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

Unyango lwabantu abadala i-Hodgkin Lymphoma Treatment (®) -Patient Version

Ulwazi ngokubanzi malunga neLymphoma yabantu abadala engekho kwiHodgkin

IINGONGOMA EZIPHAMBILI

• I-non-Hodgkin lymphoma sisifo apho iiseli ezinobungozi (zomhlaza) zenza inkqubo ye-lymph.

• I-non-Hodgkin lymphoma inokuthi inganyangeki okanye ibe ndlongondlongo.

• Ukwaluphala, ukuba yindoda, kunye nokuba namandla amajoni omzimba kunokunyusa umngcipheko wabantu abadala abangenayo iHodgkin lymphoma.

• Iimpawu kunye neempawu zokungabikho kwe-Hodgkin lymphoma yabantu abadala zibandakanya ukudumba kwe-lymph node, umkhuhlane, ukubila ebusuku, ukunciphisa umzimba kunye nokudinwa.

• Uvavanyo oluvavanya inkqubo ye-lymph kunye namanye amalungu omzimba asetyenziselwa ukunceda ukufumanisa isifo kunye nenqanaba labadala elingelilo i-Hodgkin lymphoma.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

I-non-Hodgkin lymphoma sisifo apho iiseli ezinobungozi (zomhlaza) zenza inkqubo ye-lymph.

I-non-Hodgkin lymphoma luhlobo lomhlaza olwenzeka kwinkqubo ye-lymph. Inkqubo ye-lymph yinxalenye yenkqubo yomzimba yokuzikhusela. Inceda ukukhusela umzimba kusulelo nakwizifo.

Inkqubo ye-lymph yenziwe ngezi zinto zilandelayo:

• Lymph: Umbala, ulwelo olunamanzi oluhamba ngemithambo ye-lymph kwaye luthwala ii-lymphocyte (iiseli ezimhlophe zegazi). Zintathu iintlobo zee-lymphocyte:

• Ii-lymphocyte ze-B ezenza ii-antibodies zokunceda ukulwa usulelo. Ikwabizwa ngokuba zii-B. Uninzi lweentlobo ze-non-Hodgkin lymphoma ziqala kwii-lymphocyte ze-B.

• I-lymphocyte T ezinceda ii-lymphocyte ze-B zenze ii-antibodies ezinceda ukulwa usulelo. Ikwabizwa ngokuba ziiseli T.

• Iiseli zombulali zendalo ezihlasela iiseli zomhlaza kunye neentsholongwane. Ikwabizwa ngokuba ziiseli ze-NK.

• Imikhumbi ye-Lymph: Uthungelwano lweetyhubhu ezibhityileyo eziqokelela i-lymph kwiindawo ezahlukeneyo zomzimba kwaye ziyibuyisele kwigazi.

• Iimpawu zeLymph: ezincinci, ezimilise ubhontshisi ezicoca ulusu kwaye zigcine iiseli ezimhlophe zegazi ezinceda ukulwa usulelo kunye nezifo. Iimpawu ze-lymph zifunyenwe kunye nenethiwekhi yemithambo ye-lymph kuwo wonke umzimba. Amaqela e-lymph node afunyanwa entanyeni, ngaphantsi kwekhwapha, kwi-mediastinum, kwisisu, kwi-pelvis, nakwi-groin.

• I-Spleen: Ilungu elenza ii-lymphocyte, ligcina iiseli ezibomvu zegazi kunye nee-lymphocyte, zihluza igazi, zitshabalalise iiseli zegazi ezindala. I-spleen ikwicala lasekhohlo lesisu kufutshane nesisu.

• I-Thymus: Ilungu apho ii-lymphocyte ze-T zikhula kwaye zanda. I-thymus isesifubeni emva kwethambo lesifuba.

• Iitoni: Amabini amancinci amancinci e-lymph emva komqala. Kukho itoni enye kwicala ngalinye lomqala.

• Umongo wethambo: Isithambo esithambileyo, esinesiponji embindini wamathambo athile, anjengethambo lesinqe kunye nethambo lesifuba. Iiseli ezimhlophe zegazi, iiseli ezibomvu zegazi, kunye neeplatelets zenziwe kumongo wethambo.

I-Anatomy yenkqubo ye-lymph, ebonisa iinqanawa ze-lymph kunye nezitho ze-lymph ezibandakanya i-lymph nodes, i-tonsils, i-thymus, i-spleen kunye nomongo wethambo. I-Lymph (i-fluid ecacileyo) kunye nee-lymphocyte zihamba kwiinqanawa ze-lymph nakwii-lymph nodes apho i-lymphocytes zitshabalalisa izinto ezinobungozi. I-lymph ingena egazini ngomthambo omkhulu kufutshane nentliziyo.

Izicubu ze-Lymph ziyafumaneka nakwezinye iindawo zomzimba ezinje ngombhinqo wendlela yokwetyisa, i-bronchus kunye nolusu. Umhlaza unganwenwela esibindini nasemiphungeni.

Kukho iintlobo ezimbini eziqhelekileyo ze-lymphomas: iHodgkin lymphoma kunye ne-non-Hodgkin lymphoma. Esi sishwankathelo simalunga nokunyanga kwabantu abadala abangaHodgkin lymphoma, kubandakanya nokukhulelwa.

Ukufumana ulwazi malunga nezinye iintlobo ze-lymphoma, jonga oku kufutshane kwe-:

• Unyango lweLymphoblastic Leukemia yabantu abadala (i-lymphoblastic lymphoma)

• Unyango lweHodgkin Lymphoma yabantu abadala

• Unyango olunxulumene noGawulayo lweLymphoma

• Unyango lwe-Hodgkin Lymphoma yoBuntwana

• Unyango lweLymphocytic Leukemia enganyangekiyo (encinci ye-lymphocytic lymphoma)

• Unyango lweMycosis Fungoides (kubandakanya i-Sézary Syndrome) Unyango (i-T-cell lymphoma)

• Unyango lwe-CNS lweLymphoma

I-non-Hodgkin lymphoma inokuthi inganyangeki okanye ibe ndlongondlongo.

I-non-Hodgkin lymphoma iyakhula kwaye isasazeke ngamanqanaba ahlukeneyo kwaye isenokungalawuleki okanye ibe ndlongondlongo. I-Indolent lymphoma ihlala ikhula kwaye isasazeka kancinci, kwaye ineempawu kunye neempawu ezimbalwa. I-lymphoma enobundlobongela ikhula kwaye isasazeka ngokukhawuleza, kwaye ineempawu kunye neempawu ezinokuba nzima. Unyango lwe-lymphoma enganyangekiyo kunye nobundlongondlongo yahlukile.

Isishwankathelo malunga nezi ntlobo zilandelayo ze-non-Hodgkin lymphoma:

Ii-lymphomas ze-non-Hodgkin ezingafunekiyo

I-lymphoma yesigxina. I-lymphoma yesigxina yindlela eqhelekileyo ye-indolent engeyiyo iHodgkin lymphoma. Luhlobo olukhula kancinci kancinci lwe-non-Hodgkin lymphoma eqala kwii-lymphocyte ze-B. Ichaphazela ii-lymph node kwaye inokusasazeka kumongo wethambo okanye kudakada. Uninzi lwezigulana ezine-lymphoma ezinomtsalane zineminyaka engama-50 nangaphezulu ubudala xa zifunyaniswa. I-lymphoma yesigxina inokuhamba ngaphandle kwonyango. Isigulana sijongwa ngononophelo ziimpawu okanye iimpawu zokuba esi sifo sibuye kwakhona. Unyango luyafuneka ukuba iimpawu okanye iimpawu zenzeka emva kokuba umhlaza unyamalele okanye emva konyango lokuqala lomhlaza. Ngamanye amaxesha i-follicular lymphoma inokuba luhlobo olunolaka ngakumbi lwe-lymphoma, enjengokusasaza i-B-cell lymphoma enkulu.

I-Lymphoplasmacytic lymphoma. Kwiimeko ezininzi ze-lymphoplasmacytic lymphoma, ii-lymphocyte ze-B ezijika zibe ngamaseli e-plasma zenza inani elikhulu leprotheni ebizwa ngokuba yi-monoclonal immunoglobulin M (IgM) antibody. Amanqanaba aphezulu omzimba we-IgM egazini abangela ukuba iplasma yegazi ityebe. Oku kunokubangela iimpawu okanye iimpawu ezinje ngokubona okanye ukuva, iingxaki zentliziyo, ukuphefumla kancinci, intloko ebuhlungu, isiyezi, nokuba ndindisholo okanye ukubetha kwezandla neenyawo. Ngamanye amaxesha akukho miqondiso okanye iimpawu ze-lymphoplasmacytic lymphoma. Inokufunyanwa xa kuvavanywa igazi kusenziwa esinye isizathu. I-Lymphoplasmacytic lymphoma ihlala isasazeka kumongo wethambo, i-lymph node, kunye ne-spleen. Izigulane ezine-lymphoplasmacytic lymphoma kufuneka zihlolwe ukusuleleka kwintsholongwane ye-hepatitis C. Ikwabizwa ngokuba yiWaldenström macroglobulinemia.

Indawo yasemaphandleni ye-lymphoma. Olu hlobo lwe-non-Hodgkin lymphoma luqala kwii-lymphocyte ze-B kwinxalenye yelungu le-lymph elibizwa ngokuba ngumda wobubanzi. Ukuxela kwangaphambili kunokuba kubi ngakumbi kwizigulana ezineminyaka engama-70 okanye nangaphezulu, abo banesigaba se-III okanye isifo se-IV, kunye nabo banamazinga aphezulu e-lactate dehydrogenase (LDH). Kukho iintlobo ezintlanu ezahlukeneyo zommandla we-lymphoma. Ziqokelelwe luhlobo lwethishu apho i-lymphoma yenziwa khona:

• Indawo ye-Nodal marginal zone lymphoma. Iifom ze-nodal marginal zone lymphoma iifom kwii-lymph nodes. Olu hlobo lwe-non-Hodgkin lymphoma lunqabile. Ikwabizwa ngokuba yi-monocytoid B-cell lymphoma.

• Isisu esine-lymphoid tishu (MALT) ye-lymphoma. I-Gastric MALT lymphoma ihlala iqala esiswini. Olu hlobo lweendawo ze-lymphoma zommandla osecaleni kwiiseli ezikwi-mucosa ezinceda ekwenzeni ii-antibodies. Izigulane ezine-gastric MALT lymphoma nazo zinokuba ne-Helicobacter gastritis okanye isifo se-autoimmune, esifana neHashimoto thyroiditis okanye iSjögren syndrome.

• I-MALT lymphoma eyongezelelweyo. I-MALT i-lymphoma eqala ngaphandle kwesisu phantse kuwo onke amalungu omzimba kubandakanya namanye amalungu ethumbu, isisu, idlala lengqula, imiphunga, ulusu kunye neliso. Olu hlobo lweendawo ze-lymphoma zommandla osecaleni kwiiseli ezikwi-mucosa ezinceda ekwenzeni ii-antibodies. I-MALT lymphoma eyongezelelweyo engabuya emva kweminyaka emininzi yonyango.

• I-lymphoma yesisu esiswini. Olu luhlobo lwe-MALT lymphoma eyenzeka kubantu abadala abancinci kumazwe asempuma yeMeditera. Ihlala isenzeka esiswini kwaye izigulana zinokosulelwa ziintsholongwane ezibizwa ngokuba yiCampylobacter jejuni. Olu hlobo lwe-lymphoma lukwabizwa ngokuba sisifo esincinci se-immunoproliferative.

• Indawo ye-Splenic marginal zone lymphoma. Olu hlobo lwendawo ekumda we-lymphoma luqala kwincindi kwaye lunokusasazeka kwigazi kunye nomongo wethambo. Olona phawu luxhaphakileyo lolu hlobo lwe-splenic marginal zone lymphoma sisipeni esikhulu ngakumbi kunesiqhelo.

Isiseko se-anaplastic cell cell lymphoma. Olu hlobo lwe-non-Hodgkin lymphoma lulusu kuphela. Ingaba yinto enobungozi (kungekhona umhlaza) enokuthi ihambe yodwa okanye ingasasazeka kwiindawo ezininzi kwesikhumba kwaye ifuna unyango.

I-lymphomas ye-non-Hodgkin enobundlobongela

Ukusasaza i-B-cell lymphoma enkulu. Ukusasaza i-B-cell lymphoma enkulu lolona hlobo luqhelekileyo lwe-non-Hodgkin lymphoma. Ikhula ngokukhawuleza kwii-lymph node kwaye zihlala zithambile, isibindi, umongo wethambo, okanye amanye amalungu achaphazeleka. Iimpawu kunye neempawu zokusasazeka kwe-B-cell lymphoma enkulu inokubandakanya umkhuhlane, ukubila ebusuku kunye nokulahleka kobunzima. Ezi zibizwa ngokuba ziimpawu zeB.

• I-B-cell lymphoma ephambili. Olu hlobo lwe-non-Hodgkin lymphoma luhlobo lokusasaza i-B-cell lymphoma enkulu. Kuphawulwe ngokugqithisa kwe-fibrous (efana ne-scar-like) ye-lymph tissue. I-tumor ihlala ifom emva kwesifuba sesifuba. Inokucinezela kwindlela yomoya kwaye ibangele ukukhohlela kunye nengxaki yokuphefumla. Uninzi lwezigulana ezine-primary-mediastinal B-cell lymphoma ngabafazi abaneminyaka engama-30 ukuya kwengama-40 ubudala.

I-cell cell enkulu ye-lymphoma, isigaba III. I-cell cell lymphoma enkulu, isigaba III, luhlobo olunqabileyo kakhulu lwe-non-Hodgkin lymphoma. Unyango lolu hlobo lwe-lymphoma ye-follicular ifana nonyango lwe-NHL enobundlobongela kune-NHL enganyangekiyo.

I-Anaplastic cell cell enkulu. I-Anaplastic cell cell lymphoma luhlobo lwe-non-Hodgkin lymphoma edla ngokuqala kwii-lymphocyte ze-T. Iiseli zomhlaza nazo zinophawu olubizwa ngokuba yiCD30 kumphezulu weseli.

Zimbini iintlobo ze-aplastic cell cell lymphoma:

• I-cellular lymphoma enkulu enqamlezileyo. Olu hlobo lwe-aplastic large cell lymphoma ikakhulu ichaphazela ulusu, kodwa amanye amalungu omzimba anokuchaphazeleka. Iimpawu ze-aplastic cell cell lymphoma enkulu zibandakanya amaqhuma omnye okanye nangaphezulu okanye izilonda kulusu. Olu hlobo lwe-lymphoma lunqabile kwaye alunamdla.

• Inkqubo ye-aplastic cell cell lymphoma. Olu hlobo lwe-anaplastic cell cell lymphoma iqala kwii-lymph node kwaye inokuchaphazela amanye amalungu omzimba. Olu hlobo lwe-lymphoma lukhulu ngakumbi. Abaguli banokuba neeproteni ezininzi ze-anaplastic lymphoma kinase (ALK) ngaphakathi kweeseli ze-lymphoma. Ezi zigulana zinesifo esingcono kunezigulana ezingenayo iprotein eyongezelelweyo ye-ALK. Inkqubo ye-aplastic cell cell lymphoma ixhaphake kakhulu ebantwaneni kunabantu abadala. (Jonga isishwankathelo se- malunga nonyango lwe-Non-Hodgkin Lymphoma Treatment ngolwazi oluthe kratya.)

• I-Extranodal NK- / T-cell lymphoma. I-Extranodal NK- / T-cell lymphoma ihlala iqala kwindawo ejikeleze impumlo. Inokuchaphazela ne-paranasal sinus (indawo engenamathambo ejikeleze impumlo), uphahla lomlomo, itrachea, ulusu, isisu kunye namathumbu. Uninzi lwee-extranodal NK- / T-cell lymphoma zine-Epstein-Barr virus kwiiseli zethumba. Ngamanye amaxesha kwenzeka isifo se-hemophagocytic (imeko encomekayo apho zininzi kakhulu ii-histiocytes kunye neeseli ze-T ezibangela ukudumba okukhulu emzimbeni). Unyango lokucinezela amajoni omzimba luyafuneka. Olu hlobo lwe-non-Hodgkin lymphoma aluqhelekanga eUnited States.

• Iigymphomatoid granulomatosis. I-Lymphomatoid granulomatosis ichaphazela kakhulu imiphunga. Inokuchaphazela nezono ze-paranasal (iindawo ezingenamathambo emathanjeni ajikeleze impumlo), ulusu, izintso, kunye nenkqubo ye-nervous system. Kwi-lymphomatoid granulomatosis, umhlaza uhlasela imithambo yegazi kwaye ubulale izicwili. Ngenxa yokuba umhlaza unganwenwela kwingqondo, unikwa i-intrathecal chemotherapy okanye unyango ngemitha kwingqondo.

• I-angioimmunoblastic T-cell lymphoma. Olu hlobo lwe-non-Hodgkin lymphoma luqala kwiiseli ze-T. I-lymph nodes ezidumbileyo ziyimpawu eziqhelekileyo. Eminye imiqondiso inokubandakanya irhashalala, umkhuhlane, ukwehla kobunzima, okanye ukubila ebusuku. Kukho amanqanaba aphezulu egamma globulin (izilwa-buhlungu) egazini. Izigulana zisenokuba nosulelo olungenelelayo kuba amajoni omzimba abuthathaka.

• Umda weT-cell lymphoma. I-Peripheral T-cell lymphoma iqala kwii-lymphocyte ezivuthiweyo. Olu hlobo lwe-T lymphocyte lukhula kwi-thymus gland kwaye luhambe luye kwezinye iisayithi ze-lymphatic emzimbeni ezinje ngee-lymph node, umongo wethambo kunye nodakada. Kukho iintlobo ezintathu ze-T-cell lymphoma yomda:

• I-hepatosplenic T-cell lymphoma. Olu luhlobo olungaqhelekanga lwe-T-cell lymphoma yomda eyenzeka ikakhulu kubafana abancinci. Iqala esibindini kunye nodaka kwaye iiseli zomhlaza nazo zine-T-cell receptor ebizwa ngokuba yi-gamma / delta kumphezulu weseli.

• I-panniculitis engaphantsi kwe-T-cell lymphoma. I-panniculitis engaphantsi kwe-T-cell lymphoma iqala kulusu okanye kwi-mucosa. Kungenzeka nge-hemophagocytic syndrome (imeko enzulu apho kukho i-histiocyte esebenzayo kunye neeseli ze-T ezibangela ukuvuvukala okukhulu emzimbeni). Unyango lokucinezela amajoni omzimba luyafuneka.

• Uhlobo lwe-Enteropathy yohlobo lwe-T-cell lymphoma. Olu hlobo lweparipheral T-cell lymphoma lwenzeka kwisisu esincinci sezigulana ezinesifo esinganyangekiyo se-celiac (impendulo yomzimba kwi-gluten ebangela ukungondleki). Izigulana ezifunyaniswe zinesifo se-celiac ebuntwaneni kwaye zihlala kukutya okungahambisani ne-gluten kunqabile ukuba zikhulise uhlobo lwe-enteropathy-T-cell lymphoma.

• I-B-cell lymphoma enkulu yangaphakathi. Olu hlobo lwe-non-Hodgkin lymphoma luchaphazela imithambo yegazi, ngakumbi imithambo yegazi encinci kwingqondo, izintso, imiphunga kunye nolusu. Iimpawu kunye neempawu ze-B-cell lymphoma enkulu yangaphakathi ibangelwa yimithambo yegazi evaliweyo. Ikwabizwa ngokuba yi-intravascular lymphomatosis.

• IBurkitt lymphoma.I-Burkitt lymphoma luhlobo lwe-B-cell non-Hodgkin lymphoma ekhula kwaye isasazeka ngokukhawuleza. Inokuchaphazela umhlathi, amathambo obuso, amathumbu, izintso, amaqanda, okanye amanye amalungu. Zintathu iintlobo eziphambili zeBurkitt lymphoma (i-endemic, sporadic, kunye ne-immunodeficiency ehambelana nayo). I-Endemic Burkitt lymphoma ixhaphake e-Afrika kwaye inxulunyaniswa ne-Epstein-Barr virus, kunye ne-Burkitt lymphoma eyenzeka manqaphanqapha ivela kwihlabathi liphela. I-Burkitt lymphoma enxulumene ne-immunodeficiency idla ngokubonakalayo kwizigulane ezine-AIDS. I-Burkitt lymphoma inokusasazeka kwingqondo kunye nentambo yomqolo kunye nonyango lokuthintela ukusasazeka kwayo kunokunikwa. I-Burkitt lymphoma yenzeka rhoqo kubantwana nakubantu abadala abancinci (Jonga isishwankathelo se- soNyango lwe-Non-Hodgkin Lymphoma Unyango ngolwazi oluthe kratya.) IBurkitt lymphoma ikwabizwa ngokuba kukusasaza i-lymphoma encinci engacacanga.

• I-lymphoblastic lymphoma. I-lymphoblastic lymphoma ingaqala kwiiseli ze-T okanye kwiiseli ze-B, kodwa zihlala ziqala kwiiseli ze-T. Kulolu hlobo lwe-non-Hodgkin lymphoma, zininzi ii-lymphoblast (iiseli ezimhlophe zegazi ezimhlophe) kwii-lymph node nakwi-thymus gland. Ezi lymphoblast zinokusasazeka ziye kwezinye iindawo emzimbeni, ezinje ngomongo wethambo, ingqondo kunye nomqolo. I-lymphoblastic lymphoma ixhaphake kakhulu kulutsha nakubantu abadala abancinci. Kufana ne-lymphoblastic leukemia (i-lymphoblast ifumaneka kakhulu kumongo wethambo nasegazini) (Jonga isishwankathelo se- ku- Unyango lweLukymphoblastic Leukemia yaBadala ngolwazi oluthe kratya.)

• I-T-cell leukemia / lymphoma yabantu abadala. I-T-cell leukemia / lymphoma yabantu abadala ibangelwa yintsholongwane ye-T-cell leukemia virus type 1 (HTLV-1). Iimpawu zibandakanya izilonda zethambo nolusu, amanqanaba aphezulu egazi le-calcium, kunye ne-lymph node, udakada, kunye nesibindi esikhudlwana kunesiqhelo.

• Ingubo yeseli lymphoma. I-Mantle cell lymphoma luhlobo lwe-B-cell non-Hodgkin lymphoma edla ngokwenzeka kubantu abadala abaphakathi okanye abadala. Iqala kwii-lymph nodes kwaye isasazeka kwi-spleen, umongo wethambo, igazi, ngamanye amaxesha i-esophagus, isisu kunye namathumbu. Izigulana ezineengubo zeseli lymphoma zineprotein eninzi ebizwa ngokuba yi-cyclin-D1 okanye utshintsho oluthile kwiiseli ze-lymphoma. Kwezinye izigulana ezingenazo iimpawu okanye iimpawu ze-lymphoma yokulibazisa ukuqala konyango akuchaphazeli ukuxela kwangaphambili.

• Ukuhanjiswa kwasemva kwe-lymphoproliferative disorder. Esi sifo senzeka kwizigulana ezinentliziyo, imiphunga, isibindi, izintso, okanye ukufakelwa kwepancreas kwaye zifuna unyango lobomi bokuzikhusela. Uninzi lwe-posttransplant lymphoproliferative ukuphazamiseka kuchaphazela iiseli ze-B kunye ne-Epstein-Barr virus kwiiseli. Iziphazamiso zeLymphoproliferative zihlala ziphathwa njengomhlaza.

• Inyaniso ye-histiocytic lymphoma. Olu luhlobo olunqabileyo, olunolunya kakhulu lwe-lymphoma. Ayaziwa nokuba iqala kwiiseli ze-B okanye kwiiseli zeT. Ayiphenduli kakuhle kunyango nge-chemotherapy esemgangathweni.

• I-primary effusion lymphoma. I-lymphoma ye-primary effusion iqala kwiiseli ze-B ezifumaneka kwindawo apho kukho ukwakheka okukhulu kolwelo, njengeendawo eziphakathi kwembombo yomphunga kunye nodonga lwesifuba (i-pleural effusion), ingxowa ejikeleze intliziyo kunye nentliziyo (pericardial effusion), okanye kwisisu esiswini. Ngokwesiqhelo akukho thumba linokubonwa. Olu hlobo lwe-lymphoma luhlala luvela kwizigulana ezinesifo se-HIV.

• Iplasmablastic lymphoma. I-Plasmablastic lymphoma luhlobo lwe-B-cell enkulu engeyiyo iHodgkin lymphoma enobundlobongela. Ihlala ibonakala kwizigulana ezinosulelo lwe-HIV.

Ukwaluphala, ukuba yindoda, kunye nokuba namandla amajoni omzimba kunokunyusa umngcipheko wabantu abadala abangenayo iHodgkin lymphoma.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini.

Ezi kunye neminye imingcipheko inokunyusa umngcipheko weentlobo ezithile zabantu abadala abangenayo iHodgkin lymphoma:

• Ukuba mdala, uyindoda, okanye umhlophe.

• Ukuba nezi meko zilandelayo zonyango ezenza buthathaka amajoni omzimba:

• Ukuphazamiseka kwilifa lokuzikhusela kwizifo (njenge-hypogammaglobulinemia okanye iWiskott-Aldrich syndrome).

• Isifo sokuzimela (njenge-rheumatoid arthritis, i-psoriasis, okanye i-Sjögren syndrome).

• Intsholongwane kaGawulayo / uGawulayo.

• Uhlobo lwe-virus ye-T-lymphotrophic yohlobo lwe-I okanye i-Epstein-Barr intsholongwane.

• Usulelo lwe-Helicobacter pylori.

• Ukuthatha iziyobisi ezikhuselayo emva kokufakwa komzimba.

Iimpawu kunye neempawu zokungabikho kwe-Hodgkin lymphoma yabantu abadala zibandakanya ukudumba kwe-lymph node, umkhuhlane, ukubila ebusuku, ukunciphisa umzimba kunye nokudinwa.

Le miqondiso kunye neempawu zingabangelwa ngumntu omdala ongeyena uHodgkin lymphoma okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukuvuvukala kwii-lymph node entanyeni, phantsi kwekhwapha, kwi-groin okanye kwisisu.

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Ukumanzisa ukubila ebusuku.

• Ndiziva ndidiniwe.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukudumba kolusu okanye ukurhawuzelela ulusu.

• Intlungu esifubeni, esiswini, okanye emathanjeni ngaphandle kwesizathu esaziwayo.

• Xa umkhuhlane, ukumanzisa ukubila ebusuku, kunye nokwehla kobunzima kwenzeka kunye, eli qela leempawu zibizwa ngokuba zii-B.

Ezinye iimpawu kunye neempawu zabantu abadala ezingezizo iHodgkin lymphoma zinokwenzeka kwaye zixhomekeke koku kulandelayo:

• Apho umhlaza wenzeka emzimbeni.

• Ubungakanani bethumba.

• Ukukhawuleza ngokukhawuleza kwethumba.

Uvavanyo oluvavanya inkqubo ye-lymph kunye namanye amalungu omzimba asetyenziselwa ukunceda ukufumanisa isifo kunye nenqanaba labadala elingelilo i-Hodgkin lymphoma.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yempilo yesigulana, kubandakanya umkhuhlane, ukubila ebusuku, kunye nokwehla kwesisindo, imikhwa yezempilo, kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Gcwalisa ubalo lwegazi (i-CBC): Inkqubo apho kuthathwa khona isampulu yegazi kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

• Isixa sehemoglobin (iprotein ethwala ioksijini) kwiiseli ezibomvu zegazi.

• Inxalenye yesampulu eyenziwe ngeeseli ezibomvu zegazi.

Gcwalisa ubalo lwegazi (CBC). Igazi liqokelelwa ngokufaka inaliti emthanjeni kwaye livumele igazi ukuba lingene kumbhobho. Isampulu yegazi ithunyelwa elebhu kwaye iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets kubalwa. I-CBC isetyenziselwa ukuvavanya, ukufumanisa isifo, kunye nokubeka iliso kwiimeko ezininzi ezahlukeneyo.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Uvavanyo lwe-LDH: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa isixa se-lactic dehydrogenase. Inani elonyukayo le-LDH egazini linokuba luphawu lomonakalo wethishu, i-lymphoma, okanye ezinye izifo.

• Uvavanyo lwe-Hepatitis B kunye nohlobo lwe-hepatitis C: Inkqubo apho kuvavanywa isampuli yegazi ukulinganisa izixa ze-antigen ezithile ze-hepatitis B kunye / okanye ii-antibodies kunye nezixa ezithile ze-hepatitis C. Ezi antijeni okanye izilwa-buhlungu kuthiwa ziziphawuli. Iimpawu zokumakisha ezahlukileyo okanye indibaniselwano yamakishi zisetyenziselwa ukumisela ukuba ngaba isigulana sinesifo se-hepatitis B okanye i-C, sinokosulelwa ngaphambili okanye isitofu sokugonya, okanye sisengozini yosulelo. Izigulana eziye zanyangelwa intsholongwane ye-hepatitis B kwixa elidlulileyo zifuna ukuqhubeka nokubeka iliso ukujonga ukuba iphinde yasebenza. Ukwazi ukuba umntu une-hepatitis B okanye i-C kunokunceda ekucwangciseni unyango.

• Uvavanyo lwe-HIV: Uvavanyo lokulinganisa inqanaba leentsholongwane ze-HIV kwisampulu yegazi. Ii-antibodies zenziwa ngumzimba xa uhlaselwe yinto yasemzini. Inqanaba eliphezulu lee-antibodies ze-HIV linokuthetha ukuba umzimba wosulelwe yi-HIV.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentamo, isifuba, isisu, isinqe, kunye ne-lymph node, ezithathwe kwiiangile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• Umnqweno wethambo kunye ne-biopsy: Ukususwa komongo wethambo kunye nesiqwenga samathambo ngokufaka inaliti kwimvubu okanye amathambo ebele. Ugqirha wezifo ujonga umongo wethambo kunye nethambo phantsi kwemicroscope ukukhangela iimpawu zomhlaza.

Umnqweno wethambo lomnqweno kunye ne-biopsy. Emva kokuba indawo encinci yolusu iphonyiwe, inaliti yomongo wethambo ifakwa kwisithambo sethambo lesigulana. Iisampulu zegazi, ithambo, kunye nomongo wethambo ziyasuswa ukuze zihlolwe phantsi kwemicroscope.

• I-lymph node biopsy: Ukususwa kwayo yonke into okanye inxalenye ye-lymph node. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukujonga iiseli zomhlaza. Enye yezi ndlela zilandelayo zinokwenziwa:

• I-biopsy ekhethekileyo: Ukususwa kwe-lymph node yonke.

• Incinci ye-biopsy: Ukususwa kwenxalenye ye-lymph node.

• I-biopsy engundoqo: Ukususwa kwenxalenye ye-lymph node usebenzisa inaliti ebanzi.

Ukuba umhlaza ufumanekile, kungenziwa ezi mvavanyo zilandelayo ukufundisisa iiseli zomhlaza:

• I-Immunohistochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yesicwili somguli. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen ethile kwisampulu yethishu, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukufumanisa isifo somhlaza kunye nokunceda uxelele olunye uhlobo lomhlaza kolunye uhlobo lomhlaza.

• Uhlalutyo lwe-cytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yegazi okanye umongo wethambo ubalwa kwaye ujongwa kulo naluphi na utshintsho, njengokwaphuka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

• Immunophenotyping: Uvavanyo lwaselabhoratri olusebenzisa izilwa-buhlungu ukufumanisa iiseli zomhlaza ngokusekwe kwiindidi zeantigens okanye iimpawu zokumakisha phezu kweeseli. Olu vavanyo lusetyenziselwa ukunceda ukufumanisa iintlobo ezithile ze-lymphoma.

• I-FISH (i-fluorescence in situ hybridization): Uvavanyo lwaselebhu olusetyenziselwa ukujonga nokubala ii-genes okanye ii-chromosomes kwiiseli nakwizicubu. Amacandelo e-DNA aqukethe idayi ye-fluorescent yenziwa elebhu kwaye yongezwa kwisampulu yeeseli zomguli okanye izicwili. Xa ezi ziqwenga zeDNA zidayiweyo zinamathela kwimfuza ethile okanye kwiindawo zechromosomes kwisampulu, ziyakhanya xa zijongwa phantsi kwemicroscope ebengezelayo. Uvavanyo lwe-FISH lusetyenziselwa ukunceda ekuchongeni umhlaza kunye nokunceda ekucwangciseni unyango.

Olunye uvavanyo kunye neenkqubo zinokwenziwa ngokuxhomekeke kwiimpawu ezibonakalayo kunye nalapho umhlaza wenzeka khona emzimbeni.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Iimpawu kunye neempawu zesigulana, kubandakanya nokuba banazo na iimpawu ze-B (umkhuhlane ngaphandle kwesizathu esaziwayo, ukuncipha komzimba ngaphandle kwesizathu esaziwayo, okanye ukubila ebusuku).

• Isigaba somhlaza (ubungakanani besisu somhlaza kunye nokuba umhlaza usasazekile kwamanye amalungu omzimba okanye ii-lymph node).

• Uhlobo lwe-non-Hodgkin lymphoma.

• Isixa se-lactate dehydrogenase (LDH) egazini.

• Nokuba kukho utshintsho oluthile kwimfuza.

• Iminyaka yesigulana, isini, kunye nempilo ngokubanzi.

• Nokuba i-lymphoma isandula kufunyaniswa, iyaqhubeka nokukhula ngexesha lonyango, okanye iphinde yabuya (buyela).

Kwi-non-Hodgkin lymphoma ngexesha lokukhulelwa, ukhetho kunyango luxhomekeke:

• Iminqweno yesigulana.

• Yeyiphi ikota yokukhulelwa ekuyo isiguli.

• Nokuba umntwana angaziswa kwangethuba.

Ezinye iintlobo ze-non-Hodgkin lymphoma zisasazeka ngokukhawuleza kunabanye. Uninzi lwee-non-Hodgkin lymphomas ezenzeka ngexesha lokukhulelwa zinoburharha. Ukulibazisa unyango lwe-lymphoma enobudlova kude kube emva kokuzalwa komntwana kunokunciphisa ithuba lokusinda komama. Unyango olukhawulezileyo luyacetyiswa, kwanaxa ukhulelwe.

Amanqanaba e-Non-Hodgkin Lymphoma yabantu abadala

IINGONGOMA EZIPHAMBILI

• Emva kokuba umntu omdala engeyiyo iHodgkin lymphoma efunyanisiwe, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwinkqubo ye-lymph okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Amanqanaba alandelayo asetyenziselwa abantu abadala abangenayo iHodgkin lymphoma:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Ukuphinda-phinda iHodgkin Lymphoma yabantu abadala

• I-lymphomas yabantu abadala engeyiyo iHodgkin inokuthi iqokelelwe kunyango ngokujonga ukuba ngaba umhlaza awunabundlobongela okanye ungqwabalala, nokuba ngaba ii-lymph node ezichaphazelekayo zikufuphi emzimbeni, nokuba umhlaza usandula ukufunyanwa okanye uphindaphindiwe.

Emva kokuba umntu omdala engeyiyo iHodgkin lymphoma efunyanisiwe, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwinkqubo ye-lymph okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa uhlobo lomhlaza kwaye ukuba iiseli zomhlaza zisasazekile ngaphakathi kwinkqubo ye-lymph okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba lesi sifo ukuze ucwangcise unyango. Iziphumo zovavanyo kunye neenkqubo ezenziwe ekuchongeni i-non-Hodgkin lymphoma zisetyenziselwa ukunceda ekuthatheni izigqibo ngonyango.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa kwinkqubo yokuqokelela:

• I-MRI (imaging resonance imaging) enegadolinium: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengengqondo kunye nomqolo. Into ebizwa ngokuba yi-gadolinium itofelwe kwisigulana ngomthambo. I-gadolinium iqokelela malunga neeseli zomhlaza ukuze zibonakale zikhanya emfanekisweni. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Ukugqobhoza iLumbar: Inkqubo esetyenziselwa ukuqokelela i-cerebrospinal fluid (CSF) ukusuka kumqolo womqolo. Oku kwenziwa ngokubeka inaliti phakathi kwamathambo amabini emqolo kunye nakwi-CSF ejikeleze intambo yomqolo kunye nokususa isampulu yolwelo. Isampulu ye-CSF ihlolwe phantsi kwemicroscope ngeempawu zokuba umhlaza usasazekile waya kwingqondo nakumqolo. Le nkqubo ikwabizwa ngokuba yi-LP okanye impompo yomqolo.

Ukugqobhoza iLumbar. Isigulana silele endaweni egobileyo phezu kwetafile. Emva kokuba indawo encinci kumqolo ongezantsi ifakwe inaliti, inaliti yomgogodla (inaliti ende, ebhityileyo) ifakwe kwinxalenye esezantsi yomqolo womqolo ukususa ulwelo lwe-cerebrospinal fluid (CSF, eboniswe ngombala oluhlaza okwesibhakabhaka). Ulwelo lunokuthunyelwa kwilabhoratri kuvavanyo.

Kwabasetyhini abakhulelweyo abane-non-Hodgkin lymphoma, kusetyenziswa uvavanyo lokulinganisa kunye neenkqubo ezikhusela umntwana ongekazalwa kwiingozi zemitha. Olu vavanyo kunye neenkqubo zibandakanya i-MRI (ngaphandle kokuthelekisa), i-lumbar puncture, kunye ne-ultrasound.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni. Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Amanqanaba alandelayo asetyenziselwa abantu abadala abangenayo iHodgkin lymphoma:

Inqanaba I

Isigaba I-lymphoma yabantu abadala. I-Cancer ifunyenwe kwi-lymph node enye okanye ngaphezulu kwiqela le-lymph nodes okanye, kwiimeko ezinqabileyo, umhlaza ufunyanwa kwindandatho kaWaldeyer, i-thymus, okanye i-spleen. Kwinqanaba le-IE (aliboniswanga), umhlaza usasazeke kwindawo enye ngaphandle kwenkqubo ye-lymph.

Isigaba I omdala non-Hodgkin lymphoma yahlulwe ngokwamanqanaba mna IE.

Kwinqanaba I, umhlaza ufumaneka kwenye yezi ndawo zilandelayo kwinkqubo ye-lymph:

• Enye okanye ezinye iindawo nkovu kwiqela nkovu iindawo.

• Umsesane kaWaldeyer.

• Thymus.

• Udaka.

Kwinqanaba le-IE, umhlaza ufumaneka kwindawo enye ngaphandle kwenkqubo ye-lymph.

Inqanaba II

Inqanaba II abadala i-non-Hodgkin lymphoma yahlulwe yangamanqanaba II kunye ne-IIE.

• Kwinqanaba II, umhlaza ufumaneka kumaqela amabini okanye nangaphezulu ee-lymph node ezingaphezulu kwesithambisi okanye ezantsi kwidayaphragm.

Isigaba II se-lymphoma yabantu abadala. Umhlaza ufumaneka kumaqela amabini okanye nangaphezulu ee-lymph node ezingaphezulu kwesithambisi okanye ezantsi kwidayaphragm.

• Kwinqanaba le-IIE, umhlaza usasazekile kwiqela le-lymph node ukuya kwindawo ekufutshane engaphandle kwenkqubo ye-lymph. Umhlaza usenokuthi usasazeke kwamanye amaqela e-lymph node kwicala elinye ledyaphragm.

Inqanaba IIE yabantu abadala i-lymphoma. Umhlaza usasazekile ukusuka kwiqela le-lymph node ukuya kwindawo ekufutshane engaphandle kwenkqubo ye-lymph. Umhlaza usenokuthi usasazeke kwamanye amaqela e-lymph node kwicala elinye ledyaphragm.

Kwinqanaba II, igama elithi bulky disease libhekisa kubunzima obukhulu besisu. Ubungakanani besisu esibizwa ngokuba sisifo esinamandla siyahluka ngohlobo lwe-lymphoma.

Inqanaba III

Isigaba III se-lymphoma yabantu abadala. Umhlaza ufunyanwa ngokwamaqela e-lymph node zombini ngasentla nangaphantsi kwesithambiso; okanye kwiqela le-lymph nodes ngaphezu kwesithambiso kunye nodaka.

Kwinqanaba lesithathu labantu abadala elingelilo iHodgkin lymphoma, umhlaza ufumaneka:

• kumaqela e-lymph nodes ngasentla nangaphantsi kwe-diaphragm; okanye

• kwii-lymph node ngaphezulu kwesithambisi nakwipeni.

Inqanaba IV

Isigaba IV se-lymphoma yabantu abadala. Umhlaza (a) usasazeke kwilungu elinye okanye ngaphezulu ngaphandle kwenkqubo ye-lymph; okanye (b) ifumaneka kumaqela amabini okanye nangaphezulu ee-lymph node ezingaphezulu kovalo okanye ezantsi kwidayaphragm nakwelinye ilungu elingaphandle kwenkqubo ye-lymph kwaye hayi kufutshane ne-lymph node ezichaphazelekayo; okanye (c) ifunyanwa ngokwamaqela ezele nkovu ngaphezulu kwesithambo nangaphantsi kwesithambiso nakulo naliphi na ilungu elingaphandle kwenkqubo ye-lymph; okanye (d) ifumaneka esibindini, kumongo wethambo, ngaphezulu kwendawo enye emphungeni, okanye kwi-cerebrospinal fluid (CSF). Umhlaza awusasazekanga ngokuthe ngqo kwisibindi, umongo wethambo, imiphunga, okanye i-CSF kwii-lymph node ezikufutshane.

Kwinqanaba le-IV yabantu abadala abangenayo iHodgkin lymphoma, umhlaza:

• isasazeke kwilungu elinye okanye nangaphezulu ngaphandle kwenkqubo ye-lymph; okanye

• ifumaneka kumaqela amabini okanye nangaphezulu ee-lymph node ezingaphezulu kwesithambisi okanye ezantsi kwidayaphragm nakwelinye ilungu elingaphandle kwenkqubo ye-lymph kwaye hayi kufutshane ne-lymph node ezichaphazelekayo; okanye

• ifumaneka kumaqela e-lymph nodes zombini ngasentla nangaphantsi kwesithambisi nakweliphi na ilungu elingaphandle kwenkqubo ye-lymph; okanye

• ifumaneka kwisibindi, umongo wethambo, ngaphezu kwendawo enye emiphungeni, okanye kwi-cerebrospinal fluid (CSF). Umhlaza awusasazekanga ngokuthe ngqo kwisibindi, umongo wethambo, imiphunga, okanye i-CSF kwii-lymph node ezikufutshane.

Ukuphinda-phinda iHodgkin Lymphoma yabantu abadala

Ukuphinda-phinda kwabantu abadala i-non-Hodgkin lymphoma ngumhlaza obuye wabuya (ubuye) emva kokuba unyangiwe. I-lymphoma inokubuyela kwinkqubo ye-lymph okanye kwezinye iindawo zomzimba. I-lymphoma ye-Indolent ingabuya njenge-lymphoma enobudlova. I-lymphoma enobudlova ingabuya njenge-lymphoma ye-indolent.

I-lymphomas yabantu abadala engeyiyo iHodgkin inokuthi iqokelelwe kunyango ngokujonga ukuba ngaba umhlaza awunabundlobongela okanye ungqwabalala, nokuba ngaba ii-lymph node ezichaphazelekayo zikufuphi emzimbeni, nokuba umhlaza usandula ukufunyanwa okanye uphindaphindiwe.

Jonga icandelo loLwazi ngokubanzi ngolwazi oluthe kratya kwiindidi ze-indolent (ukukhula kancinci) kunye nobundlongondlongo (bukhula ngokukhawuleza) obungeyiyo iHodgkin lymphoma.

I-non-Hodgkin lymphoma inokuthi ichazwe njengonxibelelene okanye engaqhelekanga:

• IiLymphomas ezihambelanayo: IiLymphomas apho ii-lymph node ezinomhlaza zihlala ecaleni kwenye.

• I-lymphomas engaqhelekanga: IiLymphomas apho ii-lymph node ezinomhlaza azikho ecaleni komnye nomnye, kodwa zikwicala elinye ledyaphragm.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-non-Hodgkin lymphoma.

• Izigulana ezine-non-Hodgkin lymphoma kufuneka unyango lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango

• lymphophomas.

• Unyango lwe-non-Hodgkin lymphoma yabantu abadala inokubangela iziphumo ebezingalindelekanga.

• Unyango ngemitha

• Unyango ngamayeza

• Unyango lwe-Immunotherapy

• Unyango ekujoliswe kulo

• IPlasmapheresis

• Ukulinda ulindile

• Unyango lwe-Antibiotic

• Ugqirha

• Ukufakelwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lokugonya

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-non-Hodgkin lymphoma.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-non-Hodgkin lymphoma. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kwizilingo zonyango. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Kwabafazi abakhulelweyo abane-non-Hodgkin lymphoma, unyango lukhethwe ngononophelo ukukhusela usana olungekazalwa. Izigqibo zonyango zisekwe kwiminqweno kamama, inqanaba le-non-Hodgkin lymphoma, kunye nobudala bosana olungekazalwa. Isicwangciso sonyango sinokutshintsha njengoko imiqondiso kunye neempawu, umhlaza kunye nokutshintsha kokukhulelwa. Ukukhetha olona nyango lufanelekileyo lomhlaza sisigqibo esibandakanya isigulana, usapho kunye neqela lokhathalelo lwempilo.

Izigulana ezine-non-Hodgkin lymphoma kufuneka unyango lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lwe-lymphomas.

Unyango luya kujongwa ngugqirha oncologist, ugqirha ogxile kunyango lomhlaza, okanye ugqirha wegazi, ugqirha ogxile kunyango lomhlaza wegazi. Ugqirha wezonyango unokukuthumela kwabanye ababoneleli ngezempilo abanamava kwaye ziingcali ekunyangeni abantu abadala abangenayo iHodgkin lymphoma kwaye abagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Neurosurgeon.

• Ingcali yonyango.

• Imitha ye-oncologist.

• Ingcali yezigulana.

• Ingcali yokuvuselela.

• Ezinye iingcali ze-oncology.

Unyango lwe-non-Hodgkin lymphoma yabantu abadala inokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga eziqala ngexesha lonyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Iziphumo ebezingalindelekanga ezivela kunyango lomhlaza eziqala emva konyango kwaye ziqhubeke iinyanga okanye iminyaka zibizwa ngokuba ziziphumo ezifike kade. Unyango nge-chemotherapy, unyango lwe-radiation, okanye ukufakelwa kweseli ye-stem ye-non-Hodgkin lymphoma inokunyusa umngcipheko wokuvela kade.

Iziphumo zokunyanga komhlaza zingabandakanya oku kulandelayo:

• Iingxaki zentliziyo.

• Ukungachumi (ukungakwazi ukuba nabantwana).

• Ukuphulukana nethambo.

• I-Neuropathy (umonakalo wentsholongwane obangela ukuba ndindisholo okanye ukuhamba nzima).

• Umhlaza wesibini, onje:

• Umhlaza wemiphunga.

• Umhlaza wobuchopho.

• Umhlaza wezintso.

• Umhlaza wesinyi.

• Melanoma.

• IHodgkin lymphoma.

• Isifo seMyelodysplastic.

• Leukemia olunamandla.

Ezinye iziphumo ezinokufika emva kwexesha zinokunyangwa okanye zilawulwe. Kubalulekile ukuba uthethe nogqirha wakho malunga neziphumo zonyango lomhlaza olunokuba nazo kuwe. Ukulandelelana rhoqo ukujonga iziphumo zasemva kwexesha kubalulekile.

Iindidi ezisithoba zonyango olusetyenziswayo:

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula.

Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza. Ngamanye amaxesha umzimba opheleleyo we-irradiation unikezwa ngaphambi kokufakelwa kweseli.

Unyango lwe-Proton beam radiation lusebenzisa imijelo yeeproton (amasuntswana amancinci anexabiso elifanelekileyo) ukubulala iiseli zesisu. Olu hlobo lonyango lunokuhlisa isixa somonakalo kwimitha yenyama kufutshane nethumba, njengentliziyo okanye ibele.

Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-non-Hodgkin lymphoma yabantu abadala, kwaye inokusetyenziswa njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

Kumfazi okhulelweyo one-non-Hodgkin lymphoma, unyango ngemitha kufuneka lunikezwe emva kokubeleka, ukuba kunokwenzeka, ukuthintela nawuphi na umngcipheko kusana olungekazalwa. Ukuba unyango luyafuneka kwangoko, umfazi unokuthatha isigqibo sokuqhubeka nokukhulelwa kwaye afumane unyango ngemitha. Ikhaka elikhokelayo lisetyenziselwa ukugubungela isisu somfazi okhulelweyo ukunceda ukukhusela usana olungekazalwa kwimisebe yelanga kangangoko kunokwenzeka.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid (i-intrathecal chemotherapy), ilungu, okanye isinqe somzimba esifana nesisu, amachiza ikakhulu achaphazela iiseli zomhlaza kwezo ndawo (i-chemotherapy yengingqi). Ukudibanisa i-chemotherapy yonyango kusetyenziswa amachiza amabini okanye nangaphezulu. Iziyobisi zeSteroid zinokongezwa, ukunciphisa ukudumba kunye nokunciphisa ukuphendula komzimba.

Inkqubo yokudibanisa i-chemotherapy isetyenziselwa unyango lwe-non-Hodgkin lymphoma yabantu abadala.

I-Intrathecal chemotherapy ingasetyenziselwa unyango lwe-lymphoma eqala ukuqala kumasende okanye kwiisinus (iindawo ezingenanto) ezijikeleze impumlo, ukusabalalisa i-B-cell lymphoma, iBurkitt lymphoma, i-lymphoblastic lymphoma, kunye ne-T-cell lymphomas. Kunikwa ukunciphisa ithuba lokuba iiseli ze-lymphoma zisasazeke kwingqondo nakwintambo yomqolo. Oku kubizwa ngokuba yi-CNS prophylaxis.

Unyango lwe-chemotherapy. Amachiza e-anticancer afakwe kwisithuba se-intrathecal, esi sithuba esigcina i-cerebrospinal fluid (CSF, eboniswe ngombala oluhlaza okwesibhakabhaka). Zimbini iindlela zokwenza oku. Enye indlela, eboniswe kwinxalenye ephezulu yomzobo, kukujova amachiza kwindawo yokugcina izilwanyana i-Ommaya (isikhongozeli esimile okomgangatho obekwe phantsi kwentloko entloko ngexesha lotyando; ibamba amachiza njengoko ehamba ngombhobho omncinci esiya kwingqondo ). Enye indlela, eboniswe kwinxalenye esezantsi yomzobo, kukujova amachiza ngqo kwi-CSF kwinxalenye esezantsi yomqolo womqolo, emva kokuba indawo encinci kumqolo ongezantsi ifakwe amanxeba.

Xa owasetyhini okhulelweyo anyangwa ngekhemotherapy kwi-non-Hodgkin lymphoma, usana olungekazalwa alunakukhuselwa ekubeni lubhenceke kwi-chemotherapy. Ezinye iirejimeni zekhemotherapy zinokubangela iziphene zokuzalwa ukuba zinikwe kwikota yokuqala.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Ama-immunomodulators kunye nonyango lwe-CAR T-cell ziindidi ze-immunotherapy.

• Ama-Immunomodulators: I-Lenalidomide yi-immunomodulator esetyenziselwa ukunyanga i-non-Hodgkin lymphoma yabantu abadala.

• Unyango lwe-CAR T-cell: Iiseli ze-T zesigulana (uhlobo lweseli yamajoni omzimba) ziyatshintshwa ukuze zihlasele iiproteni ezithile kubuso beeseli zomhlaza. Iiseli ze-T zithathwa kwisigulana kwaye ii-receptors ezizodwa zongezwa kumphezulu wazo kwilabhoratri. Iiseli eziguqulweyo zibizwa ngokuba ziiseli ze-chimeric antigen receptor (CAR) T. Iiseli ze-CAR T zikhula elebhu kwaye zinikwa isigulana ngokufakwa. Iiseli ze-CAR T ziphindaphindeka kwigazi lesigulana kwaye zihlasela iiseli zomhlaza. Unyango lwe-CAR T-cell (njenge-axicabtagene ciloleucel okanye tisagenlecleucel) isetyenziselwa ukunyanga i-B-cell lymphoma enkulu engaphendulanga kunyango.

Unyango lwe-CAR T-cell. Uhlobo lonyango apho iiseli ze-T zesigulana (uhlobo lweseli yomzimba yokuzikhusela) ziguqulwa kwilabhoratri ukuze zibophelele kwiiseli zomhlaza kwaye zibabulale. Igazi eliphuma emthanjeni engalweni yesigulana lihamba lingena kwityhubhu lisiya kumatshini weapheresis (ongaboniswanga), osusa iiseli ezimhlophe zegazi, kubandakanya neeseli zeT, kwaye uthumele lonke igazi libuyele kwisigulana. Emva koko, i-gene ye-receptor ekhethekileyo ebizwa ngokuba yi-chimeric antigen receptor (CAR) ifakwe kwiiseli ze-T elebhu. Izigidi zeeseli ze-CAR T zikhuliswa elebhu zize zinikwe isigulana ngokufakwa. Iiseli ze-CAR T ziyakwazi ukubopha kwi-antigen kwiiseli zomhlaza kwaye zibabulale.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Unyango lwe-monoclonal antibody, unyango lwe-proteasome inhibitor, kunye ne-kinase inhibitor yonyango ziindidi zonyango olujolisiweyo olusetyenziselwa ukunyanga i-non-Hodgkin lymphoma yabantu abadala.

Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu ezivela kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa.

Iindidi zee-antibodies ze-monoclonal zibandakanya:

• I-Rituximab, isetyenziselwa ukunyanga iintlobo ezininzi ze-non-Hodgkin lymphoma.

• I-Obinutuzumab, esetyenziselwa ukunyanga i-follicular lymphoma.

• I-Brentuximab vedotin, equlethe i-anti-monoclonal antibody ebopha kwiprotheni ebizwa ngokuba yi-CD30 efumaneka kwezinye iiseli ze-lymphoma. Iqulethe iyeza lokuchasana nomhlaza elinokunceda ekubulaleni iiseli zomhlaza.

• I-Yttrium Y 90-ibritumomab tiuxetan, umzekelo we-radiolabeled monoclonal antibody.

Unyango lweproteasome inhibitor luthintela isenzo seproteasomes kwiiseli zomhlaza. IiProteasomes zisusa iiproteni ezingasafunekiyo kwiseli. Xa iiproteasomes zivaliwe, iiproteni ziyakha kwiseli kwaye kunokubangela ukuba iseli yomhlaza ife. I-Bortezomib isetyenziselwa ukunciphisa ubuninzi be-immunoglobulin M esegazini emva konyango lomhlaza kwi-lymphoplasmacytic lymphoma. Kukwafundwa ngayo ukunyanga ingubo yeselmoma ebuyileyo.

Unyango lweKinase inhibitor luthintela iiproteni ezithile, ezinokukunceda ukugcina iiseli ze-lymphoma zingakhuli kwaye zinokubabulala. Unyango lweKinase inhibitor lubandakanya:

• ICopanlisib, idelalisib, kunye ne-duvelisib, ethintela iiprotein ze-P13K kwaye inokunceda ukugcina iiseli ze-lymphoma zingakhuli. Zisetyenziselwa ukunyanga ii-lymphomas ezingezizo zeHodgkin ezibuyise umva (zabuya) okanye ezingakhange zibengcono emva konyango ezinye iindlela ezimbini zonyango.

• Ibrutinib kunye ne-acalabrutinib, iindidi zonyango lwe-Bruton tyrosine kinase inhibitor. Zisetyenziselwa ukunyanga i-lymphoplasmacytic lymphoma kunye ne-mantle cell lymphoma.

I-Venetoclax ingasetyenziselwa ukuphatha ingubo ye-cell lymphoma. Ibhloka isenzo seprotein ebizwa ngokuba yi-B-cell lymphoma-2 (BCL-2) kwaye inokunceda ukubulala iiseli zomhlaza.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya.

IPlasmapheresis

Ukuba igazi liyajiya ngeeproteni ze-antibody eyongezelelweyo kwaye ichaphazela ukujikeleza, iplasmapheresis yenziwa ukususa iplasma eyongezelelweyo kunye neeproteni zomzimba ezichasene negazi. Kule nkqubo, igazi liyasuswa kwisigulana lize lithunyelwe ngomatshini ohlukanisa iplasma (ulwelo oluyinxalenye yegazi) kwiiseli zegazi. Iplasma yesigulana inezinto zokulwa ezingafunekiyo kwaye ayibuyiswanga kwisigulana. Iiseli zegazi eziqhelekileyo zibuyiselwa egazini kunye neplasma enikelweyo okanye into ebuyiselweyo. I-Plasmapheresis ayigcini ii-antibodies ezintsha ekubeni zenziwe.

Ukulinda ulindile

Ukuhlala ulindile kubeka esweni imeko yesigulana ngaphandle kokunikezela ngonyango de kuvele iimpawu okanye utshintsho.

Unyango lwe-Antibiotic

Unyango lwe-Antibiotic lunyango olusebenzisa amayeza ukunyanga usulelo kunye nomhlaza obangelwa ziintsholongwane kunye nezinye izinto ezincinci.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya.

Ugqirha

Utyando lunokusetyenziselwa ukususa i-lymphoma kwizigulana ezithile ezine-indolent okanye ezinobundlongondlongo ezingezizo iHodgkin lymphoma.

Uhlobo lotyando olusetyenzisiweyo luxhomekeke apho i-lymphoma yenziwa khona emzimbeni:

• Ukucocwa kwendawo kwizigulana ezithile ezine-mucosa ezinxulumene ne-lymphoid tishu (MALT) i-lymphoma, i-PTLD, kunye ne-T-cell lymphoma yamathumbu amancinci.

• I-Splenectomy kwizigulana ezinendawo ekumda ophantsi ye-lymphoma yethanga.

Izigulana ezineentliziyo, imiphunga, isibindi, izintso, okanye ukufakelwa kwepancreas zihlala zifuna ukuthatha iziyobisi ukucinezela amajoni omzimba kubo bonke ubomi babo. Ukunyanzeliswa kwexesha elide emva kokufakelwa komzimba kunokubangela uhlobo oluthile lwe-non-Hodgkin lymphoma ebizwa ngokuba yi-post-transplant lymphoproliferative disorder (PLTD).

Utyando oluncinci lwamathumbu kuhlala kufuneka ukuba kufunyaniswe isifo se-celiac kubantu abadala abaphuhlisa uhlobo lwe-T-cell lymphoma.

Ukufakelwa kweseli

Ukufakelwa kweseli kwestem yindlela yokunika iidosi eziphezulu zekhemotherapy kunye / okanye umzimba wonke kunye nokutshintsha iiseli ezenza igazi ezonakaliswe ngumhlaza. Iiseli zesinti (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana (ukufakelwa okuzenzekelayo) okanye umnikeli (ukufakelwa kweallogeneic) kwaye kugcinwe ngumkhenkce kwaye kugcinwa. Emva kokuba i-chemotherapy kunye / okanye unyango lwe-radiation lugqityiwe, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Ukufakelwa kweseli. (Inyathelo 1): Igazi lithathwa emthanjeni engalweni yomnikeli. Isigulana okanye omnye umntu angangumnikeli. Igazi lihamba ngomatshini osusa iiseli zeziqu. Emva koko igazi libuyiselwa kulowo unikeleyo ngomthambo okwenye ingalo. (Inyathelo 2): Isigulana sifumana ichemotherapy yokubulala iiseli ezenza igazi. Isigulana sinokufumana unyango ngemitha (engaboniswanga). (Inyathelo 3): Isigulana sifumana iiseli zeziqu ngokusebenzisa ipayinti ebekwe kwisitya segazi esifubeni.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lokugonya

Unyango lwe-Vaccine lunyango lomhlaza olusebenzisa into okanye iqela lezinto ukukhuthaza amajoni omzimba ukuba afumane ithumba alibulale.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Unyango lwe-Indolent Non-Hodgkin Lymphoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwenqanaba lokungakhathali mna kunye nokungakhathali, inqanaba lesibini labantu abadala elingelilo iHodgkin lymphoma linokubandakanya oku kulandelayo:

• Unyango ngemitha.
• Unyango lwe-monoclonal antibody (rituximab) kunye / okanye ichemotherapy.
• Ukulinda ulindile.

Ukuba ithumba likhulu kakhulu ukuba linganyangwa ngonyango lwe-radiation, unyango olunokunyanga, inqanaba lesibini le-II, III, okanye i-IV yabantu abadala abangayiyo iHodgkin lymphoma iya kusetyenziswa.

Unyango lwe-non-Hodgkin lymphoma yabantu abadala abangakhathaliyo, inqanaba lesibini, okanye lesine, elinokubandakanya oku kulandelayo:

• Ukujonga ukulinda izigulana ezingenazo iimpawu okanye iimpawu.

• Unyango lwe-Monoclonal antibody (rituximab) kunye okanye ngaphandle kwe-chemotherapy.

• Ulondolozo lonyango kunye ne-rituximab.

• Unyango lwe-Monoclonal antibody (obinutuzumab).

• Unyango lwe-PI3K inhibitor (copanlisib, idelalisib, okanye duvelisib).

• I-Lenalidomide kunye ne-rituximab.

• Unyango lwe-Radiolabeled monoclonal antibody.

• Uvavanyo lweklinikhi yonyango lweedosi ephezulu okanye ngaphandle komzimba opheleleyo we-irradiation okanye unyango lwe-monollonal antibody, olandelwa

• autologous okanye allogeneic stem cell transplant.

• Uvavanyo lweklinikhi lwe-chemotherapy kunye okanye ngaphandle kwonyango lokugonya.

• Uvavanyo lweklinikhi lweentlobo ezintsha zeentsholongwane ze-monoclonal.

• Uvavanyo lweklinikhi yonyango lwemitha olubandakanya ii-lymph node ezikufuphi, kwizigulana ezinesifo seNqanaba III.

• Uvavanyo lweklinikhi yonyango lwedosi ephantsi, ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

Olunye unyango lwe-indolent non-Hodgkin lymphoma luxhomekeke kuhlobo lwe-non-Hodgkin lymphoma. Unyango lunokubandakanya oku kulandelayo:

• Kwi-follicular lymphoma, unyango lunokubakho kuvavanyo lweklinikhi yonyango olutsha lwe-anti-monoclonal antibody, irejimeni entsha ye-chemotherapy, okanye isiqu

ukufakelwa kweseli.

• Kwi-follicular lymphoma ebuyileyo (ebuyayo) okanye engakhange ibengcono emva konyango, unyango lunokubandakanya i-PI3K inhibitor

(copanlisib, idelalisib, okanye duvelisib).

• Kwi-lymphoplasmacytic lymphoma, unyango lwe-Bruton tyrosine kinase inhibitor kunye / okanye i-plasmapheresis okanye unyango lwe-proteasome inhibitor (ukuba iyafuneka

ukwenza igazi licekeceke) kuyasetyenziswa. Olunye unyango olufana nezo zisetyenziselwa i-follicular lymphoma nazo zinokunikwa.

• Kwizicubu ze-lymphoid ezinxulumene nesisu esiswini (MALT) i-lymphoma, unyango lwe-antibiotic yokunyanga usulelo lwe-Helicobacter pylori lunikwa kuqala.

Kwiimpawu ezingaphenduliyo kunyango lwe-antibiotic, unyango lonyango lwe-radiation, utyando, okanye i-rituximab kunye okanye ngaphandle kwe-chemotherapy.

• Kwi-MALT lymphoma yeliso kunye ne-lymphoma yesisu esiswini, unyango lwe-antibiotic lusetyenziselwa ukunyanga usulelo.

• Kwi-splenic zone marginal zone lymphoma, i-rituximab kunye okanye ngaphandle kwe-chemotherapy kunye ne-B-cell receptor therapy isetyenziswa njengonyango lokuqala. Ukuba i-tumor ayiphenduli kunyango, i-splenectomy inokwenziwa.

Unyango lwe-Aggressive Non-Hodgkin Lymphoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwenqanaba lobundlongondlongo mna kunye nobundlongondlongo, inqanaba lesibini labantu abadala elingelilo iHodgkin lymphoma linokubandakanya oku kulandelayo:

• Unyango lwe-monoclonal antibody (rituximab) kunye nokudibanisa i-chemotherapy. Ngamanye amaxesha unyango lwe-radiation lunikwa kamva.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango lwe-monoclonal antibody kunye nokudibanisa i-chemotherapy.

Unyango lwenqanaba lesibini elinobundlongondlongo, elingadibaniyo ne-II, i-III, okanye i-IV yabantu abadala abangayiyo iHodgkin lymphoma inokubandakanya oku kulandelayo:

• Unyango lwe-Monoclonal antibody (rituximab) ngokudibanisa i-chemotherapy.

• Ukudibanisa i-chemotherapy.

• Uvavanyo lweklinikhi yonyango lwe-monoclonal anti-anti ngokudityaniswa kwe-chemotherapy elandelwa lonyango lwe-radiation.

Olunye unyango luxhomekeke kuhlobo lwe-non-Hodgkin lymphoma enobundlobongela. Unyango lunokubandakanya oku kulandelayo:

• Kwi-extranodal NK- / T-cell lymphoma, unyango lwemitha olunokunikwa ngaphambi, ngexesha, okanye emva kwe-chemotherapy kunye ne-CNS prophylaxis.

• Ngengubo yeseli lymphoma, unyango lwe-monoclonal antibody ngokudibanisa i-chemotherapy, elandelwa kukufakelwa kweseli. Unyango lwe-monoclonal antibody lunokunikwa emva kwexesha njengonyango lwesondlo (unyango olunikwa emva konyango lokuqala ukunceda ukugcina umhlaza ungabuyi).

• Ukuphazamiseka emva kokutshintshwa kwe-lymphoproliferative disorder, unyango ngamachiza omzimba anokumiswa. Ukuba oku akusebenzi okanye akunakwenziwa, unyango lwe-monoclonal antibody lodwa okanye ngekhemotherapy lunokunikwa. Ngomhlaza ongasasazwanga, ukusetyenziswa kotyando lokususa umhlaza okanye unyango lwemitha kunokusetyenziswa.

• Kwi-plasmablastic lymphoma, unyango lufana nezo zisetyenziselwa i-lymphoblastic lymphoma okanye iBurkitt lymphoma.

Ngolwazi malunga nonyango lwe-lymphoblastic lymphoma, jonga kwiNyango yeLymphoblastic Lymphoma kunye nolwazi malunga nonyango lweBurkitt lymphoma.

Unyango lweLymphoblastic Lymphoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-lymphoblastic lymphoma yabantu abadala inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy kunye ne-CNS prophylaxis. Ngamanye amaxesha unyango lwe-radiation lukwanikezelwa ukunciphisa ithumba elikhulu.

• Unyango ekujoliswe kulo nge-monoclonal antibody yodwa (rituximab) okanye idityaniswe nonyango lwe-kinase inhibitor (ibrutinib).

• Uvavanyo lweklinikhi yokufakelwa kweseli emva konyango lokuqala.

Unyango lweBurkitt Lymphoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-Burkitt lymphoma yabantu abadala inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy kunye okanye ngaphandle kwonyango lwe-monoclonal antibody.

• I-CNS yokuthintela.

Unyango lweLymphoma engekho rhoqo kwiHodgkin

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-indolent, yabantu abadala abangaqhelekanga be-non-Hodgkin lymphoma inokubandakanya oku kulandelayo:

• Chemotherapy ngeyeza elinye okanye nangaphezulu.

• Unyango lwe-monoclonal antibody (rituximab okanye obinutuzumab).

• Igama Lenidomide.

• Unyango lwe-Radiolabeled monoclonal antibody.

• Unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Uvavanyo lweklinikhi yokufakelwa kweseli yeseli ye-autologous okanye i-allogeneic.

Unyango lwe-non-Hodgkin lymphoma yabantu abadala abanolunya, inokubandakanya oku kulandelayo:

• I-Chemotherapy kunye okanye ngaphandle kokufakwa kweseli.

• Unyango lwe-monoclonal antibody kunye okanye ngaphandle kwendibaniselwano yechemotherapy elandelwa kukufakelwa kweeseli ezizimeleyo.

• Unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwe-Radiolabeled monoclonal antibody.

• Unyango lwe-CAR T-cell.

• Ingubo yeseli lymphoma, unyango lunokubandakanya oku kulandelayo:

• Unyango lwe-Bruton tyrosine kinase inhibitor.

• Igama Lenidomide.

• Uvavanyo lweklinikhi lwe-lenalidomide yonyango lwe-monoclonal antibody.

• Uvavanyo lweklinikhi ngokuthelekisa i-lenalidomide nolunye unyango.

• Uvavanyo lweklinikhi yonyango lweproteasome inhibitor (bortezomib).

• Uvavanyo lweklinikhi yokufakelwa ngokutsha kweseli yeseli.

Unyango lwe-lymphoma ye-indolent ebuya njenge-lymphoma enobundlobongela ixhomekeke kuhlobo lwe-non-Hodgkin lymphoma kwaye inokubandakanya unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi. Unyango lwe-lymphoma enobundlobongela ebuya njenge-lymphoma enganyangekiyo inokubandakanya i-chemotherapy.

Unyango lwe-Non-Hodgkin Lymphoma Ngexesha lokukhulelwa

Kweli Candelo

• I-Indolent Non-Hodgkin Lymphoma Ngexesha lokukhulelwa

• I-Lymphoma engeyiyo iHodgkin Lymphoma Ngexesha lokukhulelwa

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

I-Indolent Non-Hodgkin Lymphoma Ngexesha lokukhulelwa

Abasetyhini abane-indolent (ekhula kancinci) engeyiyo iHodgkin lymphoma ngexesha lokukhulelwa banokuphathwa ngokulinda de kube emva kokubeleka. (Jonga uKhetho lonyango lweCandelo le-Indolent Non-Hodgkin Lymphoma ngolwazi oluthe kratya.)

I-Lymphoma engeyiyo iHodgkin Lymphoma Ngexesha lokukhulelwa

Unyango lwe-non-Hodgkin lymphoma enobundlobongela ngexesha lokukhulelwa kunokubandakanya oku kulandelayo:

• Unyango olunikezwe kwangoko ngokuxhomekeke kuhlobo lwe-non-Hodgkin lymphoma ukwandisa amathuba okusinda komama. Unyango lunokubandakanya i-chemotherapy kunye ne-rituximab.

• Ukuhanjiswa kwangoko kosana olulandelwa lunyango olusekwe kuhlobo lwe-non-Hodgkin lymphoma.

• Ukuba kwi-trimester yokuqala yokukhulelwa, i-oncologists yonyango inokucebisa ukuba kuphele ukukhulelwa ukuze unyango luqale. Unyango luxhomekeke kuhlobo lwe-non-Hodgkin lymphoma.

Ukufunda ngakumbi malunga nabantu abadala abangaHodgkin Lymphoma

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nabantu abadala abangenawo iHodgkin lymphoma, bona oku kulandelayo:

• Iphepha lasekhaya elingelilo i-Hodgkin Lymphoma

• Iziyobisi ezivunyiweyo ze-Non-Hodgkin Lymphoma

• Iithagethi zoMhlaza ezijolise kuko

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli