Types/lymphoma/patient/adult-nhl-treatment-pdq

Chithandizo Chachikulire Chosakhala Hodgkin Lymphoma (®) -Patient Version

Zambiri Zokhudza Achikulire Osakhala Hodgkin Lymphoma

MFUNDO ZOFUNIKA

• Non-Hodgkin lymphoma ndi matenda omwe mumakhala maselo owopsa (khansa) omwe amapezeka m'mitsempha.

• Non-Hodgkin lymphoma ikhoza kukhala yolekerera kapena yamwano.

• Kukalamba, kukhala wamwamuna, komanso kukhala ndi chitetezo chamthupi chofooka kumatha kuwonjezera chiopsezo cha achikulire omwe si Hodgkin lymphoma.

• Zizindikiro za achikulire omwe si Hodgkin lymphoma amaphatikizapo ma lymph node otupa, malungo, kutuluka thukuta usiku, kuwonda, komanso kutopa.

• Kuyesa komwe kumayang'ana ma lymph system ndi ziwalo zina za thupi kumagwiritsidwa ntchito kuthandizira kuzindikira ndikukhazikitsa wamkulu yemwe si Hodgkin lymphoma.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Non-Hodgkin lymphoma ndi matenda omwe mumakhala maselo owopsa (khansa) omwe amapezeka m'mitsempha.

Non-Hodgkin lymphoma ndi mtundu wa khansa yomwe imapangidwa mumitsempha. Mitsempha ya m'thupi ndi mbali ya chitetezo cha mthupi. Zimathandiza kuteteza thupi kumatenda ndi matenda.

Mitsempha ya m'mimba imapangidwa ndi izi:

• Lymph: Chamadzimadzi chopanda utoto, chamadzi chomwe chimadutsa m'mitsempha yam'mimba ndipo chimanyamula ma lymphocyte (maselo oyera amwazi). Pali mitundu itatu ya ma lymphocyte:

• Ma lymphocyte B omwe amapanga ma antibodies kuti athandizire kulimbana ndi matenda. Amatchedwanso B maselo. Mitundu yambiri ya non-Hodgkin lymphoma imayamba mu ma lymphocyte a B.

• Ma lymphocyte a T omwe amathandiza ma lymphocyte a B kupanga ma antibodies omwe amathandiza kulimbana ndi matenda. Amatchedwanso T cell.

• Maselo opha achilengedwe omwe amalimbana ndi ma khansa ndi ma virus. Amatchedwanso NK maselo.

• Zombo zamagulu: Nthambo yamachubu yopyapyala yomwe imasonkhanitsa ma lymph kuchokera mbali zosiyanasiyana za thupi ndikuyibwezera m'magazi.

• Matenda am'mimba: Tinthu tating'onoting'ono tomwe timapanga nyemba zomwe zimasefa ma lymph ndikusunga maselo oyera omwe amathandiza kulimbana ndi matenda ndi matenda. Ma lymph lymph amapezeka pamitsempha yamafuta mthupi lonse. Magulu a ma lymph node amapezeka m khosi, pansi pamimba, mediastinum, pamimba, m'chiuno, ndi m'mabako.

• Nthata: Chiwalo chomwe chimapanga ma lymphocyte, chimasunga maselo ofiira ndi ma lymphocyte, chimasefa magazi, ndikuwononga maselo akale amwazi. Nduluyo ili kumanzere kwa mimba pafupi ndi m'mimba.

• Thymus: Chiwalo chomwe ma T-lymphocyte amakula ndikuchulukirachulukira. Thymus ili pachifuwa kuseri kwa mafupa.

• Tonsils: Tinthu tating'ono ting'onoting'ono tating'onoting'ono tambiri kumbuyo kwa mmero. Pali matani amodzi mbali iliyonse ya mmero.

• Mafupa a mafupa: Minofu yofewa, yamatope yapakati pamafupa ena, monga fupa la m'chiuno ndi chifupa cha m'mawere. Maselo oyera a magazi, maselo ofiira ofiira, ndi ma platelet amapangidwa m'mafupa.

Anatomy of the lymph system, yowonetsa ziwiya zam'mimba ndi ziwalo zam'mimba kuphatikiza ma lymph node, matonil, thymus, ndulu, ndi mafupa. Lymph (clear fluid) ndi ma lymphocyte amayenda kudzera mumitsempha yam'mimba ndikupita kumalo am'mimba momwe ma lymphocyte amawonongera zinthu zowopsa. Nthiti imalowa m'magazi kudzera mumitsempha yayikulu pafupi ndi mtima.

Minofu yamagulu imapezekanso m'malo ena amthupi monga gawo la m'mimba, bronchus, ndi khungu. Khansa imafalikira mpaka pachiwindi ndi m'mapapu.

Pali mitundu iwiri ya ma lymphomas: Hodgkin lymphoma ndi non-Hodgkin lymphoma. Chidule ichi ndi cha chithandizo cha achikulire omwe si a Hodgkin lymphoma, kuphatikiza panthawi yapakati.

Kuti mumve zambiri za mitundu ina ya lymphoma, onani mwachidule zotsatirazi za :

• Kuchiza Kwachikulire Kachilombo ka Khansa ya m'magazi (lymphoblastic lymphoma)

• Chithandizo cha Hodgkin Lymphoma Treatment

• Chithandizo cha Lymphoma Chokhudzana ndi Edzi

• Kuchiza Kwachinyamata Osakhala Hodgkin Lymphoma

• Matenda a Lymphocytic Leukemia Treatment (ang'onoang'ono a lymphocytic lymphoma)

• Chithandizo cha Mycosis Fungoides (Kuphatikiza Sézary Syndrome) (cutaneous T-cell lymphoma)

• Chithandizo choyambirira cha CNS Lymphoma

Non-Hodgkin lymphoma ikhoza kukhala yolekerera kapena yamwano.

Non-Hodgkin lymphoma imakula ndikufalikira pamitundu yosiyanasiyana ndipo imatha kukhala yoletsa kapena yamwano. Indolent lymphoma imakula ndikufalikira pang'onopang'ono, ndipo imakhala ndi zizindikilo zochepa. Aggressive lymphoma imakula ndikufalikira mwachangu, ndipo imakhala ndi zizindikilo zomwe zingakhale zovuta. Mankhwala a indolent and aukali lymphoma ndi osiyana.

Chidule ichi ndi cha mitundu yotsatirayi ya non-Hodgkin lymphoma:

Osavomerezeka omwe si a Hodgkin lymphomas

Follicular lymphoma. Follicular lymphoma ndi mtundu wofala kwambiri wa non-Hodgkin lymphoma. Ndi mtundu wofulumira kwambiri wa non-Hodgkin lymphoma womwe umayamba mu ma lymphocyte a B. Zimakhudza ma lymph node ndipo zimatha kufalikira mpaka m'mafupa kapena ndulu. Odwala ambiri omwe ali ndi follicular lymphoma ali ndi zaka 50 kapena kupitilira apo akapezedwa. Follicular lymphoma imatha popanda chithandizo. Wodwalayo amayang'anitsitsa zizindikiro kuti matendawo abwerera. Chithandizo chimafunikira ngati zizindikilo zimayamba khansa itasowa kapena mutalandira chithandizo cha khansa koyamba. Nthawi zina follicular lymphoma imatha kukhala mtundu wankhanza kwambiri wa lymphoma, monga kufalikira kwa B-cell lymphoma.

Lymphoplasmacytic lymphoma. Nthawi zambiri ma lymphoplasmacytic lymphoma, ma lymphocyte a B omwe amasandulika maselo am'magazi amadzipangira mapuloteni ambiri otchedwa monoclonal immunoglobulin M (IgM) antibody. Mulingo wambiri wama anti-IgM m'magazi amachititsa kuti magazi m'madzi akule. Izi zimatha kuyambitsa zizindikilo monga zovuta kuwona kapena kumva, mavuto amtima, kupuma movutikira, kupweteka mutu, chizungulire, kufooka kapena kumva kulira kwa manja ndi mapazi. Nthawi zina palibe zizindikilo za lymphoplasmacytic lymphoma. Ikhoza kupezeka mukayezetsa magazi pazifukwa zina. Lymphoplasmacytic lymphoma nthawi zambiri imafalikira mpaka m'mafupa, ma lymph node, ndi ndulu. Odwala omwe ali ndi lymphoplasmacytic lymphoma ayenera kufufuzidwa ngati ali ndi kachilombo ka hepatitis C. Amatchedwanso Waldenström macroglobulinemia.

Malo am'mbali a lymphoma. Mtundu wa non-Hodgkin lymphoma umayambira mu ma lymphocyte a B omwe ali munthawi yaminyewa yam'magazi yotchedwa m'mbali mwake. Matendawa akhoza kukhala oyipa kwambiri kwa odwala azaka 70 kapena kupitilira apo, omwe ali ndi gawo lachitatu kapena gawo IV, komanso omwe ali ndi milingo yayikulu ya lactate dehydrogenase (LDH). Pali mitundu isanu yosiyanasiyana ya m'mphepete mwa zone lymphoma. Amagawidwa ndi mtundu wa minofu komwe lymphoma idapanga:

• Nodal m'mphepete mwa nyanja lymphoma. Nodal marginal zone zone lymphoma imapanga ma lymph node. Mtundu wa non-Hodgkin lymphoma ndi wosowa. Amatchedwanso monocytoid B-cell lymphoma.

• Matumbo am'mimba am'magazi amtundu wa lymphoid (MALT) lymphoma. Gastric MALT lymphoma nthawi zambiri imayamba m'mimba. Mtundu wa m'mphepete mwa m'mphepete mwa lymphoma umapangidwa m'maselo amu mucosa omwe amathandizira kupanga ma antibodies. Odwala omwe ali ndi chapamimba MALT lymphoma amathanso kukhala ndi Helicobacter gastritis kapena matenda amthupi, monga Hashimoto thyroiditis kapena Sjögren syndrome.

• Zowonjezera MALT lymphoma. Extragastric MALT lymphoma imayamba kunja kwa m'mimba pafupifupi gawo lililonse la thupi kuphatikiza magawo ena am'mimba, zotupa zamatenda, chithokomiro, mapapo, khungu, komanso mozungulira diso. Mtundu wa m'mphepete mwa m'mphepete mwa lymphoma umapangidwa m'maselo amu mucosa omwe amathandizira kupanga ma antibodies. Extragastric MALT lymphoma imatha kubwerera zaka zambiri mutalandira chithandizo.

• Mediterranean m'mimba lymphoma. Ichi ndi mtundu wa MALT lymphoma womwe umapezeka mwa achinyamata kumayiko akum'mawa kwa Mediterranean. Nthawi zambiri amapezeka m'mimba ndipo odwala amathanso kutenga mabakiteriya otchedwa Campylobacter jejuni. Mtundu wa lymphoma umatchedwanso kuti immunoproliferative ang'ono matumbo matumbo.

• Splenic m'mphepete mwa nyanja lymphoma. Mtundu wa m'mphepete mwa m'mphepete mwa lymphoma umayamba munthawi ndipo umatha kufalikira kugazi ndi m'mafupa. Chizindikiro chofala kwambiri chamtundu wa splenic marginal zone lymphoma ndi ndulu yayikulu kuposa yachibadwa.

Pulayimale cutaneous anaplastic lalikulu cell lymphoma. Mtundu wa non-Hodgkin lymphoma uli pakhungu lokha. Chitha kukhala chotupa chosaopsa (osati khansa) chomwe chitha kumatha chokha kapena chitha kufalikira m'malo ambiri pakhungu ndikusowa chithandizo.

Olusa omwe si Hodgkin lymphomas

Kufalitsa lalikulu B-cell lymphoma. Kusokoneza lalikulu B-cell lymphoma ndi mtundu wofala kwambiri wa non-Hodgkin lymphoma. Amakula msanga m'matumbo ndipo nthawi zambiri ndulu, chiwindi, mafupa, kapena ziwalo zina zimakhudzidwanso. Zizindikiro za kufalikira kwa B-cell lymphoma imatha kuphatikizira malungo, kutuluka thukuta usiku, ndi kuonda. Izi zimatchedwanso B zizindikiro.

• Pulayimale yayikulu pakati B-cell lymphoma. Mtundu wa non-Hodgkin lymphoma ndi mtundu waukulu wa B-cell lymphoma. Amadziwika ndi kuchuluka kwa mitsempha yamafupa (yofiira). Nthawi zambiri chotupa chimakhala kuseli kwa chifuwa. Ikhoza kupitilira munjira zopumira kenako kumayambitsa kutsokomola komanso kupuma movutikira. Odwala ambiri omwe ali ndi kachilombo koyambitsa matenda akuluakulu a B-cell lymphoma ndi amayi omwe ali ndi zaka 30 mpaka 40.

Chotsatira chachikulu cell lymphoma, gawo lachitatu. Chotsatira chachikulu cha cell lymphoma, gawo lachitatu, ndi mtundu wosowa kwambiri wa non-Hodgkin lymphoma. Kuchiza kwamtunduwu wa follicular lymphoma kuli ngati chithandizo cha NHL yachiwawa kuposa NHL yolemetsa.

Anaplastic lalikulu cell lymphoma. Anaplastic large cell lymphoma ndi mtundu wa non-Hodgkin lymphoma womwe nthawi zambiri umayambira ma T lymphocyte. Maselo a khansa amakhalanso ndi chikhomo chotchedwa CD30 pamwamba pamaselo.

Pali mitundu iwiri ya anaplastic large cell lymphoma:

• Sakanizani anaplastic lalikulu cell lymphoma. Mtundu wa anaplastic large cell lymphoma umakhudza kwambiri khungu, koma ziwalo zina zathupi zimatha kukhudzidwanso. Zizindikiro zazing'ono zopanikizika za cell lymphoma zimaphatikizira chimodzi kapena zingapo zotupa pakhungu. Mtundu wa lymphoma ndi wosowa komanso wosasangalatsa.

• Mapangidwe apamwamba a cell lymphoma. Mtundu wa anaplastic large cell lymphoma umayamba mwanjira zam'mimba ndipo umatha kukhudza ziwalo zina za thupi. Mtundu wa lymphoma ndiwowopsa. Odwala amatha kukhala ndi mapuloteni ambiri a anaplastic lymphoma kinase (ALK) mkati mwa ma lymphoma. Odwalawa ali ndi vuto labwino kuposa odwala omwe alibe mapuloteni owonjezera a ALK. Makina akuluakulu amtundu wa lymphoma amakhala ofala kwambiri kwa ana kuposa achikulire. (Onani chidule cha pa Chithandizo cha Ana Osakhala Hodgkin Lymphoma Treatment kuti mumve zambiri.)

• Extranodal NK- / T-cell lymphoma. Extranodal NK- / T-cell lymphoma nthawi zambiri imayamba mdera lozungulira mphuno. Zitha kukhudzanso sinus ya paranasal (malo abowo m'mafupa ozungulira mphuno), denga la mkamwa, trachea, khungu, m'mimba, ndi matumbo. Matenda ambiri a extranodal NK- / T-cell lymphoma amakhala ndi kachilombo ka Epstein-Barr m'maselo otupa. Nthawi zina matenda a hemophagocytic amapezeka (vuto lalikulu momwe mumakhala ma histiocyte ochulukirapo komanso ma T omwe amachititsa kutupa kwakukulu mthupi). Chithandizo chopondereza chitetezo cha mthupi chimafunika. Mtundu wa non-Hodgkin lymphoma siwofala ku United States.

• Lymphomatoid granulomatosis. Lymphomatoid granulomatosis imakhudza kwambiri mapapu. Zitha kukhudzanso matupi a paranasal (malo abowo m'mafupa ozungulira mphuno), khungu, impso, komanso dongosolo lamanjenje. Khansa ya lymphomatoid granulomatosis, khansa imalowa mumitsempha yamagazi ndikupha minofu. Chifukwa khansayo imatha kufalikira kuubongo, intrathecal chemotherapy kapena mankhwala a radiation kuubongo amaperekedwa.

• Angioimmunoblastic T-cell lymphoma. Mtundu wa non-Hodgkin lymphoma umayamba m'maselo a T. Kutupa ma lymph node ndi chizindikiro chofala. Zizindikiro zina zimatha kuphulika pakhungu, kutentha thupi, kuchepa thupi, kapena kutuluka thukuta usiku. Pakhoza kukhalanso ndi ma gamma globulin (ma antibodies) ambiri m'magazi. Odwala amathanso kukhala ndi matenda otenga mwayi chifukwa chitetezo chamthupi chawo chafooka.

• Zozungulira T-cell lymphoma. Mphepete mwa T-cell lymphoma imayamba mu ma lymphocyte okhwima a T. Mtundu wa T lymphocyte umakhwima mu thymus gland ndikupita kumalo ena am'magazi amthupi monga ma lymph node, mafupa, ndi ndulu. Pali magawo atatu a T-cell lymphoma:

• Matenda a hepatosplenic T-cell lymphoma. Ichi ndi mtundu wachilendo wa T-cell lymphoma yomwe imapezeka makamaka mwa anyamata. Imayambira m'chiwindi ndi nthenda ndipo ma cell a khansa amakhalanso ndi cholandilira T chomwe chimatchedwa gamma / delta pamwamba pa selo.

• Subcutaneous panniculitis ngati T-cell lymphoma. Subcutaneous panniculitis-ngati T-cell lymphoma imayamba pakhungu kapena mucosa. Zitha kuchitika ndi hemophagocytic syndrome (vuto lalikulu momwe mumakhala ma histiocyte ochulukirapo komanso ma T omwe amachititsa kutupa kwakukulu mthupi). Chithandizo chopondereza chitetezo cha mthupi chimafunika.

• Matenda a Enteropathy-matumbo a T-cell lymphoma. Mtundu wamtunduwu wa T-cell lymphoma umapezeka m'matumbo ang'onoang'ono a odwala omwe alibe matenda a leliac (chitetezo chamthupi cha gluten chomwe chimayambitsa kusowa kwa zakudya m'thupi). Odwala omwe amapezeka kuti ali ndi matenda a leliac ali mwana ndipo amakhalabe ndi zakudya zopanda thanzi nthawi zambiri samakhala ndi matenda am'mimba a T-cell lymphoma.

• Mitsempha yayikulu ya B-cell lymphoma. Mtundu wa non-Hodgkin lymphoma umakhudza mitsempha yamagazi, makamaka mitsempha yaying'ono yamagazi muubongo, impso, mapapo, ndi khungu. Zizindikiro za B-cell lymphoma yayikulu yam'mimba imayamba chifukwa chamitsempha yamagazi yotsekedwa. Amatchedwanso intravascular lymphomatosis.

• Burkitt lymphoma.Burkitt lymphoma ndi mtundu wa B-cell non-Hodgkin lymphoma yomwe imakula ndikufalikira mwachangu kwambiri. Zitha kukhudza nsagwada, mafupa akumaso, matumbo, impso, thumba losunga mazira, kapena ziwalo zina. Pali mitundu itatu yayikulu ya Burkitt lymphoma (yodwala, yapakatikati, komanso yokhudzana ndi chitetezo chamthupi). Matenda a Burkitt lymphoma amapezeka ku Africa ndipo amalumikizidwa ndi kachilombo ka Epstein-Barr, ndipo Burkitt lymphoma imachitika padziko lonse lapansi. Burkitt lymphoma yokhudzana ndi chitetezo cha mthupi imapezeka kawirikawiri kwa odwala omwe ali ndi Edzi. Burkitt lymphoma imatha kufalikira kuubongo ndi msana wam'mimba komanso chithandizo chopewa kufalikira kwake. Burkitt lymphoma imachitika kawirikawiri mwa ana ndi achikulire (Onani chidule cha pa Chithandizo cha Ana Osakhala Hodgkin Lymphoma Chithandizo kuti mumve zambiri.) Burkitt lymphoma imadziwikanso kuti kufalitsa pang'ono noncleaved-cell lymphoma.

• Lymphoblastic lymphoma. Lymphoblastic lymphoma ikhoza kuyamba m'maselo a T kapena ma B, koma nthawi zambiri imayamba m'maselo a T. Mu mtundu uwu wosakhala Hodgkin lymphoma, pali ma lymphoblast ambiri (maselo oyera amwazi) m'matenda am'mimba ndi thymus gland. Ma lymphoblast amatha kufalikira m'malo ena m'thupi, monga mafupa, ubongo, ndi msana. Lymphoblastic lymphoma imakonda kwambiri achinyamata komanso achinyamata. Zili ngati leukemia ya lymphoblastic (ma lymphoblast amapezeka m'mafupa ndi magazi). (Onani chidule cha pa Chithandizo cha Akulu Acute Lymphoblastic Leukemia Treatment kuti mumve zambiri.)

• Akuluakulu a T-cell khansa ya m'magazi / lymphoma. Matenda akuluakulu a T-cell leukemia / lymphoma amayamba chifukwa cha mtundu wa 1 wa T-cell leukemia virus 1 (HTLV-1). Zizindikiro zimaphatikizira zotupa zamafupa ndi khungu, kuchuluka kwa calcium yam'magazi, ndi ma lymph node, ndulu, ndi chiwindi zomwe ndizazikulu kuposa zachilendo.

• Mantle cell lymphoma. Mantle cell lymphoma ndi mtundu wa B-cell non-Hodgkin lymphoma yomwe imakonda kupezeka kwa achikulire kapena achikulire. Amayambira kumatenda am'mimba ndipo amafalikira mpaka pamphaka, m'mafupa, magazi, ndipo nthawi zina pamimba, m'mimba, ndi m'matumbo. Odwala omwe ali ndi mantle cell lymphoma ali ndi mapuloteni ochulukirapo otchedwa cyclin-D1 kapena majini ena amasintha m'maselo a lymphoma. Odwala ena omwe alibe zizindikilo za lymphoma zomwe zimachedwetsa kuyamba kwa mankhwala sizimakhudza matendawa.

• Posttransplantation matenda a lymphoproliferative. Matendawa amapezeka mwa odwala omwe ali ndi mtima, mapapo, chiwindi, impso, kapena kapamba ndipo amafunikira chithandizo chamankhwala chokhazikika. Matenda ambiri a posttransplant lymphoproliferative amakhudza maselo a B ndipo amakhala ndi kachilombo ka Epstein-Barr m'maselo. Matenda a Lymphoproliferative nthawi zambiri amachitidwa ngati khansa.

• Histiocytic lymphoma yeniyeni. Ichi ndi mtundu wosowa, woopsa kwambiri wa lymphoma. Sizikudziwika ngati imayamba m'maselo a B kapena ma T cell. Sichimayankha bwino chithandizo chamankhwala omwe ali ndi chemotherapy wamba.

• Primary effusion lymphoma. Primary effusion lymphoma imayamba m'maselo a B omwe amapezeka mdera lomwe mumakhala madzi ambiri, monga madera omwe amakhala pakatikati pa mapapo ndi chifuwa (pleural effusion), thumba mozungulira mtima ndi mtima (pericardial effusion), kapena m'mimba. Nthawi zambiri palibe chotupa chomwe chimawoneka. Mtundu wa lymphoma nthawi zambiri umapezeka mwa odwala omwe ali ndi kachilombo ka HIV.

• Plasmablastic lymphoma. Plasmablastic lymphoma ndi mtundu wa B-cell non-Hodgkin lymphoma womwe ndi wankhanza kwambiri. Kawirikawiri amapezeka kwa odwala omwe ali ndi kachilombo ka HIV.

Kukalamba, kukhala wamwamuna, komanso kukhala ndi chitetezo chamthupi chofooka kumatha kuwonjezera chiopsezo cha achikulire omwe si Hodgkin lymphoma.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo.

Izi ndi zina mwaziwopsezo zitha kukulitsa chiopsezo cha mitundu ina ya achikulire omwe si Hodgkin lymphoma:

• Kukhala wamkulu, wamwamuna, kapena woyera.

• Kukhala ndi chimodzi mwazinthu zotsatirazi zomwe zimafooketsa chitetezo chamthupi:

• Matenda obadwa nawo (monga hypogammaglobulinemia kapena matenda a Wiskott-Aldrich).

• Matenda osokoneza bongo (monga nyamakazi, psoriasis, kapena matenda a Sjögren).

• HIV / Edzi.

• Matenda a T-lymphotrophic virus amtundu wa I kapena Epstein-Barr virus.

• Matenda a Helicobacter pylori.

• Kutenga mankhwala osokoneza bongo atatha kumuika thupi.

Zizindikiro za achikulire omwe si Hodgkin lymphoma amaphatikizapo ma lymph node otupa, malungo, kutuluka thukuta usiku, kuwonda, komanso kutopa.

Zizindikiro izi zimatha kuyambitsidwa ndi achikulire omwe si Hodgkin lymphoma kapena zinthu zina. Funsani dokotala ngati muli ndi izi:

• Kutupa mu ma lymph node m khosi, pansi pamimba, kubuula, kapena m'mimba.

• Kutentha thupi popanda chifukwa chodziwika.

• Kukhetsa thukuta usiku.

• Kumva kutopa kwambiri.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kutupa khungu kapena khungu loyabwa.

• Kupweteka pachifuwa, pamimba, kapena mafupa popanda chifukwa chodziwika.

• Pamene malungo, kutuluka thukuta usiku, ndi kuchepa thupi kumachitika palimodzi, gululi limadziwika kuti B.

Zizindikiro zina za achikulire omwe si a Hodgkin lymphoma zitha kuchitika ndikudalira izi:

• Komwe khansa imapangika mthupi.

• Kukula kwa chotupacho.

• Kutupa kumakula msanga.

Kuyesa komwe kumayang'ana ma lymph system ndi ziwalo zina za thupi kumagwiritsidwa ntchito kuthandizira kuzindikira ndikukhazikitsa wamkulu yemwe si Hodgkin lymphoma.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikizapo kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri ya thanzi la wodwalayo, kuphatikiza malungo, kutuluka thukuta usiku, komanso kuwonda, zizolowezi zake, matenda am'mbuyomu ndi chithandizo chake chidzachitikanso.

• Kuwerengera kwathunthu kwa magazi (CBC): Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la nyemba lopangidwa ndi maselo ofiira amwazi.

Kuwerengera kwathunthu kwa magazi (CBC). Magazi amatengedwa polowetsa singano mumtsempha ndikuloleza magazi kuti alowe mu chubu. Sampulo yamwazi imatumizidwa ku labotale ndipo maselo ofiira amwazi, maselo oyera amwazi, ndi ma platelet amawerengedwa. CBC imagwiritsidwa ntchito kuyesa, kuzindikira, ndikuwunika zochitika zosiyanasiyana.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

• Kuyesa kwa LDH: Njira yoyeserera magazi kuti ayese kuchuluka kwa lactic dehydrogenase. Kuchuluka kwa LDH m'magazi kungakhale chizindikiro cha kuwonongeka kwa minofu, lymphoma, kapena matenda ena.

• Kuyesedwa kwa Hepatitis B ndi hepatitis C: Njira yomwe magazi amafufuzira kuti athe kuyeza kuchuluka kwa ma antigen a hepatitis B ndi / kapena ma antibodies komanso kuchuluka kwa ma virus a hepatitis C. Ma antigen kapena ma antibodies amatchedwa zikwangwani. Zizindikiro zosiyanasiyana kapena mitundu yazizindikiro amagwiritsidwa ntchito kuti adziwe ngati wodwala ali ndi matenda a hepatitis B kapena C, adadwalapo kapena katemera, kapena atenga kachilombo. Odwala omwe adachiritsidwa ndi kachilombo ka hepatitis B m'mbuyomu amafunika kupitiliza kuwunika kuti awone ngati ayambiranso. Kudziwa ngati munthu ali ndi matenda a chiwindi a B kapena C kungathandize kukonzekera chithandizo.

• Kuyezetsa HIV: Kuyesa kuyeza kuchuluka kwa ma antibodies a HIV muchitsanzo cha magazi. Ma antibodies amapangidwa ndi thupi likaukiridwa ndi chinthu chakunja. Mulingo wokwanira wa ma antibodies a HIV ungatanthauze kuti thupi lili ndi kachilombo ka HIV.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga khosi, chifuwa, mimba, mafupa a chiuno, ndi ma lymph node, otengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira.

• Kulakalaka kwa mafupa ndi biopsy: Kuchotsa mafupa ndi fupa laling'ono poika singano m'chiuno kapena m'chifuwa. Dokotala akuwona mafupa ndi mafupa pansi pa microscope kuti ayang'ane zizindikiro za khansa.

Kukhumba kwamfupa ndi mafupa. Gawo laling'ono la khungu litachita dzanzi, singano ya m'mafupa imalowetsedwa m'fupa la m'chiuno la wodwalayo. Zitsanzo zamagazi, mafupa, ndi mafupa amachotsedwa kuti zikaunikidwe ndi microscope.

• Lymph node biopsy: Kuchotsa zonse kapena gawo la mwanabele. Wodwala amayang'ana minofu pansi pa microscope kuti aone ngati ali ndi khansa. Chimodzi mwazinthu zotsatirazi za biopsies zitha kuchitidwa:

• Chisokonezo chodabwitsa: Kuchotsa khungu lonse.

• Incopal biopsy: Kuchotsa gawo la mwanabele.

• Core biopsy: Kuchotsa gawo lamankhwala am'mimba pogwiritsa ntchito singano yayikulu.

Ngati khansa ipezeka, mayesero otsatirawa angachitike kuti muphunzire za maselo a khansa:

• Immunohistochemistry: Kuyesa kwa labotale komwe kumagwiritsa ntchito ma antibodies kuti aone ngati ali ndi ma antigen (zolembera) muzitsanzo za minofu ya wodwala. Ma antibodies nthawi zambiri amalumikizidwa ndi enzyme kapena utoto wa fulorosenti. Ma antibodies atagwirizana ndi antigen inayake munthawi ya minofu, enzyme kapena utoto umayambitsidwa, ndipo antigen imatha kuwonedwa ndi microscope. Mayeso amtunduwu amagwiritsidwa ntchito pothandiza kuzindikira khansa ndikuthandizira kudziwa khansa yamtundu wina wa khansa.

• Kusanthula kwa cytogenetic: Kuyesa kwa labotale komwe ma chromosomes am'magazi am'magazi kapena m'mafupa amawerengedwa ndikuwunika ngati pali kusintha kulikonse, monga kusweka, kusowa, kukonzedwanso, kapena ma chromosomes owonjezera. Kusintha kwa ma chromosomes ena kungakhale chizindikiro cha khansa. Kusanthula kwa cytogenetic kumagwiritsidwa ntchito kuthandizira kuzindikira khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

• Immunophenotyping: Kuyesa kwa labotale komwe kumagwiritsa ntchito ma antibodies kuti azindikire maselo a khansa kutengera mitundu ya ma antigen kapena zolembera zomwe zili pamwamba pamaselo. Mayesowa amagwiritsidwa ntchito kuthandizira kudziwa mitundu ina ya lymphoma.

• FISH (fluorescence in situ hybridization): Kuyesa kwa labotale komwe kumayang'ana ndikuwerengera majini kapena ma chromosomes m'maselo ndi minofu. Zidutswa za DNA zomwe zimakhala ndi utoto wa fulorosenti zimapangidwa mu labotale ndikuwonjezeredwa muzitsanzo zamaselo a wodwalayo. Zidutswa za DNA zoterezi zikalumikizana ndi majini kapena madera ena a chromosomes mchitsanzo, zimawala zikawonedwa ndi microscope ya fulorosenti. Kuyesa kwa FISH kumagwiritsidwa ntchito kuthandizira kuzindikira khansa ndikuthandizira kukonzekera mankhwala.

Mayesero ndi njira zina zitha kuchitidwa kutengera zizindikilo zomwe zikuwoneka komanso komwe khansara imapanga mthupi.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Njira zakulosera zamankhwala ndi chithandizo zimadalira izi:

• Zizindikiro za wodwalayo, kuphatikiza ngati ali ndi zizindikiro za B (malungo popanda chifukwa chodziwika, kuchepa thupi popanda chifukwa chodziwikiratu, kapena kutuluka thukuta usiku).

• Gawo la khansa (kukula kwa zotupa za khansa komanso ngati khansayo yafalikira mbali zina za thupi kapena ma lymph node).

• Mtundu wa non-Hodgkin lymphoma.

• Kuchuluka kwa lactate dehydrogenase (LDH) m'magazi.

• Kaya pali kusintha kwina m'majini.

• Msinkhu wa wodwalayo, kugonana, komanso thanzi labwino.

• Kaya lymphoma yangotuluka kumene, ikupitilizabe kukula panthawi yamankhwala, kapena yabwereranso.

Kwa non-Hodgkin lymphoma panthawi yoyembekezera, njira zamankhwala zimadaliranso:

• Zokhumba za wodwalayo.

• Ndi miyezi iti yapakati ya mimba yomwe wodwalayo ali.

• Kaya mwanayo angathe kubala msanga.

Mitundu ina ya non-Hodgkin lymphoma imafalikira mwachangu kuposa ena. Matenda ambiri omwe si a Hodgkin omwe amapezeka nthawi yapakati amakhala okwiya. Kuchedwetsa chithandizo cha mwankhanza cha lymphoma mpaka atabadwa mwana kumachepetsa mwayi wamayi wopulumuka. Chithandizo cha nthawi yomweyo chimalimbikitsidwa, ngakhale mutakhala ndi pakati.

Magawo a Achikulire Osakhala a Hodgkin Lymphoma

MFUNDO ZOFUNIKA

• Pambuyo poti munthu wamkulu yemwe si Hodgkin lymphoma wapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa ma lymph system kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Magawo otsatirawa amagwiritsidwa ntchito kwa achikulire omwe si a Hodgkin lymphoma:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Achikulire Osakhala Hodgkin Lymphoma

• Ma lymphomas achikulire omwe si a Hodgkin atha kugawidwa kuti akalandire chithandizo kutengera khansa ngati yaulesi kapena yankhanza, ngati ma lymph node omwe ali ndi vuto ali pafupi wina ndi mzake mthupi, komanso ngati khansa yapezeka kumene kapena yabwereza.

Pambuyo poti munthu wamkulu yemwe si Hodgkin lymphoma wapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa ma lymph system kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza mtundu wa khansa komanso ngati ma cell a khansa afalikira mkati mwa lymph kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunika kudziwa gawo la matendawa kuti mukonzekere chithandizo. Zotsatira za mayeso ndi njira zomwe zachitika kuti apeze omwe si a Hodgkin lymphoma amagwiritsidwa ntchito kuthandizira kupanga zisankho zamankhwala.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwanso ntchito pokonza:

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, komanso kompyuta kuti ipange zithunzi zingapo zazomwe zili mkati mwa thupi, monga ubongo ndi msana. Chinthu chotchedwa gadolinium chimalowetsedwa mwa wodwalayo kudzera mu mtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• Lumbar puncture: Njira yogwiritsira ntchito cerebrospinal fluid (CSF) kuchokera pamtsempha. Izi zimachitika poika singano pakati pa mafupa awiri mumsana ndi CSF mozungulira msana ndikuchotsa madzi. Chitsanzo cha CSF chimayang'aniridwa ndi microscope ngati pali zisonyezo kuti khansara yafalikira kuubongo ndi msana. Njirayi imatchedwanso LP kapena tapu ya msana.

Lumbar kuboola. Wodwala amagona pamalo okuta patebulo. Dera laling'ono kumunsi kumapeto kwake, dzenje la msana (singano yayitali, yopyapyala) imalowetsedwa m'munsi mwa msana kuti muchotse madzi amadzimadzi (CSF, omwe akuwonetsedwa ndi buluu). Timadzimadzi timatumizidwa ku labotale kukayezetsa.

Kwa amayi apakati omwe alibe Hodgkin lymphoma, kuyesa magawo ndi njira zotetezera mwana wosabadwa kuzowopsa za radiation zimagwiritsidwa ntchito. Kuyesaku ndi njira zake zimaphatikizapo MRI (popanda kusiyanitsa), kuboola lumbar, ndi ultrasound.

Pali njira zitatu zomwe khansa imafalikira mthupi. Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Magawo otsatirawa amagwiritsidwa ntchito kwa achikulire omwe si a Hodgkin lymphoma:

Gawo I

Gawo I wamkulu lymphoma. Khansara imapezeka m'mimba imodzi kapena ingapo m'magulu am'magazi kapena, nthawi zambiri, khansa imapezeka mu mphete ya Waldeyer, thymus, kapena ndulu. Pa siteji IE (yosawonetsedwa), khansa yafalikira kudera lina kunja kwa ma lymph system.

Gawo I wamkulu wosakhala Hodgkin lymphoma lagawika magawo I ndi IE.

Pachigawo choyamba ine, khansa imapezeka m'malo amodzi am'mimba:

• Mmodzi kapena angapo mwanabele mu gulu la mwanabele.

• Mphete ya Waldeyer.

• Thymus.

• Nkhumba.

Mu gawo la IE, khansa imapezeka mdera lina kunja kwa ma lymph system.

Gawo II

Gawo lachiwiri wamkulu wosakhala Hodgkin lymphoma lagawidwa magawo II ndi IIE.

• Mu gawo lachiwiri, khansa imapezeka m'magulu awiri kapena kupitilira apo am'magazi omwe ali pamwambapa kapena pansi pake.

Gawo lachiwiri la lymphoma wamkulu. Khansa imapezeka m'magulu awiri kapena kupitilira apo am'magazi omwe ali pamwambapa kapena pansi pake.

• Mu gawo lachiwiri la IIE, khansa yafalikira kuchokera pagulu lamankhwala kupita kumalo oyandikira omwe ali kunja kwa ma lymph system. Khansa ikhoza kufalikira m'magulu ena am'mimba omwe ali mbali yomweyo ya chifundacho.

Gawo IIE wamkulu lymphoma. Khansa yafalikira kuchokera pagulu lamagulu am'mimba kupita kumadera oyandikira omwe ali kunja kwa ma lymph system. Khansa ikhoza kufalikira m'magulu ena am'mimba omwe ali mbali yomweyo ya chifundacho.

Mu gawo lachiwiri, mawu akuti bulky matenda amatanthauza chotupa chachikulu. Kukula kwa chotupa chomwe chimatchedwa bulky matenda chimasiyana kutengera mtundu wa lymphoma.

Gawo III

Gawo lachitatu la lymphoma wamkulu. Khansa imapezeka m'magulu am'mimba pamwamba ndi pansi pake; kapena pagulu lamankhwala am'mimba pamwamba pa diaphragm ndi ndulu.

Mu gawo lachitatu la achikulire omwe si a Hodgkin lymphoma, khansa imapezeka:

• m'magulu am'mimba pamwamba ndi pansi pake; kapena

• mu ma lymph node pamwambapa pa diaphragm ndi mu ndulu.

Gawo IV

Gawo IV wamkulu lymphoma. Khansa (a) yafalikira m'chiwalo chimodzi kapena zingapo kunja kwa mafupa; kapena (b) amapezeka m'magulu awiri kapena kupitilira apo am'magazi omwe ali pamwambapa kapena pansi pamtsempha komanso m'chiwalo chimodzi chomwe chili kunja kwa ma lymph system osati pafupi ndi ma lymph node; kapena (c) amapezeka m'magulu am'mimba pamwamba pa chifundamunsi ndi pansi pa chifundacho ndi chiwalo chilichonse chomwe chili kunja kwa mafupa; kapena (d) amapezeka mchiwindi, mafupa, malo opitilira mapapo, kapena cerebrospinal fluid (CSF). Khansara siinafalikire mwachindunji m'chiwindi, m'mafupa, m'mapapo, kapena CSF kuchokera ku ma lymph node apafupi.

Mu gawo IV wamkulu wosakhala Hodgkin lymphoma, khansa:

• yafalikira m'chiwalo chimodzi kapena zingapo kunja kwa mafupa; kapena

• imapezeka m'magulu awiri kapena kupitilira apo am'magazi omwe ali pamwamba pa chifundamtima kapena pansi pa diaphragm ndi chiwalo chimodzi chomwe chili kunja kwa ma lymph system osati pafupi ndi ma lymph node; kapena

• imapezeka m'magulu am'mimba pamwamba ndi pansi pa diaphragm komanso m'chiwalo chilichonse chomwe chili kunja kwa ma lymph; kapena

• amapezeka mchiwindi, mafupa, malo opitilira mapapo, kapena cerebrospinal fluid (CSF). Khansara siinafalikire mwachindunji m'chiwindi, m'mafupa, m'mapapo, kapena CSF kuchokera ku ma lymph node apafupi.

Achikulire Osakhala Hodgkin Lymphoma

Wachikulire yemwe si Hodgkin lymphoma ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Lymphoma imatha kubwereranso mumatumbo kapena mbali zina za thupi. Indolent lymphoma ikhoza kubweranso ngati lymphoma yowawa. Aggressive lymphoma imatha kubwerera ngati indolent lymphoma.

Ma lymphomas achikulire omwe si a Hodgkin atha kugawidwa kuti akalandire chithandizo kutengera khansa ngati yaulesi kapena yankhanza, ngati ma lymph node omwe ali ndi vuto ali pafupi wina ndi mzake mthupi, komanso ngati khansa yapezeka kumene kapena yabwereza.

Onani gawo la General Information kuti mumve zambiri za mitundu ya maulesi (omwe akukula pang'onopang'ono) komanso achiwawa (omwe akukula mwachangu) osakhala Hodgkin lymphoma.

Non-Hodgkin lymphoma ingathenso kufotokozedwa ngati yophatikizira kapena yosagwirizana:

• Ma lymphomas ophatikizana: Ma lymphoma momwe ma lymph node omwe ali ndi khansa amakhala pafupi.

• Ma lymphomas osadziwika: Ma lymphomas omwe ma lymph node omwe ali ndi khansa samayandikana, koma amakhala mbali imodzi ya chifundacho.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe alibe Hodgkin lymphoma.

• Odwala omwe si a Hodgkin lymphoma akuyenera kukonzekereratu ndi gulu la omwe amapereka chithandizo chamankhwala

• ma lymphomas.

• Kuchiza kwa achikulire omwe si Hodgkin lymphoma kumatha kuyambitsa zovuta.

• Thandizo la radiation

• Chemotherapy

• Chitetezo chamatenda

• Chithandizo chofuna

• Plasmapheresis

• Kudikira kudikira

• Thandizo la maantibayotiki

• Opaleshoni

• Kupanga khungu la tsinde

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Thandizo la katemera

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe alibe Hodgkin lymphoma.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe alibe Hodgkin lymphoma. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Kwa amayi apakati omwe alibe Hodgkin lymphoma, chithandizo chimasankhidwa mosamala kuteteza mwana wosabadwa. Zosankha zamankhwala zimadalira zofuna za amayi, gawo la non-Hodgkin lymphoma, komanso zaka za mwana wosabadwa. Dongosolo la chithandizo lingasinthe momwe zizindikilo, khansa, ndi pakati zimasinthira. Kusankha chithandizo choyenera kwambiri cha khansa ndichisankho chomwe chimakhudza gulu la odwala, banja, komanso zamankhwala.

Odwala omwe si a Hodgkin lymphoma akuyenera kukonzedwa ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandizira ma lymphomas.

Chithandizochi chidzagwiridwa ndi a oncologist azachipatala, adotolo odziwika bwino pochiza khansa, kapena hematologist, dokotala yemwe amadziwika bwino pochiza khansa yamagazi. Odwala oncologist atha kukutumizirani kwa ena othandizira azaumoyo omwe ali ndi chidziwitso ndipo ndi akatswiri pochiza achikulire omwe si a Hodgkin lymphoma komanso omwe amadziwika bwino pamankhwala ena. Izi zingaphatikizepo akatswiri awa:

• Neurosurgeon.

• Katswiri wa zamagulu.

• Wofufuza oncologist.

• Katswiri wazamaphunziro.

• Katswiri wokonzanso.

• Akatswiri ena a oncology.

Kuchiza kwa achikulire omwe si Hodgkin lymphoma kumatha kuyambitsa zovuta.

Kuti mumve zambiri zamankhwala oyambilira omwe amayamba mukalandira chithandizo cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Kuchiza ndi chemotherapy, radiation radiation, kapena stem cell kumuika kwa non-Hodgkin lymphoma kumatha kuwonjezera ngozi zakuchedwa.

Zotsatira zakumapeto kwa chithandizo cha khansa zitha kuphatikizira izi:

• Mavuto amtima.

• Kusabereka (kulephera kukhala ndi ana).

• Kutaya kwa mafupa.

• Neuropathy (kuwonongeka kwa mitsempha komwe kumayambitsa dzanzi kapena kuyenda movutikira).

• Khansara yachiwiri, monga:

• Khansa ya m'mapapo.

• Khansara yaubongo.

• Khansa ya impso.

• Khansara ya chikhodzodzo.

• Khansa ya pakhungu.

• Hodgkin lymphoma.

• Matenda a Myelodysplastic.

• Khansa ya m'magazi yambiri.

Zotsatira zina mochedwa zimatha kuthandizidwa kapena kuwongoleredwa. Ndikofunika kuti mulankhule ndi adotolo za momwe chithandizo cha khansa chimakhudzira inu. Kutsata pafupipafupi kuti muwone zotsatira zakuchedwa ndikofunikira.

Mitundu isanu ndi inayi yothandizidwa moyenera imagwiritsidwa ntchito:

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule.

Thandizo la radiation lakunja limagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chakuthupi ndi khansa. Nthawi zina kutulutsa thupi kwathunthu kumaperekedwa kusanachitike.

Thandizo la radiation la radiation limagwiritsa ntchito ma proton (tinthu tating'onoting'ono tomwe tili ndi vuto) kupha maselo otupa. Chithandizo chamtunduwu chimatha kuchepetsa kuwonongeka kwa radiation ku minofu yathanzi pafupi ndi chotupa, monga mtima kapena bere.

Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza achikulire omwe si a Hodgkin lymphoma, ndipo atha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti athetse zizolowezi ndikusintha moyo.

Kwa mayi wapakati yemwe alibe Hodgkin lymphoma, mankhwala othandizira ma radiation ayenera kuperekedwa atabereka, ngati zingatheke, kuti apewe chiopsezo chilichonse kwa mwana wosabadwa. Ngati chithandizo chikufunika nthawi yomweyo, mayiyo angasankhe kupitiriza kutenga pakati ndikulandila chithandizo chama radiation. Chishango chotsogolera chimagwiritsidwa ntchito kuphimba pamimba ya mayi wapakati kuti ateteze mwana yemwe sanabadwe ku radiation momwe angathere.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika mu cerebrospinal fluid (intrathecal chemotherapy), chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala awiri kapena kuposa anticancer. Mankhwala a steroid akhoza kuwonjezeredwa, kuti achepetse kutupa ndikuchepetsa chitetezo chamthupi.

Njira yothandizirana ndi chemotherapy imagwiritsidwa ntchito pochiza munthu wamkulu yemwe si Hodgkin lymphoma.

Intrathecal chemotherapy itha kugwiritsidwanso ntchito pochiza lymphoma yomwe imayamba kupezeka m'machende kapena m'matope (mabowo) mozungulira mphuno, imafalitsa B-cell lymphoma, Burkitt lymphoma, lymphoblastic lymphoma, ndi ma T-cell lymphomas ena owopsa. Zimaperekedwa kuti muchepetse mwayi woti ma lymphoma cell afalikire kuubongo ndi msana. Izi zimatchedwa CNS prophylaxis.

Mankhwala otchedwa intrathecal chemotherapy. Mankhwala a anticancer amalowetsedwa mu intrathecal space, omwe ndi malo omwe amakhala ndi cerebrospinal fluid (CSF, yowonetsedwa ndi buluu). Pali njira ziwiri zochitira izi. Njira imodzi, yomwe ikuwonetsedwa kumtunda kwa chiwerengerocho, ndi kuyika mankhwalawo mu dziwe la Ommaya (chidebe chowoneka ngati dome chomwe chimayikidwa pansi pamutu pochita opareshoni; imagwira mankhwalawo akamadutsa chubu kakang'ono kupita muubongo ). Njira ina, yomwe ikuwonetsedwa kumapeto kwa chiwerengerocho, ndikulowetsa mankhwalawo mu CSF m'munsi mwa msana, pambuyo poti dera laling'ono kumunsi kwanjenjemera.

Mayi woyembekezera akamalandira mankhwala a chemotherapy a non-Hodgkin lymphoma, mwana wosabadwa sangatetezedwe kuti asamupatse chemotherapy. Mitundu ina ya chemotherapy imatha kubweretsa zoperewera mukapatsidwa trimester yoyamba.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Ma immunomodulators ndi CAR T-cell therapy ndi mitundu ya ma immunotherapy.

• Immunomodulators: Lenalidomide ndi immunomodulator yomwe imagwiritsidwa ntchito pochiza achikulire omwe si a Hodgkin lymphoma.

• Chithandizo cha C-T-cell: Maselo a T a wodwalayo (mtundu wa chitetezo chamthupi) amasinthidwa kuti awononge mapuloteni ena omwe ali ndi khansa. Maselo a T amachotsedwa kwa wodwalayo ndipo ma receptors ena apadera amawonjezedwa pamwamba pa labotore. Maselo osinthidwa amatchedwa chimeric antigen receptor (CAR) T maselo. Maselo a CAR T amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amachulukana m'magazi a wodwalayo ndikuukira ma cell a khansa. Mankhwala a CAR T-cell (monga axicabtagene ciloleucel kapena tisagenlecleucel) amagwiritsidwa ntchito pochizira B-cell lymphoma yayikulu yomwe sinayankhe kuchipatala.

Chithandizo cha CAR T-cell. Mtundu wa chithandizo momwe ma T cell a wodwala (mtundu wa chitetezo chamthupi) amasinthidwa mu labotore kotero amamangiriridwa ndi ma cell a khansa ndikuwapha. Magazi ochokera mumthambo wadzanja la wodwalayo amayenda kudzera mu chubu kupita kumakina a apheresis (osawonetsedwa), omwe amachotsa maselo oyera, kuphatikiza ma T, ndikutumiza magazi otsalawo kwa wodwalayo. Kenako, jini la cholandirira chapadera lotchedwa chimeric antigen receptor (CAR) imalowetsedwa m'maselo a T mu labotale. Maselo a CAR T mamiliyoni amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amatha kumangiriza antigen pamaselo a khansa ndikuwapha.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Mankhwala a monoclonal antibody, proteasome inhibitor therapy, ndi kinase inhibitor therapy ndi mitundu ya mankhwala omwe amagwiritsidwa ntchito pochiza achikulire omwe si a Hodgkin lymphoma.

Mankhwala a monoclonal antibody ndi mankhwala a khansa omwe amagwiritsa ntchito ma antibodies opangidwa mu labotale kuchokera ku mtundu umodzi wamthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa.

Mitundu yama antibodies monoclonal ndi awa:

• Rituximab, yomwe imagwiritsidwa ntchito pochiza mitundu yambiri ya non-Hodgkin lymphoma.

• Obinutuzumab, amagwiritsidwa ntchito pochizira follicular lymphoma.

• Brentuximab vedotin, yomwe imakhala ndi antioclonal antibody yomwe imamangiriza puloteni yotchedwa CD30 yomwe imapezeka m'maselo ena a lymphoma. Mulinso mankhwala oletsa khansa omwe angathandize kupha maselo a khansa.

• Yttrium Y 90-ibritumomab tiuxetan, chitsanzo cha anti-monoclonal antibody yozungulira.

Proteasome inhibitor therapy imalepheretsa zochita za ma proteasomes m'maselo a khansa. Proteasomes amachotsa mapuloteni omwe safunikiranso ndi selo. Ma proteasomes akatsekedwa, mapulotiniwo amakhala m'maselo ndipo amatha kupangitsa kuti khungu la khansa lifa. Bortezomib imagwiritsidwa ntchito pochepetsa kuchuluka kwa ma immunoglobulin M omwe ali m'magazi pambuyo pochiza khansa ya lymphoplasmacytic lymphoma. Ikuwerengedwanso kuti ichiritse mantle cell lymphoma.

Mankhwala a Kinase inhibitor amaletsa mapuloteni ena, omwe amathandizira kuti ma cell a lymphoma asakule ndipo amatha kuwapha. Mankhwala a Kinase inhibitor ndi awa:

• Copanlisib, idelalisib, ndi duvelisib, yomwe imaletsa mapuloteni a P13K ndipo imathandizira kuti maselo am'magazi azikula. Amagwiritsidwa ntchito pochizira ma follicular non-Hodgkin lymphomas omwe abwereranso (kubwerera) kapena sanakhale bwino atalandira chithandizo chamankhwala osachepera awiri.

• Ibrutinib ndi acalabrutinib, mitundu ya Bruton tyrosine kinase inhibitor therapy. Amagwiritsidwa ntchito pochizira lymphoplasmacytic lymphoma ndi mantle cell lymphoma.

Venetoclax itha kugwiritsidwanso ntchito kuthana ndi mantle cell lymphoma. Imalepheretsa puloteni yotchedwa B-cell lymphoma-2 (BCL-2) ndipo imathandizira kupha ma cell a khansa.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri.

Plasmapheresis

Ngati magazi amakula ndi mapuloteni owonjezera a antibody ndipo amakhudza kufalikira kwake, plasmapheresis imachitika kuti ichotse plasma ndi ma protein a antibody m'magazi. Pochita izi, magazi amachotsedwa mwa wodwalayo ndikutumizidwa kudzera pamakina omwe amalekanitsa plasma (gawo lamadzi la magazi) ndi maselo amwaziwo. Plasma ya wodwalayo imakhala ndi ma antibodies omwe safunika ndipo sabwezeredwa kwa wodwalayo. Maselo abwinobwino amabwezedwa m'magazi limodzi ndi plasma yoperekedwa kapena m'malo mwa plasma. Plasmapheresis sasunga ma antibodies atsopano kuti asapangike.

Kudikira kudikira

Kuyembekezera mwachidwi kumayang'anitsitsa matenda a wodwalayo osamupatsa chithandizo chilichonse mpaka zizindikilo kapena zizindikiritso zikuwoneka kapena kusintha.

Thandizo la maantibayotiki

Thandizo la maantibayotiki ndi mankhwala omwe amagwiritsa ntchito mankhwala kuchiza matenda ndi khansa yoyambitsidwa ndi mabakiteriya ndi tizilombo tina tating'onoting'ono.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri.

Opaleshoni

Opaleshoni itha kugwiritsidwa ntchito kuchotsa lymphoma mwa odwala ena omwe ali ndi ulesi kapena amwano omwe si a Hodgkin lymphoma.

Mtundu wa opaleshoni womwe umagwiritsidwa ntchito umadalira komwe ma lymphoma amapangidwa mthupi:

• Kudulidwa kwam'deralo kwa odwala ena omwe ali ndi mucosa-associated lymphoid tissue (MALT) lymphoma, PTLD, ndi matumbo ang'onoang'ono a T-cell lymphoma.

• Splenectomy kwa odwala omwe ali ndi m'mphepete mwa zone lymphoma ya ndulu.

Odwala omwe ali ndi mtima, mapapo, chiwindi, impso, kapena kapamba nthawi zambiri amayenera kumwa mankhwala kuti ateteze chitetezo cha mthupi kwa moyo wawo wonse. Kutetezedwa kwa thupi kwa nthawi yayitali pambuyo poti chiwalo cha thupi chitha kudwala kumatha kuyambitsa mtundu wina wa non-Hodgkin lymphoma wotchedwa post-transplant lymphoproliferative disorder (PLTD).

Kuchita opaleshoni yaying'ono nthawi zambiri kumafunikira kuti mupeze matenda a celiac mwa akulu omwe amapanga mtundu wa T-cell lymphoma.

Kupanga khungu la tsinde

Kuika timitengo tating'onoting'ono ndi njira yoperekera mankhwala amphamvu kwambiri a chemotherapy ndi / kapena kutentha kwa thupi kwathunthu ndikusintha ma cell omwe amapanga magazi omwe awonongedwa ndi chithandizo cha khansa. Maselo opatsirana (maselo osakhazikika amwazi) amachotsedwa m'magazi kapena m'mafupa a wodwalayo (autologous transplant) kapena wopereka (allogeneic transplant) ndipo amawundana ndikusungidwa. Chemotherapy ndi / kapena radiation ikamalizidwa, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Kupanga khungu la tsinde. (Gawo 1): Magazi amatengedwa mumtambo wa woperekayo. Wodwala kapena wina akhoza kukhala woperekayo. Magazi amayenda kudzera pamakina omwe amachotsa maselowo. Kenako magaziwo amabwezera woperekayo kudzera mumitsempha ya mkono wina. (Gawo 2): Wodwalayo amalandila chemotherapy kuti aphe maselo omwe amapanga magazi. Wodwala atha kulandira chithandizo cha radiation (chosawonetsedwa). (Gawo 3): Wodwalayo amalandila maselo am'magazi kudzera mu catheter yoyikidwa mumtsuko wamagazi pachifuwa.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Thandizo la katemera

Chithandizo cha katemera ndi mankhwala a khansa omwe amagwiritsa ntchito chinthu kapena gulu lazinthu zolimbikitsa chitetezo cha mthupi kuti chipeze chotupacho ndikuchipha.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Chithandizo cha Indolent Non-Hodgkin Lymphoma

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha gawo laulesi I komanso lofooka, gawo lachiwiri lachiwiri lomwe si Hodgkin lymphoma lingaphatikizepo izi:

• Thandizo la radiation.
• Mankhwala a monoclonal antibody (rituximab) ndi / kapena chemotherapy.
• Kudikira kudikira.

Ngati chotupacho ndi chachikulu kwambiri kuti sangachiritsidwe ndi mankhwala a radiation, njira zothandizirana ndi gawo lachiwiri, III, kapena IV wamkulu yemwe si Hodgkin lymphoma adzagwiritsidwa ntchito.

Chithandizo cha gawo lachiwiri, lachiwiri, kapena IV la achikulire omwe si a Hodgkin lymphoma atha kukhala awa:

• Kuyang'anira mwachidwi odwala omwe alibe zizindikilo kapena zizindikilo.

• Thandizo la monoclonal antibody (rituximab) kapena chemotherapy.

• Mankhwala osamalira ndi rituximab.

• Mankhwala a monoclonal antibody (obinutuzumab).

• PI3K inhibitor therapy (copanlisib, idelalisib, kapena duvelisib).

• Lenalidomide ndi rituximab.

• Mankhwala othandiza kuthana ndi maondo opatsirana.

• Kuyesedwa kwachipatala cha chemotherapy yayikulu kapena yopanda thupi lonse kapena mankhwala opatsirana a monoclonal antibody, otsatiridwa ndi

• autologous kapena allogeneic stem cell kumuika.

• Kuyesedwa kwachipatala kwa chemotherapy kapena popanda katemera.

• Kuyesedwa kwachipatala kwamitundu yatsopano yama antibodies monoclonal.

• Kuyesedwa kwachipatala kwa mankhwala a radiation omwe amaphatikizapo ma lymph node apafupi, kwa odwala omwe ali ndi matenda a gawo lachitatu.

• Kuyesedwa kwachipatala kwa mankhwala ochepetsa mphamvu ya radiation, kuti athetse zizindikiro ndikukweza moyo wabwino.

Mankhwala ena a indolent non-Hodgkin lymphoma amadalira mtundu wa non-Hodgkin lymphoma. Chithandizo chingaphatikizepo izi:

• Kwa follicular lymphoma, chithandizo chitha kukhala pakuyesedwa kwamankhwala a monoclonal antibody, chemotherapy regimen, kapena tsinde

kusintha kwa selo.

• Kwa follicular lymphoma yomwe yabwereranso (yabwerera) kapena sinakhale bwino mutalandira chithandizo, mankhwala atha kuphatikizira PI3K inhibitor

(copanlisib, idelalisib, kapena duvelisib).

• Kwa lymphoplasmacytic lymphoma, Bruton tyrosine kinase inhibitor therapy ndi / kapena plasmapheresis kapena proteasome inhibitor therapy (ngati kuli kofunikira

kupanga magazi owonda) amagwiritsidwa ntchito. Mankhwala ena omwe ali ngati omwe amagwiritsidwa ntchito pa follicular lymphoma amathanso kuperekedwa.

• Kwa gastric mucosa-associated lymphoid tissue (MALT) lymphoma, mankhwala opha tizilombo oti athetse matenda a Helicobacter pylori amaperekedwa koyamba.

Kwa zotupa zomwe sizimayankha mankhwala a maantibayotiki, chithandizo ndi mankhwala a radiation, opaleshoni, kapena rituximab kapena chemotherapy.

• Kwa extragastric MALT lymphoma ya diso ndi Mediterranean m'mimba lymphoma, mankhwala a antibiotic amagwiritsidwa ntchito pochiza matenda.

• Kwa splenic marginal zone lymphoma, rituximab kapena chemotherapy kapena B-cell receptor therapy imagwiritsidwa ntchito ngati chithandizo choyambirira. Ngati chotupacho sichiyankha kuchipatala, splenectomy itha kuchitidwa.

Chithandizo cha Aggressive Non-Hodgkin Lymphoma

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Kuchiza kwa gawo lankhanza ine komanso wankhanza, wopondereza wachiwiri wamkulu yemwe si Hodgkin lymphoma atha kukhala ndi izi:

• Mankhwala a monoclonal antibody (rituximab) ndi kuphatikiza chemotherapy. Nthawi zina mankhwala a radiation amaperekedwa pambuyo pake.

• Kuyesedwa kwachipatala kwamtundu watsopano wa monoclonal antibody therapy ndi kuphatikiza chemotherapy.

Kuchiza kwa gawo lachiwiri, III, kapena IV wamkulu yemwe si Hodgkin lymphoma atha kukhala ndi izi:

• Thandizo la monoclonal antibody (rituximab) limodzi ndi chemotherapy.

• Kuphatikiza chemotherapy.

• Kuyesedwa kwachipatala kwa mankhwala opatsirana a monoclonal anti-chemotherapy osakanikirana ndi ma radiation.

Mankhwala ena amadalira mtundu wankhanza wosakhala Hodgkin lymphoma. Chithandizo chingaphatikizepo izi:

• Kwa extranodal NK- / T-cell lymphoma, mankhwala a radiation omwe angaperekedwe musanafike, mkati, kapena pambuyo pa chemotherapy ndi CNS prophylaxis.

• Kwa mantle cell lymphoma, mankhwala a monoclonal antibody okhala ndi chemotherapy osakanikirana, otsatiridwa ndi kuphatika kwa cell. Thandizo la monoclonal antibody lingaperekedwe pambuyo pake ngati mankhwala osamalira (chithandizo chomwe chimaperekedwa pambuyo pothandizidwa koyamba kuti khansa isabwerere).

• Kwa posttransplantation matenda a lymphoproliferative, chithandizo chamankhwala osokoneza bongo chimatha. Ngati izi sizigwira ntchito kapena sizingachitike, mankhwala a monoclonal antibody okha kapena chemotherapy amatha kuperekedwa. Kwa khansa yomwe sikufalikira, opaleshoni yochotsa khansa kapena mankhwala a radiation angagwiritsidwe ntchito.

• Kwa plasmablastic lymphoma, mankhwala ali ngati omwe amagwiritsidwa ntchito pa lymphoblastic lymphoma kapena Burkitt lymphoma.

Kuti mumve zambiri za chithandizo cha lymphoblastic lymphoma, onani Chithandizo cha Lymphoblastic Lymphoma komanso kuti mumve zambiri za chithandizo cha Burkitt lymphoma, onani Chithandizo cha Burkitt Lymphoma.

Chithandizo cha Lymphoblastic Lymphoma

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha wamkulu lymphoblastic lymphoma chingaphatikizepo izi:

• Kuphatikiza kwa chemotherapy ndi CNS prophylaxis. Nthawi zina mankhwala a radiation amaperekedwanso kuti achepetse chotupa chachikulu.

• Chithandizo chomwe mukufuna ndi monoclonal antibody chokha (rituximab) kapena kuphatikiza ndi kinase inhibitor therapy (ibrutinib).

• Kuyesedwa kwachipatala kwa kuphatika kwa ma cell am'madzi mutatha kulandira chithandizo.

Chithandizo cha Burkitt Lymphoma

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha wamkulu Burkitt lymphoma chingaphatikizepo izi:

• Kuphatikiza kwa chemotherapy kapena popanda monoclonal antibody therapy.

• CNS yothandizira.

Kuchiza kwa Opanda Hodgkin Lymphoma

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha achikulire omwe sakhala a Hodgkin lymphoma atha kukhala ndi izi:

• Chemotherapy ndi mankhwala amodzi kapena angapo.

• Thandizo la monoclonal antibody (rituximab kapena obinutuzumab).

• Lenalidomide.

• Mankhwala othandiza kuthana ndi maondo opatsirana.

• Thandizo la radiation ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

• Kuyesedwa kwachipatala kwa kuponyedwa kwa cell autologous kapena allogeneic.

Chithandizo cha achikulire achiwawa omwe si a Hodgkin lymphoma atha kuphatikizira izi:

• Chemotherapy yokhala ndi kapena yopanda tsinde.

• Thandizo la monoclonal antibody limodzi kapena popanda kuphatikiza chemotherapy lotsatiridwa ndi autologous stem cell kumuika.

• Thandizo la radiation ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

• Mankhwala othandiza kuthana ndi maondo opatsirana.

• Chithandizo cha CAR T-cell.

• Kwa mantle cell lymphoma, chithandizo chitha kuphatikizira izi:

• Bruton tyrosine kinase inhibitor mankhwala.

• Lenalidomide.

• Kuyesedwa kwachipatala kwa lenalidomide ndi mankhwala a monoclonal antibody.

• Kuyesa kwamankhwala poyerekeza lenalidomide ndi mankhwala ena.

• Kuyesedwa kwachipatala kwa proteasome inhibitor therapy (bortezomib).

• Kuyesedwa kwachipatala kwa kuponyedwa kwa ma cell kapena autologous kapena allogeneic.

Kuchiza kwa indolent lymphoma yomwe imabweranso ngati lymphoma yovuta imadalira mtundu wa non-Hodgkin lymphoma ndipo imatha kuphatikizira mankhwala othandizira poizoniyu ngati mankhwala ochepetsa nkhawa kuti athane ndi matenda ndikukhala ndi moyo wabwino. Chithandizo cha lymphoma champhamvu chomwe chimabwerera ngati indolent lymphoma chingaphatikizepo chemotherapy.

Chithandizo cha Non-Hodgkin Lymphoma Pakati pa Mimba

M'chigawo chino

• Indolent Non-Hodgkin Lymphoma Pakati pa Mimba

• Waukali Non-Hodgkin Lymphoma Pakati pa Mimba

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Indolent Non-Hodgkin Lymphoma Pakati pa Mimba

Amayi omwe ali ndi ulesi (omwe akuchedwa kukula) omwe si a Hodgkin lymphoma panthawi yapakati amatha kuthandizidwa modikirira mpaka atabereka. (Onani gawo la Chithandizo cha Indolent Non-Hodgkin Lymphoma gawo kuti mumve zambiri.)

Waukali Non-Hodgkin Lymphoma Pakati pa Mimba

Chithandizo cha non-Hodgkin lymphoma panthawi yapakati chimatha kukhala ndi izi:

• Chithandizo chomwe chimaperekedwa nthawi yomweyo kutengera mtundu wa non-Hodgkin lymphoma wokulitsa mwayi wamayi wopulumuka. Chithandizochi chimatha kuphatikizira kuphatikiza chemotherapy ndi rituximab.

• Kubereka koyambirira kwa mwana ndikutsatiridwa ndi mtundu wa non-Hodgkin lymphoma.

• Ngati m'nthawi ya trimester yoyamba, oncologists azachipatala angakulangizeni kutha kwa mimba kuti mankhwala ayambe. Chithandizo chimadalira mtundu wa non-Hodgkin lymphoma.

Kuti mudziwe zambiri za achikulire omwe si a Hodgkin Lymphoma

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza achikulire omwe si a Hodgkin lymphoma, onani izi:

• Tsamba Lanyumba Lopanda Hodgkin Lymphoma

• Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma

• Njira Zochizira Khansa

• Immunotherapy Kuchiza Khansa

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira