Nānā nui o MEITL
Ua ʻike mua ʻia ʻo MEITL ʻo Enteropathy Type Intestinal T-cell Lymphoma Type 2. Eia naʻe, ua hoʻoponopono hou ʻia e ka World Health Organization (WHO) i ko mākou aʻo hou ʻana e pili ana i ia. Ua hele mai ka hoʻololi o ka hoʻohālikelike ʻana i ka makahiki 2017 a no ka mea ʻike mākou i kēia manawa, ʻaʻole like me Enteropathy Type Intestinal T-cell Lymphoma Type 1 (i kēia manawa ʻo EATL), ʻaʻole pili ʻo MEITL me nā maʻi ʻōpū o mua e like me ka maʻi celiac.
He aha ka MEITL?
He mea kakaʻikahi loa ka MEITL, a he ʻano maʻi ʻino o ke koko keʻokeʻo i kapa ʻia ʻo T-cell lymphocytes. ʻO nā pūnae T i loko o ke kapa o kāu ʻōpū (bowel) a me nā ʻāpana o kou ʻōpū ʻōpū i kapa ʻia epithelial T-cell. ʻO kēia kahi i kapa ʻia ai ka inoa Monomorphic Epitheliotropic Intestinal T-cell Lymphoma mai.
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 MEITL 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 MEITL
ʻAʻole kakaikahi nā Lymphomas T-cell intestinal, a ʻo MEITL kekahi o nā mea liʻiliʻi. He mea maʻamau ia i nā poʻe me ka ʻAsia a me ka Hispanic.
Cytogenetics a me MEITL
Hiki i nā poʻe me kekahi mau hoʻololi genetic ke piʻi nui aʻe i ka hoʻomohala ʻana i ka MEITL.
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 MEITL, 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.
ʻO nā loli cytogenetic maʻamau i ka poʻe me MEITL
Nui nā loli cytogenetic like ʻole e hiki ke hana i nā poʻe me lymphoma. ʻO kekahi o nā mea maʻamau i ʻike ʻia i ka poʻe me MEITL e pili ana i ka hoʻololi ʻana i nā genes suppressor tumor.
ʻO nā genes suppressor tumor he mau genes ia e aʻo ai i ka ʻōnaehana pale e ʻike a luku i nā cell cancerous. Eia nō naʻe, ke loaʻa ka hoʻololi ʻana i ka gene suppressor tumor, ʻaʻole i loaʻa i kāu ʻōnaehana pale i nā ʻōlelo kuhikuhi kūpono, a no laila ma kahi o ka ʻike ʻana a me ka luku ʻana i ka lymphoma, e hoʻomau ka maʻi kanesa e ulu a hoʻonui.
Hiki paha kēia inā loaʻa iā ʻoe ka hoʻololi ʻana i kahi gene i kapa ʻia ʻo SETD2 a i ʻole he hapa o kāu chromosomes (3p21) e nalowale ana.
ʻO nā hoʻololi ʻē aʻe i hiki ke hopena i ka ulu ʻana o MEITL he hoʻololi i ke ala JAK-STAT. ʻO kēia alahele he ʻuena kamaʻilio ma waena o kekahi o kāu mau protein e hāʻawi pū i ka ʻike i kāu ʻōnaehana pale i ka pehea e hoʻoponopono ai i kāu mau cell a luku i nā mea maʻi maʻi. Ke hoʻololi ʻia ke ʻano o ke kamaʻilio ʻana o kēia mau protein kekahi i kekahi, hiki i ka MEITL ke ulu.
Nā hōʻailona o MEITL
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 MEITL
- 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 ka MEITL?
No ka mea he ʻano lymphoma koʻikoʻi ʻo MEITL, e loaʻa paha iā ʻoe nā hōʻailona ma lalo o 3 mau mahina ma mua o ka loaʻa ʻana o ka maʻi. ʻOiai 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.
Nā hoʻololi i kāu hoʻāʻo koko
Inā loaʻa iā ʻoe MEITL kekahi mau hoʻololi i kāu mau hoʻāʻo koko e komo pū kekahi:
- kiʻekiʻe kiʻekiʻe lactate dehydrogenase (LDH).
- 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 maʻi maʻi, a i ʻole ke kau ʻana i kāu MEITL.
- Endoscopy (a i ʻole capsule endoscopy kahi e ale ai i kahi ʻano pahupaʻi liʻiliʻi o ka pahupaʻikiʻi e kiʻi i nā kiʻi o loko o kou ʻōpū a me kou ʻōpū)
- 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
Lapaau no MEITL
No ka mea kakaikahi ka MEITL, ʻaʻohe koho lapaʻau kūpaʻa. Eia nō naʻe, hoʻokumu ʻia nā lāʻau lapaʻau ma luna o nā lāʻau lapaʻau i ʻoi aku ka maikaʻi o nā lymphoma T-cell ʻē aʻe, a i ʻole i nā poʻe me lymphoma i loaʻa nā ʻano hoʻololi like. Me nā hoʻokolohua lapaʻau hou aku, manaʻolana mākou e ʻike ʻia nā koho lapaʻau hou a maikaʻi hoʻi e hoʻohālikelike i ka mālama ʻana i nā poʻe me MEITL.
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 kekahi manawa ke hoʻomaka, ʻoiai ʻo ka hapa nui o ka poʻe me MEITL 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:
- 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 MEITL Refractory a i ʻole Relapsed
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 MEITL.
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 e hoʻomaikaʻi ai i ka mālama ʻana i ka MEITL 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 lāʻau hou e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a puni ka honua no nā poʻe maʻi me ka maʻi hou a me ka MEITL hou.
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 MEITL kahi maʻi maʻi maʻi ʻehaʻeha o kou mau keʻokeʻo keʻokeʻo i kapa ʻia ʻo T-cell lymphocytes.
- Hoʻomaka ka MEITL i loko o kou ʻōpū liʻiliʻi, akā hiki ke laha i nā wahi ʻē aʻe o kou kino.
- Ōuli Hiki i ka MEITL ke komo i ka ʻeha a i ʻole ka ʻūhā i loko o kou ʻōpū, ka ʻōpū 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 a me ka B-hōʻailona.
- Pono ʻoe i nā ʻano hoʻāʻo like ʻole a me nā scans no ka hoʻomaʻamaʻa ʻana a me ka pae MEITL.
- Hoʻokomo pinepine ʻia ka lāʻau lapaʻau i ka chemotherapy a me kahi transplant cell stem hiki ke hoʻololi.
- 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.
