No ka hoʻomaopopo ʻana i ka MCL 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.
- 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.
B-cell Lymphocytes a me MCL
Hoʻokumu ʻia ka MCL 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 MCL 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.
- Hoʻolaha ʻia (diffuse) ma mua o ka hui pū ʻana.
ʻOiai ʻo MCL ka lymphoma e ulu wikiwiki ana (aggressive), hiki ke ho'ōla 'ia kekahi po'e me MCL me ka lapaʻau ʻana, ʻoiai inā ʻike ʻia ʻoe me kahi pae kiʻekiʻe. 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 hōʻailona o Mantle Cell Lymphoma
Hiki ke ʻokoʻa nā hōʻailona o Mantle Cell Lymphoma i waena o nā kānaka. ʻO nā hōʻailona e loaʻa iā ʻoe e hilinaʻi ʻia inā loaʻa iā ʻoe kahi ʻano molowa a i ʻole ʻino o ka MCL, a ma hea ka MCL i loko o kou kino.
Ināʻoe he molowa MCL ʻO kāu hōʻailona wale nō paha ka nui o ka spleen. Eia nō naʻe, hiki ke ʻike pinepine ʻole ʻia kēia i ka ulu mālie ʻana i kahi manawa lōʻihi, no laila e ʻike ʻia inā loaʻa ʻoe i ka nānā ʻana a i ʻole ka nānā kino no kekahi mea ʻē aʻe.
Ināʻoe he hoʻopaʻapaʻa MCL hiki iā ʻoe ke ʻike i kahi puʻupuʻu e piʻi koke ma lalo o kou ʻili ma kou ʻāʻī, ʻāʻī a i ʻole ka ʻāʻī. He puʻu lymph pehu kēia e pehu ana i kona piha ʻana i nā pūnaeau lymphoma maʻi maʻi.
Nā ʻōuli o Lymphoma
- Hono i nā kikowaena lymph
- ʻO ke koko a i ʻole ka ʻeha ʻana i ʻoi aku ma mua o ka mea maʻamau - e komo pū ana i loko o kou poo
- ʻO ka manawa pōkole
- ʻAʻole i hoʻomaikaʻi ʻia ka luhi nui me ka hoʻomaha a me ka hiamoe
- ʻEha a nāwaliwali paha i nā ʻiʻo, iwi a me nā hono
- ʻAʻole hele a hoʻi hou mai
- Nalo ka ʻai (ʻaʻole makemake e ʻai)
- Ka hoʻemi kaumaha i manaʻo ʻole ʻia
- B-hōʻailona.
Moʻolelo hoʻomanawanui - E hui me Steve Towell i kāna kamaʻilio ʻana e pili ana i kona ʻike i ka noho ʻana me MCL
No ka mana piha o kā Steve kamaʻilio, Bus maʻaneʻi.
Ka ʻike ʻana i ka Lymphoma Cell Mantle
Hiki ke paʻakikī ka ʻike ʻana i ka MCL i kekahi manawa a hiki ke lawe i kekahi mau pule.
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 mea he nui nā ʻano subtypes o MCL, loaʻa paha iā ʻoe nā hoʻāʻo 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 MCL.
No ka ʻike ʻana i ka MCL 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 MCL.
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 puʻupuʻu lymph pehu a i ʻole ka ʻōpū e nānā i nā hōʻailona o MCL.
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.
Hoʻokumu MCL
Ke hōʻoia ʻia kāu hōʻoia ʻana o MCL, loaʻa iā ʻoe nā hoʻokolohua hou aʻe e ʻike ai i ka nui o nā wahi o kou kino i hoʻopilikia ʻia e ka lymphoma. Kapa ʻia kēia ʻano hoʻokūkū.
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 ʻekahi (I), pae ʻelua (II), pae ʻekolu (III) a i ʻole ka pae ʻehā (IV) MCL.
E pili ana kāu pae o MCL 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.
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 pūnaewele lymphoma – inā he molowa a ʻāʻī paha. ʻOi aku ka ikaika o kāu MCL, ʻoi aku ka ʻokoʻa o ka nānā ʻana i nā cell maʻamau.
ʻO nā papa he 1-4 (haʻahaʻa, waena, kiʻekiʻe). Inā loaʻa iā ʻoe kahi lymphoma kiʻekiʻe (ʻoi aku ka huhū), 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.
- 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.
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.
He mea nui e kamaʻilio me kāu kauka e pili ana i kāu mau mea pilikia ponoʻī i hiki iā ʻoe ke ʻike maopopo i ka mea e manaʻo ai mai kāu mau lapaʻau.
Hoʻohui me nā mea ʻē aʻe me MCL a i ʻole nā ʻano subtypes o lymphoma
Hiki ke kaumaha i ka ʻike ʻana iā ʻoe he MCL. Hiki ke kōkua i ka pilina ʻana me nā poʻe ʻē aʻe i hala, a i ʻole e hele nei i nā mea like.
Inā makemake ʻoe e launa pū me nā poʻe ʻē aʻe e noho pū ana me MCL a i ʻole nā subtypes ʻē aʻe o ka lymphoma hiki iā ʻoe ke hui pū i kā mākou hui Facebook paʻa ma ke kaomi ʻana i nā loulou ma lalo nei.
Nā kahu hānai Lymphoma
Hiki iā ʻoe ke hoʻokaʻaʻike i kā mākou Lymphoma Care Nurses. Loaʻa iā lākou e kōkua me ka ʻōlelo aʻo, e hāʻawi i nā lawelawe ʻike i loaʻa a loaʻa ka ʻike hou e pili ana i ka MCL a me kāna mau lapaʻau. E kelepona iā lākou ma ke kaomi ʻana i ka pihi "Contact Us" ma lalo o ka pale
Nā kumu o ka Mantle Cell Lymphoma & Cytogenetic Tests
ʻO ka hapa nui o ka poʻe me Mantle Cell Lymphoma, loaʻa kahi hoʻololi genetic i kapa ʻia he translocation, e pili ana i nā chromosomes 11 a me 14. ʻO kēia hoʻololi ʻana ke kumu o kāu mau pūnaʻi B e hana nui i kahi protein i kapa ʻia ʻo 'cyclin D1'.
ʻO Cyclin D1 ka protein e hoʻoikaika i ka ulu ola kino. Inā ʻoi aku ka nui o ia mea, hoʻopilikia ia i ke koena a hoʻoulu i ka nui o nā lymphocytes B-cell i hana ʻia i loko o ka ʻāpana ʻaʻahu o kāu. lymph aka wahi. Ma muli o ka hana ʻia ʻana o nā cell i ka nui ma mua o ka maʻamau, ʻaʻole lākou e ulu pono a lilo i ka maʻi kanesa.
Ua wehewehe ʻo Cytogenetics
Hana ʻia nā hoʻokolohua cytogenetic e nānā i nā ʻano like ʻole e pili ana i kāu maʻi.
Loaʻa iā mākou he 23 mau chromosomes, a ua helu ʻia lākou e like me ko lākou nui. Inā loaʻa iā ʻoe ka MCL, 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.
Unuhi
ʻO ka hoʻololi cytogenetic maʻamau i ka MCL ke hoʻololi i kahi wahi liʻiliʻi o ʻelua o kāu mau chromosomes. Hoʻopili maʻamau kēia i nā chromosomes 11 a me 14. Ua helu ʻia kēlā me kēia ʻāpana o nā chromosomes, a he ʻāpana ia o ka ʻaoʻao lalo o kēia mau chromosomes (i hōʻike ʻia me ka aq) i hoʻololi ʻia.
Ma ka chromosome 11, ʻo ia ka ʻāpana helu 13, e hoʻololi me ka pauku 32 ma ka chromosome 14. Ke hana ʻia kēia, kapa ʻia ia he unuhi. Ua kakau pinepine ia e like me t(11:14)(13q:32q).
moʻolelo holoi
I kekahi manawa nalo paha kekahi hapa o ka chromosome. Ke hiki mai keia, ua kapaia he kāpae. Inā nalo ka hapa luna o kāu chromosome 17, e kākau ʻia ʻo ia ma ke ʻano del(17p).
He mea nui e ʻike i ke ʻano o nā hoʻololi cytogenetic i loaʻa iā ʻoe ma mua o kou hoʻomaka ʻana i ka mālama ʻana, no ka mea, pono nā loli like ʻole i nā ʻano lapaʻau like ʻole.
Nā lāʻau lapaʻau no MCL
ʻAʻohe mea nui i kūpono i nā ala āpau e mālama ai i ka poʻe me MCL. E noʻonoʻo kāu kauka i nā mea he nui ma mua o ka hoʻomaka ʻana i kahi hoʻolālā lapaʻau e ʻōlelo aku iā ʻoe.
He mea nui e hoʻomanaʻo i kāu koho ʻana i ka mālama ʻana a aia iā ʻoe ke kuleana e nīnau i nā nīnau he nui āu e pono ai e hōʻoluʻolu i kāu hoʻoholo. Ke ʻae kāu kauka a me kāu kauka i kahi hoʻolālā lapaʻau, pono ʻoe e kau inoa i kahi palapala ʻae ma mua o ka loaʻa ʻana o ka lāʻau lapaʻau. He ala kūhelu kēia e ʻōlelo ai ua maopopo ʻoe i nā pilikia a me nā pōmaikaʻi o ka lāʻau lapaʻau a makemake ʻoe e loaʻa.
ʻO kekahi mau mea a kāu kauka e noʻonoʻo ai, i ka wā e hoʻomohala ai i kahi hoʻolālā lapaʻau no ʻoe:
- ʻO ke kahua o kāu MCL a inā he moloā a ʻino paha
- ʻO nā hōʻailona āu e loaʻa nei a pehea e hopena ai i kou kino a me ka maikaʻi o ke ola
- ʻEhia kou mau makahiki
- ʻO kou ola kino a noʻonoʻo i kēia manawa, me nā maʻi ʻē aʻe a i ʻole nā maʻi āu e mālama ʻia nei
- ʻO kāu mau makemake ke loaʻa iā ʻoe ka ʻike āpau e hana i kahi koho ʻike.
ʻO ka lāʻau lapaʻau mua
ʻO ka manawa mua ʻoe e hoʻomaka ai i ka mālama ʻana no MCL ua kapa ʻia ʻo ia ka lāʻau lapaʻau mua. ʻO nā kuʻuna lapaʻau laina mua maʻamau no MCL me:
- R-CHOP
- R-DHAP
- R-maxi-CHOP
- Hyper-CVAD
- ʻO ka chemotherapy kiʻekiʻe i ukali ʻia e kahi ka hoʻololi ʻana i ke ʻano o ke kino
- ʻO Bendamustine a me Rituximab
A i ʻole, hiki iā ʻoe ke komo i kahi hoʻokolohua lapaʻau inā loaʻa kahi mea āu e ʻae ai. Inā makemake ʻoe e komo i kahi hoʻokolohua lapaʻau, e nīnau iā ʻoe i ke kauka inā loaʻa kekahi.
Inā ʻike ʻoe i ka inoa o ka lapaʻau e loaʻa iā ʻoe, e kaomi i ka loulou ma lalo no ka ʻike hou aku e pili ana i kēlā protocol.
Ka wānana no MCL
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. Hiki i ka MCL ke pane maikaʻi i ka lāʻau lapaʻau, akā ʻaʻole ia he mea maʻamau no ka hoʻi hou ʻana a pono e mālama hou.
Nā mea hiki ke hoʻopili i ka wānana
ʻO kekahi mau mea e pili ana i kāu prognosis penei:
- ʻO ʻoe nā makahiki a me ke olakino holoʻokoʻa i ka manawa o ka maʻi maʻi.
- Pehea ʻoe e pane ai i ka lāʻau lapaʻau.
- He aha inā inā loaʻa iā ʻoe nā genetic mutations.
- ʻO ka subtype o Hodgkin Lymphoma iā ʻoe.
Inā makemake ʻoe e ʻike hou aku e pili ana i kāu wānana ponoʻī, e ʻoluʻolu e kamaʻilio me kāu kauka haematologist a i ʻole oncologist. Hiki iā lākou ke wehewehe i kāu mau pilikia a me ka wānana iā ʻoe.
MCL i hoʻihoʻi hou ʻia a me Refractory
Hiki i ka hapa nui o ka poʻe me MCL ke pane maikaʻi i kā lākou lāʻau lapaʻau mua, a hele i ke kala ʻana. ʻO ke kala ʻana ka wā ʻaʻohe hōʻailona o MCL i koe i loko o kou kino, hiki ke ʻike ʻia ma nā scans a i ʻole nā hoʻokolohua ʻē aʻe. Eia naʻe, he mea maʻamau ka MCL e hoʻi hou - a hoʻi mai. No kekahi, he mau mahina kēia ma hope o ka pau ʻana o ka mālama ʻana, akā no ka hapa nui, ʻelua a ʻoi aku paha ia mau makahiki.
No kekahi poʻe, ʻaʻole ʻoi aku ka maikaʻi o ka MCL, a i ʻole e ʻoi aku ka ʻino inā ʻoe e mālama ana. Inā ʻaʻole ʻoi aku ka maikaʻi o ka maʻi lymphoma me ka mālama ʻana, kapa ʻia ia he refractory.
Ke hoʻi hou ʻoe a hoʻopaʻa ʻole paha i ka MCL e ʻōlelo paha kāu kauka iā ʻoe e komo i kahi hoʻokolohua lapaʻau a hoʻomaka paha i kahi lapaʻau hou e ʻoi aku ka maikaʻi no ʻoe.
Lapaʻau no ka MCL hoʻihoʻi a i ʻole refractory
Aia nā ʻano lāʻau lapaʻau like ʻole e hana maikaʻi iā ʻoe. ʻO nā lāʻau lapaʻau maʻamau no ka relapsed, a i ʻole refractory MCL e komo pū me:
- Hoʻokolokolo hoʻokolohua
- ʻO ka lāʻau lapaʻau i hoʻopaʻa ʻia - BTK inhibitor hiki ke komo i ka ibrutinib (ImbruvicaTM), acalabrutinib (Calquence ™) a i ʻole zanubrutinib (Brukinsa™)
- Immunomodulators - lenalidomide (RevlimidTM)
- ʻO nā hui like ʻole o ka chemotherapy
- ʻO ka hoʻololi ʻana i ke ʻano o ke ʻano o ke ʻano allogeneic
- CAR T-cell therapy - ʻae ʻia akā ʻaʻole i loaʻa kālā i ka lehulehu
Ola, Noho me a ma hope o MCL
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 noho maikaʻi me MCL.
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 MCL 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.
ʻO nā moʻolelo hoʻomanawanui hou aku
hōʻuluʻulu manaʻo
- ʻO Mantle Cell Lymphoma (MCL) kahi ʻano subtype o Non-Hodgkin Lymphoma e hana ʻia i ka wā e lilo ai kāu lymphocytes B-cell ma ka ʻaoʻao o waho o kāu mau lymph nodes - ka ʻāpana mantle, i maʻi kanesa.
- ʻO ka MCL ka mea maʻamau, akā hiki ke molowa.
- ʻAʻole pono ka lymphoma Indolent i ka mālama ʻana, akā pono ka MCL koʻikoʻi e lapaʻau ma hope koke o kou ʻike ʻia ʻana.
- Nui nā ʻano lapaʻau like ʻole i loaʻa no MCL.
- ʻO ka hapa nui o nā lāʻau lapaʻau mua e loaʻa iā ʻoe ke kala ʻana, akā he mea maʻamau ka hoʻi hou ʻana o MCL. Pono ʻoe i nā lāʻau lapaʻau hou inā hoʻi hou kāu MCL.
- Inā ʻaʻole pono ka lāʻau lapaʻau mua, ua kapa ʻia kāu MCL he refractory. E hoʻomaka ʻia ʻoe ma kahi lapaʻau ʻē aʻe i ʻoi aku ka maikaʻi.
- Manaʻo ʻia nā hoʻokolohua lapaʻau no kēlā me kēia me ka MCL hoʻihoʻi a i ʻole refractory MCL.
- Loaʻa ke kākoʻo, ʻaʻole ʻoe hoʻokahi. Hiki iā ʻoe ke hoʻokaʻaʻike i kā mākou Lymphoma Care Nurses ma ke kaomi ʻana i ke pihi Hoʻokaʻaʻike iā mākou ma lalo o ka pale.
