Ka Manaʻo o ka Enteropathy-Associated T-cell Lymphoma (EATL)
ʻO Enteropathy-Associated T-cell Lymphoma (EATL) he ʻano kakaʻikahi loa ia o Peripheral T-cell Non-Hodgkin Lymphoma e hana ʻia ke lilo nā lymphocytes T-cell i loko o kou ʻōpū i ke kanesa.
ʻO ka huaʻōlelo "Enteropathy" ʻo ia hoʻi ka maʻi o ka ʻōpū (a i ʻole ka ʻōpū).
ʻOiai e hoʻomaka ana ʻo EATL i nā lymphocytes T-cell i loko o kou ʻōpū liʻiliʻi, hiki ke laha i nā wahi ʻē aʻe o kou kino e like me kou iwi iwi, akemāmā, ake, umauma, ʻili a i ʻole kakaʻikaʻi ʻole i kāu ʻōnaehana nerve waena (CNS) me kou lolo. a me ke kuamoʻo.
He lymphoma koʻikoʻi ʻo EATL, ʻo ia hoʻi ka ulu wikiwiki ʻana, a hiki ke hoʻomaka nā hōʻailona ma kahi manawa pōkole.
E pili ana i nā lymphocytes T-cell
ʻO nā lymphocytes T-cell he mau keʻokeʻo keʻokeʻo kūikawā e kākoʻo ana i kā mākou ʻōnaehana pale ma ke kaua ʻana i nā maʻi a me nā maʻi.
ʻAʻole e like me nā ʻāpana koko ʻē aʻe, ʻaʻole noho maʻamau nā lymphocytes T-cell i loko o ko mākou koko, akā aia i loko o kā mākou lymphatic system. Eia nō naʻe, no ka mea, ʻo kā lākou hana ka hakakā ʻana i ka maʻi a me ka maʻi, hiki iā lākou ke hele i kēlā me kēia wahi o ko mākou kino e like me ko mākou koko, ʻili, ʻōpū, ʻōpū a me ka lolo.
Loaʻa kekahi mau hōʻiliʻili o nā lymphocytes T-cell i loko o kā mākou ʻōpū ʻōpū e komo pū ana me ko mākou waha, ʻōpū a me nā ʻōpū. Hoʻomaka ka EATL i ka wā e lilo ai nā lymphocytes T-cell i loko o kou ʻōpū i ke kanesa.
ʻO wai ka mea e loaʻa iā EATL
Aia nā ʻano like ʻole o nā lymphomas intestinal a me EATL ʻoiai ʻaʻole kakaikahi ka nui, ʻo ia ka lymphoma T-cell maʻamau.
ʻO ka EATL ka mea maʻamau i ka poʻe i loaʻa i ka maʻi celiac, kahi maʻi o kou ʻōpū kahi i loaʻa iā ʻoe ka intolerance i ka gluten. ʻO Gluten kahi protein i loaʻa i ka hapa nui o ka palaoa, ka palaoa a me ka oats. Ua kapa ʻia ka poʻe me ka hoʻololi genetic HLA-DQ2 homozygosity ʻoi aku ka maʻi i ka maʻi celiac, no laila, ʻo kēia hoʻololi ʻana he kumu pilikia no ka hoʻomohala ʻana i ka EATL.
Inā loaʻa iā ʻoe ka ulcerative jejunitis ma ke ʻano he hoʻopiʻi o kāu maʻi celiac, ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka EATL.
Loaʻa i ka poʻe me ka lymphoma T-cell intestinal ka hoʻololi ʻana ma ke ala JAK-STAT. ʻO kēia alahele kahi pilina ma waena o nā protein i loko o ke kelepona e hāʻawi i ka ʻike e pili ana i ka hana a me ka ulu ʻana o nā cell, a me ka wā e luku ʻia ai. Manaʻo ʻia ka hoʻololi ʻana i ke ala JAK-STAT e hoʻoikaika i ka ulu ʻana o nā pūnaewele lymphoma maʻi kanesa.
ʻO ka hapa nui o ka poʻe i ʻike ʻia me ka EATL ʻoi aku ma mua o 60 mau makahiki, akā hiki ke hoʻopilikia i ka poʻe ʻōpio. ʻOi aku ka maʻamau i nā kāne ma mua o nā wahine.
Nā hōʻailona o Enteropathy-Associated T-cell Lymphoma (EATL)
ʻO kekahi mau hōʻailona o ka lymphoma ka mea maʻamau i nā kānaka āpau me kēlā me kēia ʻano lymphoma, a pili kekahi i ke ʻano a me kahi o lymphoma āu i loaʻa ai. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei e ʻike i kāu kauka no ka nānā ʻana.
Nā hōʻailona o EATL
- ʻeha ʻōpū a ʻeha paha (ʻeha ʻōpū)
- diarrhea
- ke koko ʻokoʻa ke hele ʻoe i ka lua
- he ālai i loko o kou ʻōpū e hiki ai ke hōʻeha i ka ʻeha, ka pehu, ka pilikia me ka hele ʻana o ka makani a/a i ʻole ka po, kahe koko, nausea a me ka luaʻi.
- poho o ka 'ai a me/a poho kaumaha
- ʻili ʻili me ka ʻili ʻili a i ʻole nā ʻōpala i hāpai ʻia.
- Nā hōʻailona B (e nānā i ke kiʻi).
Nā hōʻailona maʻamau o ka lymphoma
- luhi
- ʻO nā pūnaʻi lymph pehu (he puʻupuʻu e piʻi aʻe ma lalo o kou ʻili, maʻamau ma kou ʻāʻī, ʻāʻī a i ʻole ka ʻāʻī)
- he mea hoʻonui ʻia a i ʻole he ate
- ʻoi aku ke koko a me ka ʻeha ma mua o ka maʻamau
- nā maʻi hele ʻole a hoʻi hou mai.
Pehea e ʻike ʻia ai ʻo Enteropathy-Associated T-cell Lymphoma
No ka mea he ʻano lymphoma koʻikoʻi ʻo EATL, loaʻa paha iā ʻoe nā hōʻailona ma lalo o 3 mahina ma mua o ka loaʻa ʻana o ka maʻi maʻi, akā no kekahi poʻe hiki ke lōʻihi. He mea nui ke kūkākūkā ākea me kāu kauka i hiki iā lākou ke hoʻolālā i nā hoʻokolohua kūpono no ʻoe.
E hoʻomaka ana kāu kauka me kekahi mau hoʻāʻo koko a me kahi laʻana stool (kahi laʻana o kāu poo), e hoʻoholo i nā kumu ʻē aʻe e like me ka maʻi a i ʻole nā allergies. Eia naʻe, inā manaʻo lākou he maʻi maʻi ʻoe e like me ka lymphoma i loko o kou ʻōpū, pono ʻoe i kahi biopsy o ka ʻāpana i hoʻopilikia ʻia o kou ʻōpū.
Pono paha kēia e hana i ka wā o ke kaʻina hana kahi i wehe ʻia ai kahi ʻāpana o kou ʻōpū a hoʻouna ʻia i ka pathology e hoʻāʻo ʻia no nā hōʻailona o ka lymphoma. Kapa ʻia kēia he ʻoki ʻōpū.
Nā hoʻololi i kāu hoʻāʻo koko
Inā loaʻa iā ʻoe ka EATL, hiki i kekahi mau hoʻololi i kāu hoʻāʻo koko ke komo:
- kiʻekiʻe kiʻekiʻe lactate dehydrogenase (LDH).
- haʻahaʻa calcium
- haʻahaʻa albumin
- nā koko ʻulaʻula haʻahaʻa a i ʻole hemoglobin (anemia).
Aia nā kumu ʻē aʻe e hiki ai ke hoʻololi like i kāu mau hoʻāʻo koko, no laila he mea nui e kamaʻilio me kāu kauka e pili ana i kāu mau hopena āpau.
Nānā a me nā ho'āʻo
Nui nā hoʻokolohua like ʻole a me ka nānā ʻana i hiki i kāu kauka ke ʻōlelo aku iā ʻoe e kōkua i ka hoʻomaʻamaʻa ʻana, a i ʻole ke kau ʻana i kāu EATL.
- Hoʻoponopono
- Biopsy iwi ʻōiwi
- Ka pākuʻina o ka tomography (CT)
- Hoʻomaka ka hoʻoliʻi résonance magneto (MRI)
- ʻO ka nānā ʻana o Positron Emission Tomography (PET).
- Nā hoʻāʻo ma kou puʻuwai, ate a me nā puʻupaʻa (e hōʻoia i ka ikaika o lākou e hoʻokō ai i ka lāʻau i koho ʻia)
- ʻO Biopsy
Lapaʻau no EATL
Ma mua o ka hoʻomaka ʻana o ka mālama ʻana, pono ʻoe e lawa pono e ʻae i nā lāʻau ʻawaʻawa. Hiki i kēia ke paʻakikī i ka hoʻomaka ʻana, ʻoiai ʻo ka hapa nui o ka poʻe me EATL ʻaʻole maikaʻi i ka wā i ʻike mua ʻia ai. Akā, na kāu kauka e hana pū me ʻoe, a e mālama pono iā ʻoe i mea e hiki ai i kou kino ke ʻae i ka mālama ʻana.
ʻO ka lāʻau lapaʻau mua
ʻO ka manawa mua ʻoe e hoʻomaka ai i ka mālama ʻana ua kapa ʻia ka lāʻau lapaʻau mua. ʻO Chemotherapy ke ʻano lapaʻau maʻamau āu e loaʻa ai, a hahai pinepine ʻia e kahi ka hoʻololi ʻana i ke ʻano o ke kino.
ʻO nā protocols chemotherapy maʻamau e hāʻawi ʻia iā ʻoe:
- IVE-MTX - ka hui pū ʻana o nā lāʻau lapaʻau chemotherapy i kapa ʻia ʻo ifosphamide, vincristine, etoposide, methotrexate i ukali ʻia e kahi autologous stem cell transplant.
- kua - ka hui pū ʻana o nā lāʻau lapaʻau chemotherapy 3 i kapa ʻia ʻo cyclophosphamide, doxorubicin a me vincristine, a me kahi steroid i kapa ʻia prednisolone.
- CHEOP - e like me ka lāʻau lapaʻau e like me CHOP me kahi chemotherapy hou i kapa ʻia ʻo etoposide.
Lapaʻau laina lua
Inā loaʻa iā ʻoe kahi lymphoma refractory, a ua hoʻi hou ʻoe, pono ʻoe i ka lāʻau lapaʻau lua.
ʻO Lymphoma hoʻopaʻapaʻa
Hoʻopau ʻia ke kala ʻana a me ka hapa
ʻO ke kala ʻana i ka hapa ʻo ia ka lymphoma i loko o kou kino, akā ʻaʻole ia ma mua o ka hapalua o kāu mea ma mua o ka hoʻomaka ʻana i ka mālama ʻana.
Hoʻoholo
Lapaʻau no ka Refractory a i ʻole Relapsed EATL
Nui nā ʻano lāʻau lapaʻau e makemake paha kāu kauka e hoʻāʻo inā loaʻa iā ʻoe ka refractory a i ʻole ka hoʻihoʻi ʻana i ka EATL.
ʻO kekahi o nā lāʻau lapaʻau penei:
- ʻO ka chemotherapy maʻi kiʻekiʻe ma hope o ka hoʻololi ʻana i ke ʻano o ke kino me ka hoʻohana ʻana i kāu mau pūnaewele ponoʻī - a ka hoʻololi ʻana i ke ʻano o ke kino
- ʻO ka lāʻau lapaʻau kiʻekiʻe me ka hoʻohana ʻana i nā pūnaewele kumu o ka mea hāʻawi (kekahi mea ʻē aʻe) - a ka hoʻololi ʻana i ke ʻano o ke ʻano o ke ʻano allogeneic
- Nā ʻano like ʻole o ka chemotherapy
- Romidepsin
- ʻO Brentuximab vedotin
- ʻO Pralatrexate
- ʻO ke kelepona
- Hoʻokolokolo hoʻokolohua
Nā ho'āʻo hoʻokolohua
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. He mea nui nā hoʻokolohua lapaʻau no ka loaʻa ʻana o nā lāʻau lapaʻau hou, a i ʻole nā hui pū ʻana o nā lāʻau lapaʻau e hoʻomaikaʻi ai i ka mālama ʻana iā EATL i ka wā e hiki mai ana.
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 hiki ʻole ke loaʻa ma waho o ka hoʻokolokolo. Inā makemake ʻoe e komo i kahi hoʻokolohua lapaʻau, e nīnau i kāu kauka i nā hoʻokolohua lapaʻau āu e kūpono ai.
Nui nā lāʻau lapaʻau a me nā hui hoʻoponopono hou e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a puni ka honua no nā poʻe maʻi me ka EATL hou i ʻike hou ʻia.
Nā hopena ʻaoʻao maʻamau o ka mālama ʻana
ʻO nā hopena ʻaoʻao o ka lāʻau e pili ana i ke ʻano o ka lapaʻau āu e loaʻa nei. Hiki i kāu kauka haematologist a i ʻole kahu maʻi maʻi lapaʻau kūikawā ke kamaʻilio me ʻoe e pili ana i nā mea e manaʻo ʻia mai kāu mālama ʻana a pehea e hoʻopau ai i kāu mau hōʻailona, eia naʻe kekahi o nā hopena ʻaoʻao maʻamau:
Pau ka lauoho, me ka lauoho ma kou poo a me ka lauoho a pau ma kou kino.
Nā hoʻololi i kou ʻōpū, e pili ana i ka ma'i pa'i a i 'ole ka constipation.
ʻO ka maʻiʻeha, ʻeha a hoʻololi paha i ke ʻano o ka ʻono.
'Oloke, ʻo ia ka luhi nui ʻaʻole i hoʻomaikaʻi ʻia me ka hoʻomaha a me ka hiamoe.
ʻO nā helu koko haʻahaʻa me haʻahaʻa hemoglobin, platelet haʻahaʻa a nā keʻokeʻo haʻahaʻa.
Hoʻololi i ka manaʻo e pili ana i ka helu ʻana, nā pine a me nā nila, ke kani ʻana, ka ʻeha (peripheral neuropathy)
He aha kāu e manaʻo ai ke pau ka mālama ʻana
Ke hoʻopau ʻoe i kāu mālama ʻana, makemake mau kāu kauka hematologist e ʻike mau iā ʻoe. E loaʻa iā ʻoe nā mākaʻikaʻi maʻamau me nā hoʻāʻo koko a me nā scans. ʻEhia ka manawa e loaʻa ai kēia mau hoʻāʻo ʻana ma muli o kou kūlana pilikino a hiki i kāu kauka hematologist ke haʻi iā ʻoe i ka nui o ko lākou makemake e ʻike iā ʻoe.
He manawa hoʻohauʻoli a pilikia paha ke hoʻopau ʻoe i ka mālama ʻana - i kekahi manawa ʻelua. ʻAʻohe ala kūpono a hewa ʻole. Akā, he mea nui e kamaʻilio e pili ana i kou mau manaʻo a me kāu mea e pono ai me kāu poʻe aloha.
Loaʻa ke kākoʻo inā pilikia ʻoe i ka hoʻopau ʻana i ka lāʻau lapaʻau. E kamaʻilio me kāu hui lapaʻau - kāu kauka haematologist a i ʻole kahu maʻi maʻi maʻi kūikawā no ka mea hiki iā lākou ke kuhikuhi iā ʻoe no nā lawelawe aʻoaʻo i loko o ka haukapila. Hiki i kāu kauka kūloko (ke kauka lapaʻau - GP) ke kōkua pū me kēia.
Nā kahu hānai Lymphoma
Hiki iā ʻoe ke hāʻawi i kekahi o kā mākou Lymphoma Care Nurses a i ʻole leka uila. E kaomi wale i ka pihi "Contact Us" ma lalo o ka pale no nā kikoʻī pili.
hōʻuluʻulu manaʻo
- ʻO ka EATL kahi maʻi maʻi maʻi kakaʻikahi a paʻakikī o kāu mau keʻokeʻo keʻokeʻo i kapa ʻia ʻo T-cell lymphocytes.
- Hoʻomaka ka EATL ma kou ʻōpū liʻiliʻi, akā hiki ke laha i nā wahi ʻē aʻe o kou kino.
- Ōuli Hiki i ka EATL ke komo i ka ʻeha a i ʻole ka ʻūhā i loko o kou ʻōpū, ka maʻi ʻaʻai a i ʻole ka paʻakikī o ka hele ʻana i ka makani a i ʻole ka pehu, ke koko i ka wā e hele ai ʻoe i ka lua, nalowale ka ʻai a me ke kaumaha. B-hōʻailona.
- Pono ʻoe i nā ʻano ʻano like ʻole nā hoʻāʻo a me nā scans e ʻike a hoʻopaʻa i ka EATL, me ka ʻoki ʻana i ka ʻōpū.
- lapaʻau e hoʻokomo pinepine i ka chemotherapy a me ka hiki waihoʻoluʻu helehelena molaki.
- Pono paha ʻoe ma mua o hoʻokahi ʻano lapaʻau.
- ʻAʻole ʻoe wale nō, e kamaʻilio me kāu hui lapaʻau inā makemake ʻoe i ke kākoʻo hou aku, a i ʻole e kelepona i kā mākou Lymphoma Care Nurses.
