ʻO ka nānā ʻana o Burkitt Lymphoma (BL)
ʻO Burkitt lymphoma (BL) ʻo ia ka subtype koʻikoʻi loa o ka lymphoma, a manaʻo ʻia ʻo ia ka ulu wikiwiki loa - a i ʻole ke ʻano o ka maʻi kanesa.
Ma muli o ka hoʻomaka ʻana a pālahalaha loa, pono e mālama ʻia me ka chemoimmunotherapy ikaika loa ma hope o ka maʻi ʻana. Eia nō naʻe, no ka hana maikaʻi ʻana o ka chemotherapy i nā pūnaewele ulu wikiwiki, ʻoi loa ka hopena i ka luku ʻana i nā pūnaewele Burkitt Lymphoma.
Hiki ke ho'ōla 'ia ka hapa nui o nā keiki me Burkitt Lymphoma.
Ka hoʻomaopopo ʻana i nā lymphocytes B-cell
ʻO Burkitt Lymphoma kahi maʻi kanesa o nā lymphocytes B-cell, no laila e hoʻomaopopo i ka Burkitt Lymphoma pono ʻoe e ʻike iki e pili ana i kāu lymphocytes B-Cell.
ʻO nā lymphocytes pūnaewele B:
- He ʻano o ke koko keʻokeʻo.
- E hakakā i nā germs e ho'ōki i kou maʻi.
- E hoʻomanaʻo i nā germs i loaʻa iā ʻoe i ka wā ma mua, no laila inā loaʻa hou iā ʻoe ka germ 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 e noho mau i loko o kou ʻōpū a me kou mau lymph nodes. Noho kekahi i kou thymus a me kou koko (e nānā i ke kiʻi ma lalo).
- Hiki ke hele ma kāu ʻōnaehana lymphatic, i kekahi ʻāpana o kou kino e hakakā ai i ka maʻi a i ʻole ka maʻi.
He aha ka hopena ke hana ʻole kāu B-cell Lymphocytes i ka mea i manaʻo ʻia?
Ke hoʻomaka ka loli a me ka hana ʻino ʻana o kāu lymphocytes B-cell hiki iā ʻoe ke loaʻa iā Burkitt Lymphoma. Hoʻomaka kēia mau lymphocytes B-cell ʻino e ulu me ke kāohi ʻole ʻia, a hoʻoulu i nā mea ʻino lymphoma ʻē aʻe.
Ke loaʻa iā ʻoe ka Burkitt Lymphoma, kāu lymphocytes B-cell cancerous:
- E ulu a māhuahua koke.
- ʻAʻole e hana maikaʻi i ka hakakā ʻana i nā germs e maʻi ai ʻoe.
- E nānā a hana ʻokoʻa loa i kāu mau pūnaʻi B olakino (maikaʻi).
- Hiki ke ulu a ulu ka lymphoma ma nā wahi he nui o kou kino.
Nā ʻano liʻiliʻi o Burkitt Lymphoma
Endemic Burkitt Lymphoma, ʻoi aku ka maʻamau i nā poʻe me kahi ʻano ʻApelika, a ʻo ia ka lymphoma maʻamau i nā keiki ʻApelika. ʻOi aku ka maʻamau o ka poʻe i loaʻa i ka maʻi maʻi maʻi a i ʻole Epstein-Barr virus (EBV).
Hoʻomaka pinepine ʻo Endemic Burkitt Lymphoma ma kou ʻāʻī, a i ʻole ma nā iwi ʻē aʻe o kou alo, akā hiki ke hoʻomaka pū ma kou ʻōpū (opu).
Sporadic Burkitt Lymphoma hiki ke ulu i nā kānaka ma nā wahi a pau o ka honua. Hiki paha iā ʻoe ke loaʻa kēia inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo Epstein-Barr virus. Hoʻomaka pinepine ia i loko o kou ʻōpū (ʻōpū), no laila e loaʻa iā ʻoe ka ʻeha a i ʻole ka hōʻoluʻolu i kou ʻōpū. Hiki paha iā ʻoe ke pilikia i ka ʻai ʻana no ka mea hiki koke iā ʻoe ke māʻona inā ʻaʻole ʻoe e ʻai nui.
Hiki i ka Sporadic Burkitt Lymphoma ke laha i kou CNS pūnaewele puni honua), me kou lolo a me ke kuamoʻo, kou thyroid gland, tonsils a me nā iwi ma kou alo.
ʻOi aku ka maʻamau o Burkitt Lymphoma pili i ka Immunodeficiency inā ʻaʻole e holo pono kāu ʻōnaehana pale. Hiki paha kēia inā loaʻa iā ʻoe kahi maʻi e like me ka maʻi maʻi immunodeficiency kanaka (HIV), a i ʻole ua loaʻa iā ʻoe ka maʻi immunodeficiency (AIDS).
Eia nō naʻe, hiki iā ʻoe ke loaʻa i kēia ʻano BL inā ʻoe e lawe i ka lāʻau e hoʻonāwaliwali ai kou ʻōnaehana pale. Lawe kekahi poʻe i kēia mau lāʻau inā loaʻa iā lākou ka ʻōnaehana pale ʻana, a i ʻole inā ua loaʻa iā ʻoe kahi hoʻololi ʻana.
Pehea ka maʻamau o Burkitt Lymphoma?
Hoʻopilikia ka lymphoma Burkitt i nā kānaka o kēlā me kēia makahiki, me nā keiki a me nā pākeke. ʻO ia ke ʻano lymphoma maʻamau i nā keiki ma waena o 5 a me 10 mau makahiki a loaʻa iā 30% o nā lymphoma kamaliʻi āpau - ʻo ia hoʻi, ʻo 3 o kēlā me kēia 10 keiki me ka lymphoma e loaʻa iā Burkitt Lymphoma.
ʻOi aku ka kakaikahi i nā poʻe mākua me 1 a 2 wale nō poʻe mākua mai loko o kēlā me kēia 100 (1-2%) me ka lymphoma i loaʻa iā Burkitt Lymphoma. I ka poʻe mākua, ʻoi aku ka maʻamau i ka poʻe ma waena o 30-50 mau makahiki.
Nā ʻōuli o Lymphoma
Inā ʻoe e nānā i ke kiʻi o kā mākou ʻōnaehana lymphatic, (e kaomi maanei), ʻO ka lymph nodes nā mea liʻiliʻi melemele poepoe/oval i loko o nā wahi a pau o ko mākou kino.
No ka mea aia lākou ma nā wahi a pau o ko mākou kino, hiki ke hoʻomaka ʻo BL ma nā wahi āpau o kou kino, akā ʻoi aku ka maʻamau o ka hoʻomaka ʻana ma nā ʻōpū lymph ma kou poʻo, ka maka, ka ʻāʻī a i ʻole ka ʻōpū. No laila, loaʻa paha iā ʻoe kahi puʻupuʻu a ʻeha paha e hiki mai ana ʻaʻole hoʻōla a nui aʻe.
Ua like kekahi mau hōʻailona o ka lymphoma Burkitt me nā hōʻailona o nā lymphomas ʻē aʻe, a pili paha kekahi i kahi e ulu ai ka lymphoma.
Hiki ke loaʻa nā wahi maʻamau ʻo Burkitt Lymphoma:
- lymph nodes ma kou ʻāʻī, ʻāʻī a me ka ʻāʻī
- kou ʻōpū a me kou ʻōpū
- kou ʻōnaehana hoʻokele waena (CNS) - ka lolo a me ke kuamoʻo
- ka iwi o ka iwi
- ʻoʻoleʻa, ate a me nā mea ʻē aʻe o kou kino
- kou āwae a i ʻole nā iwi ʻē aʻe ma kou alo.
ʻO Burkitt Lymphoma nodal a me ka nodal hou
Hiki ke hoʻomaka ʻo Burkitt Lymphoma i loko o kāu mau lymph nodes a i ʻole ma waho o kāu mau lymph nodes. Ke hoʻomaka ia i loko o kāu mau lymph nodes ua kapa ʻia ʻo ia "nodal". Ke hoʻomaka ʻo ia ma waho o kāu mau lymph nodes - e like me kāu mau ʻōpū a i ʻole ka iwi iwi i kapa ʻia ʻo "extra nodal".
ʻO ka hōʻailona maʻamau o ka nodal Burkitt Lymphoma ʻo ia ka pehu lymph nodes i hiki ke loaʻa ma kekahi ʻāpana o kou kino. Ua ʻike pinepine ʻia lākou ma kou ʻāʻī, ka ʻāʻī a i ʻole ka ʻāʻī, no ka mea ua kokoke kēia mau lymph nodes i kou ʻili.
Akā, loaʻa iā mākou nā lymph nodes ma ka umauma, ka ʻōpū, nā lima, nā wāwae a me ke poʻo. Ma muli o ka ulu a laha koke ʻana o Burkitt Lymphoma, ʻike paha ʻoe i ka pehu ʻana o nā ʻōpū lymph ma nā wahi he nui o kou kino.
ʻO nā hōʻailona ʻē aʻe o ka pehu lymph nodes a i ʻole lymphoma extranodal
Ma muli o nā ʻāpana o kou kino i pehu ʻia nā ʻōpū lymph hiki iā ʻoe ke ʻike i nā hōʻailona like ʻole. ʻAʻole ʻeha ka nui o nā puʻu lymph pehu e pili ana i ka lymphoma, akā hiki ke ʻeha inā hoʻokau lākou i ke kaomi i nā ʻāpana ʻē aʻe, nā aʻalolo a i ʻole i nui loa.
Ma waho aʻe o nā lymph nodes, loaʻa iā mākou nā kiko lymphoid ma nā ʻāpana like ʻole o ko mākou kino e like me ko mākou waha, ʻōpū, ʻōpū, nā māmā. ʻO ka ʻiʻo Lymphoid he mau wahi ia o nā cell immune e noho ana ma nā wahi o ko mākou kino e kiaʻi a hakakā i nā maʻi. Hiki ke hoʻomaka a laha paha ʻo Burkitt Lymphoma i kekahi o kēia mau wahi.
Hiki i nā hōʻailona ke komo i kēia mau mea.
Wahi i pili | Ōuli |
ʻO ka umauma a i ʻole ka ʻāʻī | ʻO ka manawa pōkole Hoʻololi i kou leo ʻO kahi maʻi mau ʻEha, ʻeha a ʻeha paha ma ka umauma a i ʻole ka ʻāʻī Hoʻololi i ka puʻuwai puʻuwai inā pili ka puʻuwai |
Pūnaehana nūnū waena (Ka lolo, ke kuamoʻo a me ka wahi ma hope o kou mau maka) | Hoʻololi huikau a hoʻomanaʻo paha Hoʻoponopono Nā hoʻololi i kāu ʻike Nawaliwali, kani a wela paha Paʻakikī hele Paʻakikī i ka hele ʻana i ka lua Hoʻopaʻa (kūpono) Nā hoʻololi kūlohelohe |
Puu – (Wā, ʻōpū a me ka ʻōpū) | ʻEha nā niho a me nā ʻāʻī a hiki ke hoʻokomo i kahi puʻupuʻu ma kou ʻāʻī a i ʻole kokoke i kou mau niho (inā loaʻa iā ʻoe kahi puʻupuʻu, hiki ke ʻano like ʻole kou maka) ʻEha a i ʻole ka ʻāʻī ma kou ʻāwae Nausea me ka luaʻi ʻole Ka weheweheʻana a iʻole ka paʻa ʻO ka ʻōpū pehu (ke nānā paha ʻoe i ka hāpai ʻana) Koko ke hele i ka lua Manaʻo piha inā ʻaʻole ʻoe i ʻai, a ʻai liʻiliʻi paha Pilikia i ka ale ʻana. |
Puʻupuʻu iwi | ʻO nā hoʻololi i kāu helu koko maikaʻi me:
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Nā ʻano o kāu ʻōnaehana lymphatic - Spleen and thymus
ʻO kou ʻōpū he ʻōkana e kānana i kou koko a mālama i ke olakino. He okana nō hoʻi ia o kāu ʻōnaehana lymphatic kahi e noho ai kāu lymphocytes B-cell a hana i nā antibodies e hakakā i ka maʻi. Aia ia ma ka ʻaoʻao hema o kou ʻōpū luna ma lalo o kou māmā a kokoke i kou ʻōpū (opu). Hiki iā ʻoe ke ʻike i ke kiʻi o ia mea ma ka kiʻi ʻōnaehana lymphatic.
Ke nui loa kou ʻāʻī, hiki iā ia ke hoʻoikaika i kou ʻōpū a māʻona ʻoe, ʻoiai inā ʻaʻole ʻoe i ʻai nui. Hiki iā ʻoe ke loaʻa:
- ka helu haʻahaʻa
- luhi loa (fatigue)
- kaumaha lilo
- jaundice (ka melemele o kou ʻili a me kou mau maka)
- ʻeha ma kou ʻōpū a i ʻole ka manaʻo o ka "puʻu".
oukou kāu thyma ʻo ia kekahi o kāu ʻōnaehana lymphatic. He ʻano pepeke ia e noho ana ma hope pono o kou iwi umauma i mua o kou umauma. Ke ola nei kekahi mau pūnaʻi B a hele i loko o kou thymus. Inā loaʻa ka lymphoma i kou thymus hiki iā ʻoe ke loaʻa kahi puʻupuʻu i loko o kou umauma e hiki ke hoʻokau i ke kaomi i nā ʻāpana ʻē aʻe o kou umauma. Hiki ke like nā hōʻailona me nā mea i helu ʻia ma ka papa ma luna.
ake
- ʻO Jaundice - ʻo ia ka wā e hoʻomaka ai kou ʻili a me kou mau maka e nānā melemele.
- ʻO ka ʻeha a i ʻole ka hōʻoluʻolu hiki ke piʻi i kou poʻohiwi hema.
- Pau ka ʻai (ʻaʻole makemake e ʻai) a me ke kaumaha.
- ʻO ka pehu o kou ʻōpū ma muli o ke kūkulu ʻana o ka wai (ascites).
- Ke koko ʻokoʻa.
B-hōʻailona
Hiki ke loaʻa nā hōʻailona B i ka wā e ulu ikaika ana ka lymphoma, no laila hiki ke maʻamau ke loaʻa iā ʻoe ka Burkitt Lymphoma. Hiki iā ia ke hōʻike i ka hoʻohana ʻana o ka lymphoma i kāu mālama ikehu I kekahi manawa ke kumu kēia mau hōʻailona ma muli o ka hana ʻana o nā cell lymphoma i nā kemika e pili ana i ke ʻano o kou kino e hoʻoponopono ai i kou wela.
E hōʻike mau i kāu kauka inā loaʻa iā ʻoe nā hōʻailona B.
ʻO ka ʻike a me ka hoʻopaʻa ʻana o Burkitt Lymphoma
Inā manaʻo kāu kauka e loaʻa iā ʻoe ka lymphoma, pono lākou e hoʻonohonoho i nā hoʻokolohua koʻikoʻi. Pono kēia mau ho'āʻo e hōʻoia a hoʻopau paha i ka lymphoma ke kumu o kāu mau hōʻailona.
No ka ʻike ʻana i ka Burkitt Lymphoma, pono ʻoe i kahi biopsy. ʻO ka biopsy kahi kaʻina hana e wehe ai i kahi ʻāpana, a i ʻole nā mea āpau i hoʻopilikia ʻia a/a i ʻole kahi laʻana o ka iwi iwi. A laila nānā ʻia ka biopsy e nā ʻepekema i loko o kahi keʻena hana e ʻike inā he mau loli e kōkua i ke kauka e ʻike i ka maʻi o Burkitt.
Ke loaʻa iā ʻoe kahi biopsy, loaʻa paha iā ʻoe kahi maʻi anesthetic kūloko a i ʻole maʻamau. E pili ana kēia i ke ʻano o ka biopsy a me kahi ʻāpana o kou kino i lawe ʻia mai. Aia nā ʻano biopsies like ʻole a pono paha ʻoe i ʻoi aku ma mua o hoʻokahi no ka loaʻa ʻana o ka laʻana maikaʻi loa.
Nā ho'āʻo koko
Lawe ʻia nā hoʻāʻo koko i ka wā e hoʻāʻo ai e hōʻoia i kāu lymphoma, akā i loko o kāu mālama ʻana e hōʻoia i ka hana pono ʻana o kāu mau kino a hiki ke hoʻokō i kā mākou lapaʻau.
Biopsy kumu a i ʻole ka nila maikaʻi
Lawe ʻia nā biopsies koʻikoʻi a i ʻole ka nila maikaʻi no ka wehe ʻana i kahi laʻana o ka pehu lymph node a i ʻole ka ʻōpū e nānā i nā hōʻailona o ka lymphoma.
Hoʻohana maʻamau kāu kauka i kahi anesthetic kūloko e hoʻopau i ka wahi i ʻole ʻoe e ʻeha i ka wā o ke kaʻina hana, akā e ala ʻoe i kēia biopsy. A laila e hoʻokomo lākou i kahi nila i loko o ka ʻōpū lymph pehu a i ʻole ka puʻupuʻu a wehe i kahi laʻana o ka ʻiʻo.
Inā hohonu i loko o kou kino ka pehu lymph node a puʻupuʻu paha, hiki ke hana ʻia ka biopsy me ke kōkua o ke ultrasound a i ʻole ke alakaʻi x-ray (kiʻi).
Loaʻa paha iā ʻoe kahi maʻi anesthetic maʻamau no kēia (kahi e hiamoe ai ʻoe no kahi manawa liʻiliʻi). Loaʻa paha iā ʻoe kekahi mau humuhumu ma hope.
ʻOi aku ka nui o nā biopsies o ka nila ma mua o ka biopsy nila.
ʻO ka biopsy node excision
Hana ʻia nā biopsies node excisional inā hohonu loa kou ʻōpū lymph a i ʻole ka ʻōpū i loko o kou kino a hiki ʻole ke loaʻa ʻia e kahi biopsy kumu a i ʻole ka nila. Loaʻa iā ʻoe kahi maʻi maʻi maʻi maʻi e hoʻomoe iā ʻoe no kahi manawa liʻiliʻi i noho mālie ʻoe, ʻaʻohe ʻeha.
I loko o kēia kaʻina hana, e hoʻoneʻe ke kauka lapaʻau i ka puʻupuʻu lymph holoʻokoʻa a hoʻouna ʻia i ka pathology no ka hoʻāʻo.
E loaʻa iā ʻoe kahi ʻeha liʻiliʻi me nā humuhumu liʻiliʻi, a me kahi ʻaʻahu ma luna.
Noho mau nā humuhumu no 7-10 mau lā, akā na kāu kauka a kahu hānai paha e aʻo iā ʻoe i ke ʻano o ka mālama ʻana i ka lole, a me ka manawa e hoʻi ai e wehe i nā humuhumu.
ʻO Burkitt Lymphoma Diagnosis
Ke loaʻa i kāu kauka nā hopena mai kāu hoʻāʻo koko a me nā biopsies e hiki iā lākou ke haʻi iā ʻoe inā he Burkitt Lymphoma kāu a hiki paha ke haʻi iā ʻoe i ke ʻano subtype o Burkitt iā ʻoe. A laila makemake lākou e hana i nā hoʻokolohua hou aʻe i ka pae a me ka helu ʻana i kāu lymphoma.
ʻO ka hoʻopaʻa ʻana a me ka helu ʻana i ka Lymphoma Burkitt
Ke ʻike ʻia ʻoe me Burkitt Lymphoma, e nīnau hou kāu kauka e pili ana i kāu lymphoma. E komo pū ana kēia mau mea:
- He aha kāu lymphoma?
- He aha kāu ʻano ʻano o Burkitt?
Kaomi ma nā poʻomanaʻo ma lalo nei e aʻo hou e pili ana i ka hoʻonohonoho ʻana a me ka hoʻopaʻa ʻana.
Hōʻike ka staging i ka nui o kou kino i hoʻopilikia ʻia e kāu lymphoma - a i ʻole, pehea ka lōʻihi o ka laha ʻana mai kahi i hoʻomaka mua ai.
Hiki i nā pūnae B ke hele i kekahi wahi o kou kino. 'O ia ho'i, hiki i nā pūnaewele lymphoma (nā ma'i 'a'ai B-cell), hiki ke hele i kekahi wahi o kou kino. Pono ʻoe e hoʻāʻo hou aku e ʻike i kēia ʻike. Kapa ʻia kēia mau hoʻokolohua he staging tests a ke loaʻa iā ʻoe nā hopena, e ʻike ʻoe inā loaʻa iā ʻoe ka pae hoʻokahi (I), pae ʻelua (II), pae ʻekolu (III) a i ʻole pae ʻehā (IV) Burkitt Lymphoma. Eia nō naʻe, no ka mea ʻoi loa ka koʻikoʻi o Burkitt's, ʻo ia ka manawa he pae holomua (pae 3 a i ʻole 4) ke ʻike ʻia ʻoe,
E pili ana kāu pae o ka lymphoma i:
- ʻEhia mau wahi o kou kino i loaʻa i ka lymphoma
- Ma kahi e komo ai ka lymphoma inā aia ma luna, ma lalo a ma nā ʻaoʻao ʻelua o kāu diaphragm (he ʻiʻo nui, ʻano dome ma lalo o ka iwi ʻaoʻao e hoʻokaʻawale i ka umauma mai kou ʻōpū)
- Inā ua laha ka lymphoma i kou iwi iwi a i ʻole nā ʻano ʻē aʻe e like me ke ake, ka māmā, ka ʻili a i ʻole ka iwi.
Kapa ʻia nā pae I a me II 'o ka pae mua a i ʻole ka palena palena' (e pili ana i kahi ʻāpana o kou kino).
Ua kapa ʻia nā pae III a me IV he 'pae holomua' (ʻoi aku ka laulā).
Hana 1 | Hoʻokahi wahi puʻupuʻu lymph i hoʻopilikia ʻia, ma luna a ma lalo paha o ka diaphragm* |
Hana 2 | ʻelua a ʻoi aʻe paha nā ʻāpana lymph node ma ka ʻaoʻao hoʻokahi o ka diaphragm* |
Hana 3 | ma ka liʻiliʻi hoʻokahi wahi lymph node ma luna a ma ka liʻiliʻi loa hoʻokahi wahi lymph node ma lalo o ka diaphragm* e pili ana |
Hana 4 | Aia ka lymphoma i loko o nā pūnana lymph he nui a ua laha i nā wahi ʻē aʻe o ke kino (e laʻa me ka iwi, ka māmā, ka ate) |
ʻO ka ʻike hoʻokūkū keu
Hiki i kāu kauka ke kamaʻilio e pili ana i kāu pae ma ka hoʻohana ʻana i kahi leka, e like me A,B, E, X a i ʻole S. Hāʻawi kēia mau leka i ka ʻike hou aku e pili ana i nā hōʻailona āu i loaʻa ai a i ʻole ka hopena o kou kino e ka lymphoma. Kōkua kēia ʻike a pau i kāu kauka e ʻimi i ka hoʻolālā lapaʻau maikaʻi loa no ʻoe.
palapala | Meaning | nui |
A a i ʻole B |
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E & X |
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S |
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(ʻO kou spleen he ʻōkana i loko o kāu ʻōnaehana lymphatic e kānana a hoʻomaʻemaʻe i kou koko, a he wahi ia e hoʻomaha ai kou mau cell B a hana i nā antibodies) |
Nā hoʻāʻo no ke kahua
No ka ʻike ʻana i ka pae āu e loaʻa ai, e noi ʻia paha ʻoe e loaʻa i kekahi o kēia mau hoʻokolohua staging:
Ka pākuʻina o ka tomography (CT)
Lawe kēia mau kiʻi i nā kiʻi o loko o kou umauma, ka ʻōpū a i ʻole ke pelvis. Hāʻawi lākou i nā kiʻi kikoʻī e hāʻawi i ka ʻike hou aku ma mua o kahi X-ray maʻamau.
ʻO ka ʻōmole helu Positron emoate (PET)
He scan kēia e kiʻi i nā kiʻi o loko o kou kino holoʻokoʻa. E hāʻawi ʻia ʻoe i kahi lāʻau lapaʻau e hoʻopaʻa ʻia ai nā cell cancerous - e like me nā cell lymphoma. ʻO ka lāʻau lapaʻau e kōkua ana i ka PET scan e ʻike i kahi o ka lymphoma a me ka nui a me ke ʻano ma ke kuhikuhi ʻana i nā wahi me nā cell lymphoma. Ua kapa ʻia kēia mau wahi he "wela".
Pahu lumbar
ʻO ka ʻoki ʻana i ka lumbar kahi hana e nānā ai inā loaʻa iā ʻoe kahi lymphoma i loko o kou ʻōnaehana ʻōnaehana waena (CNS), e pili ana i kou lolo, spinal cord a me kahi wahi a puni kou mau maka. Pono ʻoe e ʻōlelo mālie i ka wā o ke kaʻina hana, no laila e loaʻa i nā pēpē a me nā keiki kahi maʻi maʻi maʻamau e hoʻomoe iā lākou no kahi manawa liʻiliʻi e hana ʻia ai ke kaʻina hana. Pono ka hapa nui o ka poʻe mākua i kahi anesthetic kūloko no ke kaʻina hana e hoʻopau ai i ka wahi.
Na kāu kauka e hoʻokomo i ka nila ma kou kua, a e lawe i kahi wai liʻiliʻi i kapa ʻia ʻo "ka wai o ke kuamoʻo o ka lolo” (CSF) mai a puni kou iwi kuamoʻo. ʻO ka CSF kahi wai e hana like me ka mea hoʻopuʻi i kou CNS. Lawe pū ia i nā protein like ʻole a me nā maʻi e hakakā ana i nā cell immune e like me nā lymphocytes e pale i kou lolo a me ke kuamoʻo. Hiki nō hoʻi iā CSF ke kōkua i ka hoʻokahe ʻana i kekahi wai ʻē aʻe i loaʻa iā ʻoe i loko o kou lolo a i ʻole a puni kou iwi kuamoʻo e pale ai i ka pehu ʻana ma ia mau wahi.
A laila e hoʻouna ʻia ka laʻana CSF i ka pathology a nānā ʻia no nā hōʻailona o ka lymphoma.
Biopsy iwi ʻōiwi
- ʻO ka aspirate iwi iwi (BMA): lawe ʻia kēia hoʻāʻo ʻana i kahi wahi liʻiliʻi o ka wai i loaʻa ma ka hakahaka o ka iwi.
- ʻO ka iwi aspirate trepine (BMAT): lawe kēia ho'āʻo i kahi laʻana liʻiliʻi o ka ʻiʻo iwi iwi.
Hoʻouna ʻia nā laʻana i ka pathology kahi e nānā ʻia ai nā hōʻailona o ka lymphoma.
Hiki ke ʻokoʻa ke kaʻina hana no nā biopsies iwi iwi ma muli o kahi āu e mālama ai, akā e hoʻokomo pinepine ʻia kahi anesthetic kūloko e hoʻopau i ka wahi.
Ma kekahi mau haukapila, hiki ke hāʻawi ʻia iā ʻoe i ka hoʻomaha māmā e kōkua iā ʻoe e hoʻomaha a hiki ke kāpae iā ʻoe mai ka hoʻomanaʻo ʻana i ke kaʻina hana. ʻAʻole pono ka nui o ka poʻe i kēia a loaʻa paha i kahi "whistle green" e omo ai. He lāʻau hōʻeha ʻeha ko loko o kēia puʻupuʻu ʻōmaʻomaʻo (i kapa ʻia ʻo Penthrox a i ʻole methoxyflurane), āu e hoʻohana ai e like me ka mea e pono ai i ke kaʻina hana.
E hōʻoia ʻoe e nīnau i kāu kauka i nā mea i loaʻa e hōʻoluʻolu iā ʻoe i ka wā o ke kaʻina hana, a e kamaʻilio pū me lākou e pili ana i kou manaʻo he koho maikaʻi loa ia no ʻoe.
Hiki ke loaʻa ka ʻike hou aku e pili ana i nā biopsies iwi ma kā mākou ʻaoʻao pūnaewele ma aneʻi.
ʻO Burkitt Lymphoma ka subtype lymphoma koʻikoʻi loa a me ka maʻi maʻi ʻino loa. No laila, manaʻo mau ʻia he lymphoma kiʻekiʻe.
ʻO ka māka e pili ana i ka wikiwiki o ka hoʻonui ʻana o nā cell, ke ʻano o ko lākou ʻano a me ko lākou ʻano.
Hoʻonui koke nā pūla lymphoma papa kiʻekiʻe, ʻokoʻa loa ka nānā ʻana mai kāu mau lymphocytes B-cell maʻamau a ʻaʻole hiki iā ʻoe ke hana e like me ka hana o nā lymphocytes.
ʻO ka pilikia haʻahaʻa a me ka Lymphoma Burkitt kiʻekiʻe
Hiki i kāu kauka ke kuhikuhi i kāu Burkitt ma ke ʻano kiʻekiʻe a i ʻole ka pilikia haʻahaʻa. He ʻike hou kēia a lākou e hoʻohana ai no ka hoʻoholo ʻana i ka lāʻau lapaʻau maikaʻi loa no ʻoe. E hoʻoholo ʻia kāu pilikia ma muli o kēia:
- Inā loaʻa iā ʻoe ka lymphoma i loko o kāu ʻōnaehana nūnū waena (CNS).
- Inā hōʻike kāu hōʻike koko i kahi kiʻekiʻe lactate dehydrogenase (LDH).
- Inā loaʻa iā ʻoe nā hoʻololi a i ʻole nā hoʻololi genetic.
Hōʻike Cytogenetic
Hana ʻia nā hoʻokolohua cytogenetic e nānā i nā ʻano like ʻole e pili ana i kāu maʻi. No ka ʻike hou aku e pili ana i kēia, e ʻoluʻolu e ʻike i kā mākou ʻāpana no ka hoʻomaopopo ʻana i kāu genetics lymphoma ma lalo o kēia ʻaoʻao. ʻO nā hoʻokolohua i hoʻohana ʻia no ka nānā ʻana i nā hoʻololi genetic i kapa ʻia nā hoʻokolohua cytogenetic. Ke nānā nei kēia mau hoʻāʻo e ʻike inā ua loli ʻoe i nā chromosomes a me nā genes.
Loaʻa iā mākou he 23 mau chromosomes, a ua helu ʻia lākou e like me ko lākou nui. Ke loaʻa iā ʻoe ka Burkitt Lymphoma, 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 loaʻa kahi hoʻololi (ʻokoʻa) i 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.
Unuhi ma Burkitt Lymphoma
Ma Burkitt Lymphoma e loaʻa iā ʻoe ka ʻokoʻa o kāu mau genes i kapa ʻia he unuhi. Hana ʻia kēia i ka wā e hoʻololi ai kahi hapa liʻiliʻi o nā chromosomes ʻelua. Hoʻopili mau ʻia ka moʻo iā Burkitt Lymphoma me ka MYC gene ma ka 8th chromosome me ka unuhi ʻana me kahi gene ma ka 14th chromosome. E ʻike ʻoe ua kākau ʻia ma ke ʻano he t(8:14).
Lapaʻau no Burkitt Lymphoma
I ka pau ʻana o kāu mau hopena mai ka biopsy, ka hoʻāʻo cytogenetic a me nā scan staging, e nānā ke kauka i kēia mau mea e hoʻoholo ai i ka lāʻau maikaʻi loa no ʻoe. 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 ana kāu kauka i nā kumu he nui e pili ana i kāu Burkitt Lymphoma, akā pono ʻoe e hoʻomaka i ka mālama ʻana me ka chemo-immunotherapy ma hope koke o ka maʻi ʻana. Me ka mālama ʻole ʻia ʻo Burkitt Lymphoma he mea make, akā naʻe me ka mālama ʻana, aia kahi manawa kūpono e ola ai.
ʻO Chemo-immunotherapy ka loaʻa ʻana o nā lāʻau i kapa ʻia ʻo ka chemotherapy a me kahi antibody monoclonal. Ua kapa pinepine ʻia nā antibodies monoclonal i ka immunotherapy no ka mea kōkua lākou i kāu ʻōnaehana pale e hakakā i ka maʻi kanesa. Hana ʻia ka Chemotherapy ma ka hoʻouka ʻana i nā cell ulu wikiwiki.
ʻO nā mea ʻē aʻe a kāu kauka e noʻonoʻo ai i ka wā e hoʻolālā ai i kāu mālama ʻana e komo pū me kāu:
- ka pae pākahi o ka lymphoma, nā hoʻololi genetic a me nā hōʻailona
- makahiki, ka moʻolelo lapaʻau i hala a me ke ola kino
- ka maikaʻi o ke kino a me ka noʻonoʻo a me nā makemake o ka maʻi
- nā hōʻailona āu e loaʻa nei.
Nā hoʻāʻo ʻē aʻe
Hiki ke kauoha ʻia nā hoʻāʻo hou aʻe ma mua o kou hoʻomaka ʻana i ka mālama ʻana i mea e hiki ai i kou puʻuwai, nā māmā a me nā puʻupaʻa ke hoʻokō i ka mālama ʻana. Hiki i kēia mau mea ke komo i ka ECG (electrocardiogram), ka hoʻāʻo ʻana o ka māmā a i ʻole ka hōʻiliʻili mimi 24-hola.
Hiki i kāu kauka a kahu maʻi maʻi ke wehewehe i kāu hoʻolālā lapaʻau a me nā hopena ʻaoʻao hiki iā ʻoe, a aia ma laila e pane i kāu nīnau. He mea nui e nīnau i kāu kauka a i ʻole kahu maʻi maʻi i nā nīnau e pili ana i kekahi mea āu i maopopo ʻole ai.
Hiki iā ʻoe ke kelepona a leka uila paha i ka Lymphoma Australia Nurse Helpline me kāu mau nīnau a hiki iā mākou ke kōkua iā ʻoe e loaʻa ka ʻike kūpono.
ʻO ka laina mālama kahu hānai Lymphoma:
Helu kelepona: 1800 953 081
Email: kahu@lymphoma.org.au
Nā nīnau e nīnau i kāu kauka ma mua o kou hoʻomaka ʻana i ka lapaʻau
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.
Ka mālama ʻana i kou momona ( kou hiki ke hana i nā pēpē i kou wā ʻelemakule)
Ma mua o ka hoʻomaka ʻana i ka mālama ʻana, aia kekahi mau mea e noʻonoʻo ai. ʻIke au he nui paha kāu e noʻonoʻo ai, akā ʻo ka hoʻomaʻamaʻa ʻana i nā mea ma mua o kou hoʻomaka ʻana i ka lapaʻau hiki ke kōkua nui ma hope.
ʻO kekahi o nā hopena ʻaoʻao o ka mālama ʻana i ka lymphoma hiki ke paʻakikī i ka hāpai ʻana, a i ʻole ka hāpai ʻana i kekahi ma hope o ke ola. No ke aʻo ʻana e pili ana i kekahi o nā mea hiki ke hana i mea e hoʻonui ai i kou manawa e loaʻa ai nā pēpē ma hope o ke ola, hiki iā ʻoe ke nānā i kēia wikiō ma ke kaomi ʻana i ke kiʻi ma lalo nei.
Laina Laina Mua
Hoʻomaka i ka mālama ʻana no ka Burkitt Lymphoma (BL)
Ke hoʻomaka mua ʻoe i ka mālama ʻana, ua like paha kou manaʻo me ke kanaka ma kēia kiʻi. Akā ʻo ka ʻike ʻana i ka mea e manaʻo ai hiki ke maʻalahi. No laila e hoʻomau i ka heluhelu a e haʻi mākou iā ʻoe e pili ana i nā mea e hiki mai ana.
ʻO ka manawa mua i loaʻa iā ʻoe kahi ʻano lapaʻau i kapa ʻia ʻo ka lāʻau lapaʻau mua. Ke hoʻomaka ʻoe i ka mālama ʻana, 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.
Hāʻawi pinepine ʻia ma ke ʻano he infusion i loko o kou vein. Pono ka hapa nui o nā keiki a me nā ʻōpio i kahi mea i kapa ʻia he tunneled catheter e hoʻokomo ʻia ai ka lāʻau. Hoʻohana ʻia ka catheter tunneled no laila ʻaʻole pono ʻoe e loaʻa i ka nila i kēlā me kēia manawa āu e mālama ai a i ʻole hoʻāʻo koko. Hiki iā ʻoe ke ʻike i ka ʻike e pili ana i nā catheters tunneled ma ke kaomi ʻana i ke pihi ma lalo.
Nā Kūlana Lapaʻau maʻamau no Burkitt Lymphoma
Hoʻohana maikaʻi loa kāu lapaʻau ʻana i kāu lymphoma, akā hiki ke hoʻopilikia pū i kāu mau sela maikaʻi. No laila, pono ʻoe i ka manawa no ka hoʻōla hou ʻana o kāu mau cell maikaʻi. ʻOi aku ka wikiwiki o nā pūnaewele olakino ma mua o nā pūnaewele lymphoma no ka mea ʻoi aku ka maikaʻi o ka hoʻonohonoho ʻana.
ʻO nā protocol lapaʻau maʻamau e hāʻawi ʻia iā ʻoe:
DA-R-EPOCH (Rituximab i hoʻoponopono ʻia, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin)
R-CODOX-M (rituximab, cyclophosphamide, vincristine, doxorubicin, methotrexate)
- Hoʻololi ʻia ʻo R-CODOX-M me R-IVAC (rituximab, ifosfamide, etoposide, cytarabine)
GMALL 2002 (nā maʻi ma mua o 55 makahiki)
GMALL 2002 (nā maʻi ma lalo o 55 makahiki)
Hyper CVAD ʻāpana A
- Hoʻololi ʻia ka Hyper CVAD ʻāpana A me Hyper CVAD Mahele B
ʻO ka Lymphoma Burkitt i hoʻihoʻi hou a i ʻole Refractory
I kekahi mau hihia, ʻaʻole hiki i kāu lymphoma ke pane i ka lālani mua o kāu lapaʻau. Ke hana ʻia kēia, kapa ʻia kou lymphoma he refractory.
I kekahi manawa, loaʻa iā ʻoe kahi pane maikaʻi mai kāu mālama ʻana, akā hiki ke hoʻi hou ka lymphoma (hoʻi mai) ma hope o kekahi manawa.
No nā Burkitt Lymphoma ʻelua e hoʻihoʻi hou ʻia e hāʻawi ʻia ʻoe i nā lāʻau lapaʻau hou aku.
Hiki ke komo i nā lāʻau lapaʻau ma ka laina ʻelua a ʻekolu paha:
- ʻoi aku ka immuno-chemotherapy
- waihoʻoluʻu helehelena molaki
- CAR T-cell therapy
No ka ʻike hou aku e pili ana i nā lāʻau lapaʻau a me nā mea e noʻonoʻo ai e ʻike i kā mākou ʻaoʻao lapaʻau.
Prognosis no Burkitt 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 Burkitt 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 Burkitt Lymphoma i kou kino. Eia naʻe, aia kekahi pūʻulu liʻiliʻi o ka poʻe i pane ʻole i ka mālama ʻana.
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 Burkitt 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.
Ola - Noho pū me, a ma hope o ke kanesa
ʻO ke ola olakino, a i ʻole kekahi mau loli ola maikaʻi ma hope o ka mālama ʻana he mea kōkua nui ia i kou ola hou ʻana. Nui nā mea hiki iā ʻoe ke hana e kōkua iā ʻoe e ola maikaʻi ma hope o Burkitt's.
He nui ka poʻe i ʻike ma hope o ka hōʻoia ʻana i ka maʻi kanesa, a i ʻole ka mālama ʻana, e loli ana kā lākou mau pahuhopu a me nā mea nui i ke ola. ʻO ka ʻike ʻana i ke ʻano o kāu 'maʻamau hou' hiki ke hoʻolōʻihi i ka manawa a hoʻonāukiuki. He ʻokoʻa paha nā manaʻolana o kou ʻohana a me kou mau hoaaloha. Hiki paha iā ʻoe ke kaʻawale, luhi a i ʻole kekahi mau manaʻo like ʻole e loli i kēlā me kēia lā.
ʻO nā pahuhopu nui ma hope o ka mālama ʻana i kāu lymphoma ʻo ka hoʻi ʻana i ke ola a:
- e ʻeleu i kāu hana, ʻohana, a me nā kuleana ola ʻē aʻe
- e hoʻemi i nā hopena ʻaoʻao a me nā hōʻailona o ka maʻi kanesa a me ka mālama ʻana
- ʻike a mālama i nā hopena hope loa
- kōkua iā ʻoe e kūʻokoʻa e like me ka hiki
- hoʻomaikaʻi i kou maikaʻi o ke ola a mālama i ke olakino noʻonoʻo maikaʻi
Hiki ke hāʻawi ʻia iā ʻoe nā ʻano hoʻolaʻa maʻi kanesa. Hiki i kēia ke manaʻo i kekahi o ka laulā ākea o na lawelawe e like me:
- kino kino, hooponopono eha
- hoʻolālā meaʻai a me ka hoʻoikaika kino
- ka manaʻo, ka ʻoihana a me ke aʻo kālā.
hōʻuluʻulu manaʻo
- ʻO Burkitt Lymphoma ka ʻano maʻi maʻi ʻino loa e hiki ke loaʻa iā ʻoe - akā ʻo ia ka mea e pane maikaʻi loa ia i ka mālama ʻana.
- Nui nā keiki me Burkitt Lymphoma hiki ke ho'ōla.
- Hana ʻia ʻo Burkitt Lymphoma i ka wā e lilo ai kāu lymphocytes B-cell i ka maʻi kanesa a hoʻomaka i ka hana ʻino.
- Pono ʻoe e mālama me ka chemo-immunotherapy ma hope koke o kou ʻike ʻana.
- I kekahi mau hihia, ʻaʻole hiki i kāu lymphoma ke pane i ka lāʻau lapaʻau, a i ʻole e hoʻi hou ma hope o ka mālama ʻana a pono ʻoe i nā lāʻau hou inā loaʻa kēia.
- E nīnau i kāu kauka e pili ana i nā hoʻokolohua lapaʻau i hiki iā ʻoe ke kūpono.
