Izinhlobo / i-lymphoma / isiguli / i-adult-nhl-treatment-pdq

Ukwelashwa Kwe-Adult Non-Hodgkin Lymphoma (®) –Patient Version

Imininingwane ejwayelekile Mayelana Ne-Adult Non-Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

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

• I-non-Hodgkin lymphoma ingaba indolent noma ibe nolaka.

• Ukuguga, ukuba ngowesilisa, nokuba namasosha omzimba abuthakathaka kungakhuphula ubungozi bokungabi yiHodgkin lymphoma yabantu abadala.

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

• Izivivinyo ezihlola uhlelo lwe-lymph nezinye izingxenye zomzimba zisetshenziselwa ukusiza ukuxilonga nokubeka isigaba sabantu abadala esingeyona iHodgkin lymphoma.

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

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

I-non-Hodgkin lymphoma uhlobo lomdlavuza olwenzeka 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 (amangqamuzana amhlophe egazi). Kunezinhlobo ezintathu zama-lymphocyte:

• Ama-lymphocyte B enza amasosha omzimba ukusiza ukulwa nokutheleleka. Ebizwa nangokuthi amaseli B. Izinhlobo eziningi ze-non-Hodgkin lymphoma ziqala kuma-lymphocyte B.

• Ama-lymphocyte T asiza ama-lymphocyte B enza amasosha omzimba asiza ukulwa nokutheleleka. Ebizwa nangokuthi ama-T cell.

• Amaseli okubulala wemvelo ahlasela amangqamuzana omdlavuza namagciwane. Ebizwa nangokuthi amaseli we-NK.

• 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 entanyeni, ngaphansi kwekhwapha, i-mediastinum, isisu, i-pelvis, ne-groin.

• 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.

• Amathani: Izixuku ezimbili ezincane zezicubu zomzimba ngemuva komphimbo. Kukhona i-tonsil eyodwa ohlangothini ngalunye lomphimbo.

• 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.

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 ezifana nolwelwesi lokugaya ukudla, i-bronchus, nesikhumba. Umdlavuza ungadlulela esibindini nasemaphashini.

Kunezinhlobo ezimbili ezijwayelekile zama-lymphomas: iHodgkin lymphoma kanye ne-non-Hodgkin lymphoma. Lesi sifinyezo simayelana nokwelashwa kwe-non-Hodgkin lymphoma yabantu abadala, kufaka phakathi ngesikhathi sokukhulelwa.

Ukuze uthole imininingwane ngezinye izinhlobo ze-lymphoma, bheka izifinyezo ezilandelayo ze-:

• Ukwelashwa Kwe-Adult Acute Lymphoblastic Leukemia (lymphoblastic lymphoma)

• Ukwelashwa Kwabantu Abadala I-Hodgkin Lymphoma

• Ukwelashwa Okuhlobene Nengculaza

• Ukwelashwa Kwe-Non-Hodgkin Lymphoma Treatment

• Ukwelashwa Kwe-Lymphocytic Leukemia Treatment (i-lymphocytic lymphoma encane)

• Ukwelashwa kwe-Mycosis Fungoides (Kubandakanya i-Sézary Syndrome) (i-T-cell lymphoma)

• Ukwelashwa Kwe-CNS Lymphoma Eyinhloko

I-non-Hodgkin lymphoma ingaba indolent noma ibe nolaka.

I-non-Hodgkin lymphoma iyakhula futhi isakazeke ngamazinga ahlukene futhi ingaba nobudlova noma ibe nolaka. I-Indolent lymphoma ivame ukukhula nokusabalalisa kancane, futhi inezimpawu nezimpawu ezimbalwa. I-lymphoma enobudlova ikhula futhi isakazeke ngokushesha, futhi inezimpawu nezimpawu ezingaba nzima. Imithi yokwelashwa ye-lymphoma engavumi futhi enobudlova yehlukile.

Lesi sifinyezo simayelana nezinhlobo ezilandelayo ze-non-Hodgkin lymphoma:

Ama-lymphomas angama-Indolent non-Hodgkin

I-lymphoma elandelayo. I-lymphoma elandelwayo uhlobo oluvame kakhulu lwe-indolent non-Hodgkin lymphoma. Luhlobo olukhula kancane kakhulu lwe-non-Hodgkin lymphoma oluqala kuma-lymphocyte B. Ithinta ama-lymph node futhi ingasakazeka emnkantsheni noma emathanjeni. Iningi leziguli ezine-follicular lymphoma zineminyaka engama-50 nangaphezulu lapho zitholakala. I-lymphoma elandelayo ingahamba ngaphandle kokwelashwa. Isiguli sibhekelwa ngeso lokhozi izimpawu noma izimpawu zokuthi lesi sifo sibuye. Ukwelashwa kuyadingeka uma izimpawu noma izimpawu zenzeka ngemuva kokuba umdlavuza unyamalale noma ngemuva kokwelashwa kokuqala komdlavuza. Ngezinye izikhathi i-follicular lymphoma ingaba uhlobo olunolaka kakhulu lwe-lymphoma, njengokusabalalisa i-B-cell lymphoma enkulu.

I-lymphoma ye-Lymphoplasmacytic. Ezimweni eziningi ze-lymphoplasmacytic lymphoma, ama-lymphocyte B aphenduka amangqamuzana e-plasma enza inani elikhulu leprotheyini elibizwa ngokuthi yi-monoclonal immunoglobulin M (IgM) antibody. Amazinga aphezulu e-antibody ye-IgM egazini abangela ukuthi iplasma yegazi ikhule. Lokhu kungadala izimpawu noma izimpawu ezifana nenkinga yokubona noma yokuzwa, izinkinga zenhliziyo, ukuphefumula okuncane, ikhanda elibuhlungu, isiyezi, nokuba ndikindiki noma ukuhayiza kwezandla nezinyawo. Kwesinye isikhathi azikho izimpawu noma izimpawu ze-lymphoplasmacytic lymphoma. Kutholakala lapho kwenziwa ukuhlolwa kwegazi ngesinye isizathu. I-Lymphoplasmacytic lymphoma ivame ukusakazeka kumnkantsha wethambo, ama-lymph node kanye ne-spleen. Iziguli ezine-lymphoplasmacytic lymphoma kufanele zihlolwe ukutheleleka kwegciwane le-hepatitis C. Kubizwa nangokuthi iWaldenström macroglobulinemia.

I-marginal zone lymphoma. Lolu hlobo lwe-non-Hodgkin lymphoma luqala kuma-lymphocyte B engxenyeni yezicubu ze-lymph ezibizwa ngokuthi indawo eseceleni. Isibikezelo singase sibe sibi kakhulu ezigulini ezineminyaka engama-70 noma ngaphezulu, lezo ezinesifo sesigaba III noma sesigaba IV, nalabo abanamazinga aphezulu e-lactate dehydrogenase (LDH). Kunezinhlobo ezinhlanu ezihlukene ze-marginal zone lymphoma. Zihlelwe ngohlobo lwezicubu lapho kwakhiwa khona i-lymphoma:

• I-Nodal marginal zone lymphoma. Amafomu we-nodal marginal zone lymphoma akha ama-lymph node. Lolu hlobo lwe-non-Hodgkin lymphoma aluvamile. Kubizwa nangokuthi i-monocytoid B-cell lymphoma.

• Izicubu ze-lymphoid ezihlobene ne-mucosa (MALT) lymphoma. I-Gastric MALT lymphoma ivame ukuqala esiswini. Lolu hlobo lwamafomu we-marginal zone lymphoma lakha amaseli akwi-mucosa asiza ukwenza amasosha omzimba. Iziguli ezine-MALT lymphoma esiswini nazo zingaba ne-Helicobacter gastritis noma isifo esizimele, njenge-Hashimoto thyroiditis noma i-Sjögren syndrome.

• I-MLT lymphoma eyengeziwe. I-Extragastric MALT lymphoma iqala ngaphandle kwesisu cishe kuzo zonke izingxenye zomzimba kubandakanya ezinye izingxenye zomgudu wamathumbu, izindlala zamathe, igilo, amaphaphu, isikhumba naseduze kweso. Lolu hlobo lwamafomu we-marginal zone lymphoma lakha amaseli akwi-mucosa asiza ukwenza amasosha omzimba. I-Extragastric MALT lymphoma ingabuya eminyakeni eminingi ngemuva kokwelashwa.

• I-lymphoma yesisu esiswini saseMedithera. Lolu uhlobo lwe-MALT lymphoma olwenzeka kubantu abadala abasemazweni asempumalanga yeMedithera. Imvamisa kwakheka esiswini kanti iziguli nazo zingatheleleka ngamagciwane abizwa ngeCampylobacter jejuni. Lolu hlobo lwe-lymphoma lubizwa nangokuthi isifo samathumbu esincane se-immunoproliferative.

• I-Splenic marginal zone lymphoma. Lolu hlobo lwe-marginal zone lymphoma luqala ebuchosheni futhi lungasakazeka egazini lomnkantsha kanye nasemnkantsheni wethambo. Isibonakaliso esivame kakhulu salolu hlobo lwe-splenic marginal zone lymphoma yisipele esikhulu kakhulu kunokujwayelekile.

I-cellular lymphoma enkulu yesikhumba esinqunyiwe. Lolu hlobo lwe-non-Hodgkin lymphoma lusesikhumbeni kuphela. Kungaba i-nodule enobungozi (hhayi umdlavuza) engazimela yodwa noma ingasakazeka ezindaweni eziningi esikhunjeni futhi idinga ukwelashwa.

Ama-lymphomas angenabudlova angenabudlova

Ukusabalalisa i-B-cell lymphoma enkulu. Ukusabalalisa i-B-cell lymphoma enkulu uhlobo oluvame kakhulu lwe-non-Hodgkin lymphoma. Ikhula ngokushesha kuma-lymph node futhi imvamisa ubende, isibindi, umnkantsha noma ezinye izitho ziyathinteka. Izimpawu nezimpawu zokusakazeka okukhulu kwe-B-cell lymphoma kungabandakanya umkhuhlane, ukujuluka kobusuku, nokuncipha. Lezi zibizwa nangokuthi izimpawu ze-B.

• I-B-cell lymphoma enkulu ephakathi. Lolu hlobo lwe-non-Hodgkin lymphoma luhlobo lokusabalalisa okukhulu kwe-B-cell lymphoma. Iphawulwe ngokugcwala kwezicubu zomzimba ezinemicu (efana nesibazi). Kuqubuka isimila ngemuva kwesifuba sesifuba. Ingacindezela ezindleleni zomoya futhi ibangele ukukhwehlela nenkinga yokuphefumula. Iningi leziguli ezine-B-cell lymphoma eyinhloko ephakathi kwabesifazane kungabesifazane abaneminyaka engama-30 kuya kwengu-40 ubudala.

I-cell cell lymphoma enkulu, isigaba III. I-cell cell lymphoma enkulu, isigaba III, uhlobo olungavamile kakhulu lwe-non-Hodgkin lymphoma. Ukwelashwa kwalolu hlobo lwe-follicular lymphoma kufana nokwelashwa kwe-NHL enobudlova kune-NHL engasebenzi.

Anaplastic enkulu cell lymphoma. I-Anaplastic large cell lymphoma uhlobo lwe-non-Hodgkin lymphoma evame ukuqala kuma-T lymphocyte. Amaseli womdlavuza nawo anomaka obizwa nge-CD30 ebusweni beseli.

Kunezinhlobo ezimbili ze-anaplastic large cell lymphoma:

• I-cellular lymphoma enkulu engenalutho. Lolu hlobo lwe-anaplastic large cell lymphoma luthinta kakhulu isikhumba, kepha ezinye izingxenye zomzimba nazo zingathinteka. Izimpawu zesikhumba se-aplastic large cell lymphoma zifaka phakathi amaqhubu noma izilonda esikhunjeni. Lolu hlobo lwe-lymphoma aluvamile futhi alunamsebenzi.

• Isistimu ye-anaplastic enkulu yeseli lymphoma. Lolu hlobo lwe-anaplastic cell cell lymphoma luqala kuma-lymph node futhi lungathinta ezinye izingxenye zomzimba. Lolu hlobo lwe-lymphoma lunolaka kakhulu. Iziguli zingaba namaprotheni amaningi e-anaplastic lymphoma kinase (ALK) ngaphakathi kwamaseli e-lymphoma. Lezi ziguli zinesibikezelo esingcono kuneziguli ezingenawo amanye amaprotheni e-ALK. I-systemic anaplastic cell cell lymphoma yande kakhulu ezinganeni kunabantu abadala. (Bheka isifinyezo se- ku-Childhood Non-Hodgkin Lymphoma Treatment ukuthola eminye imininingwane.)

• I-Extranodal NK- / T-cell lymphoma. I-Extranodal NK- / T-cell lymphoma ivame ukuqala endaweni ezungeze ikhala. Kungaphinde kuthinte i-paranasal sinus (izikhala ezingenalutho emathanjeni azungeze ikhala), uphahla lomlomo, i-trachea, isikhumba, isisu namathumbu. Izimo eziningi ze-extranodal NK- / T-cell lymphoma zinegciwane le-Epstein-Barr kumaseli wesimila. Kwesinye isikhathi i-hemophagocytic syndrome ivela (isimo esibi lapho kunama-histiocyte amaningi asebenzayo nama-T cell abangela ukuvuvukala okukhulu emzimbeni). Ukwelashwa ukucindezela amasosha omzimba kuyadingeka. Lolu hlobo lwe-non-Hodgkin lymphoma aluvamile e-United States.

• I-Lymphomatoid granulomatosis. I-lymphomatoid granulomatosis ithinta kakhulu amaphaphu. Kungathinta nezono ze-paranasal (izikhala ezingenalutho emathanjeni azungeze ikhala), isikhumba, izinso, nesistimu yezinzwa emaphakathi. Ku-lymphomatoid granulomatosis, umdlavuza uhlasela imithambo yegazi futhi ubulale izicubu. Ngoba umdlavuza ungasabalala ungene ebuchosheni, kunikezwa i-intrathecal chemotherapy noma ukwelashwa ngemisebe ebuchosheni.

• I-Angioimmunoblastic T-cell lymphoma. Lolu hlobo lwe-non-Hodgkin lymphoma luqala kumaseli we-T. Ama-lymph node avuvukile ayisibonakaliso esivamile. Ezinye izimpawu zingabandakanya ukuqubuka kwesikhumba, imfiva, ukunciphisa umzimba, noma ukujuluka ebusuku. Kungase kube namazinga aphezulu egamma globulin (amasosha omzimba) egazini. Iziguli nazo zingaba nezifo ezingosomathuba ngoba amasosha omzimba abuthakathaka.

• I-Peripheral T-cell lymphoma. I-Peripheral T-cell lymphoma iqala kuma-lymphocyte avuthiwe e-T. Lolu hlobo lwe-T lymphocyte lukhula ku-thymus gland futhi luhambele kwamanye amasayithi e-lymphatic emzimbeni njengama-lymph node, umnkantsha wethambo, nobende. Kunezinhlobo ezintathu zama-peripheral T-cell lymphoma:

• I-hepatosplenic T-cell lymphoma. Lolu uhlobo olungavamile lwe-T-cell lymphoma yomngcele eyenzeka kakhulu ezinsizweni. Iqala esibindi nasengubeni futhi amaseli omdlavuza nawo ane-T-cell receptor ebizwa nge-gamma / delta ebusweni beseli.

• I-panniculitis efana ne-T-cell lymphoma. I-subcutaneous panniculitis-efana ne-T-cell lymphoma iqala esikhunjeni noma ku-mucosa. Kungenzeka ne-hemophagocytic syndrome (isimo esibi lapho kunama-histiocyte amaningi asebenzayo nama-T cell abangela ukuvuvukala okukhulu emzimbeni). Ukwelashwa ukucindezela amasosha omzimba kuyadingeka.

• Uhlobo lwe-Enteropathy-type intestinal T-cell lymphoma. Lolu hlobo lwe-peripheral T-cell lymphoma lwenzeka emathunjini amancane eziguli ezinesifo se-celiac esingelashwa (impendulo yomzimba ku-gluten ebangela ukungondleki). Iziguli ezitholwa zinesifo se-celiac ebuntwaneni futhi zihlala ekudleni okungenayo i-gluten akuvamile ukuba zibe ne-enteropathy-type intestinal T-cell lymphoma.

• I-B-cell lymphoma enkulu yangaphakathi. Lolu hlobo lwe-non-Hodgkin lymphoma luthinta imithambo yegazi, ikakhulukazi imithambo yegazi emincane ebuchosheni, ezinso, emaphashini nasesikhumbeni. Izimpawu nezimpawu ze-B-cell lymphoma enkulu ye-intravascular ibangelwa yimithambo yegazi evinjiwe. Ibizwa nangokuthi i-intravascular lymphomatosis.

• IBurkitt lymphoma.I-Burkitt lymphoma uhlobo lwe-B-cell non-Hodgkin lymphoma ekhula futhi isabalale ngokushesha okukhulu. Kungathinta umhlathi, amathambo obuso, amathumbu, izinso, amaqanda, noma ezinye izitho. Kunezinhlobo ezintathu ezinkulu zeBurkitt lymphoma (endemic, sporadic, and immunodeficiency related). I-Endemic Burkitt lymphoma ivame ukwenzeka e-Afrika futhi ixhunyaniswe negciwane le-Epstein-Barr, kanti okungajwayelekile iBurkitt lymphoma kwenzeka emhlabeni wonke. I-Burkitt lymphoma ehlobene nokuzivikela komzimba ivame ukubonakala ezigulini ezine-AIDS. IBurkitt lymphoma ingasakazeka ebuchosheni nakumgogodla kanye nokwelashwa ukuvimbela ukusabalala kwayo kunganikezwa. IBurkitt lymphoma yenzeka kakhulu ezinganeni nakubantu abadala (Bheka isifinyezo se- ku-Childhood Non-Hodgkin Lymphoma Treatment ukuthola eminye imininingwane.) IBurkitt lymphoma ibizwa nangokuthi isabalalisa i-noncleaved-cell lymphoma encane.

• I-lymphoblastic lymphoma. I-lymphoblastic lymphoma ingaqala kumaseli we-T noma kumaseli we-B, kepha ivame ukuqala kumaseli we-T. Kulolu hlobo lwe-non-Hodgkin lymphoma, kunama-lymphoblast amaningi kakhulu (amangqamuzana amhlophe egazi angavuthiwe) kuma-lymph node naku-thymus gland. La ma-lymphoblast angasakazeka aye kwezinye izindawo emzimbeni, njengomnkantsha wethambo, ubuchopho nomgogodla. I-lymphoblastic lymphoma ivame kakhulu kubantu abasha nasebekhulile. Kufana ne-acute lymphoblastic leukemia (ama-lymphoblast atholakala kakhulu emnkantsheni nasegazini). (Bheka isifinyezo se- ku-Adult Acute Lymphoblastic Leukemia Treatment ukuthola eminye imininingwane.)

• I-T-cell leukemia / lymphoma yabantu abadala. I-T-cell leukemia / lymphoma yabantu abadala ibangelwa yi-human T-cell leukemia virus type 1 (HTLV-1). Izimpawu zifaka izilonda zamathambo nezikhumba, amazinga aphezulu egazi le-calcium, nama-lymph node, ubende, nesibindi esikhudlwana kunokujwayelekile.

• I-Mantle cell lymphoma. I-Mantle cell lymphoma uhlobo lwe-B-cell non-Hodgkin lymphoma evame ukuvela kubantu abadala abaneminyaka ephakathi noma ngaphezulu. Iqala kuma-lymph node futhi isabalalele ebuchosheni, emnkantsheni wethambo, egazini, futhi kwesinye isikhathi ingono, isisu namathumbu. Iziguli ezine-mantle cell lymphoma zinamaprotheni amaningi kakhulu abizwa nge-cyclin-D1 noma ushintsho oluthile lwezakhi zofuzo kumaseli e-lymphoma. Kwezinye iziguli ezingenazo izimpawu noma izimpawu ze-lymphoma ukubambezela ukuqala kokwelashwa akuthinti ukubikezela.

• Isifo se-posttransplantation lymphoproliferative. Lesi sifo sivela ezigulini ezinenhliziyo, amaphaphu, isibindi, izinso noma ukufakwa kwamanyikwe futhi ezidinga ukwelashwa impilo yonke. Iningi le-posttransplant lymphoproliferative disorders lithinta amaseli we-B futhi linegciwane le-Epstein-Barr kumaseli. Izinkinga zeLymphoproliferative zivame ukuphathwa njengomdlavuza.

• I-histomaocytic lymphoma yangempela. Lolu uhlobo olungavamile, olunolaka kakhulu lwe-lymphoma. Akwaziwa ukuthi iqala kumaseli we-B noma ama-T cell. Ayiphenduli kahle ekwelashweni ngamakhemikhali ajwayelekile.

• I-primary effusion lymphoma. I-primary effusion lymphoma iqala kumaseli we-B atholakala endaweni lapho kukhona khona uketshezi olukhulu, njengezindawo eziphakathi kolwelwesi lwamaphaphu nodonga lwesifuba (i-pleural effusion), isikhwama esizungeze inhliziyo nenhliziyo (pericardial effusion), noma esiswini. Imvamisa asikho isimila esingabonakala. Lolu hlobo lwe-lymphoma luvame ukuvela ezigulini ezine-HIV.

• I-Plasmablastic lymphoma. I-Plasmablastic lymphoma uhlobo lwe-B-cell enkulu engeyona iHodgkin lymphoma enolaka kakhulu. Kuvame ukubonakala ezigulini ezinesifo se-HIV.

Ukuguga, ukuba ngowesilisa, nokuba namasosha omzimba abuthakathaka kungakhuphula ubungozi bokungabi yiHodgkin 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.

Lezi nezinye izinto ezinobungozi zingakhuphula ubungozi bezinhlobo ezithile zabantu abadala abangewona iHodgkin lymphoma:

• Ukuba mdala, owesilisa, noma omhlophe.

• Ukuba nesinye sezifo ezilandelayo zezempilo ezenza buthaka amasosha omzimba:

• Isifo sokuzivikela ezifweni (njenge-hypogammaglobulinemia noma i-Wiskott-Aldrich syndrome).

• Isifo sokuzilimaza (njenge-rheumatoid arthritis, i-psoriasis, noma i-Sjögren syndrome).

• I-HIV / AIDS.

• Uhlobo lwe-T-lymphotrophic virus hlobo I noma ukutheleleka ngegciwane le-Epstein-Barr.

• Ukutheleleka kwe-Helicobacter pylori.

• Ukuthatha izidakamizwa zokuzivikela emzimbeni ngemuva kokufakelwa komzimba.

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

Lezi zimpawu nezimpawu zingabangelwa yi-non-Hodgkin lymphoma yabantu abadala noma ngezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ukuvuvukala kuma-lymph node entanyeni, ngaphansi kwekhwapha, emgodini, noma esiswini.

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Kumanzisa ukujuluka ebusuku.

• Ukuzizwa ngikhathele kakhulu.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuqhuma kwesikhumba noma isikhumba esilumayo.

• Ubuhlungu esifubeni, esiswini, noma emathanjeni ngaphandle kwesizathu esaziwayo.

• Lapho umkhuhlane, ukumanzisa ukujuluka ebusuku, nokwehla kwesisindo kwenzeka ndawonye, ​​leli qembu lezimpawu libizwa ngezimpawu ze-B.

Ezinye izimpawu nezimpawu ze-non-Hodgkin lymphoma yabantu abadala zingavela futhi zincike kokulandelayo:

• Lapho umdlavuza wakha khona emzimbeni.

• Usayizi wesimila.

• Sikhula ngokushesha kangakanani isimila.

Izivivinyo ezihlola uhlelo lwe-lymph nezinye izingxenye zomzimba zisetshenziselwa ukusiza ukuxilonga nokubeka isigaba sabantu abadala esingeyona iHodgkin lymphoma.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• 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, kubandakanya umkhuhlane, ukujuluka ebusuku, ukwehla kwesisindo, imikhuba yezempilo, nokugula 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. 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. Iziguli ezelashelwe igciwane lesifo sokusha kwesibindi kohlobo B esikhathini esidlule zidinga ukuqashwa okuqhubekayo ukubheka ukuthi ngabe ziphinde zasebenza yini. Ukwazi ukuthi umuntu unesifo sokusha kwesibindi kohlobo B noma C kungasiza ukuhlela ukwelashwa.

• Ukuhlolelwa i-HIV: Isivivinyo sokulinganisa izinga lama-antibodies e-HIV kusampula yegazi. Ama-antibody enziwa ngumzimba lapho ehlaselwa yinto yangaphandle. Izinga eliphezulu lama-antibodies e-HIV kungasho ukuthi umzimba utheleleke nge-HIV.

• 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-computerized tomography, noma i-computer axial tomography.

• I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo 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.

• Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha kanye nocezu oluncane lwethambo ngokufaka inaliti ethangeni noma emathanjeni esifuba. Isazi sezifo sibheka umnkantsha nethambo ngaphansi kwemicroscope ukubheka izimpawu zomdlavuza.

Ukufiswa komnkantsha we-Bone kanye ne-biopsy. Ngemuva kokuba indawo encane yesikhumba ibanjiwe, kufakwa inaliti yomnkantsha ethanjeni lesinqe lesiguli. Amasampula egazi, amathambo, nomnkantsha uyasuswa ukuze kuhlolwe ngaphansi kwesibonakhulu.

• I-lymph node biopsy: Ukususwa kwakho konke noma ingxenye ye-lymph node. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza. 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 kwengxenye ye-lymph node kusetshenziswa inaliti ebanzi.

Uma umdlavuza utholakala, izivivinyo ezilandelayo zingenziwa ukutadisha amangqamuzana omdlavuza:

• I-Immunohistochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen athile (omaka) kusampula lezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophe i-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese i-antigen bese ibonwa ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokusiza ukutshela uhlobo oluthile lomdlavuza kolunye uhlobo lomdlavuza.

• Ukuhlaziywa kwe-cytogenetic: Ukuhlolwa kwelabhoratri lapho ama-chromosomes wamaseli esampula yegazi noma umnkantsha abalwa futhi ahlolwe noma yiziphi izinguquko, njengama-chromosomes aphukile, alahlekile, ahlelwe kabusha, noma amanye. Izinguquko kuma-chromosomes athile kungaba luphawu lomdlavuza. Ukuhlaziywa kwe-cytogenetic kusetshenziselwa ukuxilonga umdlavuza, ukuhlela ukwelashwa, noma ukuthola ukuthi ukwelashwa kusebenza kahle kangakanani.

• 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.

• I-FISH (i-fluorescence in situ hybridization): Ukuhlolwa kwaselebhu okusetshenziselwa ukubuka nokubala izakhi zofuzo noma ama-chromosomes kumaseli nezicubu. Izingcezu ze-DNA ezinodayi we-fluorescent zenziwa elabhoratri bese zengezwa kusampula yamaseli noma izicubu zesiguli. Lapho lezi zingcezu zeDNA ezidayiwe zinamathela kuzakhi zofuzo ezithile noma ezindaweni ezithile zama-chromosomes kusampula, ziyakhanya lapho zibhekwa ngaphansi kwesibonakhulu se-fluorescent. Ukuhlolwa kwe-FISH kusetshenziselwa ukusiza ukuthola umdlavuza nokusiza ukuhlela ukwelashwa.

Okunye ukuhlolwa nezinqubo kungenziwa ngokuya ngezimpawu nezimpawu ezibonwayo nokuthi umdlavuza wakha kuphi emzimbeni.

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

Izinketho zokubikezela nokwelashwa 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 ususabalalise yini kwezinye izingxenye zomzimba noma ama-lymph node).

• Uhlobo lwe-non-Hodgkin lymphoma.

• Inani le-lactate dehydrogenase (LDH) egazini.

• Ukuthi kunezinguquko ezithile yini kwizakhi zofuzo.

• Iminyaka yesiguli, ubulili, nempilo ejwayelekile.

• Kungakhathaliseki ukuthi i-lymphoma isanda kutholakala, iyaqhubeka nokukhula ngesikhathi sokwelashwa, noma iphinde yabuya (buyela emuva).

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

• Izifiso zesiguli.

• Iyiphi i-trimester yokukhulelwa isiguli esikuyo.

• Ukuthi ingane ingalethwa yini kusenesikhathi.

Ezinye izinhlobo ze-non-Hodgkin lymphoma zisakazeka ngokushesha ukwedlula ezinye. Iningi le-non-Hodgkin lymphomas elenzeka ngesikhathi sokukhulelwa linolaka. Ukwephuza ukwelashwa kwe-lymphoma enobudlova kuze kube ngemuva kokuzalwa kwengane kunganciphisa ithuba likamama lokusinda. Ukwelashwa ngokushesha kuvame ukunconywa, noma ngabe ukhulelwe.

Izigaba ze-Adult Non-Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwabantu abadala okungewona i-Hodgkin lymphoma, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Lezi zigaba ezilandelayo zisetshenziselwa abadala i-non-Hodgkin lymphoma:

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Abantu Abadala Abangewona AbaseHodgkin Lymphoma

• Ama-lymphomas ama-Adult non-Hodgkin angahle aqoqelwe ukwelashwa ngokuya ngokuthi umdlavuza awunamandla noma unolaka yini, noma ngabe ama-lymph node athintekile asondelene emzimbeni, nokuthi umdlavuza usanda kutholakala noma uyenzeka kaningi.

Ngemuva kokutholakala kwabantu abadala okungewona i-Hodgkin lymphoma, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwe ukuthola uhlobo lomdlavuza nokuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba sesifo ukuze uhlele ukwelashwa. Imiphumela yezivivinyo nezinqubo ezenziwe ukuxilonga i-non-Hodgkin lymphoma isetshenziselwa ukusiza ukwenza izinqumo mayelana nokwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengobuchopho nomgogodla. Into ebizwa ngokuthi i-gadolinium ijojowe esigulini ngomthambo. I-gadolinium iqoqa izungeze amangqamuzana omdlavuza ukuze akhanye ngokugqamile esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• Ukubhoboza i-Lumbar: Inqubo esetshenziselwa ukuqoqa i-cerebrospinal fluid (CSF) kusuka kukholamu lomgogodla. Lokhu kwenziwa ngokubeka inaliti phakathi kwamathambo amabili emgogodleni naku-CSF ezungeze umgogodla nokususa isampula loketshezi. Isampula le-CSF lihlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zokuthi umdlavuza ususabalele ebuchosheni nasentanyeni yomgogodla. Le nqubo ibizwa nangokuthi i-LP noma umpompi womgogodla.

Ukubhoboza i-lumbar. Isiguli silele endaweni esigoqiwe etafuleni. Ngemuva kokuthi indawo encane engezansi ingemuva, inaliti yomgogodla (inaliti ende, ezacile) ifakwa engxenyeni engezansi yekholomu lomgogodla ukususa i-cerebrospinal fluid (CSF, ekhonjiswe ngombala oluhlaza okwesibhakabhaka). Uketshezi lungathunyelwa elabhorethri ukuze ihlolwe.

Kwabesifazane abakhulelwe abane-non-Hodgkin lymphoma, kusetshenziswa izivivinyo zesiteji nezinqubo ezivikela umntwana ongakazalwa ekulimaleni kwemisebe. Lezi zivivinyo nezinqubo zifaka i-MRI (ngaphandle kokuqhathanisa), ukubhoboza i-lumbar, ne-ultrasound.

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 abadala i-non-Hodgkin lymphoma:

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 omdala non-Hodgkin lymphoma 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 sabantu abadala i-non-Hodgkin lymphoma sehlukaniswe 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 sabantu abadala abangewona iHodgkin 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 sabantu abadala abangewona iHodgkin 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.

Abantu Abadala Abangewona AbaseHodgkin Lymphoma

Umuntu omdala ophindaphindiwe ongeyona iHodgkin lymphoma ngumdlavuza obuye wabuya (ubuye) ngemuva kokuphathwa. I-lymphoma ingabuya ohlelweni lwe-lymph noma kwezinye izingxenye zomzimba. I-Indolent lymphoma ingabuya njenge-lymphoma enobudlova. I-lymphoma enobudlova ingabuya njenge-lymphoma ye-indolent.

Ama-lymphomas ama-Adult non-Hodgkin angahle aqoqelwe ukwelashwa ngokuya ngokuthi umdlavuza awunamandla noma unolaka yini, noma ngabe ama-lymph node athintekile asondelene emzimbeni, nokuthi umdlavuza usanda kutholakala noma uyenzeka kaningi.

Bona isigaba soLwazi Olujwayelekile ukuthola eminye imininingwane ngezinhlobo ze-indolent (ezikhula kancane) nezinolaka (ezikhula ngokushesha) ezingezona iHodgkin lymphoma.

I-non-Hodgkin lymphoma nayo ingachazwa njengeyihlanganisayo noma engahlanganisi:

• Ama-lymphomas afanayo: AmaLymphomas lapho ama-lymph node anomdlavuza asondelene.

• Ama-lymphomas angaqondakali: AmaLymphomas lapho ama-lymph node anomdlavuza engekho eduze komunye nomunye, kepha asohlangothini olufanayo lwe-diaphragm.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-non-Hodgkin lymphoma.

• Iziguli ezine-non-Hodgkin lymphoma kufanele ukwelashwa kwazo kuhlelwe yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni

• ama-lymphomas.

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

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• I-Immunotherapy

• Ukwelashwa okuhlosiwe

• I-Plasmapheresis

• Ukulinda okulindile

• Imithi elwa namagciwane

• Ukuhlinzwa

• Ukufakelwa kwe-stem cell

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelapha umuthi wokugoma

• 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-non-Hodgkin lymphoma.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-non-Hodgkin lymphoma. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela ezintsha zokwelapha iziguli ezinomdlavuza. Lapho izivivinyo zomtholampilo zikhombisa 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-non-Hodgkin lymphoma, ukwelashwa kukhethwe ngokucophelela ukuvikela umntwana ongakazalwa. Izinqumo zokwelashwa zisuselwa ezifisweni zikamama, isigaba se-non-Hodgkin 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-non-Hodgkin lymphoma kufanele ukwelashwa kwazo kuhlelwe yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni ama-lymphomas.

Ukwelashwa kuzobhekwa ngudokotela oncologist, udokotela ogxile ekwelapheni umdlavuza, noma nge-hematologist, udokotela ogxile ekwelapheni umdlavuza wegazi. I-oncologist yezokwelapha ingakudlulisela kwabanye abahlinzeki bezokunakekelwa kwezempilo abanolwazi futhi abangongoti ekwelapheni abantu abadala abangewona iHodgkin lymphoma futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• I-Neurosurgeon.

• Isazi sezinzwa.

• I-radiation oncologist.

• Isazi se-endocrinologist.

• Uchwepheshe wokuvuselelwa.

• Abanye ochwepheshe be-oncology.

Ukwelashwa kwe-non-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, ukwelashwa ngemisebe, noma ukufakelwa kwe-stem cell kwe-non-Hodgkin lymphoma kungakhuphula ubungozi bemiphumela yesikhashana.

Imiphumela yamuva yokwelashwa komdlavuza ingafaka okulandelayo:

• Izinkinga zenhliziyo.

• Ukungazali (ukungakwazi ukuthola abantwana).

• Ukulahleka kwamathambo.

• I-Neuropathy (ukulimala kwemizwa okubangela ukuba ndikindiki noma ukuhamba enkingeni).

• Umdlavuza wesibili, njenge:

• Umdlavuza wamaphaphu.

• Umdlavuza wobuchopho.

• Umdlavuza wezinso.

• Umdlavuza wesinye.

• I-Melanoma.

• IHodgkin lymphoma.

• Isifo seMyelodysplastic.

• I-leukemia ye-myeloid enamandla.

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela wakho ngemiphumela ukwelashwa komdlavuza okungaba nayo kuwe. Ukulandelwa njalo ukuze kubhekwe imiphumela yesikhathi sekwephuzile kubalulekile.

Izinhlobo eziyisishiyagalolunye zokwelashwa okujwayelekile zisetshenzisiwe:

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 kunikezwa ngemisebe yomzimba wonke ngaphambi kokufakelwa kabusha kwe-stem cell.

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 umuntu omdala ongeyona iHodgkin lymphoma, futhi kungasetshenziswa futhi njengokwelapha okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Owesifazane okhulelwe one-non-Hodgkin lymphoma, ukwelashwa ngemisebe kufanele kunikezwe ngemuva kokubeletha, uma kungenzeka, ukugwema noma iyiphi ingozi 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 ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. 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 kwi-cerebrospinal fluid (i-intrathecal chemotherapy), isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa imishanguzo emibili noma ngaphezulu ye-anticancer. Izidakamizwa ze-steroid zingangezwa, ukunciphisa ukuvuvukala futhi kwehlise ukuphendula komzimba.

I-systemic combination chemotherapy isetshenziselwa ukwelashwa kwe-non-Hodgkin lymphoma yabantu abadala.

I-intrathecal chemotherapy nayo ingasetshenziswa ekwelapheni i-lymphoma eqala ukwenzeka emasendeni noma esonweni (izindawo eziyize) ezungeze ikhala, isabalalise i-B-cell lymphoma enkulu, iBurkitt lymphoma, i-lymphoblastic lymphoma, kanye ne-T-cell lymphomas ethile enobudlova. Kunikezwa ukunciphisa ithuba lokuthi amangqamuzana e-lymphoma azosabalala aye ebuchosheni nasemgogodleni. Lokhu kubizwa nge-CNS prophylaxis.

Ukwelashwa ngamakhemikhali kwe-Intrathecal. Izidakamizwa ze-anticancer zifakwa esikhaleni se-intrathecal, okuyisikhala esiphethe i-cerebrospinal fluid (CSF, ekhonjiswe ngombala oluhlaza okwesibhakabhaka). Kunezindlela ezimbili ezihlukile zokwenza lokhu. Enye indlela, ekhonjiswe engxenyeni ephezulu yesibalo, ukujova izidakamizwa echibini lase-Ommaya (isitsha esimise okwedome esifakwa ngaphansi kwesikhumba lapho uhlinzwa; ibamba izidakamizwa njengoba zingena ngepayipi elincane zingena ebuchosheni ). Enye indlela, ekhonjiswe engxenyeni engezansi yesibalo, ukujova izidakamizwa ngqo kwi-CSF engxenyeni engezansi yekholomu lomgogodla, ngemuva kokuthi indawo encane engezansi ingemuva.

Lapho owesifazane okhulelwe elashwa nge-chemotherapy ye-non-Hodgkin lymphoma, umntwana ongakazalwa akakwazi ukuvikelwa ekuvezweni ekhemotherapy. Amanye amakhemikhali we-chemotherapy angadala ukukhubazeka kokuzalwa uma kunikezwa ku-trimester yokuqala.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin 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. Ama-immunomodulators kanye nokwelashwa kwe-CAR T-cell yizinhlobo ze-immunotherapy.

• Ama-Immunomodulators: I-Lenalidomide iyi-immunomodulator esetshenziselwa ukwelapha i-non-Hodgkin lymphoma yabantu abadala.

• Ukwelashwa kwe-CAR T-cell: Amaseli we-T wesiguli (uhlobo lweseli lomzimba) ayashintshwa ukuze ahlasele amaprotheni athile ebusweni bamangqamuzana omdlavuza. Amaseli we-T athathwa esigulini futhi ama-receptors akhethekile afakwa ebusweni bawo elabhoratri. Amaseli aguqukile abizwa ngamaseli we-chimeric antigen receptor (CAR) T. Amaseli e-CAR T akhuliswa elabhorethri futhi anikezwa isiguli ngokufakwa. Amaseli e-CAR T ayanda egazini lesiguli bese ehlasela amangqamuzana omdlavuza. Ukwelashwa kwe-CAR T-cell (njenge-axicabtagene ciloleucel noma tisagenlecleucel) kusetshenziselwa ukwelapha i-B-cell lymphoma enkulu engaphendulanga ekwelashweni.

Ukwelashwa kwe-CAR T-cell. Uhlobo lokwelashwa lapho kuguqulwa khona ama-T cell wesiguli (uhlobo lwamaseli omzimba) elabhoratri ngakho-ke azobopha amaseli womdlavuza futhi awabulale. Igazi elivela emthanjeni engalweni yesiguli ligeleza ngeshubhu liye emshinini we-apheresis (ongakhonjisiwe), osusa amangqamuzana amhlophe egazi, kufaka phakathi ama-T cell, bese lithumela lonke igazi emuva esigulini. Ngemuva kwalokho, kufakwa isakhi sofuzo se-receptor ekhethekile ebizwa nge-chimeric antigen receptor (CAR) kumaseli we-T elabhorethri. Izigidi zamaseli e-CAR T zikhuliswa elabhoratri bese zinikezwa isiguli ngokumnika. Amaseli e-CAR T akwazi ukubopha i-antigen kumaseli womdlavuza futhi awabulale.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Ukwelashwa kwe-monoclonal antibody, i-proteasome inhibitor therapy, kanye ne-kinase inhibitor therapy yizinhlobo zokwelashwa okuqondisiwe okusetshenziselwa ukwelapha umuntu omdala ongeyona iHodgkin lymphoma.

I-monoclonal antibody therapy iyindlela yokwelapha umdlavuza 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. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza. Ama-antibody e-monoclonal anikezwa ngokumnika.

Izinhlobo zama-antibody monoclonal zifaka:

• I-Rituximab, esetshenziselwa ukwelapha izinhlobo eziningi ze-non-Hodgkin lymphoma.

• I-Obinutuzumab, esetshenziselwa ukwelapha i-follicular lymphoma.

• I-Brentuximab vedotin, equkethe i-anti-monoclonal antibody ebopha iphrotheni ebizwa nge-CD30 etholakala kwamanye amaseli e-lymphoma. Iqukethe nomuthi olwa nomdlavuza ongasiza ekubulaleni amangqamuzana omdlavuza.

• I-Yttrium Y 90-ibritumomab tiuxetan, isibonelo se-antibody monoclonal anti-radiolabeled.

Ukwelashwa kwe-Proteasome inhibitor kuvimbela ukusebenza kwama-proteasomes kumaseli womdlavuza. Ama-Proteasomes asusa amaprotheni angasadingeki yiseli. Lapho ama-proteasomes evinjelwe, amaprotheni ayakheka esitokisini futhi angadala ukuthi iseli lomdlavuza life. I-Bortezomib isetshenziselwa ukunciphisa ukuthi i-immunoglobulin M engakanani esegazini ngemuva kokwelashwa komdlavuza we-lymphoplasmacytic lymphoma. Kuphinde kufundwe ukwelapha i-mantle cell lymphoma ebuyile.

Ukwelashwa kwe-Kinase inhibitor kuvimba amaprotheni athile, angasiza ukugcina amaseli e-lymphoma angakhuli futhi angawabulala. Ukwelashwa kwe-Kinase inhibitor kufaka phakathi:

• ICopanlisib, idelalisib, ne-duvelisib, evimba amaprotheni e-P13K futhi engasiza ukugcina amaseli e-lymphoma angakhuli. Zisetshenziselwa ukwelapha ama-follicular non-Hodgkin lymphomas abuyele emuva (abuya) noma angakatholi okungcono ngemuva kokwelashwa ngezinye izindlela okungenani ezimbili zokwelashwa.

• Ibrutinib ne-acalabrutinib, izinhlobo ze-Bruton tyrosine kinase inhibitor therapy. Zisetshenziselwa ukwelapha i-lymphoplasmacytic lymphoma ne-mantle cell lymphoma.

IVenetoclax nayo ingasetshenziselwa ukwelapha i-mantle cell lymphoma. Kuvimba ukusebenza kweprotheni ebizwa nge-B-cell lymphoma-2 (BCL-2) futhi kungasiza ekubulaleni amangqamuzana omdlavuza.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane.

I-Plasmapheresis

Uma igazi lijiyana ngamaprotheni e-antibody athe xaxa futhi lithinta ukujikeleza kwegazi, iplasmapheresis yenziwa ukususa amaprotheni amaningi e-plasma kanye ne-antibody egazini. Kule nqubo, igazi liyasuswa esigulini bese lithunyelwa ngomshini ohlukanisa i-plasma (ingxenye ewuketshezi yegazi) namaseli egazi. I-plasma yesiguli iqukethe amasosha omzimba angadingeki futhi ayibuyiselwa esigulini. Amaseli egazi ajwayelekile abuyiselwa egazini kanye ne-plasma enikelwe noma enye esikhundleni se-plasma. I-Plasmapheresis ayigcini ama-antibodies amasha ekwakhekeni.

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu.

Imithi elwa namagciwane

Ukwelashwa ngama-antibiotic ukwelashwa okusebenzisa imishanguzo ukwelapha izifo kanye nomdlavuza obangelwa amagciwane kanye nezinye izinto ezincane eziphilayo.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane.

Ukuhlinzwa

Ukuhlinzwa kungasetshenziselwa ukususa i-lymphoma ezigulini ezithile ezine-indodent noma ezinolaka ezingezona iHodgkin lymphoma.

Uhlobo lokuhlinzwa olusetshenzisiwe luxhomeke lapho i-lymphoma yakhiwa khona emzimbeni:

• Ukusikwa kwasendaweni kweziguli ezithile ezinezicubu ezihlobene ne-mucosa (MALT) lymphoma, PTLD, namathumbu amancane we-T-cell lymphoma.

• I-Splenectomy yeziguli ezine-marginal zone lymphoma yobende.

Iziguli ezinenhliziyo, amaphaphu, isibindi, izinso noma ukufakwa kwamanyikwe ngokuvamile zidinga ukuthatha izidakamizwa ukuvimbela amasosha omzimba impilo yazo yonke. Ukuzivikela komzimba isikhathi eside ngemuva kokufakelwa komzimba kungadala uhlobo oluthile lwe-non-Hodgkin lymphoma olubizwa nge-post-transplant lymphoproliferative disorder (PLTD).

Kudingeka ukuhlinzwa kwamathumbu amancane ukuthola isifo se-celiac kubantu abadala abahlakulela uhlobo lwe-T-cell lymphoma.

Ukufakelwa kwe-stem cell

Ukufakelwa kwe-stem cell kuyindlela yokunikeza imithamo ephezulu ye-chemotherapy kanye / noma i-total-body irradiation bese ubuyisela amaseli akha igazi abhujiswa ukwelashwa komdlavuza. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo lesiguli (ukufakelwa okuzenzekelayo) noma umnikeli (ukufakelwa kwe-allogeneic) futhi aqandisiwe agcinwe. Ngemuva kokuthi ukwelashwa ngamakhemikhali kanye / noma ukwelashwa ngemisebe kuqediwe, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Ukufakelwa kwe-stem cell. (Isinyathelo 1): Igazi lithathwa emthanjeni osengalweni yomnikeli. Isiguli noma omunye umuntu kungaba umnikeli. Igazi ligeleza ngomshini osusa ama-stem cells. Ngemuva kwalokho igazi libuyiselwa kumnikeli ngomthambo okwenye ingalo. (Isinyathelo 2): Isiguli sithola i-chemotherapy yokubulala amaseli akha igazi. Isiguli singathola ukwelashwa ngemisebe (okungakhonjisiwe). (Isinyathelo 3): Isiguli sithola ama-stem cells nge-catheter efakwa emthanjeni wegazi esifubeni.

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.

Ukwelapha umuthi wokugoma

Ukwelashwa ngokugoma ukwelashwa komdlavuza okusebenzisa into noma iqembu lezinto ukukhuthaza amasosha omzimba ukuthi athole isimila asibulale.

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.

Ukwelashwa kwe-Indolent Non-Hodgkin Lymphoma

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

Ukwelashwa kwesigaba se-indolent I kanye ne-indolent, isigaba se-II sabantu abadala esingewona iHodgkin lymphoma kungafaka okulandelayo:

• Ukwelashwa ngemisebe.
• Ukwelashwa kwe-monoclonal antibody (rituximab) kanye / noma i-chemotherapy.
• Ukulinda okulindile.

Uma isimila sikhulu kakhulu ukuthi singaphathwa ngemithi yokwelashwa ngemisebe, kuzosetshenziswa izindlela zokwelashwa zesigaba sesibili, i-III, noma i-IV yabantu abadala abangasiyo iHodgkin lymphoma.

Ukwelashwa kwesigaba II esingahlonizi, esingenakuqhathaniswa, noma sesine esingumuntu omdala esingeyona iHodgkin lymphoma kungafaka okulandelayo:

• Ukulinda ngokuqapha iziguli ezingenazo izimpawu noma izimpawu.

• Ukwelashwa kwe-monoclonal antibody (rituximab) nge-chemotherapy noma ngaphandle kwayo.

• Ukwelashwa kwesondlo nge-rituximab.

• Ukwelashwa kwe-monoclonal antibody (obinutuzumab).

• Ukwelashwa kwe-PI3K inhibitor (copanlisib, idelalisib, noma i-duvelisib).

• I-Lenalidomide ne-rituximab.

• Ukwelashwa kwama-antiocolonal anti-radiolabeled.

• Isivivinyo somtholampilo se-chemotherapy ephezulu ene-irradiation yomzimba ophelele noma ngaphandle kwayo noma i-radiolabeled monoclonal antibody therapy, elandelwa

• ukufakelwa kwe-stem cell okuzenzakalelayo noma kwe-allogeneic.

• Isivivinyo somtholampilo se-chemotherapy noma ngaphandle komuthi wokugoma.

• Isivivinyo somtholampilo sezinhlobo ezintsha zama-antibody monoclonal.

• Isivivinyo somtholampilo sokwelapha ngemisebe okubandakanya ama-lymph node aseduze, eziguli ezinesifo sesigaba III.

• Isivivinyo somtholampilo sokwelashwa ngemisebe ephansi, ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ezinye izindlela zokwelashwa kwe-indolent non-Hodgkin lymphoma zixhomeke ohlotsheni lwe-non-Hodgkin lymphoma. Ukwelashwa kungafaka okulandelayo:

• Nge-follicular lymphoma, ukwelashwa kungaba ngaphakathi kwesivivinyo somtholampilo sokwelapha okusha kwe-monoclonal antibody, irejimeni entsha ye-chemotherapy, noma isiqu

ukufakelwa kweseli.

• Kwi-follicular lymphoma ebuyile (ebuya) noma engakatholi ngcono ukwelashwa, ukwelashwa kungafaka i-PI3K inhibitor

(copanlisib, idelalisib, noma i-duvelisib).

• Nge-lymphoplasmacytic lymphoma, i-Bruton tyrosine kinase inhibitor therapy kanye / noma i-plasmapheresis noma i-proteasome inhibitor therapy (uma kudingeka

ukwenza igazi libe mncane) kuyasetshenziswa. Ezinye izindlela zokwelapha ezifana nalezo ezisetshenziselwa i-follicular lymphoma nazo zinganikezwa.

• Ngezicubu ze-lymphoid (MALT) lymphoma ehambisana nesisu esiswini, ukwelashwa kwama-antibiotic ukwelapha ukutheleleka kwe-Helicobacter pylori kunikezwa kuqala.

Kwezimila ezingaphenduli ekwelashweni ngama-antibiotic, ukwelashwa ukwelashwa ngemisebe, ukuhlinzwa, noma i-rituximab nge-chemotherapy noma ngaphandle kwayo.

• Nge-extragastric MALT lymphoma yeso kanye ne-Mediterranean abdominal lymphoma, ukwelashwa kwama-antibiotic kusetshenziselwa ukwelapha ukutheleleka.

• Kwi-splenic marginal zone lymphoma, i-rituximab noma engenayo i-chemotherapy ne-B-cell receptor therapy isetshenziswa njengokwelashwa kokuqala. Uma isimila singaphenduli ekwelashweni, i-splenectomy ingenziwa.

Ukwelashwa kwe-Aggressive Non-Hodgkin Lymphoma

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

Ukwelashwa kwesigaba esinolaka mina nesigaba esinolaka, esihlanganayo sesi-II sabantu abadala esingeyona iHodgkin lymphoma kungafaka okulandelayo:

• Ukwelashwa kwe-monoclonal antibody (rituximab) kanye nokuhlanganiswa kwamakhemikhali. Kwesinye isikhathi ukwelashwa ngemisebe kunikezwa kamuva.

• Isivivinyo somtholampilo sohlobo olusha lwe-monoclonal antibody therapy kanye nenhlanganisela yamakhemikhali.

Ukwelashwa kwesigaba esinolaka, esingenakuqhathaniswa sesi-II, III, noma se-IV esingasona iHodgkin lymphoma kungafaka okulandelayo:

• Ukwelashwa kwe-monoclonal antibody (rituximab) ngenhlanganisela yamakhemikhali.

• Inhlanganisela chemotherapy.

• Isivivinyo somtholampilo sokwelashwa kwe-antioclonal antibody nge-chemotherapy ehlangene elandelwa ukwelashwa ngemisebe.

Ezinye izindlela zokwelashwa zixhomeke ohlotsheni lwe-non-Hodgkin lymphoma olunolaka. Ukwelashwa kungafaka okulandelayo:

• Nge-extranodal NK- / T-cell lymphoma, ukwelashwa ngemisebe okunganikezwa ngaphambi, ngesikhathi, noma ngemuva kwe-chemotherapy kanye ne-CNS prophylaxis.

• Nge-mantle cell lymphoma, ukwelashwa kwe-monoclonal antibody nge-chemotherapy ehlanganisiwe, kulandelwa ukufakelwa kwe-stem cell. I-monoclonal antibody therapy inganikezwa ngemuva kwalokho njengokwelashwa kwesondlo (ukwelashwa okunikezwa ngemuva kokwelapha kokuqala ukusiza ukugcina umdlavuza ungabuyi).

• Nge-posttransplantation lymphoproliferative disorder, ukwelashwa ngemithi yokuzivikela emzimbeni kungamiswa. Uma lokhu kungasebenzi noma kungenakwenziwa, ukwelashwa nge-monoclonal antibody kuphela noma nge-chemotherapy kunganikezwa. Ngomdlavuza ongakasakazeki, kungasetshenziswa ukuhlinzeka ukukhipha umdlavuza noma ukwelashwa ngemisebe.

• Nge-plasmablastic lymphoma, izindlela zokwelapha zifana nalezo ezisetshenziselwa i-lymphoblastic lymphoma noma iBurkitt lymphoma.

Ukuze uthole ukwaziswa ngokwelashwa kwe-lymphoblastic lymphoma, bheka Izinketho Zokwelapha zeLymphoblastic Lymphoma kanye nolwazi mayelana nokwelashwa kweBurkitt lymphoma, bheka Izinketho Zokwelapha zeBurkitt Lymphoma.

Ukwelashwa kweLymphoblastic Lymphoma

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

Ukwelashwa kwe-lymphoblastic lymphoma yabantu abadala kungafaka okulandelayo:

• Inhlanganisela yamakhemikhali kanye ne-CNS prophylaxis. Kwesinye isikhathi ukwelashwa ngemisebe nakho kunikezwa ukunciphisa isimila esikhulu.

• Ukwelashwa okubhekiswe ku-anti-monoclonal antibody kuphela (i-rituximab) noma kuhlanganiswe ne-kinase inhibitor therapy (ibrutinib).

• Isivivinyo somtholampilo sokufakelwa kwe-stem cell ngemuva kokwelashwa kokuqala.

Ukwelashwa kweBurkitt Lymphoma

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

Ukwelashwa kwe-Burkitt lymphoma yabantu abadala kungafaka okulandelayo:

• Inhlanganisela yamakhemikhali noma ngaphandle kwe-monoclonal antibody therapy.

• I-CNS prophylaxis.

Ukwelashwa Kwe-Lymphoma Engajwayelekile Ye-Hodgkin

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

Ukwelashwa kwe-non-Hodgkin lymphoma yabantu abadala abangasebenzi, okungajwayelekile kungafaka okulandelayo:

• I-Chemotherapy ngomuthi owodwa noma ngaphezulu.

• Ukwelashwa kwe-monoclonal antibody (rituximab noma obinutuzumab).

• Lenalidomide.

• Ukwelashwa kwama-antiocolonal anti-radiolabeled.

• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Isivivinyo somtholampilo wokufakelwa kwe-stem autologous noma i-allogeneic.

Ukwelashwa kwe-non-Hodgkin lymphoma yabantu abadala abanolaka, abaphindayo kungafaka okulandelayo:

• I-Chemotherapy ngokufakelwa kwe-stem cell noma ngaphandle kwayo.

• Ukwelashwa kwe-monoclonal antibody nge-chemotherapy noma ngaphandle kokuhlanganiswa kulandelwa ukufakelwa kwe-stem cell cell.

• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Ukwelashwa kwama-antiocolonal anti-radiolabeled.

• Ukwelashwa kwe-CAR T-cell.

• Nge-mantle cell lymphoma, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa kwe-Bruton tyrosine kinase inhibitor.

• Lenalidomide.

• Isivivinyo somtholampilo se-lenalidomide esine-monoclonal antibody therapy.

• Isivivinyo somtholampilo esiqhathanisa i-lenalidomide nolunye uhlobo lokwelashwa.

• Isivivinyo somtholampilo se-proteasome inhibitor therapy (bortezomib).

• Isivivinyo somtholampilo wokufakelwa kwe-stem autologous noma i-allogeneic.

Ukwelashwa kwe-lymphoma ye-indolent ebuya njenge-lymphoma enobudlova kuncike ohlotsheni lwe-non-Hodgkin lymphoma futhi kungafaka ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo. Ukwelashwa kwe-lymphoma enobudlova ebuya njenge-lymphoma e-indolent kungafaka i-chemotherapy.

Ukwelashwa Kwe-Non-Hodgkin Lymphoma Ngesikhathi Sokukhulelwa

Kulesi Sigaba

• I-Indolent Non-Hodgkin Lymphoma Ngesikhathi Sokukhulelwa

• Ulymphoma Non-Hodgkin Lymphoma Ngesikhathi Sokukhulelwa

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

I-Indolent Non-Hodgkin Lymphoma Ngesikhathi Sokukhulelwa

Abesifazane abane-indolent (ekhula kancane) engeyona i-Hodgkin lymphoma ngesikhathi sokukhulelwa bangaphathwa ngokulinda okulindile baze babelethe. (Bheka isigaba sezindlela zokwelashwa ze-Indolent Non-Hodgkin Lymphoma section ukuthola eminye imininingwane.)

Ulymphoma Non-Hodgkin Lymphoma Ngesikhathi Sokukhulelwa

Ukwelashwa kwe-non-Hodgkin lymphoma enobudlova ngesikhathi sokukhulelwa kungafaka okulandelayo:

• Ukwelashwa okunikezwa ngaso leso sikhathi ngokuya ngohlobo lwe-non-Hodgkin lymphoma ukukhulisa amathuba omama okusinda. Ukwelashwa kungafaka inhlanganisela yamakhemikhali kanye ne-rituximab.

• Ukulethwa kwengane kusenesikhathi kulandelwa ukwelashwa okusekelwe ohlotsheni lwe-non-Hodgkin lymphoma.

• Uma ku-trimester yokuqala yokukhulelwa, oncologists bezokwelapha bangeluleka ngokuqeda ukukhulelwa ukuze kuqale ukwelashwa. Ukwelashwa kuya ngohlobo lwe-non-Hodgkin lymphoma.

Ukufunda Kabanzi Nge-Adult Non-Hodgkin Lymphoma

Ukuze uthole olunye ulwazi oluvela ku-National Cancer Institute mayelana nabantu abadala abangewona iHodgkin lymphoma, bheka okulandelayo:

• Ikhasi lasekhaya le-Non-Hodgkin Lymphoma

• Izidakamizwa zivunyelwe i-Non-Hodgkin Lymphoma

• Izindlela Zokwelapha Zomdlavuza

• I-Immunotherapy Yokwelapha Umdlavuza

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