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Ukwelashwa kwe-CNS Lymphoma Primary (®) –Patient Version

Imininingwane ejwayelekile Mayelana ne-CNS Primary Lymphoma

AMAPHUZU ASEMQOKA

• Isistimu yezinzwa eyinhloko (CNS) lymphoma yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-lymph zobuchopho kanye / noma umgogodla.

• Ukuba namasosha omzimba abuthakathaka kungakhuphula ubungozi bokuthuthukisa i-CNS lymphoma eyinhloko.

• Izivivinyo ezihlola amehlo, ubuchopho nomgogodla zisetshenziselwa ukuthola (ukuthola) nokuxilonga i-CNS lymphoma eyinhloko.

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

Isistimu yezinzwa eyinhloko (CNS) lymphoma yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-lymph zobuchopho kanye / noma umgogodla.

I-Lymphoma yisifo lapho amangqamuzana amabi (umdlavuza) akha khona ohlelweni lwe-lymph. I-lymph system iyingxenye yamasosha omzimba futhi yakhiwa yi-lymph, imikhumbi ye-lymph, ama-lymph node, ubende, i-thymus, amalaka nomnkantsha wethambo. Ama-lymphocyte (athwalwa ku-lymph) angena futhi aphume ohlelweni lwezinzwa oluphakathi (CNS). Kucatshangwa ukuthi amanye ala ma-lymphocyte aba yingozi futhi abangele ukuthi i-lymphoma yakheke ku-CNS. I-CNS primary lymphoma ingaqala ebuchosheni, emgogodleni, noma kuma-meninges (izingqimba ezakha isembozo sangaphandle sobuchopho). Ngenxa yokuthi iso lisondele kakhulu ebuchosheni, i-CNS lymphoma eyinhloko nayo ingaqala esweni (ebizwa nge-ocular lymphoma).

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.

Ukuba namasosha omzimba abuthakathaka kungakhuphula ubungozi bokuthuthukisa i-CNS lymphoma eyinhloko.

Noma yini eyandisa amathuba akho okuthola 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.

I-CNS primary lymphoma ingavela ezigulini ezitholile i-immunodeficiency syndrome (i-AIDS) noma ezinye izifo zesistimu yomzimba noma ezinokufakelwa kwezinso. Ukuze uthole olunye ulwazi mayelana ne-lymphoma ezigulini ezine-AIDS, bheka isifinyezo se- ku-AIDS-Related Lymphoma Treatment.

Izivivinyo ezihlola amehlo, ubuchopho nomgogodla zisetshenziselwa ukuthola (ukuthola) nokuxilonga i-CNS lymphoma eyinhloko.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ukuhlolwa kwe-Neurological: Uchungechunge lwemibuzo novivinyo lokuhlola ubuchopho, umgogodla nokusebenza kwe-nerve. Isivivinyo sihlola isimo somuntu ngokomqondo, ukusebenzisana, ikhono lokuhamba ngokujwayelekile, nokuthi izicubu, izinzwa, nokucabanga kusebenza kahle kangakanani. Lokhu kungabizwa nangokuthi ukuhlolwa kwe-neuro noma ukuhlolwa kwe-neurologic.

• Isivivinyo sesibani seSlit-lamp: Isivivinyo esisebenzisa imicroscope ekhethekile enesibani esikhanyayo, esincanyana sokukhanya ukubheka ngaphandle nangaphakathi kweso.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi kobuchopho 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).

• 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.

• 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 zamangqamuzana wesimila. Isampula nayo ingahlolwa inani lamaprotheni noshukela. Inani eliphakeme kunelejwayelekile lamaprotheni noma inani eliphansi kunelejwayelekile le-glucose kungaba uphawu lwesimila. 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.

• I-Stereotactic biopsy: Inqubo ye-biopsy esebenzisa ikhompyutha nedivayisi yokuskena eyi-3-dimensional (3-D) ukuthola indawo yesimila futhi iqondise ukususwa kwezicubu ukuze ibhekwe ngaphansi kwesibonakhulu ukuhlola izimpawu zomdlavuza.

Ukuhlolwa okulandelayo kungenziwa kumasampula wezicubu ezisusiwe:

• 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.

• 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-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.

• Qedela ukubalwa kwegazi (i-CBC) ngokuhluka: Inqubo lapho kukhishwa khona isampula yegazi futhi ihlolwe 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.

• 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.

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

Isibikezelo (ithuba lokululama) sincike kokulandelayo:

• Iminyaka yesiguli nempilo ejwayelekile.

• Izinga lezinto ezithile egazini nakuluketshezi lwe-cerebrospinal (CSF).

• Lapho isimila sisohlelweni oluphakathi lwezinzwa, iso, noma kokubili.

• Ukuthi isiguli sinengculaza yini.

Izinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza.

• Lapho isimila sisohlelweni oluphakathi lwezinzwa.

• Iminyaka yesiguli nempilo ejwayelekile.

• Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Ukwelashwa kwe-CNS lymphoma eyinhloko kusebenza kahle lapho isimila singasakazekanga ngaphandle kwe-cerebrum (ingxenye enkulu yobuchopho) futhi isiguli singaphansi kweminyaka engama-60, sikwazi ukwenza imisebenzi eminingi yansuku zonke, futhi asinayo i-AIDS noma ezinye izifo buthaka amasosha omzimba.

Isiteji Primary CNS Lymphoma

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwesistimu eyinhloko ye-nervous central (CNS) lymphoma, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakaze ngaphakathi kobuchopho nomgogodla noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Alukho uhlelo olujwayelekile lokubeka isiteji se-CNS lymphoma eyinhloko.

Ngemuva kokutholakala kwesistimu eyinhloko ye-nervous central (CNS) lymphoma, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakaze ngaphakathi kobuchopho nomgogodla noma kwezinye izingxenye zomzimba.

Lapho i-CNS lymphoma eyinhloko iqhubeka nokukhula, imvamisa ayisabalali ngaphezu kwesistimu yezinzwa emaphakathi noma iso. Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza ususabalalisiwe ibizwa ngokuthi yi-staging. Kubalulekile ukwazi ukuthi umdlavuza ususabalele kwezinye izingxenye zomzimba ukuze uhlele ukwelashwa. Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, 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-computer ene-tomography, noma i-computer axial tomography. Kwi-CNS lymphoma eyinhloko, kwenziwa i-CT scan esifubeni, esiswini, nasesinqeni (ingxenye yomzimba phakathi kwezinqulu).

• 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. Ukuskena i-PET ne-CT scan kungenziwa ngasikhathi sinye. Lokhu kubizwa nge-PET-CT.

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

• Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha wethambo, igazi, nocezu oluncane lwethambo ngokufaka inaliti engenalutho ethangeni noma emathanjeni esifuba. Isazi sezifo sibheka umnkantsha, igazi, nethambo ngaphansi kwesibonakhulu ukuze kubhekwe 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.

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-CNS lymphoma eyinhloko isakazeka esibindi, amangqamuzana omdlavuza esesibindi empeleni angamaseli e-lymphoma. Lesi sifo yi-metastatic CNS lymphoma, hhayi umdlavuza wesibindi.

Alukho uhlelo olujwayelekile lokubeka isiteji se-CNS lymphoma eyinhloko.

I-CNS Lymphoma Eyisisekelo Ephindaphindiwe

I-CNS) i-lymphoma umdlavuza ophindaphindiwe (ubuyile) ngemuva kokuphathwa. I-CNS primary lymphoma ivame ukubuyela ebuchosheni noma esweni.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-CNS lymphoma eyinhloko.

• Kusetshenziswa izindlela zokwelapha ezintathu ezijwayelekile:

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukwelashwa kwama-steroid

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• I-chemotherapy ephezulu ene-stem cell transplant

• Ukwelashwa okuhlosiwe

• Ukwelashwa kwe-CNS lymphoma eyinhloko 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-CNS lymphoma eyinhloko.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-central central system nervous (CNS) 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 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.

Ukuhlinzwa akusetshenziselwa ukwelapha i-CNS lymphoma eyinhloko.

Kusetshenziswa izindlela zokwelapha ezintathu ezijwayelekile:

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. Ngoba i-CNS lymphoma eyinhloko isakazeka kulo lonke ubuchopho, ukwelashwa ngemisebe yangaphandle kunikezwa bonke ubuchopho. Lokhu kubizwa ngokuthi ukwelashwa ngemisebe yobuchopho okuphelele.

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

Indlela yokwelashwa ngemisebe enikezwa ngayo incike ekutheni isiguli sine-CNS lymphoma ne-AIDS eyinhloko. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha i-CNS lymphoma eyinhloko.

Ukwelashwa kwemisebe ephezulu ebuchosheni kungalimaza izicubu ezinempilo futhi kudale ukuphazamiseka okungathinta ukucabanga, ukufunda, ukuxazulula izinkinga, ukukhuluma, ukufunda, ukubhala nenkumbulo. Izivivinyo zomtholampilo zivivinye ukusetshenziswa kwe-chemotherapy kuphela noma ngaphambi kokwelashwa ngemisebe ukunciphisa ukulimala kwezicubu zobuchopho ezinempilo ezenzeka ngokusetshenziswa kwelashwa ngemisebe.

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).

Indlela i-chemotherapy enikezwa ngayo incike ekutheni isisu sikuphi ku-CNS noma esweni. I-CNS primary lymphoma ingaphathwa nge-systemic chemotherapy, i-intrathecal chemotherapy kanye / noma i-intraventricular chemotherapy, lapho kufakwa khona izidakamizwa ze-anticancer kuma-ventricles (izimbotshana ezigcwele uketshezi) zobuchopho. Uma kutholakala i-CNS lymphoma eyinhloko esweni, imithi elwa nomdlavuza ijojowe ngqo kwi-vitreous humor (into efana ne-jelly) ngaphakathi kweso.

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 yomgogodla, ngemuva kokuthi indawo encane engezansi ingemuva.

Inethiwekhi yemithambo yegazi nezicubu, ebizwa ngokuthi umgoqo wobuchopho begazi, ivikela ubuchopho ezintweni eziyingozi. Lesi sithiyo futhi singenza ukuthi imishanguzo yokulwa nomdlavuza ingafinyeleli ebuchosheni. Ukuze welaphe i-CNS lymphoma, izidakamizwa ezithile zingasetshenziswa ukuvula ukuvuleka phakathi kwamaseli asenkingeni yegazi nobuchopho. Lokhu kubizwa ngokuthi ukuphazamiseka kwesithiyo segazi nobuchopho. Imithi elwa nomdlavuza efakwa egazini ingase ifinyelele ebuchosheni.

Ukwelashwa kwama-steroid

Ama-steroid ngamahomoni enziwa ngokwemvelo emzimbeni. Futhi zingenziwa elebhu futhi zisetshenziswe njengezidakamizwa. I-Glucocorticoids yizidakamizwa ze-steroid ezinomphumela we-anticancer kuma-lymphomas.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

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

I-chemotherapy 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.

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 kungenye yezindlela zokwelashwa ezihlosiwe ezifundwayo ekwelapheni i-CNS lymphoma eyinhloko.

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. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza. I-Rituximab uhlobo lwe-anti-monoclonal antibody esetshenziselwa ukwelapha i-CNS lymphoma esanda kutholakala ezigulini ezingenayo i-AIDS.

Ukwelashwa kwe-CNS lymphoma eyinhloko 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.

Izinketho zokwelashwa ze-CNS Primary Lymphoma

Kulesi Sigaba

• I-CNS Primary Lymphoma

• I-Lymphoma Yangaphakathi Ye-Intraocular

• I-CNS Lymphoma Eyisisekelo Ephindaphindiwe

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

I-CNS Primary Lymphoma

Ukwelashwa kwesistimu eyinhloko ye-nervous central (CNS) lymphoma kungafaka okulandelayo:

• Ukwelashwa okuphelele kwemisebe yobuchopho.

• Ukwelashwa ngamakhemikhali.

• I-Chemotherapy ilandelwa ukwelashwa ngemisebe.

• I-Chemotherapy kanye nokwelashwa okuhlosiwe (i-rituximab) kulandelwa ukwelashwa ngamakhemikhali aphezulu kanye nokufakelwa kwe-stem cell.

• Isivivinyo somtholampilo se-chemotherapy ephezulu ene-stem cell transplant.

• Isivivinyo somtholampilo wamakhemikhali aphezulu we-chemotherapy kanye nokwelashwa okuqondisiwe (i-rituximab), ngokufakelwa kwe-stem cell noma ngaphandle kokulashwa kwemisebe yobuchopho.

I-Lymphoma Yangaphakathi Ye-Intraocular

Ukwelashwa kwe-primary intraocular lymphoma kungafaka okulandelayo:

• I-Chemotherapy (i-intraocular noma i-systemic).

• Ukwelashwa okuphelele kwemisebe yobuchopho.

I-CNS Lymphoma Eyisisekelo Ephindaphindiwe

Ukwelashwa kwesistimu yezinzwa eyinhloko ephindaphindiwe (CNS) lymphoma kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa ngemisebe (uma kungatholakali ekwelashweni kwangaphambili).

• Isivivinyo somtholampilo sesidakamizwa esisha noma uhlelo lokwelashwa.

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 Okwengeziwe Nge-CNS Lymphoma Eyisisekelo

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-CNS lymphoma eyinhloko, bheka okulandelayo:

• Ikhasi Lasekhaya Lymphoma

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

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli