Ka Manaʻo no ka Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL)
ʻOi aku ka maʻamau o ka CLL ma mua o ka SLL a ʻo ia ka lua o ka maʻi maʻi maʻi mole B-cell maʻamau, i ka poʻe ma mua o 70 mau makahiki. ʻOi aku ka maʻamau o nā kāne ma mua o nā wahine, a ʻaʻole loa e pili i ka poʻe ma lalo o 40 mau makahiki.
ʻAʻole hiki ke hoʻōla ʻia ka hapa nui o nā lymphoma palaualelo, ʻo ia hoʻi ke ʻike ʻia ʻoe me CLL / SLL, e loaʻa iā ʻoe no ke koena o kou ola. Eia nō naʻe, no ka lohi o ka ulu ʻana, hiki i kekahi poʻe ke ola piha me ka ʻole o nā hōʻailona a ʻaʻole pono e hoʻōla. ʻO nā mea ʻē aʻe he nui, e loaʻa nā hōʻailona ma kekahi manawa a pono e mālama.
No ka hoʻomaopopo ʻana iā CLL/SLL, pono ʻoe e ʻike iki e pili ana i kāu lymphocytes B-Cell
ʻO nā lymphocytes pūnaewele B:
- hana ʻia i loko o kou iwi iwi (ʻo ka ʻāpana spongy i waenakonu o kou mau iwi), akā noho mau i loko o kou ʻōpū a me kou mau lymph nodes.
- he ʻano o ke koko keʻokeʻo.
- e hakakā i ka maʻi a me nā maʻi e mālama i kou olakino.
- E hoʻomanaʻo i nā maʻi i loaʻa iā ʻoe i ka wā ma mua, no laila inā loaʻa hou iā ʻoe ka maʻi like, hiki i ka ʻōnaehana pale o kou kino ke hakakā ʻoi aku ka maikaʻi a me ka wikiwiki.
- hiki ke hele ma kāu ʻōnaehana lymphatic, i kekahi ʻāpana o kou kino e hakakā ai i ka maʻi a i ʻole ka maʻi.
He aha ka hopena i kāu mau pūnaʻi B ke loaʻa iā ʻoe CLL / SLL?
Ke loaʻa iā ʻoe ka CLL / SLL i kāu lymphocytes B-cell:
- lilo i mea ʻino a ulu ʻole me ke kāohi ʻole ʻia, e hopena i ka nui o nā lymphocytes B-cell.
- ʻaʻole e make i ka wā e hana ai lākou i ke ala no nā cell olakino hou.
- ulu wikiwiki, no laila ʻaʻole ulu maikaʻi lākou a ʻaʻole hiki ke hana pono i ka hakakā ʻana i ka maʻi a me ka maʻi.
- hiki ke lawe i ka nui o ka lumi i loko o kou iwi iwi i hiki ʻole ai i kāu mau keena koko ʻē aʻe, e like me ke koko ʻulaʻula a me nā platelets hiki ʻole ke ulu pono.
Ka hoʻomaopopo ʻana iā CLL/ SLL
Ua wehewehe ʻo Polofesa Con Tam, he loea haematologist CLL/SLL ma Melbourne i ka CLL/SLL a pane i kekahi o nā nīnau āu e loaʻa ai.
Ua paʻi ʻia kēia wikiō ma Kepakemapa 2022
ʻIke maʻi me CLL
No ka nui o ka ʻike i loaʻa iā ʻoe mai kāu mau kauka a me nā kahu hānai, hiki ke kōkua i ka lohe ʻana mai kahi mea i ʻike pilikino iā CLL / SLL.
Aia ma lalo kahi wikiō o ka moʻolelo a Warren kahi i hōʻike ai ʻo ia me kāna wahine ʻo Kate i kā lākou ʻike me CLL. Kaomi ma ka wikiō inā makemake ʻoe e nānā.
Nā hōʻailona o CLL / SLL
ʻO CLL / SLL nā maʻi maʻi maʻi lohi, no laila, ʻaʻohe ou hōʻailona i ka manawa i ʻike ʻia ai ʻoe. I ka manawa pinepine, e ʻike ʻia ʻoe ma hope o ka hoʻāʻo ʻana i ke koko, a i ʻole kahi hoʻokolohua kino no kekahi mea ʻē aʻe. ʻOiaʻiʻo, nui ka poʻe me CLL / SLL e ola lōʻihi i ke ola olakino. Eia nō naʻe, hiki iā ʻoe ke hoʻomohala i nā hōʻailona i kekahi manawa ke noho nei me CLL / SLL.
Nā hōʻailona hiki iā ʻoe ke loaʻa
- luhi ʻole (fatiued). ʻAʻole maikaʻi kēia ʻano luhi ma hope o ka hoʻomaha a i ʻole ka hiamoe
- mai ka hanu
- ʻoi aku ka maʻalahi a me ke kahe ʻana ma mua o ka maʻa mau
- nā maʻi hele ʻole, a hoʻi hou mai
- ka hou ʻana i ka pō ma mua o ka maʻamau
- ke kaupaona ʻana me ka hoʻāʻo ʻole
- he puʻupuʻu hou ma kou ʻāʻī, ma lalo o kou mau lima, kou ʻāʻī, a i ʻole nā wahi ʻē aʻe o kou kino - ʻaʻohe ʻeha.
- ʻO nā helu koko haʻahaʻa e like me:
- Anemia - haʻahaʻa hemoglobin (Hb). ʻO ka Hb he pūmua ma kou mau koko ʻulaʻula e lawe ana i ka oxygen a puni kou kino.
- Thrombocytopenia - nā platelet haʻahaʻa. Kōkua nā platelets i kou koko e hoʻopaʻa ʻia i ʻole ʻoe e kahe koko a maʻalahi hoʻi e ʻeha. Kapa ʻia nā platelets he thrombocytes.
- Neutropenia - nā keʻokeʻo keʻokeʻo haʻahaʻa i kapa ʻia he neutrophils. Hoʻopilikia nā Neutrophils i ka maʻi a me ka maʻi.
- Nā hōʻailona B (e nānā i ke kiʻi)
I ka wā e ʻimi ai i ka ʻōlelo aʻo kino
Loaʻa pinepine nā kumu ʻē aʻe o kēia mau hōʻailona, e like me ka maʻi, nā pae hana, ke kaumaha, kekahi lāʻau lapaʻau a i ʻole nā mea aleʻa. Akā he mea nui iā ʻoe e ʻike i kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona e lōʻihi ana ma mua o hoʻokahi pule, a i ʻole e hele koke mai me ke kumu ʻike ʻole.
Pehea e ʻike ʻia ai ka maʻi CLL / SLL
Hiki ke paʻakikī i kāu kauka ke ʻike iā CLL / SLL. ʻAʻole maopopo nā hōʻailona, a like me nā mea i loaʻa iā ʻoe me nā maʻi maʻamau ʻē aʻe, e like me nā maʻi a me nā allergies. ʻAʻole paha ʻoe he mau hōʻailona, no laila paʻakikī ke ʻike i ka wā e ʻimi ai iā CLL / SLL. Akā inā hele ʻoe i kāu kauka me kekahi o nā hōʻailona ma luna, makemake paha lākou e hana i ka hoʻāʻo koko a me ka nānā kino.
Inā manaʻo lākou he maʻi maʻi koko paha ʻoe e like me ka lymphoma a i ʻole ka maʻi leukemia, e ʻōlelo lākou i nā hoʻokolohua hou aʻe e kiʻi i kahi kiʻi ʻoi aku ka maikaʻi o ka mea e hana nei.
Nā Biopsies
No ka hōʻoia ʻana iā CLL / SLL, pono ʻoe i nā biopsies o kāu mau lymph nodes pehu, a me kou iwi iwi. ʻO ka biopsy ka wā e wehe ʻia ai kahi ʻāpana liʻiliʻi o ka ʻiʻo a nānā ʻia i loko o ka hale hana ma lalo o kahi microscope. A laila, e nānā ka pathologist i ke ala, a me ka wikiwiki o ka ulu ʻana o kāu mau cell.
Aia nā ala like ʻole e loaʻa ai ka biopsy maikaʻi loa. Hiki i kāu kauka ke kūkākūkā i ke ʻano maikaʻi loa no kou kūlana. ʻO kekahi o nā biopsies maʻamau ka:
ʻO ka biopsy node excision
Hoʻopau kēia ʻano biopsy i kahi ʻōpū lymph holoʻokoʻa. Inā pili kou ʻōpū lymph i kou ʻili a ʻike maʻalahi, loaʻa paha iā ʻoe kahi anesthetic kūloko e hoʻopau ai i ka wahi. A laila, e ʻoki kāu kauka (i kapa ʻia hoʻi he ʻoki) ma kou ʻili ma kahi kokoke, a i ʻole ma luna o ka lymph node. E wehe ʻia kāu puʻupuʻu lymph ma o ka ʻoki. Loaʻa paha iā ʻoe nā humuhumu ma hope o kēia kaʻina hana a me kahi lole liʻiliʻi ma luna.
Inā hohonu loa ka puʻu lymph no ke kauka e manaʻo ai, pono paha ʻoe e hana i ka biopsy excisional i loko o kahi hale keʻena hana halemai. Hiki iā ʻoe ke hāʻawi ʻia i kahi anesthetic maʻamau - he lāʻau ia e hoʻomoe ai iā ʻoe i ka wā e wehe ʻia ai ka ʻōpū lymph. Ma hope o ka biopsy, e loaʻa iā ʻoe kahi ʻeha liʻiliʻi, a loaʻa paha nā humuhumu me kahi lole liʻiliʻi ma luna.
Na kāu kauka a kahu hānai paha e haʻi iā ʻoe pehea e mālama ai i ka ʻeha, a ke makemake lākou e ʻike hou iā ʻoe e wehe i nā humuhumu.
Biopsy kumu a i ʻole ka nila maikaʻi
ʻO kēia ʻano biopsy e lawe wale i kahi laʻana mai ka puʻu lymph i hoʻopilikia ʻia - ʻaʻole ia e wehe i ka puʻu lymph holoʻokoʻa. E hoʻohana kāu kauka i ka nila a i ʻole nā mea hana kūikawā ʻē aʻe e lawe i ka hāpana. E loaʻa iā ʻoe kahi anesthetic kūloko. Inā hohonu loa ka puʻu lymph no kāu kauka e ʻike a ʻike ai, hiki iā ʻoe ke hana i ka biopsy ma ke keʻena radiology. He mea pono kēia no nā biopsies hohonu no ka mea hiki i ka radiologist ke hoʻohana i ka ultrasound a i ʻole X-ray e ʻike i ka lymph node a e hōʻoia i ka loaʻa ʻana o ka nila ma kahi kūpono.
Hāʻawi kahi biopsy nilala kumu i kahi laʻana biopsy nui aʻe ma mua o kahi biopsy nila maikaʻi.
ʻO ka biopsy o ka iwi iwi
Lawe kēia biopsy i kahi laʻana mai kou iwi iwi i waenakonu o kou iwi. Lawe ʻia ia mai ka ʻūhā, akā ma muli o kou kūlana ponoʻī, hiki ke lawe ʻia mai nā iwi ʻē aʻe e like me kou iwi umauma (sternum).
E hā'awi 'ia 'oe i ka lā'au anesthetic kūloko a loa'a paha kahi ho'omaha, akā e ala ana 'oe no ke ka'ina hana. Hiki iā ʻoe ke hāʻawi ʻia i kekahi lāʻau hōʻeha ʻeha. Na ke kauka e hoʻokomo i ka nila ma kou ʻili a i loko o kou iwi e wehe ai i ka ʻāpana iwi liʻiliʻi.
Hāʻawi ʻia paha ʻoe i kahi ʻaʻahu e hoʻololi ai a hiki iā ʻoe ke ʻaʻahu i kou lole ponoʻī. Inā ʻaʻahu ʻoe i kou mau lole ponoʻī, e hōʻoia i ka hemo a hāʻawi maʻalahi i ke komo ʻana i kou ʻūhā.
Ke ho'āʻo nei i kāu biopsies
E hoʻouna ʻia kāu biopsy a me nā hoʻāʻo koko i ka pathology a nānā ʻia ma lalo o kahi microscope. Ma kēia ʻano hiki i nā kauka ke ʻike inā aia ka CLL / SLL i loko o kou iwi iwi, koko a me nā ʻōpū lymph, a i ʻole i kaupalena ʻia i hoʻokahi a ʻelua wale nō o kēia mau wahi.
E hana hou ka mea maʻi maʻi i kāu mau lymphocytes i kapa ʻia ʻo "flow cytometry". He ho'āʻo kūikawā kēia no ka nānā ʻana i nā protein a i ʻole nā "mea hōʻailona o ka cell surface" ma kāu lymphocytes e kōkua ana i ka hoʻomaʻamaʻa ʻana iā CLL / SLL, a i ʻole nā ʻano subtypes o lymphoma. Hiki i kēia mau polokina a me nā māka ke hāʻawi i ke kauka i ka ʻike e pili ana i ke ʻano o ka lapaʻau e kūpono loa iā ʻoe.
Ke kali nei i nā hualoaʻa
Hiki ke lawe i kekahi mau pule e kiʻi hou i kāu mau hopena hōʻike. He manawa paʻakikī ke kali ʻana i kēia mau hopena. Hiki ke kōkua ke kamaʻilio me ka ʻohana a i ʻole nā hoaaloha, ka ʻaha kūkā a i ʻole e kelepona mai iā mākou ma Lymphoma Australia. Hiki iā ʻoe ke kelepona i kā mākou Lymphoma Care Nurses ma ka leka uila kahu@lymphoma.org.au a i ʻole kelepona 1800 953 081.
Hiki paha iā ʻoe ke hui pū me kekahi o kā mākou hui pūnaewele e kamaʻilio me nā poʻe ʻē aʻe i loaʻa i kahi kūlana like. Hiki iā ʻoe ke loaʻa iā mākou ma:
Hoʻonohonoho ʻia o CLL / SLL
ʻO ke kau ʻana ke ala e hiki ai i kāu kauka ke wehewehe i ka nui o kou kino i hoʻopilikia ʻia e ka lymphoma, a me ke ʻano o ka ulu ʻana o nā cell lymphoma.
Pono paha ʻoe e hoʻāʻo hou e ʻike i kāu pae.
No ka 'ike hou aku e pili ana i ka ho'okani 'ana, e kaomi ma luna o ka pihi ma lalo nei.
ʻO nā hoʻāʻo ʻē aʻe āu e ʻike ai i ka lōʻihi o ka laha ʻana o kāu CLL / SLL:
- ʻO ke kiʻi kiʻi kiʻi Positron emission tomography (PET). He scan kēia o kāu ke kino holoʻokoʻa e hoʻomālamalama i nā wahi i hoʻopilikia ʻia e ka CLL / SLL. Ua like paha nā hopena me ke kiʻi ma ka hema.
- Hoʻopili ʻia ka helu helu helu (CT). Hāʻawi kēia i kahi scan kikoʻī ma mua o ka X-ray, akā no kahi kikoʻī e like me kou umauma a ʻōpū paha.
- Lumbar puncture - E hoʻohana kāu kauka i kahi nila e lawe i kahi laʻana o ka wai mai kahi kokoke i kou iwi kuamoʻo. Hana ʻia kēia e nānā inā aia kāu lymphoma i loko o kou lolo a i ʻole spinal cord. ʻAʻole pono ʻoe i kēia hoʻāʻo, akā na kāu kauka e hōʻike iā ʻoe inā hana ʻoe.
ʻO kekahi o nā ʻokoʻa koʻikoʻi ma CLL / SLL (ma waho o ko lākou wahi) aia ma ke ʻano o ka hana ʻana.
He aha ke ʻano o ka hoʻokūkū?
Ma hope o kou ʻike ʻia ʻana, e nānā kāu kauka i kāu mau hopena hoʻāʻo a pau e ʻike i ke kūlana o kāu CLL / SLL. 'Ōlelo ke kauka i ke kauka:
- pehea ka nui o CLL / SLL i loko o kou kino
- ʻehia mau wahi o kou kino i loaʻa nā pūnaʻi B maʻi kanesa a
- pehea kou kino e hoʻokō ai i ka maʻi.
E nānā kēia ʻōnaehana staging i kāu CLL e ʻike inā loaʻa iā ʻoe, a i ʻole ʻaʻohe o kēia mau mea:
- kiʻekiʻe o nā lymphocytes i loko o kou koko a iwi iwi paha - kapa ʻia kēia he lymphocytosis (lim-foe-cy-toe-sis)
- pehu nā ʻōpū lymph - lymphadenopathy (limf-a-den-op-ah-thee)
- he spleen i hoʻonui ʻia - splenomegaly (splen-oh-meg-ah-lee)
- haʻahaʻa haʻahaʻa o ke koko ʻulaʻula i loko o kou koko - anemia (a-nee-mee-yah)
- nā pae haʻahaʻa o nā platelets i kou koko - thrombocytopenia (throm-bow-cy-toe-pee-nee-yah)
- ake nui - hepatomegaly (hep-at-o-meg-a-lee)
He aha ke ʻano o kēlā me kēia pae
| RAI pae 0 | ʻO Lymphocytosis a ʻaʻohe hoʻonui ʻia o nā puʻupuʻu lymph, spleen, a i ʻole ate, a me nā helu koko ʻulaʻula maʻamau a me nā helu platelet. |
| RAI pae 1 | ʻO Lymphocytosis a me ka hoʻonui ʻia o nā lymph nodes. ʻAʻole i hoʻonui ʻia ka spleen a me ka ate a ʻo ka helu ʻulaʻula a me ka helu platelet he mea maʻamau a haʻahaʻa iki paha. |
| RAI pae 2 | ʻO Lymphocytosis a me ka spleen i hoʻonui ʻia (a me ke akepaʻa i hoʻonui ʻia paha), me ka hoʻonui ʻia ʻana o nā pūnaʻi lymph. He mea maʻamau a haʻahaʻa iki paha ka helu ʻulaʻula a me ka platelet |
| RAI pae 3 | ʻO Lymphocytosis a me ka anemia (kakaikahi loa nā pūnaʻi koko ʻulaʻula), me ka hoʻonui ʻia ʻana o nā pūnana lymph, spleen, a i ʻole ate. Kokoke ka helu maʻamau. |
| RAI pae 4 | ʻO Lymphocytosis me ka thrombocytopenia (kakaikahi loa nā platelets), me ka anemia a i ʻole, hoʻonui ʻia nā ʻōpū lymph, spleen, a i ʻole ate. |
* ʻO ka Lymphocytosis ka nui o nā lymphocytes i loko o kou koko a i ʻole ka iwi iwi
Ua hana ʻia kāu pae ma muli o:
- ka helu a me ka wahi o nā lymph nodes i pili
- inā aia ma luna, ma lalo a ma nā ʻaoʻao ʻelua o ka diaphragm nā ʻōpū lymph i hoʻopilikia ʻia (ʻO kou diaphragm he ʻiʻo nui, ʻano dome ma lalo o kou iwi iwi ʻaoʻao e hoʻokaʻawale i kou umauma mai kou ʻōpū)
- inā ua laha ka maʻi i ka iwi iwi a i ʻole nā ʻano ʻē aʻe e like me ke ake, akemāmā, iwi a i ʻole ka ʻili.
| Kōnae 1 | Hoʻokahi wahi puʻupuʻu lymph i hoʻopilikia ʻia, ma luna a ma lalo paha o ka diaphragm* |
| Kōnae 2 | ʻelua a ʻoi aʻe paha nā ʻāpana lymph node ma ka ʻaoʻao hoʻokahi o ka diaphragm* |
| Kōnae 3 | ma ka liʻiliʻi hoʻokahi wahi lymph node ma luna a ma ka liʻiliʻi loa hoʻokahi wahi lymph node ma lalo o ka diaphragm* e pili ana |
| Kōnae 4 | Aia ka lymphoma i loko o nā pūnana lymph he nui a ua laha i nā wahi ʻē aʻe o ke kino (e laʻa, iwi, akemāmā, ate) |
Eia hou, aia paha kahi leka "E" ma hope o kāu pae. 'O ka E 'o ia ho'i, loa'a iā 'oe kekahi SLL i loko o kekahi okana ma waho o kou pūnaeho lymphatic, e like me kou ake, akemāmā, iwi, a me kou 'ili. | |
Nā nīnau no kāu kauka ma mua o kou hoʻomaka ʻana i ka lapaʻau
Hiki ke koʻikoʻi ke koho ʻana o nā kauka a ʻo ke aʻo ʻana e pili ana i kou maʻi a me nā lāʻau lapaʻau e like me ke aʻo ʻana i kahi ʻōlelo hou. I ke aʻo ʻana
Hiki ke paʻakikī ke ʻike i nā nīnau e nīnau ai ke hoʻomaka ʻoe i ka mālama ʻana. Inā ʻaʻole ʻoe ʻike, ʻaʻole ʻoe, pehea ʻoe e ʻike ai i ka mea e nīnau ai?
ʻO ka loaʻa ʻana o ka ʻike kūpono hiki ke kōkua iā ʻoe e hōʻoluʻolu a ʻike i ka mea e manaʻo ai. Hiki iā ia ke kōkua iā ʻoe e hoʻolālā i mua no kāu mea e pono ai.
Hoʻohui mākou i kahi papa inoa o nā nīnau āu e ʻike ai he kōkua. ʻOiaʻiʻo, kū hoʻokahi ke kūlana o kēlā me kēia kanaka, no laila ʻaʻole i uhi kēia mau nīnau i nā mea āpau, akā hāʻawi lākou i kahi hoʻomaka maikaʻi.
Kaomi ma ka loulou ma lalo nei e kiʻi i kahi PDF o nā nīnau no kāu kauka.
Ka hoʻomaopopo ʻana i kāu genetics CLL / SLL
Nui nā kumu genetic e pili ana i kāu CLL / SLL. Ua kōkua paha kekahi i ka ulu ʻana o kou maʻi, a hāʻawi kekahi i ka ʻike pono e pili ana i ke ʻano o ka lāʻau lapaʻau maikaʻi loa no ʻoe. No ka ʻike ʻana i nā mea genetic e pili ana, pono ʻoe e hana i nā hoʻokolohua cytogenetic.
Nā ho'āʻo Cytogenetic
Hana ʻia nā hoʻokolohua cytogenetics ma kou koko a me nā biopsies e ʻimi i nā loli i kāu chromosomes a i ʻole nā genes. Loaʻa iā mākou he 23 mau chromosomes, akā inā loaʻa iā ʻoe CLL / SLL, ʻokoʻa paha kāu mau chromosomes.
Nā Chromosomea
Loaʻa i nā pūnaewele a pau o ko mākou kino (koe naʻe ke koko ʻulaʻula) kahi nucleus kahi e loaʻa ai kā mākou chromosomes. ʻO nā Chromosomes i loko o nā keena he mau kaula lōʻihi o DNA (deoxyribonucleic acid). ʻO DNA ka ʻāpana nui o ka chromosome e paʻa ana i nā ʻōlelo a ke kelepona a ua kapa ʻia kēia ʻāpana he gene.
Nā Genes
Hōʻike nā Genes i nā protein a me nā cell i loko o kou kino pehea e nānā ai a hana paha. Inā loaʻa kahi hoʻololi (ka hoʻololi ʻana a i ʻole ka hoʻololi ʻana) i kēia mau chromosomes a i ʻole nā genes, ʻaʻole e holo pono kāu mau protein a me nā cell a hiki iā ʻoe ke hoʻomohala i nā maʻi like ʻole. Me CLL / SLL hiki i kēia mau hoʻololi ke hoʻololi i ke ʻano o ka ulu ʻana a me ka ulu ʻana o kāu lymphocytes B-cell, e lilo ai lākou i maʻi kanesa.
ʻO nā hoʻololi nui ʻekolu i hiki ke hana me CLL / SLL ua kapa ʻia ʻo ka holoi ʻana, kahi unuhi a me kahi hoʻololi.
Nā hoʻololi maʻamau i CLL / SLL
ʻO ka holoi ʻana i ka wā e nalowale ana kekahi hapa o kāu chromosome. Inā ʻo kāu holoi ʻana he ʻāpana o ka chromosome 13 a i ʻole 17, kapa ʻia ʻo ia ʻo "del(13q)" a i ʻole "del(17p)". ʻO ka "q" a me ka "p" e haʻi i ke kauka i kahi hapa o ka chromosome i nalowale. Ua like ia no nā holoi ʻana ʻē aʻe.
Inā loaʻa iā ʻoe kahi unuhi, ʻo ia hoʻi, ʻo kahi hapa liʻiliʻi o nā chromosome ʻelua - chromosome 11 a me 14 no ka laʻana, hoʻololi i nā wahi me kekahi. Ke hana ʻia kēia, kapa ʻia ʻo “t(11:14)”.
Inā loaʻa iā ʻoe ka hoʻololi ʻana, ʻo ia paha he chromosome ʻē aʻe kāu. Kapa ʻia kēia ʻo Trisomy 12 (kahi chromosome 12 hou). A i ʻole he hoʻololi ʻē aʻe paha kāu i kapa ʻia ʻo IgHV mutation a i ʻole Tp53 mutation. Hiki i kēia mau hoʻololi a pau ke kōkua i kāu kauka e hana i ka lāʻau lapaʻau maikaʻi loa no ʻoe., no laila e ʻoluʻolu e nīnau i kāu kauka e wehewehe i kāu mau loli.
Pono ʻoe e loaʻa nā hoʻokolohua cytogenetic ke ʻike ʻia ʻoe me CLL / SLL a ma mua o ka mālama ʻana. ʻO nā ho'āʻo cytogenetic ka wā e nānā ai ka ʻepekema i kou koko a me ka laʻana tumo, e nānā i nā ʻokoʻa genetic (mutations) i pili i kou maʻi.
Pono nā kānaka me CLL / SLL e hoʻāʻo genetic ma mua o kou hoʻomaka ʻana i ka mālama ʻana.
ʻO kekahi o kēia mau hoʻāʻo e pono ai ʻoe i hoʻokahi wale nō no ka mea e mau ana nā hopena i loko o kou ola. ʻO nā hoʻokolohua ʻē aʻe, pono paha ʻoe e loaʻa ma mua o kēlā me kēia lapaʻau, a i ʻole i nā manawa like ʻole i kāu huakaʻi me CLL / SLL. ʻO kēia no ka mea ma ka lōʻihi o ka manawa, hiki ke hoʻololi ʻia nā genetic hou ma muli o ka mālama ʻana, kou maʻi a i ʻole nā kumu ʻē aʻe.
ʻO nā hoʻokolohua cytogenetic maʻamau e loaʻa iā ʻoe:
Ke kūlana hoʻololi IgHV
Pono e loaʻa iā ʻoe kēia ma mua o ka mālama mua ʻana wale nō. ʻAʻole loli ka IgHV i ka manawa, no laila pono e hoʻāʻo ʻia i hoʻokahi manawa. E hōʻike ʻia kēia ma ke ʻano he IgHV i hoʻololi ʻia a i ʻole IgHV i hoʻololi ʻole ʻia.
hoao i'a
Pono ʻoe e loaʻa i kēia ma mua o kēlā me kēia lapaʻau. Hiki ke loli ka hoʻololi genetic i kāu hoʻāʻo FISH i ka manawa, no laila e ʻōlelo ʻia e hoʻāʻo ʻia ma mua o ka hoʻomaka ʻana i ka mālama ʻana i ka manawa mua, a i nā manawa a pau o kāu mālama ʻana. Hiki iā ia ke hōʻike inā he holoi ʻia kāu, kahi unuhi a i ʻole kahi chromosome hou. E hōʻike ʻia kēia ma ke ʻano he del(13q), del(17p), t(11:14) a i ʻole Trisomy 12. ʻOiai ʻo kēia nā ʻano like ʻole no ka poʻe me CLL /SLL he ʻokoʻa paha kāu, akā naʻe, ʻo ka hōʻike ʻana. like me keia.
(ʻO FISH ke kū nei no Fluorescent In Sʻo ia Hybridisation a he hana hoʻāʻo i hana ʻia i ka pathology)
TP53 kūlana hoʻololi
Pono ʻoe e loaʻa i kēia ma mua o kēlā me kēia lapaʻau. Hiki ke loli ka TP53 i ka manawa, no laila e ʻōlelo ʻia e hoʻāʻo ʻia ma mua o ka hoʻomaka ʻana i ka mālama ʻana i ka manawa mua, a maʻamau i kāu mālama ʻana. ʻO TP53 kahi gene e hāʻawi i ke code no kahi protein i kapa ʻia ʻo p53 e hana ʻia. ʻO ka p53 he puʻupuʻu e kāohi ana i ka protein a hoʻōki i ka ulu ʻana o nā cell cancerous. Inā loaʻa iā ʻoe kahi hoʻololi TP53, ʻaʻole hiki iā ʻoe ke hana i ka protein p53, ʻo ia hoʻi ʻaʻole hiki i kou kino ke hoʻōki i ka ulu ʻana o nā cell cancerous.
No ke aha he mea nui?
He mea nui e hoʻomaopopo i kēia no ka mea ʻaʻole mākou i ʻike i nā poʻe āpau me CLL / SLL i nā ʻano like ʻole. Hāʻawi nā ʻokoʻa i ka ʻike i kāu kauka e pili ana i ke ʻano o ka lapaʻau ʻana i hiki ke hana, a i ʻole e hana paha no kāu CLL / SLL.
E ʻoluʻolu e kamaʻilio me kāu kauka e pili ana i kēia mau hoʻokolohua a me ke ʻano o kāu hopena no kāu mau koho lapaʻau.
No ka laʻana, ʻike mākou inā loaʻa iā ʻoe kahi hoʻololi TP53, IgHV i hoʻololi ʻole ʻia a del(17p) ʻaʻole pono ʻoe e loaʻa i ka chemotherapy no ka mea, ʻaʻole ia e hana iā ʻoe. Akā ʻaʻole kēia manaʻo ʻaʻohe lāʻau lapaʻau. Aia kekahi mau lāʻau lapaʻau i manaʻo ʻia e hiki ke hana maikaʻi no nā poʻe me kēia mau ʻano like ʻole. E kūkākūkā kākou i kēia ma ka pauku a'e.
Lapaʻau no CLL / SLL
I ka pau ʻana o kāu mau hopena mai ka biopsy, ka hoʻāʻo cytogenetic a me nā scan staging, e nānā kāu kauka i kēia mau mea e hoʻoholo ai i ka lāʻau maikaʻi loa no ʻoe. Ma kekahi mau keʻena maʻi 'aʻai, hiki i kāu kauka ke hui pū me kahi hui o nā loea e kūkākūkā i ke koho lapaʻau maikaʻi loa. Kapa ʻia kēia a hui multidisciplinary (MDT) hui.
Pehea e koho ʻia ai kaʻu papahana lapaʻau?
E noʻonoʻo kāu kauka i nā kumu he nui e pili ana i kāu CLL / SLL. ʻO nā hoʻoholo i ka wā a inā pono ʻoe e hoʻomaka a me ke ʻano o ka lāʻau maikaʻi loa e pili ana i:
- kou pae pono'ī o ka lymphoma, nā hoʻololi genetic a me nā hōʻailona
- kou mau makahiki, ka mōʻaukala olakino i hala a me ke olakino maʻamau
- kou ola kino a noʻonoʻo i kēia manawa a me nā makemake hoʻomanawanui.
Nā hoʻāʻo ʻē aʻe
E kauoha ana kāu kauka i nā hoʻokolohua hou aʻe ma mua o kou hoʻomaka ʻana i ka lapaʻau ʻana i mea e hiki ai i kou puʻuwai, nā māmā a me nā puʻupaʻa ke hoʻokō i ka mālama ʻana. Hiki i nā ho'āʻo hou ke komo i ka ECG (electrocardiogram), ka hoʻāʻo ʻana o ka māmā a i ʻole ka hōʻiliʻili mimi 24-hola.
Hiki i kāu kauka a kahu maʻi maʻi ke wehewehe i kāu hoʻolālā lapaʻau a me nā hopena ʻaoʻao iā ʻoe. Hiki iā lākou ke pane i nā nīnau āu e loaʻa ai. He mea nui e nīnau i kāu kauka a i ʻole kahu maʻi maʻi i nā nīnau e pili ana i kekahi mea āu i maopopo ʻole ai.
Kāhea iā mā˚ou
ʻO ke kali ʻana i kāu mau hopena he manawa o ke koʻikoʻi a me ka hopohopo no ʻoe a me kāu poʻe aloha. He mea nui e hoʻomohala i kahi pūnaewele kākoʻo ikaika i kēia manawa. Pono ʻoe iā lākou inā loaʻa iā ʻoe ka lāʻau lapaʻau.
Makemake ʻo Lymphoma Australia e lilo i ʻāpana o kāu pūnaewele kākoʻo. Hiki iā ʻoe ke kelepona a leka uila i ka Lymphoma Australia Nurse Helpline me kāu mau nīnau a hiki iā mākou ke kōkua iā ʻoe e loaʻa ka ʻike kūpono. Hiki iā ʻoe ke hui pū me kā mākou ʻaoʻao media no ke kākoʻo hou aku. ʻO kā mākou ʻaoʻao Lymphoma Down Under ma Facebook he wahi maikaʻi nō hoʻi e launa pū me nā poʻe ʻē aʻe a puni ʻo Australia a me New Zealand e noho nei me ka lymphoma.
ʻO ka laina mālama kahu hānai Lymphoma:
Helu kelepona: 1800 953 081
Email: kahu@lymphoma.org.au
Hiki i nā koho lapaʻau ke komo i kekahi o kēia mau mea:
Nānā a kali (ka nānā ʻana)
Ma kahi o 1 o 10 poʻe me CLL / SLL ʻaʻole pono e lapaʻau. Hiki ke kūpaʻa me ka liʻiliʻi a ʻaʻohe hōʻailona no nā mahina a i ʻole mau makahiki. Akā, hiki i kekahi o ʻoukou ke loaʻa i kekahi mau pōʻai lapaʻau a me ke kala ʻana. Inā ʻaʻole pono ʻoe e lapaʻau koke a loaʻa paha ka manawa ma waena o nā kala ʻana, e mālama ʻia ʻoe me ka wati a me ke kali (i kapa ʻia ʻo Active Monitor). Nui nā lāʻau lapaʻau maikaʻi no CLL i loaʻa, a no laila hiki ke hoʻomalu ʻia no nā makahiki he nui.
Mālama Kākoʻo
Loaʻa ka mālama kākoʻo inā loaʻa ʻoe i ka maʻi koʻikoʻi. Hiki ke kōkua iā ʻoe i ka liʻiliʻi o nā hōʻailona, a e hoʻomaikaʻi wikiwiki aʻe.
Hiki i nā pūnaeau leukemic (nā pūnaʻi B maʻi ʻaʻai i loko o kou koko a me ka iwi iwi) hiki ke ulu me ka hiki ʻole ke hoʻopaʻa ʻia a hoʻonui i kou iwi iwi, kahe koko, lymph nodes, ate a i ʻole spleen. No ka mea, ua piha ka iwi iwi me nā pūnaewele CLL / SLL ʻōpio loa no ka hana pono ʻana, e hoʻopilikia ʻia kou mau koko maʻamau. Hiki ke hoʻokomo ʻia ka lāʻau kākoʻo i nā mea e like me kou hoʻololi ʻana i ke koko a i ʻole platelet, a i ʻole he lāʻau antibiotic kāu e pale ai a mālama i nā maʻi.
Hiki i ka mālama kākoʻo ke komo i kahi kūkākūkā me kahi hui mālama kūikawā (e like me ka cardiology inā he pilikia kou puʻuwai) a i ʻole ka mālama palliative e mālama i kāu mau hōʻailona. Hiki iā ia ke kamaʻilio e pili ana i kāu mau makemake no kāu pono mālama ola i ka wā e hiki mai ana. Kapa ʻia kēia ʻo Advanced Care Planning.
Ka mālama palekana
He mea nui e ʻike e hiki ke kāhea ʻia ka hui Palliative Care i kēlā me kēia manawa i kāu ala lapaʻau ʻaʻole wale ma ka hopena o ke ola. He maikaʻi nā hui mālama palliative i ke kākoʻo ʻana i nā poʻe me nā hoʻoholo e pono ai lākou e hana i ka hopena o ko lākou ola. aka,, ʻaʻole mālama wale lākou i ka poʻe e make ana. He poʻe akamai nō hoʻi lākou i ka mālama ʻana i nā hōʻailona i kēlā me kēia manawa i kāu huakaʻi me CLL / SLL. No laila, mai makaʻu ʻoe i ke noi ʻana i kā lākou manaʻo.
Inā hoʻoholo ʻoe a me kāu kauka e hoʻohana i ka mālama kākoʻo, a i ʻole e hoʻōki i ka mālama ʻana i kāu lymphoma, hiki ke hana ʻia nā mea he nui e kōkua iā ʻoe e noho olakino a ʻoluʻolu no kekahi manawa.
Kemohana (kemo)
Hiki iā ʻoe ke loaʻa i kēia mau lāʻau ma ke ʻano he papa a/a i ʻole e hāʻawi ʻia ma ke ʻano he kulu (infusion) i loko o kou aʻa (i loko o kou kahawai koko) ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hiki ke hui pū ʻia kekahi mau lāʻau chemo me kahi lāʻau immunotherapy. Hoʻopau ʻo Chemo i nā pūnaewele ulu wikiwiki a hiki ke hoʻopilikia i kekahi o kāu mau sela maikaʻi e ulu wikiwiki ana i nā hopena ʻaoʻao.
ʻAi kino monoclonal (MAB)
Loaʻa paha iā ʻoe kahi infusion MAB ma ke keʻena maʻi maʻi a i ʻole ka haukapila. Hoʻopili ʻo MAB i ka cell lymphoma a huki i nā maʻi ʻē aʻe e hakakā ana i nā keʻokeʻo keʻokeʻo a me nā protein i ke kanesa. Kōkua kēia i kāu ʻōnaehana pale ponoʻī e hakakā i ka CLL / SLL.
Kemo-immunotherapy
Kemoterapi (no ka laʻana, FC) i hui pū me ka immunotherapy (no ka laʻana, rituximab). Hoʻohui pinepine ʻia ka mua o ka lāʻau immunotherapy i ka pōkole no ka regimen chemotherapy, e like me FCR.
Hoʻoponoponoʻia ka hopena
Hiki iā ʻoe ke lawe i kēia ma ke ʻano he papa ma ka home a i ka haukapila. Hoʻopili ʻia nā lāʻau lapaʻau i hoʻopaʻa ʻia i ka cell lymphoma a me nā hōʻailona poloka e pono ai e ulu a hoʻohua hou i nā cell. Hoʻopau kēia i ka ulu ʻana o ka maʻi maʻi, a make nā pūnaʻi lymphoma. No ka ʻike hou aku e pili ana i kēia mau lāʻau lapaʻau, e ʻoluʻolu e ʻike i kā mākou pepa ʻoiaʻiʻo o ka lāʻau lapaʻau waha.
Ka hoʻololi ʻana o ke kino-kelepona (SCT)
Inā he ʻōpio ʻoe a loaʻa iā CLL / SLL koʻikoʻi (ke ulu wikiwiki), hiki ke hoʻohana ʻia kahi SCT, akā kakaikahi kēia. No ka ʻike hou aku e pili ana i ka hoʻololi ʻana i ka stem cell e ʻoluʻolu e ʻike i nā pepa ʻike Hoʻololi i ka Lymphoma
Hoʻomaka i ka lāʻau lapaʻau
ʻAʻole koi ka poʻe he nui me CLL/SLL i ka lāʻau lapaʻau ke ʻike mua ʻia lākou. Akā, e hele ʻoe e kiaʻi a kali. He mea maʻamau kēia no ka poʻe me ka maʻi pae 1 a i ʻole 2, a me kekahi poʻe me ka maʻi pae 3.
Inā loaʻa iā ʻoe ka pae 3 a i ʻole 4 CLL/SLL pono ʻoe e hoʻomaka i ka lapaʻau. Ke hoʻomaka ʻoe i ka mālama ʻana no ka manawa mua, ua kapa ʻia ʻo ia ka lāʻau lapaʻau mua. Loaʻa paha iā ʻoe ma mua o hoʻokahi lāʻau lapaʻau, a hiki i kēia mau mea ke komo i ka chemotherapy, kahi antibody monoclonal a i ʻole ka lāʻau lapaʻau.
Ke loaʻa iā ʻoe kēia mau lāʻau lapaʻau, e loaʻa iā ʻoe i nā pōʻai. ʻO ia hoʻi, e loaʻa iā ʻoe ka lāʻau lapaʻau, a laila hoʻomaha, a laila kekahi pōʻai (pōkole) o ka mālama ʻana. No ka hapa nui o ka poʻe me CLL/SLL chemoimmunotherapy, ʻoi aku ka maikaʻi o ke kala ʻana (ʻaʻohe hōʻailona o ke kanesa).
Nā hoʻololi genetic a me ka mālama ʻana
ʻO ke ʻano o kekahi mau ʻano ʻano ʻano like ʻole e ʻoi aku ka maikaʻi o nā lāʻau lapaʻau i hoʻopaʻa ʻia iā ʻoe, a ʻo nā ʻano ʻino ʻē aʻe - a i ʻole nā genetics maʻamau, ʻoi aku ka maikaʻi o ka chemoimmunotherapy.
IgHV maʻamau (IgHV hoʻololi ʻole) A I ʻole 17p holoi A I ʻole a ka hoʻololi ʻana i kāu gene TP53
ʻO kāu CLL/SLL ʻAʻole paha e pane i ka chemotherapy, akā hiki ke pane i kekahi o kēia mau lāʻau lapaʻau ma kahi o:
- ʻO Ibrutinib - kahi lāʻau lapaʻau i hoʻopaʻa ʻia i kapa ʻia he inhibitor BTK
- Acalabrutinib - he lāʻau lapaʻau i manaʻo ʻia (BTK inhibitor) me ka ʻole a i ʻole kahi antibody monoclonal i kapa ʻia ʻo obinutuzumab
- ʻO Venetoclax & Obinutuzumab - ʻo venetoclax kahi ʻano o ka lāʻau lapaʻau i hoʻopaʻa ʻia i kapa ʻia ʻo BCL-2 inhibitor, ʻo ka obinutuzumab kahi antibody monoclonal
- ʻO Idelalisib & rituximab - ʻo idelalisib kahi lāʻau lapaʻau i hoʻopaʻa ʻia i kapa ʻia he inhibitor PI3K, a ʻo rituximab kahi antibody monoclonal.
- Hiki paha iā ʻoe ke komo i kahi hoʻokolohua lapaʻau - E nīnau i kāu kauka e pili ana i kēia
nui 'ike - Ibrutinib a me Acalabrutinib i kēia manawa ua ʻae ʻia ʻo TGA, ʻo ia hoʻi aia lākou ma Australia. Eia naʻe, ʻaʻole lākou i helu ʻia i kēia manawa PBS ma ke ʻano he lāʻau lapaʻau mua ma CLL/SLL. ʻO kēia ke kumu o ka nui o ke kālā e komo ai. Hiki paha ke loaʻa i nā lāʻau lapaʻau ma "nā kumu aloha", ʻo ia hoʻi, ua uhi ʻia ke kumukūʻai e ka hui lāʻau lapaʻau. Inā loaʻa iā ʻoe IgHV maʻamau, a i ʻole 17p holoi ʻia, e nīnau i kāu kauka e pili ana i ke komo aloha i kēia mau lāʻau lapaʻau.
Ke kākoʻo nei ʻo Lymphoma Australia i ka poʻe me CLL/SLL ma ka waiho ʻana i kahi palapala i ke Kōmike Aʻoaʻo Pōmaikaʻi Lapaʻau (PBAC) e hoʻonui i ka papa inoa PBS no kēia mau lāʻau no ka lāʻau lapaʻau mua; e hoʻonui i kēia mau lāʻau lapaʻau no ka poʻe me CLL/SLL.
Hiki iā ʻoe ke kōkua i ka hoʻonui ʻana i ka ʻike a waiho i kāu hoʻouna ponoʻī i ka PBAC no ka papa inoa PBS ma ke ʻano he lāʻau lapaʻau mua e ke kaomi maʻaneʻi.
Mi hoʻohana ʻia i ka IgHV, a i ʻole hoʻololi ʻē aʻe ma mua o nā mea i luna
Hāʻawi ʻia paha ʻoe i nā lāʻau lapaʻau maʻamau no CLL/SLL me ka chemotherapy a i ʻole chemoimmunotherapy. E hana wale ana ka immunotherapy (rituximab a i ʻole obinutuzumab) inā loaʻa i kāu mau keena CLL/SLL kahi hōʻailona ili i kapa ʻia. CD20 maluna o lakou. Hiki i kāu kauka ke hōʻike iā ʻoe inā he CD20 kāu mau cell.
Aia kekahi mau lāʻau lapaʻau like ʻole a hui pū ʻia e hiki i kāu kauka ke koho mai inā loaʻa iā ʻoe kahi IgHV hoʻololi . Eia kēia mau mea:
- Bendamutine & rituximab (BR) - ʻo ka bendamustine kahi lāʻau lapaʻau a ʻo rituximab kahi antibody monoclonal. Hāʻawi ʻia lāua ʻelua ma ke ʻano he infusion.
- Fludarabine, cyclophosphamide & rituximab (FC-R). ʻO Fludarabine a me cyclophosphamide ka chemotherapy a ʻo rituximab kahi antibody monoclonal.
- ʻO Chlorambucil & Obinutuzumab - ʻo chlorambucil kahi papa lāʻau chemotherapy a ʻo ka obinutuzumab kahi antibody monoclonal. Hāʻawi nui ʻia ia i nā poʻe ʻelemakule, ʻoi aku ka nāwaliwali.
- ʻO Chlorambucil - he papa lāʻau lapaʻau
- Hiki paha iā ʻoe ke komo i kahi hoʻokolohua lapaʻau
Inā ʻike ʻoe i ka inoa o ka lapaʻau āu e loaʻa ai, hiki iā ʻoe ke loaʻa ʻike hou aʻe ma aneʻi.
Ke kala a me ka hoʻi hou
Ma hope o ka mālama ʻana, e hele ka hapa nui o ʻoukou i ke kala ʻana. ʻO ke kala ʻana he manawa ia kahi i koe ʻole ai nā hōʻailona o CLL/SLL i loko o kou kino, a i ʻole i ka wā e hoʻomalu ʻia ai ka CLL/SLL a ʻaʻole pono e mālama ʻia. Hiki ke hoʻomau ʻia ke kala ʻana no nā makahiki he nui, akā i ka hopena, hoʻi mai ka CLL (hoʻi hou) a hāʻawi ʻia kahi lāʻau ʻē aʻe.
CLL / SLL
ʻAʻole hiki ke loaʻa i kekahi o ʻoukou ke kala ʻana me kāu lāʻau lapaʻau mua. Inā loaʻa kēia, kapa ʻia kāu CLL / SLL "refractory". Inā loaʻa iā ʻoe ka refractory CLL / SLL makemake paha kāu kauka e hoʻāʻo i kahi lāʻau lapaʻau ʻē aʻe.
Loaʻa iā ʻoe ka lāʻau lapaʻau inā loaʻa iā ʻoe ka refractory CLL / SLL a i ʻole ma hope o ka hoʻihoʻi ʻana i kapa ʻia ka lāʻau lapaʻau lua. ʻO ka pahuhopu o ka lāʻau lapaʻau ʻelua e hoʻihoʻi hou iā ʻoe i ke kala ʻana.
Inā loaʻa iā ʻoe ke kala hou aʻe, a laila e hoʻi hou a loaʻa hou ka lāʻau lapaʻau, ua kapa ʻia kēia mau lāʻau lapaʻau e hiki mai ana ka lāʻau lapaʻau ʻekolu, lāʻau lapaʻau ʻehā a pēlā aku.
Pono paha ʻoe i kekahi mau ʻano lapaʻau no kāu CLL/SLL. Ke ʻike nei ka poʻe loea i nā lāʻau lapaʻau hou a ʻoi aku ka maikaʻi e hoʻonui ana i ka lōʻihi o ke kala ʻana. Inā ʻaʻole pane maikaʻi kāu CLL/SLL i ka lapaʻau ʻana a i ʻole e hoʻihoʻi koke ʻia ma hope o ka mālama ʻana (i loko o ʻeono mahina) ʻike ʻia kēia ʻo CLL/SLL refractory a pono ʻia kahi ʻano lapaʻau ʻē aʻe.
Pehea e koho ʻia ai ka lāʻau lapaʻau lua
I ka manawa o ka hoʻihoʻi ʻana, e hilinaʻi ke koho ʻana i ka lāʻau lapaʻau i nā kumu he nui.
- Pehea ka lōʻihi o kou kala ʻana
- ʻO kou olakino a me kou mau makahiki
- He aha nā lāʻau CLL i loaʻa iā ʻoe ma mua
- ʻO kāu mau makemake.
Hiki ke hana hou kēia ʻano i nā makahiki he nui. Loaʻa nā lāʻau lapaʻau hou no ka maʻi hoʻihoʻi a i ʻole refractory a me kekahi mau lapaʻau maʻamau no ka CLL/SLL i hoʻihoʻi ʻia e hiki ke komo i kēia mau mea:
- ʻO Venetoclax - kahi lāʻau lapaʻau i hoʻopaʻa ʻia (BCL2 inhibitor) – he papa
- Ibrutinib (Ibruvica) – kahi lapaʻau i manaʻo ʻia (BTK inhibitor) - papa
- Acalabrutinib – kahi lapaʻau i manaʻo ʻia (BTK inhibitor) - papa
- ʻO Idelalisib a me Rituximab - ʻO ka idelalisib kahi lāʻau lapaʻau i manaʻo ʻia (PI3K inhibitor) a ʻo rituximab kahi antibody monoclonal. ʻO Idelalisib kahi papa a hāʻawi ʻia ʻo rituximab ma ke ʻano he kahe i loko o kou mau aʻa.
Hiki ke loaʻa ka ʻike hou aku e pili ana i nā lāʻau lapaʻau ʻaneʻi.
Inā ʻōpio ʻoe a kūpono (ma waho o ka loaʻa ʻana o CLL/SLL) hiki iā ʻoe ke loaʻa i kahi ʻO ka hoʻololi ʻana o nā pūnaʻi kumu Allogeneic.
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 o CLL / SLL 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.
Hoʻāʻo ʻia kekahi mau lāʻau lapaʻau no CLL / SLL
Nui nā lāʻau lapaʻau a me nā hui lapaʻau hou e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a puni ka honua no nā poʻe maʻi me ka maʻi CLL hou a i hoʻihoʻi hou ʻia. ʻO kekahi mau lāʻau lapaʻau e nānā ʻia nei;
- ʻO ka lāʻau lapaʻau hui Venetoclax - me ka hoʻohana ʻana i ka venetoclax me nā ʻano lapaʻau ʻē aʻe
- ʻO Zanubrutinib - kahi capsule i manaʻo ʻia (BTK inhibitor)
- Chimeric antigen receptor T-cell therapy (CAR T-cell therapy)
Hiki iā ʻoe ke heluhelu i kā mākou 'Ka hoʻomaopopo ʻana i nā hoʻokolohua lapaʻau ' pepa ʻoiaʻiʻo a kipa paha i kā mākou webpage no ka ʻike hou aku e pili ana i nā hoʻokolohua lapaʻau
Prognosis no CLL / SLL - a he aha ka hopena i ka pau ʻana o ka mālama ʻana
Nānā ka wānana i ka hopena i manaʻo ʻia o kāu CLL / SLL, a he aha ka hopena o kāu mālama ʻana.
ʻAʻole hiki ke mālama ʻia ka CLL / SLL me nā lāʻau lapaʻau o kēia manawa. ʻO ia ke ʻano o ka wā e ʻike ʻia ai ʻoe, e loaʻa iā ʻoe ka CLL / SLL no ke koena o kou ola…Akā, nui ka poʻe e ola lōʻihi a olakino me CLL / SLL. ʻO ke kumu, a i ʻole ka manaʻo o ka mālama ʻana, ʻo ia ka mālama ʻana i ka CLL / SLL i kahi pae hiki ke mālama ʻia a e hōʻoia i ka liʻiliʻi o nā hōʻailona e pili ana i kou maikaʻi o ke ola.
Loaʻa i nā kānaka āpau me CLL / SLL nā kumu pilikia like ʻole me ka makahiki, ka mōʻaukala olakino a me nā genetics. No laila, paʻakikī loa ke kamaʻilio e pili ana i ka prognosis ma ke ʻano maʻamau. Manaʻo ʻia ʻoe e kamaʻilio me kāu kauka lapaʻau e pili ana i kāu mau pilikia ponoʻī, a pehea e pili ai kēia i kāu prognosis.
Ola - Noho me ke kanesa
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 ola maikaʻi me CLL / SLL.
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. ʻO nā pahuhopu nui ma hope o ka mālama ʻana i kāu CLL / SLL e hoʻi 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 nā lawelawe ākea e like me:
- kino kino, hooponopono eha
- hoʻolālā meaʻai a me ka hoʻoikaika kino
- ka manaʻo, ka ʻoihana a me ke aʻo kālā
Loaʻa iā mākou kekahi mau ʻōlelo aʻoaʻo maikaʻi ma kā mākou pepa ʻike ma lalo nei:
- Makaʻu i ka hoʻi hou ʻana o ka maʻi kanesa a me ka hopohopo scan
- Ka mālama moe a me ka lymphoma
- Hoʻoikaika kino a me ka lymphoma
- Ka luhi a me ka lymphoma
- ʻO ka moekolohe a me ka pilina
- Ka hopena noʻonoʻo o ka maʻi lymphoma a me ka mālama ʻana
- Ka hopena manaʻo o ka noho ʻana me ka lymphoma
- Ka hopena noʻonoʻo o ka lymphoma ma hope o ka hoʻopau ʻana i ka mālama lymphoma
- Ka mālama ʻana i kekahi me Lymphoma
- Ka hopena noʻonoʻo o ka lymphoma hou a i ʻole refractory
- Nā lāʻau lapaʻau hoʻohui a me nā mea ʻē aʻe: Lymphoma
- Ka mālama ponoʻī a me ka Lymphoma
- Mea ai a me Lymphoma
ʻO Lymphoma i hoʻololi ʻia (ka hoʻololi ʻana o Richter)
He aha ka hoʻololi
ʻO ka lymphoma i hoʻololi ʻia he lymphoma i ʻike mua ʻia ma ke ʻano he molowa (ke ulu mālie) akā ua hoʻololi ʻia i kahi maʻi koʻikoʻi (ke ulu wikiwiki).
He kakaikahi ka hoʻololi ʻana, akā hiki ke hana inā e pōʻino nā genes i loko o nā pūnaewele lymphoma palaualelo i ka manawa. Hiki ke hana maoli kēia, a i ʻole ma muli o kekahi mau lāʻau lapaʻau, e ulu wikiwiki ana nā cell. Ke hana ʻia kēia ma CLL / SLL ua kapa ʻia ʻo Richter's Syndrome (RS).
Inā hiki mai kēia, hiki i kāu CLL / SLL ke lilo i ʻano Lymphoma i kapa ʻia ʻo Diffuse Large B-cell Lymphoma (DLBCL) a i ʻole he kakaikahi paha he T-cell Lymphoma.
No ka ʻike hou aku e pili ana i Transformed Lymphoma e ʻoluʻolu e ʻike i kā mākou pepa ʻike ma aneʻi.
