Ka Manaʻo no ka Natural Killer T-cell Lymphoma (NKTL)
ʻO Natural Killer T-cell Lymphoma (NKTL) he ʻano ʻano koʻikoʻi o Non-Hodgkin Lymphoma. I ka wā mua o ka maʻi hiki ke loaʻa ka pane maikaʻi loa i ka mālama ʻana a hiki ke hoʻōla ʻia. Eia nō naʻe, ʻoi aku ka nui o nā pae holomua, ʻoiai hiki iā lākou ke pane maikaʻi i ka mālama ʻana i ka wā mua, hoʻihoʻi pinepine i ka NKTL a hiki ke paʻakikī ke mālama.
Eia naʻe, ua nui ka noiʻi ʻana i ka NKTL i nā makahiki i hala iho nei, a ke hoʻāʻo ʻia nei nā ala hou o ka mālama ʻana me nā ʻano lāʻau lapaʻau hou. Ke holomua maikaʻi nei kekahi o kēia mau hoʻāʻo mua, no laila inā loaʻa iā ʻoe kahi pae kiʻekiʻe NKTL, aia ke kumu o ka manaʻolana.
He aha ka NKTL?
He maʻi maʻi ʻaʻai ʻo NKTL o nā pūnana T-Killer Natural (NK). ʻO kēia mau pūnaewele kahi ʻano o ke koko keʻokeʻo i kapa ʻia he lymphocytes. Hoʻomaka ka NKTL i ka wā e hoʻololi ʻia ai kāu mau genes i ka hana ʻole ʻana o kāu mau cell NK. Hiki iā lākou ke lilo i ka ma'i 'a'ai a ulu a'e ma waho o ka mana, e hana i nā pūna'i ma'i 'a'ai hou a laha i kou kino.
Ka hoʻomaopopo ʻana i nā Lymphocytes NK a me T-cell
He ʻāpana koʻikoʻi nā Lymphocytes o kā mākou ʻōnaehana pale e pale iā mākou mai ka maʻi a me ka maʻi, a hoʻoponopono i kā mākou ʻōnaehana pale e pale aku i nā hōʻeha autoimmune. Hana ʻia ka hoʻouka kaua ʻana i ka wā ʻoi aku ka hana o kā mākou ʻōnaehana pale ʻole a hoʻomaka e hakakā i ko mākou kino ponoʻī ma mua o ka maʻi a me ka maʻi.
E pili ana i nā pūnaewele Killer Natural (NK) a me nā Lymphocytes T-cell
- Hana ʻia nā pūnae T i loko o ko mākou iwi iwi, ʻoʻo i loko o ko mākou thymus, akā hiki ke noho ma kekahi ʻāpana o kā mākou lymphatic system - me kā mākou lymph nodes.
- Pono e ho'ā 'ia ka hapa nui o nā pūnaewele T no ka hana pono. Hoʻomaha maʻamau lākou i loko o kā mākou thymus a i ʻole nā wahi ʻē aʻe o kā mākou lymphatic system, a ala wale lākou a hakakā i ka maʻi i ka wā e hōʻike ai nā cell immune ʻē aʻe iā lākou he maʻi a maʻi paha e hakakā. I ko lākou ala ʻana, ʻo nā T-cell hiki ke hele i kekahi wahi o ko kakou kino e hakakā i ka maʻi a i ʻole ka maʻi.
- ʻO kekahi mau T-cell ke kuleana no ka "hoʻoponopono" i ka pane immune. ʻO ia hoʻi, ke luku ʻia kahi maʻi, ʻo ka Nā pūnaewele T hoʻoponopono e haʻi aku i nā pūnaewele ʻē aʻe e "kū i lalo" i ʻole lākou e hoʻomau i ka hakakā a hoʻopilikia i kā mākou mau sela maikaʻi.
- Kāhea pinepine ʻia nā cell Killer Natural (NK). “Nā pūnaewele NK”. He mau cell immune kūikawā lākou e ʻike a luku i nā germs a me nā maʻi kanesa. ʻAʻole e like me nā mea T-cell ʻē aʻe, ʻaʻole pono e hoʻāla ʻia nā cell NK e hakakā i ka maʻi kanesa. Ua mākaukau lākou e hakakā i nā manawa a pau, a e neʻe ikaika a puni kou kino i ka nānā ʻana i nā cell i loaʻa nā loli maʻi maʻi.
- Ma hope o ka hakakā ʻana i kahi maʻi a i ʻole maʻi, lilo kekahi mau T-cell “Keena hoʻomanaʻo”. Hoʻomanaʻo lākou i nā mea a pau e ʻike ai e pili ana i ka maʻi a pehea e hakakā ai. ʻO ia ala, inā loaʻa hou iā mākou ka maʻi like a i ʻole ka maʻi, hiki i kā mākou ʻōnaehana pale ʻana ke hakakā me ka wikiwiki a me ka maikaʻi.
- Hiki i kekahi mau T-cell ke kōkua i nā mea ʻē aʻe, e like me nā lymphocytes B-cell e hana pono. Ua kapa ʻia kēia mau T-cell "Kōkua T-cell”.
Nā hōʻailona o NKTL
Ke loaʻa iā ʻoe ka NKTL, loaʻa paha iā ʻoe kekahi mau hōʻailona e pili ana i ka subtype NKTL o lymphoma, a i ʻole nā hōʻailona maʻamau. ʻO kekahi o nā hōʻailona kikoʻī loa i ka NKTL penei:
- nā ʻeha a i ʻole nā wahi o ka ʻili haki i kou ihu, ka ʻaoʻao o luna o kou waha a i ʻole ka ʻāʻī
- nā ʻeha e haki ana i kou ihu a i ʻole nā wahi ʻē aʻe o kou maka i hoʻōla ʻole
- hoʻololi i ka symmetry (evenness) o kou helehelena
- pilikia i ka hanu ʻana ma kou ihu a/a i ʻole ka manaʻo o ka paʻa
- ka ihu koko a i ʻole ke koko mai kou waha
- eha ka' ā'ī
- hoʻololi i kou leo
- hoʻololi i kou ʻike ʻana mai ke kaomi ʻana o ka ʻōpū, a i ʻole ka uē ʻana mai kou mau maka
- pilikia i ka ʻai ʻana a i ʻole ka ʻai ʻana.
Nā hōʻailona maʻamau o ka lymphoma
Aia kekahi mau hōʻailona maʻamau i nā poʻe he nui me ka lymphoma, a ʻo nā mea ʻē aʻe i kapa ʻia ʻo B-symptoms pono ʻoe e hōʻike koke i kāu kauka. Hōʻike ʻia kēia mau hōʻailona ma nā kiʻi, akā no ka nānā hohonu ʻana i nā hōʻailona e kaomi i ka loulou ma luna.
ʻO ka hōʻailona a me ke kau ʻana o NKTL
ʻO ka hana mua i ka loaʻa ʻana o kahi hōʻailona ʻo ia ka loaʻa ʻana o kahi biopsy o kahi o kou kino i hoʻopilikia ʻia. Hiki ke hana ʻia kēia i ka wā o ke kaʻina hana ma lalo o kahi anesthetic maʻamau a i ʻole pono ʻoe i kahi anesthetic kūloko, ma muli o ka wahi e biopsied. Inā loaʻa iā ʻoe ka pehu lymph nodes, loaʻa iā ʻoe kahi biopsy o ka lymph node.
Pono paha ʻoe i nā ʻano hoʻāʻo like ʻole e loaʻa i ka maʻi T-cell lymphoma, e hana i kāu ʻano subtype, pae a me ka papa. E nānā i ke wikiō ma lalo nei e lohe ai mai ka Luna Hoʻokele Haematologist ʻo Dr Dejan Radeski e pili ana i nā hoʻokolohua āu e pono ai.
No ke aha i hoʻomohala ai kekahi poʻe i ka NKTL?
I nā manawa he nui ʻaʻole mākou i ʻike i ke kumu o ka lymphoma i kekahi poʻe a ʻaʻole i nā poʻe ʻē aʻe. Ua ʻike ʻia nā kumu pilikia he nui i ka hoʻonui ʻana i kou pilikia o ka loaʻa ʻana o kekahi mau lymphomas, akā nui ka poʻe me kēlā mau pilikia like ʻole e hoʻomohala i ka lymphoma.
Epstein Barr Virus
Ua ʻike mākou he mau hōʻailona ko ka poʻe me Natural Killer T-cell Lymphoma (NKTL) i kahi maʻi i kapa ʻia Epstein Barr Virus (EBV) ma luna o ko lakou mau ma'i koko. ʻO EBV ka maʻi maʻi e hoʻoulu ai i ka maʻi maʻi glandular - kapa ʻia hoʻi ka mono, a i ʻole ka honi ʻana i ka maʻi. ʻIke ʻia ka maʻi maʻi e hoʻololi i ke ʻano o ka hana ʻana o kekahi o kā mākou lymphocytes a manaʻo ʻia e kōkua i ka hoʻomohala ʻana o NKTL.
He maʻi maʻi maʻamau ka EBV, a loaʻa ka hapa nui o ka poʻe ma mua o ko lākou hiki ʻana i ke kanaka makua a hiki i ka pōʻino o kekahi mau lymphocytes ke lōʻihi loa. Eia naʻe, he mea nui e ʻike i ka hapa nui o ka poʻe i loaʻa i ka EBV ʻaʻole e ulu i ka lymphoma.
Nā Cytogenetics
Hana ʻia nā hoʻokolohua cytogenetic e nānā i nā ʻano like ʻole e pili ana i kāu maʻi. 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 ho'āʻo e ʻike inā loaʻa iā ʻoe kekahi mau loli 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 NKTL, ʻokoʻa paha 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 ko mākou mau genes i ke code (recipe) pono e hana i nā cell a me nā protein i loko o ko mākou kino, a haʻi iā lākou pehea e nānā ai a hana paha. He nui nā genes like ʻole o kēlā me kēia kaula DNA.
Hoʻololi Cytogenetic i NKTL
ʻO kekahi o nā hoʻololi i loaʻa i kekahi poʻe me NKTL ka mea i kapa ʻia a kāpae. ʻO ka holoi ʻana i ka wā e nalowale ana kahi ʻāpana o ka chromosome a no laila ʻaʻole ʻoe i loaʻa ka gene e haʻi aku i kāu mau cell i poino e hoʻoponopono a luku iā lākou iho. ʻO ia ke ʻano o ka hoʻomau ʻana o ka ulu ʻana o nā cell i pōʻino, lilo i ka maʻi kanesa a laila hana i nā pūnaewele maʻi maʻi hou.
ʻO kahi holoi maʻamau i ka NKTL ka wā e nalowale ana kahi ʻāpana o ka ʻāpana lalo o ka helu chromosome 6. Hiki ke kākau ʻia kēia ma ke ʻano he del(6q 21-25). Hōʻike ka "q" i ka ʻaoʻao lalo o ka chromosome aʻo ka 21-25 e wehewehe i kahi kikoʻī ma ka DNA kahi i nalowale ai nā genes.
Nā Paena
Aia kekahi mau hoʻololi cytogenetic e hiki ke komo i kāu lymphoma. Hiki i kekahi mau hoʻololi ke ulu i nā protein like ʻole e ulu ana ma kāu mau sela lymphoma - e like me PD-L1 , CD30 or CD38 ia ua ʻike ʻia ma nā pūnaewele koko o kekahi poʻe me NKTL. ʻO kēia mau protein ka pahuhopu o nā lāʻau i kapa ʻia ʻo immune checkpoint inhibitors a i ʻole monoclonal antibodies, i hoʻohana ʻia e hoʻopau i kāu mau sela lymphoma.
He mea nui e ʻike i ke ʻano o nā protein i loaʻa ma kāu mau pūnaeho lymphoma, no ka mea, ʻo kekahi mau lapaʻau i kapa ʻia nā antibodies monoclonal e hana wale ana ma nā lymphomas me kēia mau protein.
mutations
ʻO nā hoʻololi ʻana he hoʻololi i kāu mau genes e pili ana i kā lākou hana a hiki ke kāpae iā lākou mai ka ʻike ʻana a me ka luku ʻana i nā cell lymphoma. ʻO kekahi mau hoʻololi maʻamau i loaʻa ma nā pūnaewele NKTL penei:
- TP53
- DDX3X
- STAT2
- JAK3
- MGA
- BCOR
- ECST
- MCL1.
ʻO ka hoʻomaopopo ʻana i kēia mau hoʻololi ʻana e kōkua i nā mea noiʻi e hoʻomohala i nā lāʻau lapaʻau hou e kuhikuhi pono i kēia mau hoʻololi a hāʻawi iā ʻoe i nā koho lapaʻau hou aʻe.
E nīnau i kāu Kauka
E nīnau i kāu kauka e pili ana i kāu mau hoʻololi pilikino a pehea e pili ai kēia mau hoʻololi i kāu mau koho lapaʻau. Inā loaʻa iā ʻoe kekahi o nā hoʻololi a i ʻole nā hoʻololi i luna, e nīnau i kāu kauka i nā lāʻau lapaʻau i loaʻa e kuhikuhi i kēia mau hoʻololi.
E nīnau pū inā loaʻa kekahi mau hoʻokolohua lapaʻau e hiki ai iā ʻoe ke kuhikuhi i kekahi o nā hoʻololi cytogenetic i kāu mau sela lymphoma. ʻAʻole loaʻa nā hoʻokolohua lapaʻau āpau ma kēlā me kēia haukapila a mokuʻāina paha. Inā makemake ʻoe e hele e lilo i ʻāpana o kahi hoʻokolokolo, e hōʻike i kāu kauka i ka mamao āu e makemake ai e hele. I kekahi mau hihia, aia paha nā hoʻokolohua honua āu e ʻae ai.
Nā lapaʻau no ka Lymphoma T-cell Killer Natural
Ke hoʻopau ʻia nā hopena a pau mai kāu biopsy a me ka staging scans, e nānā kāu kauka iā lākou e hoʻoholo i nā koho lapaʻau maikaʻi loa no ʻoe. Hiki paha iā lākou ke hui pū me nā loea ʻē aʻe i kahi hālāwai multidisciplinary e hōʻoia i ka uhi ʻia o kāu mau pono āpau.
ʻO kekahi mau mea a lākou e noʻonoʻo ai i ka wā e hoʻoholo ai i nā koho lapaʻau maikaʻi loa e hāʻawi iā ʻoe:
- ka pae o ka lymphoma iā ʻoe
- nā hōʻailona āu e loaʻa nei
- pehea ka hopena o ka lymphoma i kou kino
- kou makahiki
- nā maʻi maʻi ʻē aʻe āu e loaʻa ai, nā lāʻau lapaʻau āu e lawe nei, a me kou olakino a maikaʻi
- kou mau makemake pono'ī ke loaʻa iā ʻoe ka ʻike āpau.
Kūkākūkā me nā Hematologists ʻē aʻe
No ka mea kakaikahi ka NKTL, hiki i kāu kauka hematologist ke kūkākūkā pū me nā kānaka hematologist e kūkākūkā i kāu hihia a me ka lāʻau lapaʻau maikaʻi loa no ʻoe. Hana ʻia kēia ma kahi hui hui multidisciplinary e pili ana i nā haematologists, radiologists, pathologists, radiation oncologists, nurses. ʻO MDT ka mea nui ma ka ʻāina (i loko o ka haukapila a i ʻole ka ʻāpana) akā loaʻa nā MDT aupuni ma o ka Australasian Lymphoma Alliance (ALA) T-cell Alliance.
ʻO ka Chemotherapy kahi huaʻōlelo i hoʻohana ʻia no ka wehewehe ʻana i nā lāʻau lapaʻau like ʻole e hoʻopau i nā cell ulu wikiwiki. Ma muli o ka luku ʻana i nā cell e ulu wikiwiki ana lākou i ka mālama ʻana i nā ʻano maʻi maʻi he nui, me ka Natural Killer T-cell Lymphoma.
Nā hopena ʻaoʻao maʻamau
ʻAʻole hiki i nā lāʻau lapaʻau kemotherapy ke haʻi i ka ʻokoʻa ma waena o nā cell olakino a me ka maʻi kanesa. ʻIke wale lākou ua ulu wikiwiki lākou. ʻO ia hoʻi, hiki ke hoʻouka ʻia kekahi o kāu mau sela olakino maikaʻi e ka chemotherapy e hopena i nā hopena ʻaoʻao makemake ʻole e like me:
- ʻeha nā waha
- nausea a me ka luaʻi
- pāhoehoe a i ʻole paʻa paʻa
- pau ka lauoho
- maloo ili
- he hāʻule i loko o nā pūpū koko olakino
- luhi - ʻaʻole maikaʻi ka luhi me ka hoʻomaha a me ka hiamoe.
Hiki i nā pūnaewele olakino ke hoʻoponopono a hoʻohua hou i nā pūnaewele olakino ʻoi aku ka wikiwiki ma mua o nā cell cancerous, no laila e loaʻa iā ʻoe ka chemotherapy i nā "pōkole". E loaʻa iā ʻoe kahi pōʻai o ka chemotherapy, a laila hoʻomaha i ka wā e hoʻōla hou ai kāu mau sela olakino, a laila ka pōʻai hou. ʻEhia mau pōʻaiapuni i loaʻa iā ʻoe a ʻo ka hoʻomaha ma waena e hilinaʻi ʻia i ka mālama ʻana iā ʻoe a me kou kūlana pilikino.
ʻO nā protocol chemotherapy no NKTL
ʻO kekahi o nā protocol chemotherapy maʻamau i hoʻohana ʻia no ka mālama ʻana i ka NKTL penei:
- SMILE - Steroid [dexamethasome] Methotexate, Ifosphamide, L- asparaginase, Eluna ʻaoʻao. Loaʻa iā ʻoe nā lāʻau kākoʻo e kōkua i ka pale ʻana i nā hopena ʻaoʻao a me nā pilikia. E komo pū ana kēia mau mea:
- calcium folinate no ka pale ʻana i ka ʻona mai ka methotrexate
- mesna e pale i kou ʻōpū mai ka ifosphamide
- GCSF e kōkua i kāu mau keʻokeʻo keʻokeʻo e ola hou.
ʻO nā antibodies monoclonal (MABs) nā lāʻau lapaʻau e hoʻopili i kāu ʻōnaehana pale e kōkua iā ia e hakakā i ka lymphoma me ka maikaʻi.
Aia nā ʻano like ʻole o MAB a hana lākou ma ka hoʻopili ʻana i kahi protein ma kāu cell lymphoma. A laila hoʻonoho ka MAB i nā hōʻailona e hoʻomaopopo i kāu ʻōnaehana pale i ka hoʻoweliweli o kahi pūnaewele lymphoma i hiki i kāu ʻōnaehana pale ke kau i kahi hoʻouka a luku i ka lymphoma.
I kekahi mau hihia, hiki ke loaʻa i nā cell lymphoma kahi protein ma luna o lākou (PD-L1) e hoʻopunipuni i kou ʻōnaehana pale i ka noʻonoʻo ʻana he cell olakino. Ke hoʻopili ʻia ka MAB i kēia mau protein e wehe ʻo ia i ka cell lymphoma o kāna "mask" i hiki ai i kāu ʻōnaehana pale ke ʻike iā ia he cell lymphoma. Kapa ʻia kēia mau MAB pale pale kino pale kālai.
Hana ʻia nā MAB ʻē aʻe me kahi lāʻau ʻona i nā cell lymphoma i hoʻopili ʻia iā lākou. A laila ʻimi lākou i ka pūmua (e like me CD30 a i ʻole CD38) ma ka cell lymphoma a pili iā ia. Ma ka hoʻopaʻa ʻana i ka cell lymphoma, hāʻawi kēia mau MAB i ka lāʻau ʻawaʻawa pololei i loko o ka cell lymphoma e luku ai. Kapa ʻia kēia mau MAB nā MAB i hoʻohui ʻia.
ʻO kekahi mau antibodies monoclonal hiki ke hoʻohana ʻia e mālama i ka NKTL penei:
- pembrolizumab, nivolumab
- brentuximab vedotin (MAB hoʻohui ʻia)
Hoʻohana ʻia ka radiotherapy i nā kukui uila kiʻekiʻe (radiation), e pepehi i nā maʻi maʻi maʻi. Hiki ke hoʻohana ʻia ma ke ʻano he lapaʻau iā ia iho, a i ʻole me nā lāʻau lapaʻau ʻē aʻe e like me ka chemotherapy.
Hoʻopilikia ka X-ray i ka DNA o ka cell (ke genetic material o ke cell) i hiki ʻole ai i ka lymphoma ke hoʻoponopono iā ia iho. ʻO kēia ke kumu e make ai ke kelepona. He mau lā a he mau pule paha ma hope o ka hoʻomaka ʻana o ka mālama ʻana i ka radiation no ka make ʻana o nā cell. Hiki ke hoʻomau kēia hopena no kekahi mau mahina, no laila, ʻo nā mahina ma hope o kou hoʻopau ʻana i ka mālama ʻana, hiki ke hoʻopau ʻia nā cell lymphoma cancerous.
Inā ʻike ʻia kāu NKTL i ka wā mua o ka maʻi, ʻo ia wale nō ka lāʻau e pono ai ʻoe. Eia naʻe, hāʻawi pinepine ʻia me ka chemotherapy.
ʻO ka hoʻololi ʻana i ke kelepona he hana ia e hoʻohana ʻia e mālama i kāu lymphoma, a i ʻole e hoʻomau iā ʻoe i ke kala ʻana no ka lōʻihi inā nui ka manawa e hoʻi hou ai kāu lymphoma. Hiki nō hoʻi i kāu kauka ke ʻōlelo aku i kahi transplant cell stem no ʻoe ke hoʻi hou kāu lymphoma.
ʻO ka transplant cell stem kahi hana paʻakikī a invasive e hana ʻia i nā pae. Hoʻomākaukau mua ʻia nā poʻe maʻi e hoʻololi ana i ka stem cell me ka chemotherapy wale nō a i hui pū ʻia me ka radiotherapy. Hāʻawi ʻia ka lāʻau lapaʻau chemotherapy i hoʻohana ʻia i ka hoʻololi ʻana o ke kelepona stem ma nā ʻano kiʻekiʻe ma mua o ka maʻamau. ʻO ke koho o ka chemotherapy i hāʻawi ʻia i kēia kaʻina e pili ana i ke ʻano a me ka manaʻo o ka transplant.
ʻIke hou aku e pili ana i nā Stem Cell Transplants
No ka ʻike hou aku e pili ana i ka transplant cell stem e ʻike i kā mākou ʻaoʻao pūnaewele.
Ka hoʻololi ʻana o nā pūnaʻi kumu - he hiʻohiʻona
ʻO ka hoʻololi ʻana o nā pūnaʻi pūʻali autologous - me ka hoʻohana ʻana i kāu mau pūnaewele ponoʻī
Ka hoʻololi ʻana o nā pūnaʻi kumu allogeneic – ka hoʻohana ʻana i nā pūnaewele kumu a kekahi mea ʻē aʻe
He ala koʻikoʻi nā hoʻokolohua lapaʻau e ʻimi ai i nā ala hou a maikaʻi hoʻi e mālama ai i ka lymphoma. Paipai mau mākou e nīnau i kāu kauka e pili ana i nā hoʻokolohua lapaʻau āu e ʻae ai. ʻOi loa inā loaʻa iā ʻoe kahi maʻi maʻi ʻaʻai like ʻole e like me NKTL, hāʻawi ia i nā manawa hou e hoʻāʻo ai i nā lāʻau lapaʻau like ʻole i loaʻa ʻole iā ʻoe.
ʻAʻohe mea hōʻoiaʻiʻo me nā hoʻokolohua lapaʻau, no ka mea, ʻo kā lākou kumu e hoʻāʻo i nā lāʻau lapaʻau hou a i ʻole nā hui pū ʻana o nā lāʻau lapaʻau e ʻike inā ʻoi aku ka maikaʻi ma mua o nā lāʻau lapaʻau o kēia manawa.
E kamaʻilio me kāu kauka e pili ana i nā hoʻokolohua lapaʻau inā makemake ʻoe e komo i hoʻokahi.
ʻO ka laina ʻelua a me nā lāʻau lapaʻau ʻē aʻe
He nui ka poʻe i pane maikaʻi mai ka lāʻau lapaʻau mua a hele i ke kala ʻana. ʻO kēia kahi ʻaʻohe hōʻailona ʻike ʻia o ka lymphoma i koe i loko o kou kino. Akā he mea maʻamau ka hoʻi ʻana o ka NKTL ma hope o ke kala ʻana, kapa ʻia kēia he relapse.
I kekahi mau hihia, ʻaʻole maikaʻi paha kāu NKTL me ka lāʻau lapaʻau mua. Inā loaʻa kēia, ʻōlelo ʻia kāu NKTL he refractory (a ʻaʻole pane) i ka mālama ʻana.
Inā loaʻa iā ʻoe ka NKTL refractory a ua hoʻi hou, pono ʻoe e hoʻomaka i kahi lapaʻau ʻē aʻe. Kapa ʻia kēia lāʻau lapaʻau ʻelua.
ʻO nā lāʻau lapaʻau ʻelua e hilinaʻi ʻia i ke ʻano o ka mālama ʻana iā ʻoe i ka wā ma mua, a inā he chemotherapy i kapa ʻia ʻo asparaginase a i ʻole ʻaʻole kēia mau lapaʻau. Nui nā lāʻau lapaʻau like ʻole e hiki i kāu kauka hematologist ke ʻōlelo aku. Hiki i kekahi ke komo:
Ola, noho me a ma hope o NKTL
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 NKTL.
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 NKTL 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.
hōʻuluʻulu manaʻo
- ʻO Natural Killer T-cell Lymphoma (NKTL) kahi ʻano ʻano o ʻO Lymphoma T-cell puni e hoʻomaka ana i ka wā e lilo ai nā pūna T-waho o kou mau lymph nodes i ka maʻi kanesa.
- Hoʻomaka pinepine ia ma kou alo, ka mea maʻamau i kou ihu a i ʻole ka wahi ma hope o kou ihu.
- Nui nā hōʻailona hiki iā ʻoe ke ʻike - maʻamau kekahi i nā subtypes lymphoma āpau a pili kekahi i kahi o kāu lymphoma.
- ʻO ka NKTL kahi ʻano lymphoma koʻikoʻi e pono ai ka mālama ʻana ma hope koke o ka maʻi ʻana.
- E like me ka nui o nā lymphoma koʻikoʻi, pane pinepine ʻo NKTL i ka mālama ʻana i ka wā mua a hiki iā ʻoe ke hele i kahi manawa kala ʻia akā naʻe, maʻamau ka hoʻihoʻi ʻana me nā lymphoma T-cell no laila pono ʻoe e mālama i ʻoi aku ma mua o hoʻokahi manawa.
- He ala maikaʻi nā hoʻokolohua lapaʻau e hoʻāʻo ai i nā lāʻau lapaʻau hou āu e loaʻa ʻole ai, akā ʻaʻohe mea hōʻoia e ʻoi aku ka maikaʻi ma mua o nā lāʻau lapaʻau ʻē aʻe.
- Nui nā kākoʻo i loaʻa iā ʻoe i ka wā a ma hope o ka mālama ʻana no NKTL. E kamaʻilio me kāu hui lapaʻau e pili ana i ke kākoʻo ʻē aʻe āu e pono ai.
- ʻAʻole ʻoe hoʻokahi, hiki iā ʻoe ke kelepona i kā mākou Lymphoma Care Nurses e kamaʻilio e pili ana i kāu lymphoma, lapaʻau a i ʻole nā pilikia ʻē aʻe e pili ana i kāu lymphoma. Kaomi ma ka pihi Hoʻokaʻaʻike iā mākou ma lalo o ka pale no nā kikoʻī pili.
