lymphoma Hodgkin (HL) he ʻano maʻi maʻi koko e ulu wikiwiki ana (hoʻopaʻapaʻa) e pili ana i nā mākua a me nā keiki. Hoʻopilikia ia i kahi ʻano o ke koko keʻokeʻo i kapa ʻia B-cell lymphocytes, he ʻāpana ia o kāu ʻōnaehana pale.
Nānā nui o Hodgkin Lymphoma (HL)
ʻO ka lymphoma Hodgkin kahi maʻi maʻi koko hiki ke mālama ʻia i ʻike mua ʻia i loko o kahi maʻi i ka makahiki 1830, e kekahi kauka Pelekane ʻo Thomas Hodgkin. Ua hana ʻia kēia maʻi ma hope o ʻelua mau ʻepekema i kapa ʻia ʻo Reed lāua ʻo Sternberg, i aʻo i nā laʻana kiko o ka poʻe me Hodgkin lymphoma. Ua ʻike lākou ua loaʻa i nā poʻe āpau me HL kekahi ʻano o ka cell abnormal. No ka mea, ʻo Reed lāua ʻo Sternberg ka mea mua i ʻike i kēia cell, ua kapa ʻia lākou ʻo ka Kelepona Reed-Sternberg.
No Reed Sternberg pūnaewele a me Hodgkin Lymphoma
- ʻO nā pūnaewele Reed-Sternberg he nui ʻokoʻa, ʻino (cancerous), nā lymphocytes B-cell makua.
- ʻO ka loaʻa ʻana o nā cell Reed-Sternberg e kōkua i nā kauka e ʻike i ka lymphoma Hodgkin (HL) ma kahi o ka lymphoma non-Hodgkin (NHL).
- ʻO nā lymphoma a pau i ʻike ʻia ma hope o ka lymphoma Hodgkin (ʻaʻole i loaʻa ka cell Reed-Sternberg) ua kapa ʻia ʻo non-Hodgkin lymphoma.
Nā mea pilikia no ka hoʻomohala ʻana i ka Lymphoma Hodgkin (HL)
ʻAʻole maopopo iā mākou ke kumu o ka lymphoma Hodgkin, akā ua manaʻo ʻia nā kumu pilikia like ʻole. ʻO kekahi o kēia mau mea pilikia inā loaʻa iā ʻoe:
- Ua loaʻa iā Epstein Barr virus (EBV). Hoʻokumu ka EBV i ka mononucleosis (ʻike ʻia ʻo "mono" a i ʻole ka maʻi glandular).
- ʻO ka maʻi hoʻopalekana kanaka (HIV).
- ʻO kekahi mau maʻi o kāu ʻōnaehana pale, e like me autoimmune maʻi lymphoproliferative.
- He ʻōnaehana pale kino nāwaliwali ma hope o kahi pūnaewele kino ke kanu. A i ʻole, mai kekahi mau lāʻau lapaʻau āu e lawe ai.
- He makua, kaikunāne, a kaikuahine paha me ka moʻolelo pilikino o Hodgkin lymphoma.
He mea nui e hoʻomaopopo naʻe, ʻaʻole hiki i nā poʻe āpau i loaʻa kēia mau pilikia ke hoʻomohala i ka HL, a ʻo kekahi poʻe me ka ʻike ʻole o nā kumu pilikia hiki ke hoʻomohala i ka HL.
No ka hoʻomaopopo ʻana i ka HL, pono ʻoe e ʻike iki e pili ana i kāu B-Cell lymphocytes (a i ʻole B-cell)
Nā ʻāpana B:
- He ʻano o ke koko keʻokeʻo.
- E hakakā i ka maʻi a me nā maʻi e mālama pono iā ʻoe.
- E hoʻomanaʻo i nā maʻi i loaʻa iā ʻoe i ka wā ma mua, no laila inā loaʻa hou iā ʻoe ka maʻi like, hiki i ka ʻōnaehana pale o kou kino ke hakakā me ka ʻoi aku ka maikaʻi a me ka wikiwiki.
- Hana ʻia i loko o kou iwi iwi (ʻo ka ʻāpana spongy i waenakonu o kou mau iwi), akā noho mau i loko o kāu ʻōnaehana lymphatic, e komo pū ana i loko o kou spleen, thymus a me nā lymph nodes.
- Hiki ke hele ma kāu ʻōnaehana lymphatic, a i waho i kekahi wahi o kou kino e hakakā ai i ka maʻi a i ʻole ka maʻi.
Hoʻokumu ʻia ʻo Hodgkin Lymphoma i ka wā e lilo ai kekahi o kāu mau cell B i ka maʻi kanesa
Hoʻokumu ʻo HL i ka wā e lilo ai kekahi o kāu mau pūnaʻi B i ka maʻi kanesa. Ulu lākou me ka ʻole ka mālama ʻia, ʻano ʻino a ʻaʻole make i ka wā e pono ai.
Ke loaʻa iā ʻoe ka HL nā pūnaʻi B maʻi kanesa:
- ʻAʻole e hana maikaʻi e hakakā i nā maʻi a me nā maʻi.
- E lilo i ʻoi aku ka nui ma mua o ka pono a ʻokoʻa ka nānā ʻana i kāu mau cell B-ola.
- Hiki ke ulu a ulu ka lymphoma ma kekahi wahi o kou kino.
Nā ʻano liʻiliʻi o Hodgkin Lymphoma (HL)
Ua hoʻokaʻawale mua ʻia ʻo Hodgkin Lymphoma i 4 subtypes o Classical Hodgkin Lymphoma, a me kahi subtype kaʻawale i kapa ʻia ʻo Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). Eia naʻe, ua ʻike hou ʻia ka noiʻi ʻana ʻaʻole i loaʻa i ka NLPHL nā ʻano o Hodgkin Lymphoma a no laila ua kapa hou ʻia ʻo ia ʻo Nodular Lymphocyte Predominant B-cell Lymphoma (NLPBCL). E ʻoluʻolu e aʻo hou e pili ana iā NLPBCL Bus maʻaneʻi.
No ka ʻike hou aku e pili ana i nā ʻano subtypes o Hodgkin Lymphoma maʻamau e hoʻomau ma kēia ʻaoʻao.
Lymphoma Hodgkin Ma'amau (cHL)
ʻO ka Lymphoma Hodgkin Classical (cHL) kahi lymphoma B-cell e ulu wikiwiki ana. Eia naʻe, pane maikaʻi loa ka cHL i ka mālama maʻamau me ka chemotherapy. Ma kahi o 9 i loko o 10 mau kānaka e kala ʻia ma hope o ka lāʻau lapaʻau mua. ʻO ia hoʻi, ʻaʻohe hōʻailona o ka lymphoma i koe i loko o kou kino. ʻO ka poʻe ʻōpio, pane maikaʻi loa i ka mālama ʻana.
ʻEhā mau ʻano subtypes o cHL e hana ana i ka cHL i ka subtype maʻamau o Hodgkin lymphoma. E hāʻawi ana kāu mau laʻana biopsy i ka ʻikepili e pono ai kāu kauka e hoʻoholo i ke ʻano subtype āu. E nānā ka pathologist i nā:
- Ka helu a me ke ʻano o nā pūnaewele Reed-Sternberg.
- ʻO ka nui a me ka hui ʻana o nā lymphocytes maʻamau a ʻano ʻole.
ʻAʻohe ʻano ʻano o ka cHL i loaʻa iā ʻoe, e loaʻa paha iā ʻoe ke ʻano o ka lapaʻau like. Inā ʻike ʻoe i kāu ʻano subtype, e kaomi i ke poʻomanaʻo ma lalo nei e ʻike i kahi kiʻi.
Nodular sclerosis maʻamau Hodgkin lymphoma (NScHL) ʻo ia ka subtype maʻamau. Ma kahi o 6-8 o kēlā me kēia 10 poʻe me cHL e loaʻa kēia ʻano subtype.
Ua kapa ʻia ʻo NScHL no ke ʻano o ka nānā ʻana o nā cell ma lalo o ka microscope. Hoʻoulu pinepine ia i ka hohonu i waenakonu o kou umauma (mediastinum), akā hiki ke ulu i loko o kou ʻōpū, māmā, iwi a i ʻole ka iwi iwi. ʻAʻole hiki ke ulu i loko o kou ate.
Hodgkin lymphoma ma'amau (MC-cHL) ʻo ia ka lua o ka subtype maʻamau o cHL. ʻOi aku ka maʻamau i nā kāne ma mua o nā wahine, a ʻo ka hapa nui e pili ana i ka poʻe ʻelemakule.
Hoʻoulu maʻamau ka MC-cHL i loko o nā pūnae lymph ma lalo o kou ʻili i loko o ka ʻiʻo momona, akā hiki ke ulu i loko o kou ʻōpū, iwi iwi, ake a me nā ʻano ʻē aʻe.
Lymphocyte waiwai maʻamau Hodgkin lymphoma (LR-cHL) he subtype kakaikahi o cHL. Hiki ke ʻike ʻia ma kahi pae mua ma mua o nā ʻano subtypes o cHL, a i nā poʻe ʻelemakule.
Ke loaʻa iā ʻoe ka lāʻau lapaʻau, e hoʻōla ʻia ka hapa nui o nā kānaka - ʻo ia hoʻi, ʻaʻole paha e hoʻi hou mai ka lymphoma i ka wā e hiki mai ana. Hoʻoulu pinepine ia i loko o kou mau lymph nodes o kou ʻāʻī ma lalo iho o kou ʻili, i loko o kou ʻiʻo momona.
Hodgkin lymphoma kahiko (cHL) i pau i ka lymphocyte ʻo ia ka subtype kakaikahi o cHL me ka emi iho o 5 i loko o 100 poʻe me kēia ʻano subtype. Loaʻa pinepine ʻia ka LD-cHL i nā maʻi i loaʻa i ka Human Immunodeficiency Virus (HIV) a i ʻole Epstein Barr virus (EBV).
Hiki ke LD-cHL i kāu:
- ka iwi o ka iwi
- lymph nodes i loko o kou ʻōpū (opu)
- nā kino e like me kou ake, pancreas, ʻōpū a me ka ʻōpū.
ʻIke maʻi me Hodgkin Lymphoma
I kekahi manawa hiki ke kōkua i ka lohe ʻana i kahi mea i loaʻa i kāu mea e hele nei. Ma kēia mau wikiō pōkole, hōʻike ʻo Briony i kāna moʻolelo e pili ana i ka noho ʻana me, a me ka hahau ʻana i ke kahua 4 Hodgkin Lymphoma.
Kaomi ma nā loulou ma lalo nei e lohe i kāna moʻolelo.
Nā hōʻailona o Hodgkin Lymphoma
ʻO ka hōʻailona mua a i ʻole ka hōʻailona o ka HL he puʻupuʻu, a i ʻole kekahi mau puʻupuʻu e ulu mau ana. Hiki ke ʻike ʻia kekahi mau puʻupuʻu no ka mea ua kokoke lākou i kou ʻili, a ʻike ʻia nā mea ʻē aʻe ke loaʻa kāu scan.
ʻO kēia mau puʻupuʻu he mau pūnana lymph pehu, piha i nā pūnaʻi B maʻi kanesa. Hoʻomaka pinepine lākou ma kahi ʻāpana o kou kino, ʻo ka maʻamau ke poʻo, ka ʻāʻī a i ʻole ka umauma a me ka ʻōpū, a laila hoʻolaha i kāu ʻōnaehana lymphatic. Hiki ke laha i kou ʻōpū, māmā, ake, iwi, iwi iwi a i ʻole nā ʻano ʻē aʻe.
ʻO kou ʻāʻī
ʻO kou ʻōpū he ʻōkana nāna e kānana i kou koko a mālama i ke olakino, a ʻo ia kekahi o kāu mau kino lymphatic nui. Aia ia ma ka ʻaoʻao hema o kou ʻōpū luna ma lalo o kou māmā a kokoke i kou ʻōpū (opu). Inā laha kou HL i kou puʻupuʻu, hiki iā ia ke lilo i mea nui loa a hoʻokomo i ke kaomi i kou ʻōpū, e ʻoluʻolu ai ʻoe inā ʻaʻole ʻoe i ʻai nui.
ʻO nā hōʻailona ʻē aʻe
Loaʻa paha iā ʻoe nā hōʻailona e like me ka nausea, ka maʻi ʻaʻai a me ka constipation, ma muli o kahi e ulu ai kāu lymphoma.
ʻO nā hōʻailona ʻē aʻe, e loaʻa paha iā ʻoe:
- ʻO ka luhi ʻē aʻe (ka luhi, ʻaʻole maikaʻi ma hope o kou hoʻomaha ʻana a hiamoe paha).
- ʻO ka manaʻo ʻole o ka hanu (inā loaʻa iā ʻoe ka pehu o nā ʻōpū lymph i loko o kou umauma).
- ʻO ka maʻi (ʻo ka maʻamau ka maʻi maloʻo, inā ua pehu nā ʻōpū lymph i loko o kou umauma).
- ʻOi aku ka maʻalahi o ka ʻeha ʻana a i ʻole ke koko ma mua o ka maʻamau (ma muli o ka helu platelet haʻahaʻa).
- ʻIli ʻili.
- Ke koko i loko o kou poo (hiki ke hana inā loaʻa iā ʻoe ka HL i loko o kou ʻōpū a i ʻole ka ʻōpū).
- ʻO nā maʻi hele ʻole, a i ʻole e hoʻi mau ana (hoʻi hou).
- B-hōʻailona.
B Nā hōʻailona
Manaʻo nui - I ka manawa e hoʻopili ai i kāu kauka
He mea nui e hoʻomaopopo i ka nui o nā hōʻailona a me nā hōʻailona o HL hiki ke pili i nā kumu ʻē aʻe ma waho o ka maʻi kanesa. No ka laʻana, hiki nō hoʻi i ka pehu nā kōpili lymph inā loaʻa iā ʻoe kahi maʻi. ʻO ka maʻamau naʻe, inā loaʻa iā ʻoe kahi maʻi, e hoʻomaikaʻi nā hōʻailona a hoʻi hou nā lymph nodes i ka nui maʻamau i loko o kekahi mau pule.
Me ka lymphoma, ʻaʻole e pau kēia mau hōʻailona. Hiki paha iā lākou ke ʻoi aku ka ʻino. Pono ʻoe e kelepona i kāu kauka inā loaʻa iā ʻoe:
- ʻO nā pūnaʻi lymph pehu ʻaʻole e hele, a inā ʻoi aku ka nui ma mua o kou manaʻo no kahi maʻi.
- Pokole hanu me ke kumu ole.
- ʻOi aku ka luhi ma mua o ka maʻamau a ʻaʻole maikaʻi me ka hoʻomaha a me ka hiamoe.
- ʻO ke koko ʻokoʻa a i ʻole ka ʻeha ʻana (e like me kou poo, mai kou ihu a i ʻole ka ʻāʻī).
- ʻOi aku ka ʻili ma mua o ka maʻamau.
- He mai maloo hou.
- B-hōʻailona.
Pehea e ʻike ʻia ai ʻo Hodgkin Lymphoma
Manaʻo paha kāu kauka he lymphoma kou ke loaʻa iā lākou nā hopena hoʻāʻo koko, X-ray, a i ʻole nā hopena scan ʻē aʻe. Hiki iā lākou ke ʻike i kahi puʻupuʻu inā hana lākou i kahi hoʻokolohua kino. Akā no ka ʻike ʻana i ka HL, pono ʻoe i kahi biopsy. ʻO ka biopsy kahi hana e wehe ai i kahi hapa a i ʻole nā mea āpau ʻo ka lymph node i hoʻopili ʻia a i ʻole ka iwi iwi. A laila nānā ʻia ka biopsy e nā pathologists i loko o kahi keʻena hana, e ʻike inā he mau loli e kōkua i ke kauka e hōʻoia i ka HL.
Hiki ke paʻakikī ke ʻike i ke ʻano kikoʻī o HL i loaʻa iā ʻoe, no laila pono ʻoe e loaʻa i nā biopsy ʻoi aku ma mua o hoʻokahi. Hiki i kāu kauka ke ʻike i ke ʻano subtype āu e nānā ai i kou koko a me nā biopsies āpau ma lalo o kahi microscope, a i ʻole mai ka hōʻike i loaʻa iā lākou mai ka pathology. Inā ʻaʻole ʻoe i ʻike, e nīnau i kāu kauka i ke ʻano subtype āu.
Loaʻa paha iā ʻoe kahi anesthetic kūloko a maʻamau paha ke loaʻa iā ʻoe ka biopsy. E pili ana kēia i ka ʻāpana o kou kino i lawe ʻia ai ka biopsy.
Nā Biopsies
No ka ʻike ʻana i ka HL, pono ʻoe i nā biopsies o kāu mau lymph nodes pehu, a me kou iwi iwi. ʻO ka biopsy ka wā e wehe ʻia ai kahi ʻāpana liʻiliʻi o ka ʻiʻo a nānā ʻia i loko o ka hale hana ma lalo o kahi microscope. A laila, e nānā ka pathologist i ke ala, a me ka wikiwiki o ka ulu ʻana o kāu mau cell.
Aia nā ala like ʻole e loaʻa ai ka biopsy maikaʻi loa. Hiki i kāu kauka ke kūkākūkā i ke ʻano maikaʻi loa no kou kūlana. ʻO kekahi o nā biopsies maʻamau ka:
ʻO ka biopsy node excision
Hoʻopau kēia ʻano biopsy i kahi ʻōpū lymph holoʻokoʻa. Inā pili kou ʻōpū lymph i kou ʻili a ʻike maʻalahi, loaʻa paha iā ʻoe kahi anesthetic kūloko e hoʻopau ai i ka wahi. A laila, e ʻoki kāu kauka (i kapa ʻia hoʻi he ʻoki) ma kou ʻili ma kahi kokoke, a i ʻole ma luna o ka lymph node. E wehe ʻia kāu puʻupuʻu lymph ma o ka ʻoki. Loaʻa paha iā ʻoe nā humuhumu ma hope o kēia kaʻina hana a me kahi lole liʻiliʻi ma luna.
Inā hohonu loa ka puʻu lymph no ke kauka e manaʻo ai, pono paha ʻoe e hana i ka biopsy excisional i loko o kahi hale keʻena hana halemai. Hiki iā ʻoe ke hāʻawi ʻia i kahi anesthetic maʻamau - he lāʻau ia e hoʻomoe ai iā ʻoe i ka wā e wehe ʻia ai ka ʻōpū lymph. Ma hope o ka biopsy, e loaʻa iā ʻoe kahi ʻeha liʻiliʻi, a loaʻa paha nā humuhumu me kahi lole liʻiliʻi ma luna.
Na kāu kauka a kahu hānai paha e haʻi iā ʻoe pehea e mālama ai i ka ʻeha, a ke makemake lākou e ʻike hou iā ʻoe e wehe i nā humuhumu.
Biopsy kumu a i ʻole ka nila maikaʻi
ʻO kēia ʻano biopsy e lawe wale i kahi laʻana mai ka puʻu lymph i hoʻopilikia ʻia - ʻaʻole ia e wehe i ka puʻu lymph holoʻokoʻa. E hoʻohana kāu kauka i ka nila a i ʻole nā mea hana kūikawā ʻē aʻe e lawe i ka hāpana. E loaʻa iā ʻoe kahi anesthetic kūloko. Inā hohonu loa ka puʻu lymph no kāu kauka e ʻike a ʻike ai, hiki iā ʻoe ke hana i ka biopsy ma ke keʻena radiology. He mea pono kēia no nā biopsies hohonu no ka mea hiki i ka radiologist ke hoʻohana i ka ultrasound a i ʻole X-ray e ʻike i ka lymph node a e hōʻoia i ka loaʻa ʻana o ka nila ma kahi kūpono.
Hāʻawi kahi biopsy nilala kumu i kahi laʻana biopsy nui aʻe ma mua o kahi biopsy nila maikaʻi.
ʻO ka hoʻopaʻa ʻana a me ka helu ʻana o Hodgkin Lymphoma
ʻO ke kau ʻana a me ke kau ʻana he ala ia e hiki ai i kāu kauka ke wehewehe i ka nui o kou kino i hoʻopilikia ʻia e ka lymphoma, a me ke ʻano o ka ulu ʻana o nā cell lymphoma.
No ka mea hiki i nā pūnaewele lymphoma ke hele i kekahi ʻāpana o kou kino no laila inā loaʻa iā ʻoe ka HL, e hoʻonohonoho kāu kauka i nā hoʻokolohua hou aku e nānā inā aia ma kahi ʻē aʻe. Kapa ʻia kēia mau hoʻāʻo ʻana he "staging" a hiki ke komo pū me:
Nā ho'āʻo koko
Hiki ke hana ʻia nā hoʻāʻo koko no ka nānā ʻana i nā ʻano mea like ʻole e like me kāu helu koko, nā hana ate a me nā puʻupaʻa a me ka hiki o kou kino ke hoʻopaʻa i kou koko.
ʻO ka ʻōmole helu Positron emoate (PET)
ʻO ka PET scan ka nānā ʻana i ke kino holoʻokoʻa e ʻike i kahi e ulu ai ka lymphoma. E loaʻa iā ʻoe kahi injection ma mua o ka nānā ʻana me kahi hoʻonā e hoʻomoʻa ʻia e nā sela lymphoma. Mālama kēia i nā pūnaewele lymphoma ma ka PET scan.
Ka pākuʻina o ka tomography (CT)
Pākuʻi CT hāʻawi i kahi kiʻi kikoʻī ma mua o nā hihi X maʻamau a nānā i kahi wahi kūloko e like me kou umauma a i ʻole ʻōpū
Pahu lumbar
Lumbar punctures Hoʻohana ʻia e nānā inā loaʻa iā ʻoe ka lymphoma i loko o kou lolo a i ʻole spinal cord. E hoʻohana kāu kauka i kahi nila e lawe i kahi laʻana o ka wai mai kahi kokoke i kou iwi kuamoʻo.
Nā hoʻokolohua cytogenetic
Nā hoʻokolohua cytogenetic He nānā kēia no nā hoʻololi genetic (i kapa ʻia hoʻi nā mutations a i ʻole nā ʻano like ʻole) i pili i kāu maʻi.
Biopsy iwi ʻōiwi
A biopsy iwi ʻōiwi hana ʻia e nānā inā loaʻa iā ʻoe nā pūnaewele lymphoma i loko o kāu momona momona kahi i hana ʻia ai kou mau koko koko. Na kāu kauka e hoʻohana i ka nila e lawe i kahi laʻana o ka momona mai ka waena o kou iwi - maʻamau i kou ʻūhā, akā i kekahi manawa e lawe ʻia ka hāpana mai kahi iwi ʻē aʻe. E hana ʻia kēia me ka anesthetic kūloko.
Hiki ke loaʻa ka ʻike hou aʻe e pili ana i nā hoʻokolohua, ka maʻi a me ka hoʻonohonoho ʻana ma ke kaomi ʻana i ke pihi ma lalo.
Hoʻopaʻa ʻia ʻo Hodgkin Lymphoma
He aha ke ʻano o ka hoʻokūkū?
Ma hope o kou ʻike ʻia ʻana, e nānā kāu kauka i kāu mau hopena hoʻāʻo a pau e ʻike i ke kūlana o kāu Hodgkin Lymphoma. Hōʻike ka staging i ke kauka i ka nui o ka lymphoma i loko o kou kino, ehia mau wahi o kou kino i loaʻa i nā pūnaʻi B maʻi kanesa, a me ke ʻano o kou kino e hoʻokō ai i ka maʻi.
Hoʻokumu ʻia ke kahua ma:
- ʻO ka helu a me kahi o nā lymph nodes i pili.
- Kahi o nā pūnana lymph i hoʻopilikia ʻia - aia ma luna, ma lalo a ma nā ʻaoʻao ʻelua o ka diaphragm.
- Inā ua laha ka maʻi i kou iwi iwi a i ʻole nā ʻano ʻē aʻe e like me kou ake, akemāmā, iwi a i ʻole ʻili.
ʻEhā mau pae o Hodgkin Lymphoma (HL)
Aia nā pae ʻehā o HL:
- Kapa ʻia ka pae 1 a me ka pae 2 ʻo 'pae mua/palena palena' (e pili ana i kahi ʻāpana o ke kino).
- Kapa ʻia ka pae 3 a me ka pae 4 ʻo 'pae holomua' (ʻoi aku ka laulā).
- 'A'ole e like me nā 'ano ma'i 'a'ai 'ē a'e, hiki iā 'oe ke hele i ke kala 'ana a ho'ōla 'ia mai ka pae ki'eki'e (3 a i 'ole 4) HL.
Kōnae 1 | Hoʻokahi wahi puʻupuʻu lymph i pili, ma luna a ma lalo paha o kou diaphragm. |
Kōnae 2 | ʻelua a ʻoi aku paha nā wahi lymph node ma ka ʻaoʻao hoʻokahi o kāu diaphragm. |
Kōnae 3 | ma ka liʻiliʻi hoʻokahi wahi lymph node ma luna a ma ka liʻiliʻi hoʻokahi wahi lymph node ma lalo o kou diaphragm e pili ana. |
Kōnae 4 | Aia ka lymphoma i loko o nā pūnana lymph he nui, a ua laha i nā wahi ʻē aʻe o kou kino (e laʻa, iwi, akemāmā, ate). |
Nā pae hoʻohālike ʻē aʻe
Ma waho aʻe o ka helu i hoʻohana ʻia e wehewehe i kāu pae, aia kekahi mau mea e noʻonoʻo ai kāu kauka i ke koho ʻana i nā koho maikaʻi loa e mālama iā ʻoe. E nānā lākou i ka hopena o ka lymphoma i kou kino, a me nā hōʻailona āu e loaʻa ai. Ma muli o kēia mau ʻike, ma waho aʻe o ka helu i loaʻa iā ʻoe no kāu pae, loaʻa paha iā ʻoe kahi leka. E ʻoluʻolu e ʻike i ka papa ma lalo e ʻike i ke ʻano o nā leka.
palapala | Meaning | nui |
A a i ʻole B |
|
|
E & X |
|
|
S |
|
|
E hoʻolohe pololei mai ka Lymphoma Specialist e pili ana i Staging Lymphoma
ʻO ka māka o kāu lymphoma Hodgkin ke ʻano o kāu mau sela ma lalo o kahi microscope, a pehea ka wikiwiki o ka ulu ʻana a hana i nā cell cancer hou. ʻO nā papa he 1-4 (haʻahaʻa, waena, kiʻekiʻe).
- G1 - papa haʻahaʻa - ke nānā aku kou mau pūnaewele i ka mea maʻamau a ulu lākou a pālahalaha mālie.
- G2 – papa waena – ke hoʻomaka nei kāu mau pūnaewele i ka ʻokoʻa akā aia kekahi mau cell maʻamau a ulu a laha lākou ma kahi wikiwiki.
- G3 – papa kiʻekiʻe – ʻokoʻa ke ʻano o kāu mau cell me kekahi mau cell maʻamau a ulu lākou a pālahalaha wikiwiki.
- G4 - papa kiʻekiʻe - ʻokoʻa loa kāu mau cell i ka mea maʻamau a ulu lākou a pālahalaha loa.
Nā kumu helu ʻē aʻe
Hiki ke ʻike hou ʻia ʻo HL ma ke ʻano he 'maikaʻi' a 'pono ʻole' ma muli o nā kumu haʻahaʻa, waena a kiʻekiʻe paha i loaʻa iā ʻoe a ʻaʻole paha. Hiki i kēia mau mea pilikia ke hoʻololi i ke ʻano o ka lāʻau i hāʻawi ʻia iā ʻoe, a pehea ʻoe e pane ai i ka lāʻau lapaʻau. Ua kapa ʻia kēia lāʻau lapaʻau 'Risk Adapted'.
Hāʻawi kēia ʻike a pau i kāu kauka i ke kiʻi maikaʻi e kōkua i ka hoʻoholo ʻana i ke ʻano o ka lapaʻau maikaʻi loa no ʻoe.
Hoʻopuka maʻalahi - nānā ke kahua kahi ke ulu nei kāu Lymphoma Hodgkin, a ke nānā aku nei ka mākau pehea ke ulu nei kāu Lymphoma Hodgkin.
Ka hoʻomaopopo ʻana i kāu genetics lymphoma
E ʻimi nā hoʻokolohua cytogenetic i nā loli i kāu chromosomes a i ʻole genes. Loaʻa iā mākou he 23 mau chromosomes, a ua helu ʻia lākou e like me ko lākou nui. Inā loaʻa iā ʻoe ka HL, ʻokoʻa iki ke ʻano o kāu chromosomes.
He aha nā genes a me nā chromosomes
ʻO kēlā me kēia pūnaewele e hoʻokumu i ko mākou kino he nucleus, a i loko o ka nucleus he 23 mau chromosomes.
Hana ʻia kēlā me kēia chromosome mai nā kaula lōʻihi o DNA (deoxyribonucleic acid) i loko o kā mākou mau genes.
Hāʻawi kā mākou mau genes i ke code e pono ai e hana i nā cell a me nā protein āpau i loko o ko mākou kino, a haʻi iā lākou pehea e nānā ai a hana paha.
Inā he hoʻololi i loko o kēia mau chromosomes a i ʻole nā genes, ʻaʻole e holo pono kāu mau protein a me nā cell.
Hiki i nā Lymphocytes ke lilo i mau pūnaewele lymphoma ma muli o nā hoʻololi genetic (i kapa ʻia nā hoʻololi ʻana a i ʻole nā ʻano like ʻole) i loko o nā pūnaewele. Hiki ke nānā ʻia kāu biopsy lymphoma e ke kauka lapaʻau kūikawā e ʻike inā loaʻa iā ʻoe nā hoʻololi gene.
He aha ke ʻano o ka hoʻololi ʻana o HL
Ua ʻike ʻia ka noiʻi ʻana i nā ʻano ʻano like ʻole e hiki ke hopena i kekahi mau protein e ulu ana ma ka ʻili o nā cell HL. Hiki i kēia mau protein ke kōkua i ka lymphoma e hūnā mai kou ʻōnaehana pale ʻana a i ʻole, e ulu ʻole ka maʻi kanesa.
- He ʻokoʻa iki ke ʻano o kekahi mau pūla lymphoma Hodgkin ma ka loaʻa ʻana o kahi protein i kapa ʻia ʻo CD30 ma waho o ka ʻili pūnaewele.
- inā loaʻa iā ʻoe ka Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL), hiki iā ʻoe ke hōʻike nui i kahi protein i kapa ʻia ʻo CD20 o ka ʻili o waho o kāu mau cell.
- loaʻa paha i kekahi mau pūnaewele Lymphoma Hodgkin kahi "immune checkpoint" i kapa ʻia ʻo PD-L1 a i ʻole PD-L2 ma ka ʻili pūnaewele. ʻO kēia mau wahi hoʻopaʻa palekana e kōkua i ka lymphoma e hūnā mai kou ʻōnaehana pale ʻole i hiki ʻole ke loaʻa a pepehi i ka lymphoma e like me ka mea maʻamau.
He mea koʻikoʻi kēia mau hoʻololi no ka mea hiki ke hoʻopili i ke ʻano o ka lāʻau i loaʻa iā ʻoe.
Pehea e hiki ai i kāu mau hoʻololi ke hoʻololi i ka lāʻau e loaʻa iā ʻoe
Hiki ke mālama ʻia kekahi mau lymphomas Hodgkin me kahi antibody monoclonal (MAB), akā inā ʻoi aku ka nui o kāu mau keena HL i kekahi mau māka protein. Inā hōʻike nui kāu mau pūnaewele lymphoma Hodgkin:
- CD30 hiki ke hāʻawi ʻia iā ʻoe i kahi MAB i kapa ʻia brentuximab vedotin, e kuhikuhi pono ana iā CD30.
- Hiki ke hāʻawi ʻia iā ʻoe kahi CD20 i kahi MAB i kapa ʻia he rituximab, e kuhikuhi pono ana i ka CD20. ʻAʻole ʻike ʻia ʻo CD20 ma nā keʻena maʻi maʻi o ka Hodgkin Lymphoma maʻamau, akā hiki ke loaʻa ma nā cell i Nodular Lymphocyte-predominant Hodgkin Lymphoma (a me nā lymphoma non-Hodgkin).
- Hiki ke hāʻawi ʻia iā ʻoe kahi MAB i kapa ʻia ʻo pembrolizumab, ʻo ia ka mea e kuhikuhi pono ai i ka pae hoʻopaʻa immune, e ʻike ʻia ka lymphoma i kāu ʻōnaehana pale.
Lapaʻau no Hodgkin Lymphoma
Nui nā lāʻau lapaʻau like ʻole no ka Lymphoma Hodgkin. ʻO ka lāʻau lapaʻau maikaʻi loa no ʻoe e hilinaʻi ʻia ma nā kumu he nui e like me kou mau makahiki, kou olakino holoʻokoʻa, a me ke kahua a me ka pae o kāu lymphoma. E noʻonoʻo ana kāu kauka i nā maʻi ʻē aʻe āu e loaʻa ai a me nā lāʻau lapaʻau āu e loaʻa nei no ia mau maʻi.
Ma mua o kou hoʻomaka ʻana i ka mālama ʻana, e loaʻa iā ʻoe nā hoʻokolohua hou aʻe i kapa ʻia "Nā ho'āʻo kumu". Hana ʻia kēia mau hoʻāʻo ʻana i mea e hōʻoia ai ua lawa ʻoe i ka ʻae ʻana i ka lāʻau lapaʻau, a na kāu kauka e nānā i kāu mālama ʻana i mea e hōʻoia ai ʻaʻole e hōʻeha nui ka lāʻau i kou mau kino. ʻO nā hoʻokolohua āu e loaʻa ai, e hilinaʻi ia i ke ʻano o ka lapaʻau e loaʻa iā ʻoe.
Inā ua mālama ʻoe i kāu lymphoma i ka wā ma mua, e noʻonoʻo ana kāu kauka i ka maikaʻi o ka hana ʻana iā ʻoe, a me ka maikaʻi o nā hopena ʻaoʻao iā ʻoe. A laila hiki i kāu kauka ke hāʻawi i nā koho lapaʻau maikaʻi loa no ʻoe ma muli o kou kūlana pilikino. Inā ʻaʻole ʻoe maopopo i ke kumu i hana ai ke kauka i nā hoʻoholo a lākou i hana ai, e ʻoluʻolu e nīnau iā lākou e wehewehe iā ʻoe - aia lākou e kōkua iā ʻoe.
Hiki iā ʻoe ke hāʻawi ʻia i hoʻokahi a ʻoi aku paha o nā ʻano lapaʻau ma lalo nei.
Hāʻawi ʻia ka mālama kākoʻo i nā maʻi a me nā ʻohana e kū nei i ka maʻi koʻikoʻi. Hiki i ka mālama kākoʻo ke kōkua i ka poʻe maʻi i ka liʻiliʻi o nā hōʻailona, a ʻoi aku ka wikiwiki ma o ka hoʻolohe ʻana i kēlā mau ʻano o kā lākou mālama.
Hiki i nā lāʻau lapaʻau no HL ke hoʻopilikia i kou mau koko koko maikaʻi e hiki ai ke hopena i ka lawa ʻole o ke koko olakino e mālama pono ai iā ʻoe. ʻO ka hopena, hiki ke hāʻawi ʻia iā ʻoe i ka hoʻololi ʻana me ke koko ʻulaʻula i hoʻopaʻa ʻia a i ʻole nā platelets e hoʻomaikaʻi ai i kou pae o kēia mau koko koko. Inā haʻahaʻa loa kou mau keʻokeʻo keʻokeʻo - a i ʻole e haʻahaʻa loa, hiki ke hāʻawi ʻia ʻoe i kahi injection e komo i loko o kou ʻōpū e kōkua ai i ka hoʻoulu ʻana i kou iwi iwi e hana hou i kēia mau cell. Pono paha ʻoe i nā lāʻau antibiotic inā loaʻa ʻoe i kahi maʻi ʻoiai ʻoi aku ka haʻahaʻa o kāu mau keʻokeʻo keʻokeʻo, e kōkua iā ʻoe e pale aku i nā maʻi.
Hiki i ka mālama kākoʻo ke komo pū me ka ʻike ʻana i nā loea ʻē aʻe me ka ʻike ma nā wahi ʻē aʻe o kou olakino a i ʻole ka hoʻolālā ʻana no ka mālama ʻana i ka wā e hiki mai ana e like me ke kōkua ʻana iā ʻoe e hana i kahi Hoʻolālā Hoʻomaʻamaʻa Kiʻekiʻe e wehewehe i kou makemake no kāu mālama olakino i ka wā e hiki mai ana. Inā loaʻa iā ʻoe nā hōʻailona a i ʻole nā hopena ʻaoʻao i hoʻomaikaʻi ʻole ʻia, hiki ke hāʻawi ʻia iā ʻoe e kūkākūkā me ka hui mālama palliative nā loea i ka mālama ʻana i nā hōʻailona paʻakikī e like me ka ʻeha a me ka nausea ʻaʻole i hoʻomaikaʻi ʻia me nā lāʻau maʻamau. ʻO kēia mau mea he ʻāpana o ka hoʻokele multidisciplinary o lymphoma.
ʻO ka lāʻau lapaʻau he lāʻau lapaʻau maʻi maʻi e hoʻohana ana i nā kiʻekiʻe kiʻekiʻe o ka radiation e pepehi i nā cell lymphoma a e hōʻemi i nā ʻōpū. Ma mua o ka loaʻa ʻana o ka radiation, e loaʻa iā ʻoe kahi kau hoʻolālā. He mea koʻikoʻi kēia kau no ka poʻe lapaʻau lapaʻau e hoʻolālā pehea e hoʻopaʻa ai i ka radiation i ka lymphoma, a pale aku i ka hōʻino ʻana i nā cell olakino. ʻO ka lōʻihi o ka lāʻau lapaʻau ma waena o 2-4 mau pule. I kēia manawa, pono ʻoe e hele i ke kikowaena radiation i kēlā me kēia lā (Poakahi-Palima) no ka mālama ʻana.
*Inā lōʻihi kou noho ʻana mai ke kikowaena radiation a makemake ʻoe i ke kōkua me kahi e noho ai i ka wā mālama, e ʻoluʻolu e kamaʻilio me kāu kauka a kahu hānai paha e pili ana i ke kōkua i loaʻa iā ʻoe. Hiki iā ʻoe ke kelepona i ka Cancer Council a i ʻole Leukemia Foundation ma kou mokuʻāina a ʻike inā hiki iā lākou ke kōkua i kahi e noho ai.
Hiki iā ʻoe ke loaʻa i kēia mau lāʻau ma ke ʻano he papa a/a i ʻole e hāʻawi ʻia ma ke ʻano he kulu (infusion) i loko o kou aʻa (i loko o kou kahawai koko) ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hiki ke hui pū ʻia kekahi mau lāʻau chemo me kahi lāʻau immunotherapy. Hoʻopau ʻo Chemo i nā pūnaewele ulu wikiwiki a hiki ke hoʻopilikia i kekahi o kāu mau sela maikaʻi e ulu wikiwiki ana i nā hopena ʻaoʻao.
Loaʻa paha iā ʻoe kahi infusion MAB ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hoʻopili ʻo MAB i ka cell lymphoma a huki i nā maʻi ʻē aʻe e hakakā ana i nā keʻokeʻo keʻokeʻo a me nā protein i ka maʻi kanesa i hiki ai i kāu ʻōnaehana pale pono ke hakakā i ka HL.
E hana wale ana ʻo MABS inā loaʻa iā ʻoe nā protein a i ʻole nā māka kikoʻī ma kāu mau keena lymphoma.
He ʻano hou o ka monoclonal antibody (MAB) nā mea hoʻopaʻapaʻa hoʻopaʻa palekana (ICI) a hana ʻokoʻa iki i nā MABS ʻē aʻe.
Ke hana nei ka ICI i ka wā e hoʻomohala ai kāu mau pūnana maʻi "immune checkpoints" ma luna o lākou i ʻike pinepine ʻia ma kāu mau sela olakino. Hōʻike ka wahi hoʻopaʻa immuen i kāu ʻōnaehana pale ʻana i ke olakino a maʻamau ke kelepona, no laila haʻalele kāu ʻōnaehana pale.
Hana nā ICI ma ke kāohi ʻana i ka wahi hoʻopaʻa immune i hiki ʻole i kāu mau pūnaewele lymphoma ke hoʻohālike hou he ola olakino. ʻAe kēia i kāu ʻōnaehana pale e ʻike iā lākou he maʻi kanesa, a hoʻomaka i kahi hoʻouka kaua iā lākou.
Hoʻohui ʻia ka Chemotherapy me kahi MAB (no ka laʻana, rituximab).
Hiki iā ʻoe ke lawe i kēia mau mea ma ke ʻano he papa a infusion paha i loko o kou vein. Hiki ke lawe ʻia nā lāʻau lapaʻau waha ma ka home, ʻoiai e koi ana kekahi i kahi noho maʻi pōkole. Inā loaʻa iā ʻoe kahi infusion, hiki iā ʻoe ke loaʻa ia ma ka lā keʻena lapaʻau a i ʻole ma ka haukapila. Hoʻopili ʻia nā lāʻau lapaʻau i hoʻopaʻa ʻia i ka cell lymphoma a me nā hōʻailona poloka e pono ai e ulu a hoʻohua hou i nā cell. Hoʻopau kēia i ka ulu ʻana o ka maʻi ʻaʻai a make nā sela lymphoma.
Hana ʻia kahi pūnaʻi pū a i ʻole ka iwi iwi e hoʻololi i kou iwi iwi maʻi me nā pūnaewele hou e hiki ke ulu i loko o ke koko olakino hou. Hana ʻia ka hoʻololi ʻana o ka iwi iwi no nā keiki me ka HL, aʻo ka hoʻololi ʻana o nā pūnaewele i nā keiki ʻelua.
I ka hoʻololi ʻana i ka iwi iwi, hoʻoneʻe pololei ʻia nā pūnaewele mai ka iwi o ka iwi, a e like me ka hoʻololi ʻana i ke ʻano o ke kino, ua wehe ʻia nā pū mai ke koko.
Hiki ke hoʻoneʻe ʻia nā pūnaewele mai kahi mea hāʻawi a hōʻiliʻili ʻia mai iā ʻoe ma hope o kou loaʻa ʻana i ka chemotherapy.
Inā loaʻa iā ʻoe nā pūnaewele kumu mai kahi mea hāʻawi, ua kapa ʻia ʻo ia he ka hoʻololi ʻana i ke ʻano o ke ʻano o ke ʻano allogeneic.
Inā hōʻiliʻili ʻia kāu mau pūnaewele ponoʻī, kapa ʻia ia he ka hoʻololi ʻana i ke ʻano o ke kino.
Hōʻiliʻili ʻia nā puʻupuʻu ma o ke kaʻina hana i kapa ʻia ʻo apheresis. E hoʻopili ʻia ʻoe (a i ʻole kāu mea hāʻawi) i kahi mīkini apheresis a e hoʻoneʻe ʻia kou koko, hoʻokaʻawale ʻia nā pūnaewele a hōʻiliʻili ʻia i loko o kahi ʻeke, a laila hoʻihoʻi ʻia ke koena o kou koko iā ʻoe.
Ma mua o ke kaʻina hana, e loaʻa iā ʻoe ka chemotherapy kiʻekiʻe a i ʻole ka radiotherapy kino holoʻokoʻa e pepehi i kāu mau sela lymphoma āpau. Eia nō naʻe, ʻo kēia lapaʻau kiʻekiʻe e hoʻopau i nā ʻāpana āpau o kou iwi iwi. No laila, e hoʻihoʻi ʻia nā pūnaʻi kumu i hōʻiliʻili ʻia iā ʻoe (hoʻololi ʻia). Hana ʻia kēia ma ke ʻano like me ka hāʻawi ʻia ʻana o ke kahe koko, ma ke kahe ʻana i loko o kou aʻa.
Hoʻomaka ka lapaʻau ʻana
Hiki ke paʻakikī ke ʻike i nā nīnau e nīnau ai ke hoʻomaka ʻoe i ka mālama ʻana. Inā ʻaʻole ʻoe ʻike, ʻaʻole ʻoe, pehea ʻoe e ʻike ai i ka mea e nīnau ai?
ʻO ka loaʻa ʻana o ka ʻike kūpono hiki ke kōkua iā ʻoe e hōʻoluʻolu a ʻike i ka mea e manaʻo ai. Hiki iā ia ke kōkua iā ʻoe e hoʻolālā i mua no kāu mea e pono ai.
Hoʻohui mākou i kahi papa inoa o nā nīnau āu e ʻike ai he kōkua. ʻOiaʻiʻo, kū hoʻokahi ke kūlana o kēlā me kēia kanaka, no laila ʻaʻole i uhi kēia mau nīnau i nā mea āpau, akā hāʻawi lākou i kahi hoʻomaka maikaʻi.
Kaomi ma ka loulou ma lalo nei e kiʻi i kahi PDF o nā nīnau no kāu kauka.
Kaomi ma aneʻi e hoʻoiho i nā nīnau e nīnau i kāu kauka
ʻO ka manawa mua ʻoe e hoʻomaka ai i ka lapaʻau ʻia ua kapa ʻia ka lāʻau lapaʻau mua. Ke hoʻopau ʻoe i kāu lāʻau lapaʻau mua, ʻaʻole paha ʻoe e pono hou i ka lāʻau, akā makemake paha kekahi poʻe i nā lāʻau hou aʻe i ka manawa koke, a hiki i kekahi ke hele i nā mahina a i ʻole mau makahiki me ka mālama ʻole ʻana, ma mua o ka pono ʻana o ka lāʻau hou.
ʻO ka lāʻau lapaʻau mua o ka lymphoma Hodgkin maʻamau
ʻO ke ʻano o kāu lapaʻau e pili ana i:
- ke ʻano o ka lymphoma Hodgkin iā ʻoe
- ka pae a me ka pae o kou lymphoma
- kou mau makahiki a me kou olakino holoʻokoʻa
- nā maʻi ʻē aʻe āu a i ʻole nā lāʻau lapaʻau āu e lawe nei
- kou makemake ma hope o ke kamaʻilio ʻana me kāu kauka e pili ana i kāu mau koho.
ʻO kekahi o nā lāʻau lapaʻau maʻamau āu e pono ai ke hoʻomaka mua ʻoe i ka mālama ʻana e wehewehe ʻia ma lalo nei.
Hoʻohana ʻia
Hiki ke hāʻawi ʻia ka radiation me ka chemotherapy, a i ʻole ma kāna iho.
Chemotherapy
Inā pono ʻoe e hoʻomaka i ka lāʻau lapaʻau, loaʻa paha iā ʻoe ma mua o hoʻokahi lāʻau lapaʻau, a hiki ke hoʻokomo i nā ʻano like ʻole o ka chemotherapy a monoclonal antibody a i ʻole immune checkpoint inhibitor. Ke loaʻa iā ʻoe kēia mau lāʻau lapaʻau, e loaʻa iā ʻoe i nā pōʻai. ʻO ia hoʻi, e loaʻa iā ʻoe ka lāʻau lapaʻau, a laila hoʻomaha, a laila kekahi pōʻai (pōkole) o ka mālama ʻana.
ABVD
ʻO ABVD kahi protocol lapaʻau maʻamau i hoʻohana ʻia no ka poʻe me HL. He hui ia o nā lāʻau lapaʻau chemotherapy i kapa ʻia ʻo doxorubicin, bleomycin, vinblastine a me dacarbazine.
Hoʻonui ʻia ʻo BEACOPP
ʻO Escalated BEACOPP kekahi protocol i hoʻohana ʻia no kekahi poʻe me HL. He hui ia o na laau lapaau i kapaia bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine a me procarbazine. E hāʻawi pū ʻia ʻoe i kahi lāʻau steroid i kapa ʻia ʻo prednisolone. ʻAʻole e hāʻawi ʻia kēia mau lāʻau a pau iā ʻoe i ka lā hoʻokahi, akā e loaʻa iā ʻoe i nā lā 8 a pau. E loaʻa iā ʻoe ka steroid no 2 mau pule, a laila hoʻomaha, a laila hoʻomaka i kāu pōʻai hou.
BRECADD
Hiki ke hoʻohana ʻia ka BrECADD inā loaʻa iā ʻoe kahi pae kiʻekiʻe ʻo Hodgkin Lymphoma. Ua hōʻike ʻia nā hopena maikaʻi loa, me ka nui o nā poʻe i ho'ōla ʻia a i ʻole e hele ana i ke kala lōʻihi. Aia ka protocol i ka chemotherapy a me a hoʻohuihui monoclonal antibody i kapa ʻia ʻo Brentuximab vedotin. ʻO ka vedotin kahi mea i hoʻopili ʻia i ka antibody brentuximab a he mea ʻawaʻawa ia i nā cell lymphoma.
ʻO nā lāʻau lapaʻau chemotherapy i loko o kēia protocol ka etoposide, cyclophosphamide, doxorubicin a me dacarbazine. Loaʻa iā ʻoe kahi steroid i kapa ʻia ʻo dexamethasone.
e haʻalele aku
Inā he lapaʻau kāu me bleomycin, hiki ke ʻōlelo ʻia ʻaʻole loaʻa iā ʻoe ka oxygen kahe nui i ka wā e hiki mai ana. ʻO ka oxygen kahe kiʻekiʻe ua hoʻoulu ʻia ka ʻili i loko o ka māmā o kekahi poʻe i loaʻa i ka bleomycin.
Inā makemake ʻoe i ke kōkua hanu i ka wā e hiki mai ana, hiki iā ʻoe ke mālama i ka lāʻau lapaʻau a i ʻole nā mea ʻē aʻe. I kekahi mau hihia, hiki i kāu kauka ke hāʻawi aku iā ʻoe i ka oxygen kahe nui inā ʻoi aku ka nui o nā pōmaikaʻi ma mua o nā pilikia. Eia naʻe, paipai mākou i kēlā inā ua loaʻa iā ʻoe ka lāʻau bleomycin, e ʻike i kāu mau kauka a me nā kahu hānai.
Hiki i kekahi mau halemai ke hāʻawi iā ʻoe i kahi kapa inoa ʻulaʻula a waiho i ka oxygen ma ke ʻano he allergy. He mea nui e ʻike ʻaʻole kēia he allergy, akā he mea hoʻomanaʻo ʻaʻole e hāʻawi iā ʻoe i ka oxygen ma o ka mask a i ʻole ka ihu.
Nā ho'āʻo hoʻokolohua
Nui nā hoʻokolohua lapaʻau e hana nei a inā e hoʻokō ʻoe i nā pae hoʻohālike e pono ai hiki iā ʻoe ke komo i kahi hoʻokolohua lapaʻau. E nīnau i kāu kauka no kēia mau mea. Inā makemake ʻoe i ka ʻike hou aku e pili ana i nā hoʻokolohua lapaʻau, e ʻoluʻolu e ʻike i kā mākou Ka hoʻomaopopo ʻana i ka ʻaoʻao pūnaewele hoʻokolohua lapaʻau ma aneʻi
Lapaʻau laina lua
Nui ka poʻe i ho'ōla ʻia me kā lākou lāʻau lapaʻau mua akā no kekahi, ʻaʻole hana maikaʻi ka lāʻau lapaʻau mua e like me ka mea i manaʻo ʻia. Kapa ʻia kēia maʻi 'refractory'. Loaʻa i nā mea ʻē aʻe ka hopena maikaʻi mai ka lāʻau lapaʻau mua, akā ma hope o nā mahina a i ʻole mau makahiki, hiki ke hoʻi mai ka HL. Kapa ʻia kēia he 'relapse'. Inā loaʻa iā ʻoe ka HL refractory a hoʻi hou paha, pono paha ʻoe e lapaʻau hou. Kapa ʻia kēia ʻano lāʻau lapaʻau lua. Inā makemake ʻoe i ka lāʻau lapaʻau ʻelua, pono paha ʻoe e hana hou i nā hoʻokolohua hoʻokūkū, e like me kāu i hana ai ma mua o kou hoʻomaka ʻana i ka mālama ʻana i ka manawa mua.
Nā ʻano lāʻau lapaʻau lua
Hiki ke komo i ka lāʻau lapaʻau lua:
- ʻO ka chemotherapy kiʻekiʻe a ma hope o kahi hoʻololi ʻana o ka stem cell
- ʻO nā ʻano like ʻole o ka chemotherapy (E like me IGEV - prednisolone, vinorelbine, gemcitabine, ifosfamide, me ka mesna a me ka pegfilgrastim)
- ʻO kahi antibody monoclonal a i ʻole ka mea hoʻopaʻa hoʻopaʻa i ka pale (e like me brentuximab vedotin a i ʻole pembrolizumab)
- ʻO ke kelepona
- A i ʻole hiki iā ʻoe ke kūpono no kahi hoʻokolohua lapaʻau - E nīnau i kāu kauka e pili ana i kēia.
I kekahi mau hihia koʻikoʻi loa, ke hoʻi mai ka Hodgkin Lymphoma, ua loli paha ke ʻano o kona ʻano. Hiki i kekahi o Hodgkin Lymphoma, ke hoʻi hou, hiki ke ulu me ka protein CD20 ma ka ʻili o ke kelepona, ʻoiai inā ʻaʻole ʻoe i hoʻonui i ka CD20 i ka wā i ʻike mua ʻia ai ʻoe. I kēia hihia, hiki ke loli iki ke ʻano o ka Hodgkin Lymphoma e like me ka lymphoma non-Hodgkin. Akā, he mea kakaikahi loa kēia, a inā loaʻa iā ʻoe, hiki i kāu kauka ke kamaʻilio me ʻoe e pili ana i ke ala maikaʻi loa e mālama ai.
ʻO ka lāʻau lapaʻau ʻekolu
No kekahi poʻe, pono paha ke kolu a me ka ʻehā o ka lāʻau lapaʻau. Hiki i kēia ke hoʻohui i nā lāʻau lapaʻau ma luna. Hiki i kāu kauka ke kamaʻilio me ʻoe e pili ana i nā koho maikaʻi loa no kāu kūlana pilikino.
Hiki ke ʻike ʻia nā ʻike hou aku e pili ana i nā protocol lapaʻau like ʻole ma o eviQ maanei.
NA HOAO KANAKA
He hana koʻikoʻi nā hoʻokolohua lapaʻau e ʻimi ai i nā lāʻau hou, a i ʻole nā hui pū ʻana o nā lāʻau e hoʻomaikaʻi ai i ka mālama ʻana i ka poʻe me Hodgkin Lymphoma i kēia mua aku. Hiki iā lākou ke hāʻawi iā ʻoe i kahi manawa e hoʻāʻo ai i kahi lāʻau hou, hui pū ʻana o nā lāʻau lapaʻau a i ʻole nā lāʻau lapaʻau ʻē aʻe āu e hiki ʻole ke loaʻa ma waho o ka hoʻokolokolo. Ke nānā nei kekahi mau hoʻokolohua lapaʻau no Hodgkin Lymphoma i ka CAR-T cell therapy, e ʻike inā pono paha kēia no ka poʻe me HL.
Hiki i ka lāʻau lapaʻau no HL ke waiho i nā hopena ʻaoʻao mau a i ʻole nā kūlana olakino mau mahina a hiki i nā makahiki ma hope o ka mālama ʻana. ʻO nā pahuhopu ʻē aʻe o kekahi mau hoʻokolohua lapaʻau ʻo ia ka nānā ʻana pehea e hiki ai iā mākou ke hōʻemi i kēia mau hopena hope a me nā hopena ʻaoʻao ʻē aʻe mai ka mālama ʻana.
Inā makemake ʻoe e komo i kahi hoʻokolohua lapaʻau, e nīnau i kāu kauka i nā hoʻokolohua lapaʻau āu e kūpono ai. Hiki iā ʻoe ke heluhelu i kā mākou 'Understanding Clinical Trials' pepa ʻoiaʻiʻo, kahi e papa inoa ai i nā pūnaewele hiki iā ʻoe ke kipa aku e ʻimi i kahi hoʻokolohua lapaʻau. Kaomi maanei e loulou i kā mākou pepa ʻike.
Nā hopena ʻaoʻao maʻamau o ka mālama ʻana
Nui nā hopena ʻaoʻao e hiki ke loaʻa iā ʻoe mai kāu mālama ʻana no HL. Ma mua o kou hoʻomaka ʻana i kāu lapaʻau, pono kāu kauka a kahu hānai paha e wehewehe i nā hopena ʻaoʻao āpau āu e ʻike ai. ʻAʻole paha e loaʻa iā ʻoe nā mea a pau, akā he mea nui e ʻike i ka mea e nānā ai a me ka wā e hoʻopili ai i kāu kauka. E hōʻoia iā ʻoe nā kikoʻī pili o ka mea āu e hoʻopili ai inā maikaʻi ʻoe i ka waenakonu o ka pō a i ʻole i ka hopena pule ke loaʻa ʻole kāu kauka.
ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka mālama ʻana he hoʻololi i kāu helu koko. Aia ma lalo kahi papa e wehewehe ana i ka pili o ke koko a pehea e pili ai iā ʻoe.
ʻO ke koko koko i hoʻopilikia ʻia e ka lāʻau HL
Nā pili koko koko | Nā hunaola ʻulaʻula | Platelets (pēia pū me ke koko) | |
Inoa Lapaau | Neutrophils & Lymphocytes | ʻErythrocytes | Nā Kauliana |
He aha kā lākou hana? | Kaua i ka ma'i ma'i | Lawe i ka oxygen | Uoki ke kahe ʻana |
He aha ke ʻano o ka hemahema? | Neutropenia a me lymphopenia | Anemia | ʻO ka Thrombocytopenia |
Pehea e pili ai kēia i koʻu kino? | E loaʻa iā ʻoe nā maʻi hou aʻe a paʻakikī paha ke hoʻopau iā lākou ʻoiai me ka lawe ʻana i nā lāʻau antibiotic. | Hiki paha iā ʻoe ke haʻalulu ka ʻili, luhi, hanu ʻole, ke anu a me ka poni. | Hiki iā ʻoe ke ʻeha maʻalahi, a i ʻole ke koko ʻaʻole e pau koke ke ʻoki ʻoe. |
He aha kaʻu hui lapaʻau e hoʻoponopono ai i kēia? | Hoʻopaneʻe i kāu mālama lymphoma. Hiki ke hāʻawi iā ʻoe i kahi injection i loko o kou ʻōpū me kahi lāʻau lapaʻau e hoʻoulu ai i kou iwi iwi e hana i nā keʻokeʻo keʻokeʻo hou. Hāʻawi iā ʻoe i nā lāʻau antibiotic waha a i ʻole intravenous inā loaʻa iā ʻoe kahi maʻi. | Hoʻopaneʻe i kāu mālama lymphoma. Hāʻawi iā ʻoe i ke kahe koko ʻulaʻula inā haʻahaʻa loa kāu helu kelepona. | Hoʻopaneʻe i kāu mālama lymphoma. Hāʻawi iā ʻoe i ka hoʻololi platelet inā haʻahaʻa loa kāu helu kelepona. |
ʻO nā hopena ʻaoʻao maʻamau o ka mālama ʻana no HL
Aia ma lalo ka papa inoa o kekahi mau hopena ʻaoʻao maʻamau o nā lāʻau lapaʻau HL. He mea nui e hoʻomaopopo i kēia manawa ʻo nā lāʻau lapaʻau a pau ke kumu o kēia mau hōʻailona, a pono ʻoe e kamaʻilio me kāu kauka a kahu hānai paha e pili ana i nā hopena ʻaoʻao ke kumu o kāu mālama ponoʻī.
- Ka maʻi ma ka ʻōpū (nausea) a me ka luaʻi.
- ʻEha waha (mucositis) a hoʻololi i ka ʻono o nā mea.
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a i ʻole ka maʻi maʻi (ka paʻakikī a i ʻole ka wai wai).
- ʻO ka luhi, a i ʻole ka nele o ka ikehu ʻaʻole maikaʻi ma hope o ka hoʻomaha ʻana a i ʻole ka hiamoe ʻana (ka luhi).
- ʻEha a ʻeha ka ʻiʻo (myalgia) a me ka hui (arthralgia).
- ʻO ka lauoho lauoho a me ka lahilahi (alopecia) - me kekahi mau lāʻau lapaʻau wale nō.
- Ka noʻonoʻo a me ka paʻakikī i ka hoʻomanaʻo ʻana i nā mea (ka lolo chemo).
- Hoʻololi ka manaʻo i kou mau lima a me kou mau wāwae e like me ke kani ʻana, nā pine a me nā nila a i ʻole ka ʻeha (neuropathy).
- Hoʻemi ʻia ka momona a i ʻole ka menopause mua (hoʻololi o ke ola).
Prognosis no Hodgkin Lymphoma - a he aha ka hopena i ka pau ʻana o ka mālama ʻana
ʻO Prognosis ka huaʻōlelo i hoʻohana ʻia e wehewehe i ke ala o kou maʻi, pehea e pane ai i ka mālama ʻana a pehea ʻoe e hana ai i ka wā a ma hope o ka mālama ʻana.
Nui nā kumu e kōkua ai i kāu wānana a ʻaʻole hiki ke hāʻawi i kahi ʻōlelo holoʻokoʻa e pili ana i ka prognosis. Eia nō naʻe, pane maikaʻi loa ʻo Hodgkin lymphoma i ka mālama ʻana a hiki ke hoʻōla ʻia nā maʻi he nui me kēia maʻi kanesa - ʻo ia hoʻi ma hope o ka mālama ʻana, ʻaʻohe hōʻailona o Hodgkin Lymphoma i kou kino.
Nā mea hiki ke hoʻopili i ka wānana
ʻO kekahi mau mea e pili ana i kāu prognosis penei:
- ʻO ʻoe nā makahiki a me ke olakino holoʻokoʻa i ka manawa o ka maʻi maʻi.
- Pehea ʻoe e pane ai i ka lāʻau lapaʻau.
- He aha inā inā loaʻa iā ʻoe nā genetic mutations.
- ʻO ka subtype o Hodgkin Lymphoma iā ʻoe.
Inā makemake ʻoe e ʻike hou aku e pili ana i kāu wānana ponoʻī, e ʻoluʻolu e kamaʻilio me kāu kauka haematologist a i ʻole oncologist. Hiki iā lākou ke wehewehe i kāu mau pilikia a me ka wānana iā ʻoe.
