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Mycosis Fungoides (Kuphatikiza Sézary Syndrome) Chithandizo (®) -Patient Version

Zambiri Zokhudza Mycosis Fungoides (Kuphatikiza Sézary Syndrome)

MFUNDO ZOFUNIKA

• Mycosis fungoides ndi Sézary syndrome ndi matenda omwe ma lymphocyte (mtundu wamagazi oyera) amakhala owopsa (khansa) ndipo amakhudza khungu.

• Mycosis fungoides ndi Sézary syndrome ndi mitundu yambiri ya T-cell lymphoma.

• Chizindikiro cha mycosis fungoides ndikutuluka kofiira pakhungu.

• Mu Sézary syndrome, T-cell ya khansa imapezeka m'magazi.

• Kuyesa komwe kumayesa khungu ndi magazi kumagwiritsidwa ntchito pozindikira mycosis fungoides ndi Sézary syndrome.

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

Mycosis fungoides ndi Sézary syndrome ndi matenda omwe ma lymphocyte (mtundu wamagazi oyera) amakhala owopsa (khansa) ndipo amakhudza khungu.

Nthawi zambiri, mafupa amapanga magazi am'magazi (maselo osakhwima) omwe amakhala maselo am'magazi okhwima pakapita nthawi. Selo loyambira magazi limatha kukhala khungu la myeloid kapena tsinde la lymphoid. Selo loyambira la myeloid limakhala khungu lofiira, khungu loyera lamagazi, kapena platelet. Selo la tsinde la lymphoid limakhala lymphoblast kenako imodzi mwa mitundu itatu yama lymphocyte (maselo oyera amwazi):

• B-cell lymphocyte omwe amapanga ma antibodies kuti athandize kulimbana ndi matenda.

• T-cell lymphocyte omwe amathandiza ma-lymphocyte kupanga ma antibodies omwe amathandiza kulimbana ndi matenda.

• Maselo opha achilengedwe omwe amalimbana ndi ma khansa ndi ma virus.

Kukula kwa maselo amwazi. Selo loyambira magazi limadutsa masitepe angapo kuti likhale khungu lofiira, platelet, kapena khungu loyera.

Mu mycosis fungoides, T-cell lymphocyte amakhala ndi khansa ndipo amakhudza khungu. Ma lymphocyte awa akupezeka m'magazi, amatchedwa Sézary cell. Mu matenda a Sézary, ma cell a khansa a T-cell amakhudza khungu ndipo maselo ambiri a Sézary amapezeka m'magazi.

Mycosis fungoides ndi Sézary syndrome ndi mitundu yambiri ya T-cell lymphoma.

Mycosis fungoides ndi Sézary syndrome ndi mitundu iwiri yofala kwambiri ya T-cell lymphoma (mtundu wa non-Hodgkin lymphoma). Kuti mumve zambiri zamtundu wina wa khansa yapakhungu kapena non-Hodgkin lymphoma, onani mwachidule zotsatirazi za :

• Chithandizo Cha Akulu Chopanda Hodgkin Lymphoma

• Kuchiza Khansa Yapakhungu

• Chithandizo cha khansa ya khansa

• Chithandizo cha Kaposi Sarcoma

Chizindikiro cha mycosis fungoides ndikutuluka kofiira pakhungu.

Mycosis fungoides akhoza kudutsa magawo otsatirawa:

• Gawo la Premycotic: Kutupa kofiira, kofiyira m'malo amthupi omwe nthawi zambiri sakhala padzuwa. Kuthamanga uku sikuyambitsa zizindikilo ndipo kumatha miyezi kapena zaka. Ndizovuta kuzindikira kuti zotupazo ndi mycosis fungoides panthawiyi.

• Chigawo cha chigamba: Chotupa, chofiirira, ngati zotupa ngati chikanga.

• Chigawo chazithunzi: Ziphuphu zazing'ono (mapapu) kapena zotupa zolimba pakhungu, zomwe zimatha kufiira.

• Gawo lotupa: Mawonekedwe a zotupa pakhungu. Zotupa izi zimatha kukhala ndi zilonda ndipo khungu limatha kutenga kachilomboka.

Funsani dokotala wanu ngati muli ndi zizindikiro izi.

Mu Sézary syndrome, T-cell ya khansa imapezeka m'magazi.

Komanso khungu paliponse limafiira, kuyabwa, kusenda komanso kupweteka. Pakhoza kukhalanso zigamba, zikwangwani, kapena zotupa pakhungu. Sidziwika ngati Sézary syndrome ndi mtundu wapamwamba wa mycosis fungoides kapena matenda ena.

Kuyesa komwe kumayesa khungu ndi magazi kumagwiritsidwa ntchito pozindikira mycosis fungoides ndi Sézary syndrome.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyeza kwakuthupi ndi mbiri yaumoyo: Kuyesa thupi kuti muwone ngati pali zathanzi, kuphatikiza kuwunika kwa matenda, monga zotupa, kuchuluka ndi mtundu wa zotupa pakhungu, kapena china chilichonse chomwe chimawoneka chachilendo. Zithunzi za khungu ndi mbiri yazikhalidwe za wodwalayo * ndi matenda am'mbuyomu ndikuchiritsidwa adzatengedwanso.

• Kuwerengera kwathunthu kwamagazi ndikusiyana: Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira ndi ma platelet.

• Chiwerengero ndi mtundu wama cell oyera.

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

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

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.

• Kuwerengera kwa maselo a magazi a Sézary: Njira yomwe magazi amagwiritsidwira ntchito pogwiritsa ntchito microscope kuti awerenge kuchuluka kwa maselo a Sézary.

• 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.

• Khungu lachikopa: Kuchotsa maselo kapena ziphuphu kuti ziwoneke pansi pa microscope kuti ziwone ngati zili ndi khansa. Dotolo amatha kuchotsa pakhungu pakhungu, lomwe liziwunikidwa ndi wodwalayo. Pangakhale zofunikira zopitilira khungu limodzi kuti muzindikire mycosis fungoides. Mayesero ena omwe angachitike m'maselo kapena minofu ndi awa:

• 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.

• Flow cytometry: Kuyesa kwa labotale komwe kumayeza kuchuluka kwa maselo munzitsanzo, kuchuluka kwa maselo amoyo pachitsanzo, ndi mawonekedwe ena amamaselo, monga kukula, mawonekedwe, ndi kupezeka kwa zotupa (kapena zina) pamwamba pa khungu. Maselo ochokera pagazi la wodwalayo, m'mafupa, kapena minofu ina amadetsedwa ndi utoto wa fulorosenti, amaikidwa mumadzimadzi, kenako nkuwudutsa kamodzi mwa kuwala. Zotsatira zakuyesa zimadalira momwe maselo omwe adadetsedwa ndi utoto wa fluorescent amatengera kuwala kwa kuwala. Mayesowa amagwiritsidwa ntchito kuthandizira kuzindikira ndi kusamalira mitundu ina ya khansa, monga khansa ya m'magazi ndi lymphoma.

• Mayeso okonzanso majini a T-cell receptor (TCR): Kuyesedwa kwa labotale komwe ma cell am'magazi am'magazi kapena mafupa amafufuzidwa kuti awone ngati pali zosintha zina m'matenda omwe amapanga zolandilira pa ma T cell (maselo oyera amwazi). Kuyesa kusintha kwa majini kumatha kudziwa ngati kuchuluka kwa maselo a T okhala ndi cholandilira china cha T-cell akupangidwa.

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

Njira zakulosera zamankhwala ndi chithandizo zimadalira izi:

• Gawo la khansa.

• Mtundu wa zotupa (zigamba, zolembera, kapena zotupa).

• Zaka za wodwala komanso jenda.

Mycosis fungoides ndi Sézary syndrome ndizovuta kuchiza. Chithandizo nthawi zambiri chimakhala chothandiza, kuti muchepetse zizindikiritso ndikukhalitsa moyo wabwino. Odwala omwe ali ndi matenda oyambilira amatha zaka zambiri.

Magawo a Mycosis Fungoides (Kuphatikiza Sézary Syndrome)

MFUNDO ZOFUNIKA

• Matenda a mycosis fungoides ndi Sézary atapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira pakhungu kupita mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

• Magawo otsatirawa amagwiritsidwa ntchito pa mycosis fungoides ndi Sézary syndrome:

• Gawo I Mycosis Fungoides

• Gawo II Mycosis Fungoides

• Gawo lachitatu Mycosis Fungoides

• Gawo IV Mycosis Fungoides / Sézary Syndrome

Matenda a mycosis fungoides ndi Sézary atapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira pakhungu kupita mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yapita kuchokera pakhungu kupita mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo.

Njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

• X-ray pachifuwa : X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikupita mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga ma lymph node, chifuwa, mimba, ndi mafupa, 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.

• Lymph node biopsy: Kuchotsa zonse kapena gawo la mwanabele. Katswiri wazachipatala amawona minofu yamagulu pansi pa microscope kuti aone ngati ali ndi khansa.

• 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.

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.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi. Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati mycosis fungoides imafalikira chiwindi, maselo a khansa pachiwindi ndi maselo a mycosis fungoides. Matendawa ndi metastatic mycosis fungoides, osati khansa ya chiwindi.

Magawo otsatirawa amagwiritsidwa ntchito pa mycosis fungoides ndi Sézary syndrome:

Gawo I Mycosis Fungoides

Gawo I lagawika magawo IA ndi IB motere:

• Gawo IA: Mapazi, ma papule, ndi / kapena zikwangwani zimaphimba zosakwana 10% pakhungu.

• Gawo IB: Mapazi, mapepala, ndi / kapena zikwangwani zimaphimba 10% kapena kuposa pakhungu.

• Pakhoza kukhala ochepa maselo a Sézary m'magazi.

Gawo II Mycosis Fungoides

Gawo II lidagawika magawo IIA ndi IIB motere:

• Gawo IIA: Zigamba, mapepala, ndi / kapena zikwangwani zimaphimba khungu lililonse. Matenda am'mimba ndi achilendo, koma alibe khansa.

• Gawo IIB: Chotupa chimodzi kapena zingapo zomwe zili sentimita imodzi kapena zokulirapo zimapezeka pakhungu. Matenda am'mimba amatha kukhala achilendo, koma alibe khansa.

Pakhoza kukhala ochepa maselo a Sézary m'magazi.

Gawo lachitatu Mycosis Fungoides

Gawo lachitatu, khungu 80% kapena kupitilira apo limafiyira ndipo limatha kukhala ndi zigamba, zotupa, kapena zotupa. Matenda am'mimba amatha kukhala achilendo, koma alibe khansa.

Pakhoza kukhala ochepa maselo a Sézary m'magazi.

Gawo IV Mycosis Fungoides / Sézary Syndrome

Matendawa akamakhala ndi maselo ambiri a Sézary m'magazi, amatchedwa Sézary syndrome.

Gawo IV lidagawika magawo IVA1, IVA2, ndi IVB motere:

• Gawo IVA1: Zigamba, ma papuleti, zolembera, kapena zotupa zimatha kuphimba khungu lililonse, ndipo 80% kapena kuposerapo khungu limatha kufiira. Ma lymph node amatha kukhala achilendo, koma alibe khansa. Pali kuchuluka kwa maselo a Sézary m'magazi.

• Gawo IVA2: Zigamba, ma papuleti, zolembera, kapena zotupa zimatha kuphimba khungu lililonse, ndipo 80% kapena kuposerapo khungu limatha kufiira. Ma lymph node ndi achilendo kwambiri, kapena khansa yapangidwa m'matumbo. Pakhoza kukhala kuchuluka kwa maselo a Sézary m'magazi.

• Gawo IVB: Khansa yafalikira ku ziwalo zina m'thupi, monga ndulu kapena chiwindi. Zigamba, mapepala, zikwangwani, kapena zotupa zimatha kuphimba khungu lililonse, ndipo 80% kapena kuposerapo khungu limatha kufiira. Ma lymph node amatha kukhala achilendo kapena khansa. Pakhoza kukhala kuchuluka kwa maselo a Sézary m'magazi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi khansa ya mycosis fungoides ndi Sézary syndrome khansa.

• Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Thandizo la Photodynamic

• Thandizo la radiation

• Chemotherapy

• Mankhwala ena

• Chitetezo chamatenda

• Chithandizo chofuna

• Mankhwala apamwamba a chemotherapy ndi mankhwala a radiation okhala ndi tsinde lama cell

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha mycosis fungoides ndi Sézary syndrome chingayambitse mavuto.

• 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 ali ndi khansa ya mycosis fungoides ndi Sézary syndrome khansa.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi mycosis fungoides ndi Sézary syndrome. 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.

Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Thandizo la Photodynamic

Photodynamic therapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala osokoneza bongo komanso mtundu wina wa kuwala kwa laser kupha ma cell a khansa. Mankhwala omwe sagwira ntchito mpaka kuwalako kukuwala amalowetsedwa mumtsempha. Mankhwalawa amatenga zambiri m'maselo a khansa kuposa m'maselo abwinobwino. Kwa khansa yapakhungu, kuwala kwa laser kumawala pakhungu ndipo mankhwalawo amakhala otakataka ndikupha ma cell a khansa. Chithandizo cha Photodynamic sichimawononga pang'ono minofu yathanzi. Odwala omwe amalandira chithandizo cha photodynamic adzafunika kuchepetsa nthawi yomwe amakhala padzuwa. Pali mitundu yosiyanasiyana ya mankhwala a photodynamic:

• Mu psoralen ndi ultraviolet A (PUVA), wodwalayo amalandila mankhwala otchedwa psoralen ndiyeno radiation ya ultraviolet A imalunjikitsidwa pakhungu.

• Mu extracorporeal photochemotherapy, wodwalayo amapatsidwa mankhwala kenako maselo ena amwazi amatengedwa m'thupi, amaikidwa pansi pa kuwala kwapadera kwa ultraviolet A, ndikuwabwezeretsanso m'thupi. Extracorporeal photochemotherapy itha kugwiritsidwa ntchito payokha kapena kuphatikiza mankhwala amtundu wa khungu la TECB.

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, mankhwala a radiation electron beam (TSEB) amagwiritsidwa ntchito pochiza mycosis fungoides ndi Sézary syndrome. Uwu ndi mtundu wamankhwala othandizira ma radiation akunja momwe makina othandizira ma radiation amayang'ana ma elekitironi (tinthu tating'onoting'ono, tosaoneka) pakhungu lokuta thupi lonse. Thandizo la radiation lakunja litha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

Chithandizo cha radiation cha Ultraviolet A (UVA) kapena mankhwala a radiation a ultraviolet B (UVB) atha kuperekedwa pogwiritsa ntchito nyali yapadera kapena laser yomwe imawongolera ma radiation pakhungu.

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). Nthawi zina mankhwala a chemotherapy amakhala apadera (ikani khungu pakirimu, mafuta odzola, kapena mafuta).

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri. (Mycosis fungoides ndi Sézary syndrome ndi mitundu ina ya Hodgkin lymphoma.)

Mankhwala ena

Matenda a corticosteroids amagwiritsidwa ntchito kuti athetse khungu lofiira, lotupa komanso lotupa. Ndiwo mtundu wa steroid. Matenda a corticosteroids atha kukhala kirimu, odzola, kapena mafuta.

Retinoids, monga bexarotene, ndi mankhwala okhudzana ndi vitamini A omwe amachepetsa kukula kwa mitundu ina yamaselo a khansa. Ma retinoid amatha kutengedwa pakamwa kapena kuvala khungu.

Lenalidomide ndi mankhwala omwe amathandiza chitetezo cha mthupi kupha maselo osadziwika am'magazi kapena ma cell a khansa ndipo chingalepheretse kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula.

Vorinostat ndi romidepsin ndi awiri mwa histone deacetylase (HDAC) inhibitors omwe amagwiritsidwa ntchito pochiza mycosis fungoides ndi Sézary syndrome. Ma HDAC inhibitors amayambitsa kusintha kwamankhwala komwe kumaletsa ma cell am chotupa kusagawanika.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri. (Mycosis fungoides ndi Sézary syndrome ndi mitundu ina ya Hodgkin lymphoma.)

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. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

• Interferon: Chithandizochi chimasokoneza magawikidwe a mycosis fungoides ndi Sézary cell ndipo chimatha kuchepetsa kukula kwa chotupa.

Onani Mankhwala Ovomerezeka a Non-Hodgkin Lymphoma kuti mumve zambiri. (Mycosis fungoides ndi Sézary syndrome ndi mitundu ina ya Hodgkin lymphoma.)

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti ziwononge maselo a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation.

• Thandizo la monoclonal antibody: Chithandizochi chimagwiritsa ntchito ma antibodies opangidwa mu labotore kuchokera ku mtundu umodzi wa chitetezo chamthupi. 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:

• Brentuximab vedotin, yomwe imakhala ndi antioclonal antibody yomwe imamangiriza ku protein, yotchedwa CD30, yomwe imapezeka m'mitundu ina ya ma lymphoma cell. Mulinso mankhwala oletsa khansa omwe angathandize kupha maselo a khansa.

• Mogamulizumab, yomwe imakhala ndi antioclonal antibody yomwe imagwirizana ndi protein, yotchedwa CCR4, yomwe imapezeka m'mitundu ina yama cell a lymphoma. Itha kutseka puloteni iyi ndikuthandizira chitetezo cha mthupi kupha ma cell a khansa. Amagwiritsidwa ntchito pochiza mycosis fungoides ndi Sézary syndrome yomwe idabweranso kapena sinakhale bwino atalandira chithandizo chimodzi chokha chothandizira.

Mankhwala apamwamba a chemotherapy ndi mankhwala a radiation okhala ndi tsinde lama cell

Mlingo waukulu wa chemotherapy ndipo nthawi zina mankhwala a radiation amaperekedwa kuti aphe 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 otchedwa stem cells (maselo a magazi osakhwima) amachotsedwa m'magazi kapena m'mafupa a wodwalayo kapena woperekayo ndipo amaundana ndi kusungidwa. Wodwalayo akamaliza chemotherapy ndi radiation, ma cell omwe amasungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha mycosis fungoides ndi Sézary syndrome chingayambitse mavuto.

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.

Kuchiza kwa Gawo I ndi Gawo II Mycosis Fungoides

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

Chithandizo cha gawo loyamba ndi matenda achiwiri a mycosis fungoides atha kukhala awa:

• Psoralen ndi ultraviolet A (PUVA) mankhwala othandizira ma radiation.

• Chithandizo cha radiation cha Ultraviolet B.

• Thandizo la radiation ndi mankhwala athunthu amtundu wa ma elektroniki. Nthawi zina, mankhwala a radiation amapatsidwa zotupa pakhungu, monga mankhwala ochepetsa nkhawa kuti achepetse kukula kwa chotupa kuti athe kuchepetsa zizolowezi ndikukhala ndi moyo wabwino.

• Immunotherapy yoperekedwa yokha kapena kuphatikiza ndi chithandizo chamankhwala pakhungu.

• Matenda apamwamba a chemotherapy.

• Chemotherapy yokhazikika ndi mankhwala amodzi kapena angapo, omwe atha kuphatikizidwa ndi mankhwala operekedwa pakhungu.

• Mankhwala ena (topical corticosteroids, retinoid therapy, lenalidomide, histone deacetylase inhibitors).

• Chithandizo choyenera (brentuximab vedotin).

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.

Kuchiza kwa Gawo III ndi Gawo IV Mycosis Fungoides (Kuphatikiza Sézary Syndrome)

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

Chithandizo cha gawo lachitatu lomwe lapezeka ndi gawo IV IV mycosis fungoides kuphatikiza Sézary syndrome ndiwothandiza (kuthetsa zizindikiro ndikusintha moyo) ndipo mwina ndi izi:

• Psoralen ndi ultraviolet A (PUVA) mankhwala othandizira ma radiation.

• Chithandizo cha radiation cha Ultraviolet B.

• Extracorporeal photochemotherapy yoperekedwa yokha kapena yophatikizidwa ndi mankhwala athunthu amagetsi opangira ma radiation.

• Thandizo la radiation ndi mankhwala athunthu amtundu wa ma elektroniki. Nthawi zina, mankhwala a radiation amapatsidwa zotupa pakhungu, monga mankhwala ochepetsa nkhawa kuti achepetse kukula kwa chotupa kuti athe kuchepetsa zizolowezi ndikukhala ndi moyo wabwino.

• Immunotherapy yoperekedwa yokha kapena kuphatikiza ndi chithandizo chamankhwala pakhungu.

• Chemotherapy yokhazikika ndi mankhwala amodzi kapena angapo, omwe atha kuphatikizidwa ndi mankhwala operekedwa pakhungu.

• Matenda apamwamba a chemotherapy.

• Mankhwala ena (topical corticosteroids, lenalidomide, bexarotene, histone deacetylase inhibitors).

• Chithandizo choyenera ndi brentuximab vedotin.

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.

Kuchiza kwa Recurrent Mycosis Fungoides (Kuphatikiza Sézary Syndrome)

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

Matenda a mycosis fungoides ndi Sézary syndrome abwereranso pakhungu kapena mbali zina za thupi atachiritsidwa.

Chithandizo cha matenda a mycosis fungoides kuphatikiza Sézary syndrome atha kukhala pakuyesedwa kwamankhwala ndipo atha kukhala ndi izi:

• Thandizo la radiation ndi mankhwala athunthu amtundu wa ma elektroniki. Nthawi zina, mankhwala a radiation amaperekedwa ku zotupa pakhungu ngati mankhwala ochepetsa nkhawa kuti achepetse kukula kwa chotupa kuti athetse zizolowezi ndikukhala ndi moyo wabwino.

• Psoralen ndi ultraviolet A (PUVA) mankhwala a radiation, omwe atha kuperekedwa ndi immunotherapy.

• Kutulutsa kwa ultraviolet B.

• Extracorporeal photochemotherapy.

• Systemic chemotherapy ndi mankhwala amodzi kapena angapo.

• Mankhwala ena (topical corticosteroids, retinoid therapy, lenalidomide, histone deacetylase inhibitors).

• Immunotherapy yoperekedwa yokha kapena kuphatikiza ndi chithandizo chamankhwala pakhungu.

• Mankhwala a chemotherapy apamwamba, ndipo nthawi zina mankhwala othandizira ma radiation, okhala ndi tsinde lama cell.

• Chithandizo choyenera (brentuximab vedotin kapena mogamulizumab).

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

To Learn More About Mycosis Fungoides and Sézary Syndrome

For more information from the National Cancer Institute about mycosis fungoides and Sézary syndrome, see the following:

• Lymphoma Home Page

• Photodynamic Therapy for Cancer

• Drugs Approved for Non-Hodgkin Lymphoma

• Immunotherapy to Treat Cancer

• Targeted Cancer Therapies

For general cancer information and other resources from the National Cancer Institute, see the following:

• About Cancer

• Staging

• Chemotherapy and You: Support for People With Cancer

• Radiation Therapy and You: Support for People With Cancer

• Coping with Cancer

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira