He aha ka Hodgkin Lymphoma (HL)
He ʻano maʻi maʻi ʻaʻai ʻo HL e hoʻoulu nui ai i kekahi o kāu mau keneta koko, i kapa ʻia ʻo B-cell lymphocytes, a pau ka hana pono. ʻO nā Lymphocytes nā pūnaewele kūikawā, no laila liʻiliʻi ʻoe e nānā iā lākou me kahi microscope. He ʻano ia o ke koko koko, a ʻo kā lākou hana ʻo ke kaua ʻana i nā germs e hiki ai iā ʻoe ke maʻi. Hiki i kekahi o lākou ke hakakā i ka maʻi kanesa.
'O ke 'ano o ka ma'i 'a'ai, 'o ia ka mea:
- ulu i ka wā i manaʻo ʻole ʻia
- mai hana e like me ka pono, a
- i kekahi manawa e hele i nā wahi o kou kino i manaʻo ʻole ʻia e hele.
He aha ka mea kūikawā B-cell Lymphocytes?
- Hana ʻia lākou i loko o kou mau iwi ma kahi i kapa ʻia ʻo "bone marrow".
- Hiki i nā Lymphocytes ke hele i nā wahi a pau o kou kino e hakakā ai i ka maʻi maʻi, akā ke ola mau nei i kāu ʻōnaehana lymphatic.
- Aia i kāu ʻōnaehana lymphatic kekahi o kāu mau ʻano i kapa ʻia ʻo spleen, thymus, tonsils a me ka appendix a me kāu mau lymph nodes e loaʻa ana ma kou kino holoʻokoʻa. Ua like nā moku Lymphatic me nā alanui e hoʻopili ai i kou mau kino lymphatic a me nā puʻupuʻu lymph.
- Kōkua nā Lymphocytes i nā neutrophils e hakakā i nā germs.
- Hoʻomanaʻo pū lākou i nā germs no laila inā hoʻāʻo lākou e hoʻi mai, hiki i kāu lymphocytes ke hoʻopau koke iā lākou.
B-a me ka lymphoma
Ke loaʻa iā ʻoe ka HL, lilo kou B-cell lymphocytes i ka maʻi kanesa a ua kapa ʻia nā pūpū lymphoma. He ʻokoʻa ko lākou nānā ʻana, ʻoi aku ka nui a ʻokoʻa ke ʻano ma mua o nā lymphocytes maʻamau.
ʻO nā pūnaewele lymphoma i kapa pinepine ʻia ʻo Reed-Sternberg cell. (ʻO Reed lāua ʻo Sternberg nā inoa o nā kānaka ʻepekema i ʻike mua i kēia mau cell).
He aha ke ʻano o ke kelepona Reed-Sternberg?
Eia ke kiʻi e hōʻike iā ʻoe i ke ʻano o nā pūnaewele maʻamau, a me ke ʻano o nā pūnaewele lymphoma Reed-Sternberg.
ʻO ka lymphoma Hodgkin ke ulu wikiwiki nei, no laila ua kapa ʻia i kekahi manawa he huhū. Akā ʻo ka mea maikaʻi e pili ana i ka lymphoma Hodgkin aggressive, ʻo ia ka pane pinepine ʻana i ka lāʻau lapaʻau, no ka mea, ua hoʻolālā ʻia ka lāʻau lapaʻau e hoʻouka i nā cell ulu wikiwiki.
No kēia kumu, aia kahi manawa kūpono e ola ai ʻoe ma hope o ka mālama ʻana. ʻO ia hoʻi, ʻaʻole ʻoe e loaʻa hou i ke kanesa.
Nā hōʻailona o Hodgkin Lymphoma (HL)
ʻO ka hōʻailona mua e loaʻa iā ʻoe inā loaʻa iā ʻoe ka HL hiki ke lilo i puʻupuʻu, a i ʻole kekahi mau puʻupuʻu e ulu mau ana. Hiki i kēia mau puʻupuʻu ma kāu:
- ʻāʻī (e like me ka mea ma ke kiʻi)
- ʻāʻī (kou underarm)
- ʻāʻī (kahi e hui ai ka piko o kou mau wāwae i ke koena o kou kino, a hiki i kou ʻūhā)
- a i ʻole ka ʻōpū (kou ʻōpū).
ʻOi aku ka paʻakikī o ka ʻike ʻana a me ka ʻike ʻana i nā ʻōpū lymph i loko o kou ʻōpū, no ka mea, ʻoi aku ka hohonu o kou kino ma mua o nā ʻāpana lymph ʻē aʻe. Hiki i kāu kauka ke ʻike ua pehu ʻoe i nā ʻōpū lymph ma laila ma o ka lawe ʻana i nā kiʻi kūikawā (scans) o loko o kou kino.
Hoʻopiha ʻia nā puʻupuʻu ma muli o kāu mau lymph nodes e hoʻopiha ana i nā pūnae lymphoma, kahi e pehu ai lākou. ʻAʻole ʻeha ka maʻamau akā i kekahi manawa, inā e hoʻokau ka pehu lymph nodes i nā wahi ʻē aʻe o kou kino e hōʻeha paha ia.
Ma hea e loaʻa ai ʻo Hodgkin Lymphoma?
I kekahi manawa, hiki ke laha ka lymphoma Hodgkin i nā wahi ʻē aʻe o kou kino e like me kāu:
- māmā - kōkua kou māmā iā ʻoe e hanu.
- ke akepaʻa - kōkua kou ake e hoʻoheheʻe i ka meaʻai, a hoʻomaʻemaʻe i kou kino i ʻole ʻoe e kūkulu i nā mea ʻawaʻawa (poison) i loko o kou kino.
- iwi - hāʻawi kou mau iwi i ka ikaika no laila ʻaʻole ʻoe e lele i nā wahi a pau.
- iwi iwi (aia ma waenakonu o kou mau iwi a ma laila e hana ʻia ai kou mau koko koko).
- nā kino ʻē aʻe e kōkua i kou kino e hana pono.
Inā laha kou mau sela lymphoma i nā wahi ʻē aʻe o kou kino, hiki ke kapa ʻia ʻo ia he pae kiʻekiʻe HL. E kamaʻilio hou mākou e pili ana i nā pae o HL ma hope iki, akā he mea maikaʻi ia no kou ʻike i kēia manawa, ʻoiai inā he pae kiʻekiʻe ʻo HL, hiki ke hoʻōla ʻia ʻoe.
ʻO nā hōʻailona ʻē aʻe āu e loaʻa ai:
- ʻO ka luhi maoli no ke kumu ʻole – pinepine ʻoe i ka luhi ma hope o kou hoʻomaha ʻana a i ʻole ka hiamoe.
- Pau ka hanu - ʻoiai inā ʻaʻole ʻoe e hana nei.
- ʻO ka ʻū maloʻo ʻaʻole e pau.
- ʻOi aku ka maʻalahi o ka ʻeha a i ʻole ke koko ma mua o ka maʻamau.
- ʻIli ʻili.
- Ke koko i loko o kou poo a i ʻole ma ka pepa lua ke hele ʻoe i ka lua.
- ʻO nā maʻi hele ʻole, a i ʻole e hoʻi mau ana (hoʻi hou).
- B-hōʻailona.
Nā kumu ʻē aʻe o nā hōʻailona - a i ka manawa e ʻike ai i kāu kauka
Hiki ke ʻano like ka nui o kēia mau hōʻailona a me nā mea ʻē aʻe e like me nā maʻi. ʻO ka maʻamau me kahi maʻi a i ʻole nā kumu ʻē aʻe e pau nā hōʻailona ma hope o ʻelua pule.
Ke loaʻa iā ʻoe ka HL, ʻo ka ʻAʻole hele nā hōʻailona me ka mālama ʻole.
Manaʻo paha kāu kauka he maʻi kou i ka wā mua. Akā inā hopohopo lākou he ʻano lymphoma paha ia, e kauoha lākou i nā hoʻokolohua hou. Inā ua hele ʻoe i ke kauka, a ʻaʻole maikaʻi kāu mau hōʻailona, pono ʻoe e hoʻi i ke kauka.
Pehea e ʻike ʻia ai ʻo Hodgkin Lymphoma (HL).
Nui nā ʻano like ʻole o ka lymphoma. Hoʻohui pinepine ʻia lākou i loko ʻO ka lymphoma o Hodgkin or Non-Hodgkin lymphoma. Hodgkin lymphoma a laila hui pū ʻia i:
- Classical Hodgkin Lymphoma (cHL) a i ʻole
- Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
Loaʻa ka hapa nui o ʻoukou i ka cHL, me 1 wale nō o kēlā me kēia 10 keiki a me nā ʻōpio me HL me ka subtype NLPHL.
Pehea e ʻike ai kaʻu Kauka i ka subtype iaʻu?
He mea nui i kāu kauka ke hoʻoholo i ka mea āu e loaʻa ai, no ka mea, ʻokoʻa paha ke ʻano o ka mālama ʻana a me nā lāʻau lapaʻau āu e loaʻa ai i kekahi me ka subtype ʻokoʻa. oe.
No ka ʻike ʻana i ke ʻano o ka HL, makemake kāu kauka e hana kekahi mau hoao like ole. Makemake lākou e lawe i nā laʻana o kāu pehu nā lymph nodes e hoʻāʻo iā lākou a ʻike i ke ʻano o nā cell i loko ma laila. Ke lawe ke kauka i kahi laʻana, kapa ʻia ia he biopsy.
Loaʻa paha kāu biopsy i loko o ka lumi o ke kauka, i loko o kahi lumi hana ma ka haukapila a i ʻole ma kahi keʻena radiology. E pili ana kēia i ka nui o kou mau makahiki, a me kahi o kou lymph pehu he mau nodes. Na kāu kauka e hōʻike iā ʻoe i hea ʻoe a me kou mau mākua/nā kahu pono e hele.
ʻO Biopsy
Hiki ke hana ʻia kahi biopsy ma ke ʻano he hana ma ka haukapila. E akahele loa kāu mau kauka a me nā kahu hānai, a e hōʻoia ʻoe e ʻoluʻolu e like me ka hiki ke hana lākou i ka biopsy. Hiki paha iā ʻoe ke loaʻa i kekahi lāʻau e kōkua iā ʻoe e hiamoe i ka wā o ka biopsy, a i ʻole e hoʻoheheʻe ʻia ka wahi a lākou e hana ai i ka biopsy. Kapa ʻia kēia lāʻau he anaesthetic.
Ke lawe ʻia ʻoe i ka biopsy, e hoʻouna ʻia ia i ka pathology, kahi e hoʻohana ai nā poʻe i hoʻomaʻamaʻa kūikawā i kapa ʻia ʻo "Pathologists" i nā ʻano mea hana like ʻole e nānā i nā cell i loko o ka biopsy. ʻO kekahi o nā mea hana a lākou e hoʻohana ai he microscopes kūikawā a me nā kukui, e kōkua iā lākou e ʻike i nā ʻāpana like ʻole o nā cell lymphoma. Ua ʻōlelo ʻo WʻO ka pāpale a lākou e ʻike ai e kōkua i kāu kauka e hoʻoholo i ke ʻano subtype o HL iā ʻoe.
ʻO kekahi mau ʻano biopsies āu e loaʻa ai:
Biopsy kumu a i ʻole ka nila maikaʻi
Na ke kauka a kahu kahu paha e hoʻokomo i ka nila i loko o kāu puʻu lymph pehu a wehe i kahi mea liʻiliʻi o ka puʻu lymph. Loaʻa iā ʻoe kekahi lāʻau e hoʻopōʻino i ka wahi i ʻole e ʻeha, a ma muli o kou mau makahiki, hiki paha iā ʻoe kekahi lāʻau e hiamoe ai ʻoe i hiki ai iā ʻoe ke noho mālie.
Inā hohonu ka puʻu lymph i loko o kou kino a ʻaʻole hiki iā lākou ke ʻike, hiki i ke kauka ke hoʻohana i kahi ultrasound a i ʻole x-ray kūikawā e kōkua iā lākou e ʻike i ka wā e hana ai lākou i ka biopsy.
Kuno Excisionale biopsy
Pono paha ʻoe i kahi hana e loaʻa ai kahi biopsy node excisional. Hana ʻia ia no ka wehe ʻana i kahi puʻupuʻu lymph holoʻokoʻa ma nā wahi ʻē aʻe o kou kino i hiki ʻole ke loaʻa i ka nila. E loaʻa iā ʻoe kahi maʻi anesthetic e hiamoe ai ʻoe, a ʻaʻole ʻoe e manaʻo a hoʻomanaʻo paha i ka hana. E ala aʻe ʻoe me kekahi mau humuhumu kahi i lawe ai lākou i ka puʻu lymph.
Biopsy iwi ʻōiwi
Me ka biopsy iwi iwi, hoʻokomo ke kauka i ka nila ma kou kua i lalo a i loko o kou iwi ʻūhā. ʻO kēia kekahi o nā wahi i hana ʻia ai kou mau koko koko, no laila makemake lākou e lawe i kahi laʻana o kēia iwi iwi e ʻike inā loaʻa kekahi mau maʻi lymphoma ma laila. ʻElua mau laʻana a ke kauka e lawe ai mai kēia wahi me:
- ʻO ka aspirate iwi iwi (BMA): lawe liʻiliʻi kēia hoʻokolohua ka wai i loaʻa i loko o ka iwi iwi
- ʻO ka iwi aspirate trepine (BMAT): liʻiliʻi kēia hoʻāʻo laana o ka iwi iwi
Ma muli o kou mau makahiki, hiki iā ʻoe ke loaʻa i kēia ma ke ʻano he hana me ka lāʻau anesthetic e hoʻomaha ai iā ʻoe. ʻAʻole paha ʻoe e loaʻa nā humuhumu ma hope o kēia, akā e loaʻa iā ʻoe kahi lole liʻiliʻi e like me ke kāʻei kāʻei nani ma luna o kahi i komo ai ka nila.
Ke kali nei i nā hualoaʻa
He ʻelua a ʻekolu paha pule e hoʻihoʻi mai i kāu mau hopena.
ʻO ka kali ʻana i nā hopena he manawa koʻikoʻi iā ʻoe a me kāu poʻe aloha. He mea nui iā ʻoe a me kou ʻohana a me kou ʻohana a me nā hoaaloha ke hele a kamaʻilio me kekahi āu e hilinaʻi ai i kēia manawa. Inā ʻaʻole ʻoe maopopo i ka mea e kamaʻilio ai, a i ʻole he nīnau kāu, hiki iā ʻoe ke kelepona a leka uila i kā mākou mau kahu mālama lymphoma.
No nā kikoʻī e pili ana i ka hoʻopili ʻana iā lākou, e kaomi i ka polū kāhea iā mā ou pihi ma lalo o ka pā.
Nā ʻano liʻiliʻi o Hodgkin Lymphoma
E like me kā mākou i ʻōlelo ai ma luna, aia nā ʻano like ʻole o HL - Classical Hodgkin Lymphoma a Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL).
Hoʻokaʻawale hou ʻia ka Lymphoma Hodgkin Classical i ʻehā mau ʻano like ʻole. Aia kēia mau mea:
- Nodular Sclerosis Classical Hodgkin Lymphoma (NS-cHL)
- Hodgkin Lymphoma (MC-cHL) i ka wā kamaliʻi kahiko.
- ʻO Hodgkin Lymphoma kahiko (LR-cHL)
- Lymphocyte-depleted classic Hodgkin Lymphoma (LD-cHL)
No ka ʻike hou aku e pili ana i kēia mau subtypes o HL, e kaomi i nā poʻomanaʻo ma lalo nei.
Hodgkin Lymphoma Subtypes
ʻOi aku ka maʻamau o NS-cHL i nā keiki ʻōpio a me nā ʻōpio. Ma kahi kokoke i ka hapalua o ka poʻe me ka lymphoma Hodgkin maʻamau e loaʻa kēia subtype NS-cHL.
Hiki i nā keikikāne a me nā kaikamāhine ke loaʻa iā NS-cHL, akā ʻoi aku ka maʻamau o nā kaikamahine.
Hoʻomaka maʻamau ka NS-cHL i loko o nā ʻōpū lymph i loko o kou umauma, ma kahi i kapa ʻia ʻo kāu mediastinum. Hiki iā ʻoe ke ʻike i ka mediastinum ma ke kiʻi ma lalo nei, ʻo ia ka ʻāpana i loko o ka pahu ʻeleʻele.
Hiki paha iā ʻoe a ʻaʻole hiki ke manaʻo i ka pehu ʻana o nā puʻupuʻu lymph, akā ʻo kekahi mau hōʻailona ʻē aʻe āu e loaʻa ai me ke ʻano o HL:
- ua mai
- ʻeha a ʻoluʻolu ʻole paha i loko o kou umauma
- manaʻo pōkole o ka hanu
Hiki i ka NS-cHL ke hoʻomaka, a laha paha i nā wahi ʻē aʻe o kou kino e like me kou ʻāʻī, māmā, ake, iwi a i ʻole ka iwi iwi.
He mea maʻamau ka Hodgkin Lymphoma (MC-cHL) i nā keiki ma lalo o 10 mau makahiki. Akā hiki ke hoʻopilikia i nā keiki a me nā ʻōpio o kēlā me kēia makahiki.
Inā loaʻa iā ʻoe ka MC-cHL, ʻike paha ʻoe i nā puʻupuʻu hou ma lalo pono o kou ʻili. ʻO kēia ke kumu o ka hōʻiliʻili ʻana o nā pūla lymphoma a ulu i loko o kāu mau lymph nodes i loko o ka momona momona ma lalo iho o kou ʻili. Loaʻa iā mākou a pau kēia ʻiʻo momona a kōkua ia i ka pale ʻana i ko mākou mau kino ma lalo, a hoʻomaʻamaʻa iā mākou i ke anuanu. Loaʻa paha kekahi mau pūnaewele lymphoma i loko o kāu mau kino ʻē aʻe.
Hiki ke maʻalahi ka MC-cHL i kāu kauka i kekahi manawa no ka mea he ʻano subtype ʻē aʻe o lymphoma i kapa ʻia ʻo peripheral T-cell lymphoma. No kēia kumu, makemake paha kāu kauka e hana i nā hoʻokolohua hou aku e hōʻoia i loaʻa iā ʻoe ka MC-cHL i hiki iā lākou ke hāʻawi iā ʻoe i nā lāʻau kūpono.
ʻAʻole kakaikahi ka lymphoma Hodgkin (LR-cHL) i waiwai nui i ka Lymphocyte. He kakaikahi loa ka poe i loaa keia subtype. Akā inā hana ʻoe, e pane maikaʻi loa ia i kāu lapaʻau. E ola paha ʻoe ke pau ka mālama ʻana.
Hiki paha iā ʻoe ke ʻike i kekahi mau puʻupuʻu ma lalo pono o kou ʻili inā loaʻa iā ʻoe ka LR-cHL, no ka mea, ke ulu nei nā pūnae lymphoma i loko o nā puʻupuʻu lymph ma lalo pono o kou ʻili.
He mea maʻalahi hoʻi ka LR-cHL i kāu kauka e ʻike ai no ka mea he ʻano like ʻole ia o ka HL i kapa ʻia ʻo Nodular lymphocyte predominant Hodgkin Lymphoma (NLPHL). Ua like ke ʻano o ka LR-cHL a me ka NLPHL, akā hoʻohana ʻia nā lāʻau lapaʻau like ʻole e hoʻopau iā lākou.
ʻO ka Lymphocyte-depleted classical Hodgkin Lymphoma (LD0cHL) ka mea liʻiliʻi loa o ka lymphoma Hodgkin maʻamau i nā keiki a me nā ʻōpio. ʻOi aku ka maʻamau inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo Human immunodeficiency virus (HIV), a i ʻole i loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo Epstein-Barr virus (EBV).
ʻO ka EBV kahi maʻi maʻi e hoʻoulu ai i ka maʻi maʻi glandular e loaʻa iā ʻoe ka ʻeha ʻāʻī. Ua kapa ʻia ʻo ia i kekahi manawa he "mono" a i ʻole mononucleosis. Ua kapa ʻia ʻo ia ʻo ka maʻi honi no ka mea hiki ke hoʻolaha ʻia ma ke kohu (akā ʻaʻole pono ʻoe e honi i kekahi e loaʻa ai).
ʻAʻole paha ʻoe i nā puʻupuʻu ʻokoʻa a i ʻole nā puʻu lymph pehu inā loaʻa iā ʻoe ka LD-cHL no ka mea ulu pinepine ia i waenakonu o kou mau iwi ma kahi i kapa ʻia ʻo kou iwi iwi. ʻO kēia kahi kahi i hana ʻia ai kou mau koko koko. Eia nō naʻe, hiki ke hoʻomaka i ka hohonu i loko o kou ʻōpū (a i ʻole ka ʻōpū), no laila ua hohonu loa ka puʻupuʻu iā ʻoe ke ʻike.
Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
ʻO ka Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) he ʻano liʻiliʻi loa o HL, akā ʻoi aku ka maʻamau o nā keiki ma lalo o 10 mau makahiki.
Hiki i kāu kauka ke hoʻopaʻa iā ʻoe me ka NLPHL inā ʻike kāu mau kelepona i kekahi ala. He mea ʻakaʻaka paha ia, akā i kekahi manawa ke ʻōlelo nei mākou me he popcorn ka lymphoma cell ma NLPHL. E nānā i ke kiʻi a ʻike ʻoe i kā mākou manaʻo.
Pehea ka ʻokoʻa o ka Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) me ka Lymphoma Hodgkin maʻamau?
Ke ulu mālie nei ka NLPHL ma mua o ka Classical Hodgkin Lymphoma. Inā loaʻa iā ʻoe ka NLPHL, hiki ke hoʻōla ʻia ʻoe ma hope o ka mālama ʻana, ʻo ia hoʻi, e hele aku ka lymphoma a ʻaʻole e hoʻi hou mai. Akā, no kekahi o ʻoukou, hiki ke hoʻi mai. I kekahi manawa hiki ke hoʻi koke mai, a i kekahi manawa e ola paha ʻoe me ka lymphoma ʻole no nā makahiki he nui.
Inā hoʻi mai kāu NLPHL, ua kapa ʻia ʻo ia he relapse. ʻO ka hōʻailona wale nō o ka hoʻi hou ʻana, ʻo ia ka pehu lymph node ʻaʻole e hele. Aia paha kēia ma kou ʻāʻī, ka ʻāʻī, ka ʻāʻī a i ʻole nā wahi ʻē aʻe o kou kino. Inā loaʻa iā ʻoe nā hōʻailona ʻē aʻe, e like ia me nā hōʻailona a mākou i helu ai ma luna.
Hoʻopaʻa ʻana a me ka helu ʻana o Hodgkin Lymphoma (HL)
I ka manawa i ʻike ai kāu kauka iā ʻoe me HL, makemake lākou e hana hou i nā hoʻokolohua e ʻike ai i ka nui o nā wahi o kou kino i loaʻa i nā sela lymphoma, a me ka wikiwiki o ka ulu ʻana.
Nānā ʻo Stging i kahi o ka HL. E hoʻomanaʻo ma mua ua kamaʻilio mākou e pili ana i kāu lymphocytes. Ua ʻike mākou ʻoiai ua hana ʻia lākou i loko o kou iwi iwi a noho i loko o kāu ʻōnaehana lymphatic, hiki iā lākou ke hele i kekahi ʻāpana o kou kino. No ka mea, he mau lymphocytes ma'i 'a'ai nā pūnaewele o kou lymphoma, hiki ke HL i loko o kou iwi iwi, lymphatic system a i 'ole kekahi wahi o kou kino.
Hoʻokolo ʻana i nā hoʻāʻo a me nā scans
Na kāu kauka e kauoha i kekahi mau scan e kiʻi i nā kiʻi o loko o kou kino e ʻike ai i kahi e peʻe nei kēia mau pūnaewele HL. Hiki i kēia mau scans ke komo:
C scan (He pōkole kēia no ka scan tomography computed)
Ua like ka CT scan me kahi X-ray kūikawā e hāʻawi ana i ke kiʻi kikoʻī o nā mea āpau i loko o kou umauma, ʻōpū (wahi ʻōpū) a i ʻole pelvis (kokoke i kou iwi ʻūhā). Hiki i kāu kauka ke ʻike i nā pūnaʻi lymph pehu a i ʻole nā maʻi maʻi ma kēia mau wahi ma kēia scan.
Pākuʻi PET (He pōkole kēia no Positron Emission Tomography scan)
Nānā ka PET scans i loko o kou kino holoʻokoʻa. ʻOi aku ka mālamalama o nā wahi i loaʻa i ka lymphoma ma mua o nā wahi ʻē aʻe. Pono ʻoe e loaʻa i ka nila ma kou lima a i ʻole lima no kēia mea no ka mea e hoʻokomo lākou i kahi wai e kōkua ai i nā cell lymphoma e hoʻomālamalama i ke kiʻi kamepiula. Maikaʻi loa nā kahu ma ka hana ʻana i kēia a e mālama pono lākou i ʻole e ʻeha nui.
Miliaʻike (He pōkole kēia no Magnetic Resonance Imaging)
Hoʻohana kēia scan i nā magnet i loko o ka mīkini e kiʻi i nā kiʻi o loko o kou kino. ʻAʻole ia e ʻeha, akā no ka mea aia nā mea hoʻokalakupua i loko o ka mīkini hiki ke hauʻoli loa. ʻAʻole makemake kekahi poʻe i kēia mau leo no laila e loaʻa iā ʻoe kekahi lāʻau e hiamoe iki ai ʻoe i ka wā o ka scan, no laila ʻaʻole ia e hopohopo iā ʻoe. Hiki paha iā ʻoe ke hoʻohana i nā headphone kūikawā e hoʻolohe i ke mele.
Pehea ka helu ʻana o kaʻu pae HL?
Helu ʻia ke kūlana mai ka helu ʻekahi a i ka helu ʻehā. Inā loaʻa iā ʻoe kahi pae hoʻokahi a ʻelua paha e loaʻa iā ʻoe kahi HL-pae mua. Inā loaʻa iā ʻoe ka pae ʻekolu a ʻehā paha, e loaʻa iā ʻoe kahi pae kiʻekiʻe HL.
Hiki ke kani weliweli ʻo HL pae kiʻekiʻe. Akā, no ka hele ʻana o kāu lymphocytes a puni kou kino, ua manaʻo ʻia ka lymphoma he maʻi "systemic". No laila, ʻokoʻa loa nā lymphoma kiʻekiʻe me HL i nā maʻi maʻi ʻē aʻe me ka maʻi maʻi.
E pili ana paha koʻu pae inā hiki iaʻu ke hoʻōla?
ʻAʻole hiki ke hoʻōla ʻia ka nui o nā maʻi ʻaʻa paʻa, e like me nā maʻi koko i loko o ka lolo, ka umauma, nā puʻupaʻa a me nā wahi ʻē aʻe inā ua holomua.
Akā, hiki ke ho'ōla ʻia nā lymphoma pae kiʻekiʻe me ka mālama pono ʻana, a ʻo ia ka hihia no nā keiki a me nā ʻōpio me HL.
He laʻana maikaʻi kēia kiʻi no ka ʻokoʻa ʻike paha nā pae. Hōʻike nā ʻāpana ʻulaʻula i kahi o ka Aia paha ka lymphoma i kēlā me kēia pae - ʻo kāu a ʻokoʻa iki, akā e hahai like ia kumu.
Kōnae 1 | Aia kāu HL i hoʻokahi wahi lymph node, ma luna a ma lalo paha o kāu diaphragm |
Kōnae 2 | Aia kāu HL i ʻelua a ʻoi aku paha nā wahi lymph node, akā ma ka ʻaoʻao like o kāu diaphragm |
Kōnae 3 | Aia kāu HL ma kahi liʻiliʻi o hoʻokahi wahi lymph node ma luna a ma kahi liʻiliʻi hoʻokahi wahi lymph node ma lalo o kou diaphragm |
Kōnae 4 | Aia kou HL ma nā wahi lymph nodes he nui, a ua laha i nā wahi ʻē aʻe o kou kino, e like me kou iwi, akemāmā, a i ʻole ate. |
He aha kāu diaphragm?
ʻO kou diaphragm he ʻiʻo dome e hoʻokaʻawale i nā ʻōpū o kou umauma, mai nā ʻōpū o kou ʻōpū. He kōkua nō hoʻi iā ʻoe e hanu ma ke kōkua ʻana i kou māmā e neʻe i luna a i lalo.
Nā mea nui ʻē aʻe e ʻike e pili ana i kāu pae
A me ka helu hoʻokūkū, hāʻawi ʻia paha ʻoe i kahi leka ma hope o ka helu.
Ke hoʻomanaʻo nei ʻoe i ka mea a mākou i ʻōlelo ai ma mua e pili ana i nā hōʻailona B? He pūʻulu ia o nā hōʻailona hiki ke hui pū ke loaʻa iā ʻoe ka lymphoma. Nā lākou:
- ʻO ka hou ʻana o ka pō e pulu i kou lole a me kou wahi moe
- ʻO ke kuni a me ke anu
- ʻO ka pohō ʻana me ka hoʻāʻo ʻole
Inā loaʻa iā ʻoe kēia mau hōʻailona B e loaʻa iā ʻoe ka "B" ma hope o kāu helu hoʻonohonoho, akā inā ʻaʻole loaʻa nā hōʻailona B e loaʻa iā ʻoe kahi "A" ma hope o kāu helu hoʻonohonoho.
Inā loa'a ka HL i kekahi o kou mau kino, e like me kou akemāmā, ate, a iwi paha, e loa'a iā 'oe ka leka “E” ma hope o kāu helu ho'onohonoho.
Inā loaʻa iā ʻoe kahi puʻupuʻu lymph a i ʻole ka ʻōpū i ʻoi aku ma mua o 10cm ka nui, ua kapa ʻia ʻo ia he bulky. Inā loaʻa iā ʻoe ka maʻi nui, e loaʻa iā ʻoe ka leka "X" ma hope o kāu helu hoʻonohonoho
ʻO ka hope, inā loaʻa iā HL kāu spleen, e loaʻa iā ʻoe ka leka "S" ma hope o kāu helu hoʻonohonoho. Kōkua kou spleen i ka hoʻomaʻemaʻe ʻana i kou koko, a he ʻāpana nui ia o kāu ʻōnaehana pale. ʻO ia kahi e noho ai ka nui o kāu mau keʻokeʻo keʻokeʻo a kahi e hana ai kāu lymphocytes B-cell i nā antibodies he nui e hakakā i nā maʻi.
E ʻike i ke ʻano o kēia mau mea like ʻole ma ka papa ma lalo.
Meaning | nui |
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Kōkua ka mākau ʻana i kāu kauka e hana i nā koho maikaʻi e pili ana i nā lapaʻau a lākou e hāʻawi ai iā ʻoe.
E like me ka hoʻokani ʻana, e hāʻawi ʻia kāu māka ma ke ʻano he helu mai ka hoʻokahi a i ka ʻehā. Hiki ke kākau ʻia ʻo G1, G2, G3 a i ʻole G4. Ke lilo kāu lymphocytes i ka maʻi kanesa, hoʻomaka lākou e nānā ʻokoʻa i kāu lymphocytes maʻamau. Inā loaʻa iā ʻoe kahi lymphoma papa haʻahaʻa e like me G1, hiki ke ulu lohi a ʻokoʻa wale nā pūnaewele i kāu mau lymphocytes maʻamau, akā me ka pae kiʻekiʻe, ulu wikiwiki lākou a ʻaʻole hiki ke ʻano like me kāu mau cell maʻamau.
ʻOi aku ka ʻokoʻa o ko lākou nānā ʻana, ʻoi aku ka liʻiliʻi o ka hiki ke hana pono.
Eia ka ʻike nui o kēlā me kēia papa:
- 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 keiki/ kāu mau pūnaewele me kekahi mau pūnaewele maʻamau a ulu a laha wikiwiki lākou.
- G4 – papa kiʻekiʻe – ʻokoʻa loa ke ʻano o kāu keiki/ kou mau pūnaewele i ka mea maʻamau a ʻoi aku ka wikiwiki o ka ulu ʻana a palahalaha
Nā hoʻāʻo ʻē aʻe
Loaʻa paha iā ʻoe nā hoʻokolohua ʻē aʻe ma mua o kou hoʻomaka ʻana i ka mālama ʻana, a i ka wā o ka mālama ʻana e hōʻoia i ka hiki i kou kino ke hoʻokō i nā lāʻau e loaʻa iā ʻoe. Hiki i kēia mau mea ke komo:
- Nā hoʻāʻo koko maʻamau
- Nā kani kani ʻana a i ʻole nā ʻimi ʻē aʻe a me nā hoʻāʻo ʻana o kekahi o kāu mau ʻōpū e like me kou puʻuwai, māmā a me nā puʻupaʻa
- Nā ho'āʻo Cytogenetic - he mau hoʻokolohua kūikawā kēia e ʻike ai inā loaʻa nā loli i kāu mau genes. Hōʻike kāu mau genes i nā pūnaewele i kou kino pehea e ulu ai a pehea e hana ai. Inā loaʻa kahi hoʻololi (i kapa ʻia ʻo ka mutation a i ʻole ka hoʻololi ʻana) i kāu mau genes, hiki iā lākou ke hāʻawi i nā kuhikuhi hewa. Hiki i kēia mau kuhikuhi hewa ke hoʻoulu i ka maʻi kanesa - e like me HL e ulu. ʻAʻole pono nā kānaka a pau i kēia hoʻokolohua.
- Lumbar puncture - He hana kēia e kau ai ke kauka i ka nila i loko o kou kua ma kahi kokoke i kou iwi kuamoʻo a lawe i kahi wai. E hana wale kēia inā manaʻo ʻo ia aia kāu HL i loko o kou lolo a i ʻole ka iwi kuamoʻo, a i ʻole e laha paha ma laila. Loaʻa paha i kekahi mau keiki a ʻōpio paha kekahi mau mea hoʻomaha e hiamoe ai ʻoe i ka wā hiamoe i ʻole e ʻeha, a e mālama pono ʻoe i ka wā o ke kaʻina hana.
Nā nīnau no kāu kauka ma mua o kou hoʻomaka ʻana i ka lapaʻau
Ke hōʻiliʻili kāu kauka i nā ʻike āpau mai kāu biopsies, scans a me nā hoʻokolohua ʻē aʻe; hiki iā lākou ke hoʻonohonoho i kahi hoʻolālā e mālama i kāu mālama ʻana a mālama iā ʻoe. I kekahi manawa, e kamaʻilio nā kauka i nā kauka ʻē aʻe a i ʻole nā mea lapaʻau ʻē aʻe e hōʻoia e hana lākou i ka hoʻolālā maikaʻi loa no ʻoe. Ke hui nei kēia poʻe loea e hana i kahi hoʻolālā, ua kapa ʻia ʻo ia he hui hui multidisciplinary - a i ʻole he hui MDT.
E kamaʻilio mākou e pili ana i ke ʻano o nā lāʻau lapaʻau e loaʻa paha iā ʻoe ma lalo o kēia ʻaoʻao. Akā, he mea nui ia e ʻoluʻolu e nīnau i kāu kauka i nā nīnau āu i loaʻa ai ma mua o kou hoʻomaka ʻana i ka mālama ʻana. E kōkua kēia iā ʻoe e ʻike i ka mea e manaʻo ai, a me ka manaʻo hilinaʻi.
Hiki ke paʻakikī ke ʻike i nā nīnau kūpono e nīnau ai. Akā ʻo ka ʻoiaʻiʻo, ʻaʻohe nīnau pololei a hewa paha. He ʻokoʻa kēlā me kēia kanaka a ʻokoʻa paha kāu mau nīnau i nā nīnau a kekahi keiki a ʻōpio paha. ʻO ka mea nui, ʻaʻohe nīnau naʻaupō e pili ana i kou olakino a me ka mālama ʻana. No laila e hilinaʻi e nīnau e pili ana i kekahi mea i kou manaʻo.
ʻO kekahi mau nīnau e hoʻomaka ai
No ke kōkua ʻana iā ʻoe e hoʻomaka, ua hoʻokomo mākou i kekahi mau nīnau āu a i ʻole kou mau mākua/mākua e makemake e nīnau. Inā ʻaʻole ʻoe mākaukau, a poina paha i ka nīnau ʻana i nā nīnau ma mua o ka mālama ʻana, ʻae, hiki iā ʻoe ke nīnau i ke kauka a i kāu kahu hānai i kēlā me kēia manawa. Akā ʻo ka ʻike ʻana i nā pane ma mua o kou hoʻomaka ʻana i ka mālama ʻana, hiki ke kōkua iā ʻoe e hōʻoluʻolu.
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 lapaʻau ʻana no HL 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.
Lapaʻau no Hodgkin Lymphoma
E noʻonoʻo ana kāu hui mālama ola i nā mea he nui e pili ana iā ʻoe ma mua o ka hoʻoholo ʻana i ka mea a lākou e manaʻo ai he lāʻau lapaʻau maikaʻi loa no ʻoe. ʻO kekahi o nā mea a lākou e noʻonoʻo ai:
- Inā loaʻa iā ʻoe kahi subtype maʻamau o HL a i ʻole NLymphocyte Predominant Hodgkin Lymphoma (NLPHL)
- ʻEhia kou mau makahiki
- Inā loaʻa iā ʻoe nā maʻi ʻē aʻe a i ʻole ke kino kīnā
- Inā loaʻa iā ʻoe kekahi allergies
- Pehea kou manaʻo maikaʻi ma ke kino (kou kino) a me kou noʻonoʻo (kou ʻano a me kou mau manaʻo).
Na kāu kauka a kahu hānai paha e wehewehe i kāu hoʻolālā lapaʻau a me nā hopena ʻaoʻao hiki iā ʻoe. ʻO nā hopena ʻaoʻao nā mea e hiki mai ana ma muli o kāu mālama ʻana, e like me ka maʻi, a i ʻole ka hāʻule ʻana o kou lauoho a i ʻole nā mea ʻē aʻe. Inā loaʻa iā ʻoe nā hopena ʻaoʻao, pono e hōʻike i kāu kahu hānai a kauka paha i hiki iā lākou ke kōkua iā ʻoe e ʻoi aku ka maikaʻi.
Inā he mea ʻaʻole ʻoe maopopo, a hopohopo paha ʻoe, e kamaʻilio me kāu kauka a kahu hānai paha a noi iā lākou e wehewehe i nā mea iā ʻoe.
Hiki iā ʻoe ke kelepona a leka uila paha i ka Laina kōkua kahu hānai Lymphoma Australia me kāu mau nīnau. Hiki iā mākou ke kōkua iā ʻoe e loaʻa ka ʻike kūpono. E kaomi wale i ke pihi Hoʻokaʻaʻike iā mākou ma lalo o kēia pale.
Aia nā ʻano lapaʻau like ʻole. Loaʻa paha iā ʻoe hoʻokahi ʻano, a i ʻole kekahi mau ʻano ma muli o kou kūlana. Aia kēia mau mea:
Mālama Kākoʻo
Hāʻawi ʻia ka mālama kākoʻo e kōkua iā ʻoe e ʻoi aku ka maikaʻi i ka wā o ka mālama ʻana, a hoʻōla wikiwiki.
No kekahi o ʻoukou, hiki ke ulu wikiwiki a nui loa kāu mau pūnaewele lymphoma. ʻO kēia ka mea e paʻa nui ai kou iwi iwi, kahe koko, lymph nodes, ate a i ʻole spleen. Ma muli o kēia, ʻaʻole paha ʻoe e lawa i nā keneta koko olakino. Hiki i nā lāʻau kākoʻo ke komo i ka hāʻawi ʻana iā ʻoe i ke koko a i ʻole platelet transfusion e hōʻoia i ka lawa ʻana o nā keneta koko olakino.
Inā loaʻa iā ʻoe kahi maʻi, loaʻa paha iā ʻoe nā lāʻau antibiotic e kōkua iā ʻoe e hoʻomaikaʻi wikiwiki. I kekahi mau hihia, loaʻa paha iā ʻoe kekahi lāʻau i kapa ʻia ʻo GCSF e kōkua i kou kino e hoʻonui i nā keʻokeʻo keʻokeʻo e hakakā ai i ka maʻi.
Hiki ke hoʻokomo pū i ka mālama kākoʻo i ka lawe ʻana mai i kahi hui i kapa ʻia ʻo ka hui mālama palliative. He maikaʻi ka hui mālama palliative i ka hōʻoia ʻana i kou ʻoluʻolu, a me ka hoʻomaikaʻi ʻana i kāu mau hōʻailona a i ʻole nā hopena ʻaoʻao. ʻO kekahi o nā mea hiki iā lākou ke kōkua iā ʻoe me ka ʻeha, ka maʻi a me ka hopohopo a hopohopo paha. Hiki iā lākou ke kōkua i ka hoʻolālā ʻana i ka mālama ʻana i kāu mālama olakino i ka wā e hiki mai ana.
He manaʻo maikaʻi e nīnau i kāu kauka a kahu hānai paha i nā lāʻau kākoʻo e maikaʻi paha iā ʻoe.
Ka lāʻau lapaʻau (Radiotherapy)
Hoʻohana ka radiotherapy i ka radiation e pepehi i nā maʻi kanesa. Ua like ia me nā kukui X ikaika nui a loaʻa iā ʻoe i kēlā me kēia lā no kekahi mau pule, maʻamau mai ka Pōʻakahi a hiki i ka Pōʻalima. Hiki ke ho'ohana 'ia no ka ho'ōla 'ana i ka ma'i 'a'ai, e kōkua i ka ho'oku'u 'ana iā 'oe - kahi i 'ike 'ole 'ia ai ka ma'i 'a'ai (akā hiki mai paha ma hope), a i 'ole hiki ke ho'ohana 'ia no ka mālama 'ana i kekahi mau hō'ailona.
ʻO kekahi mau hōʻailona e hiki ke mālama ʻia me ka radiotherapy me ka ʻeha a nāwaliwali paha. Hiki i kēia ke hana inā hoʻokomo kou lymphoma i kou mau aʻalolo, iwi kuamoʻo a i ʻole nā wahi ʻē aʻe o kou kino. ʻO ka radiotherapy e liʻiliʻi ai ka lymphoma (tumor) no laila ʻaʻole ia e hoʻomau i ke kaomi ʻana i kou mau aʻalolo a i ʻole nā ʻāpana o kou kino e hōʻeha ai i loko.
Kemohana (kemo)
Loaʻa paha iā ʻoe ka chemo ma ke ʻano he papa a/a i ʻole e hoʻoheheʻe ʻia (infusion) i loko o kou aʻa (i loko o kou kahawai koko) ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Loaʻa iā ʻoe ma mua o hoʻokahi ʻano chemo. Hoʻopau ʻo Chemo i nā pūnaewele ulu wikiwiki, no laila hiki ke hoʻopilikia i kekahi o kāu mau sela maikaʻi e ulu wikiwiki ana i nā hopena ʻaoʻao.
ʻAi kino monoclonal (MAB)
Hāʻawi ʻia nā MAB ma ke ʻano he infusion a hoʻopili ʻia i ka cell lymphoma a huki i nā maʻi ʻē aʻe e hakakā ana i nā keʻokeʻo keʻokeʻo a me nā protein i nā cell lymphoma. Kōkua kēia i kāu ʻōnaehana pale ponoʻī e hakakā i ka HL. I kekahi mau hihia, hiki ke hoʻohui ʻia ka MAB i kekahi lāʻau lapaʻau e pepehi pono i nā pūnaewele lymphoma maʻi kanesa. Ua kapa ʻia kēia mau MAB i conjugated MABS.
IʻO nā mea hoʻopaneʻe hoʻopaʻapaʻa mmune (ICI)
Hāʻawi ʻia nā ICI ma ke ʻano he infusion a hana e hoʻomaikaʻi i kāu ʻōnaehana pale ponoʻī, i hiki ai i kou kino ponoʻī ke hakakā i kou kanesa. Hana lākou i kēia ma ke kāohi ʻana i kekahi o nā pale pale lymphoma i kau ʻia, i ʻike ʻole ʻia e kāu ʻōnaehana pale. Ke wehe ʻia nā pale, hiki i kāu ʻōnaehana pale ke ʻike a hakakā i ke kanesa. ʻAʻole hoʻohana mau ʻia kēia mau mea no nā keiki a me nā ʻōpio me Hodgkin Lymphoma, koe wale nō inā ʻoe i loko o kahi hoʻokolohua lapaʻau.
Ka hoʻololi ʻana o ke kino-kelepona (SCT)
Inā he ʻōpio ʻoe a he ʻano hoʻopaʻapaʻa (ke ulu wikiwiki) HL hiki ke hoʻohana ʻia kahi SCT. Hiki ke hoʻololi i kāu mau pūnaewele maikaʻi ʻole me nā pūnaewele olakino maikaʻi i hiki ke ulu i kēlā me kēia ʻano o ke koko āu e pono ai.
CAR T-cell Therapy
No ka ʻike hou aku e pili ana i CAR T-cell therapy, e ʻoluʻolu e ʻike i kā mākou ʻaoʻao pūnaewele Chimeric antigen receptor (CAR) T-cell therapy.
Nā mākua a me nā keiki makua - Inā makemake ʻoe i ka ʻike hou aku e pili ana i kēia mau lapaʻau, e ʻoluʻolu e ʻike i kā mākou pūnaewele ma Nā lāʻau lapaʻau ma ʻaneʻi.
Laina Laina Mua
Hoʻomaka i ka mālama ʻana no Hodgkin Lymphoma (HL)
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.
No ka ʻike hou aku e pili ana i nā ʻano o ka lāʻau lapaʻau mua i loaʻa iā ʻoe, e ʻoluʻolu e kaomi i ka hae ma muli o ka loaʻa iā ʻoe Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL), a i ʻole maʻamau ʻo Hodgkin lymphoma. E hoʻomanaʻo e pili ana i ka Lymphoma Hodgkin maʻamau:
- Nodular sclerosis maʻamau Hodgkin lymphoma (NS-cHL)
- Hodgkin lymphoma maʻamau (MC-cHL) hui pū ʻia.
- Lymphocyte-waiwai maʻamau Hodgkin lymphoma (LR-cHL)
- Lymphocyte-depleted classical Hodgkin lymphoma (LD-cHL)
ʻOkoʻa loa ka mālama ʻana i ka lymphoma Nodular Lymphocyte Predominant Hodgkin (NLPHL) me ka lymphoma Hodgkin maʻamau (cHL). Inā loaʻa iā ʻoe kahi NLPHL mua, hiki i kāu mālama ʻana ke komo i hoʻokahi a ʻoi aku paha o kēia mau mea:
- E nānā a kali i ka nānā ʻana a hiki i ka wā e pono ai ke mālama ʻia nā hōʻailona.
- Radiotherapy wale nō.
- ʻO ka ʻoki ʻana, inā hiki ke wehe loa ʻia ke koko.
- ʻO ka chemotherapy hui pū me ka radiotherapy beam waho haʻahaʻa. Hiki i ka Chemotherapy ke komo i nā lāʻau i kapa ʻia:
- AVPC (doxorubicin, vincristine, cyclophosphamide a me ka steroid i kapa ʻia he prednisone)
- CVP (cyclophosphamide, vincristine a me kahi steroid i kapa ʻia prednisone)
- COG-ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide a me ka steroid i kapa ʻia prednisone).
- Rituximab - lawelawe ʻia kēia lāʻau lapaʻau. He antibody monoclonal ia e hoʻopaʻa nei i kahi mea loaʻa i kapa ʻia ʻo CD20 ma nā pūnaewele B, a ua hana maikaʻi loa ia e mālama i nā ʻano like ʻole o B-cell lymphoma.
- Ke komo ʻana i ka hoʻokolohua lapaʻau - kahi e hiki ai iā ʻoe ke hoʻāʻo i nā ʻano lāʻau hou a i ʻole nā ʻano lāʻau lapaʻau ʻē aʻe.
He lymphoma e ulu wikiwiki ana ka Classical Hodgkin lymphoma (cHL), no laila pono e hoʻomaka koke ka lāʻau ma hope o kou ʻike ʻia ʻana. ʻO ka lāʻau lapaʻau maʻamau no nā keiki a me nā ʻōpio me ka cHL he hui pū ʻana o ka chemotherapy. Loaʻa i kekahi mau keiki a me nā ʻōpio ka radiotherapy i nā wahi kikoʻī o ka lymphoma ma hope o ka chemotherapy.
Hiki i ke kauka ke ʻōlelo aku i kekahi o kēia mau lāʻau lapaʻau mua no ka lymphoma Hodgkin maʻamau o ka wā kamaliʻi:
COG-ABVE-PC
Aia kēia protocol i kahi steroid i kapa ʻia he prednisolone a me nā lāʻau lapaʻau chemotherapy i kapa ʻia
- doxorubicin
- bleomycin
- helenaʻi
- ʻ etoposide
- cyclophosphamide
Loaʻa iā ʻoe kēia i kēlā me kēia 21 mau lā (3-wiki) no 4-6 mau pōʻai.
Bv-AVECP
Aia kēia protocol i ka prednisolone steroid, a me kahi MAB conjugated i kapa ʻia brentuximab vedotin a me nā lāʻau lapaʻau chemotherapy i kapa ʻia:
- ʻO Doxorubicin
- Paʻa Vincristine
- Holapaau
- cyclophosphamide
Inā he 15 mau makahiki a ʻoi paha ʻoe e mālama ʻia ma ka haukapila o nā keiki a i ʻole kahi haukapila makua. He ʻokoʻa paha nā kaʻina lapaʻau ma ka haukapila makua me nā mea a mākou i helu ai ma luna. Inā mālama ʻoe i kahi haukapila makua, hiki iā ʻoe ke ʻike i ka ʻike hou aku ma kā mākou ʻO ka Lymphoma Hodgkin no nā mākua ma ʻaneʻi.
ʻO ka laina ʻelua a me ka mālama mau ʻana no Hodgkin Lymphoma (HL)
Ma hope o ka mālama ʻana, e hele ka hapa nui o ʻoukou i ke kala ʻana. ʻO ke kala ʻana he manawa i koe ʻole ai nā hōʻailona o ka HL i loko o kou kino, a i ʻole i ka wā e hoʻomalu ʻia ai ka HL a ʻaʻole pono e mālama ʻia. Hiki i kēia manawa ke lōʻihi no nā makahiki he nui, akā kakaikahi, hiki i kāu HL ke hoʻi hou (hoʻi mai). Ke hiki mai kēia, makemake paha kāu kauka e hāʻawi iā ʻoe i kahi lapaʻau hou.
I kekahi mau hihia, ʻaʻole paha ʻoe e hele i ke kala ʻana me kāu lāʻau lapaʻau mua. Inā loaʻa kēia, kapa ʻia kāu HL "refractory". Inā loaʻa iā ʻoe ka refractory HL, makemake paha kāu kauka e hoʻāʻo i kahi lāʻau lapaʻau ʻē aʻe. Hiki ke kapa ʻia kāu HL he refractory inā loaʻa iā ʻoe ka lāʻau a hele i ke kala ʻana, akā mau ke kala ʻana no lalo o 6 mau mahina.
Lapaʻau no ka Refractory and Relapsed Hodgkin Lymphoma (HL)
Loaʻa iā ʻoe ka lāʻau lapaʻau inā loaʻa iā ʻoe ka refractory HL a i ʻole ma hope o ka hoʻi hou ʻana i kapa ʻia ka lāʻau lapaʻau lua. ʻO ka pahuhopu o ka lāʻau lapaʻau ʻelua ʻo ka hoʻokuʻu hou iā ʻoe i ke kala ʻana, a i ʻole no ka manawa mua a hiki ke hana maikaʻi loa.
Inā loaʻa iā ʻoe ke kala hou aʻe, a laila e hoʻi hou a loaʻa hou ka lāʻau lapaʻau, ua kapa ʻia kēia mau lāʻau lapaʻau e hiki mai ana ka lāʻau lapaʻau ʻekolu, lāʻau lapaʻau ʻehā a pēlā aku.
Pono paha ʻoe i kekahi mau ʻano lapaʻau no kāu HL. Ke ʻike nei nā poʻe loea i nā lāʻau lapaʻau hou a ʻoi aku ka maikaʻi e hoʻonui ana i ka lōʻihi o ke kala ʻana a kōkua iā ʻoe e mālama i kou olakino i ka wā a ma hope o ka mālama ʻana.
Pehea e koho ai ke kauka i ka lapaau maikai loa no'u?
I ka manawa o ka hoʻihoʻi ʻana, e hilinaʻi ke koho ʻana i ka lāʻau lapaʻau i nā kumu he nui.
- Pehea ka lōʻihi o kou kala ʻana
- ʻO kou olakino a me kou mau makahiki
- He aha nā lāʻau HL i loaʻa iā ʻoe ma mua
- ʻO kāu mau makemake.
Hiki i kāu kauka ke kamaʻilio pū me ʻoe a me kou mau mākua a kahu paha e pili ana i ka lāʻau lapaʻau lua maikaʻi loa no ʻoe.
Nā ʻaoʻao maʻamau o ka lapaʻau ʻana no ka Lymphoma Hodgkin
ʻOiai ʻoi aku ka maikaʻi o nā lāʻau lapaʻau no HL i ka hoʻopau ʻana iā HL, hiki iā lākou ke kapa ʻia i kekahi manawa nā hopena ʻaoʻao. ʻO ia hoʻi, hiki iā lākou ke hana i nā loli makemake ʻole a i ʻole nā hōʻailona. He manawa pōkole wale nō kēia, akā hiki i kekahi ke lōʻihi aku, no laila he mea nui e hōʻike i kāu kauka a kahu hānai paha e pili ana i nā hopena ʻaoʻao āu.
He ʻokoʻa paha kāu mau hopena ʻaoʻao me kekahi mea ʻē aʻe me HL no ka mea he ʻokoʻa mākou āpau a pane ʻokoʻa i nā lāʻau lapaʻau. Hiki i nā hopena ʻaoʻao ke hilinaʻi i ke ʻano o ka lapaʻau āu e loaʻa nei.
Hiki i kāu kauka a kahu hānai paha ke haʻi iā ʻoe e pili ana i nā hopena ʻaoʻao āu e loaʻa ai ma muli o ka mālama ʻana iā ʻoe.
ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka mālama ʻana i ka lymphoma Hodgkin he helu koko haʻahaʻa, no laila he mea nui e ʻike e pili ana i kēia mau ʻāpana koko.
Nā hunaola ʻulaʻula
ʻO ke koko ʻulaʻula nā pūnaewele e ʻulaʻula ai kou koko. Loaʻa iā lākou kahi pūmua i kapa ʻia ʻo hemoglobin (Hb) e hana like me kahi kaʻa kaʻa. Lawe ʻo ia i ka oxygen mai kou mau māmā ke hanu ʻoe i loko, a laila lawe i ka oxygen i nā wahi ʻē aʻe o kou kino e hāʻawi iā ʻoe i ka ikehu. Lawe ʻo ia i ka carbon dioxide mai kou kino a hoʻihoʻi iā ia i kou mau māmā e hoʻopau i kou hanu ʻana.
Ke haʻahaʻa kou mau koko ʻulaʻula a i ʻole Hb hiki iā ʻoe ke ʻike i ka luhi, ʻeha, pau ka hanu a pilikia i kekahi manawa. Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻoluʻolu e haʻi i kāu kauka.
Nā Kauliana
ʻO nā platelets nā ʻāpana kūikawā i loko o kou koko he kala melemele. He mea koʻikoʻi lākou i ka wā e hōʻeha ai ʻoe iā ʻoe iho. Kōkua lākou i ka pale ʻana iā ʻoe mai ke koko a i ʻole ka ʻeha nui. Ke hōʻeha ʻoe iā ʻoe iho, holo kāu platelets i kahi i ʻeha a pili pū ma luna o ka ʻoki a i ʻole ka ʻeha e hoʻōki i kou kahe ʻana. Ke haʻahaʻa loa kā mākou platelets, hiki ke maʻalahi ke koko a i ʻole ʻeha ʻoe ma mua o kou maʻamau. No laila, inā ʻike ʻoe i kahi koko liʻiliʻi ke palaki ʻoe i kou mau niho, hele i ka lua a puhi paha i kāu i kēia manawa, a i ʻole i ʻoi aku ka ʻeha ma mua o ka maʻamau, pono e hōʻike iā ʻoe i ke kauka.
Nā pili koko koko
ʻO kāu lymphocytes kekahi ʻano o ke koko keʻokeʻo keʻokeʻo, akā loaʻa iā ʻoe nā ʻano ʻano keʻokeʻo keʻokeʻo ʻē aʻe. ʻO nā mea nui āu e pono ai e ʻike e pili ana i kāu neutrophils a me nā lymphocytes. ʻO kāu mau keʻokeʻo keʻokeʻo āpau he ʻāpana o kāu ʻōnaehana pale. ʻO ia hoʻi, he mau germs hakakā lākou a pau e hiki ai iā ʻoe ke maʻi. He maikaʻi loa lākou i ka hakakā ʻana i kēia mau germs, no laila ke olakino mākou i ka hapa nui o ka manawa. Akā, inā ʻaʻole holo pono kāu mau keʻena koko keʻokeʻo, a inā ʻaʻole lawa ʻoe, hiki iā ʻoe ke maʻi.
ʻO kāu neutrophils ka mua o kāu mau keʻokeʻo keʻokeʻo e ʻike a hakakā i nā germs. A laila hoʻokuʻu lākou i nā keʻokeʻo keʻokeʻo ʻē aʻe, e like me kāu lymphocytes e ʻike aia nā germs i loko o kou kino. Inā haʻahaʻa kēia mau mea hiki iā ʻoe ke maʻi me kahi maʻi. Inā hiki kēia, hiki iā ʻoe ke:
- ʻike i ka maʻi
- e loaʻa i ke kuni (38° a ʻoi aʻe paha) a wela paha kou ʻili
- e haalulu iki a i ʻole ke anu (e ʻike i ke anu i loko o kou kino a hoʻomaka e haʻalulu)
- loaʻa ka ʻeha e ʻulaʻula a i ʻole pusey
- ʻoi aku ka wikiwiki o kou puʻuwai ma mua o ka maʻamau
- ʻeha a luhi
He mea nui e hōʻike koke aku i kāu kauka inā loaʻa kēia iā ʻoe i ka Lymphoma Hodgkin, ʻoiai inā loaʻa ia i ke aumoe. Inā ʻaʻole loaʻa kāu kauka, pono ʻoe e hele i ka haukapila i loaʻa iā ʻoe kekahi lāʻau i kapa ʻia he antibiotic e kōkua i ke kaua ʻana i ka maʻi.
Eia kahi papaʻaina wikiwiki a maʻalahi me ka ʻike hou aʻe e pili ana i kāu mau koko koko.
Keʻokeʻo keʻokeʻo | ʻulaʻula | Nā Kauliana | |
Inoa Lapaau | Leukocytes. ʻO kekahi mau leukocytes nui e hoʻomanaʻo Neutrophils & Lymphocytes | ʻErythrocytes | Thrombocytes |
He aha kā lākou hana? | Kaua i ka ma'i ma'i | Lawe i ka oxygen | Uoki ke kahe ʻana |
He aha ka mea i kapa ʻia inā ʻaʻole lawa ʻoe i kēia mau cell? | Neutropenia a me lymphopenia | Anemia | ʻO ka Thrombocytopenia |
Pehea e pili ai i koʻu kino inā ʻaʻole lawa kaʻu? | 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? |
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** Ina a pau ʻo ka haʻahaʻa o kou mau koko i kapa ʻia 'pancytopenia' a makemake paha ʻoe i ka haukapila e hoʻoponopono iā lākou** | |||
ʻO nā hopena ʻaoʻao ʻē aʻe āu e loaʻa ai:
- ʻeha ʻana i ka ʻōpū (nausea) a me ka luaʻi
- waha ʻeha a ʻeha paha. Hiki ke ʻono ʻokoʻa nā mea
- loli ke hele ʻoe i ka lua. Loaʻa paha iā ʻoe ka poo paʻakikī (constipation) a i ʻole ka poo palupalu a wai (diarrhoea)
- ka luhi a i ʻole ka nele o ka ikehu ʻaʻole i kōkua ʻia e ka hoʻomaha a i ʻole ka hiamoe (ka luhi)
- nā ʻeha a me nā ʻeha ma kou ʻiʻo a me nā ami
- E hāʻule paha kou lauoho ma kou poʻo, a me nā wahi ʻē aʻe o kou kino
- paʻakikī paha ka noʻonoʻo ʻana a hoʻomanaʻo paha i nā mea
- nā manaʻo ʻē i kou mau lima a me kou mau wāwae e like me ke kani ʻana, nā pine a me nā nila, ka wela a i ʻole ka ʻeha
- hoʻololi i kou mau koko koko maikaʻi (e nānā i ka papa ma luna).
Nā ho'āʻo hoʻokolohua
Manaʻo mākou e nīnau mau ʻoe i kāu kauka e pili ana i nā hoʻokolohua lapaʻau āu e ʻae ai.
He mea nui 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 iā HL ma 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 loaʻa ai inā ʻoe i ka hoʻokolokolo. ʻO CAR T-cell therapy kahi laʻana o kahi ʻano lapaʻau i kēia manawa i nā hoʻokolohua lapaʻau.
Inā makemake ʻoe e komo i kahi hoʻokolohua lapaʻau, e nīnau i kāu kauka inā loaʻa iā ʻoe kekahi.
Prognosis, Follow-up Care & Survivorship - noho me & ma hope o HL
Hōʻikeʻike
ʻO kāu wānana e pili ana i ka maikaʻi o ka pane ʻana o kāu HL i ka mālama ʻana a pehea ʻoe e ola ai ma hope o ka mālama ʻana.
Hoʻōla ʻia ka hapa nui o nā poʻe me Hodgkin lymphoma ma hope o ka lāʻau lapaʻau mua. Eia naʻe, ʻaʻole kēia ka hihia no nā mea a pau. Inā ʻaʻole hele kāu HL ma hope o ka mālama ʻana (ʻaʻole ʻoe e hele i ke kala ʻana), e loaʻa iā ʻoe ka HL "refractory". 'O ia ho'i, 'a'ole e pane ana kāu HL i ka lā'au lapa'au o kēia manawa, no laila e ho'ā'o kāu kauka i kekahi mea'ē a'e.
Inā hele ʻoe i ke kala ʻana ma hope o ka mālama ʻana, akā hoʻi hou mai ma hope o kekahi manawa ua kapa ʻia ʻo ia he relapse. ʻO ka mea hou maikaʻi, ʻo ia ka mea maʻamau ʻo Hodgkin lymphoma refractory a hoʻi hou i ka lāʻau lapaʻau lua.
Aia nā kumu like ʻole e hiki ke hoʻopili i kāu prognosis, akā ʻo kāu kauka ke kanaka maikaʻi loa e kamaʻilio e pili ana i kēia no ka mea ua ʻike lākou i kāu mau kikoʻī āpau. Inā ʻaʻole ʻoe maopopo i ke ʻano o kāu prognosis, e nīnau wale iā lākou i ka wā e ʻike ai ʻoe iā lākou.
Malama hahai
ʻAʻole pau ka mālama ʻana mai kāu mau kauka a me nā kahu maʻi ke hoʻopau ʻoe i ka mālama ʻana. ʻOiaʻiʻo, makemake lākou e ʻike mau iā ʻoe e ʻike pehea ʻoe e hele ai a e nānā ʻaʻole ʻoe e loaʻa i nā hopena ʻaoʻao mau loa mai ka mālama ʻana. E hoʻonohonoho pū lākou i nā scans no ʻoe e hōʻoia i ka hoʻi ʻole ʻana o kāu HL.
He mea koʻikoʻi loa ʻoe e hele i kēia mau koho a lākou e hana ai no ʻoe, i hiki ke hopu koke ʻia kekahi hōʻailona o ka hoʻi hou ʻana a i ʻole nā hopena ʻaoʻao hou a mālama ʻia ʻoe a palekana.
Hiki ke hoʻomaka i kekahi mau hopena ʻaoʻao o ka lāʻau ma hope o ka hoʻopau ʻana i ka mālama ʻana. Hiki i kekahi mau hopena ʻaoʻao lōʻihi ke komo:
- luhi mau
- waha maloʻo - hiki ke hoʻonui i ka pilikia o ka maʻi niho
- nā pilikia me ka ulu ʻana o ka iwi a me ka ulu ʻana o nā ʻano kāne
- thyroid, pilikia puʻuwai a me ka māmā
- piʻi aʻe ka pilikia o kekahi maʻi maʻi ʻē aʻe e like me ka maʻi maʻi umauma (inā loaʻa ʻoe i ka radiation i kou umauma), lymphoma non-Hodgkin, maʻi leukemia a i ʻole ka maʻi maʻi thyroid.
- infertility
ʻO ka ʻike mua ʻana ma o ka nānā mau ʻana me kāu kauka, a me ka hana ʻana i nā koho ola olakino hiki ke hōʻemi i ka hopena o nā hopena lōʻihi a me nā hopena hope i nā mea ola HL lōʻihi.
Ola - noho pū me Hodgkin Lymphoma a ma hope
ʻO nā pahuhopu nui ma hope o ka mālama ʻana i kāu HL ʻo ka hoʻi ʻana i ke ola a:
- e hooikaika e like me ka hiki ma kou kula, ohana, mob a me na hana ola e ae
- e hōʻemi i nā hopena ʻaoʻao a me nā hōʻailona o ka HL a me kāna 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
Ke hana nei i nā koho olakino
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 me HL. Nā lākou:
- hoʻoikaika mau - mālama i kou kino e neʻe
- ʻai i ke olakino i ka hapa nui o ka manawa
- e kamaʻilio e pili ana i kou manaʻo me nā poʻe āu e hilinaʻi ai
- pale i ka paka (ka paka)
- e hoomaha i ka luhi o kou kino
- e ʻae i kāu kauka inā ʻike ʻoe i kekahi mau loli, e like me ka ulu ʻana o kahi puʻupuʻu ʻē aʻe, ka loaʻa ʻana o ke kuni a i ʻole ka wela o ka pō.
Hoʻoponopono i ke kanesa
He liʻiliʻi paha ka hoʻi ʻana i ka maʻamau, e hoʻomanawanui iā ʻoe iho, ua nui nā pilikia o kou kino. Inā pilikia maoli ʻoe e hoʻi i ka mea maʻamau, hiki iā ʻoe ke kamaʻilio me kāu kauka e pili ana i ke ʻano o ka hoʻoponopono ʻana i ka maʻi kanesa i loaʻa iā ʻoe.
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
Loaʻa iā mākou nā pepa ʻike no ʻoe ma ka pūnaewele
Loaʻa iā mākou kekahi mau ʻōlelo aʻoaʻo maikaʻi ma kā mākou pepa ʻike ma lalo nei:
- Makaʻu i ka hoʻi hou ʻana o ka maʻi kanesa a me ka hopohopo scan
- Ka mālama moe a me ka lymphoma
- Hoʻoikaika kino a me ka lymphoma
- Ka luhi a me ka lymphoma
- ʻO ka moekolohe a me ka pilina
- Ka hopena noʻonoʻo o ka maʻi lymphoma a me ka mālama ʻana
- Ka hopena manaʻo o ka noho ʻana me ka lymphoma
- Ka hopena noʻonoʻo o ka lymphoma ma hope o ka hoʻopau ʻana i ka mālama lymphoma
- Ka mālama ʻana i kekahi me Lymphoma
- Ka hopena noʻonoʻo o ka lymphoma hou a i ʻole refractory
- Nā lāʻau lapaʻau hoʻohui a me nā mea ʻē aʻe: Lymphoma
- Ka mālama ponoʻī a me ka Lymphoma
- Mea ai a me Lymphoma
