Ukubuka konke kweBurkitt Lymphoma
I-Burkitt lymphoma iwuhlobo oluncane lwe-lymphoma olunolaka, futhi okucatshangwa ukuthi ikhula ngokushesha kakhulu - noma uhlobo lomdlavuza olunamandla kakhulu.
Ngenxa yokuthi iqala futhi isakazeka ngokushesha okukhulu, idinga ukwelashwa nge-chemoimmunotherapy ejulile ngokushesha ngemva kokuxilongwa. Kodwa-ke, ngenxa yokuthi ukwelapha ngamakhemikhali kusebenza kahle kakhulu kumaseli akhula ngokushesha, kuthinta kakhulu amaseli eBurkitt Lymphoma.
Abantu abaningi abaneBurkitt Lymphoma bangelapheka.
Ukuqonda ama-B-cell lymphocyte
IBurkitt Lymphoma ingumdlavuza wama-B-cell lymphocyte, ngakho-ke ukuze uqonde iBurkitt Lymphoma udinga ukwazi kancane ngama-B-Cell lymphocyte akho.
I-B-Cell lymphocyte:
- Ziwuhlobo lwamangqamuzana amhlophe egazi.
- Yilwa nezifo kanye nezifo ukuze uhlale unempilo.
- Khumbula izifo obunazo esikhathini esidlule, ngakho-ke uma uthola ukutheleleka okufanayo futhi, amasosha omzimba wakho angalwa nakho ngempumelelo nangokushesha.
- Zenziwe emnkantsheni wakho (ingxenye yesiponji phakathi kwamathambo akho), kodwa ngokuvamile zihlala ku-spleen yakho kanye nama-lymph nodes akho. Abanye bahlala ku-thymus yakho nasegazini futhi.
- Ungahamba ngohlelo lwakho lwe-lymphatic, uye kunoma iyiphi ingxenye yomzimba wakho ukuze ulwe nokutheleleka noma izifo.
I-Burkitt Lymphoma iqala lapho amanye ama-B-cell akho eba nomdlavuza. Zikhula ngokungalawuleki, azijwayelekile, futhi azifi lapho kufanele.
Uma uneBurkitt Lymphoma, ama-B-cell lymphocyte akho anomdlavuza:
- Khula futhi nande ngokushesha okukhulu.
- Ngeke isebenze ngempumelelo ukulwa nezifo kanye nezifo.
- Bheka futhi uziphathe ngendlela ehluke kakhulu kuma-B-cell akho anempilo.
- Kungabangela ukuthi i-lymphoma ikhule futhi ikhule ezingxenyeni eziningi zomzimba wakho.
Izinhlobo ezingaphansi zeBurkitt Lymphoma
Kunezinhlobo ezahlukene ze-lymphoma. Chofoza izihloko ezingezansi ukuze ufunde mayelana nezinhlobo ezincane ezihlukene.
I-Endemic Burkitt Lymphoma, evame kakhulu kubantu abanesizinda sase-Afrika, futhi i-lymphoma evame kakhulu ezinganeni zase-Afrika. Kuvame kakhulu kubantu abake baba nomalaleveva noma igciwane le-Epstein-Barr (EBV).
I-Endemic Burkitt Lymphoma ivame ukuqala emhlathini wakho, noma kwamanye amathambo obuso bakho, kodwa ingase iqale nasesiswini sakho (esiswini).
I-Sporadic Burkitt Lymphoma kungenzeka kunoma iyiphi ingxenye yomhlaba futhi njengamanye ama-lymphomas kucatshangwa ukuthi avame kakhulu kubantu abaye bangenwa igciwane le-Epstein-Barr. Kuvame ukuqala esiswini sakho, ngakho-ke kungase kuvame ubuhlungu noma ukungakhululeki esiswini sakho.
I-Sporadic Burkitt Lymphoma ingasakazekela ohlelweni lwakho lwezinzwa olumaphakathi, okuhlanganisa ubuchopho bakho nomgogodla, indlala yakho yegilo, amathani namathambo ebusweni bakho.
I-Burkitt Lymphoma ehlobene ne-Immunodeficiency ivame kakhulu kubantu abanamasosha omzimba abuthaka, futhi itholakala kubantu abanegciwane lesandulela ngculazi (i-HIV) noma asebethole i-acquired immunodeficiency syndrome (AIDS).
Kodwa-ke, lolu hlobo oluncane lungakhula futhi uma uthatha imithi eyenza amasosha omzimba aqine njengaleyo ethathwe ngemva kokufakelwa isitho noma uma unesifo esizimele.
Ivame kangakanani iBurkitt Lymphoma?
I-Burkitt lymphoma ithinta abantu banoma iyiphi iminyaka, kuhlanganise nezingane kanye nabantu abadala. Iwuhlobo olujwayeleke kakhulu lwe-lymphoma ezinganeni ezineminyaka ephakathi kwemi-5 neyi-10 futhi yenza u-30% wawo wonke ama-lymphoma ezingane - lokho kusho ukuthi izingane ezi-3 kweziyishumi ezine-lymphoma zizoba ne-Burkitt Lymphoma.
Kuyivelakancane kubantu abadala abano-1 noma 2 kuphela omdala kubo bonke abayi-100 (1-2%) abane-lymphoma ene-Burkitt Lymphoma. Kubantu abadala kuvame kakhulu kulabo abaneminyaka ephakathi kuka-30-50.
Izimpawu zeLymphoma
Ezinye izimpawu ze-Burkitt lymphoma zifana nezimpawu zamanye ama-lymphomas, kanti ezinye zingase zihlotshaniswe nalapho i-lymphoma ikhula khona.
Izindawo ezivamile Burkitt Lymphoma zingatholakala zihlanganisa:
- ama-lymph nodes entanyeni yakho, ikhwapha kanye ne-groin
- isisu sakho namathumbu
- isimiso sakho sezinzwa esimaphakathi (CNS) - ubuchopho nomgogodla
- umkantsha
- ubende, isibindi nezinye izitho zomzimba wakho
- umhlathi wakho noma amanye amathambo ebusweni bakho.
I-Nodal kanye ne-nodal eyengeziwe i-Burkitt Lymphoma
I-Burkitt Lymphoma ingaqala kuma-lymph nodes akho noma ngaphandle kwama-lymph nodes akho. Uma iqala kuma-lymph nodes yakho ibizwa ngokuthi "nodal". Uma iqala ngaphandle kwama-lymph nodes - njengasezithweni zakho noma umnkantsha wamathambo ibizwa ngokuthi "i-extra nodal".
Uphawu oluvame kakhulu lwe-nodal Burkitt Lymphoma ukuvuvuka kwama-lymph nodes okungenzeka kunoma iyiphi ingxenye yomzimba wakho. Avamise ukuzwakala entanyeni yakho, ekhwapheni noma embeleni, ngoba lawa ma-lymph nodes aseduze nesikhumba sakho.
Kodwa futhi sinama-lymph nodes esifubeni, esiswini, ezingalweni, emilenzeni nasekhanda. Ngenxa yokuthi iBurkitt Lymphoma ikhula futhi isakazeka ngokushesha ungase ubone ama-lymph nodes ezindaweni eziningi zomzimba wakho evuvukala.
Ezinye izimpawu zokuvuvukala kwama-lymph nodes noma i-extranodal lymphoma
Kuye ngokuthi yiziphi izingxenye zomzimba wakho ezine-lymph nodes ezivuvukele ungase ube nezimpawu ezahlukene. Ama-lymph nodes amaningi avuvukele ahlobene ne-lymphoma awabuhlungu, kodwa angaba buhlungu uma ecindezela ezinye izitho, izinzwa noma uma ziba zinkulu kakhulu.
Ngaphezu kwama-lymph nodes, siphinde sibe nezicubu ze-lymphoid ezingxenyeni ezahlukene zemizimba yethu njengomlomo wethu, isisu, amathumbu, amaphaphu. Izicubu ze-lymphoid yizindawo zamangqamuzana omzimba omzimba ahlala ezindaweni zemizimba yethu ukuze aqaphele futhi alwe nezifo. IBurkitt Lymphoma nayo ingaqala noma isabalale kunoma iyiphi yalezi zindawo.
Izimpawu zingabandakanya okulandelayo.
Indawo ethintekile | Izimpawu |
Isifuba noma intamo | Ukuphelelwa umoya Izinguquko ezwini lakho Ukukhwehlela okungapheli Ubuhlungu, ingcindezi noma ukungakhululeki esifubeni noma entanyeni Izinguquko kusigqi senhliziyo uma ingcindezi isenhliziyweni yakho |
Isimiso sezinzwa esimaphakathi (Ubuchopho, umgogodla nendawo engemuva kwamehlo akho) | Ukudideka noma izinguquko zenkumbulo isiyezi Izinguquko embonweni wakho Ubuthakathaka, ukuluma noma ukushisa Kunzima ukuhamba Ubunzima bokuya endlini yangasese Ukuthuthumela (ilingana) Izinguquko zomuntu |
Amathumbu - (Umlomo, isisu namathumbu) | Isicanucanu noma ngaphandle kokuhlanza Uhudo noma ukuqotshwa Isisu esivuvukele (ungabukeka ukhulelwe) Igazi uma uya endlini encane Ukuzizwa usuthi noma ungadlanga, noma udle kancane kakhulu Kunzima ukugwinya. |
Umkantsha | Izinguquko ekubalweni kwakho kwegazi okuhle okuhlanganisa:
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Izitho zesistimu yakho ye-lymphatic - i-Spleen ne-thymus
Ubende lwakho yisitho esihluza igazi lakho futhi siligcine liphilile. Kuphinde kube isitho sakho se-lymphatic system lapho ama-B-cell lymphocyte akho ehlala khona futhi akhiqize amasosha omzimba ukulwa nokutheleleka. Isohlangothini lwesobunxele lwesisu sakho esingaphezulu ngaphansi kwamaphaphu akho naseduze kwesisu sakho (isisu).
Uma ubunde bakho buba bukhulu kakhulu, bungase bucindezele isisu sakho futhi bukwenze uzizwe usuthe, ngisho noma ungakadli kakhulu. Ungathola futhi:
- Izibalo zegazi eziphansi.
- Ukukhathala okwedlulele.
- Ukwehla kwesisindo.
- I-jaundice (isikhumba sakho namehlo aphuzi).
- Ubuhlungu esiswini sakho noma umuzwa "wokuqunjelwa".
Your i-thymus futhi iyingxenye yesistimu yakho ye-lymphatic. Kuyisitho esimise okwevemvane esihlala ngemuva kwethambo lakho lesifuba ngaphambili kwesifuba sakho. Amanye ama-B-cell nawo aphila futhi adlule ku-thymus yakho. Uma i-lymphoma iku-thymus yakho ungaba nesigaxa esifubeni sakho i-taht ingakwazi ukucindezela ezinye izitho esifubeni sakho. Izimpawu zingafana nalezi ezisohlwini lwethebula elingenhla.
Isibindi
- Jaundice.
- Ubuhlungu noma ukungaphatheki kahle okungaphuma kuze kufike ehlombe lakho lesokunxele.
- Ukwehla kwesifiso sokudla nokuncipha.
- Ukuvuvukala kwesisu sakho ngenxa yokwakheka koketshezi (ama-ascites).
- Ukopha okungajwayelekile.
B-izimpawu
Izimpawu ze-B zingenzeka lapho i-lymphoma ikhula ngenkuthalo. Kungabonisa ukuthi i-lymphoma isebenzisa amandla akho okugcina noma ikhiqiza amakhemikhali athinta indlela umzimba wakho olawula ngayo izinga lokushisa lakho. Bika njalo udokotela wakho ngezimpawu ze-B.
Ukuxilongwa kanye Nesiteji seBurkitt Lymphoma
Uma udokotela wakho ecabanga ukuthi ungase ube ne-lymphoma, uzodinga ukuhlela inani lokuhlolwa okubalulekile. Lezi zivivinyo ziyadingeka ukuze uqinisekise noma ukhiphe i-lymphoma njengembangela yezimpawu zakho.
Ukuze uhlole i-Burkitt Lymphoma uzodinga i-biopsy. I-biopsy iyinqubo yokukhipha ingxenye, noma yonke i-lymph node ethintekile kanye/noma isampula yomnkantsha. I-biopsy isuke ihlolwe ososayensi elabhorethri ukuze babone ukuthi azikho yini izinguquko ezisiza udokotela ahlonze i-Burkitt.
Uma wenza i-biopsy, ungase ube ne-anesthesia yendawo noma evamile. Lokhu kuzoncika ohlotsheni lwe-biopsy nokuthi ithathwe kuyiphi ingxenye yomzimba wakho. Kunezinhlobo ezahlukene ze-biopsies futhi ungase udinge ezingaphezu kweyodwa ukuze uthole isampula engcono kakhulu.
Ukuhlolwa kwegazi
Ukuhlolwa kwegazi kuthathwa uma uzama ukuxilonga i-lymphoma yakho, kodwa futhi kukho konke ukwelashwa kwakho ukuze uqiniseke ukuthi izitho zakho zisebenza kahle futhi zingakwazi ukubhekana nokwelashwa kwethu.
I-Core or fine inaliti biopsy
I-core or finele biopsies yenaliti ithathwa ukuze kukhishwe isampula ye-lymph node evuvukele noma isimila ukuze kuhlolwe izimpawu ze-lymphoma.
Udokotela wakho ngokuvamile uzosebenzisa isibulali-zinzwa sendawo ukuze enze indawo ibe ndikindiki ukuze ungezwa zinhlungu phakathi nenqubo, kodwa uzobe uphapheme phakathi nalokhu biopsy. Bazobe sebefaka inaliti ku-lymph node evuvukele noma isigaxa bese bekhipha isampula lesicubu.
Uma i-lymph node yakho evuvukele noma isigaxa sijule ngaphakathi emzimbeni wakho i-biopsy ingenziwa ngosizo lwe-ultrasound noma i-x-ray ekhethekile (imaging).
Ungase ube nesibulali-zinzwa esivamile salokhu (okukwenza ulale isikhashana). Ungase futhi ube nezitishi ezimbalwa kamuva.
I-Core Need biopsy ithatha isampula enkulu kune-finenes biopsy.
I-Excisional node biopsy
Ama-excisional node biopsies enziwa lapho i-lymph node yakho evuvukele noma isimila sijule kakhulu emzimbeni wakho ukuthi singafinyelelwa ngomongo noma ngenaliti ecolekile. Uzothola isibulali-zinzwa esivamile esizokulalisa isikhashana ukuze uhlale unganyakazi, futhi ungezwa buhlungu.
Phakathi nale nqubo, udokotela ohlinzayo uzokhipha yonke i-lymph node noma isigaxa futhi ayithumele ku-pathology ukuze ihlolwe.
Uzoba nenxeba elincane elinemithungo embalwa, kanye nengubo ngaphezulu.
Imithungo ivamise ukuhlala izinsuku eziyisi-7-10, kodwa udokotela noma unesi wakho uzokunikeza imiyalelo yokuthi unakekele ukugqokwa, nokuthi ubuya nini ukuyokhipha imithungo.
Ukuxilongwa kwe-Burkitt Lymphoma
Uma udokotela wakho esethole imiphumela ekuhlolweni kwegazi kanye nama-biopsies bazokwazi ukukutshela uma une-Burkitt Lymphoma futhi angase akwazi ukukutshela ukuthi yiluphi uhlobo oluncane lwe-Burkitt's onalo. Bazobe sebefuna ukwenza izivivinyo ezengeziwe ukuze bafake i-lymphoma yakho.
Isiteji kanye Nokugreda Burkitt Lymphoma
Uma usutholwe ukuthi une-Burkitt Lymphoma, udokotela wakho uzoba nemibuzo eminingi mayelana ne-lymphoma yakho. Lokhu kuzobandakanya:
- Isiphi isigaba se-lymphoma yakho?
- Iluphi uhlobo oluncane lweBurkitt onalo?
Chofoza izihloko ezingezansi ukuze ufunde kabanzi mayelana nesiteji kanye nokugreda.
Isiteji sisho ukuthi ungakanani umzimba wakho othintwa i-lymphoma yakho - noma, ukuthi isisabalele kangakanani lapho iqale khona.
Ama-B-cell angahamba aye kunoma iyiphi ingxenye yomzimba wakho. Lokhu kusho ukuthi amaseli e-lymphoma (ama-B-cell anomdlavuza), angaphinde ahambe kunoma iyiphi ingxenye yomzimba wakho. Kuzodingeka wenze izivivinyo ezengeziwe ukuze uthole lolu lwazi. Lezi zivivinyo zibizwa ngokuthi yi-staging test futhi uma uthola imiphumela, uzothola ukuthi unesigaba sokuqala (I), isigaba sesibili (II), isigaba sesithathu (III) noma isigaba sesine (IV) seBurkitt Lymphoma. Kodwa-ke, ngenxa yokuthi iBurkitt inolaka kakhulu ngokuvamile isivele iyisiteji esithuthukile (isigaba sesi-3 noma sesi-4) uma uxilongwa,
Isigaba sakho se-lymphoma sizoncika ku:
- Zingaki izindawo zomzimba wakho ezine-lymphoma
- Lapho i-lymphoma ihlanganisa uma ingaphezulu, ngezansi noma nhlangothi zombili ze-diaphragm yakho (umsipha omkhulu, omise okwedome ngaphansi kwezimbambo ohlukanisa isifuba nesisu sakho)
- Ukuthi i-lymphoma isisabalele kumnkantsha wakho wethambo noma ezinye izitho ezinjengesibindi, amaphaphu, isikhumba noma ithambo.
Izigaba I no-II zibizwa ngokuthi 'isigaba sokuqala noma esilinganiselwe' (okubandakanya indawo elinganiselwe yomzimba wakho).
Izigaba III kanye ne-IV zibizwa ngokuthi 'isiteji esithuthukisiwe' (sabalale kakhulu).
1 internship | indawo eyodwa ye-lymph node iyathinteka, noma ngaphezulu noma ngaphansi kwe-diaphragm* |
2 internship | izindawo ezimbili noma ngaphezulu zama-lymph node zithinteka ohlangothini olulodwa lwe-diaphragm* |
3 internship | okungenani indawo eyodwa ye-lymph node ngaphezulu kanye ne-lymph node eyodwa engaphansi kwe-diaphragm* iyathinteka |
4 internship | i-lymphoma itholakala kuma-lymph nodes amaningi futhi isisakazekele kwezinye izingxenye zomzimba (isb. amathambo, amaphaphu, isibindi) |
Ulwazi lwesiteji olwengeziwe
Udokotela wakho angase futhi akhulume ngesiteji sakho esebenzisa incwadi, efana no-A,B, E, X noma S. Lezi zincwadi zinikeza ulwazi olwengeziwe mayelana nezimpawu onazo noma ukuthi umzimba wakho uthinteka kanjani i-lymphoma. Lonke lolu lwazi lusiza udokotela wakho ukuthi akutholele uhlelo olungcono kakhulu lwezokwelapha.
Incwadi | Okusho | Ukubaluleka |
A noma B |
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E & X |
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S |
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(Ubende lwakho luyisitho ohlelweni lwakho lwe-lymphatic oluhluza futhi luhlanze igazi lakho, futhi luyindawo lapho ama-B-cell akho aphumula khona futhi enze amasosha omzimba) |
Ukuhlolwa kwesiteji
Ukuze uthole ukuthi yisiphi isigaba onaso, ungacelwa ukuthi wenze ezinye zalezi zivivinyo ezilandelayo:
Icwecwe le-computer tomography (CT)
Lezi zithwebuli zithatha izithombe zengaphakathi lesifuba sakho, isisu noma i-pelvis. Banikeza izithombe ezinemininingwane enikeza ulwazi olwengeziwe kune-X-ray evamile.
Ukuskena kwe-Positron emission tomography (PET)
Lesi iskena esithatha izithombe zengaphakathi lomzimba wakho wonke. Uzonikezwa futhi ufake inaliti ngomuthi othile othathwa amaseli anomdlavuza - njengamaseli e-lymphoma. Umuthi osiza ukuskena kwe-PET ukukhomba lapho i-lymphoma ikuphi kanye nosayizi nokuma ngokugqamisa izindawo ezinamaseli e-lymphoma. Lezi zindawo ngezinye izikhathi zibizwa ngokuthi "ezishisayo".
Ukukhishwa kwe-Lumbar
Ukubhoboza i-lumbar kuyinqubo eyenziwa ukuhlola ukuthi unayo yini i-lymphoma endaweni yakho isimiso sezinzwa esiyinhloko (CNS), okuhlanganisa ubuchopho bakho, umgogodla kanye nendawo ezungeze amehlo akho. Uzodinga ukuthi unganyakazi phakathi nenqubo, ukuze izingane kanye nezingane zibe nesibulali-zinzwa esivamile ukuze zilalise isikhashana inqubo yenziwa. Abantu abadala abaningi bazodinga kuphela umuthi obulala izinzwa wasendaweni ukuze inqubo iqede indawo.
Udokotela wakho uzokufaka inaliti emhlane wakho, futhi akhiphe uketshezi oluncane olubizwa ngokuthi “uketshezi lwe-cerebral spinal” (CSF) kusuka eduze komgogodla wakho. I-CSF iwuketshezi olusebenza kancane njengesibambisi sokwethuka ku-CNS yakho. Iphinde ithwale amaprotheni ahlukene kanye nokutheleleka okulwa namaseli omzimba afana ne-lymphocyte ukuvikela ubuchopho bakho nomgogodla. I-CSF ingasiza futhi ukukhipha noma iluphi uketshezi olwengeziwe okungenzeka unalo ebuchosheni bakho noma eduze komgogodla wakho ukuvimbela ukuvuvukala kulezo zindawo.
Isampula ye-CSF izobe isithunyelwa ku-pathology futhi ihlolwe noma yiziphi izimpawu ze-lymphoma.
I-bone yomnkantsha i-biopsy
- I-Bone marrow aspirate (BMA): lokhu kuhlola kuthatha inani elincane loketshezi olutholakala endaweni yomnkantsha.
- I-Bone marrow aspirate trephine (BMAT): lokhu kuhlola kuthatha isampula elincane lomnkantsha wethambo.
Amasampula abe esethunyelwa ku-pathology lapho ehlolelwa khona izimpawu ze-lymphoma.
Inqubo ye-biopsies yomnkantsha ingahluka kuye ngokuthi ulashwa kuphi, kodwa ngokuvamile izofaka isibulali-zinzwa sasendaweni ukuze ndikindiki indawo.
Kwezinye izibhedlela, ungase unikezwe i-sedation elula ekusiza ukuthi uphumule futhi ingakuvimba ekukhumbuleni inqubo. Nokho abantu abaningi abakudingi lokhu futhi esikhundleni salokho bangase babe “nempempe eluhlaza” abangayincela. Le nlozi eluhlaza inomuthi obulala izinhlungu kuwo (obizwa ngePenthrox noma i-methoxyflurane), owusebenzisa njengoba kudingeka kuyo yonke inqubo.
Qiniseka ukuthi ubuza udokotela wakho ukuthi yini etholakalayo ukuze ukhululeke kakhudlwana phakathi nenqubo, futhi ukhulume nabo ngalokho ocabanga ukuthi kuyoba inketho engcono kakhulu kuwe.
Ulwazi olwengeziwe mayelana nama-biopsies omnkantsha lungatholakala ekhasini lethu lewebhu lapha.
I-Burkitt Lymphoma iwuhlobo oluncane lwe-lymphoma olunamandla kakhulu kanye nomdlavuza ohlasela kakhulu. Ngakho-ke, kuhlale kubhekwa njenge-high-grade lymphoma.
Ibanga libhekisela ekutheni amaseli aphindaphindeka ngokushesha kangakanani, ukuthi abukeka kanjani nokuthi aziphatha kanjani.
Amaseli e-lymphoma ebanga eliphakeme aphindaphindeka ngokushesha okukhulu, abukeka ehluke kakhulu kuma-B-cell lymphocyte akho avamile futhi awakwazi ukusebenza ngendlela ama-lymphocyte okufanele asebenze ngayo.
Ingozi ephansi kanye nengozi ephezulu yeBurkitt Lymphoma
Udokotela wakho angase futhi abhekisele ku-Burkitt yakho njengengcuphe ephezulu noma ingozi ephansi. Lolu ulwazi olwengeziwe abalusebenzisayo ukuze bathole ukwelashwa okungcono kakhulu kwakho. Ubungozi bakho buzonqunywa ngokusekelwe kulokhu okulandelayo:
- Kungakhathaliseki ukuthi une-lymphoma ohlelweni lwakho lwezinzwa olumaphakathi (CNS).
- Uma ukuhlolwa kwegazi lakho kukhombisa i-lactate dehydrogenase (LDH) ephezulu.
- Uma unokunye ukuhlela kabusha kofuzo noma izinguquko.
Ukuhlolwa kwe-cytogenetic
Ukuhlolwa kwe-Cytogenetic kwenziwa ukuhlola ukuhlukahluka kofuzo okungenzeka kuhileleke esifweni sakho. Ukuze uthole ulwazi olwengeziwe ngalokhu sicela ubheke isigaba sethu sokuqonda i-lymphoma genetics ngokuqhubekayo kuleli khasi. Ukuhlola okusetshenziselwa ukuhlola noma yikuphi ukuguqulwa kofuzo kubizwa ngokuthi ukuhlola kwe-cytogenetic. Lokhu kuhlola kubheka ukubona ukuthi awunakho yini okushintshile kuma-chromosome nakuzakhi zofuzo.
Sivame ukuba namapheya angu-23 ama-chromosome, futhi abalwa ngokobukhulu bawo. Uma une-Burkitt Lymphoma, ama-chromosome akho angase abukeke ehluke kancane.
Ayini izakhi zofuzo nama-chromosomes
Ingqamuzana ngalinye elakha umzimba wethu linenucleus, futhi ngaphakathi ku-nucleus kunamapheya angu-23 ama-chromosome. Ichromosome ngayinye yenziwe ngemicu emide ye-DNA (deoxyribonucleic acid) equkethe izakhi zethu zofuzo. Izakhi zofuzo zethu zinikeza ikhodi edingekayo ukuze kwenziwe wonke amangqamuzana namaprotheni asemzimbeni wethu, futhi ibatshela ukuthi kufanele babukeke noma benze kanjani.
Uma kunoshintsho (ukuhlukahluka) kulawa ma-chromosome noma izakhi zofuzo, amaprotheni namaseli akho ngeke asebenze kahle.
Ama-lymphocyte angaba amaseli e-lymphoma ngenxa yezinguquko zofuzo (okuthiwa ukuguqulwa noma ukuhluka) ngaphakathi kwamaseli. I-lymphoma biopsy yakho ingase ibhekwe udokotela wezifo ezithile ukuze abone ukuthi awunazo yini izinguquko zofuzo.
Ukudluliselwa eBurkitt Lymphoma
E-Burkitt Lymphoma uzoba nokuhlukahluka kofuzo olubizwa ngokuthi i-translocation. Lokhu kwenzeka lapho ingxenye encane yama-chromosome amabili ishintsha izindawo. Isakhi sofuzo esihlala sithinta i-Burkitt Lymphoma sihlanganisa isakhi sofuzo se-MYC ku-chromosome yesi-8 futhi ukudluliselwa kwenzeka ngofuzo ku-chromosome yesi-14. Uzoyibona ibhalwe ukuthi t(8:14).
Ukwelashwa kweBurkitt Lymphoma
Uma yonke imiphumela yakho evela ku-biopsy, ukuhlolwa kwe-cytogenetic kanye nezikena zesiteji sekuqediwe, udokotela uzobuyekeza lokhu ukuze anqumele indlela yokwelashwa engcono kakhulu. Kwezinye izikhungo zomdlavuza, udokotela uzophinde ahlangane nethimba lochwepheshe ukuze kudingidwe indlela yokwelapha engcono kakhulu. Lokhu kubizwa ngokuthi a ithimba le-multidisciplinary (MDT) umhlangano.
Udokotela wakho uzocabangela izici eziningi mayelana ne-Burkitt Lymphoma yakho, kodwa uzodinga ukuqala ukwelashwa nge-chemo-immunotherapy ngokushesha ngemva kokuxilongwa. Ngaphandle kokwelashwa iBurkitt Lymphoma iyabulala, nokho ngokwelashwa kunethuba elihle kakhulu lokwelashwa.
I-Chemo-immunotherapy isho ukuba nemithi ebizwa ngokuthi i-chemotherapy kanye ne-monoclonal antibody. Amasosha omzimba e-Monoclonal ngokuvamile abizwa ngokuthi i-immunotherapy ngoba asiza amasosha akho omzimba ukulwa nomdlavuza. I-Chemotherapy isebenza ngokuhlasela ngokuqondile amaseli akhula ngokushesha.
Ezinye izinto udokotela wakho azozicabangela lapho uhlela ukwelashwa kwakho zihlanganisa:
- isigaba ngasinye se-lymphoma, izinguquko zofuzo kanye nezimpawu
- ubudala, umlando wezokwelapha odlule kanye nempilo jikelele
- ukuphila kahle ngokomzimba nangokwengqondo kwamanje kanye nezintandokazi zesiguli
- noma yiziphi izimpawu ozitholayo.
Okunye ukuhlolwa
Ukuhlolwa okwengeziwe kungase ku-odwe ngaphambi kokuba uqale ukwelashwa ukuze uqiniseke ukuthi inhliziyo yakho, amaphaphu nezinso ziyakwazi ukubhekana nokwelashwa. Lokhu kungase kuhlanganise i-ECG (i-electrocardiogram), ukuhlolwa kokusebenza kwamaphaphu noma ukuqoqwa komchamo wamahora angu-24.
Udokotela wakho noma umhlengikazi womdlavuza angakuchazela ngohlelo lwakho lokwelapha kanye nemiphumela engemihle engase ibe khona kuwe, futhi ukhona ukuphendula noma yimuphi umbuzo ongase ube nawo. Kubalulekile ukuthi ubuze udokotela wakho kanye/noma unesi womdlavuza imibuzo nganoma yini ongayiqondi.
Ungaphinda ushayele ucingo noma uthumele i-imeyili ku-Lymphoma Australia Nurse Helpline ngemibuzo yakho futhi singakusiza ukuthi uthole ulwazi olulungile.
Inombolo yocingo yomhlengikazi we-Lymphoma:
Ifoni: 1800 953 081
Email: nurse@lymphoma.org.au
Imibuzo okufanele uyibuze udokotela wakho ngaphambi kokuba uqale ukwelashwa
Kungaba nzima ukwazi ukuthi yimiphi imibuzo okufanele uyibuze lapho uqala ukwelashwa. Uma ungazi, yini ongayazi, ungazi kanjani ukuthi yini okufanele uyibuze?
Ukuba nolwazi olufanele kungakusiza uzizwe uqiniseka futhi wazi ukuthi yini ongayilindela. Kungakusiza nokuthi uhlele kusengaphambili lokho ongase ukudinge.
Sihlanganisa uhlu lwemibuzo ongayithola iwusizo. Yiqiniso, isimo sawo wonke umuntu sihlukile, ngakho le mibuzo ayihlanganisi yonke into, kodwa inikeza isiqalo esihle.
Chofoza isixhumanisi esingezansi ukuze udawunilode i-PDF ephrintekayo yemibuzo kadokotela wakho.
Ukulondolozwa Kwenzalo
Ukwelashwa kweBurkitt Lymphoma kungathinta inzalo yakho (ikhono lokuba nezingane). Lokhu kungenzeka kokubili abadala kanye nezingane, abesilisa nabesifazane. Uma wena (noma ingane yakho) ungathanda izingane kamuva ekuphileni, khuluma nodokotela wakho mayelana nokuthi ukuzala kwakho kungavikelwa yini ngokuhamba kwesikhathi.
Izinqubo Zokwelapha Ezivamile Zabantu Abadala abaneBurkitt Lymphoma
Ukwelashwa kwakho kuvame ukusebenza kahle kakhulu ngokumelene ne-lymphoma yakho, kodwa kungathinta namaseli akho amahle. Ngakho udinga isikhathi ukuze amaseli akho alungile alulame. Amaseli anempilo ahlehla ngokushesha kakhulu kunamaseli e-lymphoma ngoba ahleleke kakhulu.
Izinqubo zokwelapha ezijwayelekile ongase unikezwe zona zihlanganisa:
I-DA-R-EPOCH (i-rituximab elungisiwe umthamo, i-etoposide, i-prednisolone, i-vincristine, i-cyclophosphamide, i-doxorubicin)
R-CODOX-M (rituximab, cyclophosphamide, vincristine, doxorubicin, methotrexate)
- I-R-CODOX-M ishintshaniswa nayo I-R-IVAC (i-rituximab, ifosfamide, i-etoposide, i-cytarabine)
GMALL 2002 (iziguli ezingaphezu kweminyaka engama-55)
GMALL 2002 (iziguli ezingaphansi kweminyaka engama-55)
I-Hyper CVAD ingxenye A
- Ingxenye A yeHyper CVAD ishintshaniswa nayo IHyper CVAD Ingxenye B
Amaphrothokholi Okwelapha Ajwayelekile Ezingane ezineBurkitt Lymphoma
- I-R-COPADM: i-rituximab, i-cyclophosphamide, i-vincristine, i-methotrexate, i-cytarabine, i-Prednisolone, i-doxorubicin, i-etoposide.
- QAPHELA LMB 89: I-cyclophosphamide, i-vincristine, i-methotrexate, i-doxorubicin), i-cytarabine, i-etoposide
Okunye ukuhlukahluka kwezinqubo ze-chemotherapy ezisetshenziswa e-Burkitt lymphoma yezingane zihlanganisa:
- CHOP: I-cyclophosphamide, i-daunorubicin, i-vincristine ne-prednisolone
- I-COPAD: I-cyclophosphamide, i-cytarabine, i-doxorubicin, i-vincristine, i-etoposide, i-Prednisolone
- I-COPADM: I-cyclophosphamide, i-methotrexate, i-cytarabine, i-doxorubicin, i-vincristine, i-etoposide
I-Burkitt Lymphoma Ephindaphindiwe noma Ephikisayo
Kwezinye izimo, i-lymphoma yakho ingase ingaphenduli emgqeni wokuqala wokwelashwa onawo. Uma lokhu kwenzeka, i-lymphoma yakho ibizwa ngokuthi i-refractory.
Ngezinye izikhathi, ungathola impendulo enhle ekwelashweni kwakho, kodwa i-lymphoma ingaphinde ibuyele (ibuye) ngemva kwesikhathi esithile.
Kuyo yomibili iBurkitt Lymphoma ene-refractory nephinde yavela uzonikezwa ukwelashwa okwengeziwe.
Ukwelashwa emugqeni wesibili noma wesithathu kungabandakanya:
- i-immuno-chemotherapy eyengeziwe
- ukufakelwa kwe-cell stem
- Ukwelashwa kwe-CAR T-cell
Ukuze uthole ulwazi olwengeziwe mayelana nokwelashwa nezinto okufanele uzicabangele bheka ikhasi lethu lokwelapha.
Izivivinyo zemitholampilo
Kunconywa ukuthi noma nini lapho udinga ukuqala ukwelashwa okusha ubuze udokotela wakho mayelana nezivivinyo zomtholampilo ongase ukufanelekele.
Izivivinyo zomtholampilo zibalulekile ukuthola imithi emisha, noma inhlanganisela yemithi yokuthuthukisa ukwelashwa kweBurkitt Lymphoma esikhathini esizayo.
Bangakunikeza nethuba lokuzama umuthi omusha, inhlanganisela yemithi noma ezinye izindlela zokwelapha ongeke ukwazi ukuzithola ngaphandle kohlolo. Uma ungathanda ukubamba iqhaza esivivinyweni somtholampilo, buza udokotela wakho ukuthi yiziphi izivivinyo zomtholampilo okufanelekela kuzo.
Kukhona izindlela zokwelapha eziningi nezinhlanganisela ezintsha zokwelapha okwamanje ezihlolwayo ezivivinyweni zemitholampilo emhlabeni wonke ezigulini ezine-Burkitt Lymphoma esanda kuxilongwa nephinde yabuya.
I-prognosis ye-Burkitt Lymphoma - nokuthi kwenzekani lapho ukwelashwa kuphela
I-prognosis yigama elisetshenziselwa ukuchaza indlela okungenzeka yesifo sakho, ukuthi sizosabela kanjani ekwelashweni nokuthi uzokwenza kanjani phakathi nangemuva kokwelashwa.
Kunezici eziningi ezinomthelela ekubikezeleni kwakho futhi akunakwenzeka ukunikeza isitatimende esiphelele mayelana nokubikezela. Nokho, iBurkitt Lymphoma ivamise ukusabela kahle kakhulu ekwelashweni futhi iziguli eziningi ezinalo mdlavuza zingelapheka - okusho ukuthi ngemva kokwelashwa, alukho uphawu lweBurkitt Lymphoma emzimbeni wakho. Nokho, kuneqembu elincane labantu elingase lingasabeli kahle ekwelashweni.
Izinto ezingaba nomthelela ku-prognosis
Ezinye izici ezingase zibe nomthelela ekubikezelweni kwakho zihlanganisa:
- Uneminyaka yobudala kanye nempilo yonke ngesikhathi sokuxilongwa.
- Indlela osabela ngayo ekwelashweni.
- Kuthiwani uma kukhona ukuguqulwa kofuzo onakho.
- I-subtype ye-Burkitt Lymphoma onayo.
Uma ungathanda ukwazi okwengeziwe nge-prognosis yakho siqu, sicela ukhulume nochwepheshe wakho we-hematologist noma i-oncologist. Bazokwazi ukukuchazela izici zakho zobungozi kanye ne-prognosis kuwe.
Ukusinda - Ukuphila nomdlavuza, nangemva kwalokho
Indlela yokuphila enempilo, noma ezinye izinguquko ezinhle zokuphila ngemva kokwelashwa zingaba usizo olukhulu ekululameni kwakho. Ziningi izinto ongazenza ukukusiza ukuthi uphile kahle ngemva kukaBurkitt.
Abantu abaningi bathola ukuthi ngemva kokuxilongwa umdlavuza, noma ukwelashwa, ukuthi izinhloso zabo nezinto eziza kuqala ekuphileni ziyashintsha. Ukwazi ukuthi kuyini 'okujwayelekile kwakho okusha' kungase kuthathe isikhathi futhi kukhungathekise. Okulindelekile komndeni wakho nabangane kungase kwehluke kokwakho. Ungase uzizwe uhlukanisiwe, ukhathele noma iyiphi imizwa ehlukene engashintsha usuku ngalunye.
Imigomo eyinhloko ngemva kokwelashwa kwe-lymphoma yakho wukubuyela ekuphileni futhi:
- khuthala ngangokunokwenzeka emsebenzini wakho, emndenini, nakwezinye izindima zempilo
- nciphisa imiphumela emibi kanye nezimpawu zomdlavuza kanye nokwelashwa kwawo
- khomba futhi ulawule noma yimiphi imiphumela emibi ngemva kwesikhathi
- ukusiza ukugcina uzimele ngangokunokwenzeka
- ngcono izinga lakho lempilo futhi ugcine impilo enhle yengqondo
Izinhlobo ezahlukene zokuvuselela umdlavuza zinganconywa kuwe. Lokhu kungasho noma yiluphi uhlobo olubanzi yezinkonzo ezifana nalezi:
- ukwelashwa ngokomzimba, ukuphathwa kobuhlungu
- ukuhlela okunomsoco nokuzivocavoca
- ukwelulekwa ngokomzwelo, kwezemisebenzi nakwezezimali.
Isifinyezo
- I-Burkitt Lymphoma iwuhlobo lomdlavuza oluyingozi kakhulu ongaluthola - kodwa lokhu kusho ukuthi ngokuvamile usabela kahle kakhulu ekwelashweni.
- Abantu abaningi abaneBurkitt Lymphoma bangelapheka.
- I-Burkitt Lymphoma yenzeka lapho i-B-cell lymphocyte yakho iba nomdlavuza futhi ingathinta izingane kanye nabantu abadala.
- Uzodinga ukwelashwa nge-chemo-immunotherapy ngokushesha ngemva kokutholakala kwakho.
- Kwezinye izimo, i-lymphoma yakho ingase ingaphenduli ekwelashweni, noma ingase ibuyele emuva ngemva kokwelashwa futhi uzodinga ukwelashwa okwengeziwe uma lokhu kwenzeka.
- Buza udokotela wakho mayelana nezivivinyo zomtholampilo ongase ukufanelekele.
