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Ukwelashwa kweHodgkin Lymphoma Treatment (®) –Patient Version

Imininingwane ejwayelekile Ngobuntwana Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

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

• Izinhlobo ezimbili eziyinhloko ze-Hodgkin lymphoma yobuntwana ziyi-classic kanye ne-nodular lymphocyte-evelele.

• Ukutheleleka ngegciwane le-Epstein-Barr kanye nomlando womndeni weHodgkin lymphoma kungakhuphula ingozi yobuntwana iHodgkin lymphoma.

• Izimpawu zobuntwana iHodgkin lymphoma zifaka ama-lymph node avuvukile, umkhuhlane, ukujuluka ebusuku, nokuncipha.

• Izivivinyo ezihlola uhlelo lwe-lymph nezinye izingxenye zomzimba zisetshenziselwa ukuxilonga nokukala i-Hodgkin lymphoma yobuntwana.

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

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

I-Childhood 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 entanyeni, ngaphansi kwekhwapha, ku-mediastinum (indawo ephakathi kwamaphaphu), isisu, i-pelvis, ne-groin. I-Hodgkin lymphoma ivame ukwakheka kuma-lymph node ngaphezu kwesifafula.

• 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-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.

Amabhithi wezicubu ze-lymph ayatholakala nakwezinye izingxenye zomzimba ezinjengolwelwesi lwesisu, i-bronchus, nesikhumba.

Kunezinhlobo ezimbili ezijwayelekile ze-lymphoma: iHodgkin lymphoma kanye ne-non-Hodgkin lymphoma. Lesi sifinyezo simayelana nokwelashwa kweHodgkin lymphoma yobuntwana.

I-Hodgkin lymphoma yenzeka kaningi ezinganeni ezineminyaka engu-15 kuya kwengu-19 ubudala. Ukwelashwa kwezingane nentsha kuhlukile kunokwelashwa kwabantu abadala.

Ngemininingwane mayelana nengane engeyona iHodgkin lymphoma noma i-Hodgkin lymphoma yabantu abadala bheka izifinyezo ezilandelayo ze-:

• Ukwelashwa Kwe-Non-Hodgkin Lymphoma Treatment.

• Ukwelashwa Kwabantu Abadala I-Hodgkin Lymphoma.

Izinhlobo ezimbili eziyinhloko ze-Hodgkin lymphoma yobuntwana ziyi-classic kanye ne-nodular lymphocyte-evelele.

Izinhlobo ezimbili eziyinhloko zobuntwana iHodgkin lymphoma yilezi:

• I-Classic Hodgkin lymphoma. Lolu uhlobo oluvame kakhulu lweHodgkin lymphoma. Kwenzeka kaningi entsheni. Lapho isampula yezicubu ze-lymph node ibhekwa ngaphansi kwesibonakhulu, amaseli omdlavuza weHodgkin lymphoma, abizwa ngokuthi amangqamuzana e-Reed-Sternberg, angabonakala.

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

I-Classic Hodgkin lymphoma ihlukaniswe ngama-subtypes amane, ngokuya ngokuthi amangqamuzana omdlavuza abukeka kanjani ngaphansi kwesibonakhulu:

• I-Nodular-sclerosing Hodgkin lymphoma yenzeka kakhulu ezinganeni ezindala nasebusheni. Kuvamile ukuba nesisindo sesifuba lapho uxilongwa.

• Iseli elixubekile iHodgkin lymphoma ivame ukwenzeka ezinganeni ezingaphansi kweminyaka eyishumi ubudala. Ixhunywe nomlando wokutheleleka nge-Epstein-Barr virus (EBV) futhi imvamisa yenzeka kuma-lymph node entanyeni.

• I-Hodgkin lymphoma classic ecebile ye-lymphocyte ayivamile ezinganeni. Lapho isampula yezicubu ze-lymph node ibhekwa ngaphansi kwesibonakhulu, kunamaseli eReed-Sternberg nama-lymphocyte amaningi ajwayelekile namanye amaseli egazi.

• I-lymphocyte-depleted Hodgkin lymphoma ayivamile ezinganeni futhi yenzeka kakhulu kubantu abadala noma kubantu abadala abane-virus ye-immunodeficiency virus (HIV). Lapho isampula yezicubu ze-lymph node ibhekwa ngaphansi kwesibonakhulu, kunamaseli amaningi omdlavuza amise okwejwayelekile kanye nama-lymphocyte ambalwa ajwayelekile namanye amaseli egazi.

• I-Hodgkin lymphoma eyinhloko ye-lymphocyte. Lolu hlobo lweHodgkin lymphoma aluvamile kuneHodgkin lymphoma yakudala. Ngokuvamile kwenzeka ezinganeni ezingaphansi kweminyaka eyishumi ubudala. Lapho isampula yezicubu ze-lymph node ibhekwa ngaphansi kwesibonakhulu, amangqamuzana omdlavuza abukeka njenge "popcorn" ngenxa yomumo wawo. I-Nodular lymphocyte-evelele i-Hodgkin lymphoma ivame ukuvela njenge-lymph node evuvukile entanyeni, ngaphansi kwekhwapha, noma emgodini. Iningi labantu alinazo ezinye izimpawu noma izimpawu zomdlavuza lapho litholakala.

Ukutheleleka ngegciwane le-Epstein-Barr kanye nomlando womndeni weHodgkin lymphoma kungakhuphula ingozi yobuntwana iHodgkin lymphoma.

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 wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni.

Izingozi zobuntwana beHodgkin lymphoma zifaka okulandelayo:

• Ukutheleleka ngegciwane le-Epstein-Barr (EBV).

• Ukuba nomlando womuntu siqu we-mononucleosis ("mono").

• Ukutheleleka ngegciwane lengculazi (i-HIV).

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

• Ukuba namasosha omzimba abuthakathaka ngemuva kokufakelwa kwesitho somzimba noma kumuthi onikezwe ngemuva kokufakelwa kabusha ukuvimba isitho ekwenqabelweni ngumzimba.

• Ukuba nomzali, umfowenu, noma udade onomlando womuntu siqu weHodgkin lymphoma.

Ukuchayeka ezifweni ezivamile zisencane kunganciphisa ubungozi beHodgkin lymphoma ezinganeni ngenxa yomphumela onawo emasosheni omzimba.

Izimpawu zobuntwana iHodgkin lymphoma zifaka ama-lymph node avuvukile, umkhuhlane, ukujuluka ebusuku, nokuncipha.

Izimpawu nezimpawu zeHodgkin lymphoma zixhomeke lapho umdlavuza wakheka emzimbeni nasayizi womdlavuza. Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-Hodgkin lymphoma yobuntwana noma ngezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

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

• Umkhuhlane ngaphandle kwesizathu esaziwayo.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Kumanzisa ukujuluka ebusuku.

• Ukuzizwa ngikhathele kakhulu.

• I-Anorexia.

• Isikhumba esilumayo.

• Ukukhwehlela.

• Inkinga yokuphefumula, ikakhulukazi lapho ulele phansi.

• Ubuhlungu kuma-lymph node ngemuva kokuphuza utshwala.

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

Izivivinyo ezihlola uhlelo lwe-lymph nezinye izingxenye zomzimba zisetshenziselwa ukuxilonga nokukala i-Hodgkin lymphoma yobuntwana.

Ukuhlolwa nezinqubo ezenza izithombe zohlelo lwe-lymph nezinye izingxenye zomzimba zisize ukuxilonga iHodgkin lymphoma yobuntwana futhi zikhombise ukuthi umdlavuza ususabalale kangakanani. Inqubo esetshenziselwa ukuthola ukuthi amangqamuzana omdlavuza asakaze ngaphandle kwesistimu ye-lymph ibizwa ngokuthi yi-staging. Ukuhlela ukwelashwa, kubalulekile ukwazi ukuthi umdlavuza ususabalele yini kwezinye izingxenye zomzimba.

Lezi zivivinyo nezinqubo zingafaka okulandelayo:

• Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye 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 yegazi 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 ezikhishelwe egazini, kufaka phakathi i-albhamuin, ngezitho nezicubu emzimbeni. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• 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. Izinga eliphakeme kune-sedimentation elingaphezulu kungaba uphawu lwe-lymphoma. Futhi ibizwa ngokuthi yi-erythrocyte sedimentation rate, sed rate, noma i-ESR.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, ezifana nentamo, isifuba, isisu, noma ukhalo, ezithathwe 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.

Iskena se-computed tomography (CT) sesisu. Ingane ilele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray zangaphakathi kwesisu.

• 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. Kwesinye isikhathi kwenziwa i-PET scan ne-CT scan ngasikhathi sinye. Uma kukhona umdlavuza, lokhu kwandisa amathuba okuthi utholakale.

Ukuskena kwePositron emission tomography (PET). Ingane ilele phezu kwetafula elishibilika ngesithwebuli se-PET. Ukuphumula kwekhanda nomucu omhlophe kusiza ingane ukuba ilele inganyakazi. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni wengane, futhi isithwebuli senza isithombe sokuthi i-glucose isetshenziswa kuphi emzimbeni. Amaseli womdlavuza avela ngokugqamile esithombeni ngoba athatha i-glucose eningi kunamaseli avamile.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengama-lymph node. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

I-Magnetic resonance imaging (MRI) yesisu. Ingane ilele etafuleni elingena kuskena seMRI, esithwebula izithombe zangaphakathi komzimba. Iphedi esiswini sengane isiza ukwenza izithombe zicace bha.

• I-x-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha kanye nocezu oluncane lwethambo ngokufaka inaliti engenalutho ethangeni noma ethangeni lesifuba. Isazi sezifo sibheka umnkantsha wethambo namathambo ngaphansi kwemicroscope ukubheka amaseli angajwayelekile. Ukufiswa komnkantsha we-Bone kanye ne-biopsy kwenzelwa iziguli ezinesifo esithuthukile kanye / noma izimpawu ze-B.

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

• I-lymph node biopsy: Ukususwa kwako konke noma ingxenye yelungu elilodwa noma amaningi e-lymph node. I-lymph node ingasuswa ngesikhathi sokuhlolwa kwe-CT okuqondiswa isithombe noma i-thoracoscopy, mediastinoscopy, noma i-laparoscopy. 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.

Isazi sezifo sibheka izicubu ze-lymph node ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza abizwa ngokuthi amaseli e-Reed-Sternberg. Amaseli omhlanga-Sternberg ajwayelekile ku-Hodgkin lymphoma yakudala.

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 ..

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza (ubukhulu bomdlavuza nokuthi umdlavuza ususakazeke ngaphansi kwesifafazi noma eqenjini elingaphezu kwelilodwa lama-lymph node).

• Usayizi wesimila.

• Noma ngabe kunezimpawu ze-B (umkhuhlane ngaphandle kwesizathu esaziwayo, ukwehla kwesisindo ngaphandle kwesizathu esaziwayo, noma ukucwilisa ukujuluka ebusuku) ekuxilongweni.

• Uhlobo lweHodgkin lymphoma.

• Izici ezithile zamaseli womdlavuza.

• Ukuba nenani elingaphezu kwenani elijwayelekile lamaseli amhlophe egazi noma i-anemia ngesikhathi sokuxilongwa.

• Ukuthi kukhona yini uketshezi oluzungeze inhliziyo noma amaphaphu ekuxilongweni.

• Isilinganiso sedimentation noma i-albumin level egazini.

• Umdlavuza uphendula kahle kanjani ekwelashweni kokuqala ngamakhemikhali.

• Ubulili bengane.

• Noma ngabe umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izinketho zokwelashwa zincike naku:

• Noma ngabe kunengozi ephansi, ephakathi, noma ephezulu umdlavuza uzobuya ngemuva kokwelashwa.

• Iminyaka yengane.

• Ubungozi bemiphumela emibi yesikhathi eside.

Iningi lezingane kanye nentsha ene-Hodgkin lymphoma esanda kutholakala ingelashwa.

Izigaba Zobuntwana Hodgkin Lymphoma

AMAPHUZU ASEMQOKA

• Ngemuva kokutholwa kwengane iHodgkin lymphoma, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kohlelo lwe-lymph noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Lezi zigaba ezilandelayo zisetshenziselwa ubuntwana beHodgkin lymphoma:

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Ngaphezu kwenombolo yesiteji, izinhlamvu A, B, E, noma S zingabonakala.

• I-Hodgkin lymphoma yobuntwana iphathwa ngokwamaqembu anobungozi.

Ngemuva kokutholwa kwengane iHodgkin lymphoma, 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. 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 ubuntwana beHodgkin lymphoma:

Isiteji I

Isigaba I ebuntwaneni Hodgkin lymphoma. Umdlavuza utholakala ku-lymph node eyodwa noma amaningi eqenjini elilodwa le-lymph node. Esigabeni IE (asikhonjisiwe), umdlavuza utholakala ngaphandle kwama-lymph node esithombeni noma endaweni eyodwa.

Isigaba I sihlukaniswe isigaba sokuqala mina nesigaba IE.

• Isigaba I: Umdlavuza utholakala kwenye yezindawo ezilandelayo ohlelweni lwe-lymph:

• I-lymph node eyodwa noma ngaphezulu eqenjini elilodwa le-lymph node.

• Indandatho kaWaldeyer.

• Thymus.

• vuma.

• I-Stage IE: Umdlavuza utholakala ngaphandle kwe-lymph system esithweni esisodwa noma endaweni eyodwa.

Isigaba II

Isigaba II sihlukaniswe isigaba II nesigaba IIE.

• Isigaba II: Umdlavuza utholakala ngamaqembu ama-lymph node amabili noma ngaphezulu ngenhla noma ngaphansi kwesifafazi (umsipha omncane ngaphansi kwamaphaphu osiza ukuphefumula nokwehlukanisa isifuba esiswini).

Isigaba II sobuntwana iHodgkin lymphoma. Umdlavuza utholakala ngamaqembu ama-lymph node amabili noma ngaphezulu, futhi womabili angaphezulu (a) noma ngezansi (b) i-diaphragm.

• Isigaba IIE: Umdlavuza utholakala eqenjini elilodwa noma amaningi e-lymph node ngenhla noma ngaphansi kwesifafazi nangaphandle kwama-lymph node esithweni esiseduzane noma endaweni.

Isigaba IIE ebuntwaneni iHodgkin lymphoma. Umdlavuza utholakala eqenjini elilodwa noma amaningi e-lymph node ngenhla noma ngaphansi kwesifafazi nangaphandle kwama-lymph node esithombeni esiseduze noma endaweni (a).

Isigaba III

Isigaba III sobuntwana iHodgkin lymphoma. Umdlavuza utholakala eqenjini elilodwa noma amaningi e-lymph node ngenhla nangaphansi kwe-diaphragm (a). Esigabeni IIIE, umdlavuza utholakala emaqenjini ama-lymph node ngenhla nangaphansi kwe-diaphragm nangaphandle kwama-lymph node esithombeni esiseduze noma endaweni (b). Esigabeni IIIS, umdlavuza utholakala kumaqembu e-lymph node ngenhla nangaphansi kwe-diaphragm (a) nasesiphaleni (c). Esigabeni IIIS kanye no-E, umdlavuza utholakala emaqenjini ama-lymph node ngenhla nangaphansi kwesifafula, ngaphandle kwama-lymph node esithombeni esiseduze noma endaweni (b), nasespeleni (c).

Isigaba III sihlukaniswe isigaba III, isigaba IIIE, isigaba IIIS, nesigaba IIIE, S.

• Isigaba III: Umdlavuza utholakala emaqenjini ama-lymph node ngenhla nangaphansi kwe-diaphragm (umsipha omncane ngaphansi kwamaphaphu osiza ukuphefumula nokwehlukanisa isifuba esiswini).

• Isigaba IIIE: Umdlavuza utholakala emaqenjini ama-lymph node ngenhla nangaphansi kwesifafazi nangaphandle kwama-lymph node esithweni esiseduzane noma endaweni.

• Isigaba IIIS: I-Cancer itholakala emaqenjini ama-lymph node ngaphezulu nangaphansi kwe-diaphragm, nasesipilini.

• Isigaba IIIE, S: I-Cancer itholakala emaqenjini ama-lymph node ngenhla nangaphansi kwe-diaphragm, ngaphandle kwama-lymph node esithombeni esiseduze noma endaweni, nasesipilini.

Isigaba IV

Isigaba IV sobuntwana iHodgkin lymphoma. Umdlavuza utholakala ngaphandle kwama-lymph node kuzitho zonke noma ngaphezulu (a); noma ngaphandle kwama-lymph node esithombeni esisodwa futhi usabalalele kuma-lymph node kude kakhulu nalelo lungu (b); noma emaphashini, esibindini noma emnkantsheni wethambo.

Esigabeni IV, umdlavuza:

• itholakala ngaphandle kwama-lymph node kuso sonke isitho esisodwa noma ngaphezulu, futhi ingaba kuma-lymph node eduze kwalezo zitho; noma

• sitholakala ngaphandle kwama-lymph node esithombeni esisodwa futhi sisabalalele ezindaweni ezikude nalelo lungu; noma

• itholakala emaphashini, isibindi, umnkantsha, noma i-cerebrospinal fluid (CSF). Umdlavuza awusabalalanga uye emaphashini, esibindini, emnkantsheni, noma ku-CSF usuka ezindaweni eziseduze.

Ngaphezu kwenombolo yesiteji, izinhlamvu A, B, E, noma S zingabonakala.

Izinhlamvu A, B, E, noma S zingasetshenziselwa ukuqhubeka nokuchaza isigaba sobuntwana iHodgkin lymphoma.

• A: Isiguli asinazo izimpawu ze-B (umkhuhlane, ukwehla kwesisindo, noma ukujuluka ebusuku).

• B: Isiguli sinezimpawu ze-B.

• E: Umdlavuza utholakala esithweni noma esikhunjeni esingeyona ingxenye yohlelo lwe-lymph kodwa okungenzeka ukuthi siseduze nendawo yohlelo lwe-lymph oluthintwa ngumdlavuza.

• S: Umdlavuza utholakala ebuchosheni.

I-Hodgkin lymphoma yobuntwana iphathwa ngokwamaqembu anobungozi.

I-Hodgkin lymphoma ebuntwaneni engalashiwe ihlukaniswe ngamaqembu anobungozi ngokususelwa esiteji, ubukhulu besimila, nokuthi isiguli sinezimpawu ze-B (umkhuhlane, ukwehla kwesisindo, noma ukujuluka ebusuku). Iqembu eliyingozi lichaza ukuthi kungenzeka yini ukuthi iHodgkin lymphoma ingaphenduli ekwelashweni noma ibuye (ibuye) ngemuva kokwelashwa. Isetshenziselwa ukuhlela ukwelashwa kokuqala.

• Ubuntwana obunobungozi obuncane iHodgkin lymphoma.

• Ubuntwana obuphakathi nobungozi beHodgkin lymphoma.

• Ingozi ephezulu yobuntwana iHodgkin lymphoma.

I-Hodgkin lymphoma enobungozi obuphansi idinga ukwelashwa okuncane, imishanguzo embalwa ye-anticancer, kanye nemithamo ephansi yemithi elwa nomdlavuza kune-lymphoma eyingozi kakhulu.

I-Hodgkin Lymphoma Eyinhloko Yokukhomba / Ephindaphindayo Ezinganeni Nasebusheni

I-Hodgkin lymphoma eyinhloko yokuphikisa i-lymphoma eqhubeka ikhula noma isakazeka ngesikhathi sokwelashwa.

I-Hodgkin lymphoma ephindaphindwayo ngumdlavuza obuye wabuya (ubuya) ngemuva kokuphathwa. I-lymphoma ingabuya ohlelweni lwe-lymph noma kwezinye izingxenye zomzimba, njengamaphaphu, isibindi, amathambo noma umnkantsha.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa ezinganeni ezine-Hodgkin lymphoma.

• Izingane ezine-Hodgkin lymphoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza wezingane.

• Ukwelashwa kwengane iHodgkin lymphoma kubangela imiphumela emibi kanye nemiphumela yamuva.

• Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• Ukwelashwa okuhlosiwe

• I-Immunotherapy

• Ukuhlinzwa

• I-chemotherapy ephezulu ene-stem cell transplant

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwemisebe ye-Proton beam

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

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

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa ezinganeni ezine-Hodgkin lymphoma.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezine-Hodgkin lymphoma. Ezinye izindlela zokwelapha zijwayelekile 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.

Ngoba umdlavuza ezinganeni uyivelakancane, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezine-Hodgkin lymphoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza wezingane.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezokunakekelwa kwezempilo abangongoti ekwelapheni izingane ezine-Hodgkin lymphoma futhi ezikhethekile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• I-oncologist yezokwelapha / i-hematologist.

• I-radiation oncologist.

• Umhlengikazi ongumhlengikazi.

• Isazi sokusebenza kwengqondo.

• Usonhlala kahle.

• Ingcweti kwezempilo yengane.

Ukwelashwa kweHodgkin lymphoma ebusheni nasebekhulile abasebasha kungahluka kunokwelashwa kwezingane. Abanye abantu abasha kanye nabantu abadala abancane baphathwa ngemithi yokwelashwa yabantu abadala.

Ukwelashwa kwengane iHodgkin lymphoma kubangela imiphumela emibi kanye nemiphumela yamuva.

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. Ngoba imiphumela yangemva kwesikhathi ithinta impilo nentuthuko, izivivinyo zokulandela njalo zibalulekile.

Imiphumela yamuva yokwelashwa komdlavuza ingafaka okulandelayo:

• Izinkinga zomzimba ezithinta okulandelayo:

• Ukuthuthukiswa kwezitho zobulili nezitho zokuzala.

• Ukuzala (ikhono lokuba nezingane).

• Ukukhula kwamathambo nemisipha nokukhula.

• Umsebenzi wegilo, wenhliziyo noma wamaphaphu.

• Amazinyo, izinsini, kanye nokusebenza kwendlala yamathe.

• Umsebenzi we-Spleen (ingozi eyengeziwe yokutheleleka).

• Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza), njengesifuba, i-thyroid, isikhumba, amaphaphu, isisu noma i-colorectal.

Kwabesifazane abasinda eHodgkin lymphoma, kunengozi eyengeziwe yomdlavuza webele. Le ngozi incike enanini lemisebe esifubeni etholwe ngesikhathi sokwelashwa kanye nohlobo lwemithi yokwelapha ngamakhemikhali esetshenzisiwe. Ingozi yomdlavuza webele iyancipha uma kunikezwa imisebe kuma-ovari nayo yanikezwa.

Kuphakanyiswa ukuthi abasindile besifazane abathole ukwelashwa ngemisebe esifubeni bane-mammogram ne-MRI kanye ngonyaka eqala eminyakeni engu-8 ngemuva kokwelashwa noma eneminyaka engama-25, noma ikuphi kamuva. Kuphakanyiswa nokuthi abasindile besifazane bazihlolele amabele njalo ngenyanga kusukela ekuqaleni kokuthomba futhi bahlolwe ibele ngudokotela wezempilo njalo ngonyaka kusukela ekuthomeni kuze kube yiminyaka engama-25.

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela engaba khona sekwephuzile ebangelwe ukwelashwa okuthile. (Bheka isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Izinhlobo eziyisithupha zokwelashwa okujwayelekile 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 eqenjini eliyingozi. Isibonelo, izingane ezine-Hodgkin lymphoma ezinobungozi obuphansi zithola imishanguzo embalwa yokwelashwa, imishanguzo embalwa ye-anticancer, kanye nemithamo ephansi yezidakamizwa ze-anticancer kunezingane ezine-lymphoma ephezulu.

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. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni. Izindlela ezithile zokunikeza ukwelashwa ngemisebe kungasiza ukugcina imisebe ekulimaleni izicubu ezinempilo eziseduze. Lezi zinhlobo zokwelashwa ngemisebe yangaphandle zifaka okulandelayo:

• Ukwelashwa kwemisebe eguquguqukayo: Ukwelashwa kwemisebe eguquguqukayo kuwuhlobo lokwelashwa kwemisebe yangaphandle okusebenzisa ikhompyutha ukwenza isithombe esingu-3-dimensional (3-D) sesimila futhi kulolonge imishayo yemisebe ukuze ilingane nalesi sifo.

• Ukwelashwa kwemisebe ye-intension-modulated (IMRT): I-IMRT uhlobo lokwelashwa kwemisebe ka-3-dimensional (3-D) esebenzisa ikhompyutha ukwenza izithombe zosayizi nokuma kwesimila. Imishayo emincane yemisebe yamandla ahlukene (amandla) ihloselwe isimila ezinhlangothini eziningi.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Ukwelashwa ngemisebe kunganikezwa, ngokuya ngeqembu lengcuphe yengane kanye nohlobo lwemithi yokwelashwa ngamakhemikhali. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha iHodgkin lymphoma yobuntwana. Imisebe inikezwa kuphela ama-lymph node noma ezinye izindawo ezinomdlavuza. Ukwelashwa kwemisebe kwangaphakathi akusetshenziswanga ukwelapha iHodgkin lymphoma.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Izinhlobo zokwelashwa okuhlosiwe zifaka okulandelayo:

• Ukwelashwa kwe-monoclonal antibody: Ukwelashwa kwe-monoclonal antibody ukwelashwa komdlavuza okusebenzisa amasosha omzimba enziwe elabhoratri avela 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-Rituximab noma i-brentuximab ingasetshenziselwa ukwelapha iHodgkin lymphoma ebuntwaneni ephikisayo noma ephindaphindayo.

• Ukwelashwa kwe-Proteasome inhibitor: Ukwelashwa kwe-Proteasome inhibitor luhlobo lwezokwelapha ezihlosiwe ezivimbela ukwenziwa 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 iyi-inhibitor ye-proteasome esetshenziselwa ukwelapha i-Hodgkin lymphoma ebuntwaneni ephikisayo noma ephindaphindayo.

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 yi-biologic therapy noma i-biotherapy. Izinhlobo ze-immunotherapy zifaka okulandelayo:

• I-immune checkpoint inhibitor: Ama-PD-1 inhibitors awuhlobo lwe-immune checkpoint inhibitor therapy. I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. 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-Pembrolizumab iyi-PD-1 inhibitor engasetshenziswa ekwelapheni i-Hodgkin lymphoma yobuntwana ebuye ngemuva kokwelashwa. Amanye ama-PD-1 inhibitors, kufaka phakathi i-atezolizumab ne-nivolumab, afundwa ekwelapheni i-Hodgkin lymphoma yobuntwana ebuyile ngemuva kokwelashwa.

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).

Ukuhlinzwa

Ukuhlinzwa kungenziwa ukuze kususwe isimila esiningi ngangokunokwenzeka kwi-Hodgkin lymphoma ebuntwaneni eyaziwa kakhulu nge-nodular lymphocyte.

I-chemotherapy ephezulu ene-stem cell transplant

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 i-chemotherapy, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

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.

Ukwelashwa kwemisebe ye-Proton beam

Ukwelashwa kweProton-beam uhlobo lwamandla amakhulu, ukwelashwa kwemisebe yangaphandle okusebenzisa imifudlana yama-proton (izinhlayiya ezincane, ezikhokhiswa kahle zendaba) ukwenza imisebe. Lolu hlobo lokwelashwa ngemisebe lungasiza ekunciphiseni ukulimala kwezicubu ezinempilo eduze kwesimila, njengesifuba, inhliziyo namaphaphu.

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 sengane yakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Ezigulini ezithola i-chemotherapy iyodwa, ukuskena kwe-PET kungenziwa amasonto ama-3 noma ngaphezulu ngemuva kokuphela kokwelashwa. Ezigulini ezithola ukwelashwa ngemisebe okokugcina, ukuskena kwe-PET akufanele kwenziwe kuze kube amasonto ayi-8 kuya kwayi-12 ngemuva kokuphela kokwelashwa.

Izinketho Zokwelapha Zezingane Nezintsha Ezine-Hodgkin Lymphoma

Kulesi Sigaba

• Ingozi Ephansi Yobuntwana Hodgkin Lymphoma

• Intermediate-Risk Classic Ingane Hodgkin Lymphoma

• IHodgkin Lymphoma Yobuntwana Obusezingeni Eliphezulu

• I-Nodular Lymphocyte-Predominant Childhood Hodgkin Lymphoma

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

Ingozi Ephansi Yobuntwana Hodgkin Lymphoma

Ukwelashwa kwe-Hodgkin lymphoma engozini ephansi ezinganeni kungafaka okulandelayo:

• Inhlanganisela chemotherapy.

• Ukwelashwa ngemisebe nakho kunganikezwa ezindaweni ezinomdlavuza.

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.

Intermediate-Risk Classic Ingane Hodgkin Lymphoma

Ukwelashwa kwe-Hodgkin lymphoma yakudala engozini ezinganeni kungabandakanya okulandelayo:

• Inhlanganisela chemotherapy.

• Ukwelashwa ngemisebe nakho kunganikezwa ezindaweni ezinomdlavuza.

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.

IHodgkin Lymphoma Yobuntwana Obusezingeni Eliphezulu

Ukwelashwa kwe-Hodgkin lymphoma eyingozi kakhulu ezinganeni kungafaka okulandelayo:

• Inhlanganisela yamakhemikhali ephakeme.

• Ukwelashwa ngemisebe nakho kunganikezwa ezindaweni ezinomdlavuza.

• Isivivinyo somtholampilo sokwelapha okuhlosiwe (i-brentuximab) kanye nenhlanganisela yamakhemikhali. Ukwelashwa ngemisebe nakho kunganikezwa ezindaweni ezinomdlavuza.

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.

I-Nodular Lymphocyte-Predominant Childhood Hodgkin Lymphoma

Ukwelashwa kwe-nodular lymphocyte-evelele ebuntwaneni iHodgkin lymphoma kungafaka okulandelayo:

• Ukuhlinzwa, uma isimila singasuswa ngokuphelele.

• I-Chemotherapy noma engenawo umthamo ophansi wemithi yokwelashwa ngemisebe.

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 KweHymgkin Lymphoma Eyinhloko Yokukhomba / Yezikhathi Eziphindayo Ezinganeni Nasebusheni

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

Ukwelashwa kwe-Hodgkin lymphoma eyinhloko yengane yokuqala ephikisayo noma ephindaphindwayo ingafaka okulandelayo:

• I-Chemotherapy, ukwelashwa okuhlosiwe (i-rituximab, i-brentuximab, noma i-bortezomib), noma zombili lezi zindlela zokwelapha.

I-Immunotherapy (pembrolizumab).

• Ukwelashwa ngamakhemikhali okuphezulu nge-stem cell ukufakelwa kusetshenziswa ama-stem cell wesiguli. I-monoclonal antibody therapy (brentuximab) nayo inganikezwa.

• Ukwelashwa ngemisebe kunganikezwa ngemuva kokufakelwa kwe-stem cell kusetshenziswa amaseli we-stem wesiguli noma uma umdlavuza ungaphendulanga kwezinye izindlela zokwelapha futhi indawo enomdlavuza ayikaze yelashwe phambilini.

• Ukwelashwa ngamakhemikhali okuphezulu nge-stem cell transplant kusetshenziswa ama-stem cell womnikeli.

• Isivivinyo somtholampilo se-immunotherapy (nivolumab, pembrolizumab, noma i-atezolizumab).

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.

Ukufunda Kabanzi Nge-Childhood Hodgkin Lymphoma

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nengane iHodgkin lymphoma, bheka okulandelayo:

• I-Computed Tomography (CT) Iskena Nomdlavuza

• Izidakamizwa zivunyelwe iHodgkin Lymphoma

• Izindlela Zokwelapha Zomdlavuza

• Ukufakelwa Kwama-Stem Cell Stem

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile, bheka okulandelayo:

• Mayelana Nomdlavuza

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli