Izinhlobo / i-lymphoma / isiguli / i-omdala-hodgkin-treatment-pdq

Ukwelashwa kwe-Adult Hodgkin Lymphoma (®) –Patient Version

Imininingwane ejwayelekile Mayelana ne-Adult Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

• I-Adult Hodgkin lymphoma yisifo lapho amangqamuzana amabi (umdlavuza) akha khona ohlelweni lwe-lymph.

• Izinhlobo ezimbili eziyinhloko zeHodgkin lymphoma yilezi: i-classic kanye ne-nodular lymphocyte-evelele.

• Ubudala, ukuba ngowesilisa, ukutheleleka okwedlule kwe-Epstein-Barr, nomlando womndeni weHodgkin lymphoma kungakhuphula ubungozi beHodgkin lymphoma yabantu abadala.

• Izimpawu ze-Hodgkin lymphoma yabantu abadala zibandakanya ukuvuvukala kwama-lymph node, umkhuhlane, ukujuluka ebusuku, ukwehla kwesisindo nokukhathala.

• Ukuhlolwa okuhlola uhlelo lwe-lymph nezinye izingxenye zomzimba kusetshenziselwa ukusiza ukuxilonga nokukala i-Hodgkin lymphoma yabantu abadala.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

I-Adult Hodgkin lymphoma yisifo lapho amangqamuzana amabi (umdlavuza) akha khona ohlelweni lwe-lymph.

I-Adult Hodgkin lymphoma uhlobo lomdlavuza olukhula ohlelweni lwe-lymph. I-lymph system iyingxenye yamasosha omzimba. Kuyasiza ukuvikela umzimba ekutheleleni nasezifweni.

I-lymph system yakhiwa yilokhu okulandelayo:

• I-Lymph: I-fluid engenambala, engenamanzi ehamba emithanjeni ye-lymph futhi ephethe ama-lymphocyte ka-T no-B. Ama-lymphocyte awuhlobo lwamaseli amhlophe egazi.

• Imikhumbi yeLymph: Inethiwekhi yamashubhu amancane aqoqa i-lymph ezingxenyeni ezihlukene zomzimba bese eyibuyisela egazini.

• Ama-lymph node: Izakhiwo ezincane, ezimise ubhontshisi ezihlunga i-lymph bese zigcina amaseli amhlophe egazi asiza ukulwa nokutheleleka nezifo. Ama-lymph node atholakala kwinethiwekhi yemikhumbi ye-lymph kuwo wonke umzimba. Amaqembu ama-lymph node atholakala ku-mediastinum (indawo ephakathi kwamaphaphu), intamo, isikhwama esingaphansi kwesisu, isisu, i-pelvis, ne-groin. I-Hodgkin lymphoma ivame ukwakheka kuma-lymph node ngaphezulu kwe-diaphragm futhi kaningi kuma-lymph node ku-mediastinum.

• Ubende: Isitho esenza ama-lymphocyte, sigcine amangqamuzana abomvu egazi nama-lymphocyte, sihlunge igazi, futhi sibhubhise amangqamuzana egazi amadala. Ubende lusehlangothini lwesobunxele sesisu eduze kwesisu.

• I-Thymus: Isitho lapho ama-T lymphocyte akhula futhi anda khona. I-thymus isesifubeni ngemuva kwethambo lesifuba.

• Umnkantsha wamathambo: Izicubu ezithambile, ezinesiponji maphakathi namathambo athile, njengethambo le-hip kanye nethambo lesifuba. Amaseli egazi amhlophe, amangqamuzana abomvu egazi, nama-platelets enziwa emnkantsheni wethambo.

• Amathani: Izixuku ezimbili ezincane zezicubu zomzimba ngemuva komphimbo. Kukhona i-tonsil eyodwa ohlangothini ngalunye lomphimbo. I-Hodgkin lymphoma yabantu abadala ayifane yakha emathangeni.

I-anatomy yesistimu ye-lymph, ekhombisa izitsha ze-lymph nezitho ze-lymph kufaka phakathi ama-lymph node, amalaka, i-thymus, ubende nomnkantsha wethambo. I-Lymph (i-fluid ecacile) nama-lymphocyte ahamba ngemithambo ye-lymph angene kuma-lymph node lapho ama-lymphocyte ecekela phansi izinto eziyingozi. I-lymph ingena egazini ngomthambo omkhulu oseduze kwenhliziyo.

Izicubu zomzimba ziyatholakala nakwezinye izingxenye zomzimba, njengolwelwesi lwendlela yokugaya ukudla, i-bronchus nesikhumba.

Kunezinhlobo ezimbili ezijwayelekile ze-lymphoma: iHodgkin lymphoma kanye ne-non-Hodgkin lymphoma. Lesi sifinyezo simayelana nokwelashwa kwe-Hodgkin lymphoma yabantu abadala, kufaka phakathi nokukhulelwa.

Ngemininingwane ngeHodgkin lymphoma ezinganeni, umuntu omdala ongeyona iHodgkin lymphoma, noma i-lymphoma kubantu abathole i-immunodeficiency syndrome (i-AIDS), bheka izifinyezo ezilandelayo ze-:

• Ukwelashwa Kwe-Adult Non-Hodgkin Lymphoma

• Ukwelashwa kwe-Hodgkin Lymphoma Childhood

• Ukwelashwa Okuhlobene Nengculaza

Izinhlobo ezimbili eziyinhloko zeHodgkin lymphoma yilezi: i-classic kanye ne-nodular lymphocyte-evelele.

Iningi lamaHymgkin lymphomas luhlobo olujwayelekile. Lapho isampula yezicubu ze-lymph node ibhekwa ngaphansi kwesibonakhulu, amaseli omdlavuza weHodgkin lymphoma, abizwa ngokuthi amangqamuzana e-Reed-Sternberg, angabonakala. Uhlobo lwakudala luhlukaniswe lwaba ama-subtypes amane alandelayo:

• I-Nodular sclerosing Hodgkin lymphoma.

• Amaselula ahlanganisiwe Hodgkin lymphoma.

• Ukuqedwa kweLymphocyte Hodgkin lymphoma.

• I-Hodgkin lymphoma ejwayelekile ye-Lymphocyte.

I-Nodular lymphocyte-evelele i-Hodgkin lymphoma ayivamile futhi ijwayele ukukhula kancane kune-Hodgkin lymphoma yakudala. I-Nodular lymphocyte-evelele i-Hodgkin lymphoma ivame ukuvela njenge-lymph node evuvukile entanyeni, esifubeni, emakhwapheni, noma ekubunjweni. Iningi labantu alinazo ezinye izimpawu noma izimpawu zomdlavuza lapho uxilongwa. Ukwelashwa kuvame ukwehluka kune-Hodgkin lymphoma yakudala.

Ubudala, ukuba ngowesilisa, ukutheleleka okwedlule kwe-Epstein-Barr, nomlando womndeni weHodgkin lymphoma kungakhuphula ubungozi beHodgkin lymphoma yabantu abadala.

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini. Izici zobungozi zeHodgkin lymphoma yabantu abadala zifaka okulandelayo:

• Ubudala. IHodgkin lymphoma ivame kakhulu lapho umuntu esemdala (eneminyaka engama-20 kuya kwengu-39 kuya kwengu-39) nalapho esekhulile (eneminyaka engama-65 nangaphezulu).

• Ukuba owesilisa. Ingozi ye-Hodgkin lymphoma yabantu abadala iphakeme kancane kwabesilisa kunabesifazane.

• Ukutheleleka ngegciwane kwe-Epstein-Barr edlule. Ukutheleleka ngegciwane le-Epstein-Barr eminyakeni yobusha noma ebuntwaneni kwandisa ubungozi beHodgkin lymphoma.

• Umlando womndeni weHodgkin lymphoma. Ukuba nomzali, umfowenu noma udadewabo oneHodgkin lymphoma kwandisa ingozi yokuthuthukisa iHodgkin lymphoma.

Izimpawu ze-Hodgkin lymphoma yabantu abadala zibandakanya ukuvuvukala kwama-lymph node, umkhuhlane, ukujuluka ebusuku, ukwehla kwesisindo nokukhathala.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-Hodgkin lymphoma yabantu abadala noma ngezinye izimo. Buza udokotela wakho uma unanoma iyiphi yalezi zimpawu ezilandelayo ezingapheli:

• Ama-lymph node angenabuhlungu, avuvukile entanyeni, ekhwapheni, noma emgodini.

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Kumanzisa ukujuluka ebusuku.

• Ukwehla kwesisindo ngaphandle kwesizathu ezaziwayo ezinyangeni eziyisithupha ezidlule.

• Isikhumba esilumayo, ikakhulukazi ngemuva kokugeza noma ukuphuza utshwala.

• Ukuzizwa ngikhathele kakhulu.

Umkhuhlane ngaphandle kwesizathu esaziwayo, ukwehla kwesisindo ngaphandle kwesizathu esaziwayo, nokujuluka okujulisa ebusuku kubizwa ngezimpawu ze-B. Izimpawu ze-B ziyingxenye ebalulekile yokubeka iHodgkin lymphoma nokuqonda ithuba lesiguli lokululama.

Ukuhlolwa okuhlola uhlelo lwe-lymph nezinye izingxenye zomzimba kusetshenziselwa ukusiza ukuxilonga nokukala i-Hodgkin lymphoma yabantu abadala.

Imiphumela yezivivinyo nezinqubo ezingezansi nayo iyasiza ekwenzeni izinqumo mayelana nokwelashwa.

Lezi zivivinyo zingafaka:

• Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wezempilo yesiguli, kufaka phakathi umkhuhlane, ukujuluka ebusuku, nokwehla kwesisindo, ukugula nokwelashwa kwangaphambilini.

• Qedela ukubalwa kwegazi (i-CBC): Inqubo lapho kukhishwa khona isampula legazi futhi lihlolwe lokhu okulandelayo:

• Inani lamaseli abomvu egazi, amaseli amhlophe egazi, nama-platelets.

• Inani le-hemoglobin (iprotheni ethwala umoya-mpilo) kumaseli abomvu egazi.

• Ingxenye yesampula eyenziwe ngamaseli abomvu egazi.

Qedela ukubalwa kwegazi (CBC). Igazi liqoqwa ngokufaka inaliti emthanjeni bese livumela igazi ukuba ligelezele kushubhu. Isampuli yegazi ithunyelwa elabhorethri bese kubalwa amaseli abomvu egazi, amaseli amhlophe egazi, nama-platelets. I-CBC isetshenziselwa ukuhlola, ukuxilonga, nokuqapha izimo eziningi ezahlukahlukene.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Ukuhlolwa kwe-LDH: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-lactic dehydrogenase (LDH). Inani elinyukile le-LDH egazini kungaba uphawu lokulimala kwezicubu, i-lymphoma, noma ezinye izifo.

• Ukuhlolwa kwe-Hepatitis B ne-hepatitis C: Inqubo lapho kuhlolwe khona isampula yegazi ukukala inani lama-antigen aqondene ne-hepatitis B kanye / noma ama-antibodies kanye namanani ama-antibodies aqondene ne-hepatitis C. Lawa ma-antigen noma ama-antibodies abizwa ngokuthi omaka. Omaka abahlukene noma inhlanganisela yomaka isetshenziselwa ukunquma ukuthi ngabe isiguli sine-hepatitis B noma i-C ukutheleleka, ngabe sike sathola ukutheleleka noma umuthi wokugoma ngaphambili, noma kungenzeka sitheleleke. Ukwazi ukuthi isiguli sinesifo sokusha kwesibindi kohlobo B noma C kungasiza ukuhlela ukwelashwa.

• Ukuhlolelwa i-HIV: Isivivinyo sokulinganisa izinga lamagciwane omzimba omuntu (i-HIV) kusampula yegazi. Ama-antibody enziwa ngumzimba lapho ehlaselwa yinto yangaphandle. Izinga eliphezulu lama-antibodies e-HIV kungasho ukuthi umzimba utheleleke nge-HIV. Ukwazi ukuthi isiguli sine-HIV kungasiza yini ukuhlela ukwelashwa.

• Izinga le-sedimentation: Inqubo lapho kukhishwa khona isampula yegazi futhi ihlolwe izinga lapho amangqamuzana abomvu egazi ehlala khona phansi kwethubhu yokuhlola. Izinga le-sedimentation isilinganiso sokuthi kungakanani ukuvuvukala emzimbeni. Isilinganiso sedimentation esiphakeme kunokujwayelekile singaba uphawu lwe-lymphoma noma esinye isimo. Futhi ibizwa ngokuthi yi-erythrocyte sedimentation rate, sed rate, noma i-ESR.

• I-PET-CT scan: Inqubo ehlanganisa izithombe kusuka kuskena se-positron emission tomography (PET) kanye nokuskena kwe-computed tomography (CT). Izikena ze-PET ne-CT zenziwa ngasikhathi sinye emshinini ofanayo. Izithombe ezivela kuzo zombili izikena zihlanganisiwe ukwenza isithombe esinemininingwane eminingi kunalokho ukuhlolwa obekungakwenza ngokwakho. Ukuskena kwe-PET-CT kungasetshenziselwa ukuxilonga izifo, njengomdlavuza, ukuthola isigaba, ukuhlela ukwelashwa, noma ukuthola ukuthi ukwelashwa kusebenza kahle kangakanani.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, ezifana nentamo, isifuba, isisu, i-pelvis, nama-lymph node, athathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computer ene-tomography, noma i-computer axial tomography. Uma i-PET-CT scan ingatholakali, kungenziwa i-CT scan kuphela.

• I-PET scan (i-positron emission tomography scan): Ukuskena kwe-PET kuyinqubo yokuthola amangqamuzana amuncu omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

• I-lymph node biopsy: Ukususwa kwakho konke noma ingxenye ye-lymph node. Isazi sezifo sibuka izicubu ngaphansi kwesibonakhulu ukuze sibheke amangqamuzana omdlavuza abizwa ngokuthi amaseli omhlanga. Amaseli omhlanga-Sternberg ajwayelekile ku-Hodgkin lymphoma yakudala.

Iseli lomhlanga-Sternberg. Amaseli omhlanga-Sternberg makhulu, ama-lymphocyte angajwayelekile angaqukatha i-nucleus engaphezu kweyodwa. Lawa maseli atholakala eHodgkin lymphoma.

Olunye lwezinhlobo ezilandelayo ze-biopsies lungenziwa:

• I-Biopsy e-Excisional: Ukususwa kwayo yonke i-lymph node.

• I-incisional biopsy: Ukususwa kwengxenye ye-lymph node.

• I-Core biopsy: Ukususwa kwezicubu ku-lymph node kusetshenziswa inaliti ebanzi.

Ezinye izindawo zomzimba, njengesibindi, amaphaphu, ithambo, umnkantsha nobuchopho, nazo zingasuswa isampula lesicubu bese lihlolwa ngudokotela wezifo ukuthola izimpawu zomdlavuza.

Ukuhlolwa okulandelayo kungenziwa kwizicubu ezisuswe:

• I-Immunophenotyping: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukukhomba amangqamuzana omdlavuza asuselwa ezinhlotsheni zama-antigen noma omaka ebusweni bamaseli. Lokhu kuhlolwa kusetshenziselwa ukuxilonga izinhlobo ezithile ze-lymphoma.

Kwabesifazane abakhulelwe abane-Hodgkin lymphoma, kusetshenziswa izivivinyo zokucabanga ezivikela umntwana ongakazalwa ekulimaleni kwemisebe. Lokhu kufaka phakathi:

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI). Kwabesifazane abakhulelwe, udayi wokuqhathanisa awusetshenziswa ngesikhathi senqubo.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Izimpawu nezimpawu zesiguli, kufaka phakathi ukuthi banezimpawu ze-B noma cha (umkhuhlane ngaphandle kwesizathu esaziwayo, ukwehla kwesisindo ngaphandle kwesizathu esaziwayo, noma ukumanzisa ukujuluka ebusuku).

• Isigaba somdlavuza (ubukhulu bezimila zomdlavuza nokuthi umdlavuza ususabalele esiswini noma ngaphezu kweqembu elilodwa lama-lymph node).

• Uhlobo lweHodgkin lymphoma.

• Imiphumela yokuhlolwa kwegazi.

• Iminyaka yesiguli, ubulili, nempilo ejwayelekile.

• Noma ngabe umdlavuza usanda kutholakala, uyaqhubeka nokukhula ngesikhathi sokwelashwa, noma ubuyile ngemuva kokwelashwa.

Kwi-Hodgkin lymphoma ngesikhathi sokukhulelwa, izinketho zokwelashwa zincike naku:

• Izifiso zesiguli.

• Iminyaka yengane engakazalwa.

I-Hodgkin lymphoma yabantu abadala ingahle yelapheke uma itholakala futhi yelashwa kusenesikhathi.

Izigaba ze-Adult Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwe-Hodgkin lymphoma yabantu abadala, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba.

• Kunezindlela ezintathu umdlavuza osakazeka ngazo emzimbeni.

• Izigaba ezilandelayo zisetshenziselwa i-Hodgkin lymphoma yabantu abadala:

• Ukuqhuma I

• I-AStage II

• I-AStage III

• I-AStage IV

• I-AAdult Hodgkin lymphoma ingahle iqoqelwe ukwelashwa ngale ndlela elandelayo:

• Kuhle ekuqaleni

• Okungathandeki ekuqaleni

• Okuthuthukisiwe

Ngemuva kokutholakala kwe-Hodgkin lymphoma yabantu abadala, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwa ukuthola ukuthi umdlavuza ususabalele ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba sokuhlela ukwelashwa. Imiphumela yezivivinyo nezinqubo ezenziwe ukuxilonga kanye nesigaba seHodgkin lymphoma isetshenziselwa ukusiza ukwenza izinqumo mayelana nokwelashwa.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Lezi zigaba ezilandelayo zisetshenziselwa i-Hodgkin lymphoma yabantu abadala:

Isiteji I

Isigaba I-lymphoma yabantu abadala. Umdlavuza utholakala ku-lymph node eyodwa noma ngaphezulu eqenjini lama-lymph node noma, ezimweni ezingavamile, umdlavuza utholakala endandeni kaWaldeyer, i-thymus, noma ubende. Esigabeni IE (asikhonjisiwe), umdlavuza usabalalele endaweni eyodwa engaphandle kohlelo lwe-lymph.

Isigaba I Hodgkin lymphoma yabantu abadala ihlukaniswe ngezigaba mina no-IE.

• Esigabeni I, umdlavuza utholakala kwenye yezindawo ezilandelayo ohlelweni lwe-lymph:

• I-lymph node eyodwa noma ngaphezulu eqenjini lama-lymph node.

• Indandatho kaWaldeyer.

• Thymus.

• Ubende.

• Esigabeni IE, umdlavuza utholakala endaweni eyodwa engaphandle kohlelo lwe-lymph.

Isigaba II

Isigaba II esidala iHodgkin lymphoma ihlukaniswe ngezigaba II no-IIE.

• Esigabeni II, umdlavuza utholakala emaqenjini amabili noma ngaphezulu ama-lymph node angaphezulu kwesifafazi noma ngaphansi kwesifafazi.

Isigaba II se-lymphoma yabantu abadala. Umdlavuza utholakala emaqenjini amabili noma ngaphezulu ama-lymph node angaphezulu kwesifafazi noma ngaphansi kwesifafazi.

Esigabeni IIE, umdlavuza usabalale wasuka eqenjini lama-lymph node waya endaweni eseduze engaphandle kohlelo lwe-lymph. Umdlavuza kungenzeka usabalalele nakwamanye amaqembu e-lymph node ohlangothini olufanayo lwe-diaphragm.

Isigaba IIE i-lymphoma yabantu abadala. Umdlavuza usabalale kusuka eqenjini lama-lymph node waya endaweni eseduze engaphandle kohlelo lwe-lymph. Umdlavuza kungenzeka usabalalele nakwamanye amaqembu e-lymph node ohlangothini olufanayo lwe-diaphragm.

Esigabeni II, igama elithi bulky disease lisho isisu esikhulu. Ubukhulu besisindo se-tumor esibizwa ngokuthi yisifo esinamandla buyahluka ngokuya ngohlobo lwe-lymphoma.

Isigaba III

Isigaba III se-lymphoma yabantu abadala. Umdlavuza utholakala ngamaqembu ama-lymph node womabili ngenhla nangaphansi kwe-diaphragm; noma eqenjini lama-lymph node ngaphezulu kwe-diaphragm nasesipeleni.

Esigabeni III umuntu omdala uHodgkin lymphoma, umdlavuza uyatholakala:

• emaqenjini ama-lymph node ngenhla nangaphansi kwe-diaphragm; noma

• kuma-lymph node ngaphezulu kwe-diaphragm nasesipilini.

Isigaba IV

Isigaba IV sabantu abadala i-lymphoma. Umdlavuza (a) usabalale ezithweni zonke noma ngaphezulu ngaphandle kohlelo lwe-lymph; noma (b) sitholakala emaqenjini amabili noma ngaphezulu ama-lymph node angaphezulu kwesithsaba noma ngaphansi kwesifafazi nakulungu elilodwa elingaphandle kohlelo lwe-lymph hhayi eduze kwama-lymph node athintekile; noma (c) sitholakala emaqenjini ama-lymph node ngenhla kovalo nangaphansi kwesifafazi nakunoma yisiphi isitho esingaphandle kohlelo lwe-lymph; noma (d) sitholakala esibindi, emnkantsheni wethambo, endaweni engaphezu kweyodwa emaphashini, noma ku-cerebrospinal fluid (CSF). Umdlavuza awusabalalanga ngqo esibindini, emnkantsheni, emaphashini, noma ku-CSF kusuka kuma-lymph node aseduze.

Esigabeni IV umuntu omdala uHodgkin lymphoma, umdlavuza:

• isabalale ezithweni zonke noma ngaphezulu ngaphandle kohlelo lwe-lymph; noma

• itholakala emaqenjini amabili noma ngaphezulu ama-lymph node angaphezulu kwesifafazi noma ngaphansi kwesifafazi nakulungu elilodwa elingaphandle kohlelo lwe-lymph hhayi eduze kwama-lymph node athintekile; noma

• itholakala emaqenjini ama-lymph node womabili ngenhla nangaphansi kwe-diaphragm nakunoma yisiphi isitho esingaphandle kwesistimu ye-lymph; noma

• itholakala esibindini, emnkantsheni wethambo, ngaphezu kwendawo eyodwa emaphashini, noma i-cerebrospinal fluid (CSF). Umdlavuza awusabalalanga ngqo esibindini, emnkantsheni, emaphashini, noma ku-CSF kusuka kuma-lymph node aseduze.

I-Hodgkin lymphoma yabantu abadala ingahle iqoqelwe ukwelashwa ngale ndlela elandelayo:

Ukuqala Okuhle

I-Hodgkin lymphoma yabantu abadala ethandekayo yisigaba I noma isigaba II, ngaphandle kwezici eziyingozi ezandisa amathuba okuthi umdlavuza uzobuya ngemuva kokuphathwa.

Kusengathandeki Kusenesikhathi

Umuntu omdala ongathandeki uHodgkin lymphoma yisigaba I noma isigaba II ngesinye sezici ezilandelayo eziyingozi ezandisa amathuba okuthi umdlavuza uzobuya ngemuva kokuphathwa kwawo:

• Ukuba nesimila esifubeni esikhulu kune-1/3 yobubanzi besifuba noma okungenani amasentimitha ayi-10.

• Ukuba nomdlavuza kwesinye isitho ngaphandle kwama-lymph node.

• Ukuba nesilinganiso sedimentation ephezulu (kusampula yegazi, amangqamuzana abomvu egazi ahlala phansi kushubhu lokuhlola ngokushesha kunokujwayelekile).

• Ukuba nama-lymph node amathathu noma ngaphezulu anomdlavuza.

• Ukuba nezimpawu ze-B (umkhuhlane ngaphandle kwesizathu esaziwayo, ukwehla kwesisindo ngaphandle kwesizathu esaziwayo, noma ukumanzisa ukujuluka ebusuku).

Kuthuthukile

I-Advanced Hodgkin lymphoma isigaba III noma isigaba IV. I-Hodgkin lymphoma esezingeni eliphakeme isho ukuthi isiguli sinezici ezingama-0-3 zobungozi ezingezansi. I-Hodgkin lymphoma engathandeki ethuthukisiwe isho ukuthi isiguli sinezici ezi-4 noma ngaphezulu zezingozi ezingezansi. Lapho kunezinto eziyingozi kakhulu esigulini, maningi amathuba okuthi umdlavuza ubuye ngemuva kokuphathwa kwawo:

• Ukuba nezinga eliphansi le-albhamuin (amaprotheni) egazi (ngaphansi kwe-4).

• Ukuba nezinga eliphansi le-hemoglobin (ngaphansi kuka-10.5).

• Ukuba owesilisa.

• Ukuba neminyaka engu-45 noma ngaphezulu.

• Ukuba nesifo sesigaba IV.

• Ukuba nesibalo samaseli amhlophe aphakeme (15,000 noma ngaphezulu).

• Ukuba nesibalo se-lymphocyte esiphansi (esingaphansi kuka-600 noma ngaphansi kuka-8% wesibalo segazi elimhlophe).

Abadala Abaphindaphindiwe I-Hodgkin Lymphoma

I-Hodgkin lymphoma yabantu abadala ephindaphindiwe ngumdlavuza obuye wabuya (ubuya) ngemuva kokuba welashwe. Umdlavuza ungabuya ohlelweni lwe-lymph noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-Hodgkin lymphoma yabantu abadala.

• Iziguli ezine-Hodgkin lymphoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abanolwazi lokwelapha ama-lymphomas.

• Ukwelashwa kwe-Hodgkin lymphoma yabantu abadala kungadala imiphumela emibi.

• Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• Ukwelashwa okuhlosiwe

• I-Immunotherapy

• Ezigulini ezikhulelwe ezineHodgkin lymphoma, izinketho zokwelashwa zifaka phakathi:

• Ukulinda okulindile

• Ukwelashwa kwama-steroid

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• I-Chemotherapy ngokufakelwa kwe-stem cell

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-Hodgkin lymphoma yabantu abadala.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-Hodgkin lymphoma yabantu abadala. Ezinye izindlela zokwelapha zijwayelekile (ukwelashwa okusetshenzisiwe njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Kwabesifazane abakhulelwe abane-Hodgkin lymphoma, ukwelashwa kukhethwe ngokucophelela ukuvikela umntwana ongakazalwa. Izinqumo zokwelashwa zisuselwa ezifisweni zikamama, isigaba seHodgkin lymphoma, nobudala bengane engakazalwa. Uhlelo lokwelashwa lungashintsha njengoba izimpawu nezimpawu, umdlavuza nokukhulelwa kuguquka. Ukukhetha ukwelashwa komdlavuza okufanele kunazo zonke kuyisinqumo esithinta kahle isiguli, umndeni kanye neqembu lokunakekelwa kwezempilo.

Iziguli ezine-Hodgkin lymphoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abanolwazi lokwelapha ama-lymphomas.

Ukwelashwa kuzobhekwa ngudokotela oyi-oncologist, udokotela ogxile ekwelapheni umdlavuza. I-oncologist yezokwelapha ingakudlulisela kwabanye abahlinzeki bezempilo abanolwazi nobuchwepheshe ekwelapheni iHodgkin lymphoma yabantu abadala nabasebenza ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• I-radiation oncologist.

• Uchwepheshe wokuvuselelwa.

• Udokotela wezifo zengqondo.

• Abanye ochwepheshe be-oncology.

Ukwelashwa kwe-Hodgkin lymphoma yabantu abadala kungadala imiphumela emibi.

Ngemininingwane ngemiphumela emibi eqala ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Imiphumela emibi yokwelashwa komdlavuza eqala ngemuva kokwelashwa futhi iqhubeke izinyanga noma iminyaka ibizwa ngemiphumela ephuzile. Ukwelashwa nge-chemotherapy kanye / noma ukwelashwa ngemisebe ye-Hodgkin lymphoma kungakhuphula ingozi yomdlavuza wesibili nezinye izinkinga zezempilo izinyanga eziningi noma iminyaka ngemuva kokwelashwa. Le miphumela sekwephuzile incike ohlotsheni lokwelashwa nobudala besiguli lapho belashwa, futhi kungafaka okulandelayo:

• Umdlavuza wesibili.

• I-leukemia enamandla kanye ne-non-Hodgkin lymphoma.

• Izicubu eziqinile, ezinjenge-mesothelioma nomdlavuza wamaphaphu, isifuba, i-thyroid, ithambo, izicubu ezithambile, isisu, isisu, i-colon, i-rectum, umlomo wesibeletho, nekhanda nentamo.

• Ukungabi nenzalo.

• I-Hypothyroidism (incane kakhulu i-hormone yegilo egazini).

• Isifo senhliziyo, njengokuhlaselwa yinhliziyo.

• Izinkinga zamaphaphu, njengenkinga yokuphefumula.

• I-Avascular necrosis yethambo (ukufa kwamangqamuzana amathambo abangelwa ukungahambi kwegazi).

• Ukutheleleka okukhulu.

• Ukukhathala okungapheli.

Ukulandelwa njalo kodokotela abangochwepheshe ekutholeni nasekwelapheni imiphumela esekude kubalulekile empilweni yesikhathi eside yeziguli ezelashwa i-Hodgkin lymphoma.

Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelashwa komdlavuza esebenzisa umuthi owodwa noma ngaphezulu ukunqanda ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Ukwelashwa komdlavuza usebenzisa isidakamizwa esingaphezu kwesisodwa se-chemotherapy kubizwa nge-combination chemotherapy. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda).

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa. I-systemic combination chemotherapy isetshenziselwa ukwelashwa kwe-Hodgkin lymphoma yabantu abadala.

Lapho owesifazane okhulelwe elashwa ngamakhemikhali e-Hodgkin lymphoma, akunakwenzeka ukuvikela umntwana ongakazalwa ekuvezweni i-chemotherapy. Amanye amakhemikhali we-chemotherapy angadala ukukhubazeka kokuzalwa uma kunikezwa ku-trimester yokuqala. IVinblastine ngumuthi olwa nomdlavuza ongazange uhlanganiswe nezinkinga zokuzalwa lapho unikezwa kuma-trimesters wesibili noma wesithathu wokukhulelwa.

Bheka Izidakamizwa Kuvunyelwe iHodgkin Lymphoma ukuthola eminye imininingwane.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza. Kwesinye isikhathi inani lemisebe yomzimba linikezwa wonke umzimba ngaphambi kokufakelwa kwesitokisi.

Ukwelashwa ngemisebe ye-Proton beam kuyacutshungulwa ukwelashwa kweziguli zesifazane ezisencane ukunciphisa ubungozi besifo somdlavuza webele. Ukwelashwa kwemisebe ye-Proton beam isebenzisa imifudlana yama-proton (izinhlayiya ezincane ezinecala elihle) ukubulala amangqamuzana e-tumor. Lolu hlobo lwezokwelapha lungehlisa inani lokulimala kwemisebe ezicutshini ezinempilo eduze kwesimila njengenhliziyo noma isifuba.

Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha i-Hodgkin lymphoma yabantu abadala futhi kungasetshenziswa futhi njengokwelapha okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Owesifazane okhulelwe one-Hodgkin lymphoma, ukwelashwa ngemisebe kufanele kuhlehliswe kuze kube ngemuva kokubeletha, uma kungenzeka, ukugwema noma iyiphi ingozi yokuvezwa yimisebe enganeni engakazalwa. Uma ukwelashwa kuyadingeka ngokushesha, owesifazane anganquma ukuqhubeka nokukhulelwa futhi athole ukwelashwa ngemisebe. Isihlangu somthofu sisetshenziselwa ukumboza isisu sowesifazane okhulelwe ukusiza ukuvikela umntwana ongakazalwa emisebeni ngemisebe ngangokunokwenzeka.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza. Izindlela zokwelashwa ezihlosiwe zingadala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe.

Ukwelashwa kwe-monoclonal antibody luhlobo lwezokwelapha ezihlosiwe ezisetshenziswa ekwelapheni i-Hodgkin lymphoma.

• I-monoclonal antibody therapy iyindlela yokwelapha esebenzisa amasosha omzimba enziwe elebhu, evela ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza.

I-Brentuximab ne-rituximab ngama-antibody monoclonal asetshenziselwa ukwelapha iHodgkin lymphoma.

Bheka Izidakamizwa Kuvunyelwe iHodgkin Lymphoma ukuthola eminye imininingwane.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.

Ukwelashwa kwe-immune checkpoint inhibitor therapy uhlobo lwe-immunotherapy.

• Ukwelashwa kwe-inhibitor yokuhlola amasosha omzimba: I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba wokuzivikela. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza.

I-Nivolumab ne-pembrolizumab yizinhlobo zama-immune checkpoint inhibitors asetshenziselwa ukwelapha iHodgkin lymphoma ebuye yabuya (buyela).

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni wokuhlola, njenge-PD-L1 kumaseli we-tumor ne-PD-1 kumaseli we-T, asiza ukugcina izimpendulo ze-immune zihlolwe. Ukubopha kwe-PD-L1 kuya ku-PD-1 kugcina amaseli we-T ekubulaleni amangqamuzana omzimba emzimbeni (iphaneli engakwesobunxele). Ukuvimba ukubopha kwe-PD-L1 kuya ku-PD-1 nge-immune checkpoint inhibitor (i-anti-PD-L1 noma i-anti-PD-1) ivumela amaseli we-T ukuthi abulale amangqamuzana wesimila (iphaneli elifanele).

Bheka Izidakamizwa Kuvunyelwe iHodgkin Lymphoma ukuthola eminye imininingwane.

Ezigulini ezikhulelwe ezineHodgkin lymphoma, izinketho zokwelashwa zifaka phakathi:

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa ngaphandle uma kuvela izimpawu noma izimpawu noma zishintsha. Ukubeletha kungenziwa lapho umntwana ongakazalwa enamasonto angama-32 kuya kwangama-36 ubudala ukuze umama aqale ukwelashwa.

Ukwelashwa kwama-steroid

Ama-steroid ngamahomoni enziwa ngokwemvelo emzimbeni yizindlala ze-adrenal nangezitho zokuzala. Ezinye izinhlobo ze-steroids zenziwa elebhu. Kutholakale ezinye izidakamizwa ze-steroid ezisiza i-chemotherapy ukuthi isebenze kangcono futhi isize ukumisa ukukhula kwamangqamuzana omdlavuza. Lapho ukulethwa ngaphambi kwesikhathi kungenzeka, i-steroids nayo ingasiza amaphaphu engane engakazalwa ukuba ikhule ngokushesha kunokujwayelekile. Lokhu kunikeza izingane ezizalwa kusenesikhathi ithuba elingcono lokusinda.

Bheka Izidakamizwa Kuvunyelwe iHodgkin Lymphoma ukuthola eminye imininingwane.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

I-Chemotherapy ngokufakelwa kwe-stem cell

Imithamo ephezulu yokwelashwa ngamakhemikhali inikezwa ukubulala amangqamuzana omdlavuza. Amaseli aphilile, kufaka phakathi amaseli akha igazi, nawo abhujiswa ukwelashwa komdlavuza. Ukufakelwa kwe-stem cell ukwelashwa ukufaka amaseli akha igazi. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo wesiguli noma womnikeli futhi afriziwe futhi agcinwe. Ngemuva kokuthi isiguli siqede ukwelashwa ngamakhemikhali nokwelashwa ngemisebe, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha I-Hodgkin Lymphoma Yasekuqaleni Ethandekayo

Ukwelashwa kwe-Hodgkin lymphoma yakudala evumayo kubantu abadala kungafaka okulandelayo:

• Inhlanganisela chemotherapy.

• Inhlanganisela yamakhemikhali nokwelashwa ngemisebe ezindaweni zomzimba ezinomdlavuza.

• Ukwelashwa ngemisebe kukodwa ezigulini ezingakwazi ukwelashwa ngenhlanganisela yamakhemikhali.

Ngemininingwane mayelana nokwelashwa okubalwe ngenhla, bheka isigaba se-Treatment Option Overview section.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho zokwelashwa zeHodgkin Lymphoma yasekuqaleni engathandeki

Ukwelashwa kwe-Hodgkin lymphoma yasekuqaleni engathandeki kubantu abadala kungafaka okulandelayo:

• Inhlanganisela yamakhemikhali nokwelashwa ngemisebe ezindaweni zomzimba ezinomdlavuza.

• Inhlanganisela chemotherapy.

• Isivivinyo somtholampilo sokwelapha okubhekiswe ku-anti-monoclonal antibody (brentuximab) noma i-immunotherapy nge-immune checkpoint inhibitor therapy.

Ngemininingwane mayelana nokwelashwa okubalwe ngenhla, bheka isigaba se-Treatment Option Overview section.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho zokwelashwa ze-Advanced Classic Hodgkin Lymphoma

Ukwelashwa kwe-classic Hodgkin lymphoma kubantu abadala kungafaka okulandelayo:

• Inhlanganisela chemotherapy.

Ngemininingwane mayelana nokwelashwa okubalwe ngenhla, bheka isigaba se-Treatment Option Overview section.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho zokwelashwa ze-Recurrent Classic Hodgkin Lymphoma

Ukwelashwa kwe-Hodgkin lymphoma ejwayelekile evamile kubantu abadala kungafaka okulandelayo:

• Ukwelashwa okuqondisiwe nge-anti-monoclonal antibody (brentuximab).

• Inhlanganisela yamakhemikhali elandelwa yi-high-dose chemotherapy kanye ne-stem cell transplant. Ukwelashwa ngemisebe kunganikezwa uma umdlavuza uhlala

ngemuva kokwelashwa. Ukwelashwa okuhlosiwe (i-brentuximab) kunganikezwa ngemuva kokufakelwa kabusha kwe-stem cell.

• I-immunotherapy ene-immune checkpoint inhibitor (nivolumab noma i-pembrolizumab).

• Inhlanganisela chemotherapy.

• Inhlanganisela yokwelashwa ngamakhemikhali nokwelashwa ngemisebe ezindaweni zomzimba ezinomdlavuza ezigulini ezindala kuneminyaka engama-60.

• Ukwelashwa ngemisebe nge-chemotherapy noma ngaphandle kwayo, yeziguli ezinomdlavuza obuye kuphela kuma-lymph node.

• I-Chemotherapy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ngemininingwane mayelana nokwelashwa okubalwe ngenhla, bheka isigaba se-Treatment Option Overview section.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho Zokwelapha zeNodular Lymphocyte – Podominant Hodgkin Lymphoma

Ukwelashwa kwe-nodular lymphocyte-predominant Hodgkin lymphoma kubantu abadala kungafaka okulandelayo:

• Ukwelashwa ngemisebe ezindaweni zomzimba ezinomdlavuza, ezigulini ezine-nodular lymphocyte – evelele iHodgkin lymphoma.

• I-Chemotherapy, yeziguli ezine-advanced-stage nodular lymphocyte – evelele iHodgkin lymphoma.

• Ukwelashwa okuhlosiwe nge-monoclonal antibody (rituximab).

Ngemininingwane mayelana nokwelashwa okubalwe ngenhla, bheka isigaba se-Treatment Option Overview section.

Izinketho Zokwelapha zeHodgkin Lymphoma Ngesikhathi Sokukhulelwa

Kulesi Sigaba

• IHodgkin Lymphoma Ngesikhathi Sokuqala Sokuqala Sokukhulelwa

• IHodgkin Lymphoma Ngesikhathi Sesibili noma Sesithathu Sokukhulelwa

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

IHodgkin Lymphoma Ngesikhathi Sokuqala Sokuqala Sokukhulelwa

Lapho kutholakala iHodgkin lymphoma ku-trimester yokuqala yokukhulelwa, akusho ukuthi owesifazane uzokwelulekwa ukuthi aqede ukukhulelwa. Ukwelashwa kowesifazane ngamunye kuzoya ngesigaba se-lymphoma, ukuthi sikhula ngokushesha kangakanani, kanye nezifiso zakhe. Ukwelashwa kweHodgkin lymphoma phakathi ne-trimester yokuqala yokukhulelwa kungafaka okulandelayo:

• Ukulinda ngokuqapha lapho umdlavuza ungaphezu kovuthondaba futhi ukhula kancane. Ukubeletha kungancengwa futhi ingane ibelethwe kusenesikhathi ukuze umama aqale ukwelashwa.

• Ukwelashwa ngemisebe lapho umdlavuza ungaphezu kwesifafazi. Isihlangu somthofu sisetshenziselwa ukuvikela umntwana ongakazalwa emisebeni ngangokunokwenzeka.

• I-Chemotherapy isebenzisa umuthi owodwa noma ngaphezulu.

IHodgkin Lymphoma Ngesikhathi Sesibili noma Sesithathu Sokukhulelwa

Lapho kutholakala iHodgkin lymphoma engxenyeni yesibili yokukhulelwa, abesifazane abaningi bangabambezela ukwelashwa kuze kube ngemuva kokuzalwa kwengane. Ukwelashwa kwe-Hodgkin lymphoma phakathi ne-trimester yesibili noma yesithathu yokukhulelwa kungafaka okulandelayo:

• Ukulinda ngokuqapha, nezinhlelo zokukhuthaza ukubeletha lapho umntwana ongakazalwa enamasonto angama-32 kuye kwangama-36 ubudala.

• Ukwelashwa ngemisebe okudambisa izinkinga zokuphefumula okubangelwa isimila esikhulu esifubeni.

• Inhlanganisela yamakhemikhali usebenzisa umuthi owodwa noma ngaphezulu.

• Ukwelashwa kwama-steroid.

Ukufunda Kabanzi Nge-Adult Hodgkin Lymphoma

Ukuthola eminye imininingwane evela ku-National Cancer Institute mayelana ne-Hodgkin lymphoma yabantu abadala, bheka okulandelayo:

• Ikhasi Lasekhaya Lymphoma

• Izidakamizwa zivunyelwe iHodgkin Lymphoma

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli

Mayelana Nesi Sifinyezo se-

Mayelana ne-

I-Physician Data Query () yi-National Cancer Institute's (NCI's) yemininingwane ephelele yomdlavuza. Idathabheyisi ye- iqukethe ukufingqwa kolwazi olushicilelwe lwakamuva ngokuvikela umdlavuza, ukuthola, ufuzo, ukwelashwa, ukunakekelwa okusekelayo, kanye nomuthi ohambisanayo neminye. Ukufingqa okuningi kuza ngezinhlobo ezimbili. Izinhlobo zezempilo zinemininingwane ebhalwe ngolimi lobuchwepheshe. Izinhlobo zesiguli zibhalwe ngolimi olulula ukuluqonda nolungebona ubuchwepheshe. Zombili izinguqulo zinolwazi lomdlavuza olunembile nolusesikhathini futhi izinhlobo eziningi ziyatholakala ngeSpanishi.

I- iyinsizakalo ye-NCI. I-NCI iyingxenye yeNational Institutes of Health (NIH). I-NIH iyisikhungo sikahulumeni wesifundazwe sokucwaninga ngemvelo. Ukufingqwa kwe- kusekelwe ekubuyekezweni okuzimele kwemibhalo yezokwelapha. Akuzona izitatimende zenqubomgomo ze-NCI noma i-NIH.

Inhloso yalesi Sifinyezo

Lesi sifinyezo solwazi lomdlavuza se- sinemininingwane yamanje mayelana nokwelashwa kwe-Hodgkin lymphoma yabantu abadala. Yenzelwe ukwazisa nokusiza iziguli, imindeni, nabanakekeli. Ayinikezi imihlahlandlela esemthethweni noma izincomo zokwenza izinqumo mayelana nokunakekelwa kwezempilo.

Ababuyekezi nezibuyekezo

Amabhodi Wokuhlela abhala izifinyezo zolwazi lomdlavuza we- futhi azigcine zisesikhathini. Lawa maBhodi akhiwe ngochwepheshe bezokwelapha umdlavuza nezinye izinto ezihlobene nomdlavuza. Ukufingqwa kubuyekezwa njalo futhi kwenziwa izinguquko uma kunolwazi olusha. Idethi yesifinyezo ngasinye ("Kubuyekezwe") idethi yoshintsho lwakamuva kakhulu.

Imininingwane ekulesi sifinyeto sesiguli ithathwe enguqulweni yezempilo, ebuyekezwa njalo futhi ivuselelwe njengoba kudingeka, yiBhodi labahleli bezokwelashwa kwe- Adult Treatment.

Imininingwane Yesivivinyo Somtholampilo

Isivivinyo somtholampilo yisifundo sokuphendula umbuzo wesayensi, njengokuthi ngabe ukwelashwa okukodwa kungcono yini kunokunye. Izilingo zisuselwa ezifundweni ezedlule nakulokho okufundiwe elebhu. Isivivinyo ngasinye siphendula imibuzo ethile yesayensi ukuze kutholakale izindlela ezintsha nezingcono zokusiza iziguli ezinomdlavuza. Ngesikhathi sokuhlolwa kwemitholampilo yokwelashwa, ulwazi luyaqoqwa ngemiphumela yokwelashwa okusha nokuthi kusebenza kanjani kahle. Uma ukuhlolwa komtholampilo kukhombisa ukuthi ukwelashwa okusha kungcono kunalokho okusetshenziswayo njengamanje, ukwelashwa okusha kungaba "okujwayelekile." Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Ukuhlolwa kwemitholampilo kungatholakala ku-inthanethi kuwebhusayithi ye-NCI. Ngeminye imininingwane, shayela iCancer Information Service (CIS), isikhungo sokuxhumana se-NCI, ku-1-800-4-CANCER (1-800-422-6237).

Imvume yokusebenzisa lesi sifinyezo

I- wuphawu lokuhweba olubhalisiwe. Okuqukethwe kwemibhalo ye- kungasetshenziswa ngokukhululeka njengombhalo. Ayikwazi ukubonwa njengesifinyezo solwazi lomdlavuza se-NCI ngaphandle kokuthi sonke isifinyezo sikhonjiswe futhi sibuyekezwa njalo. Kodwa-ke, umsebenzisi angavunyelwa ukuthi abhale umusho onjengokuthi “Isifinyezo solwazi lomdlavuza se-NCI sika-NCI mayelana nokuvinjelwa umdlavuza webele sichaza izingozi ngale ndlela elandelayo: [faka nengcaphuno yesifinyezo].”

Indlela enhle yokusho lesi sifinyezo se- yile:

Izithombe ezikulesi sifinyezo zisetshenziswa ngemvume yombhali, yomculi, kanye / noma yomshicileli ukuze zisetshenziswe kwizifinyezo ze- kuphela. Uma ufuna ukusebenzisa isithombe kusuka kusifinyezo se- futhi awusisebenzisi isifinyezo sonke, kufanele uthole imvume kumnikazi. Ayikwazi ukunikezwa yiNational Cancer Institute. Imininingwane yokusebenzisa izithombe ezikulesi sifinyezo, kanye nezinye izithombe eziningi ezihlobene nomdlavuza zingatholakala ku-Visuals Online. I-Visuals Online iqoqo lezithombe zesayensi ezingaphezu kuka-3,000.

Ukuzikhulula

Imininingwane ekulezi zifinyezo akufanele isetshenziselwe ukwenza izinqumo mayelana nokubuyiselwa kwemali yomshuwalense. Imininingwane engaphezulu ngokutholakala komshuwalense iyatholakala kuCancer.gov ekhasini elithi Managing Cancer Care.

Xhumana nathi

Imininingwane engaphezulu ngokuxhumana nathi noma ukuthola usizo ngewebhusayithi yeCancer.gov ingatholakala ekhasini lethu Xhumana nathi ukuze uthole usizo. Imibuzo ingathunyelwa nakuCancer.gov nge-imeyili Ewebhusayithi yethu.