Mitundu / lymphoma / wodwala / chithandizo chokhudzana ndi zothandizira-pdq

Chithandizo cha AIDS-Related Lymphoma Treatment (®) -Patient Version

Zambiri Zokhudza Lymphoma Yokhudzana ndi Edzi

MFUNDO ZOFUNIKA

• Lymphoma yokhudzana ndi Edzi ndi matenda omwe ma cell oyipa (khansa) amapangidwa m'matenda a odwala omwe atenga matenda a immunodeficiency syndrome (AIDS).

• Pali mitundu yambiri ya lymphoma.

• Zizindikiro za lymphoma yokhudzana ndi Edzi imaphatikizapo kuonda, malungo, ndi thukuta usiku.

• Kuyesa komwe kumayang'ana ma lymph system ndi ziwalo zina za thupi kumagwiritsidwa ntchito kuthandizira (kupeza) ndikuzindikira zam'mimba zokhudzana ndi Edzi.

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

Lymphoma yokhudzana ndi Edzi ndi matenda omwe ma cell oyipa (khansa) amapangidwa m'matenda a odwala omwe atenga matenda a immunodeficiency syndrome (AIDS).

Edzi imayambitsidwa ndi kachilombo ka HIV kamene kamayambitsa ndi kufooketsa chitetezo cha mthupi. Chitetezo chamthupi chofooka sichitha kulimbana ndi matenda komanso matenda. Anthu omwe ali ndi kachilombo ka HIV ali ndi chiopsezo chowonjezereka chotenga kachilombo ndi lymphoma kapena mitundu ina ya khansa. Munthu yemwe ali ndi kachilombo ka HIV komanso mitundu ina ya matenda kapena khansa, monga lymphoma, amapezeka kuti ali ndi Edzi. Nthawi zina, anthu amapezeka kuti ali ndi matenda a Edzi komanso matenda okhudzana ndi Edzi nthawi yomweyo. Kuti mudziwe zambiri zokhudza Edzi ndi chithandizo chake, chonde onani tsamba la AIDSinfo.

Lymphoma yokhudzana ndi Edzi ndi mtundu wa khansa yomwe imakhudza ma lymph system. 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 ya matumbo ndipo chimanyamula ma lymphocyte a T ndi B. Ma lymphocyte ndi mtundu wamagazi oyera.

• 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.

Minofu yamagulu imapezekanso m'malo ena amthupi monga ubongo, m'mimba, chithokomiro, ndi khungu.

Nthawi zina lymphoma yokhudzana ndi Edzi imachitika kunja kwa ma lymph node m'mafupa, chiwindi, meninges (zotupa zochepa zomwe zimaphimba ubongo) ndi m'mimba. Nthawi zambiri, zimatha kuchitika mu anus, mtima, bile bile, gingiva, ndi minofu.

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.

Pali mitundu yambiri ya lymphoma.

Mafupa amagawika m'magulu awiri:

• Hodgkin lymphoma.

• Non-Hodgkin lymphoma.

Onse omwe si a Hodgkin lymphoma ndi Hodgkin lymphoma amatha kupezeka ndi odwala Edzi, koma omwe si a Hodgkin lymphoma ndiofala kwambiri. Munthu amene ali ndi Edzi ali ndi non-Hodgkin lymphoma, amatchedwa lymphoma yokhudzana ndi AIDS. Lymphoma yokhudzana ndi Edzi ikupezeka m'katikati mwa manjenje (CNS), amatchedwa CNS lymphoma.

Ma non-Hodgkin lymphomas amakhala m'magulu momwe ma cell awo amawonekera pansi pa microscope. Atha kukhala aulesi (akukula pang'onopang'ono) kapena achiwawa (akukula mwachangu). Ma lymphomas okhudzana ndi Edzi ndi achiwawa. Pali mitundu iwiri ikuluikulu yokhudzana ndi Edzi yosakhala Hodgkin lymphoma:

• Kusokoneza B-cell lymphoma (kuphatikiza B-cell immunoblastic lymphoma).

• Burkitt kapena Burkitt-ngati lymphoma.

Kuti mudziwe zambiri za khansa ya lymphoma kapena khansa yokhudzana ndi Edzi, onani mwachidule zotsatirazi za :

• Chithandizo Cha Akulu Chopanda Hodgkin Lymphoma

• Kuchiza Kwachinyamata Osakhala Hodgkin Lymphoma

• Chithandizo choyambirira cha CNS Lymphoma

• Chithandizo cha Kaposi Sarcoma

Zizindikiro za lymphoma yokhudzana ndi Edzi imaphatikizapo kuonda, malungo, ndi thukuta usiku.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha edzi yokhudzana ndi Edzi kapena matenda ena. Funsani dokotala ngati muli ndi izi:

• Kuchepetsa thupi kapena kutentha thupi popanda chifukwa chodziwika.

• Kutuluka thukuta usiku.

• Zilonda zopweteka, zotupa m'khosi, pachifuwa, pamimba, kapena kubuula.

• Kumverera kwodzaza pansi pa nthiti.

Kuyesa komwe kumayang'ana ma lymph system ndi ziwalo zina za thupi kumagwiritsidwa ntchito kuthandizira (kupeza) ndikuzindikira zam'mimba zokhudzana ndi Edzi.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza 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 kale kapena katemera, kapena atenga kachilombo.

• 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 kachigawo kakang'ono ka fupa poika singano yopanda kanthu 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 ayang'ane maselo a khansa. Chimodzi mwazinthu zotsatirazi za biopsies zitha kuchitidwa:

• Chisokonezo chodabwitsa: Kuchotsa khungu lonse.

• Incopal biopsy: Kuchotsa gawo la mwanabele.

• Core biopsy: Kuchotsa minofu kuchokera mu lymph node pogwiritsa ntchito singano yayikulu.

Madera ena amthupi, monga chiwindi, mapapo, mafupa, mafupa, ndi ubongo, amathanso kuchotsedwapo ndikuwunikidwa ndi wodwala ngati ali ndi khansa.

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 ma chromosomes osweka, osowa, okonzedwanso kapena 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.

• 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.

• 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.

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

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa.

• Zaka za wodwalayo.

• Chiwerengero cha ma CD lymphocyte (mtundu wamaselo oyera m'magazi).

• Chiwerengero cha malo amthupi lymphoma amapezeka kunja kwa ma lymph system.

• Kaya wodwalayo ali ndi mbiri yogwiritsa ntchito mankhwala osokoneza bongo (IV).

• Kukhoza kwa wodwala kuchita zochitika zatsiku ndi tsiku.

Magawo a Lymphoma Yokhudzana ndi Edzi

MFUNDO ZOFUNIKA

• Pambuyo popezeka ndi lymphoma yokhudzana ndi Edzi, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa lymph kapena m'mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Magawo otsatirawa amagwiritsidwa ntchito pa lymphoma yokhudzana ndi Edzi:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Kuti akalandire chithandizo, ma lymphomas okhudzana ndi Edzi amagawidwa potengera komwe adayamba m'thupi, motere:

• Zotumphukira / zokhudza zonse lymphoma

• Pulayimale CNS lymphoma

Pambuyo popezeka ndi lymphoma yokhudzana ndi Edzi, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa lymph kapena m'mbali zina za thupi.

Njira yomwe amagwiritsidwa ntchito pofufuza ngati maselo a khansa afalikira mkati mwa ma lymph system kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunika kudziwa gawo kuti mukonzekere chithandizo, koma lymphoma yokhudzana ndi Edzi imakonda kupita patsogolo ikapezeka.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa 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. Zitsanzozo zitha kuwunikiranso kachilombo ka Epstein-Barr. 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.

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 pa lymphoma yokhudzana ndi Edzi:

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 lomwe limakhudzana ndi Edzi limagawika m'magawo 1 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

• Lymphoma yokhudzana ndi Edzi yachiwiri imagawika 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.

Gawo lachitatu lokhudzana ndi Edzi, 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 IV yokhudzana ndi Edzi, 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.

Odwala omwe ali ndi kachilombo ka Epstein-Barr kapena omwe matenda a lymphoma okhudzana ndi Edzi amakhudza mafupa amakhala ndi chiopsezo chowonjezeka cha khansa kufalikira ku mitsempha yayikulu (CNS).

Kuti akalandire chithandizo, ma lymphomas okhudzana ndi Edzi amagawidwa potengera komwe adayamba m'thupi, motere:

Zotumphukira / zokhudza zonse lymphoma

Lymphoma yomwe imayamba mumatumbo kapena kwina kulikonse mthupi, kupatula ubongo, amatchedwa zotumphukira / systemic lymphoma. Itha kufalikira mthupi lonse, kuphatikiza muubongo kapena m'mafupa. Nthawi zambiri amapezeka kuti ali patsogolo.

Pulayimale CNS lymphoma

Pulayimale CNS lymphoma imayamba mkati mwa dongosolo lamanjenje (ubongo ndi msana). Amalumikizidwa ndi kachilombo ka Epstein-Barr. Lymphoma yomwe imayamba kwinakwake m'thupi ndikufalikira ku mitsempha yayikulu si CNS lymphoma yoyamba.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi matenda a lymphoma.

• Kuchiza kwa lymphoma yokhudzana ndi Edzi kumaphatikiza chithandizo cha lymphoma ndikuchiza Edzi.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Chemotherapy

• Thandizo la radiation

• Chemotherapy yamphamvu kwambiri yokhala ndi tsinde lama cell

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Kuchiza kwa lymphoma yokhudzana ndi Edzi kumatha kubweretsa zovuta.

• 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 kwa odwala omwe ali ndi matenda a lymphoma.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi matenda a 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.

Kuchiza kwa lymphoma yokhudzana ndi Edzi kumaphatikiza chithandizo cha lymphoma ndikuchiza Edzi.

Odwala omwe ali ndi Edzi afooketsa chitetezo cha mthupi ndipo chithandizo chitha kupangitsa kuti chitetezo chamthupi chitetezeke. Pachifukwa ichi, kuchiza odwala omwe ali ndi matenda a lymphoma okhudzana ndi Edzi ndi kovuta ndipo odwala ena amatha kupatsidwa mankhwala ochepera mankhwala kuposa odwala lymphoma omwe alibe AIDS.

Mankhwala ochepetsa mphamvu ya kachilombo ka HIV (HAART) amagwiritsidwa ntchito pochepetsa kuwonongeka kwa chitetezo cha mthupi chifukwa cha HIV. Kuchiza ndi HAART kumatha kulola odwala ena omwe ali ndi matenda a lymphoma okhudzana ndi Edzi kuti alandire mankhwala osokoneza bongo mosiyanasiyana. Mwa odwalawa, chithandizo chitha kugwira ntchito monganso odwala a lymphoma omwe alibe Edzi. Mankhwala otetezera ndi kuchizira matenda, omwe atha kukhala owopsa, amagwiritsidwanso ntchito.

Kuti mudziwe zambiri zokhudza Edzi ndi chithandizo chake, chonde onani tsamba la AIDSinfo.

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

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 opatsirana ambiri opatsirana khansa.

Momwe chemotherapy imaperekedwa imadalira komwe khansara yapanga. Intrathecal chemotherapy itha kugwiritsidwa ntchito kwa odwala omwe amatha kukhala ndi lymphoma mkatikati mwa manjenje (CNS).

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.

Chemotherapy imagwiritsidwa ntchito pochiza zotumphukira zokhudzana ndi Edzi / systemic lymphoma. Sizikudziwika ngati ndibwino kupatsa HAART nthawi yomweyo chemotherapy kapena chemotherapy ikatha.

Zinthu zolimbikitsa ku Colony nthawi zina zimaperekedwa limodzi ndi chemotherapy. Izi zimathandiza kuchepetsa mavuto omwe chemotherapy amatha kukhala nawo pamfupa.

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. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwalawa amaperekera zimadalira komwe khansara yapangira. Thandizo la radiation lakunja limagwiritsidwa ntchito pochizira CNS lymphoma yokhudzana ndi Edzi.

Chemotherapy yamphamvu kwambiri yokhala ndi tsinde lama cell

Mlingo waukulu wa chemotherapy umaperekedwa kuti uphe ma cell a khansa. Maselo athanzi, kuphatikiza maselo opanga magazi, nawonso amawonongedwa ndi chithandizo cha khansa. Kuika timitengo tating'onoting'ono ndi chithandizo m'malo mwa maselo omwe amapanga magazi. Maselo opangira magazi (maselo osakhwima amwazi) amachotsedwa m'magazi kapena m'mafupa a wodwalayo ndipo amawundana ndikusungidwa. Wodwalayo akamaliza chemotherapy, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

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 ndi mtundu wa mankhwala omwe amalimbana nawo.

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. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Izi zitha kugwiritsidwa ntchito zokha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Rituximab imagwiritsidwa ntchito pochizira zotumphukira zokhudzana ndi Edzi / systemic lymphoma.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Kuchiza kwa lymphoma yokhudzana ndi Edzi kumatha kubweretsa zovuta.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

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.

Njira Zothandizira Kuchiza Lymphoma Yokhudzana ndi Edzi

M'chigawo chino

• Mipata Yokhudzana ndi Edzi / Lymphoma Yogwirizana

• Edzi-Lymphoma Yogwirizana ndi Edzi Yoyambilira

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

Mipata Yokhudzana ndi Edzi / Lymphoma Yogwirizana

Chithandizo cha zotumphukira zokhudzana ndi Edzi / systemic lymphoma zitha kuphatikizira izi:

• Kuphatikiza kwa chemotherapy kapena popanda chithandizo chamankhwala.

• Mankhwala apamwamba a chemotherapy ndi kuponyera ma cell a stem, a lymphoma omwe sanayankhe mankhwala kapena abwerera.

• Intrathecal chemotherapy ya lymphoma yomwe imafalikira ku mitsempha yayikulu (CNS).

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Edzi-Lymphoma Yogwirizana ndi Edzi Yoyambilira

Chithandizo cha matenda oyambitsidwa ndi Edzi a lymphoma atha kukhala ndi izi:

• Thandizo la radiation lakunja.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri za Lymphoma Yokhudzana ndi Edzi

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudzana ndi matenda a lymphoma, onani izi:

• Kusandulika Kwamaselo Opangira Magazi

• Njira Zochizira 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