Hodgkin Lymphoma (HL) ndi chiyani?
HL ndi mtundu wa khansa yomwe imapangitsa ena mwa maselo anu a magazi, otchedwa B-cell lymphocytes kukula kwambiri, ndi kusiya kugwira ntchito bwino. Lymphocyte ndi maselo apadera, kotero ang'onoang'ono muyenera kuwayang'ana ndi microscope. Iwo ndi mtundu wa selo la magazi, ndipo ntchito yawo ndi yolimbana ndi majeremusi amene angakudwalitseni. Ena a iwo akhoza ngakhale kulimbana ndi khansa.
Khansara imatanthauza kuti maselo:
- kukula pamene iwo sakuyenera kutero
- osakhala momwe iwo ayenera, ndipo
- nthawi zina mumayenda ku ziwalo za thupi lanu zomwe sanayenera kupitako.
Kodi B-cell Lymphocytes ndi chiyani?
- Amapangidwa mkati mwa mafupa anu kumalo otchedwa "mafupa".
- Ma lymphocyte amatha kupita kumadera onse a thupi lanu kuti amenyane ndi matenda, koma nthawi zambiri amakhala m'magazi anu.
- Ma lymphatic system amaphatikizapo ziwalo zanu zotchedwa spleen, thymus, tonsils ndi appendix komanso ma lymph nodes omwe amapezeka thupi lanu lonse. Mitsempha ya lymphatic ili ngati misewu yomwe imagwirizanitsa ziwalo zanu zonse zam'mimba ndi ma lymph nodes.
- Ma lymphocyte amathandiza ma neutrophils kulimbana ndi majeremusi.
- Amakumbukiranso majeremusi kotero ngati ayesa kubwerera, ma lymphocyte anu amatha kuwachotsa mwachangu kwambiri.
B-maselo ndi lymphoma
Mukakhala ndi HL, ma B-cell lymphocyte anu amakhala khansa ndipo amatchedwa maselo a lymphoma. Amawoneka mosiyana, ndi akulu ndipo amachita mosiyana ndi ma lymphocyte wamba.
Maselo a lymphoma nthawi zambiri amatchedwanso maselo a Reed-Sternberg. (Reed ndi Sternberg anali mayina a asayansi amene anayamba kuzindikira maselowa).
Kodi cell ya Reed-Sternberg imawoneka bwanji?
Pano pali chithunzi chokuwonetsani momwe maselo abwinobwino amawonekera, komanso momwe ma cell a lymphoma a Reed-Sternberg amawonekera.
Hodgkin lymphoma nthawi zambiri imakula mofulumira, choncho nthawi zina amatchedwa aggressive. Koma chinthu chabwino cha aggressive Hodgkin lymphoma ndi chakuti nthawi zambiri amayankha bwino chithandizo, chifukwa mankhwalawa amapangidwa kuti awononge maselo omwe akukula mofulumira.
Pachifukwa ichi, pali mwayi wabwino kwambiri woti muchiritsidwe mutalandira chithandizo. Izi zikutanthauza kuti simudzakhalanso ndi khansa.
Zizindikiro za Hodgkin Lymphoma (HL)
Chizindikiro choyamba chomwe mungapeze ngati muli ndi HL chingakhale chotupa, kapena zotupa zingapo zomwe zimakula. Izi zitha kukhala pamiyendo yanu:
- khosi (monga momwe ili pachithunzichi)
- mkhwapa (mkhwapa wanu)
- groin (kumene pamwamba pa miyendo yanu imalumikizana ndi thupi lanu lonse, mpaka m'chiuno mwako)
- kapena pamimba (m'mimba mwanu).
Ma lymph nodes m'mimba mwanu angakhale ovuta kuwona ndi kumva, chifukwa ali ozama kwambiri m'thupi lanu kusiyana ndi ma lymph nodes ena. Dokotala wanu akhoza kungodziwa kuti muli ndi ma lymph nodes otupa pamenepo pojambula zithunzi zapadera mkati mwa thupi lanu.
Mitsempha imayamba chifukwa cha ma lymph nodes anu omwe amadzaza ndi maselo a lymphoma, zomwe zimawapangitsa kutupa. Nthawi zambiri sizikhala zowawa koma nthawi zina, ngati ma lymph nodes otupa akukakamiza mbali zina za thupi lanu zimatha kupweteka.
Kodi Hodgkin Lymphoma imapezeka kuti?
Nthawi zina, Hodgkin lymphoma imatha kufalikira kumadera ena a thupi lanu monga:
- mapapo - mapapo anu amakuthandizani kupuma.
- chiwindi - chiwindi chanu chimakuthandizani kugaya chakudya, ndikuyeretsa thupi lanu kuti musapange poizoni (poizoni) woyipa m'thupi lanu.
- mafupa - mafupa anu amakupatsani mphamvu kuti musagwedezeke paliponse.
- fupa la mafupa (apa ndi pakati pa mafupa anu ndipo ndi pamene maselo anu a magazi amapangidwira).
- ziwalo zina zomwe zimathandiza thupi lanu kugwira ntchito bwino.
Ngati maselo anu a lymphoma afalikira kumadera ena a thupi lanu, akhoza kutchedwa siteji yapamwamba HL. Tidzakambirana za magawo a HL mtsogolo pang'ono, koma ndibwino kuti mudziwe tsopano, kuti ngakhale mutakhala ndi gawo la HL, mutha kuchiritsidwa.
Zizindikiro zina zomwe mungapeze ndi:
- Kutopa kwambiri popanda chifukwa - nthawi zambiri umakhala wotopa ngakhale mutapuma kapena kugona.
- Kukhala wopanda mpweya - ngakhale simukuchita kalikonse.
- Chifuwa chouma chomwe sichichoka.
- Kuvulala kapena kutuluka magazi mosavuta kuposa nthawi zonse.
- Khungu loyabwa.
- Magazi mu poo kapena pa chimbudzi pamene mukupita kuchimbudzi.
- Matenda omwe samachoka, kapena amangobweranso (obwerezabwereza).
- B-zizindikiro.
Zomwe zimayambitsa zizindikiro - ndi nthawi yoti muwone dokotala wanu
Zambiri mwa zizindikirozi zimatha kukhala zofanana ndi zina monga matenda. Nthawi zambiri ndi matenda kapena chifukwa china zizindikiro zimatha pakatha milungu ingapo.
Mukakhala ndi HL, ndiye Zizindikiro sizimatha popanda chithandizo.
Dokotala wanu angaganize kuti muli ndi matenda poyamba. Koma ngati ali ndi nkhawa kuti mwina ndi mtundu wa lymphoma, adzayitanitsa mayeso owonjezera. Ngati mwapita kwa dokotala, ndipo zizindikiro zanu sizikuyenda bwino, muyenera kutero bwerera kwa dokotala.
Kodi Hodgkin Lymphoma (HL) Amadziwika bwanji?
Pali mitundu yambiri ya lymphoma. Nthawi zambiri amaikidwa m'magulu Hodgkin's lymphoma or sanali Hodgkin lymphoma. Kenako Hodgkin lymphoma imagawidwa m'magulu awiri:
- Classical Hodgkin Lymphoma (cHL) kapena
- Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
Ambiri a inu mudzakhala ndi CHL, ndi mwana mmodzi yekha mwa 1 aliwonse ndi achinyamata omwe ali ndi HL okhala ndi kagulu kakang'ono ka NLPHL.
Kodi Dokotala wanga amadziwa bwanji kuti ndili ndi mtundu wanji?
Ndikofunika kuti dokotala wanu adziwe kuti muli ndi ndani, chifukwa mitundu ya chithandizo ndi mankhwala omwe mumapeza akhoza kukhala osiyana ndi omwe ali ndi mtundu wina. inu.
Kuti mudziwe mtundu wa HL womwe muli nawo, dokotala wanu adzafuna kuchita mayeso ena osiyanasiyana. Adzafuna kutenga zitsanzo zanu kutupa ma lymph nodes kuti muwayese ndikuwona mtundu wa maselo omwe ali Apo. Dokotala akatenga chitsanzo, amatchedwa biopsy.
Mutha kukhala ndi biopsy yanu m'chipinda cha dokotala, m'chipinda cha opaleshoni kuchipatala kapena ku dipatimenti ya radiology. Izi zimatengera zaka zomwe mwakhala nazo, komanso komwe kutupa kwa lymph nodes ndi. Dokotala wanu adzakudziwitsani komwe inuyo ndi makolo anu/akukusamalirani ndiyenera kupita.
Chimake
Biopsy ikhoza kuchitidwa ngati opaleshoni kuchipatala. Madotolo anu ndi anamwino adzakhala osamala kwambiri, ndipo onetsetsani kuti muli omasuka momwe mungathere pamene akuyesa biopsy. Mutha kupezanso mankhwala omwe amakuthandizani kuti mugone panthawi yopimidwa, kapena kupanga malo omwe amapangirako dzanzi. Mankhwalawa amatchedwa anesthesia.
Mukangotenga biopsy, idzatumizidwa ku matenda, kumene anthu ophunzitsidwa mwapadera otchedwa "Pathologists" adzagwiritsa ntchito zipangizo zosiyanasiyana kuti ayang'ane ma cell omwe ali mu biopsy. Zina mwa zida zomwe adzagwiritse ntchito zidzakhala maikulosikopu apadera ndi magetsi, zomwe zimawathandiza kuona mbali zosiyanasiyana za maselo a lymphoma. Wzomwe amawona zimathandiza dokotala wanu kudziwa mtundu wanji wa HL womwe muli nawo.
Mitundu ina ya ma biopsy omwe mungakhale nawo ndi awa:
Core kapena finene singano biopsy
Dokotala kapena namwino adzayika singano m'mphuno yanu yotupa ndikuchotsamo kagawo kakang'ono ka lymph node. Mudzakhala ndi mankhwala ochititsa dzanzi m'derali kuti lisapweteke, ndipo malingana ndi msinkhu wanu, mungakhale ndi mankhwala opangira tulo kuti mukhale chete.
Ngati lymph node ili mkati mwa thupi lanu ndipo sangayimve, adokotala angagwiritse ntchito ultrasound kapena x-ray yapadera kuti awathandize kuwona pamene akuyesa biopsy.
Excisional nodndi biopsy
Mungafunike opaleshoni kuti mukhale ndi excisional node biopsy. Izi zimachitidwa kuchotsa ma lymph node m'madera ena a thupi lanu omwe sangathe kufika ndi singano. Mudzakhala ndi mankhwala opha ululu omwe angakupangitseni kugona, ndipo simudzamva kapena kukumbukira opareshoniyo. Mudzadzuka ndi zingwe zomwe zidatulutsa ma lymph node.
Mafupa a mafupa amatha
Ndi biopsy ya mafupa, dokotala amaika singano m'munsi mwanu ndi m'chiuno mwanu. Awa ndi amodzi mwa malo omwe maselo anu amwazi amapangidwira, kotero amakonda kutenga chitsanzo cha mafupa a mafupawa kuti awone ngati pali maselo a lymphoma pamenepo. Pali zitsanzo ziwiri zomwe dokotala angatenge kuchokera pamalowa kuphatikiza:
- Bone marrow aspirate (BMA): mayesowa amatenga pang'ono madzi opezeka m'mafupa danga
- Bone marrow aspirate trephine (BMAT): mayesowa amatenga pang'ono chitsanzo cha minofu ya mafupa
Kutengera zaka zanu, mutha kuchitidwa opaleshoniyi ngati mankhwala opha ululu kuti akugoneke. Mwina simudzakhalanso ndi stitch pambuyo pa izi, koma mudzakhala ndi chovala chaching'ono ngati chothandizira chokongoletsera pamalo pomwe singano inalowa.
Kudikirira zotsatira
Zitha kutenga masabata awiri kapena atatu kuti zotsatira zanu zibwerere.
Kudikira zotsatira kungakhale nthawi yodetsa nkhawa kwa inu ndi okondedwa anu. Ndikofunikira kuti inuyo ndi gulu lanu kapena achibale anu ndi anzanu kuti mulankhule ndi munthu amene mumamukhulupirira panthawiyi. Ngati simukudziwa yemwe mungalankhule naye, kapena ngati muli ndi mafunso, mutha kuyimba kapena kutumiza imelo kwa anamwino athu osamalira lymphoma.
Kuti mudziwe zambiri za momwe mungalumikizire nawo chonde dinani buluu kulumikizana nafe batani pansi pazenera.
Mitundu ya Hodgkin Lymphoma
Monga tanenera pamwambapa, pali mitundu yosiyanasiyana ya HL - classical Hodgkin Lymphoma ndi Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL).
Classical Hodgkin Lymphoma imagawikanso kukhala mitundu inayi yosiyana. Izi zikuphatikizapo:
- Nodular Sclerosis Classical Hodgkin Lymphoma (NS-cHL)
- Mixed cellularity classical childhood Hodgkin Lymphoma (MC-cHL)
- Lymphocyte-rich classical Hodgkin Lymphoma (LR-cHL)
- Lymphocyte-depleted classical Hodgkin Lymphoma (LD-cHL)
Kuti mudziwe zambiri zamagulu ang'onoang'ono a HL, dinani pamitu yomwe ili pansipa.
Classical Hodgkin Lymphoma Subtypes
NS-cHL imapezeka kwambiri mwa ana okulirapo komanso achinyamata. Pafupifupi theka la onse omwe ali ndi matenda a Hodgkin lymphoma adzakhala ndi NS-cHL subtype iyi.
Anyamata ndi atsikana amatha kupeza NS-cHL, koma ndizofala kwambiri mwa atsikana.
NS-cHL nthawi zambiri imayambira mkatikati mwa chifuwa chanu, kumalo otchedwa mediastinum. Mutha kuwona mediastinum pachithunzi pansipa, ndi gawo mkati mwa bokosi lakuda.
Mukhoza kapena simungathe kumva kuti mwatupa ma lymph nodes, koma zizindikiro zina zomwe mungapeze ndi mtundu wa HL ndi monga:
- kutsokomola
- kupweteka kapena kusamva bwino pachifuwa chanu
- kumva kupuma movutikira
NS-cHL imathanso kuyambitsa, kapena kufalikira ku ziwalo zina za thupi lanu monga ndulu, mapapo, chiwindi, mafupa kapena mafupa.
Mixed cellularity classical Hodgkin Lymphoma (MC-cHL) imapezeka kwambiri mwa ana osakwana zaka 10. Koma zikhoza kukhudzabe ana ndi achinyamata a msinkhu uliwonse.
Ngati muli ndi MC-cHL, mukhoza kuona zotupa zatsopano pansi pa khungu lanu. Izi zili choncho chifukwa maselo a lymphoma amasonkhana ndikukula m'magulu anu amtundu wamafuta omwe ali pansi pa khungu lanu. Tonsefe tili ndi minofu yamafuta awa ndipo imathandizira kuteteza ziwalo zathu zamkati, komanso zimatitenthetsa pakazizira. Ma cell ena a lymphoma atha kupezekanso m'ziwalo zanu zina.
MC-cHL nthawi zina imakhala yopusitsa kuti dokotala adziwe chifukwa imawoneka ngati mtundu wina wa lymphoma wotchedwa peripheral T-cell lymphoma. Pazifukwa izi, adotolo anu angafunike kukuyezerani zina kuti atsimikizire kuti muli ndi MC-cHL kuti akupatseni mankhwala oyenera.
Lymphocyte-rich classical Hodgkin lymphoma (LR-cHL) ndi yosowa. Ndi anthu ochepa kwambiri omwe amapeza subtype iyi. Koma ngati mutero, nthawi zambiri zimayankha bwino pamankhwala anu. Mwinamwake mudzachiritsidwa mukamaliza mankhwala.
Mutha kuona zotupa pansi pa khungu lanu ngati muli ndi LR-cHL, chifukwa maselo a lymphoma amamera m'mitsempha yomwe ili pansi pa khungu lanu.
LR-cHL ingakhalenso yachinyengo kuti dokotala adziwe chifukwa nthawi zina amawoneka ngati mtundu wina wa HL wotchedwa Nodular lymphocyte predominant Hodgkin Lymphoma (NLPHL). Onse LR-cHL ndi NLPHL amawoneka ofanana, koma mankhwala osiyanasiyana amagwiritsidwa ntchito kuti awachotse.
Lymphocyte-depleted classical Hodgkin Lymphoma (LD0cHL) mwina ndi gawo locheperako la Hodgkin lymphoma mwa ana ndi achinyamata. Zimakhala zofala ngati muli ndi matenda otchedwa human immunodeficiency virus (HIV), kapena ngati munayamba mwadwalapo kachilombo ka Epstein-Barr (EBV).
EBV ndi kachilombo komwe kamayambitsa matenda a glandular fever omwe amakupangitsani kukhala ndi zilonda zapakhosi. Komanso nthawi zina amatchedwa "mono" kapena mononucleosis. Amatchedwanso matenda akupsompsona chifukwa amatha kufalikira kudzera m'malovu (koma simukuyenera kumpsompsona aliyense kuti mutenge).
Simungakhale ndi zotupa zachilendo kapena ma lymph node otupa ngati muli ndi LD-cHL chifukwa nthawi zambiri imamera pakati pa mafupa anu pamalo otchedwa mafupa anu. Apa ndi pamene maselo anu a magazi amapangidwira. Komabe, imatha kuyambanso m'mimba mwanu (kapena m'mimba), kotero kuti zotupazo zimakhala zakuya kwambiri kuti musamve.
Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) ndi mtundu wa HL wosowa kwambiri, koma umapezeka kwambiri mwa ana osakwana zaka 10.
Dokotala wanu akhoza kukupezani ndi NLPHL ngati maselo anu akuwoneka mwanjira inayake. Zitha kuwoneka zoseketsa, koma nthawi zina timati ma cell a lymphoma mu NLPHL amawoneka ngati ma popcorn. Yang'anani pa chithunzicho ndipo muwona zomwe tikutanthauza.
Kodi Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) imasiyana bwanji ndi Hodgkin Lymphoma yakale?
NLPHL imakula pang'onopang'ono kuposa Classical Hodgkin Lymphoma. Ngati muli ndi NLPHL, mutha kuchira mukalandira chithandizo zomwe zikutanthauza kuti lymphoma ichoka ndipo osabwereranso. Koma, kwa ena a inu, zikhoza kubwereranso. Nthawi zina zimatha kubwerera mwachangu, ndipo nthawi zina mutha kukhala opanda lymphoma kwa zaka zambiri.
Ngati NLPHL yanu ibweranso imatchedwa kubwereranso. Chizindikiro chokha cha kubwereranso chikhoza kukhala chotupa cha lymph node chomwe sichichoka. Izi zitha kukhala m'khosi mwanu, m'khwapa, m'chiuno kapena mbali ina ya thupi lanu. Mukapeza zizindikiro zina, zidzakhala zofanana ndi zomwe tazilemba pamwambapa.
Kuwerengera ndi Kuwerengera kwa Hodgkin Lymphoma (HL)
Dokotala wanu atakupezani kuti muli ndi HL, adzafuna kuyesa zambiri kuti awone kuti ndi mbali zingati za thupi lanu zomwe zili ndi maselo a lymphoma, komanso momwe akukula mofulumira.
Masitepe amayang'ana komwe kuli HL. Kumbukirani kale tidalankhula za ma lymphocyte anu. Tidapeza kuti ngakhale amapangidwa m'mafupa anu ndipo amakhala m'mitsempha yanu, amathanso kupita ku gawo lililonse la thupi lanu. Chifukwa maselo a lymphoma yanu ndi khansa ya lymphocyte, HL ikhozanso kukhala m'mafupa anu, lymphatic system kapena mbali ina iliyonse ya thupi lanu.
Mayeso a Staging and Scans
Dokotala wanu adzayitanitsa ma scan kuti atenge zithunzi za mkati mwa thupi lanu kuti awone komwe ma HL awa akubisala. Makani awa atha kukhala:
CT scan (izi ndi zazifupi za computed tomography scan)
Kujambula kwa CT kuli ngati X-ray yapadera yomwe imapereka chithunzi chatsatanetsatane cha chirichonse chomwe chili mkati mwa chifuwa chanu, mimba (malo amimba) kapena pelvis (pafupi ndi mafupa a chiuno). Dokotala wanu azitha kuwona ma lymph node otupa kapena zotupa m'malo awa pa sikani iyi.
PET kuyesa (ichi ndi chachifupi cha Positron Emission Tomography scan)
Ma scan a PET amayang'ana mkati mwa thupi lanu lonse. Madera omwe ali ndi lymphoma amawoneka owala kuposa madera ena. Muyenera kukhala ndi singano m'manja mwanu kapena m'manja mwanu chifukwa adzabaya madzimadzi omwe amathandiza maselo a lymphoma kuyatsa pa chithunzi cha kompyuta. Anamwino amachita bwino kwambiri ndipo amasamala kwambiri kuti asapweteke kwambiri.
Kujambula kwa MRI (Ichi ndi chachidule cha Magnetic Resonance Imaging)
Kujambula uku kumagwiritsa ntchito maginito mkati mwa makina kujambula zithunzi za mkati mwa thupi lanu. Sizipweteka, koma chifukwa pali maginito akuzungulira mu makina amatha kukhala phokoso kwambiri. Anthu ena sakonda maphokosowa kotero mutha kukhala ndi mankhwala oti mugone pang'ono panthawi ya jambulani, kotero sizikudetsani nkhawa. Mwinanso mutha kugwiritsa ntchito mahedifoni apadera kuti mumvetsere nyimbo.
Kodi gawo langa la HL limawerengedwa bwanji?
Masitepe amawerengedwa kuchokera pa nambala wani mpaka nambala XNUMX. Ngati muli ndi gawo limodzi kapena awiri mudzakhala ndi HL yoyambirira. Ngati muli ndi gawo lachitatu kapena lachinayi, mudzakhala ndi gawo lapamwamba la HL.
Advanced siteji HL imatha kumveka yowopsa. Koma, chifukwa ma lymphocyte anu amayenda kuzungulira thupi lanu, lymphoma imatengedwa kuti ndi matenda a "systemic". Chifukwa chake, ma lymphoma apamwamba kuphatikiza HL ndi osiyana kwambiri ndi makhansa ena omwe ali ndi matenda apamwamba.
Kodi gawo langa limakhudza ngati ndingathe kuchiritsidwa?
Zotupa zambiri zolimba, monga zotupa mu ubongo, m'mawere, impso ndi malo ena sizingachiritsidwe ngati zitapita patsogolo.
Koma ma lymphoma ambiri apamwamba amatha kuchiritsidwa ndi chithandizo choyenera, ndipo nthawi zambiri zimakhala choncho kwa ana ndi achinyamata omwe ali ndi HL.
Chithunzichi ndi chitsanzo chabwino cha momwe amasiyana magawo angawonekere. Mbali zofiira zimasonyeza kumene lymphoma ikhoza kukhala pagawo lililonse - lanu likhoza kukhala a zosiyana pang'ono, koma zidzatsatira mofanana chitsanzo.
1 internship | HL wanu ali m'dera limodzi la lymph node, pamwamba kapena pansi pa diaphragm yanu |
2 internship | HL yanu ili m'madera awiri kapena angapo a lymph node, koma mbali imodzi ya diaphragm yanu |
3 internship | HL wanu ali m'dera limodzi la lymph node pamwamba ndi malo amodzi pansi pa diaphragm yanu. |
4 internship | HL yanu ili m'malo angapo a lymph nodes, ndipo yafalikira ku ziwalo zina za thupi lanu, monga mafupa, mapapo, kapena chiwindi. |
Kodi diaphragm yanu ndi chiyani?
Diaphragm yanu ndi minofu yooneka ngati dome yomwe imalekanitsa ziwalo za pachifuwa chanu, kuchokera ku ziwalo za mimba yanu. Kumakuthandizaninso kupuma pothandiza mapapu anu kuyenda mmwamba ndi pansi.
Zinthu zina zofunika kuzidziwa za siteji yanu
Komanso nambala yowerengera, mutha kupatsidwa chilembo pambuyo pa nambalayo.
Mukukumbukira zomwe tidanena kale za B-zizindikiro? Ndi gulu la zizindikiro zomwe zingachitike palimodzi mukakhala ndi lymphoma. Zikuphatikizapo:
- Kukhetsa thukuta usiku komwe kumanyowetsa zovala zanu ndi zogona
- Malungo ndi kuzizira
- Kuchepetsa thupi osayesa
Ngati muli ndi B-zizindikirozi mudzakhala ndi "B" pambuyo pa nambala yanu, koma ngati mulibe B-zizindikiro mudzakhala ndi "A" pambuyo pa nambala yanu.
Ngati chimodzi mwa ziwalo zanu, monga mapapu anu, chiwindi kapena mafupa anu ali ndi HL mudzakhala ndi chilembo "E" pambuyo pa nambala yanu.
Ngati muli ndi lymph node kapena chotupa choposa 10cm kukula kwake amatchedwa bulky. Ngati muli ndi matenda aakulu, mudzakhala ndi chilembo "X" pambuyo pa nambala yanu
Pomaliza, ngati ndulu yanu ili ndi HL, mudzakhala ndi chilembo "S" pambuyo pa nambala yanu. Mphuno yanu imathandiza kuti magazi anu akhale oyera, ndipo ndi chiwalo chachikulu cha chitetezo chanu cha mthupi. Ndiko komwe maselo anu oyera ambiri amakhala komanso pomwe ma B-cell lymphocyte amapanga ma antibodies ambiri kuti amenyane ndi majeremusi.
Onani zomwe zinthu zosiyanasiyana izi zingatanthauze mu tebulo ili m'munsimu.
kutanthauza | Importance |
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Kuwerengera kumathandiza dokotala wanu kusankha bwino pazamankhwala omwe amakupatsirani.
Monga siteji, giredi yanu idzaperekedwa ngati nambala kuyambira wani mpaka anayi. Itha kulembedwa ngati G1, G2, G3 kapena G4. Pamene ma lymphocyte akukhala khansa, amayamba kuwoneka mosiyana ndi ma lymphocyte anu abwino. Ngati muli ndi lymphoma yotsika kwambiri monga G1, maselo akukula pang'onopang'ono ndipo amangokhala osiyana pang'ono ndi ma lymphocyte anu abwino, koma ndi apamwamba, amakula mofulumira kwambiri ndipo sangawoneke ngati maselo anu abwino.
Akamaoneka mosiyana kwambiri, m’pamenenso amalephera kugwira ntchito bwino.
Nazi mwachidule za giredi iliyonse:
- G1 - kalasi yotsika - maselo anu amawoneka pafupi ndi abwino ndipo amakula ndikufalikira pang'onopang'ono.
- G2 - kalasi yapakatikati - maselo anu akuyamba kuwoneka mosiyana koma maselo ena abwinobwino amakhalapo ndipo amakula ndikufalikira pamlingo wocheperako.
- G3 - kalasi yapamwamba - maselo a mwana wanu / anu amawoneka mosiyana ndi maselo ochepa omwe amamera bwino ndipo amakula ndikufalikira mofulumira.
- G4 - kalasi yapamwamba - maselo a mwana wanu / anu amawoneka mosiyana kwambiri ndi abwino ndipo amakula ndikufalikira mofulumira kwambiri
Mayesero Ena
Mutha kuyezetsanso zina musanayambe kumwa mankhwala, komanso panthawi yamankhwala kuti muwonetsetse kuti thupi lanu limatha kuthana ndi mankhwala omwe mungakhale nawo. Izi zingaphatikizepo:
- Kuyeza magazi pafupipafupi
- Ultrasound kapena ma scan ena ndi kuyezetsa zina mwa ziwalo zanu kuphatikiza mtima wanu, mapapo ndi impso
- Mayesero a Cytogenetic - awa ndi mayesero apadera kuti awone ngati pali kusintha kulikonse mu majini anu. Majini anu amauza maselo amthupi lanu momwe angakulire komanso momwe angagwirire ntchito. Ngati pali kusintha (komwe kumatchedwanso kusintha kapena kusintha) mu majini anu, akhoza kupereka malangizo olakwika. Malangizo olakwikawa angayambitse khansa - monga HL kukula. Sikuti aliyense adzafunika mayeso awa.
- Lumbar puncture - Iyi ndi njira yomwe dokotala amaika singano kumbuyo kwanu pafupi ndi msana wanu ndikutulutsa madzi ena. Izi zitha kuchitika ngati akuwona kuti HL wanu ali muubongo kapena msana, kapena akufalikira pamenepo. Ana ena kapena achinyamata atha kukhala ndi mankhwala osokoneza bongo kuti akupangitseni kugona panthawi yomwe mukugona kotero kuti zisakupwetekeni, ndikuwonetsetsa kuti simukhala chete panthawi ya ndondomekoyi.
Mafunso kwa dokotala musanayambe mankhwala
Dokotala wanu atatolera zonse kuchokera ku biopsies, scans ndi mayeso ena; azitha kuyika ndondomeko yoyendetsera chithandizo chanu ndikukutetezani. Nthawi zina madotolo amalankhula ndi madotolo ena kapena akatswiri ena kuti atsimikizire kuti akukonzerani njira yabwino kwambiri. Akatswiriwa akakumana kuti apange dongosolo, umatchedwa msonkhano wamagulu osiyanasiyana - kapena msonkhano wa MDT.
Tikambirana za mitundu yamankhwala omwe mungapitirire nawo pang'ono patsamba lino. Koma choyamba ndikofunika kuti mukhale omasuka kufunsa dokotala mafunso aliwonse omwe muli nawo musanayambe chithandizo. Izi zidzakuthandizani kudziwa zomwe muyenera kuyembekezera, komanso kudzidalira.
Zingakhale zovuta kudziwa mafunso oyenera kufunsa. Koma kunena zoona, palibe mafunso abwino kapena olakwika. Aliyense ndi wosiyana ndipo mafunso omwe muli nawo angakhale osiyana ndi mafunso omwe mwana kapena wachinyamata ali nawo. Chofunika kwambiri ndi chakuti palibe mafunso opusa pankhani ya thanzi lanu ndi chithandizo chanu. Choncho khalani olimba mtima kufunsa chilichonse chomwe chili m'maganizo mwanu.
Mafunso ena kuti muyambe
Kuti tikuthandizeni kuti tiyambe taphatikiza mafunso omwe inu kapena makolo anu/okusungani mungafune kufunsa. Ngati simunakonzekere, kapena kuiwala kufunsa mafunso musanalandire chithandizo, zili bwino, mutha kufunsa dokotala kapena namwino wanu nthawi iliyonse. Koma kudziwa mayankho a mafunsowa musanayambe kulandira chithandizo kungakuthandizeni kuti mukhale olimba mtima.
Kusunga chonde chanu (kuthekera kwanu kupanga makanda mukadzakula)
Musanayambe chithandizo pali zinthu zina zofunika kuziganizira. Ndikudziwa kuti mwina muli ndi zambiri zoti muganizire, koma kukonza zinthu musanayambe kulandira chithandizo kungathandize kwambiri mtsogolo.
Chimodzi mwazotsatira za chithandizo cha HL chingapangitse kuti zikhale zovuta kutenga pakati, kapena kutenga mimba pambuyo pake m'moyo. Kuti mudziwe zinthu zina zimene mungachite kuti mukhale ndi mwayi wodzakhala ndi ana m’tsogolo, mukhoza kuonera vidiyoyi podina chithunzi chili m’munsichi.
Chithandizo cha Hodgkin Lymphoma
Gulu lanu lazaumoyo liganizira zambiri za inu musanapange chisankho chomaliza pa zomwe akuganiza kuti ndi chithandizo chabwino kwambiri kwa inu. Zina mwazinthu zomwe angaganizire ndi izi:
- Kaya muli ndi gulu laling'ono la HL kapena NOdular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
- Ndi zaka zingati
- Ngati muli ndi matenda kapena kulumala
- Ngati muli ndi ziwengo
- Mukumva bwino bwanji mwakuthupi (thupi lanu) komanso m'malingaliro (malingaliro ndi malingaliro anu).
Dokotala wanu kapena namwino akufotokozerani dongosolo lanu lamankhwala ndi zotsatirapo zake. Zotsatira zake ndi zinthu zomwe zimatha kuchitika chifukwa cha chithandizo chanu, monga kudwala, tsitsi lanu kuthothoka kapena zinthu zina zambiri. Ngati muli ndi zotsatira zina zoyipa, ndikofunikira kuti mudziwitse namwino wanu kapena dokotala kuti akuthandizeni kukhala bwino.
Ngati pali chilichonse chomwe simukuchimvetsetsa, kapena mukuda nkhawa, lankhulani ndi dokotala kapena namwino wanu ndipo muwafunse kuti akufotokozereni.
Mukhozanso kuyimba foni kapena imelo Lymphoma Australia Namwino Wothandizira ndi mafunso anu. Titha kukuthandizani kuti mudziwe zambiri. Ingodinani batani la Lumikizanani nafe pansi pazenera.
Pali mitundu yosiyanasiyana ya chithandizo. Mutha kukhala ndi mtundu umodzi, kapena mitundu ingapo kutengera momwe zinthu ziliri. Izi zikuphatikizapo:
Chithandizo Chothandizira
Thandizo lothandizira limaperekedwa kuti mumve bwino panthawi ya chithandizo, ndikuchira msanga.
Kwa ena a inu, maselo anu a lymphoma akhoza kukula mofulumira komanso aakulu kwambiri. Izi zimapangitsa kuti mafupa anu, magazi, ma lymph nodes, chiwindi kapena ndulu azidzaza kwambiri. Chifukwa cha ichi, simungakhale ndi maselo athanzi okwanira. Thandizo lothandizira lingaphatikizepo kukupatsirani magazi kapena mapulateleti kuti muwonetsetse kuti muli ndi maselo athanzi okwanira.
Ngati muli ndi matenda, mungakhale ndi maantibayotiki kuti akuthandizeni kuchiza msanga. Nthawi zina mutha kukhala ndi mankhwala otchedwa GCSF othandizira thupi lanu kupanga maselo oyera amwazi kuti athe kulimbana ndi matenda.
Thandizo lothandizira lingaphatikizeponso kubweretsa gulu lina lotchedwa gulu lothandizira odwala. Gulu la chisamaliro chapalliative ndilabwino pakuwonetsetsa kuti muli omasuka, ndikuwongolera zizindikiro zanu kapena zotsatirapo zake. Zina mwa zinthu zomwe atha kukuthandizani ndi monga kuwawa, kudwala kapena kuda nkhawa kapena kuda nkhawa. Angathandizenso kukonzekera momwe mungasamalire chisamaliro chanu chaumoyo m'tsogolomu.
Ndibwino kufunsa dokotala kapena namwino kuti ndi mankhwala ati omwe angakhale abwino kwa inu.
Chithandizo cha radiation (radiation)
Radiotherapy imagwiritsa ntchito radiation kupha maselo a khansa. Zili ngati ma X-ray amphamvu kwambiri ndipo mutha kukhala nawo tsiku lililonse kwa milungu ingapo, nthawi zambiri kuyambira Lolemba mpaka Lachisanu. Itha kugwiritsidwa ntchito pochiza khansa, kukuthandizani kuti mukhululuke - pomwe khansayo siidziwikanso (koma ikhoza kubwera pambuyo pake), kapena itha kugwiritsidwa ntchito kuthana ndi zovuta zina.
Zizindikiro zina zomwe zimatha kuthandizidwa ndi radiotherapy ndizopweteka kapena kufooka. Izi zikhoza kuchitika ngati lymphoma yanu ikuyika mitsempha yanu, msana kapena mbali zina za thupi lanu. Radiotherapy imapangitsa kuti lymphoma (chotupa) ikhale yaying'ono kotero kuti isapitirire kukakamiza minyewa yanu kapena mbali za thupi lanu zomwe zimapweteka.
Chemotherapy (Chemotherapy)
Mutha kukhala ndi chemo ngati piritsi ndi/kapena kukhala ngati dontho (kulowetsedwa) mumtsempha wanu (m'magazi anu) ku chipatala cha khansa kapena chipatala. Nthawi zambiri mumatha kukhala ndi mitundu yambiri yamankhwala. Chemo imapha maselo omwe akukula mwachangu, kotero imatha kukhudzanso ena mwama cell anu abwino omwe amakula mwachangu kumabweretsa zotsatira zoyipa.
Monoclonal Antibody (MAB)
Ma MAB amaperekedwa ngati kulowetsedwa ndikumangirira ku cell ya lymphoma ndikukopa matenda ena omwe amalimbana ndi maselo oyera amagazi ndi mapuloteni ku maselo a lymphoma. Izi zimathandiza kuti chitetezo chanu cha mthupi chitha kulimbana ndi HL. Nthawi zina, MAB ikhoza kuphatikizidwa ndi mankhwala ena omwe amapha mwachindunji maselo a khansa ya lymphoma. Ma MAB awa amatchedwa conjugated MABS.
IMmune checkpoint inhibitors (ICIs)
Ma ICI amaperekedwa ngati kulowetsedwa ndikugwira ntchito kuti apititse patsogolo chitetezo chanu cha mthupi, kuti thupi lanu lithe kulimbana ndi khansa yanu. Amachita izi potsekereza zotchinga zina zotchingira ma cell a lymphoma, zomwe zimawapangitsa kuti asawonekere ku chitetezo chanu chamthupi. Zopingazo zikachotsedwa, chitetezo chanu cha mthupi chimatha kuwona ndikumenyana ndi khansa. Izi sizimagwiritsidwa ntchito kawirikawiri kwa ana ndi achinyamata omwe ali ndi Hodgkin Lymphoma, kupatula ngati muli mu mayesero azachipatala.
Stem cell transplant (SCT)
Ngati ndinu wachinyamata ndipo muli ndi vuto (lokula mofulumira) HL a SCT angagwiritsidwe ntchito. Ma cell a stem amathandizira kusintha ma cell anu oyipa ndi ma cell abwino, athanzi omwe amatha kukula kukhala mtundu uliwonse wamagazi omwe mungafune.
CAR T-cell Therapy
Kuti mudziwe zambiri za CAR T-cell therapy, chonde onani tsamba lathu Chimeric antigen receptor (CAR) T-cell therapy.
Makolo ndi ana okulirapo - Ngati mungafune kudziwa zambiri pazamankhwalawa, chonde onani tsamba lathu lawebusayiti Mankhwala apa.
Chithandizo Choyamba
Kuyamba Chithandizo cha Hodgkin Lymphoma (HL)
Mukangoyamba kulandira chithandizo, mutha kumva ngati munthu yemwe ali pachithunzichi. Koma kudziwa zomwe mungayembekezere kungapangitse kuti zikhale zosavuta. Choncho pitirizani kuwerenga ndipo tikuuzeni zimene zingachitike.
Nthawi yoyamba mukakhala ndi mtundu wa mankhwala amatchedwa chithandizo choyamba. Mukayamba mankhwala, mudzakhala nawo mozungulira. Izi zikutanthauza kuti mudzakhala ndi chithandizo, ndiye kupuma, ndiye kuzungulira kwina (kuzungulira) kwa mankhwala.
Nthawi zambiri amaperekedwa ngati kulowetsedwa mumtsempha wanu. Ana ambiri ndi achinyamata adzafunika kukhala ndi chipangizo chotchedwa tunneled catheter chomwe mankhwalawa amayikidwamo. Katheta yotsekeredwa imagwiritsidwa ntchito kotero kuti simuyenera kukhala ndi singano nthawi iliyonse mukalandira chithandizo kapena kuyezetsa magazi. Mutha kupeza zambiri pa ma catheters opangidwa ndi tunnel podina batani pansipa.
Kuti muwone zambiri zamitundu yamankhwala oyamba omwe mungakhale nawo, chonde dinani chizindikirocho kutengera ngati muli nacho Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL), kapena Hodgkin lymphoma yapamwamba. Kumbukirani kuti Hodgkin Lymphoma yakale imaphatikizapo:
- Nodular sclerosis classical Hodgkin lymphoma (NS-cHL)
- Mixed cellularity classical Hodgkin lymphoma (MC-cHL)
- Lymphocyte-rich classical Hodgkin lymphoma (LR-cHL)
- Lymphocyte-depleted classical Hodgkin lymphoma (LD- cHL)
Mankhwala a Nodular Lymphocyte Predominant Hodgkin lymphoma (NLPHL) ndi osiyana kwambiri ndi a Hodgkin lymphoma (cHL). Ngati mwangoyamba kumene NLPHL chithandizo chanu chitha kukhala chimodzi kapena zingapo mwa izi:
- Yang'anani ndikudikirira kuyang'anitsitsa mpaka zizindikiro zikufunika kuthandizidwa.
- Radiotherapy yokha.
- Opaleshoni, ngati chotupa angathe kuchotsedwa kwathunthu.
- Kuphatikiza mankhwala amphamvu a chemotherapy kapena opanda mlingo wochepa wa radiotherapy wakunja. Chemotherapy ingaphatikizepo mankhwala otchedwa:
- AVPC (doxorubicin, vincristine, cyclophosphamide ndi steroid yotchedwa prednisone)
- CVP (cyclophosphamide, vincristine ndi steroid yotchedwa prednisone)
- COG-ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide ndi steroid yotchedwa prednisone).
- Rituximab - mankhwalawa amaperekedwa kudzera m'mitsempha. Ndi anti-monoclonal antibody yomwe imayang'ana cholandilira chotchedwa CD20 pa B-cell, ndipo yagwira ntchito bwino kwambiri pochiza mitundu ina ya B-cell lymphoma.
- Kutenga nawo mbali pamayesero azachipatala - komwe mutha kuyesa mitundu yatsopano yamankhwala kapena machiritso.
Classical Hodgkin lymphoma (cHL) ndi lymphoma yomwe ikukula mofulumira, choncho chithandizo chiyenera kuyamba mwamsanga mutapezeka. Chithandizo chokhazikika kwa ana ndi achinyamata omwe ali ndi CHL ndi kuphatikiza kwa chemotherapy. Ana ena ndi achinyamata amalandiranso radiotherapy kumadera ena a lymphoma pambuyo pa chemotherapy.
Dokotala angapangire chimodzi mwazinthu zotsatirazi zochizira ana a Hodgkin lymphoma:
COG-ABVE-PC
Protocol iyi imaphatikizapo steroid yotchedwa prednisolone ndi mankhwala a chemotherapy otchedwa
- kutuloji
- alireza
- vincristine
- etoposide
- cyclophosphamide
Mudzakhala ndi izi masiku 21 aliwonse (masabata atatu) pamizere 3-4.
Bv-AVECP
Protocol iyi imaphatikizapo steroid prednisolone, ndi conjugated MAB yotchedwa brentuximab vedotin ndi mankhwala a chemotherapy otchedwa:
- Doxorubicin
- Dzina Vincristine
- Etoposide
- cyclophosphamide
Ngati muli ndi zaka 15 kapena kuposerapo mutha kulandira chithandizo ku chipatala cha ana kapena kuchipatala cha akulu. Njira zochizira kuchipatala cha akuluakulu zitha kukhala zosiyana ndi zomwe tazilemba pamwambapa. Ngati mukulandira chithandizo ku chipatala cha akulu, mutha kupeza zambiri zathu Hodgkin Lymphoma kwa akuluakulu tsamba pano.
Mzere Wachiwiri komanso chithandizo chopitilira Hodgkin Lymphoma (HL)
Mukatha kulandira chithandizo ambiri a inu mudzapita kuchikhululukiro. Kukhululukidwa ndi nthawi yomwe mulibe zizindikiro za HL zomwe zatsala m'thupi lanu, kapena pamene HL ili pansi pa ulamuliro ndipo safuna chithandizo. Nthawiyi imatha zaka zambiri, koma kawirikawiri, HL yanu imatha kubwereranso (kubwerera). Izi zikachitika, dokotala wanu angafune kukupatsani chithandizo china.
Nthawi zina, simungapite ku chikhululukiro ndi chithandizo chanu choyamba. Izi zikachitika, HL wanu amatchedwa "refractory". Ngati muli ndi refractory HL dokotala wanu angafune kuyesa mankhwala ena. HL wanu akhoza kutchedwanso refractory ngati mwalandira chithandizo ndikupita ku chikhululukiro, koma chikhululukirocho chimakhala kwa miyezi yosakwana 6.
Chithandizo cha Refractory and Relapsed Hodgkin Lymphoma (HL)
Chithandizo chomwe mumapeza ngati muli ndi HL yosokoneza kapena mutayambiranso amatchedwa njira yachiwiri. Cholinga cha chithandizo chachiwiri ndikubwezeretsanso chikhululukiro, kapena kwa nthawi yoyamba ndipo zitha kukhala zothandiza kwambiri.
Ngati muli ndi chikhululukiro china, ndiye kuti mwayambiranso ndi kulandira chithandizo chochulukirapo, mankhwala otsatirawa amatchedwa mankhwala a mzere wachitatu, chithandizo cha mzere wachinayi ndi zina zotero.
Mungafunike mitundu ingapo ya chithandizo cha HL wanu. Akatswiri akupeza mankhwala atsopano komanso othandiza kwambiri omwe akuwonjezera kutalika kwa ziwongola dzanja ndikuthandizira kuti mukhale ndi thanzi labwino panthawi komanso pambuyo pa chithandizo.
Kodi adokotala angandisankhire bwanji chithandizo chabwino kwambiri?
Panthawi yobwereranso, kusankha chithandizo kudzadalira zifukwa zingapo kuphatikizapo.
- Kwa nthawi yayitali bwanji mudakhala mu chikhululukiro
- Thanzi lanu lonse ndi zaka zanu
- Ndi chithandizo chanji cha HL chomwe mudalandira m'mbuyomu
- Zokonda zanu.
Dokotala wanu azitha kuyankhula nanu ndi makolo anu kapena athandizi anu za chithandizo chabwino chamzere wachiwiri kwa inu.
Zotsatira Zodziwika za Chithandizo cha Hodgkin Lymphoma
Ngakhale mankhwala a HL ndi othandiza kwambiri pochotsa HL, amathanso kutchedwa zotsatira zoyipa. Izi zikutanthauza kuti atha kupanganso zosintha kapena zizindikiro zosafunikira. Izi nthawi zambiri zimangotenga nthawi yochepa, koma zina zimatha nthawi yayitali, kotero ndikofunikira kuti mudziwitse adokotala kapena namwino za zoyipa zomwe muli nazo.
Zotsatira zanu zitha kukhala zosiyana ndi za munthu wina yemwe ali ndi HL chifukwa tonse ndife osiyana ndipo timayankha mosiyana ndi chithandizo. Zotsatira zake zimathanso kutengera mtundu wa chithandizo chomwe mukulandira.
Dokotala wanu kapena namwino adzatha kukuuzani za zotsatirapo zomwe mungapeze potengera chithandizo chomwe mumalandira.
Chimodzi mwazotsatira zoyipa za chithandizo cha Hodgkin lymphoma ndi kuchepa kwa magazi, kotero ndikofunikira kudziwa pang'ono ma cell a magaziwa.
Maselo ofiira ofiira
Maselo ofiira ndi maselo amene amapangitsa kuti magazi anu aziwoneka ofiira. Ali ndi puloteni yomwe imatchedwa hemoglobin (Hb) yomwe imagwira ntchito ngati takisi. Imanyamula mpweya m’mapapu anu mukapuma, ndiyeno imatengera mpweyawo kupita ku ziwalo zina za thupi lanu kuti ikupatseni mphamvu. Kenako imanyamula mpweya woipa m'thupi mwanu ndikukubwezerani m'mapapo anu kuti mutuluke pamene mukupuma.
Maselo ofiira a m’magazi anu kapena Hb akatsika mumatha kumva kutopa, chizungulire, kupuma movutikira ndipo nthawi zina mumavutika kukhazikika. Ngati muli ndi zizindikiro izi, chonde auzeni dokotala wanu.
Mapulatifomu
Mapulateleti ndi maselo apadera m'magazi anu omwe ali ndi mtundu wachikasu. Ndiwofunika kwambiri mukamadzipweteka kapena kudzipweteka nokha. Amakuthandizani kuti musakhetse magazi kapena mabala kwambiri. Mukadzipweteka nokha, mapulateleti anu amathamangira kumalo omwe avulala ndikumamatirana pamdulidwe kapena zilonda kuti musakhetse magazi. Mapulateleti athu akatsika kwambiri, mutha kutulutsa magazi kapena kuvulala mosavuta kuposa momwe mumachitira. Kotero ngati muwona magazi pang'ono pamene mukutsuka mano, kupita kuchimbudzi kapena kuwombera tsopano, kapena muli ndi mikwingwirima yambiri kuposa yachibadwa, ndikofunika kuti mudziwe dokotala.
Maselo oyera
Ma lymphocyte anu ndi mtundu wa maselo oyera a magazi, koma mulinso ndi mitundu ina ya maselo oyera a magazi. Zomwe muyenera kudziwa ndi ma neutrophils ndi ma lymphocyte. Maselo anu oyera onse ndi mbali ya chitetezo chanu cha mthupi. Izi zikutanthauza kuti, onse ndi majeremusi omwe amatha kudwala. Ndiabwino kwambiri polimbana ndi majeremusiwa, choncho nthawi zambiri timakhala athanzi. Koma, ngati maselo anu oyera a magazi sakugwira ntchito bwino, kapena ngati mulibe okwanira, mukhoza kudwala.
Ma neutrophils anu ndi oyamba mwa maselo oyera amwazi kuzindikira ndi kulimbana ndi majeremusi. Kenako amalola maselo ena oyera, monga ma lymphocyte anu akudziwa kuti muli majeremusi m'thupi lanu. Ngati izi ndi zochepa mukhoza kudwala ndi matenda. Izi zikachitika, mutha:
- akudwala
- kutentha thupi (38° kapena kupitirira apo) ndipo khungu lanu likhoza kumva kutentha
- khalani wonjenjemera pang'ono kapena muzizizira (kumva kuzizira kwambiri mkati mwa thupi lanu ndikuyamba kunjenjemera)
- kukhala ndi chilonda chowoneka chofiira kapena pusey
- mtima wanu ukhoza kugunda mofulumira kuposa mmene umachitira
- kumva chizungulire ndi kutopa
Ndikofunikira kuti mudziwitse dokotala wanu nthawi yomweyo ngati izi zikuchitika mukakhala ndi Hodgkin Lymphoma, ngakhale zitachitika pakati pausiku. Ngati dokotala palibe, muyenera kupita ku chipatala kuti mukalandire mankhwala otchedwa maantibayotiki kuti muthe kulimbana ndi matendawa.
Nayi tebulo lachangu komanso losavuta lomwe lili ndi zambiri zama cell anu amwazi.
Maselo oyera | Maselo Ofiira | Mapulatifomu | |
Dzina Lachipatala | Leukocytes. Ma leukocyte ena ofunikira kukumbukira ndi Ma Neutrophils & Lymphocytes | Mabakiteriya | Thrombocytes |
Amachita chiyani? | Menyani Matenda | Kunyamula mpweya | Lekani magazi |
Amatchedwa chiyani ngati mulibe okwanira ma cellwa? | Neutropenia & lymphopenia | Anemia | Supombocytopenia |
Zingakhudze bwanji thupi langa ngati ndilibe zokwanira? | Mutenga matenda ochulukirapo ndipo mutha kukhala ndi vuto lowachotsa ngakhale mutamwa maantibayotiki | Mutha kukhala ndi khungu lotuwa, kumva kutopa, kupuma, kuzizira komanso chizungulire | Mukhoza kuvulazidwa mosavuta, kapena kutuluka magazi omwe sasiya mwamsanga pamene mwacheka |
Kodi gulu langa lachipatala lichita chiyani kuti likonze izi? |
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** Ngati onse maselo anu amagazi ndi otsika amatchedwa 'pancytopenia ndipo mungafunike kugonekedwa kuchipatala kuti muwakonze ** | |||
Zotsatira zina zomwe mungapeze ndi:
- kumva kudwala m'mimba (mseru) ndi kusanza
- zilonda mkamwa kapena zilonda. Zinthu zingayambenso kulawa mosiyana
- kusintha mukapita kuchimbudzi. Mutha kukhala ndi chimbudzi cholimba (chodzimbidwa) kapena chimbudzi chofewa komanso chamadzimadzi (kutsekula m'mimba)
- kutopa kapena kusowa mphamvu osathandizidwa ndi kupuma kapena kugona (kutopa)
- kuwawa ndi kuwawa kwa minofu ndi mafupa anu
- Tsitsi lanu pamutu panu, ndi ziwalo zina za thupi lanu zikhoza kugwa
- zingakhale zovuta kuika maganizo ake onse kapena kukumbukira zinthu
- kumverera kwachilendo m'manja ndi m'mapazi monga kugwedeza, zikhomo ndi singano, kuyaka kapena kupweteka
- kusintha kwa maselo abwino a magazi (onani tebulo pamwambapa).
Zovuta zachipatala
Tikukulangizani kuti mufunse dokotala nthawi zonse za mayesero aliwonse azachipatala omwe mungakhale nawo.
Mayesero azachipatala ndi ofunikira kuti apeze mankhwala atsopano, kapena kusakanizikana kwamankhwala kuti muchepetse chithandizo cha HL mtsogolomu. Atha kukupatsaninso mwayi woyesera mankhwala atsopano, kuphatikiza mankhwala kapena mankhwala ena omwe mungalandire pokhapokha mutayesedwa. CAR T-cell therapy ndi chitsanzo cha mtundu wa chithandizo chomwe chili m'mayesero achipatala.
Ngati mukufuna kutenga nawo mbali pamayesero azachipatala, funsani dokotala ngati pali omwe mukuyenera.
Prognosis, Care-up Care & Survivorship - kukhala ndi & pambuyo pa HL
Kuthamangitsani
Zotsatira zanu zimatanthawuza momwe HL wanu angayankhire chithandizo ndi momwe mungakhalire mutalandira chithandizo.
Anthu ambiri omwe ali ndi Hodgkin lymphoma amachiritsidwa pambuyo pa chithandizo choyamba. Komabe, izi sizili choncho kwa aliyense. Ngati HL wanu sachoka mutalandira chithandizo (simupita kuchikhululukiro), mudzakhala ndi "refractory" HL. Izi zikutanthauza kuti HL wanu sakuyankha chithandizo chamakono, kotero dokotala wanu ayesa zina.
Ngati mupita kuchikhululukiro pambuyo pa chithandizo, koma chimabweranso pakapita nthawi amatchedwa kuyambiranso. Chatsopano ndi chakuti, Hodgkin lymphoma yopweteka komanso yobwereranso imayankha bwino chithandizo chachiwiri.
Pali zinthu zosiyanasiyana zomwe zingakhudze momwe mungadziwire, koma dokotala wanu ndiye munthu wabwino kwambiri woti alankhule naye za izi chifukwa akudziwa zambiri zanu. Ngati simukutsimikiza kuti matenda anu ndi chiyani, ingowafunsani nthawi ina mukadzawawona.
Chisamaliro chotsatira
Chisamaliro chomwe mumapeza kuchokera kwa madokotala ndi anamwino sichimasiya mukamaliza mankhwala. M'malo mwake, adzafunabe kukuwonani pafupipafupi kuti adziwe momwe mukuyendera komanso kuti muwone ngati mulibe zotsatirapo zokhalitsa zamankhwala. Adzakonzanso masikeni kuti muwonetsetse kuti HL wanu sakubwerera.
Ndikofunikira kwambiri kuti mukapezeke nawo pamisonkhano yonseyi yomwe amakupangirani, kuti zizindikiro zilizonse zakuyambiranso kapena zovuta zina zitha kudyedwa msanga ndipo mukhale bwino komanso otetezeka.
Zotsatira zina za mankhwala zimatha kuyamba nthawi yayitali mukamaliza mankhwala. Zina mwazotsatira za nthawi yayitali zingaphatikizepo:
- kutopa kosalekeza
- pakamwa pouma - izi zitha kuonjezera chiopsezo cha matenda a mano
- mavuto ndi kukula kwa mafupa ndi chitukuko cha ziwalo zogonana mwa amuna
- matenda a chithokomiro, mtima ndi mapapo
- chiwopsezo cha khansa ina monga khansa ya m'mawere (ngati mutakhala ndi radiation pachifuwa), non-Hodgkin lymphoma, acute leukemia kapena khansa ya chithokomiro.
- osabereka
Kuzindikira msanga mwa kukayezetsa pafupipafupi ndi dokotala, ndikupanga zisankho zathanzi kumatha kuchepetsa zotsatira zanthawi yayitali komanso mochedwa kwa omwe apulumuka kwa nthawi yayitali.
Kupulumuka - kukhala ndi Hodgkin Lymphoma ndi pambuyo pake
Zolinga zazikulu pambuyo pa chithandizo cha HL ndi kukhalanso ndi moyo ndipo:
- khalani otanganidwa momwe mungathere kusukulu, banja, gulu la anthu ndi maudindo ena amoyo
- kuchepetsa zotsatirapo ndi zizindikiro za HL ndi chithandizo chake
- zindikirani ndikuwongolera zovuta zilizonse mochedwa
- kukuthandizani kuti mukhale odziyimira pawokha momwe mungathere
- sinthani moyo wanu komanso kukhala ndi thanzi labwino
Kupanga zisankho zabwino
Kukhala ndi moyo wathanzi, kapena kusintha kwa moyo wabwino mukalandira chithandizo kungathandize kwambiri kuti muchiritsidwe. Pali zambiri zomwe mungachite kuti mukhale ndi moyo wabwino ndi HL. Zikuphatikizapo:
- limbitsani thupi nthawi zonse - sungani thupi lanu likuyenda
- idyani zathanzi nthawi zambiri
- lankhulani za mmene mukumvera ndi anthu amene mumawakhulupirira
- pewani kusuta (kusuta)
- puma pamene thupi lako latopa
- lolani dokotala wanu ngati muwona kusintha kulikonse, monga chotupa china chikukula, kutentha thupi kapena kutuluka thukuta usiku.
Kukonzanso khansa
Zitha kutenga nthawi kuti mubwerere kuyambiranso, khalani oleza mtima ndi inu nokha, thupi lanu ladutsamo zambiri. Ngati mukuvutika kuti mubwerere mwakale, mutha kulankhula ndi dokotala za mtundu wanji wa chithandizo cha khansa chomwe chilipo kwa inu.
Mitundu yosiyanasiyana ya kukonzanso khansa ikhoza kulangizidwa kwa inu. Izi zitha kutanthauza chilichonse chamitundumitundu za mautumiki monga:
- chithandizo chamankhwala, kusamalira ululu
- kukonza zakudya ndi masewera olimbitsa thupi
- uphungu wamalingaliro, ntchito ndi zachuma
Zolemba zomwe tili nazo patsamba lanu
Tili ndi malangizo abwino kwambiri patsamba lathu pansipa:
- Kuopa kuyambiranso kwa khansa ndikuwunika nkhawa
- Kusamalira tulo ndi lymphoma
- Kuchita masewera olimbitsa thupi ndi lymphoma
- Kutopa ndi lymphoma
- Kugonana ndi ubwenzi
- Zotsatira zamaganizo za matenda a lymphoma ndi chithandizo
- Kukhudzidwa kwamalingaliro okhala ndi lymphoma
- Kukhudza kwamtima kwa lymphoma pambuyo pomaliza chithandizo cha lymphoma
- Kusamalira munthu yemwe ali ndi Lymphoma
- Zotsatira zamaganizo za kubwereranso kapena refractory lymphoma
- Chithandizo chothandizira ndi njira zina: Lymphoma
- Kudzisamalira ndi Lymphoma
- Nutrition ndi Lymphoma
