Nānā o Monoclonal B-cell Lymphocytosis
ʻAʻole ʻo Monoclonal B-cell Lymphocytosis (MBL) ka maʻi kanesa, akā ua manaʻo ʻia he kumu pilikia no ka hoʻomohala ʻana i ka Chronic Lymphocytic Leukemia. (CLL). Eia naʻe, ʻaʻole e holomua ka hapa nui o ka poʻe me MBL i CLL.
Hoʻokumu ʻia ka MBL i ka wā e hana ai kou kino i nā mea koko he nui i kapa ʻia ʻo B-cell lymphocytes. Hana ʻia kēia i ka wā e hoʻopili pinepine ai kekahi pūnaʻi B maʻamau iā ia iho, no laila, ʻokoʻa ʻole nā pūnaewele B ʻē aʻe i hana ʻia mai kēlā cell ʻē aʻe, a hana hou i nā clones.
ʻO nā Lymphocytes kahi ʻāpana o kā mākou ʻōnaehana pale a hakakā i ka maʻi a me nā maʻi. Hoʻomaopopo pū lākou i ka wā e ulu ʻole ai nā cell, a kōkua iā lākou e hoʻoponopono iā lākou iho a i ʻole e hoʻopau i nā cell abnormal.
ʻOiai loaʻa paha iā ʻoe nā pūnaʻi B ʻē aʻe, ʻaʻole ia e kōkua i kāu ʻōnaehana pale no ka mea he mea ʻino loa lākou i ka hana pono. Eia nō naʻe, no ka mea ua hoʻopaʻa ʻia kēia mau cell mai kahi pūnaʻi B like ʻole, loaʻa nō iā ʻoe nā pūnaʻi B olakino.
ʻAʻole ʻoe e loaʻa kekahi hōʻailona me MBL, akā inā e holomua kāu MBL i CLL hiki iā ʻoe ke loaʻa nā hōʻailona B. Kaomi ma aneʻi e aʻo e pili ana i nā hōʻailona B.
ʻAʻole like me nā pūnaʻi koko ʻē aʻe, noho nui nā lymphocytes i loko o kā mākou lymphatic system, me kahi helu liʻiliʻi i loko o ko mākou koko. Aia nā lymphocytes e MBL a me CLL i kou koko a me ka iwi iwi.
Nā ʻano o Monoclonal B-cell Lymphocytosis (MBL)
ʻElua mau subtypes o Monoclonal B-cell Lymphocytosis (MBL). Loaʻa kēia mau helu haʻahaʻa a me MBL helu kiʻekiʻe.
- helu haʻahaʻa MBL ʻo ia ka emi ʻana o ka nui o nā lymphocytes maʻamau i loko o kou kahe koko ma mua o 5000 (<0.5 x 10⁹/L). helu haʻahaʻa MBL ʻaʻole holomua i CLL.
- helu kiʻekiʻe MBL ʻo ia ka nui o nā lymphocytes ʻino i ʻike ʻia i loko o kou kahe koko ma mua o 5000 (>0.5 x 10⁹/L). Loaʻa ka helu kiʻekiʻe MBL a loaʻa ʻole (ma kahi o 1-2%) i kēlā me kēia makahiki o ka holomua ʻana i CLL.
Ua ʻōlelo ʻia ua hoʻololi ʻia ʻo MBL i CLL inā piʻi ka helu lymphocyte maʻamau i loko o ke koko (lymphocytosis) ma mua o 5 x 10⁹/L.
Pehea ka like o MBL me CLL?
ʻO nā lymphocytes B-cell monoclonal i ka helu kiʻekiʻe MBL he like nā proteins ma luna o lākou i loaʻa ma nā pūnaewele o ka poʻe me CLL. ʻO kēia ke kumu i manaʻo ʻia ai ka MBL e hoʻonui i kou pilikia o ka hoʻomohala ʻana iā CLL. Eia nō naʻe, me ka MBL, e emi ana nā pūnaʻi B monoclonal a ʻaʻohe hōʻailona. Inā holomua ia i ka CLL, e loaʻa iā ʻoe nā pūnaʻi B monoclonal ʻē aʻe, a hoʻomaka paha e hoʻomohala i nā hōʻailona o ka lymphoma.
ʻO wai ka mea hoʻomohala i ka MBL?
Hiki iā ʻoe ke hoʻomohala i ka MBL i kou wā ʻelemakule. He mea kakaʻikahi loa ia i ka poʻe ma lalo o 40 mau makahiki, akā ma kahi o 1 i 10 poʻe ma mua o 40 mau makahiki e loaʻa iā MBL. Hoʻonui kēia i ka poʻe ma mua o 90 mau makahiki, me kahi o 7-8 o kēlā me kēia 10 poʻe ma mua o 90 mau makahiki he MBL.
ʻO nā kumu pilikia ʻē aʻe no ka hoʻomohala ʻana i ka MBL penei:
- ʻElua mau kānaka o kou ʻohana i loaʻa i ka Chronic Lymphocytic Leukemia (CLL)
- Inā ua loaʻa iā ʻoe kekahi mau maʻi e like me ka maʻi hepa C, ka maʻi pneumonia, ka maʻi maʻi, ka cellulitis, nā maʻi ʻōpū o luna a me ka herpes zoster.
- ʻOi aku ka maʻamau o ka MBL i nā kāne ma mua o nā wahine, ʻoiai hiki i nā wahine ke loaʻa.
Inā loaʻa iā ʻoe kahi helu MBL kiʻekiʻe a holomua ia e lilo i CLL, ʻaʻole pono paha ʻoe e lapaʻau. Ma kahi o hoʻokahi o ʻelima mau kānaka me CLL ʻaʻole pono e mālama i kekahi lāʻau. ʻO ka hapa nui o ka poʻe e holomua ana i ka CLL e noho mau lākou i ke ola maʻamau a loaʻa ke ola maʻamau.
Pehea e ʻike ʻia ai ka MBL?
ʻAʻole hoʻokumu ʻia ka MBL i nā hōʻailona, no laila hiki iā ʻoe ke ʻike he pilikia ke loaʻa iā ʻoe kahi hoʻāʻo koko no kekahi kumu ʻē aʻe, e hōʻike ana he kiʻekiʻe kou kiʻekiʻe o nā lymphocytes B-cell i kou koko. Eia nō naʻe, aia kekahi mau kumu e hiki ai ke hoʻonui ʻia kāu helu lymphocyte. Hiki i kēia mau mea ke komo i ka maʻi maʻi, ka mumū a me nā pilikia auto immune.
E nānā hou kāu kauka i kāu mau hoʻāʻo koko i nā mahina ʻekolu e hiki mai ana e ʻike inā hoʻi ka helu lymphocyte i ka maʻamau. Inā mau ka pae kiʻekiʻe a piʻi aʻe paha, pono ʻoe i nā hoʻokolohua hou aʻe e ʻike ai i ke kumu.
Kahe cytometry
ʻO Flow cytometry kahi hoʻāʻo kūikawā i hana ʻia i ka pathology ma kāu mau hoʻāʻo koko, a hiki ke hoʻohana ʻia e ʻike i ka MBL. Ke nānā pono nei ʻo ia i nā pūnaewele e ʻike i nā ʻano ʻano like ʻole a pau o nā cell, me nā ʻano protein i loaʻa iā lākou. E hōʻike ʻia inā ua hoʻopaʻa ʻia nā pūnaʻi B ʻē aʻe mai ka cell mua like (monoclonal), a inā like nā protein i loaʻa ma nā cell CLL.
Hiki i ka mea hoʻopalekana ke hoʻomaopopo i ka nui o kāu mau pūnaewele B he mau pūnaewele monoclonal ʻino a ʻehia nā mea maʻamau, e kōkua iā lākou e hana inā loaʻa iā ʻoe ka MBL a i ʻole CLL.
Nā hoʻāʻo ʻē aʻe
Pono paha ʻoe i nā hoʻāʻo hou aʻe e hōʻoia i ka ʻokoʻa o nā cell abnormal i loko o kou koko wale nō a ʻaʻole i loko o kou mau lymph nodes a i ʻole nā wahi ʻē aʻe o kou kino. ʻO kēia ke kāpae ʻana i ka CLL a i ʻole nā ʻano lymphoma ʻē aʻe i kumu no ka helu monoclonal B-cell kiʻekiʻe.
- Ka pākuʻina o ka tomography (CT) - he scan maʻamau kēia e nānā i loko o kou kino. Hiki iā ia ke hōʻike inā loaʻa iā ʻoe kekahi mau lymph nodes pehu (lymphadenopathy), a i ʻole he mau maʻi koko (ohi ʻana o nā pūnaʻi B ʻino) i loko o kou kino.
- Biopsy iwi ʻōiwi - hiki ke hana ʻia kēia hoʻāʻo e ʻike inā loaʻa iā ʻoe nā pūnae B monoclonal i loko o kou iwi iwi.
Ke kali nei i nā hualoaʻa
Ke kali nei i nā hualoaʻa hiki ke lilo i manawa paʻakikī. Hiki ke kōkua ke kamaʻilio me kou ʻohana, nā hoaaloha a i ʻole kahi kahu lapaʻau kūikawā. Hiki iā ʻoe ke hoʻokaʻaʻike i kā mākou mau kahu hānai lymphoma ma ke kaomi ʻana i ka pihi contact us ma lalo o ka pale.
Hoʻoponopono i ka Monoclonal B-cell Lymphocytosis (MBL)
ʻAʻole pono ʻoe i ka lāʻau lapaʻau no MBL. Loaʻa iā ʻoe nā pūnaʻi B olakino e pale aku iā ʻoe mai ka hapa nui o nā maʻi a me nā maʻi, a ʻaʻole e loaʻa iā ʻoe nā hōʻailona e hōʻeha ai ʻoe me MBL.
Makemake kāu kauka e nānā i kāu mau ho'āʻo koko i kēlā me kēia manawa e hōʻoia i ka piʻi ʻole o kāu helu lymphocyte. I ka wā mua hiki iā lākou ke nānā i kēlā me kēia 3 mahina a i ʻole. Inā paʻa ka helu lymphocyte, pono paha ʻoe e hoʻāʻo koko i hoʻokahi manawa i ka makahiki.
He mea kakaikahi loa ka MBL e holomua i CLL, akā inā hiki ke kiʻi koke ʻia ma o nā hoʻokolohua koko maʻamau. ʻOiai inā hoʻomohala ʻoe i ka CLL, ʻaʻole pono ʻoe i ka lāʻau lapaʻau. Ma kahi o 1 i loko o 5 poʻe me CLL ʻaʻole pono e lapaʻau.
I ka wā e launa aku ai i kāu kauka
Pono ʻoe e kelepona i kāu kauka inā hoʻomaka ʻoe e ʻike i nā hōʻailona o ka lymphoma a i ʻole CLL. Hiki i kēia mau mea ke komo:
- ʻO ka ʻeha a i ʻole ke kahe ʻana o ke koko ma mua o ka mea maʻamau.
- Pokole hanu me ke kumu ole.
- ʻAʻole maikaʻi ka luhi nui me ka hiamoe a me ka hoʻomaha (ka luhi).
- ʻO nā maʻi e hoʻi mau ana a hele ʻole paha.
- ʻIli ʻili.
- ʻO kahi puʻupuʻu e piʻi mai ana ma lalo o kou ʻili ma muli o ka pehu ʻana o nā lymph nodes (maʻamau ma kou ʻāʻī, ʻāʻī a i ʻole ka ʻāʻī).
- B-hōʻailona.
Pehea e mālama ai i ke ola olakino me MBL?
Me ka hoʻonui ʻana i kou pilikia o ka hoʻomohala ʻana i ka CLL, hōʻike kekahi mau noiʻi e piʻi nui ana ka poʻe me ka MBL helu kiʻekiʻe i nā maʻi ʻē aʻe a me nā maʻi kanesa. ʻAʻole ʻike ʻia kēia pilikia nui i ka poʻe me ka helu haʻahaʻa MBL.
He mea nui e mālama pono i kou olakino a hōʻike a hōʻike i nā hōʻailona hou a i ʻole ka ʻino i kāu kauka.
Aia ma lalo kekahi mau manaʻo no ka noho maikaʻi ʻana me MBL.
- E pale i kou ʻili mai ka lā. Ke hoʻohana i waho i kahi pale lā SPF50+, e uhi i kou ʻili me nā lole, e hoʻokomo i ka pāpale a me nā aniani.
- E nānā i kou ʻili a hōʻike i nā kiko hou a i ʻole e pili ana i nā kiko, nā ʻōpala a i ʻole nā ʻeha i hoʻōla ʻole i kāu GP. He manaʻo maikaʻi nō hoʻi ka nānā ʻana i ka ʻili makahiki me kāu GP a i ʻole ke keʻena maʻi maʻi ʻili kūikawā.
- E ho'āʻo i ke koko e nānā i ke kiʻekiʻe o ka huaora D. Na kāu GP e haʻi iā ʻoe inā pono ʻoe e lawe i nā mea hoʻohui vitamin D.
- E hoʻomau i ka ʻike me nā lāʻau lapaʻau (vaccines) i loaʻa iā ʻoe. Loaʻa kēia i ka lāʻau lapaʻau maʻi maʻi i kēlā me kēia makahiki a me nā lāʻau lapaʻau i ʻōlelo ʻia i ka wā e hele ai i nā wahi ʻē aʻe o ka honua. ʻAʻole ʻōlelo ʻia nā lāʻau lapaʻau ola no ka poʻe me MBL. ʻO kahi laʻana o ka lāʻau lapaʻau ola ʻo MMR (ka maʻi maʻi, mumps a me ka rubella. E hōʻoia ʻoe e nānā i kēia me kāu GP.
- E hele mau i ka nānā 'ana i ka ma'i 'a'ai kūpono no nā makahiki e like me ka colonoscopy, mammogram a me nā pap smears.
- ʻAi maikaʻi, hoʻoikaika kino a mālama i ke kaumaha olakino. Inā makemake ʻoe i ka ʻōlelo aʻoaʻo e pili ana i kēia, e noi i kāu GP no kahi hoʻolālā hoʻokele e hiki ke komo i ka ʻike ʻana i ke kauka meaʻai, physiotherapist a i ʻole physiologist hoʻoikaika kino.
hōʻuluʻulu manaʻo
- ʻAʻole ʻo MBL ka maʻi kanesa, akā hiki ke hoʻonui i kou pilikia o ka hoʻomohala ʻana i ka CLL a i ʻole nā ʻano maʻi kanesa ʻē aʻe.
- Hoʻokumu ʻo MBL mai kahi cell abnormal i hana i nā clones nona iho.
- Hiki ke helu haʻahaʻa a helu kiʻekiʻe paha ka MBL. Hiki i ka MBL helu kiʻekiʻe ke holomua i CLL, akā kakaʻikahi loa kēia.
- ʻAʻole pono ʻo MBL i ka lāʻau lapaʻau a ʻaʻole hoʻokumu i nā hōʻailona, akā pono ʻoe e hoʻāʻo maʻamau i ke koko e nānā i kāu helu lymphocyte.
- He mea nui ke ola kino a me ka nānā mau ʻana me kāu kauka ke loaʻa iā ʻoe ka MBL.
- E hōʻike a me nā hōʻailona hou a i ʻole nā hōʻailona ʻino i kāu kauka.
