Ka nānā ʻana o ka enteropathy type intestinal T-cell lymphoma
ʻO Enteropathy type T-cell lymphoma he ʻano kakaikahi o ka lymphoma T-cell non-Hodgkin (NHL). He ʻano subtype o PTCL. Ulu ia i loko o ka ʻōpū liʻiliʻi. Hoʻoulu ia mai nā keʻokeʻo keʻokeʻo i kapa ʻia ʻo T-cells (lymphocytes).
ʻO nā ʻano enteropathy type intestinal T-cell lymphoma
ʻElua ʻano o ka lymphoma T-cell intestinal. ʻIke ʻia lākou e nā hiʻohiʻona a lākou e hōʻike ai. Kapa ʻia lākou:
- lymphoma T-cell pili i ka enteropathy (EATL): Aia kēia subtype ma kahi o 80% o nā hihia āpau o ka lymphoma T-cell intestinal. 'Enteropathy' 'o ia ho'i 'he ma'i o ka 'ōpū'. Ua kapa ʻia ʻo 'EATL type 1'.
- Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL): Aia kēia subtype ma kahi o 20% o nā hihia āpau o ka lymphoma T-cell intestinal. Kapa ʻia ʻo MEITL no ka mea, ʻano like nā ʻano T-cell ma lalo o ka microscope (he 'monomorphic' lākou). Ulu ia i loko o ke kapa o kou ʻōpū (kou 'epithelium').
ʻO wai ka mea i hoʻopili ʻia?
ʻO ka enteropathy type intestinal T-cell lymphomas maʻamau e pili i ka poʻe ʻelemakule, ma luna o 60 mau makahiki. ʻO ke ʻano hoʻokahi (ʻike ʻia ʻo EATL) i pili ikaika i ka poʻe me ka maʻi ʻōpū ʻole i mālama ʻole ʻia, i kapa ʻia ka maʻi celiac. He mea nui e ʻike i ka hapa nui o ka poʻe i loaʻa i ka maʻi celiac ʻAʻole lākou e hoʻomohala i ka lymphoma T-cell intestinal type enteropathy.
Nā hōʻailona o ka enteropathy type intestinal T-cell lymphoma
ʻO nā hōʻailona maʻamau e pili ana i ka ʻōpū a i ʻole ka ʻōpū a hiki ke komo:
- ʻO kaʻehaʻeha
- Weight lilo
- ʻO ka maʻi maʻi, hiki ke loaʻa ke koko
- 'Oloke
- ʻO kahi maʻi ʻino
Hiki i nā hōʻailona B ke komo pū kekahi:
- Weight lilo
- Hoʻohuʻu i ka hou o ka pō
- kuni
I kekahi manawa, hiki mai ka ʻōpū ʻā (poha). Hiki ke ʻike ʻia ka pōʻino (ʻaʻole lawa nā meaʻai) no ka mea ʻaʻole i komo pono ka meaʻai.
ʻO ka hōʻoia a me ke kau ʻana o ka lymphoma T-cell intestinal
A nā lāʻau kanu pono e ʻike i ka lymphoma T-cell intestinal type a hiki ke paʻakikī ke ʻike no ka mea ua like nā hōʻailona me nā kūlana ʻē aʻe, me ka maʻi celiac. He paʻakikī hoʻi ka ʻōpū ke ʻike ma nā scans.
ʻO ka endoscopy kahi hoʻāʻo diagnostic kahi i hoʻokomo ʻia ai kahi paipu lahilahi i loko o ka waha e nānā i ka ʻōpū o ka ʻōpū a hiki ke hana ʻia ka endoscopy e nānā i ka ʻōpū no nā mea ʻano ʻino. ʻOhi ʻia nā laʻana o ka ʻiʻo (he biopsy) mai ka ʻōpū o ka ʻōpū a i ʻole ka uhi o ka ʻōpū liʻiliʻi no ka hoʻāʻo ʻana.
Hiki ke loaʻa ka lymphoma T-cell intestinal ma nā wahi like ʻole o ka ʻōpū ʻaʻole e laha maʻamau i nā wahi ʻē aʻe o ke kino. Hoʻomaʻamaʻa pinepine ʻia i ka wā mua (pae 1 a i ʻole 2). Nui ka poʻe i ʻike ʻia me ka lymphoma T-cell intestinal e maʻi ʻole me ko lākou mau hōʻailona a pono e mālama ʻia.
ʻO ka wānana o ka lymphoma T-cell intestinal
He paʻakikī ka mālama ʻana i ka lymphoma T-cell intestinal no ka mea ua ʻike pinepine ʻia i ka wā ma hope a ua maʻi pinepine nā maʻi i ka manawa i ʻike ʻia ai. He mea kakaʻikahi loa ia, ʻoi aku ka paʻakikī o ka hana ʻana i nā hoʻokolohua lapaʻau no kēia hui maʻi. E hana pū ka poʻe Haematologists me ka gastroenterologist e hana i kahi hoʻolālā lapaʻau maikaʻi loa no ka mea maʻi akā he mea maʻamau no ka poʻe maʻi e hoʻi hou (hoʻi mai) ma hope o ka loaʻa ʻana o ka lāʻau lapaʻau mua.
Ka mālama ʻana i ka lymphoma T-cell ʻōpū
He paʻakikī ke mālama ʻia kēia lymphoma no ka mea maʻamau ka maʻi maʻi i ka maʻi maʻi. Pono ka poʻe maʻi ma lalo o ka mālama ʻana o ka haematologist a me ka gastroenterologist no ka mea e hana like lākou e hoʻolālā i ka lāʻau lapaʻau maikaʻi loa.
ʻO ka mea maʻamau ka lāʻau lapaʻau mua maʻamau Hiki i nā regimen ke komo:
- kua (cyclophosphamide, doxorubicin, vincristine a me prednisolone)
- CHEOP (CHOP me ka etoposide)
- ʻO Chemotherapy i ukali ʻia e ka autologous stem cell transplant
Nā hopena maʻamau o ka lāʻau lapaʻau
Nui nā hopena ʻaoʻao like ʻole o ka lāʻau lapaʻau a pili kēia i ka lāʻau i hāʻawi ʻia. Hiki i ke kauka lapaʻau a/a i ʻole kahu maʻi maʻi ke wehewehe i nā hopena ʻaoʻao kikoʻī ma mua o ka mālama ʻana. ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka lāʻau lapaʻau hiki ke komo:
- Anemia (lawe nā koko ʻulaʻula haʻahaʻa i ka oxygen a puni ke kino)
- ʻO Thrombocytopenia (nā platelets haʻahaʻa e kōkua i ke koko a me ka cotting)
- ʻO Neutropenia (ke koko keʻokeʻo haʻahaʻa e kōkua i ka pale ʻana)
- ʻO ka naʻi a me ka luaʻi
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a i ʻole ka diarrhea
- ʻO ka luhi (ka luhi a me ka nele o ka ikehu
Pono ka hui lapaʻau, kauka, kahu maʻi maʻi a i ʻole lāʻau lapaʻau, e hāʻawi i ka ʻike e pili ana i:
- He aha ka lāʻau e hāʻawi ʻia
- He aha nā hopena maʻamau a hiki ke loaʻa no ka mālama ʻana
- He aha nā hopena ʻaoʻao āu e pono ai e hōʻike i ka hui lapaʻau
- He aha nā helu hoʻokaʻaʻike, a ma hea e hele ai inā pilikia 7 lā o ka pule a me 24 mau hola i kēlā me kēia lā
Malama hahai
Ke hoʻopau ʻia ka mālama ʻana, hana ʻia nā scan staging post treatment e nānā i ka maikaʻi o ka hana ʻana. E hōʻike ana nā scans i ke kauka inā loaʻa kahi:
- Pane piha (CR a ʻaʻohe hōʻailona o ka lymphoma i koe) a i ʻole
- Pane hapa (PR a i ʻole he lymphoma i kēia manawa, akā ua hoʻemi ʻia ka nui)
Inā maikaʻi nā mea a pau, e hana ʻia nā koho maʻamau no kēlā me kēia 3-6 mahina e nānā i kēia mau mea:
- E nānā i ka pono o ka lāʻau lapaʻau
- E nānā i nā hopena ʻaoʻao mai ka lāʻau lapaʻau
- E nānā i nā hopena hope loa mai ka mālama ʻana i ka manawa
- E nānā i nā hōʻailona o ka hoʻi hou ʻana o ka lymphoma
He mea koʻikoʻi nō hoʻi kēia mau koho i hiki i ka mea maʻi ke hāpai i kekahi hopohopo e pono ai lākou e kūkākūkā me ka hui lapaʻau. ʻO kahi hoʻokolohua kino a me nā hoʻāʻo koko he mau hoʻokolohua maʻamau no kēia mau koho. Ma waho aʻe o ka manawa ma hope o ka mālama ʻana e nānā i ka hana ʻana o ka mālama ʻana, ʻaʻole i hana pinepine ʻia nā scans ke ʻole he kumu no lākou. No kekahi poʻe maʻi hiki ke emi pinepine i ka manawa.
Hoʻoponopono hou ʻia a i ʻole ka hoʻoponopono ʻana i ka lymphoma T-cell intestinal
No kekahi poʻe maʻi, ʻoi aku ka maikaʻi o ka lāʻau lapaʻau mua, a ʻaʻole hoʻi hou ka lymphoma ma hope o ka pau ʻana o ka mālama ʻana. Eia naʻe, no kekahi poʻe maʻi e hoʻi hou ka lymphoma (kau hou) a i ʻole i nā hihia koʻikoʻi ʻaʻole i pane i ka lāʻau lapaʻau mua (hale hōʻoluʻolu). Inā loaʻa kēia, aia nā lāʻau lapaʻau ʻē aʻe i hiki ke kūleʻa e like me kēia:
- ʻO ka lāʻau lapaʻau kiʻekiʻe a me ka hoʻololi ʻana i ke ʻano o nā pūnaewele kino
- ʻO ka lāʻau lapaʻau kiʻekiʻe a me ka hoʻololi ʻana o nā pūnaʻi kumu allogeneic.
- ʻO ka chemotherapy hui
- ʻO nā lāʻau olaola e like me ka romidepsin, brentuximab a i ʻole pralatrexate
- ʻO ke kelepona
- Ke komo ʻana i ka hoʻokolohua lapaʻau
Lapaʻau ma lalo o ka hoʻokolokolo ʻana
Nui nā lāʻau lapaʻau e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a puni ka honua a ma Australia no nā poʻe maʻi me ka lymphoma hou a i ʻike hou ʻia. ʻO kekahi o nā lāʻau lapaʻau i kēia manawa e noiʻi ʻia nei no ka lymphoma T-cell intestinal:
- ʻO nā hui lāʻau antibody (brentuximab vedotin)
- Nā mea pale hōʻailona kelepona (avelumab)
- ʻO nā mea hoʻopaneʻe Protesasome (bortezomib a i ʻole carfilzomib)
- HDAC inhibitors (vorinostat, romidepsin a i ʻole belinostat)
He aha ka hana ma hope o ka mālama ʻana?
Nā hopena hope
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 kaiaulu
ʻO ke olakino a me ke olakino
ʻO ke ola olakino, a i ʻole kekahi mau loli ola maikaʻi ma hope o ka mālama ʻana he mea kōkua nui ia ma hope o ka pau ʻana o ka mālama ʻana. ʻO ka hana ʻana i nā hoʻololi liʻiliʻi e like me ka ʻai ʻana a me ka hoʻonui ʻana i ke olakino hiki ke hoʻomaikaʻi i ke olakino a me ka maikaʻi a kōkua i ke kino e ola hou. He nui nā hoʻolālā mālama ponoʻī hiki ke kōkua i ka wā ho'ōla.
