B-cell lymphocytes a me PMBCL
No ka hoʻomaopopo ʻana i ka PMBCL 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 ka maʻi a me nā maʻi e mālama pono iā ʻoe.
- Hana i nā antibodies (i kapa ʻia ʻo immunoglobulins) e kōkua i ke kaua ʻana i ka maʻi a me ka maʻi.
- E hoʻomanaʻo i nā maʻi i loaʻa iā ʻoe i ka wā ma mua, no laila inā loaʻa hou iā ʻoe ka maʻi like, hiki i ka ʻōnaehana pale o kou kino ke hakakā me ka ʻoi aku ka maikaʻi a me ka wikiwiki.
- Hana ʻia i loko o kou iwi iwi (ʻo ka ʻāpana spongy i waenakonu o kou mau iwi), akā e noho mau i loko o kou ʻōpū a me kou mau lymph nodes. Noho kekahi i kou thymus a me ke koko pū kekahi.
- 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 lilo nā pūnaʻi B i ke kanesa?
Hoʻokumu ʻia ka PMBCL i ka wā e lilo ai kekahi o kāu mau pūnaʻi B i ka maʻi kanesa. Ulu lākou me ka ʻole ka mālama ʻia, ʻano ʻino, a ʻaʻole make i ka wā e pono ai.
Ke loaʻa iā ʻoe ka PMBCL i kāu lymphocytes B-cell cancerous:
- ʻAʻole e hana maikaʻi e hakakā i nā maʻi a me nā maʻi.
- Hiki ke lilo i ʻoi aku ka nui ma mua o ka pono a hiki ke nānā ʻokoʻa i kāu mau pūnaewele B olakino.
- Hiki ke ulu a ulu ka lymphoma ma kekahi wahi o kou kino.
Hiki ke ho'ōla 'ia ka PMBCL?
ʻOiai ʻo ka PMBCL he lymphoma e ulu wikiwiki ana, hiki ke ho'ōla 'ia nā kānaka he nui me ka PMBCL me ka lapaʻau ʻana, ʻoiai inā ʻike ʻia ʻoe me ka pae 3 a i ʻole 4 lymphoma (pae holomua). He ʻokoʻa loa ka pae kiʻekiʻe o ka lymphoma i nā pae kiʻekiʻe o nā maʻi maʻi ʻē aʻe ʻaʻole hiki ke hoʻōla ʻia.
Nā kumu o ka PMBCL
ʻAʻole mākou ʻike i ke kumu o ka PMBCL, akā ʻike mākou ʻaʻole ia he maʻi maʻi a ʻaʻole hiki ke hoʻoili ʻia i nā poʻe ʻē aʻe. ʻOi aku ka maʻamau i nā poʻe ma waena o 20 a 40 mau makahiki akā hiki ke loaʻa i nā keiki ʻōpio. ʻOi aku ka maʻamau o nā wahine ma mua o nā kāne.
Nā moʻolelo hoʻomanawanui - noho pū me PMBCL
Kaomi ma nā loulou ma lalo nei e heluhelu ai e pili ana iā Eleisha lāua ʻo Margy me PMBCL.
Nā hōʻailona o ka PMBCL
Hiki i nā hōʻailona o PMBCL ke kumu e ka lymphoma e kaomi ana i nā hale i loko o kou umauma. Hiki i kēia mau mea ke komo:
- ʻOlelo
- ʻEha a ʻeha paha ma kou umauma
- Hoʻololi i kou leo me ka hoarseness
- Ka pilikia loa
- Ka pehu ma kou ʻāʻī, ka maka a i ʻole nā lima
- Hoʻoponopono
- ʻO nā ʻeha poʻo i ʻoi aku ka ʻino ke kūlou ʻoe i mua
- ʻOi aku ka ʻike ʻia o nā aʻaʻaʻa umauma
Hiki ke hana ʻia kekahi o kēia mau hōʻailona ma muli o ke kaomi ʻana o ka lymphoma i kahi aʻa nui i loko o kou umauma i kapa ʻia ʻo superior vena cava (SVC). Lawe kēia vein i ke koko a pau mai ka hapa luna o kou kino a i ka puʻuwai. Inā ālai ke kaomi ʻana i ka SVC i ke kahe ʻana o ke koko, ua kapa ʻia e nā kauka kēia keakea vena cava obstruction (SVCO).
Nā hōʻailona maʻamau o Lymphoma
Hiki iā ʻoe ke ʻike i nā hōʻailona ʻē aʻe e hiki ke hoʻopilikia i kekahi me kekahi subtype o lymphoma. Hiki i kēia mau mea ke komo:
- ʻO nā puʻupuʻu lymph pehu - he puʻupuʻu hiki iā ʻoe ke ʻike a ʻike paha. (Ma ka PMBCL hiki ke ʻike ʻia kēia puʻupuʻu i loko o kou umauma, akā hiki nō ma kou ʻāʻī. armpit or groin).
- Manaʻo luhi ʻole (fatiued)
- Pau ka hanu
- ʻOi aku ka maʻalahi o ka ʻeha a i ʻole ke koko ma mua o ka maʻamau
- ʻO nā maʻi hele ʻole, a i ʻole e hoʻi mau ana (hoʻi hou)
- ʻOi aku ka hoʻoluʻu ʻana i ka pō ma mua o ka maʻamau
- Pau kou ʻai (ʻaʻole makemake e ʻai)
- ʻO ka pohō ʻana me ka hoʻāʻo ʻole
- ʻIli ʻili
Pehea e ʻike ʻia ai ʻo Primary Mediastinal B-cell Lymphoma?
Hiki ke paʻakikī ka ʻike ʻana i ka PMBCL i kekahi manawa a hiki ke lawe i kekahi mau pule.
Pono kāu kauka e hoʻonohonoho i kekahi mau hoʻokolohua koʻikoʻi. Pono kēia mau ho'āʻo e hōʻoia a hoʻopau paha i ka lymphoma ke kumu o kāu mau hōʻailona. No ka mea he nui nā ʻano subtypes o lymphoma, loaʻa paha iā ʻoe nā hoʻokolohua hou e ʻike ai i kāu mea. He mea koʻikoʻi kēia no ka mea ʻokoʻa ka hoʻokele a me ka mālama ʻana i kāu subtype me nā ʻano subtype ʻē aʻe o lymphoma.
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.
Nā Biopsies
No ka ʻike ʻana i ka PMBCL pono ʻoe i kahi biopsy. ʻO ka biopsy kahi hana e wehe ai i kahi ʻāpana, a i ʻole nā poʻo lymph 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 PMBCL.
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.
No ke aʻo ʻana e pili ana i nā ʻano biopsies ʻokoʻa i hiki ke hoʻohana ʻia no ke kōkua ʻana i ka hōʻoia ʻana i ka PMBCL, e kaomi i nā poʻomanaʻo ma lalo.
Nā biopsies kumu a i ʻole ka nila maikaʻi lawe ʻia e wehe i kahi laʻana o ka pehu lymph node a i ʻole ka ʻōpū e nānā i nā hōʻailona o PMBCL.
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.
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.
Ke lawe ʻia ka biopsy mai kāu mediastinum, pono paha ʻoe i kahi ʻano o ke kī kī i kapa ʻia he 'mediastinoscopy' no laila hiki i ke kauka ke loaʻa kahi laʻana hilinaʻi.
I ka wā o ka mediastinoscopy e hā'awi 'ia 'oe i ka ma'i ma'i ma'amau no laila 'a'ole 'oe e ala i ke ka'ina hana. Inā he lauoho kou ma kou umauma, e kahi ʻia kēia ma kahi o nā ʻoki kī (ʻoki) i hiki ke hoʻomaʻemaʻe pono ʻia me kahi antiseptic i mea e pale ai i nā maʻi ma hope o ke ʻoki ʻana, a e hōʻoia i ka uhi ʻana i ka lāʻau ʻeha. kou ili pono.
Ke kaʻina hana
E hana ke kauka lapaʻau i hoʻokahi a ʻoi aʻe paha ʻoki liʻiliʻi ma kahi kokoke a ma luna paha o kou iwi umauma i waenakonu o kou umauma, a hoʻokomo i kahi paipu me ka pahupaʻikiʻi ma ka hope i hiki iā lākou ke nānā i loko o kou umauma a ʻike i ka lymph node e lawe i kahi biopsy mai. Ke ala ʻoe, e loaʻa paha iā ʻoe ʻelua mau humuhumu a me kahi kāhiko nani ma luna o ka ʻoki.
E hoʻouna ʻia ka biopsy i ka lab a e nānā ʻia ʻoe no kekahi mau hola ma hope o ke ʻoki ʻana e hōʻoia i ka ʻole o ke koko, ke hoʻomalu ʻia kou ʻeha a me kou mau hōʻailona koʻikoʻi - e like me ke kahe koko, ka mahana a me ka puʻuwai maʻamau ma mua. hiki ke hoʻi i ka home. ʻAʻole hiki iā ʻoe ke hoʻokele a pono ʻoe e kiʻi iā ʻoe a noho pū me ʻoe no 24 mau hola ma muli o ka maʻi maʻi.
ʻO ke kau ʻana o ka PMBCL
Ke ʻike ʻia ʻoe me ka PMBCL, 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 lymphoma?
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 aʻe 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 ka pae ʻehā (IV) PMBCL.
E pili ana kāu pae o PMBCL ma:
- 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 |
|
|
E & X |
|
|
S |
|
(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".
Puʻu lāʻau
ʻO ka ʻoki lāʻau 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.
Pehea e mālama ʻia ai koʻu ʻeha i ka wā o ke kaʻina hana?
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.
He ʻokoʻa ka ulu ʻana o kāu mau sela lymphoma, a ʻokoʻa ka nānā ʻana i nā cell maʻamau. ʻO ka pae o kāu lymphoma ka wikiwiki o ka ulu ʻana o kāu mau sela lymphoma, e pili ana i ka nānā ʻana ma lalo o kahi microscope. ʻO nā papa he 1-4 (haʻahaʻa, waena, kiʻekiʻe). Inā loaʻa iā ʻoe kahi lymphoma kiʻekiʻe, ʻokoʻa loa ke ʻano o kāu mau pūnaewele lymphoma mai nā pūnaewele maʻamau, no ka mea, ke ulu wikiwiki nei lākou e ulu pono. Aia ma lalo kahi ʻike o nā māka.
Kapa ʻia nā lymphoma e ulu mālie molowa, ʻoiai ua kapa ʻia nā lymphomas ulu wikiwiki hoʻopaʻapaʻa.
Nā papa o ka lymphoma
- G1 - papa haʻahaʻa - ke nānā aku nei kāu mau cell i kahi maʻamau, a ulu lākou a pālahalaha mālie.
- G2 – papa waena – ke hoʻomaka nei kāu mau cell e nānā ʻokoʻa akā aia kekahi mau cell maʻamau, a ulu a laha lākou ma kahi wikiwiki.
- G3 – papa kiʻekiʻe – ʻokoʻa ke ʻano o kāu mau cell me kekahi mau cell maʻamau, a ulu lākou a pālahalaha wikiwiki.
- G4 - papa kiʻekiʻe - ʻokoʻa loa kāu mau cell i ka mea maʻamau, a ulu a palahalaha loa lākou.
He aha ka papa PMBCL?
ʻO PMBCL kahi kiʻekiʻe, hoʻopaʻapaʻa lymphoma. Nui ka poʻe i ʻike ʻia ma kahi pae kiʻekiʻe ma muli o ka wikiwiki o ka ulu ʻana a me ka laha ʻana, akā naʻe hiki ke hoʻōla ʻia ʻoe mai ka PMBCL hoʻokūkū kiʻekiʻe. ʻAʻole like ka Lymphoma i nā maʻi maʻi maʻi maʻi paʻa paʻa e like me ka maʻi ʻōpū a i ʻole ka maʻi ʻāʻī.
Hoʻohui kēia ʻike āpau i ke kiʻi holoʻokoʻa a kāu kauka i kūkulu ai e kōkua i ka hoʻoholo ʻana i ke ʻano o ka lāʻau lapaʻau maikaʻi loa no ʻoe.
E kamaʻilio me kāu kauka e pili ana i kāu mau pilikia ponoʻī i hiki iā ʻoe ke ʻike maopopo i ka mea e manaʻo ai mai kāu mau lapaʻau.
Ka hoʻomaopopo ʻana i kāu genetics lymphoma
Ke hoʻouna ʻia kāu biopsies i ka lab, hiki i ka pathologist ke hana i nā hoʻokolohua hou i kapa ʻia he cytogenetics.
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. Inā loaʻa iā ʻoe ka PMBCL, 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.
He aha ka hopena inā loaʻa ka loli i kaʻu mau genes a i ʻole chromosomes?
Inā loaʻa kahi hoʻololi (i kapa ʻia hoʻi he hoʻololi a hoʻololi paha) i kēia mau chromosomes a i ʻole genes, ʻaʻole e holo pono kāu mau protein a me nā cell, a hiki i nā lymphocytes ke lilo i nā pūnaewele lymphoma ma muli o nā loli i loko o nā pūnaewele.
ʻO kekahi o nā hoʻololi genetic i loaʻa i ka poʻe me ka PMBCL ua hopena i kekahi mau protein i kapa ʻia ʻo PDL1 a me PDL2 e ulu ana ma nā pūnaewele lymphoma (Ua kapa ʻia kēia mau protein i ka "immune checkpoints". ʻO ke ala o ka ʻike ʻana i nā sela olakino Ma o ka hoʻonui ʻana i kēia mau protein ma luna o lākou, hiki i nā pūnae lymphoma ke 'hoʻolikelike' he mau sela olakino maʻamau, no laila ʻaʻole ʻike kou ʻōnaehana pale iā lākou he mea pōʻino, akā e hoʻomau lākou e ulu a laha.
Hiki i nā hoʻololi ʻē aʻe ke hoʻopau i nā ala maʻamau e lawe ai i ka wā i hōʻino ai lākou i ka hoʻoponopono ʻana a i ʻole ka luku ʻana iā lākou iho a no laila hiki iā lākou ke hoʻomau i ka hoʻomohala ʻana i nā ʻano like ʻole a me ka hana ʻana i nā pūnaewele like ʻole (cancerous lymphoma).
Lapaʻau no Primary Mediastinal B-cell 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 lapaʻau 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 kāu kauka i nā kumu he nui e pili ana i kāu PMBCL. ʻO nā hoʻoholo i ka wā a inā pono ʻoe e hoʻomaka a me ke ʻano o ka lāʻau maikaʻi loa e pili ana i:
- ʻO kāu pae pākahi o ka lymphoma, nā hoʻololi genetic a me nā hōʻailona
- ʻO kou mau makahiki, ka mōʻaukala olakino i hala a me ke olakino maʻamau
- ʻO kou ola kino a me kou noʻonoʻo i kēia manawa a me nā makemake hoʻomanawanui
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 i ʻole kahu maʻi maʻi ke wehewehe i kāu hoʻolālā lapaʻau a me nā hopena ʻaoʻao hiki iā ʻoe a ma laila e pane i nā nīnau āu e loaʻa ai. 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.
Mālama i ka momona
Hiki i kekahi mau lāʻau lapaʻau ke paʻakikī i ka hāʻule ʻana a i ʻole ka hāpai ʻana i kekahi. Inā hoʻolālā ʻoe (a i ʻole kāu keiki) e hānau keiki ma hope aku, e kamaʻilio me kāu kauka e pili ana i ka mālama ʻana i kou momona.
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.
Laina kahu hānai no ka Lymphoma
Helu kelepona: 1800 953 081
Email: kahu@lymphoma.org.au
Nā nīnau e nīnau i kāu kauka ma mua o kou hoʻomaka ʻana 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.
Ua hōʻuluʻulu 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 ʻimi i kahi kope PDF hiki iā ʻoe ke hoʻoiho a paʻi.
Kaomi ma ka loulou ma lalo nei e kiʻi i kahi PDF o nā nīnau no kāu kauka.
Nā ʻano o ka lāʻau anticancer no PMBCL
ʻO ka Lymphoma B-cell Primary Mediastinal (PMBCL) kahi lymphoma e ulu wikiwiki ana, no laila pono ʻoe e hoʻomaka koke i ka mālama ʻana - maʻamau i loko o 1-3 mau pule o ka ʻike ʻia ʻana.
Hiki ke hoʻohui ʻia nā lāʻau lapaʻau like ʻole, me nā chemotherapies, monoclonal antibodies (MABs), immune checkpoint inhibitors (ICIs), a me ka lāʻau lapaʻau.
Kaomi ma nā poʻomanaʻo ma lalo nei e aʻo hou e pili ana i kekahi o nā koho lapaʻau like ʻole e hāʻawi ʻia iā ʻoe.
Hāʻawi ʻia ka mālama kākoʻo i nā maʻi a me nā ʻohana e kū nei i ka maʻi koʻikoʻi a hiki ke kōkua iā ʻoe i nā hōʻailona liʻiliʻi, a i ʻole e hoʻomaikaʻi wikiwiki aʻe ma ka hōʻoia ʻana e loaʻa iā ʻoe nā mea āu e pono ai no kou kino e like me ka hiki.
Hoʻomaikaʻi i ka helu ʻana o ke koko
Hiki i nā lāʻau lapaʻau no ka PMBCL ke hoʻopilikia i kou mau koko koko maikaʻi e hiki ke hopena i ka lawa ʻole o ke koko olakino e mālama pono ai iā ʻoe. ʻO ka hopena, hiki ke hāʻawi ʻia iā ʻoe i ka hoʻololi ʻana me ke koko ʻulaʻula i hoʻopaʻa ʻia a i ʻole nā platelets e hoʻomaikaʻi ai i kou pae o kēia mau koko koko. Inā haʻahaʻa loa kou mau keʻokeʻo keʻokeʻo - a i ʻole e haʻahaʻa loa, hiki ke hāʻawi ʻia ʻoe i kahi injection e komo i loko o kou ʻōpū e kōkua ai i ka hoʻoulu ʻana i kou iwi iwi e hana hou i kēia mau cell. Pono paha ʻoe i nā lāʻau antibiotic inā loaʻa ʻoe i kahi maʻi ʻoiai ʻoi aku ka haʻahaʻa o kāu mau keʻokeʻo keʻokeʻo, e kōkua iā ʻoe e pale aku i nā maʻi.
Ka mālama ʻana i nā hōʻailona a me ka hoʻolālā ʻana i ka mālama olakino
Hiki i ka mālama kākoʻo ke komo pū me ka ʻike ʻana i nā loea ʻē aʻe me ka ʻike ma nā wahi ʻē aʻe o kou olakino a i ʻole ka hoʻolālā ʻana no ka mālama ʻana i ka wā e hiki mai ana e like me ke kōkua ʻana iā ʻoe e hana i kahi Hoʻolālā Hoʻolālā Kiʻekiʻe e wehewehe i kou makemake no ka mālama olakino i ka wā e hiki mai ana. Inā loaʻa iā ʻoe nā hōʻailona a i ʻole nā hopena ʻaoʻao i hoʻomaikaʻi ʻole ʻia, hiki ke hāʻawi ʻia iā ʻoe e kūkākūkā me ka hui mālama palliative he loea i ka mālama ʻana i nā hōʻailona paʻakikī e like me ka ʻeha a me ka nausea ʻaʻole i hoʻomaikaʻi ʻia me nā lāʻau maʻamau. ʻO kēia mau mea he ʻāpana o ka hoʻokele multidisciplinary o lymphoma.
ʻO ka lāʻau lapaʻau he lāʻau lapaʻau maʻi maʻi e hoʻohana ana i nā kiʻekiʻe kiʻekiʻe o ka radiation e pepehi i nā cell lymphoma a e hōʻemi i nā ʻōpū. Ma mua o ka loaʻa ʻana o ka radiation, e loaʻa iā ʻoe kahi kau hoʻolālā. He mea koʻikoʻi kēia kau no ka poʻe lapaʻau lapaʻau e hoʻolālā pehea e hoʻopaʻa ai i ka radiation i ka lymphoma, a pale aku i ka hōʻino ʻana i nā cell olakino. ʻO ka lōʻihi o ka lāʻau lapaʻau ma waena o 2-4 mau pule. I kēia manawa, pono ʻoe e hele i ke kikowaena radiation i kēlā me kēia lā (Poakahi-Palima) no ka mālama ʻana.
Palapala nui
Inā lōʻihi kou noho ʻana mai ke kikowaena radiation a makemake ʻoe i ke kōkua me kahi e noho ai i ka wā o ka mālama ʻana, e ʻoluʻolu e kamaʻilio me kāu kauka a kahu hānai paha e pili ana i ke kōkua i loaʻa iā ʻoe. Hiki iā ʻoe ke kelepona i ka Cancer Council a i ʻole Leukemia Foundation ma kou mokuʻāina a ʻike inā hiki iā lākou ke kōkua i kahi e noho ai.
Hiki iā ʻoe ke loaʻa i kēia mau lāʻau ma ke ʻano he papa a/a i ʻole e hāʻawi ʻia ma ke ʻano he kulu (infusion) i loko o kou aʻa (i loko o kou kahawai koko) ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hiki ke hui pū ʻia kekahi mau lāʻau chemo me kahi lāʻau immunotherapy. Hoʻopau ʻo Chemo i nā pūnaewele ulu wikiwiki a hiki ke hoʻopilikia i kekahi o kāu mau sela maikaʻi e ulu wikiwiki ana i nā hopena ʻaoʻao.
Loaʻa paha iā ʻoe kahi infusion MAB ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hoʻopili ʻia nā MAB i ka cell lymphoma a huki i nā maʻi ʻē aʻe e hakakā ana i nā keʻokeʻo keʻokeʻo a me nā protein i ka maʻi kanesa i hiki ai i kāu ʻōnaehana pale ke kaua i ka PMBCL.
E hana wale ana ʻo MABS inā loaʻa iā ʻoe nā protein a i ʻole nā hōʻailona kikoʻī ma kāu mau sela lymphoma. ʻO kahi māka maʻamau ma PMBCL ʻo CD20. Inā loaʻa iā ʻoe kēia māka hiki iā ʻoe ke pōmaikaʻi mai ka mālama ʻana me kahi MAB.
He ʻano hou o ka monoclonal antibody (MAB) nā mea hoʻopaʻapaʻa hoʻopaʻa palekana (ICI) a hana ʻokoʻa iki i nā MABS ʻē aʻe.
Ke hana nei ka ICI i ka wā e hoʻomohala ai kāu mau puʻupuʻu maʻi "immune checkpoints" e like me PDL1 a i ʻole PDL2 ma luna o lākou i ʻike pinepine ʻia ma kāu mau sela olakino. Hōʻike ka helu hoʻopaʻa pale i kāu ʻōnaehana pale i ke olakino a maʻamau ke kelepona, no laila waiho wale kāu ʻōnaehana pale.
Hana nā ICI ma ke kāohi ʻana i ka wahi hoʻopaʻa immune i hiki ʻole i kāu mau pūnaewele lymphoma ke hoʻohālike hou he ola olakino. ʻAe kēia i kāu ʻōnaehana pale e ʻike iā lākou he maʻi kanesa, a hoʻomaka i kahi hoʻouka kaua iā lākou.
ʻO Pembrolizumab kahi laʻana o kahi mea hoʻopaʻa hoʻopaʻa i hoʻohana ʻia ma PMBCL.
Hoʻohui ʻia ka Chemotherapy me kahi MAB (no ka laʻana, rituximab).
Hana ʻia kahi pūnaʻi pū a i ʻole ka iwi iwi e hoʻololi i kou iwi iwi maʻi me nā pūnaewele hou e hiki ke ulu i loko o ke koko olakino hou. Hana ʻia ka hoʻololi ʻana o ka ʻiʻo iwi no nā keiki me ka PMBCL, aʻo ka hoʻololi ʻana o nā pūnaewele i nā keiki ʻelua.
ʻO CAR T-cell therapy he lāʻau lapaʻau hou aʻe e hāʻawi ʻia inā ua loaʻa iā ʻoe ʻelua mau lāʻau lapaʻau ʻē aʻe no kāu PMBCL.
I kekahi mau hihia, hiki iā ʻoe ke komo i ka lāʻau lapaʻau T-cell ma o ke komo ʻana i kahi hoʻokolohua lapaʻau.
Hoʻokomo ʻia ka lāʻau lapaʻau T-cell CAR i kahi precodeure mua e like me ka transplant cell stem, kahi e hoʻoneʻe ʻia ai kāu lymphocytes T-cell mai kou koko ma ke kaʻina hana apheresis. E like me ʻoe nā lymphocytes B-cell, ʻo nā cell T he ʻāpana o kāu ʻōnaehana pale a hana pū me kāu mau cell B e pale iā ʻoe mai ka maʻi a me ka maʻi.
ʻO ka lāʻau lapaʻau mua
Pono ʻoe e hoʻomaka i ka lāʻau lapaʻau ma hope koke o ka hoʻi ʻana mai o kāu mau hopena hōʻike. I kekahi mau hihia, hiki iā ʻoe ke hoʻomaka ma mua o ka loaʻa ʻana o nā hopena hōʻike.
Hiki ke paʻakikī loa ke hoʻomaka ʻoe i ka mālama ʻana. Nui paha kou mau manaʻo e pili ana i kāu e hoʻokō ai, pehea e mālama ai ma ka home, a i ʻole e loaʻa paha ʻoe i ka maʻi.
E hōʻike i kāu hui lapaʻau inā manaʻo ʻoe makemake ʻoe i ke kākoʻo hou aku
Hiki paha iā lākou ke kōkua ma ke kuhikuhi ʻana iā ʻoe e ʻike i kahi limahana a i ʻole kekahi ʻoihana mālama ola kino e kōkua iā ʻoe e hoʻoponopono i kekahi mau pilikia o ka nohona o kēlā me kēia lā āu e alo ai. Hiki iā ʻoe ke hele aku i nā kahu hānai Lymphoma ma ke kaomi ʻana i ke pihi "Contact us" ma lalo o kēia ʻaoʻao.
Ke hoʻomaka ʻoe i ka lapaʻau no ka manawa mua, ua kapa ʻia ʻo ia 'first-line treatment'. Loaʻa paha iā ʻoe ma mua o hoʻokahi lāʻau lapaʻau, a hiki i kēia mau mea ke komo i ka chemotherapy, kahi antibody monoclonal a i ʻole ka lāʻau lapaʻau. I kekahi mau hihia, loaʻa paha iā ʻoe ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana, a i ʻole nā lāʻau lapaʻau.
Nā pōʻaiapuni lapaʻau a me nā protocols
Ke loaʻa iā ʻoe kēia mau lāʻau lapaʻau, e loaʻa iā ʻoe i nā pōʻai. ʻO ia hoʻi, e loaʻa iā ʻoe ka lāʻau lapaʻau, a laila hoʻomaha, a laila kekahi pōʻai (pōkole) o ka mālama ʻana. No ka hapa nui o ka poʻe me PMBCL, ʻoi aku ka maikaʻi o ka chemoimmunotherapy no ka loaʻa ʻana o ke kala ʻana (ʻaʻohe hōʻailona o ke kanesa).
ʻO ka lāʻau lapaʻau maʻamau no ka PMBCL hiki ke komo:
ʻO R-CHOP ka lāʻau lapaʻau maʻamau no PMBCL a me ka hui pū ʻana o rituximab (a MAB) me ʻekolu mau lāʻau lapaʻau chemotherapy - cyclophosphamide, doxorubicin a me vincristine. E loaʻa iā ʻoe kahi steroid i kapa ʻia he prednisolone. Hāʻawi pinepine ʻia ʻo R-CHOP i hoʻokahi lā i kēlā me kēia 14 a i ʻole 21 mau lā.
I ka ʻehā o ka lā ma hope o ka mālama ʻana, e loaʻa nō hoʻi ʻoe i kahi injection i loko o kou ʻōpū e kōkua i ka ulu wikiwiki ʻana o kāu mau koko keʻokeʻo.
Loaʻa nā lāʻau lapaʻau like me R-CHOP akā me ka hoʻohui ʻana o kekahi chemotherapy i kapa ʻia ʻo etoposide. Hāʻawi ʻia kēia protocol ma nā ʻano like ʻole e pili ana i kāu kūlana pilikino. ʻO ka DA ma ka inoa ʻo ia ka "dose adjusted". Hāʻawi ʻia ia ma kahi o ʻelima mau lā i kēlā me kēia 21 lā. I ke ono o ka lā, e loaʻa nō hoʻi ʻoe i kahi inikia i loko o kou ʻōpū e kōkua i ka ulu wikiwiki ʻana o kāu mau koko keʻokeʻo.
ʻO ke ʻano o kekahi mau ʻano ʻano ʻano like ʻole e ʻoi aku ka maikaʻi o nā lāʻau lapaʻau i hoʻopaʻa ʻia iā ʻoe, a ʻo nā ʻano ʻino ʻē aʻe - a i ʻole nā genetics maʻamau, ʻoi aku ka maikaʻi o ka chemoimmunotherapy.
He lāʻau lapaʻau kēia, a hiki ke hāʻawi ʻia iā ʻoe inā loaʻa iā ʻoe, a i ʻole ka pilikia o ka loaʻa ʻana o ka PMBCL i kou lolo a i ʻole ke kuamoʻo. Na ke kauka e hāʻawi iā ʻoe i kahi nila ma kou kua (ma lalo o nā kūlana sterile) a hoʻokomo i ka methotrexate i loko o ka wai e hoʻopuni ana i kou spinal cord. Loaʻa iā ʻoe kēia me R-CHOP a i ʻole DA-R-EPOCH.
E like me ka'ōlelo i luna
Hiki i kēia mau mea ke komo i nā lāʻau lapaʻau i manaʻo ʻia a me nā lāʻau lapaʻau ʻē aʻe. E nīnau i kāu kauka inā he kūpono ia no nā hoʻokolohua lapaʻau lapaʻau mua.
ʻO ka lāʻau lapaʻau lua
Ma hope o ka mālama ʻana, e hele ka hapa nui o ʻoukou i ke kala ʻana. ʻO ke kala ʻana he manawa ʻaʻohe ou hōʻailona o ka PMBCL i waiho ʻia i loko o kou kino, a i ʻole ke hoʻomalu ʻia ka PMBCL a ʻaʻole pono e mālama. Hiki ke hoʻomau ʻia ke kala ʻana no nā makahiki he nui, akā i kekahi manawa hiki i ka PMBCL ke 'hoʻi hou' (hoʻi mai). Ke hana ʻia kēia, pono ʻoe e hoʻomaka hou i ka mālama ʻana, akā ʻokoʻa paha ia mai ka mālama ʻana iā ʻoe ma mua.
ʻAʻole hiki i kekahi poʻe ke pane i ka lāʻau lapaʻau mua a i ʻole ke kala ʻana. Inā loaʻa kēia, kapa ʻia kāu PMBCL he 'refractory'. Ke loaʻa iā ʻoe ka PMBCL refractory makemake kāu kauka e hoʻāʻo i kahi ʻano lāʻau lapaʻau ʻē aʻe.
ʻO ka lāʻau lapaʻau i loaʻa iā ʻoe inā ua hoʻi hou ʻoe a i ʻole refractory PMBCL ua kapa ʻia ka lāʻau lapaʻau lua. ʻO ka pahuhopu o ka lāʻau lapaʻau ʻelua e hoʻihoʻi hou iā ʻoe i ke kala ʻana. Inā loaʻa iā ʻoe ke kala hou aʻe, a laila 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.
Pehea e koho ai ke kauka i ka lāʻau lapaʻau maikaʻi loa no ka PMBCL i hoʻihoʻi hou a i ʻole refractory?
I ka manawa o ka hoʻihoʻi hou ʻana, e hilinaʻi ke koho ʻana i ka lāʻau lapaʻau i nā kumu he nui e like me:
- Pehea ka lōʻihi o kou kala ʻana
- ʻO kou olakino a me kou mau makahiki
- He aha nā lāʻau lapaʻau PMBCL i loaʻa iā ʻoe ma mua
- ʻO kāu mau makemake.
ʻO nā lāʻau lapaʻau maʻamau maʻamau a me ka laina hope no PMBCL hiki ke komo:
ʻO kahi hoʻololi ʻana o ka pūnaʻi
Hiki ke hāʻawi ʻia iā ʻoe kahi transplant cell stem inā ua hoʻi hou ʻoe, akā ʻaʻole kūpono ia no kēlā me kēia. E noʻonoʻo kāu kauka i kekahi mau mea ma mua o ka hoʻoholo ʻana inā he koho kūpono kēia no ʻoe.
Kaomi ma ka Stem cell transplants ma lalo no ka ʻike hou aku.
Pembrolizumab
He mea hoʻopaneʻe hoʻopaʻapaʻa immune (ICI), hāʻawi ʻia ia ma ke ʻano he monotherapy no ka refractory PMBCL, a i ʻole ma hope o ʻelua mau lāʻau lapaʻau mua no ka PMBCL i hoʻihoʻi ʻia (ʻaʻole i loaʻa ma ka PBS). Hiki i ka Pembrolizumab ke hana maika'i inā loa'a i kāu pūnaewele lymphoma nā wahi ho'opa'a palekana PDL1 a i 'ole PDL2 ma luna o lākou.
Chimeric antigen receptor T-cell therapy (CAR T-cell therapy)
I kēia manawa, ʻae ʻia ka lāʻau lapaʻau T-cell no ka poʻe i loaʻa i ʻelua mau ʻano lapaʻau like ʻole no kā lākou PMBCL. No ka 'ike hou aku no CAR T-cell therapy e kaomi i ka loulou ma lalo nei.
Ke komo ʻana i ka hoʻokolohua lapaʻau
Manaʻo ʻia ʻo kēlā me kēia manawa e pono ai ʻoe e hoʻomaka i nā lāʻau lapaʻau hou āu e nīnau ai i kāu kauka e pili ana i nā hoʻokolohua lapaʻau hiki iā ʻoe ke kūpono.
Nā hopena ʻaoʻao o ka mālama ʻana i ka lymphoma
Nui nā hopena ʻaoʻao o ka lāʻau lapaʻau, a hiki ke ʻokoʻa ma waena o nā kānaka a me nā ʻano lapaʻau. E nānā kāu kauka a kahu hānai i kāu mea e ʻike ai ma mua o kou hoʻomaka ʻana i ka mālama ʻana.
Hiki ke komo i kekahi mau hopena ʻaoʻao:
- Nā hoʻololi iā ʻoe he helu koko
- Ka maʻi i loko o ka ʻōpū (nausea) a/a i ʻole ka luaʻi ʻana
- ʻEha waha (mucositis); ʻike paha ʻoe i ka loli o ka ʻono o ka meaʻai a me nā mea inu
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a i ʻole ka diarrhea
- ʻO ka luhi a i ʻole ka nele o ka ikehu ʻaʻole i kōkua ʻia e ka hoʻomaha a i ʻole ka hiamoe (ka luhi)
- ʻeha ʻeha a me ka ʻeha (myalgia)
- ʻeha a me nā ʻeha o ka hui (arthralgia)
- ʻO ka lauoho lauoho a / a i ʻole ka lahilahi (alopecia)
- Ka noʻonoʻo a me ka paʻakikī i ka hoʻomanaʻo ʻana i nā mea ('chemo brain')
- Hoʻololi ka manaʻo i kou mau lima a me kou mau wāwae e like me ke kani ʻana, nā pine a me nā nila a i ʻole ka ʻeha (neuropathy)
- Hoʻemi ʻia ka momona a i ʻole ka menopause mua (hoʻololi o ke ola).
No ka ʻike hou aku e pili ana i nā hopena ʻaoʻao e kaomi i ka loulou ma lalo nei.
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 he hopena hope.
Hoʻopau i ka mālama ʻana
He manawa paʻakikī kēia no nā poʻe he nui a hiki ke pili kekahi o nā hopohopo maʻamau i:
- Helu
- ʻO ke ʻano noʻonoʻo
- Ola kino
- 'ana ma
- Hana, aʻo a me nā hana pilikanaka
He aha ka wānana no PMBCL?
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 wānana. Eia naʻe, pane maikaʻi ka PMBCL i ka lāʻau lapaʻau a hiki ke ho'ōla ʻia nā poʻe he nui i ʻike ʻia - ʻo ia hoʻi ma hope o ka mālama ʻana ʻaʻohe hōʻailona o PMBCL i loko o kou kino, a i ʻole he kala mau loa.
Nā mea hiki ke hoʻopili i ka wānana
ʻO kekahi mau mea e pili ana i kāu prognosis penei:
- ʻO kou makahiki a me kou olakino holoʻokoʻa i ka manawa o ka maʻi maʻi
- Pehea ʻoe e pane ai i ka lāʻau lapaʻau
- He aha, inā he, nā hoʻololi genetic i loaʻa iā ʻoe
Inā makemake ʻoe e ʻike hou aʻe e pili ana i kāu wānana ponoʻī, e ʻoluʻolu e kamaʻilio me kāu kauka haematologist - hiki iā lākou ke wehewehe i kāu mau kumu pilikia a me ka wānana iā ʻoe.
Ola - Noho me a ma hope o PMBCL
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 PMBCL.
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.
Nā pahuhopu ma hope o ka mālama ʻana
ʻO nā pahuhopu nui ma hope o ka mālama ʻana i kāu PMBCL 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
Hoʻoponopono i ka maʻi maʻi maʻi
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.
Nā kumuwaiwai ʻē aʻe iā ʻoe
hōʻuluʻulu manaʻo
- ʻO ka Primary Mediastinal B-cell Lymphoma (PMBCL) kahi subtype o Diffuse Large B-cell Lymphoma (DLBCL) - kahi ʻano o Non-Hodgkin Lymphoma.
- Ua kapa ʻia ʻo PMBCL no ka mea hoʻomaka kēia lymphoma i kāu mediastinum – i loko o kou umauma.
- Nui nā hōʻailona e pili ana i ka ulu ʻana o ka maʻi koko i loko o kou umauma e hoʻokau ana i ke kaomi ʻana i kou mau ala ea, nā māmā a i ʻole nā mea ʻē aʻe i loko o kou umauma.
- B-hōʻailona he pūʻulu o nā hōʻailona hiki ke loaʻa ke loaʻa iā ʻoe ka PMBCL. Pono ʻoe e hōʻike iā ʻoe i ke kauka inā loaʻa iā ʻoe kēia mau mea.
- He lymphoma koʻikoʻi ka PMBCL no laila pono ʻoe e hoʻomaka i ka lapaʻau ma hope koke o ka hōʻoia ʻana akā, hiki ke hoʻōla ʻia ka pae kiʻekiʻe 3 a i ʻole 4 PMBCL.
- Hiki i ka PMBCL ke hoʻi hou, no laila pono ʻoe i ka mālama ʻana ma mua o hoʻokahi manawa.
- Loaʻa kā mākou mau kahu hānai Lymphoma e kamaʻilio e pili ana i kāu maʻi maʻi, lapaʻau a me nā kumuwaiwai i loaʻa iā ʻoe. Kaomi ma ka pihi Hoʻokaʻaʻike iā mākou ma lalo o ka pale no nā kikoʻī.
