Isifinyezo esisheshayo sokusabalalisa i-B-cell lymphoma (DLBCL) enkulu ezinganeni
Lesi sigaba siyincazelo emfushane yokusabalalisa i-B cell lymphoma (DLBCL) enkulu ezinganeni ezineminyaka engu-0-14. Ukuze uthole ukwaziswa okwengeziwe okujulile buyekeza izigaba ezengeziwe ngezansi.
Kwenzenjani?
I-Diffuse B-cell lymphoma (DLBCL) enkulu inolaka (ekhula ngokushesha) B-cell non-Hodgkin lymphoma. Ikhula kuma-lymphocyte B (amangqamuzana amhlophe egazi) akhula ngokungalawuleki. Lawa ma-lymphocyte e-B angajwayelekile abuthana esithweni se-lymph nama-lymph nodes, ngaphakathi kwesistimu ye-lymphatic, eyingxenye yamasosha omzimba. Ngenxa yokuthi izicubu ze-lymph zitholakala kuwo wonke umzimba, i-DLBCL ingaqala cishe kunoma iyiphi ingxenye yomzimba futhi isakazeke cishe kunoma yisiphi isitho noma izicubu emzimbeni.
Ithinta bani?
I-DLBCL yenza cishe amaphesenti angu-15 azo zonke i-lymphoma ezenzeka ezinganeni. I-DLBCL ivame kakhulu kubafana kunamantombazane. I-DLBCL iwuhlobo oluncane lwe-lymphoma oluvame kakhulu kubantu abadala, olubalelwa ku-30% wezigameko ze-lymphoma yabantu abadala.
Ukwelashwa kanye ne-prognosis
I-DLBCL ezinganeni ine-prognosis enhle kakhulu (umbono). Cishe u-90% wezingane welashwa ngemva kokuthola ukwelashwa okujwayelekile ngamakhemikhali kanye ne-immunotherapy. Kunocwaningo oluningi oluzokwenziwa ekwelapheni le lymphoma, kugcizelelwa ekuphenyeni indlela yokunciphisa imiphumela ephuzile, noma imiphumela emibi evela ekwelashweni okunobuthi okungenzeka kube izinyanga kuya eminyakeni ngemuva kokwelashwa.
Uhlolojikelele lwe-Diffuse B-cell lymphoma (DLBCL) enkulu ezinganeni
I-Lymphomas yiqembu lomdlavuza we uhlelo lwe-lymphatic. I-Lymphoma yenzeka lapho ama-lymphocyte, okuwuhlobo lwamangqamuzana amhlophe egazi, ezuza ukuguqulwa kwe-DNA. Indima yama-lymphocyte ukulwa nokutheleleka, njengengxenye yomzimba Amasosha omzimba. Bangu Ama-B-lymphocyte (B-amaseli) kanye T-lymphocyte (ama-T-cell) adlala indima ehlukene.
Ku-DLBCL amaseli e-lymphoma ahlukana futhi akhule ngokungalawuleki noma awafi lapho kufanele. Kunezinhlobo ezimbili eziyinhloko ze-lymphoma. Babizwa IHodgkin lymphoma (HL) futhi I-non-Hodgkin lymphoma (NHL). I-Lymphomas iphinde ihlukaniswe ngamaqembu:
- I-Indolent (ikhula kancane) i-lymphoma
- I-lymphoma enamandla (ekhula ngokushesha).
- I-B-cell lymphoma ama-B-cell lymphocyte angajwayelekile futhi avame kakhulu. I-B-cell lymphomas yenza cishe ama-85% awo wonke ama-lymphomas
- T-cell lymphoma ama-T-cell lymphocyte angajwayelekile. I-T-cell lymphomas yenza cishe amaphesenti angu-15 awo wonke ama-lymphomas
I-Diffuse B-cell lymphoma (DLBCL) enkulu inolaka (ekhula ngokushesha) B-cell non-Hodgkin lymphoma. I-DLBCL yenza cishe amaphesenti angu-15 awo wonke ama-lymphomas avela ezinganeni. I-DLBCL iyi-lymphoma evame kakhulu kubantu abadala, ibalwa cishe amaphesenti angu-30 azo zonke izimo ze-lymphoma kubantu abadala.
I-DLBCL iqala isuka kuma-B-cell avuthiwe kusukela esikhungweni segciwane se-lymph node, noma kuma-B-cell aziwa ngokuthi ama-B-cell acushiwe. Ngakho-ke, kunezinhlobo ezimbili ezivame kakhulu ze-DLBCL:
- I-Germinal Center B-cell (GCB)
- I-B-cell (ABC) evuliwe
Imbangela eqondile ye-DLBCL ezinganeni akwaziwa. Isikhathi esiningi ayikho incazelo ezwakalayo yokuthi ingane ithole umdlavuza kuphi noma kanjani futhi abukho ubufakazi obuphakamisa ukuthi abazali nabanakekeli/ababheki bebengavimba i-lymphoma ukuthi ikhule, noma iyibangele.
Ubani othintwa ukusabalalisa i-B-cell lymphoma (DLBCL) enkulu?
Ukusabalalisa i-B-cell lymphoma (DLBCL) enkulu kungenzeka kubantu banoma iyiphi iminyaka noma ubulili. I-DLBCL ibonakala kakhulu ezinganeni ezindala nakubantu abadala (abantu abaneminyaka engu-10 - 20 ubudala). Kwenzeka kaningi kubafana kunamantombazane.
Imbangela ye-DLBCL ayaziwa. Ayikho into oyenzile noma ongakayenzi edale lokhu . Ayitheleleki futhi ayikwazi ukudluliselwa kwabanye abantu.
Nakuba izimbangela ezingenzeka ze-DLBCL zingabonakali, zikhona ezinye izinto eziyingozi eziye zahlotshaniswa ne-lymphoma. Akubona bonke abantu abanalezi zici zobungozi abazoqhubeka nokuthuthukisa i-DLBCL. Izinto eziyingozi zihlanganisa (yize ingozi isephansi kakhulu):
- Ukutheleleka kwangaphambilini ngegciwane le-Epstein-Barr (EBV) - lelo gciwane liyimbangela evamile yemfiva yezindlala
- Amasosha omzimba abuthaka ngenxa yesifo sofuzo sokuntuleka kokuzivikela komzimba (izifo ezizimele ezifana ne-dyskeratosis congenita, i-systemic lupus, i-rheumatoid arthritis)
- ukutheleleka nge-HIV
- Imithi ye-immunosuppressant ethathwa ukuvimbela ukwenqatshwa ngemva kokufakelwa kwesitho
- Ukuba nomfowabo noma udadewabo one-lymphoma (ikakhulukazi amawele) kuye kwaphakanyiswa ukuthi kube nesixhumanisi sofuzo somndeni esingajwayelekile kulesi sifo (lokhu akuvamile kakhulu futhi akunconywa ukuba imindeni ibe nokuhlolwa kofuzo)
Ukuba nengane okutholwe ukuthi ine-lymphoma kungaba yinto ecindezela kakhulu nengokomzwelo, akukho ukusabela okulungile noma okungalungile. Kuvamise ukucekela phansi futhi kushaqise, kubalulekile ukuthi uzivumele wena nomndeni wakho isikhathi sokucubungula nokudabuka. Kubalulekile futhi ukuthi ungathwali isisindo salokhu kugula ngokwakho, kunenqwaba yezinhlangano ezisekelayo ezikhona ukukusiza wena nomndeni wakho ngalesi sikhathi, Chofoza lapha ukuthola okwengeziwe mayelana nokwesekwa kwemindeni enengane noma umuntu osemusha one-lymphoma.
Izinhlobo zokusabalalisa i-B-cell lymphoma (DLBCL) enkulu ezinganeni
Ukusabalalisa i-B-cell lymphoma enkulu (i-DLBCL) f ingahlukaniswa ibe yizinhlobo ezincane ngokusekelwe ohlotsheni lwe-B-cell ekhule kulo (elibizwa ngokuthi “iseli yemvelaphi”).
- Isikhungo se-Germinal B-cell lymphoma (GBC): Uhlobo lwe-GCB luvame kakhulu ezigulini zezingane kunohlobo lwe-ABC. Abantu abasha banamathuba amaningi okuthola isifo sohlobo lwe-GCB (80-95% eminyakeni engu-0-20) kunabantu abadala futhi sihlotshaniswa nemiphumela ethuthukisiwe uma kuqhathaniswa nohlobo lwe-ABC.
- I-B-cell Lymphoma (ABC) evuliwe: Uhlobo lwe-ABC luvela ezindaweni ezingemuva kwe-germinal (yeseli) ngenxa yokuthi iwuhlamvu lwamaseli e-B asebekhulile. Kubizwa ngokuthi uhlobo lwe-ABC ngoba ama-B-cell enziwe asebenza futhi asebenza njengabanikeli abaphambili ezimpendulweni zokuzivikela komzimba.
I-DLBCL ingahlukaniswa njengesikhungo se-germinal B-cell (GCB) noma i-B-cell ecushiwe (ABC). I-pathologist ehlola i-lymph node biopsy yakho ingawubona umehluko phakathi kwalokhu ngokubheka amaprotheni athile kumaseli e-lymphoma. Njengamanje, lolu lwazi alusetshenziselwa ukuqondisa ukwelashwa. Kodwa-ke, ososayensi benza ucwaningo ukuze bathole ukuthi ingabe ukwelashwa okuhlukile kuyasebenza yini ngokumelene nezinhlobo ezahlukene ze-DLBCL ezivela kumaseli ahlukene.
Izimpawu zokusabalalisa i-B-cell lymphoma (DLBCL) enkulu ezinganeni
Izimpawu zokuqala ezibonwa abantu abaningi isigaxa noma izigaxa eziningi ezingasuki ngemva kwamasonto ambalwa. Ungase uzwe isigaxa esisodwa noma ngaphezulu entanyeni, ekhwapheni, noma enqeni yengane yakho. Lezi zigaxa zingama-lymph nodes avuvukele, lapho kukhula khona ama-lymphocyte angavamile. Lezi zigaxa zivame ukuqala engxenyeni eyodwa yomzimba wengane, ngokuvamile ekhanda, entanyeni noma esifubeni bese zivame ukusabalala ngendlela ebikezelwe ukusuka kwenye ingxenye ye-lymphatic system iye kwelandelayo. Ezigabeni ezithuthukile, lesi sifo singadlulela emaphashini, esibindini, emathanjeni, emnkantsheni noma kwezinye izitho.
Kukhona uhlobo olungavamile lwe-lymphoma oluveza isisindo se-mediastinal, eyaziwa ngokuthi i-primary mediastinal big-cell lymphoma (PMBCL). Le lymphoma yayivame ukuhlukaniswa njenge-subtype ye-DLBCL kodwa kusukela ngaleso sikhathi iphinde yahlelwa kabusha. I-PMBCL kulapho i-lymphoma isuka kumaseli e-thymic B. I-thymus iyisitho se-lymphoid esitholakala ngqo ngemuva kwe-sternum (isifuba).
Izimpawu ezivame kakhulu ze-DLBCL zifaka:
- Ukuvuvukala okungenabuhlungu kwama-lymph nodes entanyeni, emakhwapheni, e-groin noma esifubeni
- Ukuphefumula - ngenxa yokwanda kwama-lymph nodes esifubeni noma ku-mediastinal mass
- Ukukhwehlela (imvamisa ukukhwehlela okomile)
- Ukukhathala
- Ubunzima bokululama ekuthelelekeni
- Isikhumba esilumayo (pruritus)
B izimpawu igama elichaza izimpawu ezilandelayo :
- Ukujuluka ebusuku (ikakhulukazi ebusuku, lapho ungase udinge ukushintsha izingubo zabo zokulala nezokulala)
- Imfiva ephikelelayo
- Ukulahlekelwa kwesisindo esingachaziwe
Cishe u-20% wezingane ezine-DLBCL zikhona ezinesisindo phezulu esifubeni. Lokhu kubizwa ngokuthi "i-mediastinal mass". , Ubuningi besifuba bungabangela ukuphefumula, ukukhwehlela noma ukuvuvukala kwekhanda nentamo ngenxa yesimila esicindezela uqhoqhoqho noma imithambo emikhulu ngaphezu kwenhliziyo.
Kubalulekile ukuqaphela ukuthi eziningi zalezi zimpawu zihlobene nezinye izimbangela ngaphandle komdlavuza Lokhu kusho ukuthi i-lymphoma ingaba nzima ngodokotela ukuyixilonga.
Ukuxilongwa kwe-B-cell lymphoma enkulu (i-DLBCL)
A i-biopsy ihlale idingeka ukuze kuxilongwe i-B-cell lymphoma enkulu. A i-biopsy kuwumsebenzi wokukhipha a i-lymph node noma ezinye izicubu ezingajwayelekile ukuze uzibheke ngaphansi kwesibonakhulu ngudokotela wezifo. I-biopsy ngokuvamile yenziwa ngaphansi kwe-anesthesia ejwayelekile ukuze izingane zisize ukunciphisa ukucindezeleka.
Ngokuvamile, i-core biopsy noma i-excisional node biopsy iyindlela engcono kakhulu yophenyo. Lokhu kwenzelwa ukuqinisekisa ukuthi odokotela baqoqa inani elanele lezicubu ukuze baqedele ukuhlolwa okudingekayo ukuze bathole ukuxilongwa.
Ilinde imiphumela kungaba isikhathi esinzima. Kungasiza ukukhuluma nomndeni wakho, abangani noma umhlengikazi onguchwepheshe.
Ukuhlukaniswa kwe-B-cell lymphoma enkulu (i-DLBCL)
Kanye a ukuxilongwa ye-DLBCL yenziwa, ukuhlolwa okwengeziwe kuyadingeka ukuze kubonakale ukuthi i-lymphoma ikuphi emzimbeni. Lokhu kubizwa ukwenza isiteji. The ukwenza isiteji ye-lymphoma isiza udokotela ukuthi athole ukwelashwa okungcono kakhulu kwengane yakho.
Kunezigaba ezi-4, ukusuka esigabeni 1 (i-lymphoma endaweni eyodwa) ukuya esigabeni sesi-4 (i-lymphoma esabalele noma ethuthukisiwe).
- Isiteji sokuqala kusho isigaba 1 kanye nesigaba sesi-2 se-lymphomas. Lokhu kungase futhi kubizwe ngokuthi 'okwasendaweni'. Isigaba 1 noma sesi-2 sisho ukuthi i-lymphoma itholakala endaweni eyodwa noma ezindaweni ezimbalwa ezisondelene.
- Isigaba esithuthukile kusho ukuthi i-lymphoma yisiteji sesi-3 nesesi-4, futhi i-lymphoma esabalele. Ezimweni eziningi, i-lymphoma isakazekele ezingxenyeni zomzimba ezikude komunye nomunye.
I-lymphoma yesigaba 'ethuthukisiwe' izwakala ngokuphathelene, kodwa i-lymphoma yilokho okwaziwa ngokuthi umdlavuza wesistimu. Ingasakazeka kulo lonke uhlelo lwe-lymphatic kanye nezicubu eziseduze. Yingakho ukwelashwa kwe-systemic (chemotherapy) kuyadingeka ukwelapha i-DLBCL.
Izivivinyo ezidingekayo zingabandakanya:
- Ukuhlolwa kwegazi (njengokuthi: inani eligcwele legazi, i-blood chemistry kanye ne-erythrocyte sedimentation rate (ESR) ukubheka ubufakazi bokuvuvukala)
- I-X-ray yesifuba - lezi zithombe zizosiza ukukhomba ubukhona besifo esifubeni
- Ukuskena kwe-Positron emission tomography (PET) - kwenziwa ukuze kuqondwe zonke izindawo zezifo emzimbeni ngaphambi kokuthi kuqale ukwelashwa
- Icwecwe le-computer tomography (CT)
- I-bone yomnkantsha i-biopsy (ngokuvamile kwenziwa kuphela uma ubufakazi besifo esithuthukisiwe)
- Ukukhishwa kwe-Lumbar – Uma i-lymphoma isolwa ebuchosheni noma emgogodleni
Ingane yakho ingase futhi ibhekane nenani ukuhlolwa kwesisekelo ngaphambi kokuqala noma yikuphi ukwelashwa. Lokhu ukuhlola ukusebenza kwesitho. Lokhu kungase kuphindwe ngesikhathi nangemva kokwelashwa ukuze kuhlolwe ukuthi ingabe ukwelashwa kuye kwaphazamisa ukusebenza kwesitho. Izivivinyo ezidingekayo zingabandakanya; ;
- Ukuhlolwa komzimba
- Ukubhekwa okubalulekile (umfutho wegazi, izinga lokushisa, nezinga lokushaya kwenhliziyo)
- Ukuskena kwenhliziyo
- Ukuskena kwezinso
- Ukuhlolwa kokuphefumula
- Ukuhlolwa kwegazi
Eziningi zazo ukwenza isiteji futhi ukuhlolwa kokusebenza kwesitho zenziwa futhi ngemva kokwelashwa ukuze kubhekwe ukuthi ingabe ukwelashwa kwe-lymphoma kusebenzile kanye nokuqapha umphumela ukwelashwa okube nawo emzimbeni.
Ukuxilongwa kwe-B-cell lymphoma enkulu (i-DLBCL)
I-DLBCL ezinganeni ine-prognosis enhle kakhulu (umbono). Cishe izingane eziyi-9 kweziyi-10 (90%) ziyelapheka ngemva kokuthola izinga imiphumela emibi yokwelashwa ngamakhemikhali futhi immunotherapy. Kunocwaningo oluningi olubheke ekwelapheni le lymphoma, kugcizelelwa ekuphenyweni indlela yokunciphisa imiphumela yakamuva, noma imiphumela engemihle evela ekwelashweni okunobuthi okungenzeka kwenzeke ezinyangeni kuya eminyakeni ngemva kokwelashwa.
Ukuphila isikhathi eside nezinketho zokwelashwa kuncike ezinhlobonhlobo zezici, ezihlanganisa:
- Iminyaka yengane yakho ekuxilongweni
- Ubude noma isigaba somdlavuza
- Ukubukeka kwamaseli e-lymphoma ngaphansi kwesibonakhulu (isimo, umsebenzi kanye nesakhiwo samaseli)
- ukuthi i-lymphoma isabela kanjani ekwelashweni
Ukwelashwa kokusabalalisa i-B-cell lymphoma enkulu
Uma yonke imiphumela evela ku-biopsy kanye nokuskena kwesiteji sekuqediwe, udokotela uzobuyekeza lokhu ukuze anqume indlela yokwelapha engcono kakhulu yengane yakho. Kwezinye izikhungo zomdlavuza, udokotela uzohlangana nethimba lochwepheshe ukuze kudingidwe indlela yokwelapha engcono kakhulu. Lokhu kubizwa ngokuthi a ithimba le-multidisciplinary (MDT) umhlangano.
Odokotela bazocabangela izici eziningi mayelana ne-lymphoma yengane yakho kanye nempilo evamile ukuze banqume ukuthi nini futhi yikuphi ukwelashwa okudingekayo. Lokhu kusekelwe kokuthi;
- Isiteji kanye nebanga le-lymphoma
- Izimpawu
- Iminyaka yobudala, umlando wezokwelapha odlule nempilo jikelele
- Ukuphila kahle ngokomzimba nangokwengqondo kwamanje
- Izimo Zomphakathi
- Izintandokazi zomndeni
Njengoba i-DLBCL iyi-lymphoma ekhula ngokushesha, idinga ukwelashwa ngokushesha - ngokuvamile phakathi nezinsuku kuya emavikini okuxilongwa. Ukwelashwa kwe-DLBCL kuhlanganisa inhlanganisela ye imiphumela emibi yokwelashwa ngamakhemikhali kanye ne-immunotherapy
Ezinye iziguli ze-DLBCL ezisakhula zingelashwa ngomuthi wamakhemikhali wabantu abadala obizwa ngokuthi I-R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, & prednisolone). Lokhu ngokuvamile kuzoncika ekutheni ingane yakho yelashwa yini esibhedlela sezingane noma esibhedlela sabadala.
Ukwelashwa kwezingane okujwayelekile kwesigaba sokuqala se-DLBCL (isigaba I-IIA):
- I-BFM-90/95: 2 - 4 imijikelezo ye-chemotherapy esekelwe esigabeni sesifo
- Ama-protocol agents ezidakamizwa ahlanganisa: i-cyclophosphamide, i-cytarabine, i-methotrexate, i-mercaptopurine, i-vincristine, i-pegaspargase, i-prednisolone, i-pirarubicin, i-dexamethasone.
- I-COG-C5961: 2 - 4 imijikelezo ye-chemotherapy esekelwe esigabeni sesifo
Ukwelashwa kwezingane okujwayelekile kwesigaba esithuthukisiwe se-DLBCL (isigaba IIB-IVB):
- I-COG-C5961: 4 - 8 imijikelezo ye-chemotherapy esekelwe esigabeni sesifo
- Izidakamizwa zeProtocol zihlanganisa: i-cyclophosphamide, i-cytarabine, i-doxorubicin hydrochloride, i-etoposide, i-methotrexate, i-prednisolone, i-vincristine.
- I-BFM-90/95: 4 - 6 imijikelezo ye-chemotherapy esekelwe esigabeni sesifo
- Ama-protocol agents ezidakamizwa ahlanganisa: i-cyclophosphamide, i-cytarabine, i-methotrexate, i-mercaptopurine, i-vincristine, i-pegaspargase, i-prednisolone, i-pirarubicin, i-dexamethasone.
Imiphumela emibi evamile yokwelashwa
Ukwelashwa kwe-DLBCL kuza nengcuphe yokuba nemiphumela emibi eminingi ehlukene. Isimiso sokwelashwa ngasinye sinemiphumela engemihle yomuntu ngamunye futhi udokotela wakho okwelaphayo kanye/noma unesi ochwepheshe bomdlavuza uzokuchazela lokhu kanye nengane yakho ngaphambi kokuqala ukwelashwa.
Eminye yemiphumela emibi ejwayelekile yokwelashwa kwe-B-cell lymphoma enkulu ihlanganisa:
- I-anemia (amangqamuzana abomvu egazi aphansi)
- I-Thrombocytopenia (amaplatelet aphansi)
- I-Neutropenia (amangqamuzana amhlophe egazi aphansi)
- I-nausea nokuhlanza
- Izinkinga zamathumbu ezifana nokuqunjelwa kanye nesifo sohudo
- Ukukhathala
- Ukuzala okuncishisiwe
Ithimba lakho lezokwelapha, udokotela, umhlengikazi womdlavuza noma usokhemisi, kufanele bakunikeze ulwazi mayelana neyakho ukwelashwa, lo imiphumela emibi evamile, yiziphi izimpawu ongazibika kanye nobani ongaxhumana naye. Uma kungenjalo, sicela ubuze le mibuzo.
Ukulondolozwa kokuzala
Ezinye izindlela zokwelapha i-lymphoma zinganciphisa ukuzala. Lokhu kungenzeka kakhulu ngezinqubo ezithile zokwelashwa ngamakhemikhali (inhlanganisela yezidakamizwa) kanye nokwelashwa ngamakhemikhali kwedosi ephezulu esetshenziswa ngaphambi kokufakelwa kwe-stem cell. Ukwelashwa nge-radiotherapy ku-pelvis nakho kwandisa amathuba okuncipha kokuzala. Amanye ama-antibody therapy angase athinte inzalo, kodwa lokhu akucaci kahle.
Udokotela wakho kufanele akweluleke ngokuthi ukuzala kungase kuthinteke yini Khuluma nodokotela kanye/noma unesi ochwepheshe bomdlavuza ngaphambi kokwelashwa uqale ngokuthi ingabe ukuzala kuzothinteka yini.
Ukuze uthole ulwazi olwengeziwe noma iseluleko mayelana ne-DLBCL yezingane, ukwelashwa, imiphumela engemihle, izisekelo ezitholakalayo noma indlela yokuzulazula ohlelweni lwesibhedlela, sicela uthinte ulayini wokusekelwa womhlengikazi we-lymphoma ku. 1800 953 081 noma u-imeyli nathi nurse@lymphoma.org.au
Ukunakekelwa kokulandelela
Uma ukwelashwa sekuqediwe, ingane yakho izoba nezikena zesiteji. Lezi zikena ezokubuyekeza ukuthi ukwelashwa kusebenze kahle kangakanani. Izikena zizokhombisa odokotela ukuthi i-lymphoma isabele kanjani ekwelashweni. Lokhu kubizwa ngokuthi impendulo yokwelashwa futhi kungachazwa ngokuthi:
- Qedela impendulo (CR noma azikho izimpawu ze-lymphoma ezisele) noma a
- Impendulo engaphelele (PR noma kusekhona i-lymphoma ekhona, kodwa yehlile ngosayizi)
Ingane yakho izobe isidinga ukulandelwa udokotela wayo ngokubonana njalo nokulandelela, ngokuvamile njalo ngemva kwezinyanga ezingu-3-6. Lokhu kuqokwa kubalulekile ukuze ithimba lezokwelapha lihlole ukuthi balulama kangakanani ekwelashweni. Lezi zikhathi zokuqokwa zikunikeza ithuba elihle lokuthi ukhulume nodokotela noma unesi mayelana nanoma yikuphi okukukhathazayo. Ithimba lezokwelapha lizofuna ukwazi ukuthi ingane yakho nawe uzizwa kanjani ngokomzimba nangokwengqondo, futhi:
- Buyekeza ukusebenza ngempumelelo kokwelashwa
- Gada noma yimiphi imiphumela emibi eqhubekayo evela ekwelashweni
- Gada noma yimiphi imiphumela ephuzile yokwelashwa ngokuhamba kwesikhathi
- Qaphela izimpawu ze-lymphoma ebuyela emuva
Ingane yakho ingase ihlolwe ngokomzimba futhi ihlolwe igazi ngesikhathi ngasinye . Ngaphandle kokuthi ngokushesha ngemva kokwelashwa ukuze kubuyekezwe ukuthi ukwelashwa kusebenze kanjani, amaskena avamise ukwenziwa ngaphandle uma kunesizathu esithile sawo. Uma ingane yakho iphilile, izikhathi ezibekiwe zingancipha ngokuhamba kwesikhathi.
Ukuphathwa kabusha noma okuhlanekezelwe kwe-DLBCL
Ibuyele emuva i-lymphoma yilapho umdlavuza usubuyile, refractory i-lymphoma yilapho umdlavuza ungaphenduli ukwelashwa komugqa wokuqala. Kwezinye izingane kanye nabantu abasha, i-DLBCL iyabuya futhi kwezinye izimo ezingavamile ayiphenduli ekwelashweni kokuqala (i-refractory). Kulezi ziguli kukhona ezinye izindlela zokwelapha ezingaphumelela, lezi zihlanganisa:
- I-chemotherapy ehlanganisiwe yomthamo omkhulu ulandelwa ngu ukufakelwa kwe-autologous stem cell noma i i-allogeneic stem cell transplant (ayilungele bonke abantu)
- I-chemotherapy ehlanganisiwe
- immunotherapy
- Radiotherapy
- Ukubamba iqhaza kokuhlolwa komtholampilo
Uma kusolakala ukuthi umuntu ubuyelwe yisifo esibi, kuvame ukubhalwa izivivinyo ezifanayo, okuhlanganisa lezi zivivinyo ezishiwo ngenhla ku- ukuxilongwa futhi ukwenza isiteji ingxenye.
Ukwelashwa kusaphenywa
Ziningi izindlela zokwelapha ezihlolwayo njengamanje ezivivinyweni zemitholampilo emhlabeni wonke ezigulini ezine-lymphoma esanda kutholwa kanye nephinde yabuya. Ezinye zalezi zindlela zokwelapha zihlanganisa:
- Izivivinyo eziningi zifunda ukunciphisa iphrofayili yobuthi kanye nemiphumela yakamuva yokwelashwa ngamakhemikhali
- Ukwelashwa kwe-CAR T-cell
- Copanlisib (ALIQOPATM - PI3K inhibitor)
- I-Venetoclax (i-VENCLEXTATM - I-BCL2 inhibitor)
- I-Temsirolimus (TORISOLTM)
- I-CUDC-907 (ukwelashwa okuhlosiwe kwenoveli)
Kwenzekani ngemva kokwelashwa?
Imiphumela yakamuva
Kwesinye isikhathi umphumela ongathandeki ovela ekwelashweni ungaqhubeka noma uthuthuke izinyanga noma iminyaka ngemuva kokuqedwa kokwelashwa. Lokhu kubizwa ngokuthi umphumela ophuzile. Ukuze uthole ulwazi olwengeziwe, vakashela isigaba 'semiphumela ephuzile' ukuze ufunde kabanzi mayelana neminye imiphumela yangaphambi kwesikhathi neyamuva engenzeka ekwelashweni kwe-lymphoma.
Izingane kanye nentsha ingase ibe nemiphumela engemihle ehlobene nokwelashwa engavela ezinyangeni noma iminyaka ngemva kokwelashwa, okuhlanganisa izinkinga zokukhula kwamathambo nokuthuthukiswa kwezitho zobulili kwabesilisa, ukungazali, kanye nezifo zegilo, inhliziyo namaphaphu. Imithi eminingi yamanje yokwelapha kanye nezifundo zocwaningo manje zigxile ekuzameni ukwehlisa ingozi yale miphumela sekwephuzile.
Ngenxa yalezi zizathu kubalulekile ukuthi abasindile be-B-cell lymphoma (DLBCL) esabalele kakhulu bathole ukulandelelwa nokuqapha njalo.
