Nānā nui o ATLL
ʻO ka maʻi Leukemia-Lymphoma makua he ʻano ʻano kakaʻikahi loa ia o ka cell T Lymphoma Non-Hodgkin (NHL). Hiki iā ia ke pili i nā mākua o kēlā me kēia makahiki akā ʻoi aku ka maʻamau i nā poʻe he 60 makahiki a ʻoi aku paha. ʻOiai he subtype o NHL, hiki ke hui hou ʻia ma ke ʻano he subtype o ʻO Lymphoma T-cell ʻaoʻao (PTCL).
ʻO ka ʻike ʻana aia ʻo ATLL ma lalo o nā poʻomanaʻo ʻelua o NHL a me PTCL hiki ke maʻalahi inā ʻoe e ʻimi nei i nā hoʻokolohua lapaʻau hiki iā ʻoe ke hui pū, ʻoiai ʻaʻole nā hoʻāʻo a pau e helu i nā subtypes o lymphoma. Hiki paha iā ʻoe ke komo i nā hoʻokolohua lapaʻau e ʻimi nei i nā poʻe me:
- ʻO Lymphoma Non-Hodgkin
- ʻO Lymphoma T-cell puni
- T-cell Lymphoma
- ʻO ka maʻi Leukemia Lymphoma o nā mākua T-cell.
Hana ʻia ka ATLL i ka wā e hoʻololi ʻia ai nā genes i loko o kāu mau T-cell, e haʻi ana i ka lymphocyte T-cell pehea e ulu ai a hana. Ma muli o kēia mau hoʻololi ʻana, ulu nā T-cell i mau pūnaeho maʻi kanesa a ʻaʻole hiki ke hana pono. He mea hoʻopaʻapaʻa pinepine, ʻo ia hoʻi ke ulu a laha koke i kou kino.
Eia nō naʻe, aia he 4 mau ʻano subtypes o ATLL, a he moloā paha ka 2 o lākou, ʻo ia hoʻi, ua ulu mālie lākou a hiki ke hele pinepine i nā wā i ulu ʻole ai lākou, kokoke e like me ka hiamoe. He mea kakaikahi loa ka Indolent ATLL, a ma kekahi mau hihia, hiki ke hoʻololi i kekahi o nā ATLL koʻikoʻi i ka manawa.
Pono e mālama koke ʻia ʻo ATLL ma hope o kou ʻike ʻia ʻana, akā inā loaʻa iā ʻoe kahi lymphoma palaualelo, ʻaʻole pono ʻoe e mālama i nā mahina a i ʻole mau makahiki. I nā hihia koʻikoʻi loa, ʻaʻole pono ʻoe i ka lāʻau lapaʻau.
E pili ana i nā Lymphocytes T-cell
- Hana ʻia nā pūnaewele T mai nā pūnaewele kumu i loko o ko mākou iwi iwi, ma mua o ka neʻe ʻana i waho i loko o ko mākou ʻōnaehana lymphatic a me thymus kahi e oʻo ai lākou a ola.
- Aia i loko o kēlā me kēia T-cell kahi nucleus e paʻa i kā mākou DNA āpau, i hana ʻia me nā genes e haʻi i kā mākou mau cell pehea e ulu ai a hana.
- Hoʻomaha maʻamau lākou i loko o kou thymus, lymph nodes a i ʻole nā ʻāpana ʻē aʻe o kāu ʻōnaehana lymphatic, a ala wale lākou a hakakā i ka maʻi i ka wā e hōʻike aku ai nā cell immune ʻē aʻe iā lākou he maʻi a maʻi paha e hakakā. Ke ala aʻe lākou, hiki i nā pūnae T ke hele i kekahi ʻāpana o kou 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 kou mau sela maikaʻi ke pau ka maʻi.
- Ma hope o ka hakakā ʻana i kahi maʻi a i ʻole maʻi, lilo kekahi mau T-cell “Nā pūnāwai T hoʻomanaʻo” a 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 ʻoe ka maʻi like ʻole a i ʻole ka maʻi, hiki i kāu ʻōnaehana pale ke kaua aku iā ia me ka wikiwiki a me ka maikaʻi.
He aha ke kumu o ATLL?
Loaʻa ka ATLL i ka poʻe i loaʻa i kekahi maʻi me kahi maʻi maʻi ʻaʻole i kapa ʻia Ke kanaka T-cell Lymphotropic Virus 1 (HTLV-1). ʻOiai ʻaʻole maopopo i ke kaʻina hana pololei, me he mea lā ua hoʻololi ʻo HTLV-1 i kāu mau genes, no laila e hāʻawi lākou i nā ʻōlelo kuhi hewa i ke ʻano o ka ulu ʻana a me ka hana o nā T-cell. ʻO ka hopena, hoʻomau ka hoʻonui ʻana o nā pūnaʻi T maʻi maʻi a hoʻonui i nā pūnaʻi T maʻi kanesa.
Akā naʻe, ʻAʻole hoʻomohala ka hapa nui o nā poʻe me HTLV-1 i ka ATLL, no laila ua manaʻo ʻia he kumu pilikia, akā ʻaʻole ia he kumu. ʻOiaʻiʻo, ma kahi o 1 wale nō i kēlā me kēia 20 poʻe me HTLV e hoʻomohala i ka ATLL. ʻAʻole maopopo iā mākou ke kumu e ulu ai i kekahi poʻe a ʻaʻole i nā poʻe ʻē aʻe.
ʻO ka hapa nui o ka poʻe me HTLV-1 ua loaʻa i ka maʻi i ko lākou wā kamaliʻi e hānai ʻia ana, a i ʻole i ka wā kamaliʻi a i ʻole ka wā makua. I ka nui o nā hihia, ʻaʻole ulu ʻo ATLL no 50 mau makahiki a ʻoi aʻe paha ma hope o kou loaʻa mua ʻana iā HTLV-1.
No ka ʻike hou aku e pili ana i nā kumu a me nā kumu pilikia Bus maʻaneʻi.
Endemic HTLV-1
ʻO kekahi mau maʻi maʻi maʻamau ka mea maʻamau i kekahi mau wahi o ka honua, ʻoiai ʻaʻole i loaʻa pinepine ʻia ma nā wahi ʻē aʻe o ka honua. Ma kahi o ka mea maʻamau, ʻōlelo ʻia he endemic. E ʻike ʻia paha ʻoe i ka HTLV-1 inā ua noho ʻoe ma kahi ʻāina a i ʻole kahi wahi e hoʻopau ʻia ai.
Loaʻa ka HTLV-1 i nā ʻāina ma lalo.
- Iapana
- China
- ka Caribbean
- na Seychelles
- Pāpua Nūkini
- waena a me ʻAmelika Hema
- waena a me ka ʻĀkau o Australia
- ʻIlana
- Romania a me
- mau wahi o Aferika.
Inā ua ʻike ʻia ʻoe me ka HTLV-1 pono ʻoe e hoʻohana mau i kahi pale pale i ka wā o ka moe kolohe e like me ka condom kūloko a i waho paha me ka spermacide a i ʻole ka pā niho. Kōkua kēia i ka pale ʻana i kāu hoa.
Inā he pēpē kāu, hiki ke ʻōlelo ʻia ʻaʻole ʻoe e hānai a hoʻohana i kahi pani waiu maikaʻi. Inā makemake ʻoe e loaʻa nā keiki, e kamaʻilio me kāu kauka e pili ana i ka hāpai ʻana i ka wā e pale ana i kāu hoa kāne a me kāu pēpē mai HTLV-1.
Pono ʻoe e hōʻoia inā he koko ʻoe, ʻo ka mea kōkua iā ʻoe e komo i nā mīkina lima a pale iā lākou iho mai kou koko. Pono lākou e holoi i ke koko me ka wai kahe a me ke kopa inā pili lākou i kou koko. ʻOi aku ka pilikia o ka loaʻa ʻana o HTLV-1 inā loaʻa iā lākou nā ʻeha hāmama a i ʻole nā wahi haʻihaʻi o ka ʻili a piʻi kou koko i kēia mau wahi haʻihaʻi. Mai kaʻana like i nā nila o kēlā me kēia ʻano.
Nā hōʻailona o ATLL
Ua like paha nā hōʻailona o ATLL me nā hōʻailona o nā ʻano lymphoma ʻē aʻe, a i ʻole kikoʻī i ka subtype o ATLL i loaʻa iā ʻoe a me ka ʻāpana o kou kino e ulu ana.
ʻO nā hōʻailona maʻamau o nā subtypes like ʻole o ka lymphoma hiki ke komo:
- 'Oloke
- Hono i nā kikowaena lymph ʻike ʻia e like me nā puʻupuʻu ma lalo o kou ʻili āu e ʻike ai a ʻike paha.
- ʻO nā ʻeha a me nā ʻeha i loko o kou ʻiʻo a me nā hui.
- Loaʻa i nā maʻi he nui, a i ʻole ka paʻakikī e hoʻopau iā lākou.
- ʻIli ʻili
- B-hōʻailona
B-hōʻailona
Nā hōʻailona a me nā hōʻailona o nā ʻano subtypes o ATLL | ||||
Ōuli | ATLL koʻikoʻi | Lymphomatous ATLL | ATLL mau loa | Puhi ATLL |
Lymphocytes i ka hoʻāʻo koko | Kiʻekiʻe a kiʻekiʻe loa a ʻano ʻano like ʻole. | ʻO ka mea maʻamau. | Kiʻekiʻe iki a liʻiliʻi me nā hiʻohiʻona kūlohelohe. | Maʻamau, ʻaʻole hiki ke ʻike ʻia kekahi mau mea ʻino. |
ʻO ka lactate dehydrogenase (LDH) i ka hoʻāʻo koko | Kiʻekiʻe | ʻO ka mea maʻamau. | Kiʻekiʻe iki paha. | Kiʻamau. |
ʻO ka calcium i ka hoʻāʻo koko | Kiʻekiʻe | Hiki ke kiʻekiʻe a maʻamau paha. | Kiʻamau. | Kiʻamau. |
Paheʻe kaʻili | I kekahi manawa. | I kekahi manawa. | ʻAe - ʻulaʻula a ʻeleʻele paha nā ʻili o ka ʻili. | ʻAe - nā ʻili ʻili a i ʻole nā puʻupuʻu liʻiliʻi ma kou ʻili. |
Hono i nā kikowaena lymph | ʻO ka maʻamau. | ʻAe. | Ka pehu iki. | ʻAʻole. |
ʻO ke akepaʻa pehu a i ʻole ka spleen | ʻO ka maʻamau. | pinepine. | ʻoluʻolu. | ʻAʻole. |
Lymphoma cell i loko o ka iwi iwi | I kekahi manawa. | Kakaikahi loa. | ʻAʻole. | ʻAʻole. |
Pehea e ʻike ʻia ai ka maʻi ATLL?
No ka ʻike ʻana i ka lymphoma, pono ʻoe i kahi biopsy. ʻO ke ʻano o ka biopsy e pili ana i kahi o kāu mau sela lymphoma i manaʻo ʻia i loko o kou kino, a me nā hōʻailona āu e loaʻa nei.
Nā ʻano biopsies
- ʻO ka biopsy Lymph node inā loaʻa iā ʻoe ka pehu lymph nodes. Ma muli o kahi o ka lymph node, hiki iā ʻoe ke loaʻa kēia me ka anesthetic kūloko i loko o nā lumi o nā kauka, a i ʻole ma lalo o ka anesthetic maʻamau i ke ʻoki ʻana inā he hohonu i loko o kou kino.
- Biopsy o ʻokoʻa like ʻole e like me kou māmā a i ʻole ka ʻōpū inā manaʻo ʻia e ulu ana ka lymphoma i loko o kēia mau ʻōpū. Hana ʻia kēia ma ke ʻoki ʻana me kahi anaesthetic maʻamau.
- Biopsy iwi ʻōiwi inā ua hoʻonui ʻoe i nā helu keʻokeʻo keʻokeʻo i kou koko. Hana ʻia kēia me ka lāʻau lapaʻau kūloko.
- ʻ binaehana ʻili inā loaʻa iā ʻoe kahi ʻōpala a i ʻole nā ʻeha ma kou ʻili. Hana ʻia kēia me ka lāʻau anesthetic kūloko.
Pono paha ʻoe ma mua o hoʻokahi biopsy. ʻAʻole ʻōlelo ʻia nā biopsies niila maikaʻi e ʻike i ka lymphoma no ka mea hāʻawi lākou i nā kiko kūpono e loiloi pono ʻia. Akā, ma ka liʻiliʻi loa e loaʻa iā ʻoe kahi biopsy nilala kumu. Hāʻawi kēia i nā kikoʻoi aku ma mua o ka biopsy nila maikaʻi. Eia nō naʻe, pono paha ʻoe i kahi biopsy excisional, kahi kahi e wehe ʻia ai kahi puʻupuʻu lymph holoʻokoʻa a nānā ʻia i ka pathology.
Nā hoʻāʻo ʻē aʻe āu e pono ai
Loaʻa iā ʻoe nā hoʻāʻo koko e nānā i kāu helu keʻokeʻo keʻokeʻo a me nā pae calcium. E ho'āʻo ʻoe i ke koko e ʻike inā ua loaʻa iā ʻoe a i loaʻa paha iā HLTV-1. Hana pinepine ʻia kēia mau mea.
Loaʻa paha iā ʻoe nā hoʻokolohua ʻē aʻe e like me CT scan, ultrasound a MRI paha. I kekahi manawa, loaʻa paha iā ʻoe kahi biopsy i ka wā o kēia mau scans i hiki iā lākou ke loaʻa, a e hōʻoia i kā lākou biopsy i nā wahi kūpono.
Loaʻa (haʻahaʻa) a maikaʻi ʻole (kiʻekiʻe) pilikia ATLL
ʻAʻole hoʻonohonoho ʻia ʻo ATLL e like me ke ʻano o nā subtypes o lymphoma. Hoʻohui ʻia ʻo ATLL i kahi pilikia kūpono a maikaʻi ʻole paha. Hiki ke kapa ʻia ʻo Favorable ka pilikia haʻahaʻa, a ʻo ka mea maikaʻi ʻole paha ke kapa ʻia he pilikia kiʻekiʻe.
ʻO ka ʻike ʻana i kou pilikia e kōkua i ke alakaʻi ʻana i kāu kauka e ʻōlelo i nā koho lapaʻau maikaʻi loa no ʻoe a hāʻawi iā ʻoe i ka ʻōlelo aʻo maikaʻi loa.
ʻAʻole maikaʻi kāu pilikia (kiʻekiʻe) inā loaʻa iā ʻoe kahi ATLL koʻikoʻi a i ʻole he ATLL mau ʻoe a hōʻike ʻia kāu hoʻāʻo koko:
- haʻahaʻa albumin
- kiʻekiʻe lactate dehydrogenase (LDH)
- kiʻekiʻe koko urea nitrogen (BUN).
Ke kali nei i nā hualoaʻa
Ke kali nei i nā hualoaʻa hiki ke lilo i manawa paʻakikī a hiki ke kōkua i ke kamaʻilio ʻana me ka ʻohana, nā hoaaloha a i ʻole kahi kahu hānai kūikawā.
Nā ʻano haʻahaʻa o ATLL
Aia he 4 mau ʻano subtypes o ATLL - ʻo 2 ka huhū a me ka 2 moloā. Eia nō naʻe, ʻo ka hapa nui o ka poʻe i loaʻa i ka ATLL he subtype koʻikoʻi, a ma kahi o 1 i ka 4 poʻe me ATLL palaualelo e holomua i kahi ʻano ʻino i kekahi manawa.
Kaomi ma nā poʻomanaʻo ma lalo nei e aʻo hou aʻe e pili ana i nā ʻano subtype like ʻole o ATLL a me nā hōʻailona a me nā hōʻailona e loaʻa iā ʻoe me nā ʻano subtypes. Ma waho aʻe o kēia mau mea, loaʻa paha iā ʻoe kekahi o nā hōʻailona maʻamau o ka lymphoma i ʻōlelo ʻia ma luna.
ʻO nā ATLL koʻikoʻi
ʻO Acute ka hoʻomaka ʻana o ka ATLL a laha koke. Manaʻo ʻia he ATLL maikaʻi ʻole a kiʻekiʻe paha.
Loaʻa paha iā ʻoe kekahi o nā hōʻailona i helu ʻia ma luna nei, akā e like me kēlā, nā hōʻailona ʻē aʻe āu e loaʻa ai me kēia ʻano subtype:
- ʻO ka luhi nui e hiki koke mai ana a ʻaʻole i hoʻomaikaʻi ʻia me ka hoʻomaha a me ka hiamoe.
- He ʻūhū ma kekahi ʻāpana o kou ʻili.
- Pokole o ka hanu.
- Hoʻololi i kāu mau hoʻāʻo koko e pili ana i ka helu keʻokeʻo keʻokeʻo kiʻekiʻe, nā lymphocytes kiʻekiʻe, ka calcium a me ka pae lactate dehydrogenase (LDH).
- ʻEha iwi.
- Kū'ē.
- Hoʻoponopono i ka naʻau.
- Constipation - hiki ke paʻakikī.
- B-hōʻailona.
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona a me nā hōʻailona e ʻike koke i kāu kauka kūloko (GP) i ka hikiwawe. Pono lākou e loiloi iā ʻoe a hoʻonohonoho i nā hoʻokolohua a me nā kuhikuhi no ʻoe. Pono ʻoe e lapaʻau ma hope koke iho o kou ʻike ʻia ʻana me Acute ATLL.
He ATLL koʻikoʻi kēia subtype. Kapa ʻia ʻo ia he lymphomatous no ka mea e pili ana i kāu ʻōnaehana lymphatic, no laila ʻo nā hōʻailona maʻamau e komo pū ana:
- Hiki iā ʻoe ke ʻike a ʻike paha ma kou ʻāʻī, underarms a i ʻole ka ʻāʻī. ʻO kēia no ka mea kokoke loa kēia mau lymph nodes i kou ʻili i hiki ke maʻalahi ke ʻike a ʻike ʻia. Hiki ke ʻike ʻia ka pehu lymph nodes ma kekahi ʻāpana o kou kino me ka CT a i ʻole PET scan.
- ʻO nā maʻi maʻi paʻakikī ke hoʻopau a hoʻi hou mai paha.
- Loaʻa nā kiʻekiʻe kiʻekiʻe o ka calcium a me ka lactate dehydrogenase (LDH) i kāu hoʻāʻo koko.
- ʻAhu a i ʻole ʻili ʻili
- Pokole o ka hanu.
- Kū'ē.
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona a me nā hōʻailona e ʻike koke i kāu kauka kūloko (GP) i ka hikiwawe. Pono lākou e loiloi iā ʻoe a hoʻonohonoho i nā hoʻokolohua a me nā kuhikuhi no ʻoe. Pono ʻoe e mālama koke ma hope o ka loaʻa ʻana o ka lymphomatous ATLL.
ʻO nā ATLL palaka
Hiki ke kiʻekiʻe a haʻahaʻa paha ka ATLL maʻi. He lohi ka ulu ʻana no laila ʻaʻole ʻoe e ʻike i kekahi hōʻailona ma mua. ʻO nā hōʻailona i loaʻa iā ʻoe ke ʻoi aʻe ka ʻino i ka wā lōʻihi. No kēia kumu, nui ka poʻe e waiho i kā lākou hōʻailona i nā mea ʻē aʻe e like me ka ʻelemakule a i ʻole ke kaumaha. Eia naʻe, ʻo nā hōʻailona maʻamau a me nā hōʻailona e loaʻa iā ʻoe inā loaʻa iā ʻoe ka ATLL mau:
- Nā pae kiʻekiʻe o ke koko keʻokeʻo ma nā hoʻāʻo koko. Hiki ke piʻi mālie kēia mau mea i ka wā.
- ʻO nā pūnaʻi lymph pehu e hoʻonui i ka nui no ka manawa lōʻihi.
- Hoʻonui ʻia ka spleen a i ʻole ate.
- ʻO ka ʻūhū a i ʻole ka ʻili o kou ʻili.
- ʻO ka pōkole o ka hanu eʻoi aʻe kaʻino no ka manawa lōʻihi (mai nā mahina a hiki i nā makahiki).
- 'Olokilo.
- haʻahaʻa albumin
- kiʻekiʻe lactate dehydrogenase (LDH)
- kiʻekiʻe koko urea nitrogen (BUN).
oe ʻaʻole pono paha ka lāʻau lapaʻau inā loaʻa iā ʻoe ka ATLL maʻi maʻi haʻahaʻa, eia naʻe e pili ana kēia i kāu mau hōʻailona a me nā hōʻailona a inā pili ia i kou olakino holoʻokoʻa.
E hoʻomaka koke ʻoe i ka lāʻau lapaʻau ma hope o kāu hōʻoia inā loaʻa iā ʻoe ka ATLL pilikia nui.
ʻO ka Smoldering ATLL kahi ʻano liʻiliʻi o ka lymphoma e ulu ana a manaʻo ʻia he ATLL haʻahaʻa a maikaʻi paha.
ʻAʻole loaʻa iā ʻoe kekahi hōʻailona me kēia ʻano subtype. Inā ʻoe e hana, ʻoluʻolu loa lākou a hiki ke hoʻokomo ʻia kahi ʻōpala a i ʻole nā ʻeha (ʻeha) ma kou ʻili i hoʻōla ʻole a hele ʻole. Hiki paha iā ʻoe ke ʻike i ka pōkole o ka hanu e ʻoi aku ka ʻino ma kahi lōʻihi o ka manawa (mau mahina a mau makahiki).
ʻAʻole paha ʻoe e pono i kahi lapaʻau no ka puhi ʻana i ka ATLL, akā naʻe inā loaʻa iā ʻoe nā ʻili a i ʻole nā huhū e hoʻopilikia nei iā ʻoe, pono paha ʻoe i ka lapaʻau e hoʻomaikaʻi ai i kēia mau hōʻailona e like me ka steroid cream a i ʻole radiation i ka wahi i hoʻopilikia ʻia.
Lapaʻau ʻana i ka maʻi leukemia-lymphoma T-cell makua (ATLL)
ʻO ka mālama multidisciplinary
I nā hihia he nui, e hui pū kāu kauka haematologists a me nā kauka olakino ʻē aʻe e kūkākūkā i kāu hihia. He mea maikaʻi loa kēia inā loaʻa iā ʻoe kahi lymphoma kakaʻikahi no ka mea e loaʻa iā ʻoe nā poʻe ʻokoʻa like ʻole e nānā i kou kūlana ponoʻī e hoʻoholo ai i ke ala maikaʻi loa e kōkua ai iā ʻoe, a e hōʻoia i ka loaʻa ʻana o nā koho lapaʻau maikaʻi loa a mālama.
Hiki nō hoʻi iā ʻoe ke noi i kāu kauka haematologist e hōʻike i kāu hihia ma ka Australasian Lymphoma T-cell Alliance halawai. Hoʻākoakoa kēia hui i nā poʻe loea mai nā wahi a puni o ka ʻāina i loaʻa i kēia lā me nā hanana noiʻi hou loa i nā lymphomas T-cell rare. Hiki iā lākou ke aʻo aku i kāu haematologist no nā hoʻokolohua lapaʻau a i ʻole nā koho lapaʻau hou i loaʻa iā ʻoe.
Ma mua o kou hoʻomaka ʻana i ka lāʻau lapaʻau
Ma mua o kou hoʻomaka ʻana i ka mālama ʻana, aia kekahi mau mea e pono ai ʻoe e noʻonoʻo a hoʻomākaukau. ʻO ka loaʻa ʻana o ka papa inoa o nā mea e hana ai i ka wā e kali ana i ka mālama ʻana, hiki ke kōkua pū me ka hopohopo o ke kali ʻana, no ka mea, e hana ikaika ana ʻoe i ka hoʻomaikaʻi ʻana iā ʻoe iho.
Māmā
Hiki i nā lāʻau lapaʻau ke hoʻopilikia i kou ulu ʻana, e paʻakikī a paʻakikī paha ka hāpai ʻana, a i ʻole ka hāpai ʻana i kekahi. Inā he mau makahiki hānau keiki ʻoe, ʻoiai inā ʻaʻole ʻoe e noʻonoʻo e pili ana i ka loaʻa ʻana o ka ʻohana a i ʻole e hoʻonui i kou ʻohana i kēia manawa, pono ʻoe e kamaʻilio me kāu kauka e pili ana i ka mālama ʻana i kou momona, pale i ka hāpai ʻana i makemake ʻole ʻia a pale a mālama paha i ka menopause mua a i ʻole. lawa ole ovarian.
Nā nīnau e nīnau i kāu kauka
Ke ʻike mua ʻia ʻoe, a i ʻole e hoʻomaka i ka mālama ʻana ma hope o ka hoʻi hou ʻana, hiki ke paʻakikī ke noʻonoʻo pololei a ʻike i nā nīnau e nīnau ai. Akā he mea nui iā ʻoe ka ʻike kūpono a pau e pono ai ʻoe e hoʻoholo i kāu mālama olakino a ʻike i ka mea e manaʻo ai. Kaomi ma ka loulou ma lalo nei e hoʻoiho i nā nīnau e nīnau i kāu kauka.
Nā mea maʻamau e pono ai ʻoe e ʻike a pehea e hoʻomākaukau ai
ʻO ka loaʻa ʻana o ka lāʻau lapaʻau e hoʻololi i kou ola a me ke ola o ka poʻe kokoke iā ʻoe no kekahi manawa. He mea nui e ʻike i ka mea e manaʻo ai a hoʻomākaukau. Pono ʻoe e ʻike i ke kākoʻo i loaʻa iā ʻoe. Ua hoʻomohala mākou i kekahi mau ʻōlelo aʻoaʻo e pili ana i nā mea kūpono e pono ai ʻoe e ʻike inā loaʻa iā ʻoe a i ʻole kekahi mea aloha i ka lymphoma. Kaomi i ka loulou ma lalo no ka ʻike hou aku.
E noʻonoʻo nā kauka i nā kumu he nui e pili ana i ka lymphoma a me kou olakino maʻamau e hoʻoholo ai i ka manawa a me ka lāʻau maikaʻi loa iā ʻoe. E noʻonoʻo lākou:
- ʻO ka subtype o ATLL i loaʻa iā ʻoe - a inā he haʻahaʻa a kiʻekiʻe paha.
- ʻO nā hōʻailona āu i loaʻa.
- ʻO kou mau makahiki, ka mōʻaukala olakino i hala, ke ola kino a me ka naʻau.
- Inā paha ua loaʻa iā ʻoe ka lāʻau lapaʻau no ka ATLL i ka wā ma mua.
- ʻO kou kūpono e komo i kahi hoʻokolohua lapaʻau.
- ʻO kāu mau makemake pilikino ma hope o ka hāʻawi ʻia ʻana o nā ʻike āpau āu e pono ai e hoʻoholo.
ʻO ka lāʻau lapaʻau mua
ʻO ka manawa mua āu e lapaʻau ai no ATLL ua kapa ʻia ʻo ia ka lāʻau lapaʻau mua. Hāʻawi pinepine ʻia i nā pōʻai a loaʻa paha iā ʻoe he 4, a i ʻole 6, a i ʻole 8 mau pōʻai o ka mālama ʻana ma ke ʻano o kāu lāʻau lapaʻau mua. ʻEhia mau pōʻaiapuni āu e hilinaʻi ai i ka protocol lapaʻau.
Hoʻokomo pinepine ʻia nā lāʻau lapaʻau mua maʻamau no ka ATLL kiʻekiʻe lāʻau anti-viral e hoʻomalu i kāu maʻi HTLV-1 a hiki ke komo i ka lāʻau lapaʻau chemotherapy ʻo ia paha kekahi o nā mea i lalo.
- kua (cyclophosphamide, doxorubicin, vincristine a me kahi steroid i kapa ʻia he prednisolone).
- CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide a me kahi steroid i kapa ʻia he prednisolone).
- Bv-CHP (conjugated monoclonal antibody i kapa ʻia ʻo Brentuximab vedotin, cyclophosphamide, doxorubicin a me kahi steroid i kapa ʻia prednisolone).
- EPOCH i hoʻoponopono ʻia (etoposide, vincristine, doxorubicin, cyclophosphamide a me kahi steroid i kapa ʻia he prednisolone).
- Hyper-CVAD (cyclophosphamide, vincristine, doxorubicin a me kahi steroid i kapa ʻia dexamethasone) e hoʻololi ana me ka methotrexate kiʻekiʻe a me ka cytarabine.
- Ke kuʻi ʻōnaʻi ʻōnaeho kūpono paha i kekahi mau maʻi.
- Cke komo ʻana i ka hoʻokolokolo linical.
Inā he haʻahaʻa kou pilikia ATLL me nā hōʻailona haʻahaʻa a ʻaʻohe paha, ʻaʻole pono ʻoe i ka chemotherapy. Loaʻa paha iā ʻoe ka lāʻau antiviral e mālama i ka HTLV-1 a me kekahi o nā koho lapaʻau ma lalo nei.
- 'E kia'i a kali' (mālama hana).
- ʻO nā ʻaila steroid o nā lotions e hoʻomaikaʻi i nā hōʻailona o ka ʻili a me ka ʻili.
- Radiotherapy.
Hoʻoponopono hou ʻia a i ʻole Refractory o ATLL
E pane maikaʻi ʻo ATLL i ka Immunochemotherapy, akā hoʻi pinepine ia (hoʻi hou), a i ʻole i nā hihia liʻiliʻi ʻaʻole pane i ka lāʻau lapaʻau mua (palekana). Ke hiki mai kēia, hiki iā ʻoe ke kūpono no nā ʻano lapaʻau like ʻole a i ʻole nā hoʻokolohua lapaʻau.
Aia kekahi mau lapaʻau e hāʻawi ʻia iā ʻoe ma lalo nei akā naʻe, me ka noiʻi mau a me nā hoʻokolohua lapaʻau e hoʻomaikaʻi ana i nā lāʻau lapaʻau no ka poʻe me nā lymphomas relapsed a refractory, hiki ke hāʻawi ʻia iā ʻoe kahi mea ʻokoʻa i lalo.
- DHAP (dexamethasone, cytarabine a me cisplatin)
- ESHAP (detoposide, methylprednisolone, cytarabine a me cisplatin)
- GDP (gemcitabine, dexamethasone a me cisplatin)
- hau (ifosfamide, carboplatin a me etoposide)
Hoʻopau i ka mālama ʻana
Hiki ke hoʻohauʻoli ka hoʻopau ʻana i ka mālama ʻana, a i ʻole he manawa hopohopo nui iā ʻoe. Hiki iā ia ke hoʻohauʻoli a me ka hopohopo. He mea maʻamau ke ʻike i nā manaʻo like ʻole ke hoʻopau ʻoe i ka mālama ʻana. A inā ʻoe i hoʻokō maikaʻi i ka wā o ka mālama ʻana, ʻike paha ʻoe i ka wā e lohi ai nā mea āpau a loaʻa iā ʻoe ka manawa e noʻonoʻo ai i kāu mea i loaʻa ai, a pehea e hoʻi ai i kekahi ʻano o ke ola e like me ke ola ma mua o ka mālama ʻana, lilo ʻoe. kaumaha.
Pono ʻoe e hana i nā manaʻo o nā poʻe ʻē aʻe a puni ʻoe a me kā lākou mau manaʻo. He nui nā poʻe maʻi e haʻi i ka paʻakikī o ka poʻe a puni lākou e hoʻi i ka maʻamau ma mua o ka mākaukau.
Ma ka ʻaoʻao ʻē aʻe, ua ʻōlelo ka poʻe maʻi ʻē aʻe e like me ka paʻa ʻana o ka poʻe a puni lākou a ʻaʻole e hoʻokuʻu iā lākou e hoʻi i ka maʻamau, no ka mea makaʻu lākou i kekahi mea ʻē aʻe.
Loaʻa iā mākou nā ʻōlelo aʻoaʻo e pili ana i ka mea e manaʻo ai, a pehea e hoʻokele ai i nā manaʻo, a me nā manaʻolana o nā mea ʻē aʻe ma kā mākou Finishing treatment webpage.
Nānā hou
E hoʻomau ʻoe e ʻike i kāu haematologist a i ʻole oncologist ma hope o ka pau ʻana o ka mālama ʻana. E loiloi lākou iā ʻoe no nā hopena ʻaoʻao mai ka mālama ʻana, a i ʻole nā hopena ʻaoʻao hou e hiki ke loaʻa i nā mahina a i ʻole mau makahiki ma hope o ka pau ʻana o ka mālama ʻana. Hiki iā ʻoe ke ʻike hou aku e pili ana i nā hopena hope ma ke kaomi ʻana i ka hopena o ka lapaau loulou ma luna.
E nānā pū ana lākou iā ʻoe i nā hōʻailona no nā hōʻailona o ka hoʻi hou ʻana o kāu lymphoma i hiki ke hoʻomaka koke ka lāʻau lapaʻau e pono ai.
Hiki i kāu mau hoʻonohonoho hahai ke komo i kekahi o kēia mau mea:
- PET a i ʻole CT scan a me nā hopena
- Nā ho'āʻo koko
- ʻO ka nānā kino o kāu mau lymph nodes
- Nā nīnau e pili ana i kou manaʻo, a me ka hoʻololi ʻana i ke ola ma hope o ka mālama ʻana.
- Nā kuhikuhi no ka mālama hou inā pono.
hōʻuluʻulu manaʻo
- ʻO ATLL kahi ʻano kakaikahi loa o T-cell Non-Hodgkin Lymphoma. Hiki ke hui pū ʻia ma ke ʻano he subtype o Peripheral T-cell Lymphoma.
- Loaʻa iā ATLL he 4 mau ʻano ʻano like ʻole, a he mau papa haʻahaʻa a kiʻekiʻe paha lākou ma muli o ke ʻano koʻikoʻi, a me ke ʻano o ka hopena i kou kino.
- ʻAʻole paha ʻoe i nā hōʻailona, a i ʻole nā hōʻailona haʻahaʻa loa inā loaʻa iā ʻoe kahi lymphoma haʻahaʻa.
- E hōʻike i nā mea hou a i ʻole nā ʻino nā hōʻailona i kāu kauka no ka hoʻokolokolo ʻana, ʻoi aku ka maʻi ʻaʻole e hele aku, pehu lymph node or B-hōʻailona.
- Pono ʻia kahi biopsy e hōʻoia i kahi hōʻailona o ATLL - i kekahi manawa ʻoi aku ka nui ma mua o hoʻokahi.
- Inā loaʻa iā ʻoe kahi ATLL pilikia haʻahaʻa, ʻaʻole paha ʻoe e pono i ka lāʻau lapaʻau, akā pono ʻo ATLL pilikia nui e mālama wikiwiki loa.
- Hiki i ka ATLL ke pane maikaʻi i ka lāʻau lapaʻau, akā pinepine ka hoʻihoʻi ʻana e pono ai ka mālama hou ʻana.
- E nīnau i kāu kauka e pili ana i nā hoʻokolohua lapaʻau i hiki iā ʻoe ke kūpono.
- E hoʻomau ʻoe e ʻike i kāu hematologist a i ʻole oncologist no ka nānā mau ʻana ma hope o ka pau ʻana o ka mālama ʻana.
