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Unyango lweHodgkin Lymphoma yoNyango (®) -Ingxelo yePatient

Ulwazi ngokubanzi malunga neHodgkin Lymphoma yobuntwana

IINGONGOMA EZIPHAMBILI

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

• Ezi ntlobo zimbini ziphambili zobuntwana zeHodgkin lymphoma zii-classic kunye ne-nodular lymphocyte-ephambili.

• Usulelo lwe-Epstein-Barr yintsholongwane kunye nembali yosapho yeHodgkin lymphoma inokunyusa umngcipheko wobuntwana kwiHodgkin lymphoma.

• Iimpawu zobuntwana iHodgkin lymphoma zibandakanya ukudumba kwe-lymph node, umkhuhlane, ukubila ebusuku kunye nokuhla komzimba.

• Uvavanyo oluvavanya inkqubo ye-lymph kunye namanye amalungu omzimba asetyenziselwa ukuxilonga kunye nenqanaba lobuntwana kwiHodgkin lymphoma.

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

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

Ubuntwana Hodgkin lymphoma luhlobo lomhlaza olukhula 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 luphethe ii-lymphocyte ze-T kunye ne-B. IiLymphocyte ziluhlobo lweeseli ezimhlophe zegazi.

• 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 (indawo phakathi kwemiphunga), isisu, i-pelvis, kunye ne-groin. I-Hodgkin lymphoma ixhaphakileyo kwiifom ze-lymph ngaphezu kwesithsaba.

• 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.

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

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

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.

Iimpawu ze-lymph tissue nazo zifumaneka kwezinye iindawo zomzimba ezifana ne-lining of the gastrointestinal tract, bronchus, kunye nesikhumba.

Kukho iintlobo ezimbini eziqhelekileyo ze-lymphoma: iHodgkin lymphoma kunye ne-non-Hodgkin lymphoma. Esi sishwankathelo simalunga nonyango lobuntwana lweHodgkin lymphoma.

IHodgkin lymphoma yenzeka rhoqo kulutsha oluneminyaka eli-15 ukuya kweli-19 ubudala. Unyango lwabantwana nakwishumi elivisayo lwahlukile kunonyango lwabantu abadala.

Ukufumana ulwazi malunga ne-non-Hodgkin lymphoma yobuntwana okanye iHodgkin lymphoma yabantu abadala jonga ezi zishwankathelo zilandelayo zePDP

• Unyango lwe-Hodgkin Lymphoma yoBuntwana.

• Unyango lweHodgkin Lymphoma yabantu abadala.

Ezi ntlobo zimbini ziphambili zobuntwana zeHodgkin lymphoma zii-classic kunye ne-nodular lymphocyte-ephambili.

Ezona ntlobo zimbini ziphambili zobuntwana zeHodgkin lymphoma zezi:

• Iklasikhi iHodgkin lymphoma. Olu luhlobo oluqhelekileyo lweHodgkin lymphoma. Kwenzeka rhoqo kulutsha. Xa isampulu yamathambo e-lymph node ejongwa phantsi kwemicroscope, iiseli zomhlaza zeHodgkin lymphoma, ezibizwa ngokuba ziiseli zeReed-Sternberg.

Iseli yeRed-Sternberg. Iiseli zeRed-Sternberg zinkulu, ii-lymphocyte ezingaqhelekanga ezinokuba nenqaku elingaphezulu kwesinye. Ezi seli zifumaneka kwiHodgkin lymphoma.

I-Classic Hodgkin lymphoma yahlulwe yangamacandelwana amane, ngokusekwe kwindlela iiseli zomhlaza ezibonakala ngayo phantsi kwemicroscope:

• I-Nodular-sclerosing Hodgkin lymphoma yenzeka kakhulu kubantwana abadala nakwishumi elivisayo. Kuqhelekile ukuba nobunzima besifuba ekuchongeni.

• Iiseli ezixutyiweyo zeHodgkin lymphoma zihlala zenzeka kubantwana abangaphantsi kweminyaka eli-10 ubudala. Inxulunyaniswa nembali yosulelo lwe-Epstein-Barr (EBV) kwaye ihlala isenzeka kwii-lymph node entanyeni.

• I-lymphocyte-rich rich Hodgkin lymphoma inqabile ebantwaneni. Xa isampulu yamathambo e-lymph node ajongwa phantsi kwemicroscope, kukho iiseli zeRed-Sternberg kunye nee-lymphocyte ezininzi eziqhelekileyo kunye nezinye iiseli zegazi.

• I-lymphocyte-depleted Hodgkin lymphoma inqabile ebantwaneni kwaye ixhaphake kakhulu kubantu abadala okanye kubantu abadala abane-virus ye-immunodeficiency virus (HIV). Xa isampulu yamathambo e-lymph node ajongwa phantsi kwemicroscope, zininzi iiseli zomhlaza ezime ngendlela engaqhelekanga kunye nee-lymphocyte ezimbalwa eziqhelekileyo kunye nezinye iiseli zegazi.

• I-Nodular lymphocyte-ephambili yeHodgkin lymphoma. Olu hlobo lweHodgkin lymphoma aluqhelekanga kuneHodgkin lymphoma. Oku kwenzeka rhoqo kubantwana abangaphantsi kweminyaka eli-10 ubudala. Xa isampulu yamathambo e-lymph node ajongwa phantsi kwemicroscope, iiseli zomhlaza zijongeka njenge "popcorn" ngenxa yemilo yazo. I-Nodular lymphocyte-eyona nto iphambili kwiHodgkin lymphoma ihlala isenzeka njenge-lymph node edumbileyo entanyeni, ngaphantsi kwekhwapha, okanye ekuthini kuqhume. Uninzi lwabantu alunazo naziphi na ezinye iimpawu okanye iimpawu zomhlaza xa kufunyaniswa isifo.

Usulelo lwe-Epstein-Barr yintsholongwane kunye nembali yosapho yeHodgkin lymphoma inokunyusa umngcipheko wobuntwana kwiHodgkin 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 umntwana wakho usengozini.

Izinto ezinobungozi kwiHodgkin lymphoma yobuntwana zibandakanya oku kulandelayo:

• Ukosulelwa yintsholongwane kaEpstein-Barr (EBV).

• Ukuba nembali yobuqu ye-mononucleosis ("mono").

• Ukosulelwa yintsholongwane kaGawulayo (i-HIV).

• Ukuba nezifo ezithile zamajoni omzimba, njenge-autoimmune lymphoproliferative syndrome.

• Ukuba namajoni omzimba abuthathaka emva kokufakelwa komzimba okanye amayeza anikwe emva kokufakelwa ukuze unqande ilungu ukuba lingaliwa ngumzimba.

• Ukuba nomzali, umntakwabo, okanye udade onembali yobuqu yeHodgkin lymphoma.

Ukuvezwa kusulelo oluqhelekileyo ebuntwaneni bokuqala kunokunciphisa umngcipheko weHodgkin lymphoma ebantwaneni ngenxa yempembelelo enayo kumajoni omzimba.

Iimpawu zobuntwana iHodgkin lymphoma zibandakanya ukudumba kwe-lymph node, umkhuhlane, ukubila ebusuku kunye nokuhla komzimba.

Iimpawu kunye neempawu zeHodgkin lymphoma zixhomekeke apho umhlaza wenzeka emzimbeni kunye nobungakanani bomhlaza. Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa yi-Hodgkin lymphoma yobuntwana okanye ngezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Iimbumba ezingenazintlungu, ezidumbileyo kufutshane nekhola okanye entanyeni, esifubeni, ngaphantsi kwekhwapha, okanye emhlubulweni.

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukumanzisa ukubila ebusuku.

• Ndiziva ndidiniwe.

• Anorexia.

• Ulusu olurhawuzayo.

• Ukukhohlela.

• Ingxaki yokuphefumla, ngakumbi xa ulele phantsi.

• Ubuhlungu kwii-lymph node emva kokusela utywala.

Umkhuhlane ngaphandle kwesizathu esaziwayo, ukunciphisa umzimba ngaphandle kwesizathu esaziwayo, okanye ukubila ebusuku kubizwa ngokuba ziimpawu zeB. Iimpawu ze-B ziyinxalenye ebalulekileyo yokubeka iHodgkin lymphoma kunye nokuqonda ithuba lesigulana lokufumana kwakhona.

Uvavanyo oluvavanya inkqubo ye-lymph kunye namanye amalungu omzimba asetyenziselwa ukuxilonga kunye nenqanaba lobuntwana kwiHodgkin lymphoma.

Uvavanyo kunye neenkqubo ezenza imifanekiso yenkqubo ye-lymph kunye namanye amalungu omzimba ancede ekuchongeni i-Hodgkin lymphoma yobuntwana kwaye ubonise ukuba umhlaza usasazeke kangakanani. Inkqubo esetyenziselwa ukufumanisa ukuba iiseli zomhlaza zisasazekile ngaphandle kwenkqubo ye-lymph ibizwa ngokuba yistage. Ukucwangcisa unyango, kubalulekile ukwazi ukuba umhlaza usasazekile na kwamanye amalungu omzimba.

Olu vavanyo kunye neenkqubo zinokubandakanya oku kulandelayo:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana 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 yegazi eyenziwe ziiseli 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, kubandakanya i-albin, ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Inqanaba lentlenga: Inkqubo apho isampulu yegazi itsalwa khona kwaye ihlolwe inqanaba apho iiseli ezibomvu zegazi zihlala emazantsi etyhubhu yovavanyo. Iqondo lentlenge ngumlinganiso wokuba kukudumba okungakanani emzimbeni. Iqondo elingaphezulu kwelesiqhelo lentlenga linokuba luphawu lwe-lymphoma. Ikwabizwa ngokuba sisixa se-erythrocyte sedimentation, sed rate, okanye ESR.

• I-CT scan (i-CAT scan): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentamo, isifuba, isisu, okanye isinqe, esithathwe kwiimbombo 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.

Ikhompyuter ye-tomography (CT) yesisu. Umntwana ulele phezu kwetafile etyibilika ngesikena se-CT, esithatha imifanekiso ye-x-ray engaphakathi esiswini.

• 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. Ngamanye amaxesha i-PET scan kunye ne-CT scan zenziwa ngaxeshanye. Ukuba kukho nawuphi na umhlaza, oku kwandisa amathuba okuba kufumaneke.

Ukuskena i-Positron emission tomography (PET). Umntwana ulele phezu kwetafile etyibilika kwisikena sePET. Ukuphumla kwentloko kunye nomtya omhlophe kunceda umntwana ukuba alale. Inani elincinci leswekile ene-radioactive (iswekile) itofwe emthanjeni womntwana, kwaye iskena senza umfanekiso apho iswekile isetyenziswa khona emzimbeni. Iiseli zomhlaza zibonakala ziqaqambile emfanekisweni kuba zithatha iswekile eninzi kuneseli eziqhelekileyo.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengee-lymph node. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

Imagnetic resonance imaging (MRI) yesisu. Umntwana ulele phezu kwetafile etyibilika kwisikena se-MRI, esithatha imifanekiso engaphakathi komzimba. Iphedi esiswini somntwana inceda ukwenza imifanekiso icace gca.

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Umnqweno wethambo kunye ne-biopsy: Ukususwa komongo wethambo kunye neqhekeza elincinci lokufaka inaliti engenamathambo kwi-hipbone okanye kwi-breastbone. Ugqirha wezifo ujonga umongo wethambo kunye nethambo phantsi kwemicroscope ukukhangela iiseli ezingaqhelekanga. Umnqweno wethambo lomnqweno kunye ne-biopsy yenziwa kwizigulana ezinezifo eziphambili kunye / okanye neempawu zeB.

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

• I-lymph node biopsy: Ukususwa kwazo zonke okanye inxalenye yelinye okanye ezinye i-lymph node. I-lymph node ingasuswa ngexesha lokukhonjiswa komfanekiso we-CT okanye i-thoracoscopy, i-mediastinoscopy, okanye i-laparoscopy. 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 kwezicubu kwi-lymph node kusetyenziswa inaliti ebanzi.

Ugqirha wezifo ujonga izicubu ze-lymph node phantsi kwemicroscope ukujonga iiseli zomhlaza ezibizwa ngokuba ziiseli zeReed-Sternberg. Iiseli zeRed-Sternberg ziqhelekile kwiHodgkin lymphoma yakudala.

Olu vavanyo lulandelayo lunokwenziwa kwizicubu ezisusiweyo:

• 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.

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

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Isigaba somhlaza (ubungakanani bomhlaza kunye nokuba umhlaza usasazeke ngezantsi kwesithambiso okanye ngaphezulu kweqela elinye le-lymph node).

• Ubungakanani bethumba.

• Nokuba zikhona iimpawu ze-B (umkhuhlane ngaphandle kwesizathu esaziwayo, ukwehla kwesisindo ngaphandle kwesizathu esaziwayo, okanye ukubila ebusuku) xa kufunyaniswa isifo.

• Uhlobo lweHodgkin lymphoma.

• Iimpawu ezithile zeeseli zomhlaza.

• Ukuba nenani elingaphezulu kweqhelekileyo leeseli ezimhlophe zegazi okanye i-anemia ngexesha lokuchongwa.

• Nokuba kukho ulwelo olujikeleze intliziyo okanye imiphunga xa kufunyaniswa isifo.

• Iqondo lentlenge okanye inqanaba lealbumin egazini.

• Ngaba umhlaza uphendula njani kunyango lokuqala ngechemotherapy.

• Isini somntwana.

• Nokuba umhlaza usanda kufunyaniswa okanye ubuyile kwakhona (buyela).

Ukhetho lonyango luxhomekeke:

• Nokuba kukho umngcipheko ophantsi, ophakathi, okanye ophezulu umhlaza uya kubuya emva konyango.

• Iminyaka yomntwana.

• Umngcipheko weempembelelo zexesha elide.

Uninzi lwabantwana kunye nabakwishumi elivisayo abaneHodgkin lymphoma esandula ukufunyanwa banokunyangwa.

Amanqanaba obuNtwana eHodgkin Lymphoma

IINGONGOMA EZIPHAMBILI

• Emva kobuntwana iHodgkin lymphoma ifunyenwe, kuvavanywa kwenziwa ukufumanisa ukuba iiseli zomhlaza zisasazekile ngaphakathi kwinkqubo ye-lymph okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Amanqanaba alandelayo asetyenziselwa ubuntwana iHodgkin lymphoma:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Ukongeza kwinani lesigaba, oonobumba A, B, E, okanye S banokuqatshelwa.

• I-Hodgkin lymphoma yobuntwana inyangwa ngokwamaqela omngcipheko.

Emva kobuntwana iHodgkin lymphoma ifunyenwe, kuvavanywa kwenziwa ukufumanisa ukuba iiseli zomhlaza zisasazekile ngaphakathi kwinkqubo ye-lymph okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwenkqubo ye-lymph okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Iziphumo zovavanyo kunye neenkqubo ezenziweyo zokuchonga kunye nenqanaba leHodgkin lymphoma zisetyenziselwa ukunceda ekwenzeni izigqibo ngonyango.

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 ubuntwana iHodgkin lymphoma:

Inqanaba I

Inqanaba I lobuntwana Hodgkin lymphoma. I-Cancer ifunyanwa kwi-lymph node enye okanye ngaphezulu kwiqela elinye le-lymph node. Kwinqanaba le-IE (aliboniswanga), umhlaza ufumaneka ngaphandle kwe-lymph node kwilungu elinye okanye kwindawo.

Inqanaba I lahlulwe laba linqanaba I kunye nenqanaba IE.

• Isigaba I: Umhlaza ufumaneka kwenye yezi ndawo zilandelayo kwinkqubo ye-lymph:

• Inombolo enye okanye ezingaphezulu kwenye ye-lymph node group.

• Umsesane kaWaldeyer.

• Thymus.

• Ndicela

• Isigaba IE: Umhlaza ufumaneka ngaphandle kwenkqubo ye-lymph kwilungu elinye okanye kwindawo.

Inqanaba II

Inqanaba II lahlulwe laba linqanaba II kunye nenqanaba IIE.

• Isigaba II: I-Cancer ifunyenwe kumaqela e-lymph node amabini okanye ngaphezulu okanye ngaphezulu okanye ngaphantsi kwesithsaba (isisipha esincinci ngaphantsi kwemiphunga esinceda ukuphefumla kunye nokwahlula isifuba esiswini).

Isigaba II sobuntwana iHodgkin lymphoma. Umhlaza ufumaneka kumaqela amabini okanye nangaphezulu e-lymph node, kwaye zombini zingaphezulu (a) okanye ngaphantsi (b) kwidayaphragm.

• Isigaba IIE: Umhlaza ufumaneka kwelinye okanye ngaphezulu kwamaqela e-lymph node ngaphezulu okanye ngaphantsi kwesithambiso nangaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo.

Inqanaba IIE lobuntwana iHodgkin lymphoma. Umhlaza ufumaneka kwelinye okanye ngaphezulu kwamaqela e-lymph node ngaphezulu okanye ngaphantsi kwesithambisi nangaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo (a).

Inqanaba III

Isigaba III sobuntwana iHodgkin lymphoma. Umhlaza ufumaneka kwelinye okanye ngaphezulu kwamaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi (a). Kwinqanaba le-IIIE, umhlaza ufunyanwa kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi nangaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo (b). Kwinqanaba le-IIIS, umhlaza ufunyanwa kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi (a) nakwipeni (c). Kwinqanaba le-IIIS kunye no-E, umhlaza ufunyanwa kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi, ngaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo (b), nakwipeni (c).

Inqanaba III lahlulwe langena kwinqanaba III, inqanaba IIIE, inqanaba IIIS, kunye nenqanaba IIIE, S.

• Isigaba III: Umhlaza ufumaneka kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi (umsipha obhityileyo ongaphantsi kwemiphunga onceda ukuphefumla nokwahlula isifuba esiswini).

• Isigaba IIIE: Umhlaza ufunyanwa kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi nangaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo.

• Isigaba IIIS: Umhlaza ufumaneka kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi, nakwipeni.

• Isigaba IIIE, S: Umhlaza ufumaneka kumaqela e-lymph node ngaphezulu nangaphantsi kwesithambisi, ngaphandle kwe-lymph node kwilungu elikufutshane okanye kwindawo, nakwipeni.

Inqanaba IV

Inqanaba IV lobuntwana iHodgkin lymphoma. Umhlaza ufunyanwa ngaphandle kwamalungu enkovu kwilungu elinye okanye ngaphezulu (a); okanye ngaphandle kwee-lymph node kwilungu elinye kwaye zinwenwele kwii-lymph node kude nelungu (b); okanye emiphungeni, kwisibindi, okanye kumongo wethambo.

Kwinqanaba IV, umhlaza:

• ifunyanwa ngaphandle kwamalungu enkovu kwilungu elinye okanye nangaphezulu, kwaye inokuba kwii-lymph node ezikufutshane nalawo malungu; okanye

• ifumaneka ngaphandle kwe-lymph node kwilungu elinye kwaye isasazeke kwiindawo ezikude kakhulu kwelo lungu; okanye

• ifumaneka kwimiphunga, isibindi, umongo wethambo, okanye ulwelo lwe-cerebrospinal fluid (CSF). Umhlaza awusasazekanga waya emiphungeni, isibindi, umongo wethambo, okanye i-CSF kwiindawo ezikufutshane.

Ukongeza kwinani lesigaba, oonobumba A, B, E, okanye S banokuqatshelwa.

Iileta A, B, E, okanye i-S zingasetyenziselwa ukuchaza ngakumbi inqanaba lobuntwana iHodgkin lymphoma.

• A: Isigulana asinazo iimpawu ze-B (umkhuhlane, ukwehla kobunzima, okanye ukubila ebusuku).

• B: Isigulana sineempawu zeB.

• E: Umhlaza ufumaneka kwilungu okanye kwinyama engeyonxalenye yenkqubo ye-lymph kodwa enokuthi ibe ecaleni kwendawo ye-lymph echaphazelekayo ngumhlaza.

• S: Umhlaza ufumaneka kudakada.

I-Hodgkin lymphoma yobuntwana inyangwa ngokwamaqela omngcipheko.

I-Hodgkin lymphoma yobuntwana enganyangekiyo yahlulwe yangamacandelo asemngciphekweni ngokusekwe kwinqanaba, ubungakanani besisu, nokuba isigulana sineempawu ze-B (umkhuhlane, ukwehla kobunzima, okanye ukubila ebusuku). Iqela lomngcipheko lichaza ukuba iHodgkin lymphoma ayizukuphendula kunyango okanye iphinde ibuye (ibuye) emva konyango. Isetyenziselwa ukucwangcisa unyango lokuqala.

• Umngcipheko wobuntwana obuphantsi kweHodgkin lymphoma.

• Umngcipheko ophakathi wobuntwana kwiHodgkin lymphoma.

• Umngcipheko wokukhula komntwana kwiHodgkin lymphoma.

IHodgkin lymphoma enobungozi obuphantsi ifuna unyango oluncinci, amayeza amancinci e-anticancer, kunye needosi ezisezantsi zamachiza e-anticancer kune-lymphoma ephezulu.

Iiprayimari zokuBonakalisa / iiHodgkin Lymphoma zaBantwana zaBafikisayo

I-Hodgkin lymphoma ye-primary refractory i-lymphoma eqhubeka ikhula okanye isasazeka ngexesha lonyango.

I-Hodgkin lymphoma ephindaphindayo ngumhlaza obuye wabuya (ubuya) emva kokuba unyangiwe. I-lymphoma inokubuyela kwinkqubo ye-lymph okanye kwezinye iindawo zomzimba, njengemiphunga, isibindi, amathambo, okanye umongo wethambo.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango lwabantwana abaneHodgkin lymphoma.

• Abantwana abane-Hodgkin lymphoma kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza wabantwana.

• Unyango lweHodgkin lymphoma yobuntwana lubangela iziphumo ebezingalindelekanga kunye neziphumo zasemva kwexesha.

• Iindidi ezintandathu zonyango zisetyenziswa:

• Unyango ngamayeza

• Unyango ngemitha

• Unyango ekujoliswe kulo

• Unyango lwe-Immunotherapy

• Ugqirha

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ngemitha yeproton

• 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 lwabantwana abaneHodgkin lymphoma.

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abaneHodgkin lymphoma. Olunye unyango lusemgangathweni kwaye ezinye ziyavavanywa kuvavanyo lweklinikhi. 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.

Kuba umhlaza ebantwaneni unqabile, ukuthatha inxaxheba kuvavanyo lweklinikhi kufuneka kuthathelwe ingqalelo. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Abantwana abane-Hodgkin lymphoma kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza wabantwana.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngezempilo babantwana abaziingcali ekunyangeni abantwana abane-Hodgkin lymphoma kwaye abagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• Ugqirha wezonyango / ihematologist.

• Imitha ye-oncologist.

• Ingcali yomongikazi wabantwana.

• Ingcali yeengqondo.

• Unontlalontle.

• Ingcali kubomi bomntwana.

Unyango lwe-Hodgkin lymphoma kulutsha nakubantu abadala abancinci banokwahluka kunonyango lwabantwana. Abanye abantwana abafikisayo kunye nabantu abadala abancinci baphathwa ngendlela yonyango yabantu abadala.

Unyango lweHodgkin lymphoma yobuntwana lubangela iziphumo ebezingalindelekanga kunye neziphumo zasemva kwexesha.

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. Kuba iziphumo ezifike emva kwexesha zichaphazela impilo kunye nophuhliso, iimviwo zokulandela rhoqo zibalulekile.

Iziphumo zokunyanga komhlaza zingabandakanya oku kulandelayo:

• Iingxaki zomzimba ezichaphazela oku kulandelayo:

• Ukuphuhliswa kwesini kunye namalungu okuzala.

• Ukuchuma (ukukwazi ukuba nabantwana).

• Ukukhula kwamathambo kunye nezihlunu kunye nophuhliso.

• Umsebenzi we-thyroid, intliziyo, okanye umphunga.

• Amazinyo, iintsini, kunye nomsebenzi wamadlala amathe.

• Umsebenzi we-Spleen (ukwanda komngcipheko wosulelo).

• Utshintsho kwiimvakalelo, iimvakalelo, ukucinga, ukufunda, okanye inkumbulo.

• Umhlaza wesibini (iintlobo ezintsha zomhlaza), ezinje ngesifuba, idlala lengqula, ulusu, umphunga, isisu, okanye umbala omnyama.

Kubafazi abasindayo kwiHodgkin lymphoma, kukho umngcipheko okhulayo womhlaza webele. Lo mngcipheko uxhomekeke kubungakanani bemitha ebeleni efunyenwe ngexesha lonyango kunye nerejimeni yerehemotherapy esetyenzisiweyo. Umngcipheko womhlaza wamabele uyancipha ukuba kunikwe nemitha kwii-ovari.

Kuyacetyiswa ukuba abasindileyo ababhinqileyo abafumana unyango ngemitha esibelekweni bane-mammogram kunye neMRI kanye ngonyaka ukuqala kweminyaka esi-8 emva konyango okanye kubudala beminyaka engama-25, nokuba yeyiphi na kamva. Kukwacetyiswa ukuba abasindileyo ababhinqileyo bazihlole amabele inyanga nenyanga beqala ukufikisa kwaye benze uvavanyo lwebele olwenziwa yingcali yezempilo minyaka le ukuqala ekufikiseni ukuya kwiminyaka engama-25.

Ezinye iziphumo ezinokufika emva kwexesha zinokunyangwa okanye zilawulwe. Kubalulekile ukuba uthethe noogqirha bomntwana wakho malunga neziphumo ezinokubakho emva kwexesha ezibangelwa lunyango oluthile. (Jonga isishwankathelo se- malunga neZiphumo eziMva zaNyango zoMhlaza woMntwana ngolwazi oluthe kratya).

Iindidi ezintandathu zonyango zisetyenziswa:

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa ichiza elinye okanye nangaphezulu ukunqanda ukukhula kweeseli zomhlaza, nokuba kungokubulala iiseli okanye ukuziyeka zahlule. Unyango lomhlaza usebenzisa iyeza elingaphezulu kwesinye lamachiza okubizwa ngokuba yi-chemotherapy. 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, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi).

Indlela ichemotherapy enikwa ngayo ixhomekeke kwiqela lomngcipheko. Umzekelo, abantwana abanomngcipheko ophantsi weHodgkin lymphoma bafumana unyango oluncinci, iziyobisi ezimbalwa ze-anticancer, kunye needosi ezisezantsi zamachiza e-anticancer kunabantwana abane-lymphoma ephezulu.

Jonga iziyobisi ezivunyiweyo zeHodgkin Lymphoma ngolwazi oluthe kratya.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza. Iindlela ezithile zokunika unyango ngemitha kunokunceda ukugcina imitha ingonakalisi izicubu ezisempilweni ezikufutshane. Ezi ntlobo zonyango lwangaphandle lwemitha zibandakanya oku kulandelayo:

• Unyango lwe-radiation oluguquguqukayo: Unyango lwe-radiation oluguquguqukayo luhlobo lonyango lwangaphandle lwemitha olusebenzisa ikhompyuter ukwenza umfanekiso we-3-dimensional (3-D) yesisu kunye nokuma kwemitha yemitha ukuze ilingane nethumba.

• Unyango lwe-radiation ye-intension-modulated (IMRT): I-IMRT luhlobo lonyango lwe-3-dimensional (3-D) olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Unyango ngemitha lunokunikwa, ngokusekwe kwiqela lomngcipheko womntwana kunye nerejimeni yerehemotherapy. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga iHodgkin lymphoma yobuntwana. Imitha inikezelwa kuphela kwii-lymph node okanye ezinye iindawo ezinomhlaza. Unyango lwangaphakathi lwemitha alusetyenziswanga ukunyanga iHodgkin lymphoma.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Iindidi zonyango olujolise kuzo zibandakanya oku kulandelayo:

• Unyango lwe-monoclonal antibody: unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu ezivela kuhlobo olunye lweseli yomzimba. 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. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza.

I-Rituximab okanye i-brentuximab ingasetyenziselwa ukunyanga i-Hodgkin lymphoma ebuntwaneni okanye ephindaphindayo.

• Unyango lwe-Proteasome inhibitor: Unyango lwe-Proteasome inhibitor luhlobo lonyango ekujoliswe kulo oluvala isenzo seproteasomes kwiiseli zomhlaza. IiProteasomes zisusa iiproteni ezingasafunekiyo kwiseli. Xa iiproteasomes zivaliwe, iiproteni ziyakha kwiseli kwaye kunokubangela ukuba iseli yomhlaza ife.

I-Bortezomib yi-proteasome inhibitor esetyenziselwa ukunyanga i-Hodgkin lymphoma ebuntwaneni okanye ephindaphindayo.

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. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba lonyango lwe-biologic okanye i-biotherapy. Iindidi zonyango lwe-immunotherapy zibandakanya oku kulandelayo:

• Isithinteli sokujonga ukungasebenzi komzimba: I-PD-1 inhibitors luhlobo lonyango lwe-immune checkpoint inhibitor. I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza.

I-Pembrolizumab yi-PD-1 inhibitor enokusetyenziselwa unyango lwe-Hodgkin lymphoma ebuyileyo emva konyango. Ezinye ii-PD-1 inhibitors, kubandakanya i-atezolizumab kunye ne-nivolumab, ziyafundwa kunyango lwe-Hodgkin lymphoma ebuyileyo emva konyango.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

Ugqirha

Utyando lunokwenziwa ukususa i-tumor kangangoko kunokwenzeka kwi-Hodgkin lymphoma ebuntwaneni.

I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

Amanqanaba aphezulu e-chemotherapy anikezelwa ukubulala iiseli zomhlaza. Iiseli ezisempilweni, kubandakanya iiseli ezenza igazi, nazo ziyatshatyalaliswa lunyango lomhlaza. Ukufakelwa kweseli kwistem kunyango endaweni yeeseli ezenza igazi. Iiseli zeziqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana okanye somnikeli kwaye zibandisiwe kwaye zigcinwe. Emva kokuba isiguli sigqibe i-chemotherapy, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Jonga iziyobisi ezivunyiweyo zeHodgkin Lymphoma ngolwazi oluthe kratya.

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 ngemitha yeproton

Unyango lweProton-beam luhlobo lwamandla amakhulu, unyango lwangaphandle lwemitha olusebenzisa imijelo yeeproton (ezincinci, ezinobungakanani obuchanekileyo) ukwenza imitha. Olu hlobo lonyango lwemitha lunokunceda ukunciphisa umonakalo kwizicubu ezisempilweni kufutshane nethumba, esifubeni, entliziyweni nasemiphungeni.

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 yomntwana wakho itshintshile okanye ukuba umhlaza ubuye wabuya (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Kwizigulana ezifumana ichemotherapy yodwa, ukuskena kwePET kunokwenziwa kwiiveki ezi-3 okanye nangaphezulu emva kokuphela konyango. Kwizigulana ezifumana unyango ngemitha ekugqibeleni, ukuskena kwe-PET akufuneki kwenziwe kude kube kwiiveki ezi-8 ukuya kwezi-12 emva kokuba unyango luphelile.

Ukhetho kunyango lwaBantwana naBafikisayo kwiHodgkin Lymphoma

Kweli Candelo

• Umngcipheko osezantsi woBuntwana kwiHodgkin Lymphoma

• Umngcipheko ophakathi phakathi kwabantwana kwiHodgkin Lymphoma

• Umngcipheko oPhezulu waBantwana aBadala kwiHodgkin Lymphoma

• I-Nodular Lymphocyte-ephambili yabantwana kwiHodgkin Lymphoma

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

Umngcipheko osezantsi woBuntwana kwiHodgkin Lymphoma

Unyango lwe-Hodgkin lymphoma eyingozi esezantsi ebantwaneni inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango ngemitha lunokunikwa kwiindawo ezinomhlaza.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Umngcipheko ophakathi phakathi kwabantwana kwiHodgkin Lymphoma

Unyango lwe-classic Hodgkin lymphoma ebantwaneni inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango ngemitha lunokunikwa kwiindawo ezinomhlaza.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Umngcipheko oPhezulu waBantwana aBadala kwiHodgkin Lymphoma

Unyango lwe-Hodgkin lymphoma eyingozi kakhulu kubantwana inokubandakanya oku kulandelayo:

• Ukudityaniswa kwedosi ephezulu.

• Unyango ngemitha lunokunikwa kwiindawo ezinomhlaza.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo (brentuximab) kunye nokudibanisa i-chemotherapy. Unyango ngemitha lunokunikwa kwiindawo ezinomhlaza.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

I-Nodular Lymphocyte-ephambili yabantwana kwiHodgkin Lymphoma

Unyango lwe-nodular lymphocyte-ephambili yobuntwana kwiHodgkin lymphoma inokubandakanya oku kulandelayo:

• Utyando, ukuba ithumba lisuswe ngokupheleleyo.

• I-Chemotherapy kunye okanye ngaphandle kwethamo elisezantsi lonyango lwangaphandle.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Iinketho zonyango kunyango olusisiseko lokuphinda / iHodgkin Lymphoma yaBantwana naBafikisayo

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

Unyango lwe-Hodgkin lymphoma yaseprayimari yokuqala okanye ebuntwaneni obuqhelekileyo inokubandakanya oku kulandelayo:

• I-Chemotherapy, unyango ekujoliswe kulo (rituximab, brentuximab, okanye bortezomib), okanye zombini ezi zonyango.

Unyango lwe-Immunotherapy (pembrolizumab).

• Unyango oluphezulu lwe-chemotherapy kunye nokufakelwa kweseli ye-stem usebenzisa iiseli zesigulana somguli. Unyango lwe-monoclonal antibody (brentuximab) lunokunikwa kwakhona.

• Unyango ngemitha lunokunikwa emva kokufakelwa kweseli ye-stem usebenzisa iiseli zesigulana okanye ukuba umhlaza awuphendulanga kolunye unyango kwaye indawo enomhlaza ayikanyangwa ngaphambili.

• Unyango oluphezulu lwe-chemotherapy kunye nokufakelwa kweseli ye-stem usebenzisa iiseli zeziqu zabanikeli.

• Uvavanyo lweklinikhi lwe-immunotherapy (nivolumab, pembrolizumab, okanye atezolizumab).

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi ngeHodgkin Lymphoma yobuntwana

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga neHodgkin lymphoma yobuntwana, jonga oku kulandelayo:

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iziyobisi ezivunyiweyo zeHodgkin Lymphoma

• Iithagethi zoMhlaza ezijolise kuko

• Utyando lweSeli oluQulunqwe ngegazi

Ngolwazi oluthe kratya lomhlaza wabantwana kunye nezinye izixhobo zomhlaza ngokubanzi, jonga oku kulandelayo:

• Malunga noMhlaza

• Umhlaza wabantwana

• Unyango lokuKhangela uMhlaza waBantwanaPhuma kwiNgcazelo yokuzihlangula

• Iziphumo zokugqibela zonyango lweCancer yoMntwana

• Abafikisayo kunye naBantu abaDala abaDala abanomhlaza

• Abantwana abanomhlaza: Isikhokelo sabazali

• Umhlaza kuBantwana nakwishumi elivisayo

• Ukuqokelela

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli