ʻO ka nānā ʻana o anaplastic large cell lymphoma (ALCL)
ʻO Lymphomas he hui o na ma'i ma'i ma'i o ka ʻōnaehana lymphatic. Loaʻa ka Lymphoma i ka wā e loaʻa ai ka hoʻololi DNA i nā lymphocytes, kahi ʻano o ke koko keʻokeʻo. ʻO ke kuleana o nā lymphocytes ka hakakā ʻana i ka maʻi, ma ke ʻano he ʻāpana o ke kino ʻōnaehana pale ʻino. Aia B-lymphocytes (B-cell) a T-lymphocytes (T-cell) e pāʻani ana i nā hana like ʻole.
A laila māhele a ulu ʻole nā pūnaewele lymphoma a make ʻole i ka wā e pono ai. Loaʻa ka Lymphoma i nā lymphocytes maʻamau. ʻElua ʻano nui o ka lymphoma. Kāhea ʻia lākou lymphoma Hodgkin (HL) a lymphoma non-Hodgkin (NHL). Hoʻokaʻawale ʻia nā Lymphomas i:
- ʻO ka lymphoma molowa (ke ulu mālie).
- ʻO lymphoma kūpikipikiʻō (wikiwiki).
- B-cell lymphoma ʻO nā lymphocytes B-cell kūponoʻole a ʻo ia ka mea maʻamau. ʻO nā lymphomas B-cell ma kahi o 85% o nā lymphoma a pau
- T-cell lymphoma he mau lymphocytes T-cell maʻamau. Loaʻa nā lymphomas T-cell ma kahi o 15% o nā lymphomas āpau
ʻO ka Anaplastic large cell lymphoma (ALCL) he mea hōʻeuʻeu (ke ulu wikiwiki) T-cell non-Hodgkin lymphoma. Hoʻoulu ia i ka wā e ulu ʻino ai nā T-lymphocytes oʻo a ma ke ʻano kaohi ʻole ʻia.
Hoʻokumu pinepine ʻia nā T-lymphocytes maʻamau i loko o nā lymph nodes o ka ʻāʻī akā hiki ke puka mai ka umauma, ka ʻōpū, ka ʻili, ka māmā a me ka iwi. Hiki i ka Anaplastic Large Cell lymphoma ke hoʻopili i kekahi ʻāpana ʻē aʻe o ke kino e like me ka iwi iwi, ka spleen, ke koko a me nā ʻāpana a me nā ʻiʻo.
No ke aha i kapa ʻia ai ka lymphoma 'anaplastic large cell'?
Ke nānā ʻia nā cell ma lalo o kahi microscope, loaʻa iā lākou nā māka ʻokoʻa e hoʻomaopopo iā lākou i nā kauka a me ka pathologist. ʻO kēia kahi ala hoʻokahi e hiki ai i nā pathologists ke haʻi i ka ʻokoʻa ma waena o B-cell lymphoma a me T-cell lymphoma. Loaʻa i nā pūnaewele nā hōʻailona ʻike like ʻole. Ke loaʻa kahi marker e manaʻo ʻia he maikaʻi, ʻo ka loaʻa ʻole o kahi marker i kapa ʻia he ʻino.
ʻO kekahi o nā mea hōʻailona nui o anaplastic large cell lymphoma, ʻo ia ka loaʻa ʻana o ʻelua mau māka protein ʻokoʻa ma ka ʻili o nā T-lymphocytes. CD30 a me ALK (Anaplastic Lymphoma Kinase).
ʻIke ʻia ka lymphoma cell nui anaplastic he CD30 maikaʻi a hiki ke ALK ʻino a i ʻole ALK maikaʻi. Hōʻike ikaika ʻia ʻo CD30 aʻo ALK wale nō ka maikaʻi ma kahi o 90% o nā hihia i nā keiki. ʻOi aku ka maʻamau o ka ALK negative anaplastic cell lymphoma nui i nā poʻe ʻelemakule i loaʻa i kēia lymphoma.
ʻElua mau ʻano subtypes o anaplastic large cell lymphoma (ALCL)
- ʻO ka lymphoma pūnaewele nui anaplastic ʻili mua - hiki ke ALK maikaʻi a maikaʻi ʻole a he CD30 maikaʻi
- Systemic anaplastic nui cell lymphoma - hiki ke ALK maikaʻi a maikaʻi ʻole a he CD30 maikaʻi
ʻO wai ka mea i hoʻopilikia ʻia e anaplastic large cell lymphoma?
ʻO ka Lymphoma ka 7% o nā maʻi maʻi maʻi kamaliʻi, ʻo ia ke kolu o ka maʻi maʻi maʻamau i nā keiki 0-14 mau makahiki, ma hope o ka maʻi leukemia a me ka lolo a i ʻole ka maʻi ʻaʻai waena.
Aia ka Anaplastic large cell lymphoma (ALCL) ma kahi o 10% o ka wā kamaliʻi nā hihia lymphoma non-Hodgkin. ʻOiai he haʻahaʻa ka maʻi o ka ALCL, ʻo ia kekahi o nā lymphoma kamaliʻi maʻamau. ʻO ka helu ALCL no 30-40% o nā lymphoma pūnaewele nui i nā keiki.
Hiki ke loaʻa ka ALCL i kēlā me kēia makahiki a i kēlā me kēia kāne. Loaʻa maʻamau ka ALCL ma waena o nā makahiki o 1-10 mau makahiki, me ka lua o ka pale ʻana i ka pūʻulu makahiki 11-15-makahiki. Ma ka holoʻokoʻa, ʻo ka awelika o ka makahiki ma ka maʻi he 10 mau makahiki i nā keiki. He mea maʻamau ka ALCL i nā keikikāne ma mua o nā kaikamāhine.
ʻO ka Anaplastic Large Cell lymphoma kekahi o nā maʻi maʻamau ʻehā nā ʻano lymphoma non-Hodgkin i nā keiki, ʻo nā ʻano ʻē aʻe:
- Hoʻolahalaha nui B-cell lymphoma - aia ma kahi o 15% o NHL kamaliʻi
- ʻO ka lymphoma o Burkitt - helu ʻia ma kahi o 40% o NHL kamaliʻi
- Lymphoblastic lymphoma - ma kahi o 25% - 30% o NHL kamaliʻi
He aha nā kumu o ka anaplastic large cell lymphoma (ALCL)?
I ka hapanui o nā hihia o anaplastic large cell lymphoma (ALCL), ʻaʻole ʻike ʻia ke kumu. ʻAʻohe mea āu i hana ai a ʻaʻole paha i hana i kumu i kēia no kāu keiki. ʻAʻole ia he maʻi maʻi a ʻaʻole hiki ke hoʻoili ʻia i nā poʻe ʻē aʻe. ʻO ka mea a mākou e ʻike ai, ua pōʻino nā protein kūikawā a i ʻole nā genes (e lilo i mutated) a laila ulu nā cell me ka hiki ʻole ke kāohi.
ʻOiai ʻaʻole maopopo nā kumu kumu o ka ALCL, aia kekahi mau mea i hoʻopili ʻia i kona hoʻomohala ʻana, hiki i kēia ke komo (ʻoiai he haʻahaʻa loa ka pilikia):
- ʻO ka maʻi mua me ka maʻi Epstein-Barr (EBV) - ʻo kēia maʻi ke kumu o ka maʻi maʻamau maʻamau.
- Nawaliwali ka ʻōnaehana pale ma muli o kahi maʻi hoʻoilina ʻole (autoimmune maʻi)
- ʻO ka maʻi HIV
- ʻO ka lāʻau lapaʻau immunosuppressant i lawe ʻia e pale i ka hōʻole ʻana ma hope o ka hoʻololi ʻana o ke kino a i ʻole ka hoʻololi ʻana o ke ʻano o ke kino allogeneic (donor).
Nā ʻano o anaplastic large cell lymphoma (ALCL)
Hiki ke hoʻokaʻawale ʻia ʻo Anaplastic large cell lymphoma (ALCL) i ʻelua ʻano:
- ʻO ka lymphoma pūnaewele nui anaplastic ʻili mua
- Systemic anaplastic nui cell lymphoma
ʻO kekahi o nā mea hōʻike nui o ka anaplastic large cell lymphoma (ALCL), ʻo ia ka loaʻa ʻana o ʻelua mau māka protein ʻokoʻa ma ka ʻili o nā T-lymphocytes. CD30 a me ALK (Anaplastic Lymphoma Kinase).
ʻIke ʻia ʻo Anaplastic large cell lymphoma (ALCL) he CD30 maikaʻi a hiki ke ALK ʻino a i ʻole ALK maikaʻi. Hōʻike ikaika ʻia ʻo CD30 aʻo ALK wale nō ka maikaʻi ma kahi o 90% o nā hihia i nā keiki.
ʻO ka lymphoma pūnaewele nui anaplastic ʻili mua
- ʻAʻole maʻamau i nā keiki a hiki ke ALK maikaʻi ʻole a i ʻole ALK maikaʻi akā he CD30 maikaʻi mau.
- Loaʻa maʻamau me ka puʻupuʻu hoʻokahi a i ʻole ka maʻi ulcerating ma ka ʻili
- Hoʻopili pinepine ʻia i ka ʻili a hiki i nā ʻeha ke hoʻoponopono iā ia iho. ʻO kēia kala kūlohelohe, akā, pōkole pinepine i ka hoʻi ʻana mai o ka maʻi.
- Ke hahai nei ka ALCL kino kumu mua i ka papa hana ha'aha'a ma mua o ka ALCL pūnaewele.
- Hoʻohana mau ʻia ʻo ia ma ke ʻano he lymphoma molowa (ke ulu mālie) ʻoiai e paʻa mau ana i ka ʻili. Inā lōʻihi ia ma waho o ka ʻili, i nā pūnae lymph a i ʻole nā ʻāpana, e hoʻololi ka hoʻokele o ka lymphoma i ka ALCL systemic.
- ʻO ka hoʻololi ʻana o ka mālama ʻana i kēia ma ke ʻano he lymphoma palaka i kahi lymphoma koʻikoʻi ma kahi o 10% o nā maʻi i loaʻa i ka ALCL cutaneous mua.
Systemic anaplastic large cell lymphoma (ALCL)
- ʻOi aku ka maʻamau ma mua o ka ALCL ʻili mua
- He lymphoma huhū (ke ulu wikiwiki) e pono ai ke mālama koke
- Hiki iā ALK maikaʻi a i ʻole ALK maikaʻi ʻole me 90% o nā hihia ALCL pediatric he ALCL pūnaewele ʻo ia ka ALK maikaʻi.
- ʻO ka inoa 'systemic' 'o ia hoʻi, hiki i ka lymphoma ke hoʻopilikia i nā ʻāpana āpau o ke kino e like me nā iwi, ka ʻili, ka iwi iwi, ka māmā a me ke ake.
Nā hōʻailona o ka anaplastic large cell lymphoma (ALCL)
ʻO nā hōʻailona mua he puʻupuʻu a i ʻole nā puʻupuʻu e hele ʻole ma hope o kekahi mau pule. Hiki paha iā ʻoe ke ʻike i hoʻokahi a ʻoi aʻe paha nā puʻupuʻu ma ka ʻāʻī o kāu keiki, ka ʻāʻī a i ʻole ka ʻāʻī. ʻO kēia mau puʻupuʻu he mau lymph nodes, kahi e ulu ai nā lymphocytes maʻamau. Hoʻomaka pinepine kēia mau puʻupuʻu ma kekahi ʻāpana o ke kino o ke keiki, ʻo ia hoʻi ke poʻo, ka ʻāʻī a i ʻole ka umauma a laila e laha ma ke ʻano wānana mai kekahi ʻāpana o ka ʻōnaehana lymphatic a i kekahi. I nā pae kiʻekiʻe, hiki ke laha ka maʻi i nā māmā, ate, iwi, iwi iwi a i ʻole nā mea ʻē aʻe.
ʻO nā hōʻailona maʻamau o anaplastic large cell lymphoma penei:
- Nā maʻi hoʻomau
- ʻO ka pehu ʻole o ka lymph nodes ma ka ʻāʻī, underarm, ʻāʻī a i ʻole ka umauma
- ʻO ka pōkole o ka hanu - ma muli o ka hoʻonui ʻia ʻana o nā lymph nodes i loko o ka umauma a i ʻole ka mediastinal mass
- Cough (ʻo ka maʻamau maloʻo cough)
- 'Oloke
- Paʻakikī ke hoʻōla mai kahi maʻi
- ʻili ʻili (pruritus)
B nā hōʻailona ʻo ia ka mea a nā kauka i kapa ai i kēia mau hōʻailona i loaʻa i kekahi mau keiki a hiki ke komo:
- ʻO ka wela o ka pō (ʻoi aku i ka pō, kahi e pono ai ʻoe e hoʻololi i ko lākou lole moe a me nā moena)
- ʻO ke kuni mau
- ʻO ka pohō kaumahaʻole
He mea nui e hoʻomaopopo i ka nui o kēia mau hōʻailona hiki ke pili i nā kumu ʻē aʻe ma mua o ka maʻi kanesa a paʻakikī i kekahi manawa no nā kauka ke ʻike.
ʻO ka hōʻoia ʻana o ka anaplastic large cell lymphoma (ALCL)
A nā lāʻau kanu koi mau ʻia no ka hōʻoia ʻana o ka lymphoma cell nui anaplastic (ALCL). A nā lāʻau kanu he hana e wehe i a limu lymph a i ʻole nā ʻiʻo ʻino ʻē aʻe e nānā iā ia ma lalo o ka microscope e kahi mea maʻi. Hana ʻia ka biopsy ma lalo o ka anesthetic maʻamau no nā keiki e kōkua i ka hōʻemi ʻana i ka pilikia.
An biopsy node excisional ʻo ia ka koho noiʻi maikaʻi loa, ʻoiai ʻo ia ka mea e hōʻiliʻili ai i ka nui o ka ʻiʻo e hiki ai ke hana i ka hoʻāʻo pono no kahi hōʻailona.
Ke kali nei i nā hualoaʻa hiki ke lilo i manawa paʻakikī. Hiki ke kōkua ke kamaʻilio me kou ʻohana, nā hoaaloha a i ʻole kahi kahu lapaʻau kūikawā.
ʻO ka hoʻopaʻa ʻana o ka anaplastic large cell lymphoma (ALCL)
I ka manawa a ʻike, no ka anaplastic large cell lymphoma (ALCL), pono nā ho'āʻo hou aku e ʻike i kahi ʻē aʻe o ke kino i loaʻa ai ka lymphoma a i ʻole i pā. Kapa ʻia kēia e hoʻokū nei. ka kūlana ʻO ka lymphoma e kōkua i ke kauka e ʻike i ka lāʻau maikaʻi loa no kāu keiki.
ʻEhā mau ʻanuʻu, mai ka pae 1 (lymphoma ma kahi wahi) a hiki i ka pae 4 (lymphoma i laha ʻia).
- Anuu mua 'o ia ho'i ka pae 1 a me kekahi mau lymphoma papa 2. Hiki ke kapa ʻia kēia 'localised'. ʻO ka pae 1 a i ʻole 2 ʻo ia ka loaʻa ʻana o ka lymphoma ma kahi wahi a i ʻole kekahi mau wahi kokoke.
- ʻIa pae kiʻekiʻe 'o ia ho'i, 'o ka lymphoma ka pae 3 a me ka pae 4, a he lymphoma laha. I ka hapanui o nā hihia, ua laha ka lymphoma i nā ʻāpana o ke kino i mamao loa mai kekahi i kekahi.
ʻO ka 'Advanced' stage lymphoma ke kani e pili ana, akā ʻo ka lymphoma ka mea i ʻike ʻia he maʻi maʻi ʻōnaehana. Hiki ke laha a puni ka ʻōnaehana lymphatic a me nā ʻiʻo kokoke. ʻO ia ke kumu e pono ai ka mālama ʻana i ka ʻōnaehana (chemotherapy) no ka mālama ʻana i ka lymphoma cell nui anaplastic.
Hiki ke komo i nā ho'āʻo a me nā scan e pono ai:
- Nā ho'āʻo koko (e like me: helu koko piha, kemika koko a me ka erythrocyte sedimentation rate (ESR) no ka huli ʻana i nā hōʻike o ka mumū)
- Kānana x-ray - e kōkua kēia mau kiʻi e ʻike i ke ʻano o ka maʻi i loko o ka umauma
- ʻO ka ʻōmole helu Positron emoate (PET) - hana ʻia e hoʻomaopopo i nā wahi āpau o ka maʻi i loko o ke kino ma mua o ka hoʻomaka ʻana o ka mālama ʻana
- Ka pākuʻina o ka tomography (CT)
- Biopsy iwi ʻōiwi (ʻo ka hana maʻamau inā ʻike ʻia ka maʻi ʻoi loa)
- Pahu lumbar – Inā kānalua ka lymphoma i loko o ka lolo a i ʻole ke kuamoʻo
Hiki i kāu keiki ke loaʻa i kekahi mau nā hoʻokolohua kumu ma mua o ka hoʻomaka ʻana o kekahi lapaʻau e nānā i ka hana o ke kino. Hoʻohana pinepine ʻia kēia mau mea i ka wā a ma hope o ka pau ʻana o ka mālama ʻana no ka loiloi inā ua pili ka mālama ʻana i ka hana o ke kino. I kekahi manawa pono paha e hoʻoponopono ʻia ka mālama ʻana a me ka mālama ʻana e kōkua i ka mālama ʻana i kekahi nā hopena maikaʻi ʻole. Hiki i kēia mau mea ke komo:
- Ke kaulike
- Nā ʻike koʻikoʻi (Ke koko, ka mahana, a me ka helu pulse)
- ʻImi puʻuwai
- Kiʻi ʻāʻī
- Nā hoʻāʻo hanu
He nui nā mea kūlana a nā hoʻokolohua hana kino hana hou ʻia ma hope o ka lapaʻau ʻana e nānā inā ua holo ka lapaʻau lymphoma a nānā i ka hopena i loaʻa i ke kino.
Ka wānana o anaplastic large cell lymphoma (ALCL)
ʻO ka helu ola lōʻihi no ka liʻiliʻi (ka wā mua) anaplastic nui cell lymphoma ma waena o 80% - 90%. ʻO ke ola lōʻihi no ka holomua (pae III a me IV) anaplastic nui cell lymphoma ma kahi o 60% - 75%.
ʻO ka poʻe i pane ʻole i ka lāʻau lapaʻau maʻamau a i ʻole ka hoʻihoʻi hou ʻana, aia nō nā lāʻau lapaʻau i hiki ke loaʻa i ke kala lōʻihi.
Hiki ke hilinaʻi ʻia nā koho ola lōʻihi a me ka mālama ʻana i nā kumu like ʻole, me:
- ʻO ka makahiki o kāu keiki ma ka hōʻoia
- Ka lōʻihi a i ʻole ka pae o ka maʻi kanesa
- ʻO ke ʻano o ALCL
- Pehea e pane ai ka lymphoma i ka lāʻau lapaʻau
E kamaʻilio me ke kauka o kāu keiki e pili ana i ka maʻi o kāu keiki, nā koho lapaʻau a me ka wānana.
Hoʻomaʻamaʻa ʻana i ka anaplastic large cell lymphoma (ALCL)
Ke pau nā hualoaʻa mai ka biopsy a me nā scans staging, e nānā ke kauka i kēia mau mea no ka hoʻoholo ʻana i ka lāʻau lapaʻau maikaʻi loa no kāu keiki. Ma kekahi mau kikowaena maʻi 'aʻai, e hui pū ke kauka me kahi hui o nā loea e kūkākūkā i ke koho lapaʻau maikaʻi loa. Kapa ʻia kēia a hui multidisciplinary (MDT) hui.
E noʻonoʻo nā kauka i nā kumu he nui e pili ana i ka lymphoma o kāu keiki a me ke olakino maʻamau e hoʻoholo ai i ka wā a me ka lāʻau e pono ai. Hoʻokumu ʻia kēia ma:
- ʻO ka pae a me ka pae o ka lymphoma
- Ōuli
- ʻO ka makahiki, ka mōʻaukala olakino a me ke olakino maʻamau
- Ke ola kino a me ka noʻonoʻo o kēia manawa
- Nā kūlana pilikanaka
- Nā makemake ʻohana
No ka mea he lymphoma e ulu wikiwiki ana ka anaplastic cell lymphoma, pono e hoʻomaka ka mālama ʻana i loko o kekahi mau lā a i ʻole mau pule ma hope o ka hana ʻana i kahi hōʻailona.
ʻO nā protocols Chemotherapy a me nā mea maʻamau i hoʻohana ʻia:
Hiki ke mālama ʻia ka maʻi maʻi kūloko o ka Stage I a i ʻole ka Stage II me kahi papa pōkole 9-wiki o ka chemotherapy:
- CHOP chemotherapy ka papa hana: (cyclophosphamide, doxorubicin, vincristine a me prednisolone)
No ka maʻi kiʻekiʻe (Stage III a me IV), aia kekahi mau protocol lapaʻau kūpono e like me:
- APO: ʻO Adriamycin (Doxorubicin), Methotrexate, Vincristine, 6-mecaptipurine a me Prednisolone. Hoʻohana pinepine ʻia kēia protocol ma mua o hoʻokahi makahiki ma ke ʻano he maʻi ma waho.
- ALCL 99: Dexamethasone, Cyclophosphamide, Methotrexate, Ifosphamide, Cytarabine, Etoposide a me Doxorubicin. Pono kēia protocol i ke komo ʻana i ka haukapila no kāna hoʻokele, akā hiki i nā mea maʻi ke hoʻi i ka home ma waena o nā pōʻai protocol.
- NHL – BFM90: Methotrexate kiʻekiʻe, Cyclophosphamide, Ifosfamide, Etoposide, Doxorubicin
Nā hopena maʻamau o ka lāʻau lapaʻau:
ʻO ka lāʻau lapaʻau no Anaplastic Large Cell lymphoma e hele mai me ka pilikia o ka hoʻomohala ʻana i nā hopena ʻaoʻao like ʻole. He hopena ʻaoʻao ko kēlā me kēia ʻano lapaʻau a na ke kauka lapaʻau a/a i ʻole kahu hānai maʻi maʻi kūikawā e wehewehe iā ʻoe a me kāu keiki ma mua o ka hoʻomaka ʻana i ka mālama ʻana. No ka ʻike hou aku i kekahi o nā mea nui loa hopena maʻamau a me nā ala e kōkua ai i ka mālama ʻana i kēia mau mea i kāu keiki, e ʻike i ka ʻāpana ma hopena ʻaoʻao maʻamau.
ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka mālama ʻana no ka lymphoma cell nui anaplastic (ʻaʻole nā mea āpau) e komo pū:
- Anemia (ke koko ʻulaʻula haʻahaʻa)
- ʻO ka Thrombocytopenia (nā platelet haʻahaʻa)
- Neutropenia (ke koko keʻokeʻo haʻahaʻa)
- ʻO ka naʻi a me ka luaʻi
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a me ka diarrhea
- 'Oloke
- Hoemi i ka momona
Pono ka hui lapa'au, kauka, kahu ma'i 'a'ai a lā'au lapa'au paha, e hā'awi iā 'oe i ka 'ike e pili ana i ka lapaʻau, ka hopena maʻamau, he aha nā hōʻailona e hōʻike a ʻo wai e hoʻopili. Inā ʻaʻole, e nīnau i kēia mau nīnau.
No ka ʻike hou aku e kelepona i ka laina kākoʻo kahu hānai lymphoma ma 1800 953 081 a leka uila iā mākou ma kahu@lymhpoma.org.au
Malama hahai
Ke hoʻopau ʻia ka mālama ʻana, e loaʻa i kāu keiki nā scan staging staging. ʻO kēia mau scans e nānā i ka maikaʻi o ka hana ʻana. E hōʻike ana nā scans i nā kauka:
- Pane piha (CR a ʻaʻohe hōʻailona o ka lymphoma i koe) a i ʻole
- pane hapa (PR a i ʻole he lymphoma i kēia manawa, akā ua hoʻemi ʻia ka nui)
A laila pono kāu keiki e hahai ʻia e kāna kauka me nā koho maʻamau maʻamau, maʻamau i kēlā me kēia 3-6 mahina. He mea nui kēia mau koho i hiki i kā lākou hui lapaʻau ke nānā i ka maikaʻi o ko lākou ola ʻana mai ka mālama ʻana. He manawa maikaʻi nō hoʻi ia no ʻoe e kamaʻilio me kā lākou kauka a kahu hānai paha e pili ana i nā pilikia āu e loaʻa ai. E makemake ana kā lākou hui lapaʻau e ʻike pehea lākou a me ʻoe i ke kino a me ka noʻonoʻo, a i:
- E nānā i ka pono o ka lāʻau lapaʻau
- E nānā i nā hopena ʻaoʻao mai ka lāʻau lapaʻau
- E nānā i nā hopena hope loa mai ka mālama ʻana i ka manawa
- E nānā i nā hōʻailona o ka hoʻi hou ʻana o ka lymphoma
Loaʻa paha iā lākou kahi hoʻokolohua kino a hoʻāʻo koko no kēia mau koho. Ma waho aʻe o ka manawa ma hope o ka mālama ʻana e nānā i ke ʻano o ka hana ʻana o ka mālama ʻana, ʻaʻole hana pinepine ʻia nā scans ke ʻole he kumu kūikawā no lākou. Inā noho maikaʻi lākou, hiki ke emi pinepine nā koho i ka manawa.
Lapaʻau hou ʻana a i ʻole Refractory no ALCL
Hoʻihoʻi hou ʻia ʻO ka lymphoma ka wā i hoʻi mai ai ke kanesa, hale hōʻoluʻolu ʻO ka lymphoma ka wā e pane ʻole mai ai ke kanesa nā lāʻau lapaʻau mua. No kekahi po'e keiki a me ka po'e 'ōpio, ho'i mai 'o Anaplastic Large Cell lymphoma a ma kekahi mau hihia 'a'ole ia e pane i ka lapa'au mua (refractory). No kēia mau maʻi aia kekahi mau lāʻau lapaʻau ʻē aʻe i hiki ke kūleʻa, a hiki ke komo:
- ʻO ka chemotherapy hui pū ʻana kiʻekiʻe ukali ma autologous (mau pūnaewele ponoʻī) ka hoʻololi ʻana i ke ʻano o ke kino aiʻole ka hoʻololi ʻana i ke ʻano o nā pūnaʻi kumu allogeneic (donor).
- ʻO ka chemotherapy hui
- ʻO ka lāʻau chemotherapy me ka vinblastine
- immunotherapy
- ʻO ke kelepona
- Ke komo ʻana i ka hoʻokolohua lapaʻau
Ke kānalua ʻia ka hoʻihoʻi hou ʻana, hana pinepine ʻia nā hoʻokolohua hoʻokūkū like, me nā hoʻokolohua i ʻōlelo ʻia ma luna o ka 'hōʻailona a me ka hoʻonohonoho ʻana' pauku.
Lapaʻau ma lalo o ka hoʻokolokolo ʻana
ʻO ka prognosis o pediatric anaplastic large cell lymphoma ua kū mau i ka 60% - 75% no ka maʻi holomua no laila ke hoʻomau nei nā noiʻi i ka hana o nā mea lapaʻau i manaʻo ʻia, e like me ka ALK inhibitors a me ka anti-CD30 antibody drug conjugates, i nā hoʻāʻo e hoʻāʻo. a hoʻomaikaʻi i nā hopena.
Nui nā lāʻau lapaʻau e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a ʻo kekahi o kēia mau lāʻau lapaʻau e komo pū ana:
- Brentuximab Vedotin - anti-CD30 antibody drug conjugate
- ʻO Crizotinib - mea hoʻokae ALK
- ʻO ka lāʻau chemotherapy me ka vinblastine
He aha ka hana ma hope o ka mālama ʻana?
I kekahi manawa a hopena ʻaoʻao hiki ke hoʻomau a ulu paha nā mahina a i ʻole mau makahiki ma hope o ka pau ʻana o ka mālama ʻana. Kapa ʻia kēia a hopena lohi.
Hiki i nā keiki a me nā ʻōpio ke loaʻa nā hopena ʻaoʻao pili i ka mālama ʻana i hiki ke ʻike ʻia i mau mahina a i ʻole mau makahiki ma hope o ka mālama ʻana, me nā pilikia me ka ulu ʻana o ka iwi a me ka ulu ʻana o nā ʻano kāne i loko o nā kāne, ka ʻike ʻole, a me nā maʻi thyroid, naʻau a me ka māmā. Nui nā ʻano lapaʻau o kēia manawa a me nā noiʻi noiʻi i kēia manawa i ka hoʻāʻo ʻana e hōʻemi i ka hopena o kēia mau hopena hope.
No kēia mau kumu he mea nui ka poʻe ola o ka anaplastic large cell lymphoma i mau heck ups.
