No ka hoʻomaopopo ʻana iā FL, pono ʻoe e ʻike iki e pili ana i kāu lymphocytes B-Cell.
ʻO nā lymphocytes pūnaewele B:
- He ʻano o ke koko keʻokeʻo
- E hakakā i ka maʻi a me nā maʻi e mālama pono iā ʻoe.
- 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 me ka ʻoi aku ka maikaʻi a me ka wikiwiki.
- Hana ʻia i loko o kou iwi iwi (ʻo ka ʻāpana spongy i waenakonu o kou mau iwi), akā e noho mau i loko o kou ʻōpū a me kou mau lymph nodes. Noho kekahi i kou thymus a me ke koko pū kekahi.
- Hiki ke hele ma kāu ʻōnaehana lymphatic, i kekahi ʻāpana o kou kino e hakakā ai i ka maʻi a i ʻole ka maʻi.
Hoʻoulu ʻia ka follicular lymphoma (FL) i ka wā e lilo ai kāu mau pūnaʻi B i ke kanesa
Hoʻokumu ʻo FL i ka wā i kāhea ʻia kekahi o kāu mau lymphocytes B-cell follicular center B-cells lilo i ma'i ma'i. Ke nānā ka pathologist i kou koko a i ʻole nā biopsies, ma lalo o kahi microscope e ʻike lākou he hui pū ʻia ʻoe o nā cell centrocyte, nā mea liʻiliʻi a hiki i ka liʻiliʻi B-nui, a me nā centroblasts he mau pūnaʻi B nui.
Loaʻa ka Lymphoma i ka ulu ʻana o kēia mau pūnaewele me ka hiki ʻole ke hoʻopaʻa ʻia, ʻano ʻole, a ʻaʻole make i ka wā e pono ai.
Ke loaʻa iā ʻoe ka FL, nā pūnaʻi B maʻi kanesa:
- ʻAʻole e hana maikaʻi e hakakā i nā maʻi a me nā maʻi.
- Hiki ke ʻokoʻa ke ʻano o kāu mau sela B-lymphocyte olakino.
- Hiki ke ulu a ulu ka lymphoma ma kekahi wahi o kou kino.
ʻO FL ka lymphoma ulu lohi loa (indolent) a ma muli o ke ʻano palaualelo o kēia lymphoma e ʻike mau ʻia i ka wā o ka pae kiʻekiʻe. ʻAʻole hoʻōla ka pae kiʻekiʻe ʻo FL, akā ʻo ka pahuhopu o ka mālama ʻana ʻo ia ka mālama ʻana i nā maʻi no nā makahiki he nui. Inā ʻike ʻia kāu FL i ka wā mua, hiki ke ho'ōla ʻia ʻoe e kekahi mau ʻano lapaʻau.
I kekahi manawa, hiki i ka follicular lymphoma (FL) ke hōʻike i ka hui pū ʻana o nā sela e komo pū ana me ka Lymphoma B-Cell Lymphoma (ke ulu wikiwiki). Hiki ke hoʻololi i kēia ʻano hana i ka manawa a kapa ʻia ʻo 'transformation'. ʻO FL i hoʻololi ʻia, ʻo ia hoʻi ke ʻano o kāu mau pūnaewele a ʻoi aku ka like Hoʻopuehu nui B cell lymphoma (DLBCL) a kakaikahi paha, ʻO ka lymphoma o Burkitt (BL).
Loaʻa iā wai ka follicular lymphoma (FL)?
ʻO FL ke ʻano maʻamau maʻamau o ka ulu lohi (indolent) Non-Hodgkin's Lymphoma (NHL). Ma kahi o 2 o kēlā me kēia 10 poʻe me nā lymphoma palaualelo me ka subtype o FL. He mea maʻamau ia i ka poʻe ma mua o 50 mau makahiki, a ʻoi aku ka nui o nā wahine ma mua o nā kāne.
He kakaikahi ka lymphoma follicular pediatric akā hiki ke loaʻa i nā keiki, nā ʻōpio a me nā ʻōpio. He ʻokoʻa kona ʻano i ka subtype makua a hiki ke hoʻōla pinepine ʻia.
He aha ke kumu o ka lymphoma follicular?
ʻAʻole mākou ʻike i ke kumu o ka FL, akā manaʻo ʻia nā ʻano pilikia like ʻole e hoʻonui i kou pilikia o ka hoʻomohala ʻana. ʻO kekahi, nā kumu pilikia no FL i manaʻo ʻia e komo:
- nā maʻi e pili ana i kāu ʻōnaehana pale e like me ka maʻi Celiac, Sjogren's syndrome, lupus, rheumatoid arthritis a i ʻole ka maʻi maʻi immunodeficiency kanaka (HIV)
- ka mālama ʻana i ka maʻi maʻi ma mua, me ka chemotherapy a i ʻole radiation therapy
- he lālā o ka ʻohana me ka lymphoma
*He mea nui e hoʻomaopopo, ʻaʻole nā kānaka a pau i loaʻa kēia mau mea pilikia e hoʻomohala i ka FL, a ʻo kekahi poʻe me ka loaʻa ʻole o ia mau pilikia hiki ke hoʻomohala i ka FL.
ʻIke maʻi me ka follicular lymphoma (FL)
Nā hōʻailona o ka follicular lymphoma (FL)
ʻAʻohe ou hōʻailona i ka wā i ʻike mua ʻia ai ʻoe me FL. He nui ka poʻe i ʻike wale ʻia ke loaʻa iā lākou kahi hoʻāʻo koko, scans, a i ʻole kahi hoʻokolokolo kino no kekahi mea ʻē aʻe. ʻO kēia ma muli o ke ʻano molowa – ulu lohi a hiamoe paha o FL.
Inā ʻike ʻoe i nā hōʻailona, ʻo nā hōʻailona mua a me nā hōʻailona o FL he puʻupuʻu, a i ʻole kekahi mau puʻupuʻu e ulu mau ana. Hiki iā ʻoe ke manaʻo a ʻike paha iā lākou ma kou ʻāʻī, ʻāʻī, a i ʻole ka ʻāʻī. ʻO kēia mau puʻupuʻu he lymph nodes (glands) i hoʻonui ʻia, ua pehu ʻia ma muli o ka nui ʻana o nā pūnaʻi B maʻi maʻi e ulu ana i loko o lākou. Hoʻomaka pinepine lākou ma kahi ʻāpana o kou kino, a laila hoʻolaha i kāu ʻōnaehana lymphatic.
Hiki ke ulu mālie kēia mau lymph nodes no ka manawa lōʻihi, hiki ke paʻakikī ke ʻike inā he mau loli.
Hiki ke laha ka Follicular Lymphoma (FL) i kekahi wahi o kou kino
Hiki iā FL ke laha i kāu
- ʻāpala
- kāu thyma
- ka umauma
- ate
- iwi
- ka iwi o ka iwi
- a i ʻole nā kino ʻē aʻe.
ʻO kou ʻōpū he ʻōkana e kānana i kou koko a mālama i ke olakino. He okana nō hoʻi ia o kāu ʻōnaehana lymphatic kahi e noho ai kāu mau pūnaʻi B a hana i nā antibodies e hakakā i ka maʻi. Aia ia ma ka ʻaoʻao hema o kou ʻōpū luna ma lalo o kou māmā a kokoke i kou ʻōpū (opu).
Ke nui loa kou ʻāʻī, hiki iā ia ke hoʻoikaika i kou ʻōpū a māʻona ʻoe, ʻoiai inā ʻaʻole ʻoe i ʻai nui.
ʻO kou thymus kekahi ʻāpana o kāu ʻōnaehana lymphatic. He ʻano pepeke ia e noho ana ma hope pono o kou iwi umauma i mua o kou umauma. Ke ola nei kekahi mau pūnaʻi B a hele i loko o kou thymus.
Nā hōʻailona maʻamau o ka lymphoma
Hiki ke like nā hōʻailona he nui o FL me nā hōʻailona i loaʻa i nā kānaka i kekahi subtype o lymphoma hiki ke komo i kēia mau mea:
- luhi luhi ʻole (fatiued)
- pau ka hanu
- ʻili ʻili
- nā maʻi hele ʻole a hoʻi hou mai
- nā hoʻololi i kāu hoʻāʻo koko
- ʻulaʻula haʻahaʻa a me nā platelets
- nui loa nā lymphocytes a/a i ʻole nā lymphocytes i hana pono ʻole
- nā keʻokeʻo i hoʻohaʻahaʻa ʻia (me nā neutrophils)
- kiʻekiʻe lactic acid dehydrogenase (LDH) - he ʻano protein i hoʻohana ʻia e hana i ka ikehu. Inā hōʻino ʻia kāu mau sela e kou lymphoma, hiki i ka LDH ke kahe i waho o kāu mau pūnaewele a i loko o kou koko
- kiʻekiʻe beta-2 microglobulin - he ʻano protein i hana ʻia e nā pūnaewele lymphoma. Hiki ke loaʻa iā ia i loko o kou koko, mimi a i ʻole ka wai o ka spinal cerebral
- B-hōʻailona
ʻO nā hōʻailona ʻē aʻe o ka follicular lymphoma e hilinaʻi paha ma kahi o kou maʻi i loko o kou kino
Wahi i pili | Ōuli |
Gut - me kou ʻōpū a me ka ʻōpū | Nausea me ka luaʻi ʻole a i ʻole ka luaʻi ʻana (ka maʻi i loko o kou ʻōpū a kiola paha) ʻO ka maʻi maʻi a i ʻole ka paʻa ʻana (ka wai a i ʻole ka wai paʻakikī) Koko ke hele i ka lua Manaʻo piha inā ʻaʻole ʻoe i ʻai nui |
Pūnaehana nūnū waena (CNS) - me kou lolo a me ke kuamoʻo | Hoʻololi huikau a hoʻomanaʻo paha Nā hoʻololi kūlohelohe Ka hopu Nawaliwali, numbness, kuni a i ʻole nā kui a me nā nila ma kou mau lima a me kou mau wāwae |
umauma | ʻO ka manawa pōkole ʻO kaʻeha hope He ʻūhā maloʻo |
ʻŌiwi iwi | ʻO nā helu koko haʻahaʻa e pili ana i nā ʻulaʻula, nā keʻokeʻo a me nā platelet e hopena i: o Pokole hanu o ʻO nā maʻi maʻi e hoʻi mai ana a paʻakikī paha ke hoʻopau ʻia o He koko ʻokoʻa a ʻeha paha
|
Skin | ʻulaʻula a poni paha ke nānā aku ʻO nā puʻupuʻu a me nā puʻupuʻu ma kou ʻili he ʻili a ʻulaʻula a poni paha Pana |
I ka wā e launa aku ai i kāu kauka
Aia kekahi mau hōʻailona e hōʻike ana e hoʻomaka ana kāu FL e ulu a ʻoi aku ka paʻakikī. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e kelepona i kāu kauka. Mai kali no nā koho hou aʻe. He mea nui e hoʻokuʻu koke iā lākou i hiki iā lākou ke hana i nā hoʻolālā no ka mālama ʻana inā pono ʻoe.
E kelepona iā ʻoe inā ʻoe:
- ua pehu nā pūnaʻi lymph ʻaʻole e hele, a inā ʻoi aku ka nui ma mua o kou manaʻo no kahi maʻi
- he manawa pokole ka hanu me ke kumu ole
- ʻoi aku ka luhi ma mua o ka mea maʻamau a ʻaʻole maikaʻi me ka hoʻomaha a me ka hiamoe
- e ʻike i ke koko ʻokoʻa a i ʻole ka ʻeha ʻana (me ka poʻe i loko o kā mākou poo, mai kou ihu a i ʻole ka ʻāʻī)
- e hoʻomohala i kahi maʻi ʻē aʻe (he ʻulaʻula ʻulaʻula ʻulaʻula hiki ke ʻano he kahe koko ma lalo o kou ʻili)
- e ʻoi aku ka ʻeha ma mua o ka maʻamau
- e hoʻomohala i kahi ʻū maloʻo hou
- ʻike i nā hōʻailona B.
He mea nui e hoʻomaopopo i ka nui o nā hōʻailona a me nā hōʻailona o FL hiki ke pili i nā kumu ʻē aʻe ma waho o ka maʻi kanesa. No ka laʻana, hiki nō hoʻi i ka pehu nā kōpili lymph inā loaʻa iā ʻoe kahi maʻi. ʻO ka mea maʻamau, inā loaʻa iā ʻoe kahi maʻi, e hoʻomaikaʻi nā hōʻailona, a e hoʻi ka nui o nā lymph nodes i ka nui maʻamau i loko o kekahi mau pule. Me ka lymphoma, ʻaʻole e pau kēia mau hōʻailona. Hiki paha iā lākou ke ʻoi aku ka ʻino.
Pehea e ʻike ʻia ai ka follicular lymphoma (FL)?
Hiki ke paʻakikī ka ʻike ʻana iā FL i kekahi manawa a hiki ke lawe i kekahi mau pule.
Inā manaʻo kāu kauka he lymphoma paha kāu, pono lākou e hoʻonohonoho i nā hoʻokolohua koʻikoʻi. Pono kēia mau ho'āʻo e hōʻoia a hoʻopau paha i ka lymphoma ke kumu o kāu mau hōʻailona. He mea koʻikoʻi ka hōʻoia ʻana i ke ʻano o Non-Hodgkin's Lymphoma (NHL) no ka mea ʻokoʻa ka hoʻokele a me ka mālama ʻana i kāu ʻano subtype me nā ʻano subtype ʻē aʻe o NHL.
No ka ʻike ʻana i ka FL pono ʻoe i kahi biopsy. ʻO ka biopsy kahi hana e wehe ai i kahi ʻāpana, a i ʻole nā mea āpau i hoʻopilikia ʻia a/a i ʻole ka iwi iwi. A laila nānā ʻia ka biopsy e nā ʻepekema i loko o kahi keʻena hana e ʻike inā he mau loli e kōkua i ke kauka e ʻike i ka FL.
Ke loaʻa iā ʻoe kahi biopsy, loaʻa paha iā ʻoe kahi maʻi anesthetic kūloko a i ʻole maʻamau. E pili ana kēia i ke ʻano o ka biopsy a me kahi ʻāpana o kou kino i lawe ʻia mai. Aia nā ʻano biopsies like ʻole, a pono paha ʻoe ma mua o hoʻokahi no ka loaʻa ʻana o ka laʻana maikaʻi loa.
Nā ho'āʻo koko
E loaʻa iā ʻoe nā hoʻokolohua koko he nui i ka manawa. E hoʻomaka ʻoe me nā hoʻāʻo koko ma mua o kou loaʻa ʻana i kahi maʻi me FL. Loaʻa iā ʻoe ma mua a i ka wā o ka mālama ʻana inā pono ʻoe i ka lapaʻau. Hāʻawi lākou i kāu kauka i ke kiʻi o kou olakino maʻamau, no laila hiki iā lākou ke hana i nā hoʻoholo maikaʻi loa me ʻoe e pili ana i kāu pono mālama olakino a me ka mālama ʻana.
ʻO ka nila maikaʻi a i ʻole biopsy kumu
ʻO ka biopsy koʻikoʻi e pili ana i ke kauka e hoʻohana ana i ka nila a hoʻokomo i loko o kāu puʻupuʻu lymph pehu a i ʻole ka puʻupuʻu i hiki iā lākou ke wehe i kahi laʻana o ka ʻiʻo e hoʻāʻo ai no ka lymphoma. Hana ʻia kēia ma lalo o kahi anesthesia kūloko, ʻoiai ʻoe e ala ana.
Inā hohonu ka puʻu lymph i hoʻopilikia ʻia i loko o kou kino, hiki ke hana ʻia ka biopsy me ke kōkua o ke ultrasound a i ʻole ke alakaʻi x-ray (kiʻi).
ʻO ka biopsy node excision
Hana ʻia kahi biopsy excisional inā hohonu loa kou ʻōpū lymph node ʻaʻole hiki ke kiʻi ʻia me ka nila, a inā makemake kāu kauka e wehe a nānā i ka puʻu lymph holoʻokoʻa.
Hana ʻia ia e like me ke kaʻina hana o ka lā ma ke keʻena hana a loaʻa iā ʻoe kahi maʻi maʻi maʻamau e hoʻomoe iā ʻoe no kahi manawa liʻiliʻi i ka wā e pau ai ke kaʻina hana. Ke ala ʻoe e loaʻa iā ʻoe kahi ʻeha liʻiliʻi a me nā humuhumu. Hiki i kāu kauka a kahu hānai paha ke hōʻike iā ʻoe pehea e mālama ai i ka ʻeha, a me ka wā e wehe ai i kou mau humuhumu.
Na ke kauka e koho i ka biopsy maikaʻi loa iā ʻoe.
Results
Ke loaʻa i kāu kauka nā hopena mai kāu hoʻāʻo koko a me nā biopsies e hiki iā lākou ke haʻi iā ʻoe inā loaʻa iā ʻoe ka FL a hiki paha ke haʻi iā ʻoe i ke ʻano subtype o FL iā ʻoe. A laila makemake lākou e hana i nā hoʻokolohua hou aʻe i ka pae a me ka helu ʻana i kāu FL.
ʻO ka hoʻopaʻa ʻana a me ka helu ʻana i ka lymphoma follicular
Ke ʻike ʻia ʻoe me FL, e nīnau hou kāu kauka e pili ana i kāu lymphoma. E komo pū ana kēia mau mea:
- He aha kāu lymphoma?
- He aha kāu lymphoma?
- He aha ka subtype o FL iā ʻoe?
Kaomi ma nā poʻomanaʻo ma lalo nei e aʻo hou e pili ana i ka hoʻonohonoho ʻana a me ka hoʻopaʻa ʻana.
Hōʻike ka staging i ka nui o kou kino i hoʻopilikia ʻia e kāu lymphoma - a i ʻole, pehea ka lōʻihi o ka laha ʻana mai kahi i hoʻomaka mua ai.
Hiki i nā pūnae B ke hele i kekahi wahi o kou kino. 'O ia ho'i, hiki i nā pūnaewele lymphoma (nā ma'i 'a'ai B-cell), hiki ke hele i kekahi wahi o kou kino. Pono ʻoe e hoʻāʻo hou aʻe e ʻike i kēia ʻike. Kapa ʻia kēia mau hoʻokolohua he staging tests a ke loaʻa iā ʻoe nā hopena, e ʻike ʻoe inā loaʻa iā ʻoe ka pae hoʻokahi (I), pae ʻelua (II), pae ʻekolu (III) a i ʻole pae ʻehā (IV) FL.
E pili ana kāu pae o FL ma:
- ʻEhia mau wahi o kou kino i loaʻa i ka lymphoma
- Ma kahi e komo ai ka lymphoma inā aia ma luna, ma lalo a ma nā ʻaoʻao ʻelua o kāu diaphragm (he ʻiʻo nui, ʻano dome ma lalo o ka iwi ʻaoʻao e hoʻokaʻawale i ka umauma mai kou ʻōpū)
- Inā ua laha ka lymphoma i kou iwi iwi a i ʻole nā ʻano ʻē aʻe e like me ke ake, ka māmā, ka ʻili a i ʻole ka iwi.
Kapa ʻia nā pae I a me II 'o ka pae mua a i ʻole ka palena palena' (e pili ana i kahi ʻāpana o kou kino).
Ua kapa ʻia nā pae III a me IV he 'pae holomua' (ʻoi aku ka laulā).
Hana 1 | Hoʻopili ʻia hoʻokahi wahi puʻupuʻu lymph, ma luna a ma lalo paha o ka diaphragm*. |
Hana 2 | Hoʻopili ʻia ʻelua a ʻoi aʻe paha nā ʻāpana lymph node ma ka ʻaoʻao hoʻokahi o ka diaphragm*. |
Hana 3 | Hoʻokahi liʻiliʻi liʻiliʻi o ka lymph node ma luna a ma ka liʻiliʻi hoʻokahi wahi lymph node ma lalo o ka diaphragm* e pili ana. |
Hana 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 i nā iwi, nā māmā, nā ate). |
ʻO ka ʻike hoʻokūkū keu
Hiki i kāu kauka ke kamaʻilio e pili ana i kāu pae ma ka hoʻohana ʻana i kahi leka, e like me A,B, E, X a i ʻole S. Hāʻawi kēia mau leka i ka ʻike hou aku e pili ana i nā hōʻailona āu i loaʻa ai a i ʻole ka hopena o kou kino e ka lymphoma. Kōkua kēia ʻike a pau i kāu kauka e ʻimi i ka hoʻolālā lapaʻau maikaʻi loa no ʻoe.
palapala | Meaning | nui |
A a i ʻole B |
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E & X |
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S |
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(ʻO kou spleen he ʻōkana i loko o kāu ʻōnaehana lymphatic e kānana a hoʻomaʻemaʻe i kou koko, a he wahi ia e hoʻomaha ai kou mau cell B a hana i nā antibodies) |
Nā hoʻāʻo no ke kahua
No ka ʻike ʻana i ka pae āu e loaʻa ai, e noi ʻia paha ʻoe e loaʻa i kekahi o kēia mau hoʻokolohua staging:
Ka pākuʻina o ka tomography (CT)
Lawe kēia mau kiʻi i nā kiʻi o loko o kou umauma, ka ʻōpū a i ʻole ke pelvis. Hāʻawi lākou i nā kiʻi kikoʻī e hāʻawi i ka ʻike hou aku ma mua o kahi X-ray maʻamau.
ʻO ka ʻōmole helu Positron emoate (PET)
He scan kēia e kiʻi i nā kiʻi o loko o kou kino holoʻokoʻa. E hāʻawi ʻia ʻoe i kahi lāʻau lapaʻau e hoʻopaʻa ʻia ai nā cell cancerous - e like me nā cell lymphoma. ʻO ka lāʻau lapaʻau e kōkua ana i ka PET scan e ʻike i kahi o ka lymphoma a me ka nui a me ke ʻano ma ke kuhikuhi ʻana i nā wahi me nā cell lymphoma. Ua kapa ʻia kēia mau wahi he "wela".
Pahu lumbar
ʻO ka ʻoki ʻana i ka lumbar kahi hana e nānā ai inā loaʻa iā ʻoe kahi lymphoma i loko o kou ʻōnaehana ʻōnaehana waena (CNS), e pili ana i kou lolo, spinal cord a me kahi wahi a puni kou mau maka. Pono ʻoe e ʻōlelo mālie i ka wā o ke kaʻina hana, no laila e loaʻa i nā pēpē a me nā keiki kahi maʻi maʻi maʻamau e hoʻomoe iā lākou no kahi manawa liʻiliʻi e hana ʻia ai ke kaʻina hana. Pono ka hapa nui o ka poʻe mākua i kahi anesthetic kūloko no ke kaʻina hana e hoʻopau ai i ka wahi.
Na kāu kauka e hoʻokomo i ka nila ma kou kua, a e lawe i kahi wai liʻiliʻi i kapa ʻia ʻo "ka wai o ke kuamoʻo o ka lolo” (CSF) mai a puni kou iwi kuamoʻo. ʻO ka CSF kahi wai e hana like me ka mea hoʻopuʻi i kou CNS. Lawe pū ia i nā protein like ʻole a me nā maʻi e hakakā ana i nā cell immune e like me nā lymphocytes e pale i kou lolo a me ke kuamoʻo. Hiki nō hoʻi iā CSF ke kōkua i ka hoʻokahe ʻana i kekahi wai ʻē aʻe i loaʻa iā ʻoe i loko o kou lolo a i ʻole a puni kou iwi kuamoʻo e pale ai i ka pehu ʻana ma ia mau wahi.
A laila e hoʻouna ʻia ka laʻana CSF i ka pathology a nānā ʻia no nā hōʻailona o ka lymphoma.
Biopsy iwi ʻōiwi
- ʻO ka aspirate iwi iwi (BMA): lawe ʻia kēia hoʻāʻo ʻana i kahi wahi liʻiliʻi o ka wai i loaʻa ma ka hakahaka o ka iwi.
- ʻO ka iwi aspirate trepine (BMAT): lawe kēia ho'āʻo i kahi laʻana liʻiliʻi o ka ʻiʻo iwi iwi.
Hoʻouna ʻia nā laʻana i ka pathology kahi e nānā ʻia ai nā hōʻailona o ka lymphoma.
Hiki ke ʻokoʻa ke kaʻina hana no nā biopsies iwi iwi ma muli o kahi āu e mālama ai, akā e hoʻokomo pinepine ʻia kahi anesthetic kūloko e hoʻopau i ka wahi.
Ma kekahi mau haukapila, hiki ke hāʻawi ʻia iā ʻoe i ka hoʻomaha māmā e kōkua iā ʻoe e hoʻomaha a hiki ke kāpae iā ʻoe mai ka hoʻomanaʻo ʻana i ke kaʻina hana. ʻAʻole pono ka nui o ka poʻe i kēia a loaʻa paha i kahi "whistle green" e omo ai. He lāʻau hōʻeha ʻeha ko loko o kēia puʻupuʻu ʻōmaʻomaʻo (i kapa ʻia ʻo Penthrox a i ʻole methoxyflurane), āu e hoʻohana ai e like me ka mea e pono ai i ke kaʻina hana.
E hōʻoia ʻoe e nīnau i kāu kauka i nā mea i loaʻa e hōʻoluʻolu iā ʻoe i ka wā o ke kaʻina hana, a e kamaʻilio pū me lākou e pili ana i kou manaʻo he koho maikaʻi loa ia no ʻoe.
Hiki ke loaʻa ka ʻike hou aku e pili ana i nā biopsies iwi ma kā mākou ʻaoʻao pūnaewele ma aneʻi.
He ʻokoʻa ka ulu ʻana o kāu mau sela lymphoma a ʻokoʻa ke ʻano o nā cell maʻamau. ʻO ka pae o kāu follicular lymphoma ke ʻano o ka nānā ʻana o kāu mau sela lymphoma ma lalo o kahi microscope. Loaʻa i nā papa 1-2 (nā papa haʻahaʻa) kahi helu liʻiliʻi o nā centroblasts (nā pūnaʻi B nui). 'O ka papa 3a a me 3b (ke papa ki'eki'e) he nui ka heluna o nā centroblasts (nā pūnana B nui), a 'ike pinepine 'ia nā centrocytes (li'ili'i a me ke kikowaena B). E ʻokoʻa ke ʻano o kāu mau cell i nā cell maʻamau a ulu ʻokoʻa. ʻOi aku ka nui o nā pūnaewele centroblast e ʻoi aku ka ʻoi aku ka ʻoi aku o ka ʻoi aku ka ikaika (ke ulu wikiwiki) o kou ʻōpū. Aia ma lalo kahi ʻike o nā māka.
Ka helu ʻana o ka World Health Organization (WHO) i ka follicular lymphoma (FL)
Papa | Definition |
1 | Papa haʻahaʻa: ʻIke ʻia nā 0-5 centroblasts i loko o nā pūpū lymphoma. 3 mai loko o 4 mau pūnaewele he molowa (ke ulu lohi) follicular B-cell |
2 | Papa haʻahaʻa: 6-15 centroblasts i ikeia ma na keena lymphoma. 3 mai loko o 4 mau pūnaewele he molowa (ke ulu lohi) follicular B-cell |
3A | Papa kiʻekiʻe: ʻOi aku ma mua o 15 centroblasts a me nā centrocytes i loaʻa i loko o nā pūnaewele lymphoma. Aia kahi hui o nā pūnaʻi lymphoma follicular (ke ulu mālie) a me nā pūnaewele lymphoma ikaika (ke ulu wikiwiki) i kapa ʻia ʻo diffuse nui B. |
3B | Papa kiʻekiʻe: Ma mua o 15 centroblasts me ʻAʻOLE ʻike ʻia nā centrocytes i loko o nā pūpū lymphoma. Aia kahi hui o nā pūnaʻi lymphoma follicular (ke ulu mālie) a me nā pūnaewele lymphoma ikaika (ke ulu wikiwiki) i kapa ʻia ʻo diffuse nui B. no kēia Papa 3b ua mālama ʻia e like me Diffuse Large B Cell Lymphoma subtype (DLBCL) ADD: Link to DLBCL |
He mea koʻikoʻi ka helu ʻana a me ke kau ʻana o kāu FL no ka mea e hōʻike ana inā pono ʻoe i ka lapaʻau a me ke ʻano o ka lapaʻau.
- Wāwae ʻAʻole pono paha ʻo IV FL i ka lapaʻau koke ʻana a hiki ke hoʻokomo ʻia ʻoe i ka mākaʻikaʻi ikaika (nānā a kali) no ka mea he haʻahaʻa kāu (ke ulu mālie) FL.
- Papa FL- 3A a me 3B ua hana mau ia e like me ka DLBCL kahi subtype ko'iko'i o NHL.
He mea nui e kamaʻilio me kāu kauka e pili ana i kāu mau mea pilikia ponoʻī i hiki iā ʻoe ke ʻike maopopo i ka mea e manaʻo ai mai kāu mau lapaʻau.
Nā ʻano liʻiliʻi o Follicular lymphoma (FL)
Ke hoʻihoʻi mai kāu kauka i kāu mau hopena a pau, hiki iā lākou ke hōʻike iā ʻoe i ka pae a me ka pae o FL i loaʻa iā ʻoe. Hiki ke haʻi ʻia iā ʻoe he subtype kikoʻī o FL, akā ʻaʻole kēia ka hihia no kēlā me kēia.
Inā haʻi ʻia iā ʻoe he subtype kikoʻī, kaomi i nā loulou ma lalo nei e aʻo hou e pili ana i kēlā subtype.
Ua kapa ʻia ʻo Duodenal-type follicular lymphoma ma mua o ka gastrointestinal follicular lymphoma (PGFL). He FL ulu lohi loa ia a ʻike pinepine ʻia i kona wā mua.
Ulu ia ma ka ʻāpana mua o kou ʻōpū liʻiliʻi (duodenum), ma mua o kou ʻōpū. ʻO ka PGFL ka hapanui o ka ʻāina, ʻo ia hoʻi, loaʻa ia ma kahi hoʻokahi, a ʻaʻole ia e laha i nā wahi ʻē aʻe o kou kino.
Ōuli
ʻO kekahi mau hōʻailona e loaʻa iā ʻoe me PGFL, ʻo ia ka ʻeha ʻōpū a me ka ʻeha puʻuwai, a i ʻole ʻoe e ʻike ʻole i nā hōʻailona. ʻO ka hoʻomaʻamaʻa ʻana paha he ʻokiʻoki a kiaʻi a kali paha (ka nānā ikaika). ma muli o kāu mau hōʻailona.
ʻOiai i ka wā e pono ai ke ʻoki ʻana, maikaʻi loa ka hopena no ka poʻe me Duodenal-type FL.
He pūʻulu lymphoma i hoʻopuehu ʻia (diffuse) i ʻike nui ʻia ma kahi ʻāpana o kou kino. ʻO nā hōʻailona koʻikoʻi he nui nui (tumor) i ʻike ʻia ma ke ʻano he puʻupuʻu ma kou ʻāʻī (inguinal).
ʻO ka lymphoma follicular ʻano paediatric he ʻano laha loa o ka lymphoma follicular. Hoʻopilikia ka hapa nui i nā keiki akā hiki ke pili i nā pākeke a hiki i kahi o 40 mau makahiki.
Hōʻike ka noiʻi he ʻokoʻa a ʻokoʻa ka P-TFL i ka lymphoma follicular maʻamau. ʻOi aku kona ʻano me ka maʻi maʻi (non cancerous) a ʻike pinepine ʻia i loko o hoʻokahi ʻāpana o kou kino. ʻAʻole maʻamau ka laha ʻana mai kahi i ulu mua ai.
ʻO ka PTFL ka mea maʻamau i nā lymph nodes kokoke i kou poʻo a me kou ʻāʻī.
ʻO ka lapaʻau ʻana no ka lymphoma follicular ʻano paediatric e pili ana i ka ʻoki ʻana no ka wehe ʻana i nā puʻupuʻu lymph i hoʻopilikia ʻia, a i ʻole kiaʻi a kali (ka nānā ikaika). Ma hope o ka hoʻomaʻamaʻa maikaʻi ʻana, ʻaʻole hiki ke hoʻi hou kēia subtype.
Hoʻomaopopo i kāu lymphoma cytogenetics
E like me nā ho'āʻo a pau i luna, loaʻa paha iā ʻoe nā hoʻokolohua cytogenetic. ʻO kēia kahi e nānā ʻia ai kou koko a me ke koko no 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 FL, 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 ko 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.
Inā loaʻa kahi hoʻololi (ʻokoʻa) i kēia mau chromosomes a i ʻole nā genes, ʻaʻole e holo pono kāu mau protein a me nā cell.
Hiki i nā Lymphocytes ke lilo i mau pūnaewele lymphoma ma muli o nā hoʻololi genetic (i kapa ʻia nā hoʻololi ʻana a i ʻole nā ʻano like ʻole) i loko o nā pūnaewele. Hiki ke nānā ʻia kāu biopsy lymphoma e ke kauka lapaʻau kūikawā e ʻike inā loaʻa iā ʻoe nā hoʻololi gene.
He aha ke ʻano o ka hoʻololi ʻana o FL?
ʻO ka hōʻike nui
Ua ʻike ʻia ka noiʻi ʻana i nā hoʻololi genetic like ʻole (mutations) hiki ke kumu i kahi ka ʻōlelo ʻana (nui loa) o kekahi mau polokina ma ka ili o na keena FL. Ke hoʻonui nui ʻia kēia mau protein, ʻo lākou kōkua i ka ulu ʻana o kou maʻi kanesa.
ʻO nā protein ʻokoʻa kekahi ʻāpana o kahi pūʻulu e ʻōlelo maʻamau i nā cell e ulu, a i ʻole e make a mālama i ke koena olakino. Hoʻomaopopo maʻamau lākou inā pōʻino ke kelepona, a hoʻomaka paha e lilo i ka maʻi kanesa, a haʻi i kēia mau cell e hoʻoponopono iā lākou iho a make paha. Akā, ʻo ka hōʻike nui ʻana o kekahi o nā protein e haʻi ana i ka ulu ʻana o nā cell lymphoma, ke kumu i lilo ai kēia kaʻina hana i mea kaulike ʻole, a hiki i nā pūnaeho maʻi maʻi ke hoʻomau i ka ulu a hoʻonui.
ʻO kekahi mau protein i hiki ke hoʻonui ʻia i kāu mau FL cell e komo pū ana:
- CD5
- CD10
- CD20
- CD23
- CD43
- BCL6
- IRF4
- MUM1
Unuhi
Hiki i nā genes ke hoʻololi i ka hana a me ka ulu ʻana ma muli o a unuhi. Hana ʻia kahi unuhi ke hoʻololi nā genes ma nā chromosomes ʻelua i nā wahi. He mea maʻamau ka unuhi ʻana i ka poʻe me FL. Inā loaʻa iā ʻoe kahi unuhi i kāu mau pūnaewele FL, aia paha ia ma waena o kāu chromosome 14 a me 18. Ke loaʻa iā ʻoe kahi unuhi o nā genes ma ka 14th a me 18th chromosomes ua kākau ʻia e like me t(14:18).
No ke aha he mea nui e ʻike e pili ana i nā loli genetic iaʻu?
He mea koʻikoʻi nā hoʻololi genetic no ka mea hiki iā lākou ke kōkua i kāu kauka e wānana i ka hana a me ka ulu ʻana o kāu FL. Hiki ke kōkua iā lākou e hoʻolālā i kahi tratment e kūpono loa iā ʻoe.
ʻAʻole koʻikoʻi ka hoʻomanaʻo ʻana i ka inoa o kāu hoʻololi genetic. Akā, ʻo ka ʻike ʻana iā ʻoe kekahi o kēia mau hoʻololi gene e wehewehe i ke kumu e pono ai ʻoe i nā lāʻau lapaʻau ʻē aʻe i nā poʻe ʻē aʻe me FL.
ʻO ka loaʻa ʻana o nā hoʻololi genetic i ka lymphoma ua alakaʻi i ka noiʻi a me ka hoʻomohala ʻana i nā lāʻau lapaʻau hou e kuhikuhi ana i nā protein a i ʻole nā genes i pili. Ke hoʻomau nei kēia noiʻi ʻana i ka loaʻa ʻana o nā loli hou aʻe.
ʻO kekahi mau ala e hiki ai i kāu hoʻololi genetic ke hopena i kāu mālama ʻana:
- Inā ʻoi aku ka nui o ka CD20 ma kāu mau pūnaewele FL a pono ʻoe i ka lāʻau lapaʻau, loaʻa paha iā ʻoe kahi lāʻau i kapa ʻia he rituximab (i kapa ʻia ʻo Mabthera a i ʻole Rituxan). He mea maʻamau ka overexpression CD20 i ka poʻe me ka lymphoma follicular.
- Inā loaʻa iā ʻoe ka overexpression o IRF4 a i ʻole MUM1, hiki ke hōʻike ʻia ʻoi aku ka ikaika o kāu FL ma mua o ka palaualelo, a pono paha e mālama.
- Hiki paha i kekahi mau hoʻololi genetic ke ʻoi aku ka maikaʻi o ka lāʻau lapaʻau e mālama i kāu FL.
Nā nīnau e nīnau i kāu kauka
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
Lapaʻau no Follicular Lymphoma (FL)
Ke hiki mai nā hopena a pau mai kāu biopsies, ka hoʻāʻo cytogenetic a me nā scan staging, hiki i kāu kauka ke hana i nā hoʻolālā e pili ana i ka mālama ʻana i kāu FL. I nā hihia he nui paha kēia i ka lawe ʻana i ke ala "E nānā a kali". ʻO ke ʻano kēia, ʻaʻole pono kāu lymphoma i kahi lapaʻau, akā makemake lākou e kiaʻi pono e ʻike inā hoʻomaka ka lymphoma e ulu nui, a i ʻole e loaʻa iā ʻoe nā hōʻailona a i ʻole ke olakino. Hiki iā ʻoe ke hoʻoiho i kā mākou pepa ʻoiaʻiʻo ma Watch and Wait ma ke kaomi ʻana i ka loulou ma lalo nei.
I ka wā e hoʻomaka ai ka lapaʻau
E nānā kāu kauka i kēia mau mea e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa no ʻoe. Ma kekahi mau kikowaena maʻi 'aʻai, e hui pū ke kauka me kahi hui o nā loea e kūkākūkā i ke koho lapaʻau maikaʻi loa. Kapa ʻia kēia a hui multidisciplinary (MDT) hui.
E noʻonoʻo kāu kauka i nā kumu he nui e pili ana i kāu FL. 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:
- ʻO kāu pae pākahi o ka lymphoma, nā hoʻololi genetic, a me nā hōʻailona
- ʻO kou mau makahiki, ka mōʻaukala olakino i hala, a me ke olakino maʻamau
- ʻO kou ola kino a me kou noʻonoʻo i kēia manawa a me nā makemake hoʻomanawanui.
Hiki ke kauoha ʻia nā hoʻāʻo hou aʻe ma mua o kou hoʻomaka ʻana i ka mālama ʻana i mea e hiki ai i kou puʻuwai, nā māmā a me nā puʻupaʻa ke hoʻokō i ka mālama ʻana. Hiki i kēia mau mea 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 hiki iā ʻoe a ma laila e pane i kāu nīnau. 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.
ʻO ka pahuhopu o ka mālama ʻana iā FL e:
- Hoʻolōʻihi i ke kala ʻana
- Hāʻawi i ka hoʻomalu maʻi
- Hoʻonui i ka maikaʻi o ke ola
- E ho'ēmi i nā hōʻailona a i ʻole nā hopena ʻaoʻao me ka mālama kākoʻo a palliative paha
Hiki iā ʻoe ke kelepona a leka uila paha i ka Lymphoma Australia Nurse Helpline me kāu mau nīnau a hiki iā mākou ke kōkua iā ʻoe e loaʻa ka ʻike kūpono.
E nana a kali
I kekahi mau hihia, hiki i kāu kauka ke hoʻoholo ʻaʻole pono ʻoe e loaʻa i kahi lāʻau lapaʻau. ʻO kēia no ka mea pinepine, ʻo ka Follicular Lymphoma e hiamoe ana (a i ʻole e hiamoe ana) a e ulu mālie ana ʻaʻole ia e hoʻopilikia i kou kino. Ua hōʻike ʻia ka noiʻi ʻaʻohe pono o ka hoʻomaka ʻana i ka mālama ʻana i kēia manawa, a hele mai me ka pilikia o nā hopena ʻaoʻao mai ka mālama ʻana.
Inā "ala" ka lymphoma a hoʻomaka e ulu wikiwiki, a laila e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau.
ʻO ka laina mālama kahu hānai Lymphoma:
Helu kelepona: 1800 953 081
Email: kahu@lymphoma.org.au
I ka manawa hea e pono ai ka lapaʻau ʻana no Follicular Lymphoma (FL)?
E like me ka mea i ʻōlelo ʻia ma luna, ʻaʻole pono ka poʻe āpau me FL e hoʻomaka koke i ka mālama ʻana. No ke kōkua ʻana i kāu mau kauka e hoʻoholo i ka manawa e hoʻomaka ai ka mālama ʻana, ua hoʻokumu ʻia kahi pae i kapa ʻia ʻo 'GELF criteria'. Inā loaʻa iā ʻoe hoʻokahi a ʻoi aʻe paha o kēia mau hōʻailona, pono paha ʻoe e lapaʻau:
- ʻO kahi puʻupuʻu nui ma mua o 7cm ka nui.
- 3 pehu lymph node ma 3 mau wahi ʻokoʻa, ʻoi aku ka nui ma mua o 3cms ka nui.
- Nā hōʻailona B mau.
- Hoʻonui ʻia ka spleen (splenomegaly)
- ʻO ke koʻikoʻi ma kekahi o kāu mau ʻōpū o loko ma muli o ka pehu ʻana o ka lymph nodes.
- ʻO ka wai me nā pūnaewele lymphoma i loko o kou māmā a i ʻole ka ʻōpū (Pleural effusions or ascites).
- Loaʻa nā pūnaewele FL i loko o kou koko a iwi iwi paha (nā hoʻololi leukemic) a i ʻole ka emi ʻana o kāu mau sela koko olakino ʻē aʻe (cytopenias). 'O ia ho'i, ke ho'ōki nei kāu FL i kou iwi iwi mai ka hiki ke ho'ohua i nā keneta koko olakino.
- LDH kiʻekiʻe a i ʻole Beta2- microglobulin (he mau hoʻāʻo koko kēia).
Kaomi ma nā poʻomanaʻo ma lalo nei e ʻike i nā ʻano lapaʻau like ʻole e hoʻohana ʻia e mālama i kāu FL.
Hāʻawi ʻia ka mālama kākoʻo i nā maʻi a me nā ʻohana e kū nei i ka maʻi koʻikoʻi. Hiki i ka mālama kākoʻo ke kōkua i ka poʻe maʻi i ka liʻiliʻi o nā hōʻailona, a ʻoi aku ka wikiwiki ma o ka hoʻolohe ʻana i kēlā mau ʻano o kā lākou mālama.
No kekahi o ʻoukou me FL, hiki ke ulu aʻe ko ʻoukou mau maʻi leukemic me ka hiki ʻole ke hoʻopaʻa ʻia a hoʻopaʻa ʻia i kou iwi iwi, kahe koko, lymph nodes, ate a i ʻole spleen. Ma muli o ka piha o ka iwi iwi me nā pūnaewele FL ʻōpio ʻaʻole hiki ke hana pono, 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 ma kahi papa a i ʻole i loko o kahi hui infusion i loko o ka haukapila. Loaʻa paha iā ʻoe nā lāʻau antibiotic e pale ai a mālama paha i nā maʻi.
Hiki ke komo i ke kūkākūkā me kahi hui mālama kūikawā a i ʻole ka mālama palliative. Hiki ke kamaʻilio e pili ana i ka mālama ʻana i ka wā e hiki mai ana, i kapa ʻia ʻo Advanced Care Planning. ʻO kēia mau mea he ʻāpana o ka hoʻokele multidisciplinary o lymphoma.
Hiki i ka mālama kākoʻo ke komo i ka mālama palliative e kōkua i ka hoʻomaikaʻi ʻana i kāu mau hōʻailona a me nā hopena ʻaoʻao, a me ka mālama hope o ke ola inā pono.
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. Hiki iā lākou ke kōkua i ka hoʻomalu a mālama i nā hōʻailona (e like me ka paʻakikī o ka mālama ʻana i ka ʻeha a me ka nausea) i loaʻa paha iā ʻoe ma muli o kou maʻi a i ʻole ka mālama ʻana.
Inā hoʻoholo ʻoe a me kāu kauka e hoʻohana i ka mālama kākoʻo a hoʻōki paha i ka mālama ʻana i kāu lymphoma, hiki ke hana ʻia nā mea he nui e kōkua iā ʻoe e noho olakino a ʻoluʻolu e like me ka hiki no kekahi manawa.
ʻO ka lāʻau lapaʻau he lāʻau lapaʻau maʻi maʻi e hoʻohana ana i nā kiʻekiʻe kiʻekiʻe o ka radiation e pepehi i nā cell lymphoma a e hōʻemi i nā ʻōpū. Ma mua o ka loaʻa ʻana o ka radiation, e loaʻa iā ʻoe kahi kau hoʻolālā. He mea koʻikoʻi kēia kau no ka poʻe lapaʻau lapaʻau e hoʻolālā pehea e hoʻopaʻa ai i ka radiation i ka lymphoma, a pale aku i ka hōʻino ʻana i nā cell olakino. ʻO ka lōʻihi o ka lāʻau lapaʻau ma waena o 2-4 mau pule. I kēia manawa, pono ʻoe e hele i ke kikowaena radiation i kēlā me kēia lā (Poakahi-Palima) no ka mālama ʻana.
*Inā lōʻihi kou noho ʻana mai ke kikowaena radiation a makemake ʻoe i ke kōkua me kahi e noho ai i ka wā mālama, e ʻoluʻolu e kamaʻilio me kāu kauka a kahu hānai paha e pili ana i ke kōkua i loaʻa iā ʻoe. Hiki iā ʻoe ke kelepona i ka Cancer Council a i ʻole Leukemia Foundation ma kou mokuʻāina a ʻike inā hiki iā lākou ke kōkua i kahi e noho ai.
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.
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 ka maʻi maʻi i hiki i kāu ʻōnaehana pale ke kaua i ka FL.
E hana wale ana ʻo MABS inā loaʻa iā ʻoe nā protein a i ʻole nā hōʻailona kikoʻī ma kāu mau sela lymphoma. ʻO kahi māka maʻamau ma FL ʻo CD20. Inā loaʻa iā ʻoe kēia māka hiki iā ʻoe ke pōmaikaʻi mai ka mālama ʻana me kahi MAB.
Hoʻohui ʻia ka Chemotherapy me kahi MAB (no ka laʻana, rituximab).
Hiki iā ʻoe ke lawe i kēia mau mea ma ke ʻano he papa a infusion paha i loko o kou vein. Hiki ke lawe ʻia nā lāʻau lapaʻau waha ma ka home, ʻoiai e koi ana kekahi i kahi noho maʻi pōkole. Inā loaʻa iā ʻoe kahi infusion, hiki iā ʻoe ke loaʻa ia ma ka lā keʻena lapaʻau a i ʻole ma 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 ʻaʻai a make nā sela lymphoma.
Hana ʻia kahi pūnaʻi pū a i ʻole ka iwi iwi e hoʻololi i kou iwi iwi maʻi me nā pūnaewele hou e hiki ke ulu i nā pūnaʻi koko olakino hou. Hoʻohana pinepine ʻia ka hoʻololi ʻana o ka iwi iwi no nā keiki me FL, aʻo ka hoʻololi ʻana i nā pūnaewele puʻupuʻu i hana ʻia no nā keiki ʻelua.
I ka hoʻololi ʻana i ka iwi iwi, hoʻoneʻe pololei ʻia nā pūnaewele mai ka iwi o ka iwi, a e like me ka hoʻololi ʻana i ke ʻano o ke kino, ua wehe ʻia nā pū mai ke koko.
Hiki ke hoʻoneʻe ʻia nā pūnaewele mai kahi mea hāʻawi a hōʻiliʻili ʻia mai iā ʻoe ma hope o kou loaʻa ʻana i ka chemotherapy.
Inā loaʻa iā ʻoe nā pūnaewele kumu mai kahi mea hāʻawi, ua kapa ʻia ʻo ia he allogeneic stem cell transplant.
Inā hōʻiliʻili ʻia kāu mau pūnaewele ponoʻī, ua kapa ʻia ia he autologous stem cell transplant.
Hōʻiliʻili ʻia nā puʻupuʻu ma o ke kaʻina hana i kapa ʻia ʻo apheresis. E hoʻopili ʻia ʻoe (a i ʻole kāu mea hāʻawi) i kahi mīkini apheresis a e hoʻoneʻe ʻia kou koko, hoʻokaʻawale ʻia nā pūnaewele a hōʻiliʻili ʻia i loko o kahi ʻeke, a laila hoʻihoʻi ʻia ke koena o kou koko iā ʻoe.
Ma mua o ke kaʻina hana, e loaʻa iā ʻoe ka chemotherapy kiʻekiʻe a i ʻole ka radiotherapy kino holoʻokoʻa e pepehi i kāu mau sela lymphoma āpau. Eia nō naʻe, ʻo kēia lapaʻau kiʻekiʻe e hoʻopau i nā ʻāpana āpau o kou iwi iwi. No laila, e hoʻihoʻi ʻia nā pūnaʻi kumu i hōʻiliʻili ʻia iā ʻoe (hoʻololi ʻia). Hana ʻia kēia ma ke ʻano like me ka hāʻawi ʻia ʻana o ke kahe koko, ma ke kahe ʻana i loko o kou aʻa.
He lāʻau lapaʻau hou ʻo CAR T-cell therapy e hāʻawi wale ʻia inā ua loaʻa iā ʻoe ʻelua mau lāʻau lapaʻau ʻē aʻe no kāu FL.
I kekahi mau hihia, hiki iā ʻoe ke komo i ka lāʻau lapaʻau T-cell ma o ke komo ʻana i kahi hoʻokolohua lapaʻau.
Hoʻokomo ʻia ka lāʻau lapaʻau T-cell CAR i kahi kaʻina hana mua e like me ka transplant cell stem, kahi e hoʻoneʻe ʻia ai kāu lymphocytes T-cell mai kou koko ma ke kaʻina hana apheresis. E like me ʻoe nā lymphocytes B-cell, ʻo nā cell T he ʻāpana o kāu ʻōnaehana pale a hana pū me kāu mau cell B e pale iā ʻoe mai ka maʻi a me ka maʻi.
Ke hoʻoneʻe ʻia nā T-cell, hoʻouna ʻia lākou i kahi keʻena hana i hana hou ʻia. Hana ʻia kēia ma ka hoʻohui ʻana i ka T-cell i kahi antigen e kōkua iā ia e ʻike maopopo i ka lymphoma a hakakā ʻoi aku ka maikaʻi.
ʻO ka chimeric ka loaʻa ʻana o nā ʻāpana me nā kumu like ʻole no laila ke hoʻohui ʻia o kahi antigen i ka T-cell e lilo ia i chimeric.
Ke hana hou ʻia nā T-cell e hoʻihoʻi ʻia iā ʻoe e hoʻomaka e hakakā i ka lymphoma.
Lapaʻau laina mua - Hoʻomaka ka lapaʻau
Hoʻomaka i ka lāʻau lapaʻau
ʻO ka manawa mua ʻoe e hoʻomaka ai i ka lāʻau lapaʻau, kapa ʻia ʻo ia ka lāʻau lapaʻau mua. Ke hoʻopau ʻoe i kāu lāʻau lapaʻau mua, ʻaʻole paha ʻoe e pono hou i ka lāʻau no nā makahiki he nui. Pono kekahi poʻe e hoʻomaʻamaʻa hou i ka manawa koke, a ʻo kekahi poʻe e hele i mau mahina a i ʻole mau makahiki, ma mua o ka pono ʻana i nā lāʻau hou.
Ke hoʻomaka ʻoe i ka lāʻau lapaʻau, loaʻa paha iā ʻoe ma mua o hoʻokahi lāʻau lapaʻau. Hiki i kēia ke komo i ka chemotherapy, kahi antibody monoclonal a i ʻole ka lāʻau lapaʻau. I kekahi mau hihia, loaʻa paha iā ʻoe ka lāʻau lapaʻau a i ʻole ke ʻoki ʻana, a i ʻole nā lāʻau lapaʻau.
Nā pōʻai 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 FL, ʻoi aku ka maikaʻi o ka chemoimmunotherapy no ka loaʻa ʻana o ke kala ʻana (ʻaʻohe hōʻailona o ke kanesa).
Ke hui pū ʻia kāu hoʻolālā lapaʻau holoʻokoʻa, ua kapa ʻia ʻo kāu protocol mālama. Hiki i kekahi mau wahi ke kapa ʻia he ʻano lapaʻau.
E koho kāu kauka i ka protocol lapaʻau maikaʻi loa no ʻoe ma muli o nā kumu i lalo
- ʻO ke kahua a me ka helu o kāu FL.
- ʻO kēlā me kēia hoʻololi genetic iā ʻoe.
- ʻO kou mau makahiki a me kou olakino holoʻokoʻa.
- ʻO nā maʻi ʻē aʻe a i ʻole nā lāʻau lapaʻau āu e lawe ai.
- ʻO kāu mau makemake ma hope o ke kūkākūkā ʻana i kāu mau koho me kāu kauka.
ʻO nā hiʻohiʻona o nā kaʻina chemoimmunotherapy hiki iā ʻoe ke mālama iā FL
- ʻO BR kahi hui pū o Bendamustine a me Rituximab (a MAB).
- BO a i ʻole GB- kahi hui o Bendamustine a me Obinutuzumab (a MAB).
- ʻO RCHOP kahi hui o rituximab (a MAB) me nā lāʻau lapaʻau chemotherapy cyclophosphamide, doxorubicin, vincristine a me prednisolone. Hoʻohana wale ʻia kēia kaʻina no ka mālama ʻana iā FL inā ʻoi aku ke kiʻekiʻe, maʻamau ka papa 3a a i luna.
- O- CHOP kahi hui o Obinutuzumab, cyclophosphamide, vincristine, doxorubicin a me prednisolone. Hoʻohana wale ʻia kēia kaʻina no ka mālama ʻana iā FL inā ʻoi aku ke kiʻekiʻe, maʻamau ka papa 3a a i luna.
Nā ho'āʻo hoʻokolohua
Nui nā hoʻokolohua lapaʻau ma Australia a puni ka honua, e ʻimi ana i nā ala e hoʻomaikaʻi ai i ka mālama ʻana i ka poʻe me ka lymphoma. Inā makemake ʻoe e aʻo hou e pili ana i nā hoʻokolohua lapaʻau, kaomi i ke pihi ma lalo. Hiki iā ʻoe ke kamaʻilio pū me kāu kauka lapaʻau - kāu haematologist a i ʻole oncologist e pili ana i nā hoʻokolohua lapaʻau e hiki iā ʻoe ke kūpono.
Maintenance therapy
Hāʻawi ʻia ka lāʻau mālama mālama me ka manaʻo e mālama iā ʻoe i ke kala ʻana no ka manawa lōʻihi, ma hope o kāu lapaʻau mua.
Kala piha
He nui ka poʻe i pane maikaʻi loa i ka lāʻau lapaʻau mua a loaʻa ke kala piha. ʻO ia ke ʻano o ka pau ʻana o kāu mālama ʻana, ʻaʻohe FL ʻike ʻia i koe i loko o kou kino. Hiki ke hōʻoia ʻia kēia ma hope o ka scan PET. Eia naʻe, he mea nui e hoʻomaopopo ʻaʻole like ka kala piha ʻana me ka lāʻau lapaʻau. Me ka ho'ōla, ua hala ka lymphoma a ʻaʻole paha e hoʻi mai.
Akā, ʻike mākou me nā lymphoma indolent e like me FL, hele pinepine lākou ma hope o kekahi manawa. He mau mahina a mau makahiki paha kēia ma hope o kāu mālama ʻana, akā e hoʻi mai ana. Kapa ʻia kēia he relapse. I ka wā e hiki mai ana, pono paha ʻoe e hoʻomaʻamaʻa hou aʻe, a i ʻole e hele paha ʻoe i ka "nānā a kali" inā mau ka palaualelo me ka ʻole o nā hōʻailona.
Kala kala ʻāpana
No kekahi poʻe, ʻaʻole i loaʻa i ka lāʻau lapaʻau mua ke kala piha ʻana, akā he kala ʻāpana. ʻO ia hoʻi, ua hala ka hapa nui o ka maʻi, akā aia kekahi mau hōʻailona o ia maʻi i koe i loko o kou kino. He pane maikaʻi nō ia, no ka mea, e hoʻomanaʻo ʻo FL he lymphoma palaualelo ʻaʻole hiki ke ho'ōla ʻia. Akā inā loaʻa iā ʻoe kahi pane hapa, hiki ke hoʻi i ka hiamoe, a ʻaʻole pono ʻoe i ka lāʻau hoʻoikaika hou akā e hele e nānā a kali.
Inā loaʻa iā ʻoe ke kala piha a ʻāpana paha e ʻike ʻia ma kāu hahai ʻana i ka PET scan.
No ka ho'āʻo e hoʻomau iā ʻoe i ke kala ʻana no ka lōʻihi o ka hiki, hiki i kāu kauka ke ʻōlelo iā ʻoe e hele i ka lāʻau mālama mālama no ʻelua makahiki ma hope o kāu lapaʻau mua.
He aha ke ʻano o ka mālama mālama?
Hāʻawi pinepine ʻia ka lāʻau mālama mālama i hoʻokahi manawa i kēlā me kēia 2-3 mahina a he antibody monoclonal. ʻO nā antibodies monoclonal i hoʻohana ʻia no ka mālama ʻana he rituximab a i ʻole obinutuzumab. He maikaʻi kēia mau lāʻau ʻelua inā loaʻa iā ʻoe ka protein CD20 ma kāu mau sela lymphoma, ka mea maʻamau me FL.
Laina Laina lua
Inā hoʻihoʻi hou kāu FL a ʻaʻole ʻae ʻia i ka lāʻau lapaʻau mua, pono paha ʻoe i ka lāʻau lapaʻau lua. ʻO Refractory FL ka wā ʻaʻole ʻoe e kala piha a ʻāpana paha mai kāu lāʻau lapaʻau mua.
Inā ʻoe ma lalo o 70 mau makahiki, hiki ke hāʻawi ʻia iā ʻoe i nā hui like ʻole o nā lāʻau lapaʻau, a ukali ʻia e kahi transplant cell stem. Eia nō naʻe, ʻaʻole kūpono ka hoʻololi ʻana i nā cell stem no kēlā me kēia kanaka. Hiki i kāu kauka ke kamaʻilio hou aku iā ʻoe e pili ana i kou kūpono ponoʻī no kēia ʻano lapaʻau.
Inā ʻaʻole ʻoe e hoʻololi i ka stem-cell, aia kekahi mau protocol lapaʻau e hāʻawi ʻia iā ʻoe.
Hoʻohana ʻia kēia mau lāʻau lapaʻau e hoʻihoʻi iā ʻoe i ke kala ʻana a mālama i kāu lymphoma no ka wā lōʻihi.
Nā protocol lapaʻau inā loaʻa iā ʻoe kahi hoʻololi stem-cell
RICE
ʻO RICE kahi chemo ikaika o nā haʻina haʻihaʻi (haʻihaʻi) a i ʻole infusional (ma o ka drip) o ifosfamide, carboplatin a me etoposide. Loaʻa paha iā ʻoe kēia inā ua hoʻi hou ʻoe a i ʻole ma mua o kahi transplant cell stem autologous. Pono ʻoe e mālama i kēia ma ka haukapila
R-GDP
ʻO R-GDP kahi hui o gemcitabine, dexamethasone a me cisplatin. Loaʻa paha iā ʻoe kēia inā ua hoʻi hou ʻoe a i ʻole ma mua o kahi transplant cell stem autologous.
Nā protocols lapaʻau inā ʻaʻole ʻoe e hoʻololi i ka stem-cell transplant
R-CHOP/ O-CHOP
ʻO R-CHOP a i ʻole O-CHOP kahi hui o rituximab a i ʻole obinutuzumab (a MAB) me nā lāʻau chemo cyclophosphamide, doxorubicin, vincristine a me ka loulou prednisolone i eviQ.
R-CVP
ʻO R-CVP kahi hui o rituximab, cyclophosphamide, vincristine a me prednisolone. Loaʻa paha iā ʻoe kēia inā he ʻelemakule ʻoe me nā pilikia olakino ʻē aʻe.
O-CVP
ʻO ka O-CVP kahi hui o obinutuzimab, cyclophosphamide, vincristine a me prednisolone. Loaʻa paha iā ʻoe kēia inā he ʻelemakule ʻoe me nā pilikia olakino ʻē aʻe.
Ke kalawela
Hiki ke ho'ohana 'ia ka lā'au lapa'au ke ho'i hou kāu FL. Hana ʻia ia inā e hoʻihoʻi hou ʻia i kahi wahi kūloko a kōkua i ka hoʻomalu ʻana i kāu FL a hoʻemi i kekahi mau hōʻailona āu e loaʻa ai.
ʻO ka lāʻau lapaʻau ʻekolu
I kekahi mau hihia, pono paha ʻoe e hoʻomaʻamaʻa hou aʻe ma hope o ka hoʻi hou ʻana o ka lua a i ʻole ke kolu. E like pinepine ka lāʻau lapaʻau ʻekolu me nā lāʻau ma luna.
I kekahi mau hihia, inā "hoʻololi" kāu FL a hoʻomaka e hana e like me kahi subtype koʻikoʻi o ka lymphoma i kapa ʻia ʻo Diffuse large B-cell lymphoma, hiki iā ʻoe ke koho i ka CAR T-cell therapy ma ke ʻano he kolu a ʻehā paha o ka lāʻau lapaʻau. Na kāu kauka e hōʻike iā ʻoe inā hoʻomaka kāu FL e hoʻololi.
Lymphoma i hoololiia
ʻO ka lymphoma i hoʻololi ʻia he lymphoma i ʻike mua ʻia ma ke ʻano he molowa (ke ulu mālie) akā ua lilo ia (hoʻololi ʻia i loko o) lymphoma ʻeha (ke ulu wikiwiki).
Hiki ke hoʻololi i kāu FL inā loaʻa iā ʻoe nā hoʻololi genetic hou aku i kāu mau pūnaewele lymphoma i ka manawa, e hōʻeha hou aʻe. Hiki ke hana maoli kēia, a i ʻole ma muli o kekahi mau lāʻau lapaʻau. ʻO kēia pōʻino hou i nā genes ke kumu e ulu wikiwiki ai nā cell.
He haʻahaʻa ka pilikia o ka hoʻololi ʻana. Hōʻike ka noiʻi ma luna o 10 a 15 mau makahiki ma hope o ka hōʻoia ʻana, ma kahi o 2-3 mau kānaka mai ka 100 me FL i kēlā me kēia makahiki, hiki ke hoʻololi i kahi subtype ʻoi aku ka ikaika.
ʻO ka manawa maʻamau mai kahi hōʻailona a hiki i ka hoʻololi ʻana he 3-6 mau makahiki.
Inā loaʻa iā ʻoe kahi hoʻololi mai FL, e hoʻololi ʻia paha ia i kahi subtype o lymphoma i kapa ʻia ʻo Diffuse large B-cell lymphoma (DLBCL) a i ʻole, ʻoi aku ka kakaikahi Burkitt lymphoma. Pono ʻoe i ka lāʻau chemoimmunotherapy koke.
Ma muli o ka holomua ʻana i nā lāʻau lapaʻau, ua hoʻomaikaʻi maikaʻi ka hopena no ka lymphoma follicular i hoʻololi ʻia i nā makahiki i hala.
Nā hopena ʻaoʻao maʻamau o ka mālama ʻana
Nui nā hopena ʻaoʻao e loaʻa iā ʻoe mai kāu mālama ʻana no FL. Ma mua o kou hoʻomaka ʻana i kāu lapaʻau, pono kāu kauka a kahu hānai paha e wehewehe i nā hopena ʻaoʻao āpau āu e ʻike ai. ʻAʻole paha e loaʻa iā ʻoe nā mea a pau, akā he mea nui e ʻike i ka mea e nānā ai a me ka wā e hoʻopili ai i kāu kauka. E hōʻoia iā ʻoe nā kikoʻī pili o ka mea āu e hoʻopili ai inā maikaʻi ʻoe i ka waenakonu o ka pō a i ʻole ma ka hopena pule ke loaʻa ʻole kāu kauka.
ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka mālama ʻana he hoʻololi i kāu helu koko. Aia ma lalo kahi papa e wehewehe ana i ka pili o ke koko a pehea e pili ai iā ʻoe.
ʻO ke koko koko i hoʻopilikia ʻia e ka mālama ʻana iā FL
Nā pili koko koko | Nā hunaola ʻulaʻula | Platelets (pēia pū me ke koko) | |
Inoa Lapaau | Neutrophils & Lymphocytes | ʻErythrocytes | Nā Kauliana |
He aha kā lākou hana? | Kaua i ka ma'i ma'i | Lawe i ka oxygen | Uoki ke kahe ʻana |
He aha ke ʻano o ka hemahema? | Neutropenia a me lymphopenia | Anemia | ʻO ka Thrombocytopenia |
Pehea e pili ai kēia i koʻu kino? | E loaʻa iā ʻoe nā maʻi hou aʻe a paʻakikī paha ke hoʻopau iā lākou ʻoiai me ka lawe ʻana i nā lāʻau antibiotic | Hiki paha iā ʻoe ke haʻalulu ka ʻili, luhi, hanu ʻole, ke anu a me ka poni | Hiki iā ʻoe ke ʻeha maʻalahi, a i ʻole ke koko ʻaʻole e pau koke ke ʻoki ʻoe |
He aha kaʻu hui lapaʻau e hoʻoponopono ai i kēia? | ● Hoʻopaneʻe i kāu mālama lymphoma ● Hāʻawi iā ʻoe i nā lāʻau ʻokoʻa waha a i ʻole i loko o ke koko inā he maʻi kou | ● Hoʻopaneʻe i kāu mālama lymphoma ● Hāʻawi iā ʻoe i ke kahe koko ʻulaʻula inā haʻahaʻa loa kāu helu kelepona | ● Hoʻopaneʻe i kāu mālama lymphoma ● Hāʻawi iā ʻoe i ka hoʻololi platelet inā haʻahaʻa loa kāu helu kelepona |
Nā hopena ʻaoʻao maʻamau ʻē aʻe o ka mālama ʻana no FL
Aia ma lalo ka papa inoa o kekahi mau hopena ʻaoʻao maʻamau o nā lāʻau lapaʻau FL. He mea nui e hoʻomaopopo i kēia manawa nā lāʻau lapaʻau a pau ke kumu o kēia mau hōʻailona, a pono ʻoe e kamaʻilio me kāu kauka a kahu hānai paha e pili ana i nā hopena ʻaoʻao ke kumu o kāu mālama ponoʻī.
- Ka maʻi ma ka ʻōpū (nausea) a me ka luaʻi.
- ʻEha waha (mucositis) a hoʻololi i ka ʻono o nā mea.
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a i ʻole ka maʻi maʻi (ka paʻakikī a i ʻole ka wai wai).
- ʻO ka luhi, a i ʻole ka nele o ka ikehu ʻaʻole maikaʻi ma hope o ka hoʻomaha ʻana a i ʻole ka hiamoe ʻana (ka luhi).
- ʻEha a ʻeha ka ʻiʻo (myalgia) a me ka hui (arthralgia).
- ʻO ka lauoho lauoho a me ka lahilahi (alopecia) - me kekahi mau lāʻau lapaʻau wale nō.
- Ka noʻonoʻo a me ka paʻakikī i ka hoʻomanaʻo ʻana i nā mea (ka lolo chemo).
- Hoʻololi ka manaʻo i kou mau lima a me kou mau wāwae e like me ke kani ʻana, nā pine a me nā nila a i ʻole ka ʻeha (neuropathy).
- Hoʻemi ʻia ka momona a i ʻole ka menopause mua (hoʻololi o ke ola).
Ka mālama ʻana - He aha ka hopena ke pau ka mālama ʻana?
Ke ho'opau 'oe i ka mālama 'ana, makemake paha 'oe e ho'olei i kou mau kāma'a hula, e kau i kou mau lima i ka lewa a e pā'ina e like me kēia kanaka (inā loa'a iā 'oe ka ikehu), a i 'ole paha e piha 'oe i ka hopohopo a me ke ko'iko'i no ka mea e hiki mai ana.
He mea maʻamau a maʻamau nā manaʻo ʻelua. He mea maʻamau nō hoʻi ka manaʻo i hoʻokahi ala, hoʻokahi manawa, a ma kekahi ala i ka manawa aʻe.
ʻAʻole ʻoe wale nō ke pau ka mālama ʻana. Loaʻa iā ʻoe ke kamaʻilio mau me kāu hui loea, a hiki iā ʻoe ke kelepona iā lākou inā he pilikia kāu.
E nānā mau ʻia ʻoe me ka hoʻāʻo koko a me ka hoʻokolokolo kino e nānā i nā hōʻailona a i ʻole ka hoʻi hou ʻana a i ʻole nā hopena ʻaoʻao lōʻihi mai kāu mālama ʻana. I kekahi mau hihia, loaʻa iā ʻoe kahi scan e like me PET a i ʻole CT, akā ʻaʻole pono kēia inā maʻamau nā hoʻokolohua ʻē aʻe a ʻaʻole ʻoe e loaʻa i nā hōʻailona.
Hōʻikeʻike
ʻO Prognosis ka huaʻōlelo i hoʻohana ʻia e wehewehe i ke ala o kou maʻi, pehea e pane ai i ka mālama ʻana a pehea ʻoe e hana ai i ka wā a ma hope o ka mālama ʻana.
Nui nā kumu e kōkua ai i kāu wānana a ʻaʻole hiki ke hāʻawi i kahi ʻōlelo holoʻokoʻa e pili ana i ka prognosis. Eia nō naʻe, pane maikaʻi loa ʻo FL i ka mālama ʻana a hiki i nā maʻi he nui me kēia maʻi kanesa ke loaʻa nā kala lōʻihi - ʻo ia hoʻi ma hope o ka mālama ʻana, ʻaʻohe hōʻailona o FL i kou kino.
Nā mea hiki ke hoʻopili i ka wānana
ʻO kekahi mau mea e pili ana i kāu prognosis penei:
- ʻO ʻoe nā makahiki a me ke olakino holoʻokoʻa i ka manawa o ka maʻi maʻi.
- Pehea ʻoe e pane ai i ka lāʻau lapaʻau.
- He aha inā inā loaʻa iā ʻoe nā genetic mutations.
- ʻO ka subtype o FL iā ʻoe.
Inā makemake ʻoe e ʻike hou aku e pili ana i kāu wānana ponoʻī, e ʻoluʻolu e kamaʻilio me kāu kauka haematologist a i ʻole oncologist. Hiki iā lākou ke wehewehe i kāu mau pilikia a me ka wānana iā ʻoe.
Ola - noho me ka follicular lymphoma
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 DLBCL.
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 no kāu DLBCL ʻo ka hoʻi ʻana i ke ola a:
- E hoʻoikaika i kāu hana, ʻohana, a me nā kuleana ola ʻē aʻe.
- E hōʻemi i nā hopena ʻaoʻao a me nā hōʻailona o ka maʻi kanesa a me ka mālama ʻana.
- E ʻike a mālama i nā hopena hope loa.
- Kōkua e mālama iā ʻoe e like me ka hiki.
- E hoʻomaikaʻi i kou maikaʻi o ke ola a mālama i ke olakino noʻonoʻo maikaʻi.
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:
- Hoʻoponopono kino, hoʻoponopono ʻeha.
- Hoʻolālā meaʻai a me ka hoʻoikaika kino.
- Ka ʻōlelo aʻoaʻo noʻonoʻo, ʻoihana a me ke kālā.
