Iindidi / i-lymphoma / isiguli / i-mycosis-fungoides-unyango-pdq

Unyango lweMycosis Fungoides (kubandakanya i-Sézary Syndrome) Unyango (®) -iPatient Version

Ulwazi ngokubanzi malunga neMycosis Fungoides (kubandakanya iSézary Syndrome)

IINGONGOMA EZIPHAMBILI

• I-Mycosis fungoides kunye ne-Sézary syndrome zizifo apho ii-lymphocyte (uhlobo lweseli emhlophe yegazi) ziba yingozi (umhlaza) kwaye zichaphazele ulusu.

• I-Mycosis fungoides kunye ne-Sézary syndrome ziintlobo ze-T-cell lymphoma.

• Uphawu lwe-mycosis fungoides kukukhawuleza okubomvu kwesikhumba.

• Kwi-Sézary syndrome, iiseli zomhlaza ze-T zifunyanwa egazini.

• Uvavanyo oluvavanya ulusu kunye negazi zisetyenziselwa ukufumanisa isifo se-mycosis fungoides kunye ne-Sézary syndrome.

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

I-Mycosis fungoides kunye ne-Sézary syndrome zizifo apho ii-lymphocyte (uhlobo lweseli emhlophe yegazi) ziba yingozi (umhlaza) kwaye zichaphazele ulusu.

Ngokwesiqhelo, umongo wethambo wenza iiseli ze-stem zegazi (iiseli ezingafakwanga) eziba ziiseli zegazi ezivuthiweyo ngokuhamba kwexesha. Iseli yegazi inokuba siseli se-myeloid okanye iseli ye-lymphoid stem. Iseli yeseli ye-myeloid iba yiseli ebomvu yegazi, iseli emhlophe yegazi, okanye iplatelet. Iseli ye-lymphoid stem cell iba yi-lymphoblast emva koko ibe yenye yeentlobo ezintathu ze-lymphocyte (iiseli ezimhlophe zegazi):

• Ii-B-cell lymphocyte ezenza ii-antibodies zokunceda ukulwa usulelo.

• I-T-cell lymphocyte ezinceda ii-B-lymphocyte zenza izilwa-buhlungu ezinceda ukulwa usulelo.

• Iiseli zombulali zendalo ezihlasela iiseli zomhlaza kunye neentsholongwane.

Ukuphuhliswa kweseli yegazi. Iseli yegazi ihamba ngamanqanaba aliqela ukuze ibe yiseli ebomvu yegazi, iplatelet, okanye iseli yegazi emhlophe.

Kwi-mycosis fungoides, i-T-cell lymphocyte iba ngumhlaza kwaye ichaphazele ulusu. Xa ezi lymphocyte zisenzeka egazini, zibizwa ngokuba ziiseli zeSezary. Kwi-Sézary syndrome, iiseli ezinomhlaza ze-T-cell lymphocyte zichaphazela ulusu kwaye inani elikhulu leeseli zeSézary zifumaneka egazini.

I-Mycosis fungoides kunye ne-Sézary syndrome ziintlobo ze-T-cell lymphoma.

I-Mycosis fungoides kunye ne-Sézary syndrome zezona ntlobo zimbini zixhaphakileyo ze-T-cell lymphoma (uhlobo lwe-non-Hodgkin lymphoma). Ngolwazi malunga nolunye uhlobo lomhlaza wolusu okanye i-non-Hodgkin lymphoma, jonga ezi zishwankathelo zilandelayo ze-:

• Unyango lwabantu abadala abanga-Hodgkin Lymphoma

• Unyango lomhlaza wolusu

• Unyango lweMelanoma

• Unyango lweKaposi Sarcoma

Uphawu lwe-mycosis fungoides kukukhawuleza okubomvu kwesikhumba.

I-Mycosis fungoides inokuhamba ngezi zigaba zilandelayo:

• Isigaba se-Premycotic: Isikali esibomvu, esibomvu kwindawo zomzimba ezingadibani nelanga. Oku kugqabhuka akubangeli zimpawu kwaye kunokuhlala iinyanga okanye iminyaka. Kunzima ukufumanisa irhashalala njenge-mycosis fungoides ngeli nqanaba.

• Isigaba sesigaba: Ukubhitya, ukubomvu, kunye nerhashalala.

• Isigaba seplaque: Amaqhuma amancinci aphakamileyo (iipapu) okanye izilonda eziqinileyo kulusu, ezinokuthi zibe bomvu.

• Isigaba se-Tumor: Ifom yesilonda kulusu. Ezi tumors zinokukhula izilonda kwaye ulusu lunokosuleleka.

Jonga ugqirha wakho ukuba unayo nayiphi na le miqondiso.

Kwi-Sézary syndrome, iiseli zomhlaza ze-T zifunyanwa egazini.

Kwakhona, ulusu emzimbeni wonke lubomvu, urhawuzelele, uxobukile, kwaye kubuhlungu. Kukho nokuba neepatches, iiplate, okanye izicubu kulusu. Ayaziwa ukuba iSézary syndrome luhlobo oluphambili lwe-mycosis fungoides okanye isifo esahlukileyo.

Uvavanyo oluvavanya ulusu kunye negazi zisetyenziselwa ukufumanisa isifo se-mycosis fungoides kunye ne-Sézary syndrome.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma, inani nohlobo lwezilonda kulusu, okanye nayiphi na into ebonakala ingaqhelekanga. Imifanekiso yolusu kunye nembali yempilo yesigulana * kunye nezigulo zangaphambili kunye nonyango ziya kuthathwa.

• Gcwalisa ubalo lwegazi ngokwahluka: Inkqubo apho isampulu yegazi itsalwa kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi kunye neeplatelets.

• Inani nohlobo lweeseli ezimhlophe zegazi.

• 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.

• Ukubala kweeseli zeSezari: Inkqubo apho isampulu yegazi ijongwa khona ngemicroscope ukubala inani leeseli zeSezary.

• 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.

• Ulusu lwe-biopsy: Ukususwa kweeseli okanye izicwili ukuze zibonwe phantsi kwemicroscope ukujonga imiqondiso yomhlaza. Ugqirha ususa ukukhula kolusu, oluya kuvavanywa ngugqirha wezifo. Ngaphezu kwesinye isikhumba sebhayopsy sinokufuneka ukuze kufunyaniswe i-mycosis fungoides. Olunye uvavanyo olunokuthi lwenziwe kwiiseli okanye kwisampulu yeethishu zibandakanya oku kulandelayo:

• 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.

• Ukuhamba kwe-cytometry: Uvavanyo lwelebhu olulinganisa inani leeseli kwisampulu, ipesenti yeeseli eziphilayo kwisampulu, kunye neempawu ezithile zeeseli, ezinje ngobungakanani, imilo, kunye nobukho beempawu zethumba (okanye ezinye) umphezulu weseli. Iiseli ezivela kwisampulu yegazi lesigulana, umongo wethambo, okanye ezinye izicwili zinamabala edayi ye-fluorescent, ibekwe kulwelo, emva koko idlulise nganye nganye kwitampu yokukhanya. Iziphumo zovavanyo zisekwe kwindlela iiseli ezazinebala ledayi ye-fluorescent zisabela njani kwimbonakalo yokukhanya. Olu vavanyo lusetyenziselwa ukunceda ekuchongeni nasekulawuleni iintlobo ezithile zomhlaza, ezinje ngeleukemia kunye ne-lymphoma.

• Uvavanyo lokuhlengahlengisa kwakhona i-T-cell receptor (TCR): Uvavanyo lwaselebhu apho iiseli ezikwisampulu yegazi okanye umongo wethambo zijongwa ukuze kubonwe ukuba ngaba kukho utshintsho oluthile kwiijeni ezenza ii-receptors kwiiseli ze-T (iiseli ezimhlophe zegazi). Ukuvavanywa kolu tshintsho lwemfuza kunokuxela ukuba ngaba inani elikhulu leeseli ze-T ezinesamkeli esithile seT-cell ziyenziwa.

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

Ukuxela kwangaphambili kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lomhlaza.

• Uhlobo lwesilonda (iipatches, iiplagi, okanye izicubu).

• Iminyaka yesigulana kunye nesini.

I-Mycosis fungoides kunye ne-Sézary syndrome kunzima ukuzinyanga. Unyango luhlala ludlamkile, ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi. Izigulana ezinesifo sokuqala zinokuphila iminyaka emininzi.

Amanqanaba eMycosis Fungoides (kubandakanya iSézary Syndrome)

IINGONGOMA EZIPHAMBILI

• Emva kokuba i-mycosis fungoides kunye ne-Sézary syndrome zichongiwe, kwenziwa iimvavanyo zokufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ukusuka kulusu ukuya kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa i-mycosis fungoides kunye ne-Sézary syndrome:

• Isigaba I-Mycosis Fungoides

• Isigaba II Mycosis Fungoides

• Inqanaba III iMycosis Fungoides

• Isigaba IV Mycosis Fungoides / Sézary Syndrome

Emva kokuba i-mycosis fungoides kunye ne-Sézary syndrome zichongiwe, kwenziwa iimvavanyo zokufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ukusuka kulusu ukuya kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ukusuka eluswini uye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango.

Le nkqubo ilandelayo inokusetyenziswa kwinkqubo yokuqokelela:

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

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengee-lymph node, isifuba, isisu, kunye ne-pelvis, ethathwe kwiikona 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.

• I-lymph node biopsy: Ukususwa kwayo yonke into okanye inxalenye ye-lymph node. Ugqirha wezifo ujonga izicubu ze-lymph node phantsi kwemicroscope ukujonga iiseli zomhlaza.

• 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 iimpawu zomhlaza.

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.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba. I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba i-mycosis fungoides isasazeka esibindini, iiseli zomhlaza esibindini ziiseli ze-mycosis fungoides. Esi sifo siyi-metastatic mycosis fungoides, hayi umhlaza wesibindi.

La manqanaba alandelayo asetyenziselwa i-mycosis fungoides kunye ne-Sézary syndrome:

Isigaba I-Mycosis Fungoides

Inqanaba I lahlulwe ngokwamanqanaba IA kunye ne-IB ngolu hlobo lulandelayo:

• Isigaba IA: Iipatches, iipilisi, kunye / okanye iiplagi zigubungela ngaphantsi kwe-10% yomhlaba wolusu.

• Isigaba IB: Iipatches, iipilisi, kunye / okanye iiplagi zigubungela iipesenti ezili-10 okanye ngaphezulu kwesikhumba.

• Kunokubakho inani eliphantsi leeseli zeSézary egazini.

Isigaba II Mycosis Fungoides

Inqanaba II lahlulwe ngokwamanqanaba IIA kunye ne-IIB ngolu hlobo lulandelayo:

• Isigaba IIA: IiPatches, iipilisi, kunye / okanye iiplagi zigubungela naliphi na inani lolusu. Iimpawu zeLymph aziqhelekanga, kodwa azinomdlavuza.

• Isigaba IIB: Isinye okanye ezingaphezulu izicubu ezi-1 sentimitha okanye ezinkulu zifumaneka kulusu. Iimpawu zeLymph zinokungaqhelekanga, kodwa azinomhlaza.

Kunokubakho inani eliphantsi leeseli zeSézary egazini.

Inqanaba III iMycosis Fungoides

Kwinqanaba le-III, i-80% okanye ngaphezulu komphezulu wolusu ubomvu kwaye unokuba namachaphaza, iipapuli, iiplagi, okanye amathumba. Iimpawu zeLymph zinokungaqhelekanga, kodwa azinomhlaza.

Kunokubakho inani eliphantsi leeseli zeSézary egazini.

Isigaba IV Mycosis Fungoides / Sézary Syndrome

Xa inani eliphezulu leeseli zeSézary zisegazini, esi sifo sibizwa ngokuba yiSezar syndrome.

Isigaba IV sahlulwe sangamanqanaba e-IVA1, IVA2, kunye ne-IVB ngolu hlobo lulandelayo:

• Isigaba se-IVA1: Iipatches, iipilisi, iiplate, okanye izicubu zinokugubungela naliphi na inani lolusu, kwaye iipesenti ezingama-80 okanye ngaphezulu zolusu zinokubomvu. Ii-lymph node zisenokungaqhelekanga, kodwa azinomhlaza. Kukho inani eliphezulu leeseli zeSézary egazini.

• Isigaba se-IVA2: Amachaphaza, iipapuli, iiplate, okanye izicubu zinokugubungela naliphi na inani lolusu, kwaye iipesenti ezingama-80 okanye nangaphezulu zolusu zinokubomvu. Ii-lymph node aziqhelekanga kakhulu, okanye umhlaza wenziwe kwii-lymph node. Kunokubakho inani elikhulu leeseli zeSézary egazini.

• Isigaba IVB: Umhlaza usasazeke kwamanye amalungu omzimba, anjengepeni okanye isibindi. Iipatches, iipapuli, iipleyiti, amathumba anokugubungela naliphi na inani lolusu, kwaye iipesenti ezingama-80 okanye nangaphezulu zolusu zingabomvu. Ii-lymph node zinokungaqhelekanga okanye zibe nomhlaza. Kunokubakho inani elikhulu leeseli zeSézary egazini.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-mycosis fungoides kunye nomhlaza wesezar syndrome.

• Iindlela ezisixhenxe zonyango olusetyenziswayo:

• Unyango lwe-Photodynamic

• Unyango ngemitha

• Unyango ngamayeza

• Olunye unyango lweziyobisi

• Unyango lwe-Immunotherapy

• Unyango ekujoliswe kulo

• I-dose ephezulu ye-chemotherapy kunye neyeza zonyango kunye nokufakelwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-mycosis fungoides kunye ne-Sézary syndrome lunokubangela iziphumo ebezingalindelekanga.

• 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-mycosis fungoides kunye nomhlaza wesezar syndrome.

Iindlela ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-mycosis fungoides kunye neSezar syndrome. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa 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. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindlela ezisixhenxe zonyango olusetyenziswayo:

Unyango lwe-Photodynamic

Unyango lwe-Photodynamic lunyango lomhlaza olusebenzisa ichiza kunye nohlobo oluthile lokukhanya kwelaser ukubulala iiseli zomhlaza. Iyeza elingasebenziyo lide libonakaliswe kukukhanya lifakwe emthanjeni. Iyeza liqokelela ngakumbi kwiiseli zomhlaza kuneeseli eziqhelekileyo. Umhlaza wolusu, ukukhanya kwe-laser kukhanyisiwe kulusu kwaye ichiza liyasebenza kwaye libulala iiseli zomhlaza. Unyango lwe-Photodynamic lubangela umonakalo omncinci kwizicubu ezisempilweni. Izigulana ezisebenzisa unyango lwe-photodynamic ziya kufuna ukunciphisa umda wexesha elichithwa elangeni. Kukho iintlobo ezahlukeneyo zonyango lwe-photodynamic:

• Unyango lwe-psoralen kunye ne-ultraviolet A (PUVA), isigulana sifumana iyeza elibizwa ngokuba yi-psoralen emva koko i-radiation ye-ultraviolet ibhekiswa esikhumbeni.

• Kwi-extracorporeal photochemotherapy, isigulana sinikwa iziyobisi emva koko sithatyathwe ezinye iiseli zegazi emzimbeni, sibekwe phantsi kwelitha ekhethekileyo yelitha, size sibuyiselwe emzimbeni. I-extracorporeal photochemotherapy inokusetyenziswa yodwa okanye idityaniswe nonyango lwe-elektroniki yesikhumba (TSEB).

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, unyango olupheleleyo lwe-electron beam (TSEB) unyango lwe-radiation lusetyenziselwa ukunyanga i-mycosis fungoides kunye ne-Sézary syndrome. Olu luhlobo lonyango lwemitha lwangaphandle apho umatshini wonyango wemitha ujolise kwii-elektronon (ezincinci, amasuntswana angabonakaliyo) kulusu olugubungela umzimba wonke. Unyango lwangaphandle lwemitha lusenokusetyenziswa njengonyango lokunyanga ukukhupha iimpawu kunye nokuphucula umgangatho wobomi.

Unyango lwe-radiation ye-Ultraviolet A (UVA) okanye unyango lwe-ultraviolet B (UVB) lunokunikezelwa kusetyenziswa isibane esikhethekileyo okanye i-laser ehambisa imitha kulusu.

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). Ngamanye amaxesha i-chemotherapy ingumxholo (faka ulusu kwi-cream, lotion, okanye i-ointment).

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya. (I-Mycosis fungoides kunye ne-Sézary syndrome ziindidi ze-non-Hodgkin lymphoma.)

Olunye unyango lweziyobisi

Izihloko ze-corticosteroids zisetyenziselwa ukunciphisa isikhumba esibomvu, esidumbileyo nesinesifo esidlamkileyo. Luhlobo lwe-steroid. Izihloko ze-corticosteroids zisenokuba kwikrimu, into yokuthambisa, okanye ioyile.

I-Retinoids, efana ne-bexarotene, iziyobisi ezinxulumene nevithamini A ezinokucothisa ukukhula kweentlobo ezithile zeeseli zomhlaza. Ii-retinoids zinokuthathwa ngomlomo okanye zibekwe eluswini.

ILenalidomide sisiyobisi esinceda amajoni omzimba abulale iiseli zegazi ezingaqhelekanga okanye iiseli zomhlaza kwaye anokuthintela ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule.

IVorinostat kunye ne-romidepsin zimbini ze-histone deacetylase (HDAC) inhibitors ezisetyenziselwa ukunyanga i-mycosis fungoides kunye neSezar syndrome. I-HDAC inhibitors zibangela utshintsho lwekhemikhali olunqanda iiseli zesisu ekuhlukaniseni.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya. (I-Mycosis fungoides kunye ne-Sézary syndrome ziindidi ze-non-Hodgkin lymphoma.)

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 yi-biotherapy okanye unyango lwe-biologic.

• I-Interferon: Olu nyango luphazamisa ukwahlula i-mycosis fungoides kunye neesézary iiseli kwaye lunokucothisa ukukhula kwethumba.

Jonga iziyobisi ezivunyiweyo ze-non-Hodgkin Lymphoma ngolwazi oluthe kratya. (I-Mycosis fungoides kunye ne-Sézary syndrome ziindidi ze-non-Hodgkin lymphoma.)

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli zomhlaza. Unyango ekujoliswe kulo lubangela ukwenzakala okuncinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango ngemitha.

• Unyango lwe-monoclonal antibody: Olu nyango lusebenzisa 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-Brentuximab vedotin, equlathe i-monoclonal antibody ebopha kwiproteni, ebizwa ngokuba yi-CD30, efumaneka kwezinye iintlobo zeeseli ze-lymphoma. Iqulethe iyeza lokuchasana nomhlaza elinokunceda ekubulaleni iiseli zomhlaza.

• I-Mogamulizumab, equlethe i-anti-monoclonal antibody ebopha kwiprotheni, ebizwa ngokuba yiCCR4, efumaneka kwezinye iintlobo zeeseli ze-lymphoma. Ingayivimba le protein kwaye incede amajoni omzimba abulale iiseli zomhlaza. Isetyenziselwa ukunyanga i-mycosis fungoides kunye ne-Sézary syndrome ebuyileyo okanye engakhange ibengcono emva konyango ubuncinci.

I-dose ephezulu ye-chemotherapy kunye neyeza zonyango kunye nokufakelwa kweseli

Amanani aphezulu e-chemotherapy kwaye ngamanye amaxesha unyango lwe-radiation lunikezelwa 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 kunye nonyango lwe-radiation, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-mycosis fungoides kunye ne-Sézary syndrome lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

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 lweNqanaba I kunye neBakala II iMycosis Fungoides

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

Unyango lwenqanaba elitsha elichongiweyo I kunye nenqanaba II i-mycosis fungoides inokubandakanya oku kulandelayo:

• I-Psoralen kunye ne-ultraviolet A (PUVA).

• Unyango lwe-Ultraviolet B.

• Unyango lwe-radiation kunye nonyango olupheleleyo lwe-radiation electron radiation. Ngamanye amaxesha, unyango ngemitha lunikezelwa kwizilonda zolusu, njengonyango lokuthomalalisa ukunciphisa ubungakanani beethumba ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwe-Immunotherapy lunikezelwa lodwa okanye ludibene nonyango olujolise kulusu.

• I-chemotherapy yamacandelo.

• Inkqubo yonyango ngamayeza enye kunye nangaphezulu, enokudityaniswa nonyango olujolise kulusu.

• Olunye unyango lweziyobisi (i-corticosteroids, i-retinoid yonyango, i-lenalidomide, i-histone deacetylase inhibitors).

• Unyango olujolisiweyo (brentuximab vedotin).

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.

Unyango lweSigaba III kunye neNqanaba IV iMycosis Fungoides (kubandakanya iSézary Syndrome)

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

Unyango lwenqanaba lesithathu elisandula ukufumanisa isifo kunye nenqanaba IV i-mycosis fungoides kubandakanya i-Sézary syndrome iyathomalalisa (ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi) kwaye inokubandakanya oku kulandelayo:

• I-Psoralen kunye ne-ultraviolet A (PUVA).

• Unyango lwe-Ultraviolet B.

• I-extracorporeal photochemotherapy enikwe yodwa okanye idityaniswe kunye nonyango olupheleleyo lwe-radiation electron radiation.

• Unyango lwe-radiation kunye nonyango olupheleleyo lwe-radiation electron radiation. Ngamanye amaxesha, unyango ngemitha lunikezelwa kwizilonda zolusu, njengonyango lokuthomalalisa ukunciphisa ubungakanani beethumba ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwe-Immunotherapy lunikezelwa lodwa okanye ludibene nonyango olujolise kulusu.

• Inkqubo yonyango ngamayeza enye kunye nangaphezulu, enokudityaniswa nonyango olujolise kulusu.

• I-chemotherapy yamacandelo.

• Olunye unyango lweziyobisi (ii-corticosteroids, i-lenalidomide, i-bexarotene, i-histone deacetylase inhibitors).

• Unyango olujolise kwi-brentuximab vedotin.

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.

Unyango lwe-Mycosis Fungoides eQhelekileyo (kubandakanya iSézary Syndrome)

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

Ukuphindaphinda i-mycosis fungoides kunye ne-Sézary syndrome zibuyele esikhumbeni okanye kwamanye amalungu omzimba emva kokuba ziphathwe.

Unyango lwe-mycosis fungoides ephindaphindiweyo kubandakanya i-Sézary syndrome inokubakho kuvavanyo lweklinikhi kwaye inokubandakanya oku kulandelayo:

• Unyango lwe-radiation kunye nonyango olupheleleyo lwe-radiation electron radiation. Ngamanye amaxesha, unyango ngemitha lunikezelwa kwizilonda zolusu njengonyango lokuthomalalisa ukunciphisa ubungakanani beethumba ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• I-Psoralen kunye ne-ultraviolet A (PUVA) unyango lwe-radiation, olunokuthi lunikezwe nge-immunotherapy.

• Imitha ye-Ultraviolet B.

• I-extracorporeal photochemotherapy.

• I-chemotherapy yenkqubo enye kunye nangaphezulu.

• Olunye unyango lweziyobisi (i-corticosteroids, i-retinoid yonyango, i-lenalidomide, i-histone deacetylase inhibitors).

• Unyango lwe-Immunotherapy lunikezelwa lodwa okanye ludibene nonyango olujolise kulusu.

• I-dose ephezulu ye-chemotherapy, kwaye ngamanye amaxesha unyango lwe-radiation, kunye nokufakelwa kweseli ye-stem.

• Unyango olujolisiweyo (brentuximab vedotin okanye mogamulizumab).

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 malunga neMycosis Fungoides kunye neSezar Syndrome

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-mycosis fungoides kunye neSézary syndrome, bona oku kulandelayo:

• Iphepha lasekhaya leLymphoma

• Unyango lwe-Photodynamic kuMhlaza

• Iziyobisi ezivunyiweyo ze-Non-Hodgkin Lymphoma

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

• Iithagethi zoMhlaza ezijolise kuko

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