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Unyango lwePrayimari lwe-CNS Lymphoma (®) -iPatient Version

Ulwazi ngokubanzi malunga nePrayimari ye-CNS Lymphoma

IINGONGOMA EZIPHAMBILI

• Inkqubo ephambili ye-nervous system (CNS) i-lymphoma sisifo apho iiseli ezinobungozi (zomhlaza) zibumba kwinyama ye-lymph yengqondo kunye / okanye intambo yomqolo.

• Ukuba namajoni omzimba abuthathaka kunokunyusa umngcipheko wokuphuhlisa i-CNS lymphoma.

• Uvavanyo oluvavanya amehlo, ingqondo, kunye nentambo yomqolo zisetyenziselwa ukufumana (ukufumana) kunye nokuchonga i-CNS lymphoma ephambili.

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

Inkqubo ephambili ye-nervous system (CNS) i-lymphoma sisifo apho iiseli ezinobungozi (zomhlaza) zibumba kwinyama ye-lymph yengqondo kunye / okanye intambo yomqolo.

I-Lymphoma sisifo apho umhlaza (umhlaza) weeseli wenza khona kwinkqubo ye-lymph. Inkqubo ye-lymph yinxalenye yesistim somzimba kwaye yenziwe nge-lymph, izitya ze-lymph, i-lymph nodes, i-spleen, i-thymus, i-tonsils kunye nomongo wethambo. I-lymphocyte (eqhutywa kwi-lymph) ihamba kwaye iphume kwinkqubo ye-nervous system (CNS). Kucingelwa ukuba ezinye zezi lymphocyte ziba mandundu kwaye zibangele ukuba i-lymphoma yenze i-CNS. I-CNS ephambili ye-lymphoma ingaqala kwingqondo, kumqolo womqolo, okanye kwiminyango (umaleko owenza isigubungelo sangaphandle sobuchopho). Ngenxa yokuba iliso lisondele kakhulu kwingqondo, i-CNS lymphoma yokuqala nayo ingaqala kwiso (elibizwa ngokuba yi-ocular lymphoma).

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.

Ukuba namajoni omzimba abuthathaka kunokunyusa umngcipheko wokuphuhlisa i-CNS lymphoma.

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

I-CNS ephambili ye-lymphoma inokwenzeka kwizigulana ezifumene isifo se-immunodeficiency syndrome (i-AIDS) okanye ezinye iingxaki zesixokelelwano sokhuselo lomzimba okanye abanokufakelwa kwezintso. Ngolwazi oluthe kratya malunga ne-lymphoma kwizigulana ezine-AIDS, jonga isishwankathelo se- kunyango lwe-Lymphoma enxulumene noGawulayo.

Uvavanyo oluvavanya amehlo, ingqondo, kunye nentambo yomqolo zisetyenziselwa ukufumana (ukufumana) kunye nokuchonga i-CNS lymphoma ephambili.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: 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.

• Uvavanyo lwe-Neurological: Uthotho lwemibuzo kunye novavanyo lokujonga ubuchopho, intambo yomqolo kunye nokusebenza kwentliziyo. Uvavanyo lujonga imeko yomntu ngokwengqondo, ulungelelwaniso, amandla okuhamba ngesiqhelo, kunye nendlela esebenza ngayo izihlunu, imizwa kunye nengqondo. Oku kunokubizwa ngokuba luvavanyo lwe-neuro okanye uvavanyo lwe-neurologic.

• Uvavanyo lweliso lesibane sesilayi: Uviwo olusebenzisa imicroscope ekhethekileyo enesibane esikhanyayo nesimxinwa sokukhanya ukujonga ngaphandle nangaphakathi kweliso.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi kwengqondo 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).

• 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.

• 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 zeeseli zethumba. Isampulu inokujongwa kwakhona kwixabiso leprotein kunye neswekile. Inani elingaphezulu kweprotheyini eliqhelekileyo okanye elisezantsi kunesiqhelo iswekile inokuba luphawu lwethumba. 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.

• Stereotactic biopsy: Inkqubo ye-biopsy esebenzisa ikhompyuter kunye ne-3-dimensional (3-D) isixhobo sokuskena ukufumana indawo yethumba kunye nokukhokelela ekususweni kwethishu ukuze ijongwe phantsi kwemicroscope ukujonga imiqondiso yomhlaza.

Olu vavanyo lulandelayo lunokwenziwa kwiisampulu zethishu ezisusiweyo:

• 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.

• 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 lweCytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yegazi okanye umongo wethambo zibalwa kwaye zijongwa 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.

• 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.

• Gcwalisa ubalo lwegazi (CBC) ngokwahluka-hlukeneyo: 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.

• 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.

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

Ukuxela kwangaphambili (ithuba lokuchacha) kuxhomekeke koku kulandelayo:

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Inqanaba lezinto ezithile egazini kunye ne-cerebrospinal fluid (CSF).

• Apho ithumba likumbindi woluvo, iliso, okanye zombini.

• Nokuba isigulana sinoGawulayo.

Ukhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lomhlaza.

• Apho ithumba likwinkqubo yemithambo-luvo.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Unyango lwe-CNS lymphoma ephambili lusebenza kakuhle xa ithumba lingasasazekanga ngaphandle kwecrebrum (elona nxalenye inkulu yengqondo) kwaye isigulana singaphantsi kweminyaka engama-60, sikwazi ukwenza imisebenzi emininzi yemihla ngemihla, kwaye asinayo i-AIDS okanye ezinye izifo buthathaka amajoni omzimba.

Ukuqala kweNqanaba le-CNS yeLymphoma

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe ukuba kukho inkqubo ye-nervous central (CNS) i-lymphoma, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwengqondo kunye nomqolo okanye kwezinye iindawo zomzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Akukho nkqubo yokulinganisa esemgangathweni ye-CNS lymphoma ephambili.

Emva kokuba kufunyaniswe ukuba kukho inkqubo ye-nervous central (CNS) i-lymphoma, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwengqondo kunye nomqolo okanye kwezinye iindawo zomzimba.

Xa i-CNS lymphoma ephambili iqhubeka nokukhula, ihlala ingasasazeki ngaphaya kwenkqubo ye-neva okanye iliso. Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ibizwa ngokuba yi-staging. Kubalulekile ukuba wazi ukuba umhlaza unwenwele kwamanye amalungu omzimba ukuze ucwangcise unyango. Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa kwinkqubo yokubeka esiteji:

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile 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 yicompography tomography, ikhompyuter yeTomography, okanye ikhompyuter ye-axial tomography Kwi-CNS ephambili ye-lymphoma, ukuskena kwe-CT kwenziwa kwisifuba, isisu, kunye nesinqe (icandelo lomzimba phakathi kwesinqe).

• 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. Ukuskena i-PET kunye ne-CT scan kunokwenziwa ngaxeshanye. Oku kubizwa ngokuba yi-PET-CT.

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

• Umnqweno womongo wethambo kunye ne-biopsy: Ukususwa komongo wethambo, igazi, kunye nesiqwenga samathambo ngokufaka inaliti engenanto kumqolo okanye ithambo lesifuba. Ugqirha wezifo ujonga umongo wethambo, igazi 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.

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-CNS lymphoma ephambili isasazeka esibindini, iiseli zomhlaza esibindini ziiseli ze-lymphoma. Esi sifo siyi-metastatic CNS lymphoma, hayi umhlaza wesibindi.

Akukho nkqubo yokulinganisa esemgangathweni ye-CNS lymphoma ephambili.

Ukuphinda-phinda i-CNS Lymphoma

Inkqubo yangaphakathi ye-nervous central (CNS) i-lymphoma ngumhlaza ophindaphindiweyo (ubuye) emva kokuba unyangiwe. I-CNS ephambili ye-lymphoma ihlala iphinda isebenze kwingqondo okanye kwiliso.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-CNS lymphoma ephambili.

• Kusetyenziswe iindlela ezintathu zonyango:

• Unyango ngemitha

• Unyango ngamayeza

• Unyango lwe-Steroid

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Unyango ekujoliswe kulo

• Unyango lwe-CNS ephambili ye-lymphoma inokubangela 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-CNS lymphoma ephambili.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinenkqubo yokuqala ye-nervous system (CNS) lymphoma. 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.

Utyando alusetyenziswanga ukunyanga i-CNS lymphoma.

Kusetyenziswe iindlela ezintathu zonyango:

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. Ngenxa yokuba i-CNS lymphoma ephambili isasazeka kuyo yonke ingqondo, unyango lwangaphandle lwemitha lunikezelwa kwingqondo iphela. Oku kubizwa ngokuba lunyango olupheleleyo lonyango ngemitha.

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

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke ekubeni isigulana sine-CNS lymphoma kunye ne-AIDS. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-CNS lymphoma ephambili.

Unyango lwedosi ephezulu yengqondo inokonakalisa izicwili ezisempilweni kwaye ibangele ukuphazamiseka okunokuchaphazela ukucinga, ukufunda, ukusombulula iingxaki, intetho, ukufunda, ukubhala, kunye nenkumbulo. Uvavanyo lweklinikhi luvavanye ukusetyenziswa kwe-chemotherapy kuphela okanye ngaphambi konyango lwe-radiation ukunciphisa umonakalo kwizicubu zobuchopho ezisempilweni ezenzeka ngokusetyenziswa kwonyango lwemitha.

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).

Indlela i-chemotherapy enikwa ngayo ixhomekeke apho ithumba likhoyo kwi-CNS okanye iliso. I-CNS ephambili ye-lymphoma inokunyangwa ngenkqubo ye-chemotherapy, i-intrathecal chemotherapy kunye / okanye i-intraventricular chemotherapy, apho iziyobisi ze-anticancer zibekwa kwii-ventricles (imithambo egcwele ulwelo) yobuchopho. Ukuba i-CNS lymphoma ephambili ifunyenwe kwiliso, iziyobisi ezichasene nomhlaza zifakwe ngqo kwi-vitreous humor (into efana nejeli) ngaphakathi kwiso.

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 engezantsi yomzobo, kukujova amachiza ngqo kwi-CSF kwinxalenye esezantsi yomqolo womqolo, emva kokuba indawo encinci kumqolo ongezantsi iphakathi.

Uthungelwano lwemithambo yegazi kunye nezicubu, ezibizwa ngokuba ngumqobo wegazi nengqondo, lukhusela ingqondo kwizinto ezinobungozi. Esi sithintelo sinokugcina iziyobisi ze-anticancer zingafikeleli kwingqondo. Ukunyanga i-CNS lymphoma, amachiza athile anokusetyenziselwa ukwenza ukuvuleka phakathi kweeseli kuthintelo lwegazi nengqondo. Oku kubizwa ngokuba kukuphazamiseka okuthintela igazi. Iziyobisi ezichasene nomhlaza ezifakwe kwigazi zinokufikelela kwingqondo.

Unyango lwe-Steroid

IiSteroids zihormone ezenziwe ngokwendalo emzimbeni. Kananjalo zinokwenziwa elebhu kwaye zisetyenziswe njengeziyobisi. I-Glucocorticoids ziziyobisi ze-steroid ezinesiphumo se-anticancer kwi-lymphomas.

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.

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.

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 lolunye uhlobo lonyango ekujoliswe kulo olufundwayo kunyango lwe-CNS lymphoma.

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. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Rituximab luhlobo lwe-monoclonal antibody esetyenziselwa ukunyanga i-CNS lymphoma esandula kufunyanwa kwizigulana ezingenayo i-AIDS.

Unyango lwe-CNS ephambili ye-lymphoma inokubangela 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.

Ukhetho kunyango lwe-CNS Lymphoma

Kweli Candelo

• Iiprayimari ze-CNS Lymphoma

• I-Lymphoma yangaphakathi ye-Intraocular

• Ukuphinda-phinda i-CNS Lymphoma

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

Iiprayimari ze-CNS Lymphoma

Unyango lwenkqubo ephambili ye-nervous system (CNS) i-lymphoma inokubandakanya oku kulandelayo:

• Unyango olupheleleyo lobushushu.

• Unyango ngamayeza.

• I-Chemotherapy ilandelwa ngonyango lwe-radiation.

• I-Chemotherapy kunye nonyango ekujoliswe kulo (i-rituximab) elandelwa yidosi ephezulu yonyango kunye nokufakwa kweseli.

• Uvavanyo lweklinikhi yonyango lweedosi ephezulu kunye nokufakwa kweseli.

• Uvavanyo lweklinikhi yonyango lweedosi ephezulu kunye nonyango ekujolise kulo (i-rituximab), kunye okanye ngaphandle kokufakwa kweseli okanye isinyango esipheleleyo sonyango lwemitha.

I-Lymphoma yangaphakathi ye-Intraocular

Unyango lwe-primary intraocular lymphoma inokubandakanya oku kulandelayo:

• Chemotherapy (intraocular okanye systemic).

• Unyango olupheleleyo lobushushu.

Ukuphinda-phinda i-CNS Lymphoma

Unyango lwe-CNS) i-lymphoma inokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Unyango ngemitha (ukuba alufumananga kunyango lwangaphambili).

• Uvavanyo lweklinikhi lwesiyobisi esitsha okanye ishedyuli yonyango.

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 ngePrayimari ye-CNS Lymphoma

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-CNS lymphoma ephambili, jonga oku kulandelayo:

• Iphepha lasekhaya leLymphoma

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