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I-Mycosis Fungoides (Kubandakanya i-Sézary Syndrome) Ukwelashwa (®) -Patient Version

Imininingwane ejwayelekile Mayelana neMycosis Fungoides (Kubandakanya iSézary Syndrome)

AMAPHUZU ASEMQOKA

• I-Mycosis fungoides ne-Sézary syndrome yizifo lapho i-lymphocyte (uhlobo lweseli elimhlophe) iba yingozi (umdlavuza) futhi ithinte isikhumba.

• I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ze-T-cell lymphoma enqunyiwe.

• Uphawu lwe-mycosis fungoides ukuqubuka okubomvu esikhunjeni.

• Ku-Sézary syndrome, ama-T-cell anomdlavuza atholakala egazini.

• Ukuhlolwa okuhlola isikhumba negazi kusetshenziselwa ukuxilonga i-mycosis fungoides ne-Sézary syndrome.

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

I-Mycosis fungoides ne-Sézary syndrome yizifo lapho i-lymphocyte (uhlobo lweseli elimhlophe) iba yingozi (umdlavuza) futhi ithinte isikhumba.

Imvamisa, umnkantsha wenza amangqamuzana egazi (amangqamuzana angavuthiwe) aphenduka amaseli egazi avuthiwe ngokuhamba kwesikhathi. Iseli lesiqu segazi lingahle libe iseli le-myeloid noma iseli le-lymphoid stem. Iseli lesiqu se-myeloid liba yiseli elibomvu, iseli elimhlophe, noma iplatelet. Iseli lesiqu le-lymphoid liba yi-lymphoblast bese kuba olunye lwezinhlobo ezintathu zama-lymphocyte (amaseli amhlophe egazi):

• Ama-lymphocyte e-B enza amasosha omzimba ukusiza ukulwa nokutheleleka.

• Ama-lymphocyte angama-T asiza ama-B-lymphocyte enza amasosha omzimba asiza ukulwa nokutheleleka.

• Amaseli okubulala wemvelo ahlasela amangqamuzana omdlavuza namagciwane.

Ukuthuthukiswa kwamangqamuzana egazi. Iseli lesiqu segazi lidlula ezinyathelweni eziningana ukuze libe yiseli elibomvu, iplatelet, noma iseli elimhlophe.

Ku-mycosis fungoides, ama-T-cell lymphocyte aba nomdlavuza futhi athinte isikhumba. Lapho la ma-lymphocyte evela egazini, abizwa ngokuthi amaseli weSézary. Ku-Sézary syndrome, ama-lymphocyte anomdlavuza we-T-cell athinta isikhumba futhi izinombolo ezinkulu zamaseli we-Sézary zitholakala egazini.

I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ze-T-cell lymphoma enqunyiwe.

I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ezimbili ezivame kakhulu ze-T-cell lymphoma (uhlobo lwe-non-Hodgkin lymphoma). Ngemininingwane mayelana nezinye izinhlobo zomdlavuza wesikhumba noma i-non-Hodgkin lymphoma, bheka izifinyezo ezilandelayo ze-:

• Ukwelashwa Kwe-Adult Non-Hodgkin Lymphoma

• Ukwelashwa Komdlavuza Wesikhumba

• Ukwelashwa Kwe-Melanoma

• Ukwelashwa kweKaposi Sarcoma

Uphawu lwe-mycosis fungoides ukuqubuka okubomvu esikhunjeni.

I-Mycosis fungoides ingahle idlule kulezi zigaba ezilandelayo:

• Isigaba se-premycotic: Ukuqhuma okubomvu, okubomvu ezindaweni zomzimba okuvame ukungatholakali elangeni. Lokhu kuqhuma akubangeli zimpawu futhi kungahlala izinyanga noma iminyaka. Kunzima ukuxilonga ukuqubuka njenge-mycosis fungoides phakathi nalesi sigaba.

• Isigaba sesigaba: Ukuqhuma, okubomvu, ukuqubuka okufana ne-eczema.

• Isigaba seplaque: Amaqhubu amancane aphakanyisiwe (ama-papules) noma izilonda eziqinile esikhunjeni, ezingabomvu.

• Isigaba sesimila: Ifomu lesimila esikhunjeni. Lezi zicubu zingaba nezilonda bese isikhumba sitheleleka.

Buza udokotela wakho uma unanoma iyiphi yalezi zimpawu.

Ku-Sézary syndrome, ama-T-cell anomdlavuza atholakala egazini.

Futhi, isikhumba emzimbeni wonke sibomvu, siyaluma, siyaxobuka futhi sibuhlungu. Kungase kube khona nezimagqabhagqabha, izingcwecwe noma izicubu esikhunjeni. Akwaziwa ukuthi iSézary syndrome ifomu eliphambili le-mycosis fungoides noma isifo esihlukile.

Ukuhlolwa okuhlola isikhumba negazi kusetshenziselwa ukuxilonga i-mycosis fungoides ne-Sézary syndrome.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa, inombolo nohlobo lwezilonda zesikhumba, noma yini enye ebonakala ingajwayelekile. Izithombe zesikhumba nomlando wemikhuba yempilo yesiguli * kanye nokugula okwedlule kanye nokwelashwa nakho kuzothathwa.

• Gcwalisa ukubalwa kwegazi ngokuhluka: Inqubo lapho kukhishwa khona isampula legazi futhi lihlolwe lokhu okulandelayo:

• Inani lamaseli abomvu nama-platelets.

• Inombolo nohlobo lwamaseli amhlophe egazi.

• 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.

• Isibalo samaseli egazi le-Sézary: Inqubo lapho isampula yegazi ibukwa khona ngaphansi kwesibonakhulu ukubala inani lamaseli we-Sézary.

• 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.

• Skin biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ukuhlola izimpawu zomdlavuza. Udokotela angasusa ukukhula esikhunjeni, okuzohlolwa ngudokotela wezifo. Kungadingeka okungaphezu kwesisodwa i-biopsy yesikhumba ukuthola i-mycosis fungoides. Olunye uvivinyo olungenziwa kumaseli noma kwisampula lezicubu lubandakanya okulandelayo:

• 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.

• Flow cytometry: Isivivinyo selabhorethri esikala inani lamaseli esampula, iphesenti lamaseli aphilayo kusampula, nezici ezithile zamaseli, njengosayizi, umumo, nokuba khona komaka be-tumor (noma okunye) ubuso beseli. Amaseli avela kusampula yegazi lesiguli, umnkantsha, noma ezinye izicubu anamabala ombala we-fluorescent, afakwa kuketshezi, abese edluliswa ngalinye ngesikhathi emgqeni wokukhanya. Imiphumela yokuhlolwa isuselwa ekutheni amangqamuzana abenebala lodayi we-fluorescent asabela kanjani oshalweni lokukhanya. Lokhu kuhlolwa kusetshenziselwa ukuxilonga nokuphatha izinhlobo ezithile zomdlavuza, njenge-leukemia ne-lymphoma.

• Ukuhlolwa kokuhlelwa kabusha kofuzo kwe-T-cell receptor (TCR): Ukuhlolwa kwelabhorethri lapho kuhlolwe khona amaseli esampula yegazi noma umnkantsha ukuze kubonwe uma ngabe kukhona ushintsho oluthile kuzakhi zofuzo ezenza ama-receptors kuma-T cell (amaseli amhlophe egazi). Ukuhlolelwa lezi zinguquko zofuzo kungatshela ukuthi kwenziwa yini amanani amakhulu amaseli we-T ane-T-cell receptor ethile.

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

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza.

• Uhlobo lwesilonda (ama-patches, ama-plaque, noma izicubu).

• Iminyaka yesiguli nobulili.

I-Mycosis fungoides ne-Sézary syndrome kunzima ukuyelapha. Ukwelashwa kuvame ukuthambisa, ukunciphisa izimpawu nokuthuthukisa ikhwalithi yempilo. Iziguli ezinesifo sokuqala zingaphila iminyaka eminingi.

Izigaba zeMycosis Fungoides (Kubandakanya iSézary Syndrome)

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwe-mycosis fungoides ne-Sézary syndrome, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asabalale esikhumbeni aya kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa i-mycosis fungoides ne-Sézary syndrome:

• Isigaba I Mycosis Fungoides

• Isigaba II Mycosis Fungoides

• Isigaba III Mycosis Fungoides

• Isigaba IV Mycosis Fungoides / Sézary Syndrome

Ngemuva kokutholakala kwe-mycosis fungoides ne-Sézary syndrome, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asabalale esikhumbeni aya kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza ususakazekile yini esikhumbeni uye kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa.

Izinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• 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.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, ezinjengama-lymph node, isifuba, isisu, ne-pelvis, 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.

• 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.

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

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

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.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba. Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma i-mycosis fungoides isakazekela esibindi, amaseli omdlavuza wesibindi empeleni angamaseli e-mycosis fungoides. Lesi sifo yi-metastatic mycosis fungoides, hhayi umdlavuza wesibindi.

Lezi zigaba ezilandelayo zisetshenziselwa i-mycosis fungoides ne-Sézary syndrome:

Isigaba I Mycosis Fungoides

Isigaba I sihlukaniswe ngezigaba IA ne-IB ngokulandelayo:

• I-Stage IA: Ama-patches, ama-papules, kanye / noma ama-plaque ahlanganisa ngaphansi kuka-10% wesikhumba.

• Isigaba IB: Ama-Patches, ama-papules, kanye / noma ama-plaque ahlanganisa u-10% noma ngaphezulu kwesikhumba.

• Kungaba nenani eliphansi lamaseli we-Sézary egazini.

Isigaba II Mycosis Fungoides

Isigaba II sihlukaniswe ngezigaba IIA no-IIB ngokulandelayo:

• Isigaba IIA: Ama-patches, ama-papules, kanye / noma ama-plaque ahlanganisa noma yiliphi inani lesikhumba. Ama-lymph node awajwayelekile, kepha awanomdlavuza.

• Isigaba IIB: Isigaxa esisodwa noma ngaphezulu esingamasentimitha ayi-1 noma sikhulu sitholakala esikhunjeni. Ama-lymph node angahle abe angajwayelekile, kepha awawona umdlavuza.

Kungaba nenani eliphansi lamaseli we-Sézary egazini.

Isigaba III Mycosis Fungoides

Esigabeni III, u-80% noma ngaphezulu wesikhumba ubomvu futhi ungaba nama-patches, ama-papules, ama-plaque noma izicubu. Ama-lymph node angahle abe angajwayelekile, kepha awawona umdlavuza.

Kungaba nenani eliphansi lamaseli we-Sézary egazini.

Isigaba IV Mycosis Fungoides / Sézary Syndrome

Lapho kunenani eliphakeme lamaseli we-Sézary egazini, lesi sifo sibizwa nge-Sézary syndrome.

Isigaba IV sihlukaniswe ngezigaba IVA1, IVA2, ne-IVB ngokulandelayo:

• Isigaba IVA1: Ama-patches, ama-papules, ama-plaque, noma izicubu zingamboza noma yiliphi inani lesikhumba, futhi u-80% noma ngaphezulu wesikhumba ungabomvu. Ama-lymph node angahle abe angajwayelekile, kepha awawona umdlavuza. Kunenombolo ephezulu yamaseli we-Sézary egazini.

• Isigaba IVA2: Ama-patches, ama-papules, ama-plaque, noma izicubu zingamboza noma yiliphi inani lesikhumba, futhi u-80% noma ngaphezulu wesikhumba ungabomvu. Ama-lymph node ajwayelekile kakhulu, noma umdlavuza wakhekile kuma-lymph node. Kungaba nenani eliphezulu lamaseli we-Sézary egazini.

• Isigaba IVB: Umdlavuza usabalalele kwezinye izitho zomzimba, njengobende noma isibindi. Amachashazi, ama-papules, ama-plaque, noma izicubu zingamboza noma yiliphi inani lesikhumba, futhi u-80% noma ngaphezulu wesikhumba ungabomvu. Ama-lymph node kungenzeka angajwayelekile noma abe nomdlavuza. Kungaba nenani eliphezulu lamaseli we-Sézary egazini.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-mycosis fungoides nomdlavuza weSezar syndrome.

• Izinhlobo eziyisikhombisa zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa kwe-Photodynamic

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Olunye ukwelashwa kwezidakamizwa

• I-Immunotherapy

• Ukwelashwa okuhlosiwe

• I-chemotherapy ephezulu kanye nokwelashwa ngemisebe nge-stem cell transplant

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwe-mycosis fungoides ne-Sézary syndrome kungadala imiphumela emibi.

• 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-mycosis fungoides nomdlavuza weSezar syndrome.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-mycosis fungoides ne-Sézary syndrome. 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 zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo eziyisikhombisa zokwelashwa okujwayelekile zisetshenzisiwe:

Ukwelashwa kwe-Photodynamic

Ukwelashwa kwe-Photodynamic ukwelashwa komdlavuza okusebenzisa umuthi nohlobo oluthile lwe-laser light ukubulala amaseli womdlavuza. Umuthi ongasebenzi kuze kube yilapho uvezwa ukukhanya ufakwa emthanjeni. Umuthi uqoqa okuningi kumaseli womdlavuza kunamaseli ajwayelekile. Ngomdlavuza wesikhumba, ukukhanya kwe-laser kukhanya esikhunjeni futhi umuthi uyasebenza bese ubulala amangqamuzana omdlavuza. Ukwelashwa kwe-Photodynamic kubangela ukulimala okuncane kwezicubu ezinempilo. Iziguli ezithola ukwelashwa kwe-photodynamic kuzodinga ukunciphisa isikhathi esichithwa elangeni. Kunezinhlobo ezahlukahlukene zokwelashwa kwe-photodynamic:

• Ekwelashweni kwe-psoralen ne-ultraviolet A (PUVA), isiguli sithola umuthi obizwa ngokuthi i-psoralen bese kuthi imisebe ye-ultraviolet A iqondiswe esikhunjeni.

• E-extracorporeal photochemotherapy, isiguli sinikezwa imishanguzo bese amanye amangqamuzana egazi ethathwa emzimbeni, afakwe ngaphansi kwelambu elikhethekile le-ultraviolet A, bese elibuyiselwa emzimbeni. I-Extracorporeal photochemotherapy ingasetshenziswa yodwa noma ihlanganiswe nokwelashwa kwemisebe yesikhumba esiphelele (TSEB).

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, ukwelashwa kwemisebe yesikhumba esiphelele (TSEB) kusetshenziselwa ukwelapha i-mycosis fungoides ne-Sézary syndrome. Lolu wuhlobo lokwelashwa kwemisebe yangaphandle lapho umshini wokwelapha ngemisebe uhlose ama-electron (amancane, izinhlayiya ezingabonakali) esikhunjeni esimboze umzimba wonke. Ukwelashwa kwemisebe yangaphandle kungasetshenziswa njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ukwelashwa ngemisebe ye-Ultraviolet A (UVA) noma i-ultraviolet B (UVB) radiation kunganikezwa kusetshenziswa isibani esikhethekile noma i-laser eqondisa imisebe esikhumbeni.

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). Kwesinye isikhathi i-chemotherapy i-topical (faka isikhumba kukhilimu, i-lotion, noma amafutha).

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane. (I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ze-non-Hodgkin lymphoma.)

Olunye ukwelashwa kwezidakamizwa

Kusetshenziswa ama-corticosteroids ama-topical ukukhulula isikhumba esibomvu, esivuvukile nesivuthayo. Luhlobo lwe-steroid. Ama-corticosteroids aphezulu angaba kukhilimu, i-lotion, noma amafutha.

Ama-retinoid, njenge-bexarotene, yizidakamizwa ezihlobene novithamini A onganciphisa ukukhula kwezinhlobo ezithile zamaseli womdlavuza. Ama-retinoid angathathwa ngomlomo noma afakwe esikhunjeni.

ILenalidomide isidakamizwa esisiza amasosha omzimba abulale amangqamuzana egazi angajwayelekile noma amangqamuzana omdlavuza futhi angavimbela ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule.

IVorinostat ne-romidepsin yizona ezimbili ze-histone deacetylase (HDAC) inhibitors ezisetshenziselwa ukwelapha i-mycosis fungoides ne-Sézary syndrome. Ama-HDAC inhibitors abangela ushintsho lwamakhemikhali oluvimba amangqamuzana e-tumor ekuhlukaniseni.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane. (I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ze-non-Hodgkin lymphoma.)

I-Immunotherapy

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

• I-Interferon: Lokhu kwelashwa kuphazamisa ukuhlukaniswa kwama-mycosis fungoides namaseli weSézary futhi kunganciphisa ukukhula kwesimila.

Bheka Izidakamizwa Kuvunyelwe i-Non-Hodgkin Lymphoma ukuthola eminye imininingwane. (I-Mycosis fungoides ne-Sézary syndrome yizinhlobo ze-non-Hodgkin lymphoma.)

Ukwelashwa okuhlosiwe

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

• Ukwelashwa kwe-monoclonal antibody: Le ndlela yokwelapha isebenzisa amasosha omzimba enziwe elabhoratri avela ohlotsheni olulodwa lweseli lomzimba. 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-Brentuximab vedotin, equkethe i-anti-monoclonal antibody ebopha iphrotheni, ebizwa nge-CD30, etholakala kwezinye izinhlobo zamaseli e-lymphoma. Iqukethe nomuthi olwa nomdlavuza ongasiza ekubulaleni amangqamuzana omdlavuza.

• IMogamulizumab, equkethe i-anti-monoclonal antibody ebopha iphrotheni, ebizwa ngeCCR4, etholakala kwezinye izinhlobo zamaseli e-lymphoma. Kungavimba le protein futhi kusize amasosha omzimba abulale amangqamuzana omdlavuza. Isetshenziselwa ukwelapha i-mycosis fungoides ne-Sézary syndrome ebuyile noma engazange ibe ngcono ngemuva kokwelashwa okungenani nge-systemic therapy eyodwa.

I-chemotherapy ephezulu kanye nokwelashwa ngemisebe nge-stem cell transplant

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

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa kwe-mycosis fungoides ne-Sézary syndrome kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

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 kweSigaba I kanye neSigaba II i-Mycosis Fungoides

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

Ukwelashwa kwesigaba esanda kutholakala I nesigaba II i-mycosis fungoides kungafaka okulandelayo:

• Ukwelashwa kwemisebe ye-Psoralen ne-ultraviolet A (PUVA).

• Ukwelashwa kwemisebe ye-Ultraviolet B.

• Ukwelashwa ngemisebe ngemithi yokwelashwa ngemisebe yesikhumba esewonke. Kwezinye izimo, ukwelashwa ngemisebe kunikezwa izilonda zesikhumba, njengokwelashwa okunciphisayo ukunciphisa usayizi wesimila ukuze kudambise izimpawu futhi kuthuthukise ikhwalithi yempilo.

• I-Immunotherapy enikezwa yodwa noma ihlanganiswe nokwelashwa okuqondiswe esikhunjeni.

• I-topical chemotherapy.

• I-chemotherapy yesistimu ngomuthi owodwa noma ngaphezulu, engahlanganiswa nokwelashwa okuqondiswe esikhunjeni.

• Olunye ukwelashwa kwezidakamizwa (i-topical corticosteroids, i-retinoid therapy, i-lenalidomide, i-histone deacetylase inhibitors).

• Ukwelashwa okuhlosiwe (i-brentuximab vedotin).

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.

Ukwelashwa kweStage III neStage IV Mycosis Fungoides (Kubandakanya iSézary Syndrome)

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

Ukwelashwa kwesigaba III esanda kutholakala kanye nesigaba IV se-mycosis fungoides kufaka phakathi iSezary syndrome kuyadambisa (ukunciphisa izimpawu nokwenza ngcono izinga lempilo) futhi kungafaka okulandelayo:

• Ukwelashwa kwemisebe ye-Psoralen ne-ultraviolet A (PUVA).

• Ukwelashwa kwemisebe ye-Ultraviolet B.

• I-Extracorporeal photochemotherapy enikezwe yodwa noma ihlanganiswe nokwelashwa okuphelele kwemisebe ye-electron beam radiation.

• Ukwelashwa ngemisebe ngemithi yokwelashwa ngemisebe yesikhumba esewonke. Kwezinye izimo, ukwelashwa ngemisebe kunikezwa izilonda zesikhumba, njengokwelashwa okunciphisayo ukunciphisa usayizi wesimila ukuze kudambise izimpawu futhi kuthuthukise ikhwalithi yempilo.

• I-Immunotherapy enikezwa yodwa noma ihlanganiswe nokwelashwa okuqondiswe esikhunjeni.

• I-chemotherapy yesistimu ngomuthi owodwa noma ngaphezulu, engahlanganiswa nokwelashwa okuqondiswe esikhunjeni.

• I-topical chemotherapy.

• Olunye ukwelashwa kwezidakamizwa (i-topical corticosteroids, i-lenalidomide, i-bexarotene, i-histone deacetylase inhibitors).

• Ukwelashwa okubhekiswe ku-brentuximab vedotin.

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.

Ukwelashwa Kwe-Recurrent Mycosis Fungoides (Kubandakanya i-Sézary Syndrome)

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

Ama-mycosis fungoides ne-Sézary syndrome abuye esikhunjeni noma kwezinye izingxenye zomzimba ngemuva kokuba selashwe.

Ukwelashwa kwama-mycosis fungoides aphindaphindiwe kufaka phakathi i-Sézary syndrome kungahle kube ngaphakathi kwesivivinyo somtholampilo futhi kungafaka okulandelayo:

• Ukwelashwa ngemisebe ngemithi yokwelashwa ngemisebe yesikhumba esewonke. Kwezinye izimo, ukwelashwa ngemisebe kunikezwa izilonda zesikhumba njengokwelashwa okunciphisayo ukunciphisa usayizi wesimila ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• I-Psoralen ne-ultraviolet A (PUVA) yokwelapha ngemisebe, enganikezwa nge-immunotherapy.

• Imisebe ye-Ultraviolet B.

• I-Extracorporeal photochemotherapy.

• I-chemotherapy ehlelekile ngomuthi owodwa noma ngaphezulu.

• Olunye ukwelashwa kwezidakamizwa (i-topical corticosteroids, i-retinoid therapy, i-lenalidomide, i-histone deacetylase inhibitors).

• I-Immunotherapy enikezwa yodwa noma ihlanganiswe nokwelashwa okuqondiswe esikhunjeni.

• Ukwelashwa ngamakhemikhali aphezulu, futhi ngezinye izikhathi ukwelashwa ngemisebe, ngokufakelwa kwe-stem cell.

• Ukwelashwa okuhlosiwe (i-brentuximab vedotin noma i-mogamulizumab).

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

To Learn More About Mycosis Fungoides and Sézary Syndrome

For more information from the National Cancer Institute about mycosis fungoides and Sézary syndrome, see the following:

• Lymphoma Home Page

• Photodynamic Therapy for Cancer

• Drugs Approved for Non-Hodgkin Lymphoma

• Immunotherapy to Treat Cancer

• Targeted Cancer Therapies

For general cancer information and other resources from the National Cancer Institute, see the following:

• About Cancer

• Staging

• Chemotherapy and You: Support for People With Cancer

• Radiation Therapy and You: Support for People With Cancer

• Coping with Cancer

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli