Kiʻi wikiwiki o ka diffuse nui B-cell lymphoma (DLBCL) i nā keiki
He wehewehe pōkole kēia o ka diffuse large B cell lymphoma (DLBCL) i nā keiki 0-14 makahiki. No ka ʻike hohonu hou e nānā i nā ʻāpana ʻē aʻe ma lalo nei.
He aha ia?
ʻO ka diffuse large B-cell lymphoma (DLBCL) he mea hoʻopaʻapaʻa (ke ulu wikiwiki) B-cell non-Hodgkin lymphoma. Hoʻoulu ia mai nā lymphocytes B (ke koko keʻokeʻo) e ulu me ka ʻole ʻia. ʻO kēia mau lymphocytes B maʻamau e hōʻiliʻili i loko o ka ʻiʻo lymph a me nā nodes lymph, i loko o ka ʻōnaehana lymphatic, kahi ʻāpana o ka ʻōnaehana pale. Ma muli o ka loaʻa ʻana o ka ʻiʻo lymph ma ke kino holoʻokoʻa, hiki i ka DLBCL ke hoʻomaka ma kahi kokoke i nā wahi āpau o ke kino a palahalaha i kahi kokoke i nā ʻāpana a i ʻole nāʻiʻo o ke kino.
ʻO wai ka hopena?
Aia ka DLBCL ma kahi o 15% o nā lymphoma āpau i loaʻa i nā keiki. ʻOi aku ka maʻamau o DLBCL i nā keikikāne ma mua o nā kaikamahine. ʻO DLBCL ka subtype lymphoma maʻamau i nā pākeke, helu ʻia ma kahi o 30% o nā hihia lymphoma makua.
Lapaʻau a me ka wānana
Loaʻa i ka DLBCL i nā keiki kahi wānana maikaʻi loa (nānā). Ma kahi o 90% o nā keiki e ho'ōla ʻia ma hope o ka loaʻa ʻana o ka chemotherapy maʻamau a me ka immunotherapy. Nui nā noiʻi e pili ana i ka mālama ʻana i kēia lymphoma, me ka manaʻo nui i ka noiʻi ʻana pehea e hōʻemi ai i nā hopena hope loa, a i ʻole nā hopena ʻaoʻao mai ka lāʻau ʻawaʻawa hiki ke loaʻa nā mahina a hiki i nā makahiki ma hope o ka mālama ʻana.
Ka nānā ʻana o ka diffuse nui B-cell lymphoma (DLBCL) i nā keiki
ʻO Lymphomas he hui o na ma'i ma'i ma'i o ka ʻōnaehana lymphatic. Loaʻa ka Lymphoma i ka wā e loaʻa ai ka hoʻololi DNA i nā lymphocytes, kahi ʻano o ke koko keʻokeʻo. ʻO ke kuleana o nā lymphocytes ka hakakā ʻana i ka maʻi, ma ke ʻano he ʻāpana o ke kino ʻōnaehana pale ʻino. Aia B-lymphocytes (B-cell) a T-lymphocytes (T-cell) e pāʻani ana i nā hana like ʻole.
I ka DLBCL, puunaue a ulu ka lymphoma me ka hoomalu ole a make ole i ka wa pono. ʻElua ʻano nui o ka lymphoma. Kāhea ʻia lākou lymphoma Hodgkin (HL) a lymphoma non-Hodgkin (NHL). Hoʻokaʻawale ʻia nā Lymphomas i:
- ʻO ka lymphoma molowa (ke ulu mālie).
- ʻO lymphoma kūpikipikiʻō (wikiwiki).
- B-cell lymphoma ʻO nā lymphocytes B-cell kūponoʻole a ʻo ia ka mea maʻamau. ʻO nā lymphomas B-cell ma kahi o 85% o nā lymphoma a pau
- T-cell lymphoma he mau lymphocytes T-cell maʻamau. Loaʻa nā lymphomas T-cell ma kahi o 15% o nā lymphomas āpau
ʻO ka diffuse large B-cell lymphoma (DLBCL) he mea hoʻopaʻapaʻa (ke ulu wikiwiki) B-cell non-Hodgkin lymphoma. Loaʻa ka DLBCL ma kahi o 15% o nā lymphoma āpau i loaʻa i nā keiki. ʻO DLBCL ka lymphoma maʻamau i nā pākeke, helu ʻia ma kahi o 30% o nā hihia lymphoma āpau i nā pākeke.
Hoʻokumu ʻia ka DLBCL mai nā pūnaewele B makua mai ke kikowaena germinal o kahi puʻupuʻu lymph, a i ʻole mai nā pūnaewele B i ʻike ʻia he mau pūnaewele B hoʻāla ʻia. No laila, ʻelua mau ʻano maʻamau o DLBCL:
- Kelepona B (GCB)
- Hoʻohana ʻia ʻo B-cell (ABC)
ʻAʻole ʻike ʻia ke kumu kūpono o DLBCL i nā keiki. ʻO ka hapa nui o ka manawa ʻaʻohe wehewehe kūpono no kahi a pehea i loaʻa ai ke keiki i ka maʻi kanesa a ʻaʻohe mea hōʻike e hōʻike ana ua hiki i nā mākua a me nā kahu hānai ke pale i ka lymphoma mai ka ulu ʻana, a i ʻole ke kumu.
ʻO wai ka mea i hoʻopilikia ʻia e ka diffuse large B-cell lymphoma (DLBCL)?
Hiki ke loaʻa ka diffuse lymphoma B-cell nui (DLBCL) i nā kānaka o kēlā me kēia makahiki a i ʻole ke kāne. ʻIke pinepine ʻia ka DLBCL i nā keiki ʻōpio a me nā poʻe ʻōpio (nā kānaka 10 - 20 mau makahiki). Loaʻa pinepine i nā keikikāne ma mua o nā kaikamāhine.
ʻAʻole ʻike ʻia ke kumu o DLBCL. ʻAʻohe mea āu i hana ai a ʻaʻole i hana i kumu i kēia. ʻAʻole ia he maʻi maʻi a ʻaʻole hiki ke hoʻoili ʻia i nā poʻe ʻē aʻe.
ʻOiai ʻaʻole maopopo nā kumu kumu o DLBCL, aia kekahi nā mea pilikia i pili me ka lymphoma. ʻAʻole nā kānaka a pau i loaʻa kēia mau pilikia e hoʻomau i ka hoʻomohala ʻana i ka DLBCL. Aia nā kumu pilikia (ʻoiai he haʻahaʻa loa ka pilikia):
- ʻO ka maʻi ma mua me ka maʻi maʻi Epstein-Barr (EBV) - ʻo ia ke kumu maʻamau o ka maʻi maʻi glandular
- Nawaliwali ka ʻōnaehana pale ma muli o kahi maʻi hoʻoilina ʻole (maʻi autoimmune e like me dyskeratosis congenita, systemic lupus, rheumatoid arthritis)
- ʻO ka maʻi HIV
- ʻO ka lāʻau immunosuppressant i lawe ʻia e pale i ka hōʻole ʻana ma hope o ka hoʻololi ʻana o ke kino
- ʻO ka loaʻa ʻana o kahi kaikunāne a i ʻole kaikuahine me lymphoma (ʻoi aku nā māhoe) ua manaʻo ʻia e loaʻa kahi pilina ʻohana ʻohana i ka maʻi (he kakaikahi loa kēia a ʻaʻole ʻōlelo ʻia no nā ʻohana e hoʻāʻo ʻia)
ʻO ka loaʻa ʻana o kahi keiki i loaʻa i ka lymphoma hiki ke lilo i mea koʻikoʻi a me ka naʻau, ʻaʻohe pane kūpono a hewa ʻole. He mea pōʻino a haʻalulu, he mea nui e hāʻawi iā ʻoe iho a me kou ʻohana i ka manawa e hoʻoponopono a kaumaha. He mea nui hoʻi ʻaʻole ʻoe e lawe i ke kaumaha o kēia maʻi ma kāu iho, aia kekahi mau hui kākoʻo e kōkua nei iā ʻoe a me kou ʻohana i kēia manawa, Bus maanei e ʻike hou aku e pili ana i ke kākoʻo ʻana i nā ʻohana i loaʻa ke keiki a i ʻole he kanaka ʻōpio me ka lymphoma.
Nā ʻano o ka diffuse large B-cell lymphoma (DLBCL) i nā keiki
Hiki ke hoʻokaʻawale ʻia ka diffuse large B-cell lymphoma (DLBCL) i nā ʻano subtypes e pili ana i ke ʻano o ka cell B i ulu mai ia (i kapa ʻia ʻo "cell of origin").
- ʻO ka lymphoma B-cell Germinal Center (GBC): ʻOi aku ka maʻamau o ke ʻano GCB i nā maʻi pediatric ma mua o ke ʻano ABC. Loaʻa i ka poʻe ʻōpio ka maʻi ʻano GCB (80-95% i 0-20 mau makahiki) ma mua o nā pākeke a pili pū me nā hopena i hoʻomaikaʻi ʻia i ka hoʻohālikelike ʻia me ke ʻano ABC.
- Lymphoma B-cell i ho'ā 'ia (ABC): ʻO ka ʻano ABC mai ke kikowaena post-germinal (o ka cell) no ka mea he maʻi maʻi B-cell oʻo. Kapa ʻia ʻo ia ʻano ʻano ABC no ka mea ua hoʻāla ʻia nā cell B a ke hana nei lākou ma ke ʻano he mea kōkua mua i nā pane pale.
Hiki ke hoʻokaʻawale ʻia ʻo DLBCL ma ke ʻano he germinal center B-cell (GCB) a i ʻole activated B-cell (ABC). Hiki ke ʻike i ka ʻokoʻa ma waena o kēia mau mea ma o ka ʻimi ʻana i kekahi mau protein ma nā cell lymphoma. I kēia manawa, ʻaʻole hoʻohana ʻia kēia ʻike e kuhikuhi i ka mālama ʻana. Eia nō naʻe, ke hana nei nā kānaka ʻepekema i ka noiʻi e ʻike ai inā maikaʻi nā lāʻau lapaʻau like ʻole e kūʻē i nā ʻano like ʻole o DLBCL e ulu ana mai nā cell like ʻole.
Nā hōʻailona o ka diffuse large B-cell lymphoma (DLBCL) i nā keiki
ʻO nā hōʻailona mua i ʻike ʻia e ka hapa nui o ka poʻe he puʻupuʻu a i ʻole nā puʻupuʻu lehulehu ʻaʻole e hele ma hope o kekahi mau pule. Hiki paha iā ʻoe ke manaʻo i hoʻokahi a ʻoi aʻe paha nā puʻupuʻu ma ka ʻāʻī o kāu keiki, ka ʻāʻī a i ʻole ka ʻāʻī. ʻO kēia mau puʻupuʻu he mau lymph nodes, kahi e ulu ai nā lymphocytes maʻamau. Hoʻomaka pinepine kēia mau puʻupuʻu ma kekahi ʻāpana o ke kino o ke keiki, ʻo ka maʻamau ke poʻo, ka ʻāʻī a i ʻole ka umauma a laila e laha ma ke ʻano ʻike ʻia mai kekahi ʻāpana o ka ʻōnaehana lymphatic a i kekahi. I nā pae kiʻekiʻe, hiki ke laha ka maʻi i nā māmā, ate, iwi, iwi iwi a i ʻole nā mea ʻē aʻe.
Aia kekahi ʻano lymphoma kakaʻikahi e loaʻa ana me ka nui mediastinal, ʻike ʻia ʻo ia mediastinal nui B-cell lymphoma (PMBCL). Ua helu ʻia kēia lymphoma ma ke ʻano he subtype o DLBCL akā ua hoʻihoʻi hou ʻia. PMBCL ʻo ia ka wā e puka mai ai ka lymphoma mai nā pūnae B-thymic. ʻO ka thymus he mea lymphoid aia ma hope pono o ka sternum (ka umauma).
ʻO nā hōʻailona maʻamau o DLBCL he:
- ʻO ka pehu ʻole o ka lymph nodes ma ka ʻāʻī, underarm, ʻāʻī a i ʻole ka umauma
- ʻO ka pōkole o ka hanu - ma muli o ka hoʻonui ʻia ʻana o nā lymph nodes i loko o ka umauma a i ʻole ka mediastinal mass
- Cough (ʻo ka maʻamau maloʻo cough)
- 'Oloke
- Paʻakikī ke hoʻōla mai kahi maʻi
- ʻili ʻili (pruritus)
B nā hōʻailona he hua'ōlelo e wehewehe ana i nā hōʻailona penei:
- ʻO ka wela o ka pō (ʻoi aku i ka pō, kahi e pono ai ʻoe e hoʻololi i ko lākou lole moe a me nā moena)
- ʻO ke kuni mau
- ʻO ka pohō kaumahaʻole
Ma kahi o 20% o nā keiki me DLBCL e loaʻa ana me ka nui ma ka umauma luna. Kapa ʻia kēia he "mediastinal mass". , Hiki i ka puʻupuʻu i loko o ka umauma ke hoʻopōkole i ka hanu, ka ʻaʻa a i ʻole ka pehu ʻana o ke poʻo a me ka ʻāʻī ma muli o ke kaomi ʻana o ke koko ma ka ʻau makani a i ʻole nā aʻa nui ma luna o ka puʻuwai.
He mea nui e hoʻomaopopo i ka nui o kēia mau hōʻailona pili i nā kumu ʻē aʻe ma mua o ka maʻi kanesa ʻO ke ʻano o ka lymphoma hiki ke paʻakikī i nā kauka ke ʻike.
ʻO ka ʻike o ka diffuse large B-cell lymphoma (DLBCL)
A nā lāʻau kanu koi mau ʻia no ka hōʻoia ʻana o ka diffuse large B-cell lymphoma. A nā lāʻau kanu he hana e wehe i a limu lymph a i ʻole nā ʻiʻo ʻino ʻē aʻe e nānā iā ia ma lalo o ka microscope e kahi mea maʻi. Hana ʻia ka biopsy ma lalo o ka anesthetic maʻamau no nā keiki e kōkua i ka hōʻemi ʻana i ka pilikia.
ʻO ka maʻamau, ʻo ka biopsy kumu a i ʻole kahi biopsy node excisional ka koho noiʻi maikaʻi loa. ʻO kēia ka mea e hōʻoia i ka hōʻiliʻili ʻana o nā kauka i ka nui o ka ʻiʻo e hoʻopau i ka hoʻāʻo pono no kahi hōʻailona.
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.
Ka hoʻopaʻa ʻana o ka diffuse large B-cell lymphoma (DLBCL)
I ka manawa a ʻike, o DLBCL, pono nā ho'āʻo hou aku e ʻike i kahi ʻē aʻe o ke kino i loaʻa ai ka lymphoma. Kapa ʻia kēia e hoʻokū nei. ka kūlana ʻO ka lymphoma e kōkua i ke kauka e hoʻoholo i ka lāʻau maikaʻi loa no kāu keiki.
Aia he 4 pae, mai ka pae 1 (lymphoma ma kahi wahi) a hiki i ka pae 4 (lymphoma i laha a holomua paha).
- Anuu mua 'o ia ho'i ka pae 1 a me kekahi mau lymphoma papa 2. Hiki ke kapa ʻia kēia 'localised'. ʻO ka pae 1 a i ʻole 2 ʻo ia ka loaʻa ʻana o ka lymphoma ma kahi wahi a i ʻole kekahi mau wahi kokoke.
- ʻIa pae kiʻekiʻe 'o ia ho'i, 'o ka lymphoma ka pae 3 a me ka pae 4, a he lymphoma laha. I ka hapanui o nā hihia, ua laha ka lymphoma i nā ʻāpana o ke kino i mamao loa mai kekahi i kekahi.
ʻO ka 'Advanced' stage lymphoma ke kani e pili ana, akā ʻo ka lymphoma ka mea i ʻike ʻia he maʻi maʻi ʻōnaehana. Hiki ke laha a puni ka ʻōnaehana lymphatic a me nā ʻiʻo kokoke. ʻO ia ke kumu e pono ai ka mālama ʻana i ka ʻōnaehana (chemotherapy) e mālama iā DLBCL.
Hiki ke komo i nā ho'āʻo:
- Nā ho'āʻo koko (e like me: helu koko piha, kemika koko a me ka erythrocyte sedimentation rate (ESR) no ka huli ʻana i nā hōʻike o ka mumū)
- Kānana x-ray - e kōkua kēia mau kiʻi e ʻike i ke ʻano o ka maʻi i loko o ka umauma
- ʻO ka ʻōmole helu Positron emoate (PET) - hana ʻia e hoʻomaopopo i nā wahi āpau o ka maʻi i loko o ke kino ma mua o ka hoʻomaka ʻana o ka mālama ʻana
- Ka pākuʻina o ka tomography (CT)
- Biopsy iwi ʻōiwi (ʻo ka hana maʻamau inā ʻike ʻia ka maʻi ʻoi loa)
- Pahu lumbar – Inā kānalua ka lymphoma i loko o ka lolo a i ʻole ke kuamoʻo
Hiki i kāu keiki ke loaʻa i kekahi mau nā hoʻokolohua kumu ma mua o ka hoʻomaka ʻana i kekahi lapaʻau. ʻO kēia ke nānā i ka hana o ke kino. Hiki ke hana hou ʻia kēia mau mea i ka wā a ma hope o ka mālama ʻana no ka loiloi inā ua pili ka lāʻau i ka hana o ke kino. ʻO nā hoʻokolohua e pono ai ke komo; ;
- Ke kaulike
- Nā ʻike koʻikoʻi (Ke koko, ka mahana, a me ka helu pulse)
- ʻImi puʻuwai
- Kiʻi ʻāʻī
- Nā hoʻāʻo hanu
- Nā ho'āʻo koko
He nui nā mea kūlana a nā hoʻokolohua hana kino hana hou ʻia ma hope o ka lapaʻau ʻana e nānā inā ua holo ka lapaʻau lymphoma a nānā i ka hopena i loaʻa i ke kino.
Ka wānana o ka diffuse large B-cell lymphoma (DLBCL)
Loaʻa i ka DLBCL i nā keiki kahi wānana maikaʻi loa (nānā). Ma kahi o 9 o kēlā me kēia 10 (90%) keiki i ho'ōla ʻia ma hope o ka loaʻa ʻana o ka maʻamau chemotherapy a immunotherapy. Nui nā noiʻi e nānā ana i ka mālama ʻana i kēia lymphoma, me ka manaʻo nui i ka noiʻi ʻana pehea e hōʻemi ai i nā hopena hope, a i ʻole nā hopena ʻaoʻao mai ka lāʻau ʻawaʻawa e hiki mai ana i mau mahina a i mau makahiki ma hope o ka mālama ʻana.
ʻO ke ola lōʻihi a me nā koho lapaʻau e hilinaʻi ʻia ma nā ʻano kumu like ʻole:
- ʻO ka makahiki o kāu keiki ma ka hōʻoia
- Ka lōʻihi a i ʻole ka pae o ka maʻi kanesa
- ʻO ke ʻano o nā pūla lymphoma ma lalo o ka microscope (ke ʻano, ka hana a me ke ʻano o nā cell)
- pehea e pane ai ka lymphoma i ka lāʻau lapaʻau
Hoʻomaʻamaʻa i ka diffuse nui B-cell lymphoma
Ke pau nā hualoaʻa mai ka biopsy a me nā scans staging, e nānā ke kauka i kēia mau mea no ka hoʻoholo ʻana i ka lāʻau lapaʻau maikaʻi loa no kāu keiki. Ma kekahi mau keʻena maʻi 'aʻai, e hui 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 nā kauka i nā kumu he nui e pili ana i ka lymphoma o kāu keiki a me ke olakino maʻamau e hoʻoholo ai i ka wā a me ka lāʻau e pono ai. Hoʻokumu ʻia kēia ma luna o;
- ʻO ka pae a me ka pae o ka lymphoma
- Ōuli
- ʻO ka makahiki, ka mōʻaukala olakino a me ke olakino maʻamau
- Ke ola kino a me ka noʻonoʻo o kēia manawa
- Nā Kūlana Pilikino
- Nā makemake ʻohana
No ka mea he lymphoma e ulu wikiwiki ana ka DLBCL, pono e mālama koke ʻia - pinepine i loko o nā lā a i nā pule o kahi maʻi. ʻO ka lāʻau DLBCL ka hui pū ʻana o chemotherapy a me ka immunotherapy
Hiki ke mālama 'ia kekahi po'e ma'i DLBCL me ka ho'oponopono chemotherapy makua i kapa 'ia R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, a me prednisolone). E pili pinepine ana kēia i ka mālama ʻia ʻana o kāu keiki i loko o kahi haukapila pediatric a i ʻole kahi haukapila makua.
Lapaʻau pediatric maʻamau no ka wā mua DLBCL (pae I-IIA):
- BFM-90/95: 2 - 4 mau manawa o ka chemotherapy e pili ana i ka pae maʻi
- ʻO nā lāʻau lapaʻau Protocol: cyclophosphamide, cytarabine, methotrexate, mercaptopurine, vincristine, pegaspargase, prednisolone, pirarubicin, dexamethasone.
- COG-C5961: 2 - 4 mau manawa o ka chemotherapy e pili ana i ka pae maʻi
Lapaʻau pediatric maʻamau no ka pae kiʻekiʻe DLBCL (pae IIB-IVB):
- COG-C5961: 4 - 8 mau manawa o ka chemotherapy e pili ana i ka pae maʻi
- ʻO nā lāʻau lapaʻau Protocol: cyclophosphamide, cytarabine, doxorubicin hydrochloride, etoposide, methotrexate, prednisolone, vincristine.
- BFM-90/95: 4 - 6 mau manawa o ka chemotherapy e pili ana i ka pae maʻi
- ʻO nā lāʻau lapaʻau Protocol: cyclophosphamide, cytarabine, methotrexate, mercaptopurine, vincristine, pegaspargase, prednisolone, pirarubicin, dexamethasone.
Nā hopena maʻamau o ka lāʻau lapaʻau
ʻO ka lāʻau lapaʻau no DLBCL e hele mai me ka pilikia o ka hoʻomohala ʻana i nā hopena ʻaoʻao like ʻole. He hopena ʻaoʻao ko kēlā me kēia ʻano lapaʻau a na kāu kauka lapaʻau a/a i ʻole kahu maʻi maʻi lapaʻau kūikawā e wehewehe iā ʻoe a me kāu keiki ma mua o ka hoʻomaka ʻana i ka mālama ʻana.
ʻO kekahi o nā hopena ʻaoʻao maʻamau o ka mālama ʻana no ka diffuse large B-cell lymphoma penei:
- Anemia (ke koko ʻulaʻula haʻahaʻa)
- ʻO ka Thrombocytopenia (nā platelet haʻahaʻa)
- Neutropenia (ke koko keʻokeʻo haʻahaʻa)
- ʻO ka naʻi a me ka luaʻi
- ʻO nā pilikia o ka ʻōpū e like me ka constipation a me ka diarrhea
- 'Oloke
- Hoemi i ka momona
Pono kāu hui lapaʻau, kauka, kahu maʻi maʻi a i ʻole lāʻau lapaʻau, e hāʻawi iā ʻoe i ka ʻike e pili ana i kāu lapaʻau, ka hopena maʻamau, he aha nā hōʻailona e hōʻike a ʻo wai e hoʻopili. Inā ʻaʻole, e nīnau i kēia mau nīnau.
Mālama i ka momona
Hiki i kekahi mau lāʻau lapaʻau no ka lymphoma ke hōʻemi i ka momona. ʻOi aku paha kēia me kekahi mau protocols chemotherapy (hui pū ʻana o nā lāʻau lapaʻau) a me ka chemotherapy kiʻekiʻe i hoʻohana ʻia ma mua o ka hoʻololi ʻana i ke kelepona pū. Hoʻonui ka radiotherapy i ke pelvis i ka liʻiliʻi o ka momona. Hiki i kekahi mau lāʻau lapaʻau antibody ke hoʻopilikia i ka momona, akā ʻaʻole maopopo kēia.
Pono kāu kauka e aʻo inā pili paha ka hānau ʻana E kamaʻilio i ke kauka a/a i ʻole kahu hānai maʻi maʻi maʻi ma mua o ka hoʻomaka ʻana o ka mālama ʻana e pili ana i ka hopena o ka hānau ʻana.
No ka ʻike hou aku a i ʻole ka ʻōlelo aʻoaʻo e pili ana i ka pediatric DLBCL, ka mālama ʻana, nā hopena ʻaoʻao, nā kākoʻo i loaʻa a pehea e hoʻokele ai i ka ʻōnaehana haukapila, e ʻoluʻolu e kelepona i ka laina kākoʻo kahu hānai lymphoma ma 1800 953 081 e leka uila iā mākou ma kahu@lymphoma.org.au
Malama hahai
Ke hoʻopau ʻia ka mālama ʻana, e loaʻa i kāu keiki nā scan staging. ʻO kēia mau scans e nānā i ka maikaʻi o ka hana ʻana. E hōʻike ana nā scans i nā kauka i ka pane ʻana o ka lymphoma i ka mālama ʻana. Kapa ʻia kēia ʻo ka pane i ka lāʻau lapaʻau a hiki ke wehewehe ʻia he:
- Pane piha (CR a ʻaʻohe hōʻailona o ka lymphoma i koe) a i ʻole
- pane hapa (PR a i ʻole he lymphoma i kēia manawa, akā ua hoʻemi ʻia ka nui)
A laila pono kāu keiki e hahai ʻia e kāna kauka me nā koho maʻamau maʻamau, maʻamau i kēlā me kēia 3-6 mahina. He mea nui kēia mau koho i hiki i ka hui lapaʻau ke nānā i ka maikaʻi o ko lākou ola ʻana mai ka mālama ʻana. Hāʻawi kēia mau koho i kahi manawa kūpono iā ʻoe e kamaʻilio me ke kauka a kahu hānai paha e pili ana i nā pilikia āu e loaʻa ai. Makemake ka hui lapaʻau e ʻike i ke ʻano o kāu keiki a me ʻoe ma ke kino a me ka noʻonoʻo, a i:
- E nānā i ka pono o ka lāʻau lapaʻau
- E nānā i nā hopena ʻaoʻao mai ka lāʻau lapaʻau
- E nānā i nā hopena hope loa mai ka mālama ʻana i ka manawa
- E nānā i nā hōʻailona o ka hoʻi hou ʻana o ka lymphoma
Loaʻa paha kāu keiki i kahi hoʻokolohua kino a hoʻāʻo koko i kēlā me kēia manawa. Ma waho aʻe o ka manawa ma hope o ka mālama ʻana e nānā i ke ʻano o ka hana ʻana o ka mālama ʻana, ʻaʻole hana pinepine ʻia nā scans ke ʻole he kumu kūikawā no lākou. Inā maikaʻi kāu keiki, hiki ke emi pinepine nā koho i ka manawa.
Hoʻoponopono hou ʻia a i ʻole ka hoʻokele refractory o DLBCL
Hoʻihoʻi hou ʻia ʻO ka lymphoma ka wā i hoʻi mai ai ke kanesa, hale hōʻoluʻolu ʻO ka lymphoma ka wā e pane ʻole mai ai ke kanesa nā lāʻau lapaʻau mua. No kekahi mau keiki a me nā ʻōpio, hoʻi mai ka DLBCL a i kekahi mau hihia kakaʻikahi ʻaʻole ia e pane i ka lāʻau lapaʻau mua (refractory). No kēia mau maʻi, aia kekahi mau lāʻau lapaʻau ʻē aʻe i hiki ke kūleʻa, penei:
- ʻO ka chemotherapy hui pū ʻana kiʻekiʻe ukali ma ka hoʻololi ʻana i ke ʻano o ke kino aiʻole ka hoʻololi ʻana i ke ʻano o ke ʻano o ke ʻano allogeneic (ʻaʻole kūpono i nā kānaka a pau)
- ʻO ka chemotherapy hui
- immunotherapy
- ʻO ke kelepona
- Ke komo ʻana i ka hoʻokolohua lapaʻau
Ke manaʻo ʻia ua loaʻa ke kanaka i ka maʻi hoʻihoʻi hou, e hana pinepine ʻia nā hoʻokolohua hoʻokūkū like, e komo pū ana nā hoʻokolohua i ʻōlelo ʻia ma luna o ka ʻike, a kūlana pauku.
Lapaʻau ma lalo o ka hoʻokolokolo ʻana
Nui nā lāʻau lapaʻau e hoʻāʻo ʻia nei i nā hoʻokolohua lapaʻau a puni ka honua no nā poʻe maʻi me ka lymphoma hou a me ka hoʻi hou ʻana. ʻO kekahi o kēia mau lāʻau lapaʻau.
- Ke aʻo nei nā hoʻāʻo he nui i ka hōʻemi ʻana i ka ʻike ʻona a me nā hopena hope loa o ka mālama ʻana i ka chemotherapy
- CAR T-cell therapy
- Copanlisib (ALIQOPATM - PI3K mea pale)
- Venetoclax (VENCLEXTATM - BCL2 mea hoʻopaneʻe)
- ʻO Temsirolimus (TORISOLTM)
- CUDC-907 (novel targeted therapy)
He aha ka hana ma hope o ka mālama ʻana?
Nā hopena lohi
I kekahi manawa, hiki ke hoʻomau a hoʻomohala paha kekahi hopena ʻaoʻao mai ka mālama ʻana i nā mahina a i ʻole mau makahiki ma hope o ka pau ʻana o ka mālama ʻana. Kapa ʻia kēia he hopena hope. No ka ʻike hou aku, e hele i ka ʻāpana 'hopena hopena' e aʻo hou aʻe e pili ana i kekahi o nā hopena mua a me nā hopena hope e hiki mai ana mai ka mālama ʻana i ka lymphoma.
Hiki i nā keiki a me nā ʻōpio ke loaʻa nā hopena ʻaoʻao e pili ana i ka mālama ʻana i hiki ke ʻike i nā mahina a i ʻole mau makahiki ma hope o ka mālama ʻana, me nā pilikia me ka ulu ʻana o ka iwi a me ka ulu ʻana o nā ʻano kāne i loko o nā kāne, ka infertility, a me nā maʻi thyroid, naʻau a me ka māmā. Nui nā ʻano lapaʻau o kēia manawa a me nā noiʻi noiʻi i kēia manawa i ka hoʻāʻo ʻana e hōʻemi i ka hopena o kēia mau hopena hope.
No kēia mau kumu he mea nui ka loaʻa ʻana o ka hahai mau ʻana a me ka nānā ʻana i nā mea ola o ka diffuse large B-cell lymphoma (DLBCL).
