats you knee and stands up, pushing at your cheek with his thumb. He tilts his head in a silly smile down at you, before he heads out the living room, leaving you to finally register what he just did.

“So, have you two ended this whole thing and started dating?”

Sungmin’s alarming words cuts through your thoughts, causing you to be brought back to the reality and realization that this all will be over so soon.

“I really should,”

“So- so you’re telling me you didn’t yesterday?! Even when I clearly hinted with my wink?!”

You really should have. Only a day away, and you’re too scared to ask, the consequences will definitely be worse this time.

Sungmin can very much sense the regret in your expressions. The worry between each crease of your eyebrow, the regret in your frown. She can even tell by how you’re sitting, awkwardly, with your hands on your lap, picking and peeling at the skin.

She sympathizes with you, but thinks you’re a real coward at the same time. The both of you. This was, after all, her brother’s fault. If he just came home and said he didn’t have a girlfriend, it would’ve been okay.

Sungmin leaves a bit later, warning you to make a move because she knows her brother won’t, just as he makes his way into his room.

“What was that about?”

“Girl stuff.” Sungmin shrugs, before skipping up the stairs, “Anyway, I’m gonna go nap”

Well, that’s strange. Minnie would usually want to sleep next to you, while watching National Geographic, what happened to that agenda?

Donghyuck fortunately doesn’t think anything about it, thinking it’s something about having a super secret tea party with cheddar bob the monkey plush and socks the teddy bear.

Instead, he takes his seat back next to you, bringing out his phone. He also doesn’t notice the stare you have set on him, nervous eyes shaking with every scroll he makes on his phone. How could he be so normal about this? Did he not mean all the things he did, after all? Why isn’t he one bit frustrated??

He is, he really is, he has been since day 10, but he’s suppressed it down for him to simply act like he doesn’t care. He cares a shit ton. What’s he supposed to do after you leave? Are you even gonna talk to him?

“Hyuck,” You call out softly. It’s warm, welcoming, but it still causes a rush of fear to run through his veins. Could this be it? The very conversation the both of you dread to have?

The word is on the tip of your tongue, so close to rolling off, so close to having everything sorted out. But just as you trail your eyes from his shirt, to hsi eyes, you’ve lost all senses. It’s ridiculous how speechless he makes you with just a glance, even funnier how much your body seems to react when his fingers brush against yours oh so faintly.

“I…”

This is it, the words are finally to come.

Donghyuck has sparkling attentive eyes, that seem to also ask for you to finally say the words, and you are going to, it’s finally going to leave your system, all the frustration.

How do we end this?

“What are you doing this evening?”

It slips away.

Those stupid words slip away. You just had a grip on it, it was just in your palms, before they fall through your fingers like sand.

“I’m… free. Why do you ask?” It seems as if he feels down at your question as well, his response not entirely seeming what he actually meant, what he actually wanted to say.

“Do you want to go out for some ice cream?”

You personally want to curse at whoever made ice cream, or ice cream sandwiches. You want to curse at them for making it taste so good, and for reminding you every single second of the day of the night you kissed Donghyuck.

Despite that, you find yourself sitting on a bench, in a park, with a tub of ice cream on your lap, and another tub on your fake boyfriend’s as well. He has the flavor of cookies and cream and strawberry, and you have a very cold tub of plain dark chocolate on your lap.

“You’re like Jeno,” Donghyuck comments as he lets his spoonful of ice cream melt on his tongue. It’s always a delightful sensation. “Boring.”

“Wow, thank you so much, Donghyuck. I feel truly loved.” You mutter, though there’s a smile that contrasts from your sour tone, smiling delightfully. Were you smiling at the ice cream, or Donghyuck?

The ice cream tastes strangely better than you remember it to be, sure chocolate has always been great, but it’s particularly sweeter and you can’t help but savor it. Donghyuck is like chocolate, he’s sweet, sweeter than you always knew he was, and you want to savor each moment with him.

“How do we end this?” Your voice is quiet, hesitant, shaky, and it tears Donghyuck apart. As much as he didn’t want the topic to come up, he had to clean up everything he did, he had to answer.

“Classes start by wednesday,” 2 days after day 14, you know this well. “and we’ll get busy by then. My family won’t notice, at least not with the both of us busy with school.”

“So that’s it?”

“Yeah, that’s it.”

Donghyuck gulps thickly, playing around with the soggy ice cream container in his hand, too afraid to look at you.

In the end, the chocolate is made from cacao, which makes it bitter, and it reminds you of how this relationship even came to be. It was fake. All the sweetness is nothing but hidden bitterness, but you can’t help but bask in it more and more, even when you know you shouldn’t.

As the sun sets, and your ice cream melts, you take in the second to last day of the sweet sensation of being able to be with Donghyuck, closing your eyes and memorizing his voice, his touch, his playful little jokes, and every habit he has. The more you want to remember it, the more it’ll be bitter later, and yet you keep your eyes shut, wishing for time to stop just for you and Donghyuck.

xi. day 13.

Half of day 13 was spent sleeping, for the both of you had gone back home to sleep at around 1 am after walking around the park and hanging by the playground. 1 pm was not a good time to wake up, you think, because it’s the time of lunch, and you haven’t even had breakfast. Not to mention how all you ate the night before was ice cream.

Fortunately, Sungmin had made both you and Donghyuck some scrambled eggs and ham, and woke you two up by sitting on top of you.

Why can’t your roommate be like her?

The moment Donghyuck got up to go wash his plate, Sungmin was replacing his spot in front of you, reaching over to pat your hand.

Your eyes are especially sleepy, droopy and blinking slowly, you almost look genuinely sad.

“So, did you finally do it? Are you two together now?”

You can’t bring yourself to tell her the truth, you can’t even bring yourself to actually acknowledge how it was the very last day of the whole act, before you go back to being friends and nothing more.

You can only imagine how frustrated she’d be if you actually told her.

Alas, you can’t lie to her. You watch with shame as her face falls, and as her face scrunches up in frustration. It’s a cute sight, but has so much more negative impact on your heart as she looks at your plate of breakfast she made, and mutters how she shouldn’t have put so much care into her cooking.

And she storms up the stairs, warning you to fix the whole situation one last time, or she’ll do it herself.

Just a moment later, Dongyuck comes back, yawning. Gosh, he looked incredibly fine in the morning.

“Where’s Sungmin?” He mumbles as he runs his fingers through his hair. You almost don’t reply with how distracted you are. Distracted by him, and Sungmin’s words.

You two are real cowards.

“Uh, another nap. I think.”

Donghyuck huffs out, looking up at the stairs, “She’s been napping a lot lately, you think she’s okay?”

Yeah, she’s definitely okay. Just really tired of your shit.

And honestly, so are you. Physically. You weren’t able to get any sleep last night, debating whether or not to go in the middle of the night and fix this whole mess. You pondered for about 3 hours, and instead of any progress, you got a mere 3 hours of sleep.

It seems like Donghyuck is just as tired as you, because the moment you’re laying on the couch, he’s climbing up on top of you and trapping you down. His hair is buried into your neck, tickling your collarbone, his breaths fanning gently against your shoulder.

You’ve done this a few times before, sure, but this time it’s a lot different. This could be the last time you’d even be sitting on this very couch, the couch you grew to love with each moment spent sitting on it. It’s when you first talked to Sungmin, and when you truly felt ten folds of love from Donghyuck’s family.

Your stomach twists, just as you twist a strand of Donghyuck’s hair between your fingers.

So after today, is he still gonna act like this? Hug you so? Hold your hand tightly?

You’ve been asking yourself this for days, the past week, even. Every time it would come up, you’d push it back down, ignore it, until it’s become something so big just sitting in the corner of your mind. So big that no matter how many times you try to ignore it, there’s always a reminder in every corner.

You can’t take it anymore, you really can’t.

“L-let’s talk.”

Donghyuck hums, he hums against your neck, you feel it vibrate through your neck, and you can’t help but feel giddy at the sensation. “About what? I thought it was nap time,”

How could he possibly be napping when it’s possibly the last day he could be with you? Did he really not care that much?

Your heart drops at the thought.

“I don’t think I can nap right now,” You blurt out.

Wow, what a way to start a conversation.

Donghyuck simply chuckles, and turns his head to look at you. The expression on his face is soft, endearing, so calm. You wished you could feel the same way he could.

“That’s strange,” He pouts, “you were the one who came to the couch first.”

The expressions on your face, however, are clearly differing from what you want. In contrast to his calm and collected face, your’s has worry written all over it, concern in every furrow of your eyebrows and uncertainty with every glance you give him.

Donghyuck’s face falters softly, you hate how carefully he observes you. It shows how genuinely caring he is for you and you hate it.

“You’re being weird, Y/n.”

His voice is worried, his previous mischievous intentions long gone and out the window. At this point, he’s peeled himself off you, sitting straight up on a couch cushion. You don’t think you can speak. Sungmin was right, you really are cowards.

Donghyuck’s hands shift from his side, to reach forward and take your hands in his, thumbs circling on yoru skin comfortingly, as if he wanted you to say it.

And that’s just the switch to make you speak.

"Okay—fine! The truth is I can't act anymore!"

You can see the shock that laces in Donghyuck’s actions. You would be shocked too, honestly, if he suddenly bursted like that.

His hands stop, freeze, no longer comforting you. He’s obviously very taken aback, his eyes are wide with shock, mouth parted slightly with nothing but mere air coming out.

He shakes his head, taking back his hands to plant them firmly on his lap, "But we were doing so well…"

Is that really what he thought about the whole thing? Just a stupid act you were doing so well in?

If it were physically possible, your heart would crack. And it really feels possible because with every second that goes by it seems to hurt more and more until it’s sure to be split completely in half. All in the palms of Lee fucking Donghyuck.

"Because I'm not even fucking faking any of it!”

Donghyuck’s breath catches in his throat.

“I hate how I genuinely like you, and everything about you! Like- like when I kiss your cheeks, at first it was weird and so—so—I can't even remember because now I love how your cheek is so soft and how you playfully tap on it for me to kiss and—and how it's so fucking warm! How can it be so warm?! Not to mention how there's always a tinge of strawberries and a scent of sunshine on your cheek and I know it's from the amount of time you spend outside playing with your sister—god, your family!"

You’ve started to choke up, there are tears crystallizing at the edges of your eyes, your face showing every emotion but happy. You have a wave of emotions swirling in you, pent up and all too stressing for you to keep in.

"I love them so much, I love how your sister is exactly like you, and she’s the little sister I never had! And your grandmother, she's so wise, the grandmother I've never had either. Your parents are so fucking nice and they're so happy that you found someone, and I'm happier that you give me the chance to feel like that someone!"

Like the night he made you the ice cream sandwich, and all the movie times where he’s held you oh so close, hell, just a few minutes ago when it felt like he meant all of it! You don’t even know if he means everything, but frankly you don’t want to know. He’s making it seem like he thinks it all just an act, and you just can’t take it. Not when he’s given you so much false hope.

"That kiss you gave me on that damned night,” You shake your head at the memory, not even bothering to look up at Donghyuck. You’re too afraid to.

A weak, almost sarcastic chuckle slips through your lips, just as you wipe the few tears that fall to your cheeks. “I have to really give it to you for that one. I really thought you had feelings too, and you must be so fucking good at acting, because one second it feels like you also genuinely love me and then the next you call this an act!"

You are unaware, completely oblivious to how he doesn’t want it to be an act. You completely miss every longing look Donghyuck gives you, how his hands twitch with the urge to reach out and just take you in his arms, to hold you and embrace you like you were always meant to be there.

His fingers twitch, hand flinching up as you stand up from the couch, the pain on your face tugging and playing at his heartstrings.

"Please, Donghyuck, let's just call this off. Make your parents happy—make yourself happy by bringing the real one home. You don't have to keep this up if you don't really want it. Goodbye, Haechan." For a moment there, you almost say his name. You want to, but you won't let yourself.

If only you had given him the chance to say anything. If only Donghyuck had the guts to interrupt you and prove you wrong, if only you weren’t such fucking cowards towards love.

"I'll see you on monday."

There, in his living room, Donghyuck desperately watches as you walk out the door, with his broken heart in your grasp and your broken pieces just within his reach as well. He suddenly hates it, he hates the living room, he hates his own room, where you would oh so casually nap on his bed and flip through his favorite spiderman comics and admire his Michael Jackson poster. He hates ice cream sandwiches, he hates his damned hoodie he had given you in the library.

He hates himself for being afraid. Of both love, and you.

xxi.

Donghyuck doesn’t even go anywhere that would remind him of you, he doesn’t want to. He’s been sleeping back at his dorm with the rest of his roommates, isolating himself in his room, thinking of every moment that led to yoru supposed ‘break up’.

HIs roommates each tried to cheer him up, thinking it was an actual breakup. Somehow, the fact that it wasn’t even real hurt him even more. He was expecting this, why did it still hurt?

Even Renjun tried to cheer him up, but just the sight of the camera in his hands reminds him of the day you wanted to help them with a video. That day was probably the day he fell completely in love. He doesn’t want his Michael Jackson hoodie back. Strangely, you don’t want it either.

Even if Donghyuck was away from home, he didn’t feel like it. You can take the man out of the home, but not the home out of the man. Mainly because Sungmin and their grandmother wanted to come see what his dorm looks like. Minnie especially likes Jaemin’s bed, full of plushies.

Donghyuck sighs and watches as his little sister starts jumping up and down his bed, ignoring the growing pain at the back of his head when the bounces of his little sister cause his head to clash with the headboard of his bed. Instead, he relishes the sound of her laughter, the sight of her smile, just before she’s gone and he doesn’t get to see her for how many weeks. Even if he wasn’t happy, that doesn’t mean his sister has to either.

“Where’s Y/n?” She suddenly blurts as she crawls next to her brother and sprawls herself over his legs. Donghyuck almost doesn’t have the heart to break it to her that you’ve broken up, her breathless giggles holding and tugging gently on his heart.

“Well,” He mumbles, tucking the messy strands of hairs behind her ear, “I don’t particularly think we’ll be seeing her…”

“What? Why not?” Sungmin sits up with a frown curling her lips down. It’s not like her usual pout when their parents refuse to get her the apple juice she wants, but it’s a lot more worried, which Donghyuck didn’t even know she could really feel.

“Well… we broke up.” There’s no other better way to tell her than that.

Though, she looks pretty perplexed, scratching her head and messing up the hair Donghyuck thought he already fixed. “I thought you guys were finally dating after that night.”

“What? Minnie, we have been dating since the beginning.”

To his utter surprise, Sungmin shakes her head, “No, no you weren’t,” she pokes at the lint on Donghyuck’s sweatpants, “you still had the deal and all.”

Confusion, frustration, shock, a whole wave of emotions hits Donghyuck, and before he knows it, he’s speaking a lot louder than before, “What?! You knew about the deal?!”

“Y-yeah. And by the way, you should really get it together and ask her out. Before I do it for you.”

Donghyuck is speechless. Has no words. His mouth is hung open with wide eyes staring at his 9 year old sister who seemed to catch onto his scheme and had found out. He won’t ask how. All he wants to ask is how you think of the relationship.

Clearly, from what you said on day thirteen, is that you clearly like him, and his family. Well, he loves you, and its pretty clear how his family adores you too, so why didn’t he stop you on that day? These are the words his sister tell him in the moment, that only echo in his mind and rack around until he’s completely registered it.

“Minnie, I have to do something.”

“I’ve been wanting that for the past two weeks, Hyuckie!”

“Wait here until mom and dad pick you up, okay?”

Just like Donghyuck, his Michael Jackson hoodie is really putting you off as well. It’s in the far corner of your bedroom, hanging limp by your chair. It’s been there for the past week you haven’t seen him, although you do occasionally feel the urge to bring it with you during class. Classes start just as the fourteenth day of fake dating ended, and you don’t have the urge to study and focus in class that much.

The black hoodie hanging just by the arm of your chair stirs something in you. Melancholy? Nostalgia? The feeling you had when you arrived at your dorm right after breaking up with Donghyuck? All of those, probably.

A ring resonates through the quiet atmosphere, and you turn, to find that someone had sent you a text.

Ms. Lee of the library: Hi Y/n, sorry to bother, but could you swing by the Library today? Jaemin has an exam and couldn’t be on duty.

You: Hey Ms. Lee! Yeah, I’ll swing by. I’ll be there soon :)

To be frank, you really don’t want to. One, you’re feeling extremely unproductive today, two, Ms. Lee is going to dump all the responsibilities on you again, and three, well, Donghyuck.

For the next 15 minutes, you stay in your bed, feeling like shit just at the thought of having to get up and walk all the way to the library. It was a mere 5 minute walk, but you were in no mood to even get up today.

Finally, you miraculously find the energy to sit up, which you find is almost impossible. Alas, if you didn’t get up, then Ms. Lee would probably call you as many times as she can until you walk into the library doors.

Mind occupied with nothing but hurrying, and packing your tote bag as quickly as you can, you reach out for the first thing you can find to throw over your pajamas, hoping it would be enough to hide the evidence of your laziness. And before you know it, you’re dashing out the door, sprinting to the library.

Finally going out and having some sunlight is actually really refreshing, you realize, just the sight of flowers in the beds of your neighbors, and the feeling of the soft wind blowing on your skin felt better than you had remembered, it really brightens your mood.

And the doors to the library don’t look as dreadful as you swore they always were. Ms. Lee, however, was.

The moment she sees you near her desk, her nagging surrounds you, comments on how you’ve left her old self to work all alone once again. Strangely, you find it quite endearing. What has gotten into you? A few days in bed, and you see the world so differently.

Soon, you get back to your usual tasks, organizing books, putting them back in their places, helping out students with finding their required books, it’s not the greatest feeling, but it’s loads better than staying in bed for who knows how long and dreading over a breakup (that wasn’t even real).

Speaking of breakups, the very person you had broken up with is within the same room as you, much to your obliviousness. Donghyuck is running left to right looking for you after asking Ms. Lee if you had come in today.

Lucky for him, this was the first day you clocked into work.

Just as you push in another book about dinosaurs, and attempt to move to another shelf, the book falls out the moment you turn.

Shocked, you stare at the book on the floor, the situation feeling all too familiar.

"What the fuck—"

"—Oh hey,"

What’s also extremely familiar, is the pair of eyes you look into when you peek into the gap where the book was supposed to be, your heart rate picking up just as fast as Donghyuck as he rushes to your side of the shelf when he’s realized it’s you.

You feel a whole storm of emotions in you, it’s got your words stopping at your throat, breath hitching along with them, and not to mention your heart going batshit crazy.

However, as your eyes automatically shoot down to avoid eye contact, and you see the dinosaur textbook you had dropped, you only feel one emotion.

"Why the fuck do you keep doing that?"

This was clearly not what Donghyuck expected, and not what you had planned either. It came out automatically the moment you saw the book on the ground.

Donghyuck clears his throat awkwardly after you had picked up the book and put it back on the shelf, shifting his eyes to the side when you look at him.

He pictured himself here, doing this, but now that he’s actually doing it, he really doesn’t know how to start.

He decides simple, "I-I have to tell you something,"

You don’t want simple. You’re not so sure about what exactly it is that you want, but it surely can’t be this easy. "Why are you here? Do you even still work here??"

"I'm sorry."

"What the fuck?"

"You ask a lot of questions,"

"Yeah well, you're pretty fucking confusing, Donghyuck."

A sensation of Deja vu hits the both of you for a moment there, those were the same words you both spoke during day 5, when he told you how much his sister loved your presence and wanted to hang out with her a little more.

You stand there, with mixed emotions swirling in your stomach. You want to find it confusing, you want to stay mad, but you can’t. Not when your heart longs for him.

And as you stare into his eyes, you realize that he feels the exact same. He longs for you just as much as you long him, he’s upset at himself just as much as you are with him.

It can be that easy, it’s always that easy. It’s always been Donghyuck.

“I’m sorry for being so…” Donghyuck can’t find the words to describe how bad he feels, it’s buried deep in the back of his head.

“Really fucking frustrating?”

His head shoots up at your words, your voice much softer than before. You didn’t look as mad as you did when he dropped the book, a rather longing look on your face.

“...Yeah. Really fucking frustrating.”

Silence envelops the conversation yet once again, as you both grimace and shift awkwardly in your spots. There is so much you want to say to each other, how much you’ve missed him, and Sungmin and his stupid ice cream sandiwches. You missed his ice cream sandwiches.

Just as you are about to turn and get back to work very awkwardly, Donghyuck is brave enough to say more.

“Minnie misses you,” He mumbles. You miss her too, you miss her nagging and sweet smile, everything about the little girl. “I miss you too.” He adds.

Can he just stop making you feel things?!

“My family really likes you,”

At this you turn around to give Donghyuck a look, slapping a book to his chest, before pointing at an empty gap at the shelf. He takes the hint, slipping the novel right in.

You don’t know if he even works here anymore, but he might as well. “Is that why you’re apologizing?”

“God—no, it’s not because of them.” Donghyuck quickly clears out, shaking his hands. “What I mean is that they really like you, and I really really like you too.”

He’s rambling, speaking so quickly you almost don’t catch what he says. His words leave a small warmth at your heart, the corner of your lips slipping up before you could stop them.

“And I don’t know, it’s not every day they like someone so easily, you know? And I liked you so easily too so—”

Donghyuck slaps a hand to his lips, leaning forward to bump his head to the books on the shelf. “Aah, this wasn’t what I planned.” (He never planned anything)

A small huff of laughter to Donghyuck’s side, and his heart lifts from the pits of his stomach, jumping up and down when he realizes you have an amused smile on your lips. It washes away when you realize he’s noticed it, and you cough awkwardly.

“I just…” Donghyuck can’t find the words to say, he can’t properly express the swirling emotions in his body. “You just do things to me that I can’t fake, things that I don’t want to fake.” God knows you feel the exact same way. He’s describing all the things you feel for him, every word makes total sense to you that you don’t think you could phrase it any other way.

“I feel all warm inside and maybe it’s the way it feels like we’ve been dating for so long, but I feel like I love you... am I going too far? I feel like—“

“—Donghyuck!“ He doesn’t even realize you were calling out for him until you tug at his sweater, skin brushing against his. It’s been days since you’ve seen each other, and just the slightest touch has both of your hearts going crazy.

He stares right at you in surprise, his jaw hanging open with no words flying out. It’s a bit cute, he looks cute.

Donghyuck can’t read the expression on your face, but he tries to. There’s longing in your eyes, and adornment in your small smile, you don’t seem upset at him anymore.

Tugging him closer, you lean in, and press your lips right onto his. It feels blissful, absolutely heavenly, but the sensation is gone once you pull away only a few seconds later. Your breath doesn’t last that long, just as you open your eyes, you are being pulled back into another kiss, soft and loving.

Donghyuck is familiar with the material of your hoodie, he remembers the certain cut at the end of your sleeve. And just as he pulls away, his assumptions were correct. It’s his Michael Jackson hoodie he gave you on the day of the library.

“This is mine,” He mumbles, pulling at your other arm.

“Do you want it back?”

He shakes his head with a smile, “No, it’s okay.” Warmth fills you, as you tangle your hand with his. “You’re mine now too, I guess.” A moment later, however, you let go, before turning and walking away with the book cart.

“Hey—Y/n! I know that was cheesy, I’m sorry!”

Bonus!

It’s 11 in the evening, you’re hungry, your boyfriend is hungry, but all the stores are either closed, or 15 minutes away by foot. Why go there when Lee Jeno is only 5 minutes away?

“You two suck.” Jeno mutters under his breath as he opens his freezer, grabbing the large tub of ice cream Jaemin had stored in there in case of a movie night. He tosses it onto the counter, before glaring at the two of you.

“Don’t make too much noise, and don’t you dare wake me up.”

Donghyuck hums at his grumpy friend, popping open the lid to the ice cream tub. “Sure, sure,”

Minutes later, you’re on the dining room floor, a cold ice cream sandwich in your hands. Donghyuck swallows the last of his own sandwich, a new eating record sitting in his notes app at a whopping 2 minutes and 10 seconds. You’re not sure how he didn’t get a brain freeze.

Your boyfriend leans down to leave a chaste kiss on your cheek, before standing to head to the kitchen, “Gonna go get some water.” he announces.

The moments are filled with sounds of the fridge door opening many times, before a yell of Jeno’s name, and a loud ‘What the fuck did I just say?!’ from a distant room in the corridor.

#HELLO #helLO1?!?!?!#I AM SRSLY SMILING WHILE IM READING THIS 🥹🥹#one of the cutest things ive ever read sdjhfjkshdfsjd #GOD WHEN ???????????#NO JUST BOTH OF THEM BEING FREAKING SIMPS FOR EACH OTHERRRRRRRRRRR #especially that part at the LIBRARY #I SRLSY COMBUSTED I THINK OMG #+++ sungmin and mcs realitionship is goals omg #the angst part really hit me right in the gut skfkjsdfjsf like why #AND I NOTICED THE SHIFT HOW MC CHANGES FROM ADDRESSING #HAECHAN TO DONGHYUCK EVEN IN JUST HER THOUGHTS@??2!?#UGH the details #anyways ive talked a lot #honestly a 100/10 fic <333 #ch: ldh #gnr: fluff #gnr: angst

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khamgiodau · 7 years ago

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LƠ XÊ MI CẤP DÕNG LYMPHO Ở TRẺ EM

1. ĐẠI CƯƠNG Lơ xê mi cấp dòng lympho là bệnh lý tăng sinh ác tình của các tế bào dòng lympho của hệ thống tạo máu. Bệnh thường gặp ở nhóm từ 2-5 tuổi. Hầu hết các trường hợp bệnh lơ xê mi cấp không có nguồn gốc từ một di truyền báo trước mà từ thay đổi di truyền somatic. 2. CHẨN ĐOÁN BỆNH 2.1. Chẩn đoán (Xem chi tiết trong bài Lơ xê mi cấp). - Một số đặc điểm di truyền tế bào và sinh học phân tử: Có thể gặp 85% các trường hợp và có giá trị tiên lượng độc lập. + Bất thường về số lượng NST: Giảm bội (hypodiploid) 50 NST (hyper-hyperdiploid). + Các đột biến di truyền: Tel-AML1 fusion gene t(12;21) (p13q22). t(12;21), 22% của Pre-B ALL; BCR-ABL fusion gene t(9;22) (q34q11). t(9;22), 3% ALL trẻ em ALL; Tái sắp xếp gen MLL tại vị trí 11q23 ảnh hưởng 80% của trẻ nhũ nhi, 3% của ALL trẻ lớn; B-cell ALL translocations liên quan gen MYC trên NST 8q24. 80% B-ALL có t(8;14) (q24q32); > 50% trường hợp T cell ALL có đột biến hoạt động liên quan đến gen NOTCH1. 2.2. Xét nghiệm trước điều trị: Các xét nghiệm cần làm tại thời điểm chẩn đoán: - Huyết tủy đồ: + Hính thái và hóa học tê ́ ba ̀ o; + Dâ ́ u â ́ n miê ̃ n di ̣ ch tu ̉ y, đă ̣ c biê ̣ t ti ̀ m dâ ́ u â ́ n tiê ̉ u câ ̀ u như CD42a va ̀ CD61; + Di truyền và sinh học phân tử. - Sinh thiết tủy xương: Quan trọng trong hội chứng Down, M7 để đánh giá reticulin / xơ hóa tủy. - Sinh hóa máu: Chức năng gan, thận, acid uric, LDH. - Đông máu cơ bản: + Fbrinogen; 14 + PT; + APTT; TT; + Nghiệm pháp rượu; + D-dimer. - Các virus: HBV, HCV, HIV, EBV, CMV. - Xét nghiệm HLA: + Nhóm 1: HLA-A; HLA-B; HLA-C; + Nhóm 2: HLA-DR ; HLA-DQ. - Định nhóm hồng cầu: ABO, Rh và một số nhóm khác như: Kell, Kidd, Duffy, Lutheran và Lewis. - Điện tâm đồ và siêu âm tim. - Chẩn đoán hính ảnh: + X-quang tim phổi; + Siêu âm ổ bụng. - Xét nghiệm dịch não tủy. 3. ĐIỀU TRỊ Phác đồ điều trị Lơ xê mi cấp dòng lympho được phân chia điều trị 5 giai đoạn khác nhau, có tính liên tục, bắt buộc phải tuân thủ chính xác và chặt chẽ; mỗi giai đoạn chuyển đổi đều được đánh giá và có tiêu chuẩn để bắt đầu sử dụng thuốc, các giai đoạn điều trị bao gồm: - Điều trị tấn công; - Điều trị củng cố; - Điều trị tăng cường 1; - Điều trị trung gian; - Điều trị tăng cường 2; - Và điều trị duy trì. 3.1. Phác đồ điều trị lơ xê mi cấp dòng lympho B a. Nhóm A: Nguy cơ chuẩn (Standard risk) - Lơ xê mi cấp dòng lympho B, 1-10 tuổi số lượng bạch cầu ≤ 50G/L và có đủ các yếu tố sau: + Không có thâm nhiễm hệ thần kinh trung ương; + Không có t(9;22), t(4;11) hoặc bộ nhiễm sắc thể 25% (týp M3): Nhóm A3. - Người bệnh có MRD (+) (≥ 10 -2 ) vào ngày 35-42 sẽ được chuyển sang nhóm A3 bất kể lúc đầu thuộc nhóm nào. b. Nhóm B: Nguy cơ cao (high risk) - Lơ xê mi cấp dòng lympho B de novo và có một trong những tiêu chuẩn sau: + Tuổi > 10; + Có thâm nhiễm hệ thần kinh trung ương; + Bạch cầu > 50G/L; + Có t(9;22), t(4;11) hoặc bộ NST 100G/L; - Làm huyết đồ để đánh giá sự nhạy cảm với methylprednisone vào ngày 8; - Sự kháng methylprednisone sẽ được đánh giá trong mỗi nhóm A1, A2, A3. - Thay methylprednisone bằng dexamethasone bắt đầu từ ngày 8. - Tủy đồ ngày 21 là yếu tố quyết định: Đối với các người bệnh nhạy hóa trị, Daunorubicine sẽ được sử dụng ngẫu nhiên vào ngày 22/29. + Tủy M1: Dùng anthracycline vào ngày 22, sau đó điều trị theo nhóm A1; + Tủy M2, M3: Chỉ định anthracycline vào ngày 22, N29. Sau khi đạt CR: Nếu tủy M2 vào ngày 21: Điều trị theo nhóm A2; Nếu tủy M3 vào ngày 21: Điều trị theo nhóm A3. - Làm tủy đồ + MRD vào cuối giai đoạn tấn công (ngày 35-42), chậm nhất là ngày 42 để đánh giá lui bệnh. Người bệnh có MRD (+) vào ngày 35-42 (≥10 -2 ) sẽ tiếp tục điều trị củng cố theo nhóm A3 (bắt đầu VEDA 1 ngay khi có thể). Kiểm tra MRD tủy trước khi bắt đầu giai đoạn VEDA. 2.2. Giai đoạn củng cố a. Nhóm A1 - Mercaptopurine: 75 mg/m 2 /ngày (uống), ngày 1 đến 77. - Vincristine: 1,5 mg/m 2 (tĩnh mạch chậm/ phút), ngày 1, 8, 29, 36, 57, 64. Không quá 2mg. - Dexamethasone: 6 mg/m 2 /ngày (uống, 3 lâ ̀ n/ngày), ngày 1-5, ngày 29-33, ngày 57-61. - Methotrexate: 25 mg/m 2 / lần (uống), ngày 8, 15, 22, 36, 43, 64, 71, 78. - IT: ngày 1, 29, 57 (tùy theo tuổi người bệnh). 18 b. Nhóm A2 - Điều trị sau tấn công bao gồm: + Giai đoạn củng cố; + Các giai đoạn kế tiếp tùy theo kết quả MRD của ngày 35-42; - Điều trị sau tấn công của nhóm A2 tùy theo kết quả MRD vào ngày 35-42 + Người bệnh có MRD (-): Sẽ được điều trị theo nhóm A1; + Người bệnh có MRD (+): Sẽ được điều trị theo nhóm A3. - Trong lúc chờ kết quả MRD, người bệnh nhóm A2 sẽ được điều trị theo giai đoạn củng cố của nhóm A1. - Nếu MRD (+): Giai đoạn củng cố sẽ không được kết thúc, người bệnh sẽ được điều trị theo giai đoạn củng cố của nhóm A3 (bắt đầu từ giai đoạn VEDA 1) ngay khi có thể. Kiểm tra MRD một cách hệ thống ngay trước khi bắt đầu VEDA. Sau đó người bệnh sẽ được điều trị như nhóm A3. Nếu MRD lần 2 vẫn cao (> 10 -2 ): Hội chẩn lại. - Nếu MRD (-): Người bệnh được tiếp tục cho đến hết giai đoạn củng cố của nhóm A1. Sau đó, người bệnh sẽ được điều trị như nhóm A1. c. Nhóm A3: (3 đợt liên tiếp: VEDA/ COPADM 2000 / VEDA) Đợt 1: VEDA 1 Bắt đầu ngay khi bạch cầu trung tính > 1G/L và TC > 100G/L - Dexamethasone: 20mg/m 2 /ngày (chia 3 lần, uống hoặc tĩnh mạch) ngày 1-5; - Vincristine: 1,5mg/m 2 (tĩnh mạch chậm/ phút) ngày 1; Không quá 2mg - Cytarabine: 2g/m 2 / mỗi lần x 2 lần/ ngày 1, 2. Truyền tĩnh mạch/ 3giờ. Tổng cộng 8g/m 2 . - VP-16: 150mg/m 2 / ngày (truyền tĩnh mạch/ 1 giờ), ngày 3, 4, 5; - IT Triple: Chỉ MTX + Depomedrol + AraC ngày 5; G-CSF: 150 μg/m 2 /ngày (= 5 μg/kg/ ngày) tiêm dưới da, bắt đầu từ ngày 7. Tiếp tục cho đến khi bạch cầu trung tính > 1G/L trong 3 ngày. Lưu ý: - Người bệnh nhóm A1 và A2 có MRD (+) vào ngày 35-42, được đưa vào nhóm A3, phải được kiểm tra MRD trước khi bắt đầu bloc COPADM. - Nếu MRD lần 2 vẫn cao (> 10 -2 ): Hội chẩn lại. 3 đợt VEDA1, COPADM, VEDA 2: Điều trị trong vòng 9 tuần. Đợt 2: COPADM 2000 Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L - Methylprednisone: 60mg/m 2 /ngày, ngày 1-5; - Vincristine: 1,5mg/m 2 (tĩnh mạch chậm/ phút), ngày 1. Không quá 2mg; - Methotrexate: 5.000mg/m 2 /ngày (truyền tĩnh mạch/ 24 giờ), ngày 1; 19 (Thuốc giải Acid folinique từ giờ thứ 36 của MTX) - Cyclophosphamide: 500mg/m 2 / lần x 2lần/ ngày (truyền tĩnh mạch/ 60phút), ngày 2, 3 (tổng cộng 2g/m 2 ); - Adriamycine: 40mg/m 2 /ngày (truyền tĩnh mạch/ 1 giờ), ngày 2; - IT Triple: MTX + Depomedrol + AraC, ngày 1. Đợt 3: VEDA 2 (giống đợt 1) Bắt đầu khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L vào các ngày 1-7. 2.3. Giai đoạn tăng cường 1 a. Nhóm A1/ A2 và A3 Phần I: Bắt đầu ngay khi bạch cầu trung tính > 1 G/L và iểu cầu > 100 G/L - Dexamethasone: 10 mg/m 2 /ngày (uống); ngày 1-15 sau đó giảm liều đến ngày 21. - Vindesine: 3mg/m 2 /lần tiêm (tĩnh mạch chậm/ 1 phút), ngày 1, 8, 15. Không quá 2 mg; - Doxorubicine: 25 mg/m 2 (truyền tĩnh mạch trong 60 phút); ngày 1, 8, 15. - L-asparaginase: 6.000 UI/m 2 (tiêm bắp/ truyền tĩnh mạch trong 60 phút); ngày 2, 4, 6, 9, 11, 13. - IT Triple: ngày 1, 29 tùy theo tuổi người bệnh. Phần II: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L - Thioguanine: 60mg/m 2 /ngày (uống), ngày 29-49. - Etoposide: 150mg/m 2 /ngày (truyền tĩnh mạch trong 60 phút); ngày 29, 36, 43. - Cytarabine: 30mg/m 2 x 2 lần/ ngày (tiêm dưới da); ngày 29, 30, 36, 37, 43, 44. - IT triple: Ngày 29, tùy theo tuổi người bệnh. Lưu ý: - Nếu không có thioguanine, thay bằng mercaptopurine liều 75mg/m 2 /ngày; - Nếu không có vindesine, thay bằng vincristine 1,5mg/m 2 (max 2mg); - Hóa trị ngày 36, 43 được tiếp tục bất kể phân tích huyết học và không có vấn đề về lâm sàng; - Siêu âm tim, điện tim trước mỗi mũi Adriamycine. 2.4. Giai đoạn trung gian a. Nhóm A2/ A1: Bắt đầu khi bạch cầu trung tính + monocytes > 1G/L và tiê ̉ u cầu > 100G/L - Vincristine: 1,5 mg/m 2 (tĩnh mạch chậm/ phút), ngày 1, 29. Không quá 2 mg. - Dexamethasone: 6 mg/m 2 / ngày (uống, chia 3 lâ ̀ n/ngày), ngày 1-5, ngày 29-33, ngày 57-61. - Mercaptopurine: 75 mg/m 2 /ngày (uống), Từ ngày 1-49. - Methotrexate: 25 mg/m 2 / lần (uống), ngày 8, 15, 22, 36, 43, 50. - IT Triple: Ngày 1, 29. 20 Lưu ý: - Trường hợp không có vấn đề về lâm sàng, giai đoạn này được tiếp tục (mà không có sự thay đổi) khi bạch cầu trung tính > 0,5G/L và tiểu cầu > 50G/L. c. Nhóm A3: PHẦN 1: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L - Vincristine: 1,5mg/m 2 /lần (tĩnh mạch chậm/ phút), ngày 1, 15. Không quá 2mg. - Dexamethasone: 6mg/m 2 /ngày (chia 3 lần, uống), ngày 1-5. - Mercaptopurine: 50mg/m 2 /ngày (uống), ngày 1-28. - Methotrexate M: 5.000mg/m 2 /ngày (truyền tĩnh mạch/ 24 giờ) ngày 1, 15. (Thuốc giải Acid folinique bắt đầu từ giờ thứ 36 của MTX) m: 25mg/m 2 /lần (uống) ngày 8, 22. - IT triple: vào giờ 24 của MTX ngày 2, 16. PHẦN 2: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và TC > 100G/L - Vincristine: 1,5mg/m 2 /lần (tĩnh mạch chậm/ phút), ngày 29. Không quá 2mg. - Dexamethasone: 6mg/m 2 /ngày (chia 3 lần, uống), ngày 29-33. - Mercaptopurine: 50mg/m 2 /ngày (uống), ngày 29-49. - Methotrexate M: 5.000mg/m 2 /ngày (truyền tĩnh mạch/ 24 giờ), ngày 29. (Thuốc giải Acid folinique bắt đầu từ giờ thứ 36 của MTX) m: 25mg/m 2 /lần (uống), ngày 36, 43, 50. - IT triple: Vào giờ 24 của MTX ngày 30. Lưu ý: - Liều mercaptopurine ở đây chỉ 50mg/m 2 /ngày ví giai đoạn này có MTX liều cao. - Ngày 15: Bắt đầu khi bạch cầu trung tính > 0,5G/L và tiểu cầu > 50G/L. 2.5. Giai đoạn tăng cường 2 a. Nhóm A1/A2: Bắt đầu từ ngày 57 của giai đoạn trung gian khi > 1G/L và tiểu cầu > 100G/L - Vincristine: 1,5 mg/m 2 (tĩnh mạch chậm/ phút), ngày 1, 10, 20, 30. Không quá 2mg. - Methotrexate: 100 mg/m 2 (truyền tĩnh mạch/ 15phút), ngày 1, 10, 20, 30. - L-Asparaginase: 20.000 UI/m 2 (truyền tĩnh mạch/ 60phút), ngày 2, 11, 21, 31. - IT Triple: Ngày 1. Lưu ý: - Không dùng acid folinique sau MTX liều trung bình; - Trường hợp không có vấn đề về lâm sàng, giai đoạn này được tiếp tục (mà không có sự thay đổi) khi bạch cầu trung tính > 0,5G/L và tiểu cầu > 50G/L; - Hướng dẫn dùng L-asparaginase liều cao: + Ngày 1, 10, 20, 30: Dùng 1/10 tổng liều truyền tĩnh mạch 60phút; + Ngày 2, 11, 21, 31: Dùng 9/10 tổng liều truyền tĩnh mạch ≥ 2 giờ. - Kiểm tra MRD sau kết thúc điều trị tăng cường 2. 21 b. Nhóm A3: PHẦN 1: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L - Prednisone: 40mg/m 2 /ngày (chia 3 lần, uống), ngày 1-15. Giảm liều từ ngày 15 và ngừng vào ngày 21. - Vincristine: 1,5mg/m 2 /ngày (tĩnh mạch chậm/ 1 phút) ngày 1, 8, 15. Không quá 2mg. - L-asparaginase: 6.000 UI/m 2 /lần (tĩnh mạch chậm/ 60 phút), tổng cộng 6 mũi, ngày 3, 5, 7, 9, 11, 13. - Daunorubicine: 30mg/m 2 /lần (tĩnh mạch chậm/ 60 phút), ngày 1, 8, 15. - IT Triple: Ngày 1. PHẦN 2: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L - Thioguanine: 60mg/m 2 /ngày (uống), ngày 29-49. - Cyclophosphamide: 1g/m 2 /ngày (tĩnh mạch chậm/ 60phút), ngày 29. - Cytarabine: 30mg/m 2 /lần x 2 lần/ngày (tiêm dưới da), ngày 29-30, ngày 36-37, ngày 43-44. - IT Triple: Ngày 29. Điều trị hỗ trợ - Dịch truyền: 2.000 ml/m 2 /ngày. - Sử dụng mesna: Tổng liều bằng 2 lần tổng liều cyclophosphamide, truyền tĩnh mạch trước cyclophosphamide 30phút, sau cyclophosphamide 4 giờ và 8 giờ. Lưu ý: - Hóa trị ngày 36, 43 được tiếp tục bất kể số lượng tế bào máu, với điều kiện không có vấn đề về lâm sàng. - Kiểm tra MRD sau kết thúc điều trị tăng cường 2. 2.6. Giai đoạn duy trì - Bắt đầu từ ngày 40 của giai đoạn tăng cường II, khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L. - Thời gian điều trị duy trì kéo dài trong 24 tháng (nam và nữ), trong đó có 12 tháng tái tấn công (RI) với vincristine và dexamethasone trong năm đầu tiên. - Nếu không có thioguanine, thay bằng mercaptopurine liều 50mg/m 2 /ngày. Bao gồm: - Vincristine: 1,5mg/m 2 /ngày (tĩnh mạch chậm). Vincristine 1 mỗi tháng, trong 12 tháng đầu. Không quá 2mg. - Dexamethasone: 6mg/m 2 /ngày (uống), ngày 1-5 mỗi tháng, trong 12 tháng đầu. + Methotrexate: 25mg/m 2 /tuần (uống), ngày 8, 15, 22 mỗi tháng. + Mercaptopurine: 75mg/m 2 /ngày (uống), ngày 1-28. + IT Triple: Mỗi 3 tháng bắt đầu từ các tháng 1, 4, 7, 10, 13, 16, 19 và 22 (tổng cộng 8 mũi). 22 PHÁC ĐỒ ĐIỀU TRỊ LƠ XÊ MI CẤP DÒNG LYMPHO B - NHÓM B 1. SƠ ĐỒ ĐIỀU TRỊ TỔNG QUÁT: FRALLE 2000-B: NHÓM B Test corticoid: Ngày 1-7 Methylprednisone + IT MTX Ngày 8-21: Tấn công VCR, PRED, DNR (Ngày 8 và 15), L-Aspa x 6 (ngày 8 - 20) NHÓM B1 NHÓM B2 Tiếp tục tấn công VCR , PRED + DNR ngày 22 + L-Aspa x 3 (ngày 22-26) Chú ý: MRD Ngày 35-42 >10 -2 , chuyển nhóm B2 Tiếp tục tấn công VCR, PRED + DNR ngày 22 và 23 + L-Aspa x 3 (Ngày 22-26) + Endoxan (ngày 22) Củng cố (8 tuần) VP16, ARAC, 6TG rồi đến VCR, PRED, 6MP,MTX + 2 đợt MTX-HD (5.000 mg/m 2 ) Củng cố (9 tuần) 3 đợt: VEDA, COPADM 2000 , VEDA Tăng cường 1 (8 tuần) VDS/ ADRIA/ PRED/ L-Aspa rồi đến 6-TG/ AraC/ VP-16 Trung gian (8 tuần) VCR, PRED, 6-MP, MTX + 2 đợt MTX-HD (5.000 mg/m 2 ) Trung gian (8 tuần) VCR, PRED, 6-MP, MTX + 3 đợt MTX-HD (5.000 mg/m 2 ) XẠ TRỊ (*) Tăng cường 2 (8 tuần) VCR, PRED, DNR, L-ASPA rồi đến 6-TG, Endoxan, AraC Duy trì 24 tháng 6-MP + MTX cùng với 12 RI: VCR + PRED *Những người bệnh thuộc nhóm B2 và nhỏ hơn 4 tuổi: Không xạ trị dự phòng trên hệ thần kinh trung ương. 23 2. PHÁC ĐỒ ĐIỀU TRỊ CHI TIẾT 2.1. Giai đoạn tấn công (B1/ B2) - Methylprednisone: 60 mg/m 2 /ngày chia 2 lần (uống hay truyền tĩnh mạch), ngày 1-7. Nếu dùng đường tĩnh mạch: Sử dụng methylprednisolone (solumedrol®) cùng liều như trên. - Methylprednisone: 40mg/m 2 , ngày 8-28 (uống hoặc tĩnh mạch), chia 3 lần từ ngày 29: Giảm liều dần, ngừng vào ngày 35. - Vincristine: 1,5mg/m 2 , ngày 8, 15, 22, 29. Truyền tĩnh mạch chậm trong 1 phút. Không quá 2mg. - L-Asparaginase: 6.000 UI/m 2 , ngày 10, 12, 14, 16. Truyền tĩnh mạch chậm trong 1 giờ ngày 18, 20, 23, 25, 27. - Daunorubicine: 40mg/m 2 , ngày 8, 15, 22 (B1, B2). Truyền tĩnh mạch chậm trong 1 giờ + ngày 23 (Với nhóm B2). - Cyclophosphamide: 1.000 mg/m 2 , + ngày 22 (Riêng nhóm B2) truyền tĩnh mạch chậm 30 phút. - IT: 3 thuốc theo tuổi, ngày 8, 15 (với MTX, DEPO, ARA-C). Ngày 22 nếu người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán. Lưu ý: - IT chỉ với methotrexate vào ngày 1 (không có methylprednisone) với điều kiện tiểu cầu > 100G/L. IT mũi 1 nên được thực hiện sớm khi có thể (không chậm quá ngày 4 của test methylprednisone) trừ trường hợp chống chỉ định (bạch cầu cao có triệu chứng, u trung thất to, ....). - Trường hợp bạch cầu tăng cao (> 500G/L): Có thể bổ sung vincristine trước ngày 8. - Vincristine có thể chỉ định liền ở những người bệnh có hội chứng tắc mạch lúc chẩn đoán, hoặc bổ sung nhanh (trước ngày 3 của test methylprednisone) khi tình trạng lâm sàng diễn tiến xấu đi hoặc tăng nhanh số lượng bạch cầu (khi đã dùng Methylprednisone). - Làm huyết đồ để đánh giá sự nhạy cảm với methylprednisone vào ngày 8. - Sự kháng methylprednisone sẽ được đánh giá để phân nhóm B1, B2. - Huyết đồ (ngày 8): Đánh giá nhạy cảm với methylprednisone. - Tủy đồ (ngày 21): Đánh giá nhạy cảm với hóa trị liệu ban đầu. - Người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán: Bổ sung thêm 1 mũi IT vào ngày 22. - Từ ngày 22, dựa vào kết quả huyết + tủy đồ người bệnh được chia làm 2 nhóm B1 và B2. 24 Nhóm B1 (tất cả các tiêu chuẩn sau ) Nhóm B2 (chỉ 1 trong các tiêu chuẩn) Không có thể thiểu bội 1G/L và tiểu cầu > 100G/L - Lanvis: 60mg/m 2 /ngày (uống), ngày 1-21. - Etoposide: 150mg/m 2 (truyền tĩnh mạch trên 1 giờ), ngày 1, 8, 15. - Cytarabine: 30mg/m2/ngày (tiêm dưới da), ngày 1, 2, 8, 9, 15, 16 (tổng cộng 12 mũi). - IT: 3 thuốc ngày 1, người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán + ngày 15(*). PHẦN 2: Bắt đầu khi bạch cầu trung tính > 0,5G/L và tiểu cầu > 50G/L - Vincristine: 1,5 mg/m 2 (tĩnh mạch chậm/ 1 phút), ngày 29. Không quá 2mg. - Methylprednisone: 40 mg/m 2 / ngày (uống, chia 3 lâ ̀ n/ngày), ngày 29-35. - Mercaptopurine: l50 mg/m 2 /ngày (uống), ngày 29-49. - Methotrexate m: 25 mg/m 2 / lần (uống), ngày 36. M: 5.000mg/m 2 /ngày (truyền tĩnh mạch 24 giờ), ngày 9, 43. - IT 3 thuốc: Ngay sau khi kết thúc MTX-HD (giờ 24), ngày 30, 44. Lưu ý: - Thuốc ngày 8, 15, 43 được tiếp tục bất kể số lượng tế bào máu (nếu không có bất thường về lâm sàng, sinh hóa). - Đối với người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán: Bổ sung thêm 1 mũi IT vào ngày 15. 25 - Nếu kết quả MRD vào ngày 35-42 dương: Người bệnh được tiếp tục điều trị giai đoạn củng cố của nhóm B2 ngay khi có thể và sẽ làm lại MRD lần 2 và ghép tế bào gốc khi đạt CR1 nếu có người cho phù hợp. - Nếu sử dụng MTX liều cao: Dùng acid folinique vào giờ thứ 36 (xem phụ lục). - Ngừng Bactrim 3 ngày trước và 5 ngày sau khi dùng MTX liều cao (xem phụ lục). - Ngừng hóa trị và nghỉ từ ngày 50-57. b. Nhóm B2 - 3 đợt liên tiếp: VEDA / COPADM 2000 / VEDA. - Giống như củng cố nhóm A3. 2.3. Giai đoạn tăng cường 1 (B1 và B2) PHẦN 1: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L. - Dexamethasone: 10mg/m 2 , ngày 1-14, chia 3 lần, uống, tĩnh mạch. Ngày 15: Giảm liều dần và ngừng ở ngày 21. - Vindesine: 3 mg/m 2 , ngày 1, 8, 15, tiêm tĩnh mạch trong 1 phút (Không quá 4mg). - L-Asparaginase: 6.000UI/m 2 , ngày 3, 5, 7, 9, 11, 13, truyền tĩnh mạch trong 60 phút. - Adriamycine: 25mg/m 2 , ngày 1, 8, 15, truyền tĩnh mạch trong 60 phút. - IT: 3 thuốc ngày 1, (ngày 15*). (IT ngày 15*: Chỉ định trong nhóm B1 có tổn thương thần kinh trung ương lúc chẩn đoán). PHẦN 2: Bắt đầu ngay khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L. - Thioguanine: 60mg/m 2 , ngày 29-49. Uống 1 lần, sáng, đói. - Etoposide: 150mg/m 2 , ngày 29, 36, 43. Truyền tĩnh mạch trong 60 phút. - Cytarabine: 30mg/m 2 x 2, ngày 29-30, ngày 36-37, ngày 43-44. Tiêm dưới da (tổng cộng 12 mũi). - IT: 3 thuốc, ngày 29. Lưu ý: - Nếu không có vindesine, thay bằng vincristine 1,5mg/m 2 /ngày (tối đa 2mg). - Nếu không có thioguanine, thay bằng mercaptopurine 50mg/m 2 /ngày. - Thuốc ngày 8, 15, 36, 43 được tiếp tục bất kể số lượng tế bào máu (và không có vấn đề gì về lâm sàng, sinh hóa). - Ngừng hóa trị và nghỉ từ ngày 50-57. 2.4. Giai đoạn trung gian a. Nhóm B1 Bắt đầu ngay khi bạch cầu trung tính và monno > 1G/L và tiểu cầu > 100G/L - Vincristin: 1,5mg/m 2 , ngày 1, 15, 29, 43. Tiêm tĩnh mạch chậm trong 1 phút (tối đa 2mg). 26 - Methylprednisone: 40mg/m 2 , ngày 1-7; ngày 29-35. Chia 3 lần, uống. - Mercaptopurine: 50mg/m 2 , ngày 1-49. Uống, sáng, đói. - Methotrexate m: 25mg/m 2 , ngày 8, 15, 22, 36, 43. Uống 1 lần, sáng, đói. M: 5.000mg/m 2 , ngày 1, 29. Truyền tĩnh mạch 24 giờ. - IT: 3 thuốc ngày 1, 29 ngay sau khi kết thúc MTX-HD (giờ 24). - IT(*): Ngày 15 nhóm B1 có tổn thương thần kinh trung ương lúc chẩn đoán. Lưu ý: - Đối với nhóm B1 có tổn thương thần kinh trung ương lúc chẩn đoán: + Bổ sung một mũi IT (*) vào ngày 15 và không thực hiện hóa trị liệu ngày 43. + Xạ trị cho những người bệnh này vào khoảng ngày 40-55. Tổng liều xạ trị là 24Gy cho đến C2 cho trẻ > 4 tuổi, và liều này giảm xuống 18Gy cho trẻ 1 G/L và tiểu cầu > 100 G/L - Vincristine: 1,5mg/m2/lần (tĩnh mạch chậm/ phút) ngày 1, 15, 29. Không quá 2mg. - Methylprednisone: 40mg/m 2 /ngày (chia 3 lần, uống), ngày 1-7, ngày 29-35. - Mercaptopurine: 50mg/m 2 /ngày (uống), ngày 1-49. - Methotrexate M: 5.000mg/m2/ngày (truyền tĩnh mạch/24 giờ), ngày 1, 15, 29, 43(*). (Thuốc giải Acid folinique bắt đầu từ giờ thứ 36 của MTX) m: 25 mg/m 2 /lần (uống), ngày 8, 22, 36. - IT: 3 thuốc (vào giờ 24 sau MTX), ngày 2, 16, 30, 43(*). Đối với trẻ > 4 tuổi: Chỉ định xạ trị dự phòng thần kinh trung ương từ ngày 40-55 và không có hóa trị vào ngày 43(*) (gồm MTX và IT). Đối với trẻ 4 tuổi, và liều này giảm xuống 18Gy cho trẻ 1G/L và tiểu cầu > 100G/L. - Thời gian điều trị duy trì kéo dài trong 24 tháng (nam lẫn nữ), trong đó có 12 tháng tái tấn công (RI) với vincristine và methylprednisone trong năm đầu tiên. Bao gồm: - Vincristine: 1,5mg/m 2 /ngày (tĩnh mạch chậm), ngày 1 mỗi tháng, trong 12 tháng đầu. Không quá 2mg. - Methylprednisone: 40mg/m2/ngày (uống), ngày 1-7 mỗi tháng, trong 12 tháng đầu. - Methotrexate: 25mg/m 2 /tuần (uống), ngày 8, 15, 22 mỗi tháng. (ngừng vào tuần có Vincristine) - Mercaptopurine: 75mg/m 2 /ngày (uống): Liên tục. - IT: 3 thuốc mỗi 3 tháng vào ngày 1 của tái tấn công, bắt đầu từ RI tháng thứ 3 (RI tháng 3, 6, 9, 12, 15, 18), tổng cộng 6 mũi. Lưu ý: - Điều kiện duy trì mỗi tháng khi bạch cầu trung tính > 0,5G/L, tiểu cầu > 100G/L. - Người bệnh đã xạ trị thí không được IT nữa. - Tiếp tục phòng ngừa Pneumocystic carinii trong giai đoạn duy trì với bactrim 25 mg/kg x 1 liều, 3 ngày mỗi tuần. Trường hợp người bệnh không chịu đựng được giai đoạn duy trí, ngưng bactrim và chuyển sang pentacarinat phun khí dung mỗi tháng. 28 PHÁC ĐỒ ĐIỀU TRỊ LƠ XÊ MI CẤP DÒNG LYMPHO T 1. SƠ ĐỒ ĐIỀU TRỊ TỔNG QUÁT Test corticoid: Ngày 1-7 Methylprednisone + IT MTX Ngày 8-21: Tấn công VCR, PRED, DNR ngày 8, 9,10 và15, ENDOXAN 1 g/m 2 N8 + L-Aspa x 9 NHÓM T1 Chú ý: MRD N35-42 > 10 -2 , chuyển nhóm T2 NHÓM T2 Củng cố (8 tuần) Endoxan, ARAC, 6TG rồi đến VCR, PRED, 6MP, MTX + 2 đợt MTX-HD (5.000 mg/m 2 ) Củng cố (9 tuần) 3 đợt : VEDA, COPADM 2000 , VEDA Tăng cường 1 (8 tuần) VDS/ ADRIA/ PRED/ L-Aspa rồi đến 6-TG, AraC, VP-16 Trung gian (8 tuần) VCR, PRED, 6-MP, MTX + 4 đợt MTX-HD (5.000 mg/m 2 ) Trung gian (8 tuần) VCR, PRED, 6-MP, MTX + 3 đợt MTX-HD (5.000 mg/m 2 ) Xạ trị Tăng cường 2 (8 tuần) VCR, PRED, DNR, L-ASPA rồi đến 6-TG, endoxan, AraC Duy trì 18 tháng 6-MP + MTX cùng với 12 RI : VCR + PRED 29 2. PHÁC ĐỒ ĐIỀU TRỊ CHI TIẾT 2.1. Giai đoạn tấn công - Methylprednisone: 60 mg/m 2 /ngày chia 2 lần (uống hay tĩnh mạch), ngày 1-7. Nếu dùng đường tĩnh mạch: Sử dụng methylprednisolone (solumedrol®) cùng liều như trên. - Methylprednisone: 40mg/m 2 , ngày 8-28, uống hoặc tĩnh mạch, chia 3 lần. Từ ngày 29: Giảm liều dần và ngừng vào ngày 35. - Vincristine: 1,5mg/m 2 , ngày 8, 15, 22, 29. Tiêm tĩnh mạch chậm trong 1 phút. Không quá 2mg. - Daunorubicine: 40mg/m 2 , ngày 8, 9, 10, 15. Truyền tĩnh mạch trong 60 phút. - L-Asparaginase: 6.000UI/m 2 , ngày 10, 12, 14, 16, 18, 20, 23, 25, 27. Truyền tĩnh mạch trong 1 giờ. - Cyclophosphamide: 1.000 mg/m 2 , ngày 22. Truyền tĩnh mạch trong 30 phút. - IT: 3 thuốc theo tuổi, ngày 8, 15 (với MTX, DEPO, ARA-C). Ngày 22 nếu người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán (*) Lưu ý: - Người bệnh có tổn thương thần kinh trung ương lúc chẩn đoán: Bổ sung thêm 1 mũi IT vào ngày 22. - Huyết đồ (ngày 8): Đánh giá nhạy cảm với methylprednisone. + Nhạy với methylprednisone: Khi tế bào blast ở máu ngoại vi (ngày 8): 5%. TỪ NGÀY 22 THEO KẾT QUẢ HUYẾT + TỦY ĐỒ NGƯỜI BỆNH ĐƯỢC PHÂN THÀNH 2 NHÓM Nhóm T1 Nhóm T2 Nhạy cảm Methylprednisone ngày 8 Kháng Methylprednisone ngày 8 Nhạy cảm hóa trị ngày 21 Kháng hóa trị ngày 21 MRD ngày 35 10 -2 - Làm tủy đồ, MRD và FISH, PCR, Karyotype (nếu có bất thường lúc chẩn đoán) vào ngày 35-42 để đánh giá lui bệnh và theo dõi sau khi đạt lui bệnh. 30 - Người bệnh có MRD dương (≥ 10 -2 ) vào ngày 35-42 sẽ được tiếp tục điều trị giai đoạn củng cố theo nhóm T2 khi đủ điều kiện. Những người bệnh này sẽ ghép tế bào gốc khi đạt CR1 và có người cho phù hợp HLA. 2.2. Giai đoạn củng cố a. Nhóm T1 PHẦN 1: Bắt đầu khi bạch cầu đa nhân trung tình và monocyte > 1G/L và tiểu cầu > 100G/L - Thioguanine: 60mg/m 2 /ngày (uống), ngày 1-21. - Cyclophosphamide: 1.000mg/m 2 (truyền tĩnh mạch trên 1 giờ), ngày1, 15. - Cytarabine: 30mg/m2/ngày (tiêm dưới da), ngày 1-2, ngày 8-9, ngày 15-16 (tổng cộng 12 mũi). - IT: 3 thuốc vào giờ 24 của MTX-HD, ngày 1, 15. PHẦN 2: Bắt đầu khi bạch cầu đa nhân trung tình > 0,5G/L và tiểu cầu > 50G/L - Vincristine: 1,5 mg/m 2 (tĩnh mạch chậm/ 1 phút), ngày 29, 43. Không quá 2mg. - Methylprednisone: 40 mg/m 2 / ngày (uống, chia 3 lâ ̀ n/ngày), ngày 29-35. - Mercaptopurine: 50 mg/m 2 /ngày (uống), ngày 29-49. - Methotrexate m: 25 mg/m 2 / lần (uống), ngày 36. M: 5.000mg/m 2 /ngày (truyền tĩnh mạch 24 giờ), ngày 29, 43. - IT: 3 thuốc vào giờ 24 của MTX-HD, ngày 30, 44. Lưu ý: - Thuốc ngày 8, 15, 43 được tiếp tục bất kể số lượng tế bào máu (nếu không có bất thường về lâm sàng, sinh hóa). - Nếu không có Thioguanine, thay bằng Mercaptopurine 50 mg/m 2 /ngày (uống). - Nếu kết quả MRD vào ngày 35-42 dương: Người bệnh được tiếp tục điều trị giai đoạn củng cố của nhóm T2 ngay khi có thể và sẽ làm lại MRD lần hai. Nếu MRD lần hai dương, người bệnh bắt buộc phải ghép tế bào gốc khi đạt CR1 nếu có người cho phù hợp. - Nếu sử dụng MTX liều cao: Dùng acid folinique vào giờ thứ 36 (xem phụ lục). - Ngừng Bactrim 3 ngày trước và 5 ngày sau khi dùng MTX liều cao (xem phụ lục). - Ngừng hóa trị và nghỉ từ ngày 50-57. b. Nhóm T2: (3 đợt liên tiếp: VEDA/ COPADM 2000 / VEDA) Giống như củng cố nhóm A3. 2.3. Giai đoạn tang cường 1: (chung cả nhóm T1 và T2) Giống như tăng cường 1 của B1 và B2. 31 2.4. Giai đoạn trung gian a. Nhóm T1: Giống như nhóm B1. b. Nhóm T2: Giống như nhóm B2. 2.5. Giai đoạn tăng cường 2: Chung cả nhóm T1 và T2 Giống như tăng cường 2 của B1 và B2. 2.6. Giai đoạn duy trì: Chung cho cả nhóm T1 và T2 Bắt đầu từ ngày 57 của giai đoạn tăng cường II, khi bạch cầu trung tính > 1G/L và tiểu cầu > 100G/L. Thời gian điều trị duy trì kéo dài trong 18 tháng (nam lẫn nữ), trong đó có 12 tháng tái tấn công (RI) với vincristine và dexamethasone trong năm đầu tiên. Bao gồm: - Vincristin: 1,5mg/m 2 /ngày (tĩnh mạch chậm), ngày 1 mỗi tháng, trong 12 tháng đầu. Không quá 2mg. - Methylprednisone: 40mg/m 2 /ngày (uống), ngày 1-7 mỗi tháng, trong 12 tháng đầu. - Methotrexate: 25mg/m 2 /tuần (uống), ngày 8, 15, 22 mỗi tháng. (ngừng vào tuần có Vincistine). - Mercaptopurine: 75mg/m 2 /ngày (uống): Liên tục. - IT: 3 thuốc mỗi 3 tháng vào ngày 1 của tái tấn công, bắt đầu từ RI tháng thứ 3 (RI tháng 3, 6, 9). Tổng cộng 3 mũi. Lưu ý: - Tái tấn công mỗi 4 tuần. Điều kiện là bạch cầu trung tính > 0,5G/L, tiểu cầu > 100G/L. - Người bệnh đã xạ trị thí không được IT nữa. - Tiếp tục phòng ngừa Pneumocystic carinii trong giai đoạn duy trì với Bactrim 25 mg/kg x 1 liều, 3 ngày mỗi tuần. Trường hợp người bệnh không chịu đựng được giai đoạn duy trì, ngừng Bactrim và chuyển sang Pentacarinat phun khí dung mỗi tháng. Các tiêu chuẩn để đánh giá mức độ đáp ứng đối với điều trị đặc hiệu theo WHO: - Tiêu chuẩn lui bệnh hoàn toàn (CR): + Huyết đồ: Bạch cầu hạt trung tính (segment neutrophile) > 1,5G/L và tiểu cầu > 150G/L. + Tủy đồ: Tế bào blasts 50%) trên một tủy giàu trung bình hoặc bính thường. - Lui bệnh một phần (PR): Tủy đồ: 5% 20% blasts, tủy giàu. 32 - Tiêu chuẩn tái phát: + Tái phát tủy đơn độc: > 25% tế bào blasts xuất hiện lại trong tủy. + Tái phát tủy kết hợp: Tối thiểu 5% tế bào blasts trong tủy và xâm lấn ngoài tủy + Tái phát thần kinh - màng não: Số lượng bạch cầu > 0,005G/L và có tế bào lơ xê mi trong dịch não tủy. Hoặc tổn thương các dây thần kinh sọ. Tái phát cơ quan ngoài tủy: Có hiện diện tế bào lơ xê mi trong tinh hoàn, buồng trứng,...). - Xét nghiệm để theo dõi và đánh giá trong suốt quá trính điều trị và khi kết thúc phác đồ điều trị: + Xét nghiệm lúc nhập viện; + Huyết đồ ngày 8: Xác định tình trạng nhạy cảm corticoid; + Tủy đồ ngày 21: Xác định tình trạng nhạy cảm hóa trị liệu; + Tủy đồ + MRD vào ngày 35-42: Xác định tình trạng lui bệnh và đánh giá MRD lần 1; + Tủy đồ + MRD vào ngày 21/29 giai đoạn củng cố: Đánh giá MRD lần 2, dành cho các người bệnh có MRD (+) vào ngày 35-42; + Tủy đồ mỗi khi kết thúc một giai đoạn điều trị (tấn công, củng cố, tăng cường 1, trung gian, tăng cường 2); + Xét nghiệm kết thúc điều trị. 33 TÀI LIỆU THAM KHẢO 1. Campana D. Status of minimal residual disease testing in childhood haematological malignances. Br J Haematol. 2008 Aug 15; [Epub ahead of print] PMID: 18710378. 2. Borowitz MJ, Devidas M, Hunger SP, et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children’s Oncology Group study. Blood. 2008; 111: 5477-5485. 3. Gaynon PS, Angiolillo AL, Carroll WL, et al. Long-term results of the children’s cancer group studies for childhood acute lymphoblastic leukemia 1983–2002: a Children’s Oncology Group Report. Leukemia. 2010; 24:285-297. 4. Moricke A, Zimmermann M, Reiter A, et al. Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000. Leukemia. 2010; 24: 265-284. 5. Pui C, Carroll W, Meshinchi S, Arceci RJ. Biology, risk stratification and therapy of pediatric acute leukemia: an update. J Clin Oncol. 2010 In press. 6. Pui CH, Campana D, Pei D, et al. Treating childhood acute lymphoblastic leukemia without cranial irradiation. N Engl J Med. 2009; 360:2730-2741. 7. Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006; 354:166-178. 8. Tallen G, Ratei R, Mann G, et al. Long-term outcome in children with relapsed acute lymphoblastic leukemia after time-point and site-of-relapse stratification and intensified short-course multidrug chemotherapy: results of trial ALL-REZ BFM 90. J Clin Oncol. 2010; 28:2339-2347. 9. FRALLE 2000-B/T. Version amendée mars 2003. 34.Bài viếtLƠ XÊ MI CẤP DÕNG LYMPHO Ở TRẺ EM xuất hiện lần đầu tại website http://khamgiodau.com

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