Kunemithi eminingi enganikezwa njengokwelashwa ngomlomo (ngomlomo) kwe-lymphoma kanye ne-chronic lymphocytic leukemia.
Uhlolojikelele lwezokwelapha zomlomo ku-lymphoma (& CLL)
Ukwelashwa kwe-lymphoma kanye ne-lymphocytic lymphoma (CLL) kungaba inhlanganisela yemithi elwa nomdlavuza. Ngokuvamile zinikezwa emthanjeni (ngokungena emthanjeni) futhi ngokuvamile zibandakanya inhlanganisela yemithi ehlanganisa i-antibody therapy kanye ne-chemotherapy (immunochemotherapy).
Lokhu kuvame ukubandakanya ukuphathwa kokwelashwa esibhedlela noma esikhungweni somdlavuza onguchwepheshe. Kodwa-ke, kube nokuthuthuka okuningi kumdlavuza wokwelapha i-lymphoma ne-CLL engathathwa ngomlomo ngendlela yethebhulethi. Lokhu kwaziwa ngokuthi yimithi yokwelapha yomlomo.
Ziyini izindlela zokwelapha zomlomo?
Imithi yokwelapha i-lymphoma yomlomo ingaba imithi ye-chemotherapy, imithi yokwelapha ehlosiwe, kanye ne-immunotherapies. Zingathathwa ngomlomo njengethebhulethi, i-capsule, noma njengoketshezi. Umuthi udonswa egazini bese uhanjiswa njengezidakamizwa ezifakwa emthanjeni.
Ukwelashwa ngomlomo kungasebenza kahle njengezinketho zokujova futhi kube nemiphumela engemihle ehlukile. Kunezici eziningi ezihlobene ne-subtype ye-lymphoma kanye nesimo sezokwelapha sesiguli okufanele silinganiswe ukuze kukhethwe ukwelashwa okungcono kakhulu kwe-lymphoma. Ngakho-ke, ukukhetha kwenziwa kangcono ekuxoxisaneni nochwepheshe.
Zisetshenziswa nini izindlela zokwelapha zomlomo?
Imithi eminingi yomlomo esetshenziselwa ukwelapha i-lymphoma ne-CLL ama-immunotherapy agents noma izindlela zokwelapha ezihlosiwe. Izindlela zokwelapha ezihlosiwe ziqondiswe ngokumelene nama-enzyme athile adingekayo ukuze i-lymphoma ikhule kuyilapho imithi yokwelapha ngamakhemikhali evamile iqondiswe kumaseli ahlukanisayo ngokushesha noma ngabe i-lymphoma noma amanye amangqamuzana avamile emzimbeni womuntu.
Njengoba imithi ye-chemotherapy ingahlukanisi phakathi kwamaseli e-lymphoma namangqamuzana anempilo avamile ilimaza ngokungafanele amangqamuzana anempilo avamile okuholela emiphumeleni engemihle efana nokubalwa kwegazi eliphansi, ukulahlekelwa izinwele, izilonda zomlomo, isicanucanu, ukuhlanza kanye nesifo sohudo kuyilapho izindlela zokwelapha ezihlosiwe ngokuvamile zithinta amangqamuzana anempilo avamile ambalwa. kwezimbalwa zalezi zinhlobo zemiphumela emibi kakhulu.
Ukuqala ukwelashwa kokwelashwa ngomlomo
Ngaphambi kokuba iziguli ziqale ukwelashwa ekhaya:
- Udokotela uzochaza ukwelashwa
- Usokhemisi uzonikeza isiguli umuthi
- Kuzohlelwa isikhathi esibekiwe ukuze kuxoxwe ngokwelashwa kanye nemiphumela engemihle engenzeka
Umhlengikazi noma usokhemisi uzochaza ngokuningiliziwe indlela yokuphuza imithi futhi lokhu kuzohlanganisa umthamo kanye nokuthi idinga ukuphuza kangaki. Kuzonikezwa imiyalelo ngokuphathwa ngendlela ephephile kanye nokugcinwa kwemithi. Kuzoxoxwa ngayo yonke imiphumela emibi yokwelashwa, futhi imininingwane ebhaliwe izonikezwa isiguli.
Izinto okufanele uzazi ngokuthatha imithi yokwelapha ngomlomo
Imithi yokwelapha umdlavuza womlomo ingaba inketho elula ezigulini njengoba ingathathwa ekhaya, nokho kunezici ezimbalwa okufanele zicatshangelwe:
- Iziguli zinomthwalo wemfanelo wokuqinisekisa ukuthi zisebenzisa imithi yazo, ngakho-ke kungase kube khona ingozi eyengeziwe yamaphutha emithi njengokukhohlwa ukuphuza imithi.
ngezinsuku ezithile noma ukuthatha umthamo ongalungile okungase kuthikameze ukusebenza komuthi ebucayini. - Kubalulekile ukuthi iziguli ziphuze yonke imithi njengoba kushiwo ukuze kwandiswe ukusebenza kahle kokwelashwa kanye nokunciphisa noma yimiphi imiphumela emibi. Njengoba ukulandelela yonke imithi kungase kube inkimbinkimbi, khuluma nethimba lochwepheshe mayelana nendlela yokugcina ithrekhi. Amathuluzi ahlukahlukene angase abe usizo okuhlanganisa ukurekhoda imithi kwidayari noma ukudala izikhumbuzi eziku-inthanethi ezinhlelweni zokusebenza noma ku-smartphone
- Iziguli zingase zizizwe zixhumene nethimba lazo lochwepheshe kunokuba bezingenza uma zithola imithi efakwa emthanjeni ngenxa yokuthi zivakashela isibhedlela noma isikhungo somdlavuza kaningi. Kodwa-ke, ukuphuza imithi ephuzwayo ekhaya kungase kube yinzuzo ezigulini okufanele zihambe ibanga elide ukuya esibhedlela sazo ngokwesikhathi nemali echithwa ekuhambeni.
- Imiphumela engemihle ingase ingabonakali noma ingabikwa ethimbeni lochwepheshe futhi amalungelo obunikazi angase angaqiniseki ukuthi ungayilawula kanjani imiphumela emibi ekhaya. Ngakho-ke, kubalulekile ukufundisa iziguli kanye nabanakekeli bazo ngalezi zindawo ezibalulekile. Imiphumela eminingi engemihle yemithi yomlomo ingadanjiswa ngokunakekelwa okusekelayo ngakho iziguli kufanele zilandele ngokucophelela yonke imiphumela emibi yokwelashwa kwazo futhi zibikele ithimba lochwepheshe lapho zenzeka, ukuze zithole ukunakekelwa okungcono kakhulu.
Izinyathelo zokuqapha lapho uthatha ukwelashwa ngomlomo ekhaya
Ukuqala ukwelashwa ekhaya:
- Imithi yokwelapha ngomlomo akufanele neze ithintwe ngezandla. Ingabangela ukucasuka
- Geza izandla kahle ngensipho namanzi ngemva kokuphatha imithi
- Gqoka amagilavu lapho ushintsha izingubo noma amashidi angcoliswe ubuhlanzo noma isifo sohudo
- Gcina amaphilisi njengoba uyalelwe usokhemisi
- Gcina amaphilisi ngokuphephile kude nezingane nezilwane ezifuywayo
- Thatha ukwelashwa ngomlomo njengoba kushiwo
- Phatha uhlu lwayo yonke imithi yamanje
- Hlela uhambo, ukugcwalisa kabusha, nezimpelasonto
- Uma uzizwa ungaphilile noma nini xhumana nethimba lakho lezempilo
- Yazisa noma yibaphi abanye abahlinzeki bezempilo mayelana nemithi yomlomo elwa nomdlavuza
- Buyisela yonke imithi engasetshenziswanga ekhemisi ukuze ilahlwe ngendlela ephephile
Izinhlobo zokwelapha ngomlomo
I-TGA egunyaziwe (i-TGA iyiGunya Lempahla Yokwelapha e-Australia) imithi yokwelapha yomdlavuza womlomo ivimbela ukukhula futhi ikhuthaze ukufa kwamaseli e-lymphoma. Ezinye izindlela zokwelapha amasosha omzimba zishukumisa amasosha omzimba esiguli ukuba abone amangqamuzana e-lymphoma futhi akhuthaze ukubhujiswa kwala mangqamuzana. Kunezigaba eziningana zale mithi ezibalwe ngezansi:
I-chemotherapy yomlomo esetshenziselwa i-lymphoma
Agent |
Class |
Ukuthi isebenza kanjani |
Izinhlobo ezingaphansi |
Imiphumela emibi ejwayelekile |
| ICyclophosphamide | I-Chemotherapy: I-ejenti ye-alkylating | Amakhemikhali aguqula i-DNA ukuze ibangele ukufa kwamaseli akhulayo | Cll HL NHL | Izibalo zegazi eziphansi Ukutheleleka Isicanucanu nokuhlanza Ukulahlekelwa kwesifiso |
| I-Etoposide | I-Chemotherapy: I-Topoisomerase II inhibitor | Iphazamisa ama-enzyme e-topoisomerase alawula ukuxhashazwa kwesakhiwo se-DNA esidingekayo ukuze kuphindaphindeke. | I-CTCL NHL | Isicanucanu nokuhlanza Ukulahlekelwa kwesifiso Uhudo Ukukhathala |
| I-Chlorambucil | I-Chemotherapy: I-ejenti ye-alkylating | Amakhemikhali aguqula i-DNA ukuze ibangele ukufa kwamaseli akhulayo | Cll FL HL NHL | Izibalo zegazi eziphansi Ukutheleleka Isicanucanu nokuhlanza Uhudo |
Okunye ukwelashwa ngomlomo okusetshenziselwa i-lymphoma
Agent |
Class |
Ukuthi isebenza kanjani |
Izinhlobo ezingaphansi |
Imiphumela emibi ejwayelekile |
| Ibrutinib | I-BTK Inhibitor | Ivimbela i-enzyme ehilelekile ekusayineni kwe-B cell receptor edingekayo ukuze i-lymphoma iphile futhi ikhule | Cll I-MCL | Izinkinga zesigqi senhliziyo Izinkinga zokuphuza Umfutho wegazi ophezulu · Amagciwane |
| I-Acalabrutinib | I-BTK inhibitor | Ivimbela i-enzyme ehilelekile ekusayineni kwe-B cell receptor edingekayo ukuze i-lymphoma iphile futhi ikhule | Cll I-MCL | bekhanda Uhudo Inzuzo yesisindo |
| Zanubrutinib | I-BTK inhibitor | Ivimbela i-enzyme ehilelekile ekusayineni kwe-B cell receptor edingekayo ukuze i-lymphoma iphile futhi ikhule | Cll I-MCL WM | Izibalo zegazi eziphansi Rash Uhudo |
| Idelalisib | I-P13K Inhibitor | Ivimbela i-enzyme ehilelekile ekusayineni kwe-B cell receptor edingekayo ukuze i-lymphoma iphile futhi ikhule | Cll FL | Uhudo Izinkinga zesibindi Izinkinga zamaphaphu Ukutheleleka |
| IVenetoclax | I-BCL2 Inhibitor | Iqondise amaprotheni aziwa ngokuvimbela amaseli e-lymphoma ukuthi angafi | Cll | I-nausea Isifo sohudo Izinkinga zokopha Ukutheleleka |
| Lenalidomide | I-ejenti ye-immunomodulatory | Indlela eqondile ayaziwa. Kucatshangelwe ukulungisa amasosha omzimba. | Isetshenziswa kwamanye ama-NHL | Ukuqubuka kwesikhumba Isicanucanu Isifo sohudo |
| I-Vorinostat | I-HDAC Inhibitor | Ivimbela ama-enzyme e-HDAC adingekayo ukuze kuvezwe izakhi zofuzo ku-DNA ukuvimbela ukukhula nokuhlukana kwamaseli e-lymphoma. | I-CTCL | Ukulahlekelwa kwesifiso Umlomo omile Ukulahlekelwa Izinwele Amagciwane |
| I-Panobinostat | I-HDAC Inhibitor | Ivimbela ama-enzyme e-HDAC adingekayo ukuze kuvezwe izakhi zofuzo ku-DNA ukuvimbela ukukhula nokuhlukana kwamaseli e-lymphoma. | HL I-CTCL | Amazinga aphezulu e-magnesium Amazinga aphezulu e-bilirubin Isicanucanu Izifo |
| I-Bexarotene | I-Retinoid | Ngokukhethekile ibopha futhi yenze kusebenze ama-retinoid receptors okuholela ekuvezweni kwezakhi zofuzo ezilawula ukukhula kwamaseli nokuphindaphinda | I-CTCL | Ukukhwabanisa isikhumba I-nausea Amazinga aphansi we-hormone yegilo Izifo |
