IHodgkin lymphoma (HL) wuhlobo lomdlavuza wegazi okhula ngokushesha (onolaka) ohlasela abantu abadala kanye nezingane. Kuthinta uhlobo lwamangqamuzana amhlophe egazi okuthiwa I-B-cell lymphocyte, eziyingxenye yamasosha akho omzimba.
Uhlolojikelele lwe-Hodgkin Lymphoma (HL)
I-Hodgkin lymphoma iwumdlavuza wegazi owelapheka kakhulu owatholwa okokuqala esigulini ngawo-1830, ngudokotela oyiNgisi ogama lakhe linguThomas Hodgkin. Lokhu kuxilongwa kwenziwa ngemuva kokuthi ososayensi ababili ababizwa ngokuthi uReed no-Sternberg, bahlole amasampula ezicubu zabantu abane-Hodgkin lymphoma. Bathole ukuthi bonke abantu abane-HL babenohlobo oluthile lweseli elingavamile. Ngenxa yokuthi uReed noSternberg baba ngabokuqala ukuthola lesi sitokisi, basibiza ngokuthi Iseli ye-Reed-Sternberg.
Mayelana namaseli e-Reed Sternberg kanye ne-Hodgkin Lymphoma
- Amaseli e-Reed-Sternberg makhulu ngokungavamile, anomdlavuza (umdlavuza), ama-B-cell lymphocyte avuthiwe.
- Ukuba khona kwamaseli eReed-Sternberg kusiza odokotela ukuthi bahlonze i-Hodgkin lymphoma (HL) esikhundleni se-non-Hodgkin lymphoma (NHL).
- Wonke ama-lymphomas atholakala ngemva kwe-Hodgkin lymphoma (angenayo iseli ye-Reed-Sternberg) abizwa ngokuthi i-non-Hodgkin lymphoma.
Izingozi zokuthuthukisa i-Hodgkin Lymphoma (HL)
Asazi ukuthi yini ebangela i-Hodgkin lymphoma, kodwa kucatshangwa ukuthi kuhileleke izici ezihlukahlukene zobungozi. Ezinye zalezi zici zobungozi zihlanganisa uma une:
- Wake waba negciwane le-Epstein Barr (EBV). I-EBV ibangela i-mononucleosis (eyaziwa nangokuthi "i-mono" noma i-glaular fever).
- I-Human immunodeficiency virus (HIV).
- Izifo ezithile zamasosha omzimba wakho, njenge yenza ngokuzenzakalelayo i-lymphoproliferative syndrome.
- Amasosha omzimba abuthakathaka ngemva kwesitho/i-stem cell ukufakelwa. Noma, emithini ethile okungenzeka ukuthi uyayidla.
- Umzali, umfowethu, noma udade onomlando womuntu siqu we-Hodgkin lymphoma.
Kubalulekile ukuqaphela nokho, ukuthi akubona bonke abantu abanalezi zici zobungozi abazothuthukisa i-HL, futhi abanye abantu abangenazo izici zobungozi ezaziwayo basengakwazi ukuthuthukisa i-HL.
Ukuze uqonde i-HL, udinga ukwazi kancane ngama-B-Cell lymphocyte (noma ama-B-cell)
B-Amaseli:
- Ziwuhlobo lwamangqamuzana amhlophe egazi.
- Yilwa nezifo kanye nezifo ukuze uhlale unempilo.
- Khumbula izifo obunazo esikhathini esidlule, ngakho-ke uma uthola ukutheleleka okufanayo futhi, amasosha omzimba wakho angalwa nakho ngempumelelo nangokushesha.
- Zenziwe emnkantsheni wakho (ingxenye yesiponji phakathi kwamathambo akho), kodwa ngokuvamile zihlala ohlelweni lwakho lwe-lymphatic, kuhlanganise ne-spleen yakho, i-thymus kanye nama-lymph nodes.
- Ungahamba ngohlelo lwakho lwe-lymphatic, futhi uphumele kunoma iyiphi ingxenye yomzimba wakho ukuze ulwe nokutheleleka noma izifo.
I-Hodgkin Lymphoma iqala lapho amanye ama-B-cell akho eba nomdlavuza
I-HL iqala lapho amanye ama-B-cell akho eba nomdlavuza. Zikhula ngokungalawuleki, azijwayelekile futhi azifi lapho kufanele.
Uma une-HL ama-B-cell anomdlavuza:
- Ngeke isebenze ngempumelelo ukulwa nezifo kanye nezifo.
- Iba nkulu kunalokho okufanele futhi ubukeke uhlukile kuma-B-cell akho anempilo.
- Kungabangela ukuthi i-lymphoma ikhule futhi ikhule kunoma iyiphi ingxenye yomzimba wakho.
Izinhlobo ezingaphansi ze-Hodgkin Lymphoma (HL)
I-Hodgkin Lymphoma ngaphambilini yayihlukaniswe yaba yi-4 subtypes ye-Classical Hodgkin Lymphoma, kanye ne-subtype ehlukile ebizwa ngokuthi i-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). Nokho, olunye ucwaningo luthole ukuthi i-NLPHL ayinazo izici ze-Hodgkin Lymphoma ngakho-ke manje isiqanjwe kabusha ngokuthi i-Nodular Lymphocyte Predominant B-cell Lymphoma (NLPBCL). Ukuze ufunde kabanzi nge-NLPBCL sicela Chofoza lapha.
Ukuze ufunde kabanzi mayelana nezinhlobo ezincane ze-Hodgkin Lymphoma yakudala qhubeka kuleli khasi.
I-Classical Hodgkin Lymphoma (cHL)
I-Classical Hodgkin Lymphoma (cHL) ikhula ngokushesha (inolaka) B-cell lymphoma. Nokho, i-cHL ngokuvamile isabela kahle kakhulu ekwelashweni okujwayelekile nge-chemotherapy. Cishe abantu abayisi-9 kwabayi-10 baya eshweni ngemva kokwelashwa komugqa wokuqala. Lokhu kusho ukuthi alukho uphawu lwe-lymphoma olusele emzimbeni wakho. Intsha ikakhulukazi, isabela kahle kakhulu ekwelashweni.
Kunezinye izinhlobo ezine ezengeziwe ze-cHL eyenza i-cHL ibe uhlobo oluncane oluvame kakhulu lwe-Hodgkin lymphoma. Amasampula akho e-biopsy azonikeza udokotela ulwazi oludingekayo ukuze udokotela wakho athole ukuthi yiluphi uhlobo oluncane onalo. I-pathologist izohlola:
- Inombolo nokuma kwamaseli e-Reed-Sternberg.
- Ubukhulu kanye nengxube ye-lymphocyte evamile futhi engavamile.
Kungakhathaliseki ukuthi yiluphi uhlobo oluncane lwe-cHL onalo, cishe uzoba nohlobo olufanayo lokwelashwa. Uma ulazi uhlobo lwakho oluncane, chofoza esihlokweni esingezansi ukuze ubone isifinyezo.
I-Nodular sclerosis classical Hodgkin lymphoma (NScHL) iwuhlobo oluncane oluvame kakhulu. Cishe abantu abangu-6-8 kwabayi-10 abane-cHL bazoba nalolu hlobo oluncane.
I-NScHL ibizwa ngokuthi amaseli abukeka kanjani ngaphansi kwesibonakhulu. Imvamisa ikhula ijule phakathi kwesifuba sakho (i-mediastinum), kodwa futhi ingakhula ubende, amaphaphu, ithambo noma umnkantsha. Akuvamile ukuthi ikhule esibindini sakho.
I-Mixed cellularity classical Hodgkin lymphoma (MC-cHL) iwuhlobo oluncane lwesibili oluvame kakhulu lwe-cHL. Kuvame kakhulu kwabesilisa kunabesifazane, futhi kuthinta kakhulu abantu abadala.
I-MC-cHL ivamise ukukhula kuma-lymph nodes ngaphansi kwesikhumba sakho ekujuleni kwezicubu ezinamafutha, kodwa futhi ingakhula kubende bakho, umnkantsha, isibindi nezinye izitho.
Lymphocyte rich classical Hodgkin lymphoma (LR-cHL) iwuhlobo oluncane olungajwayelekile lwe-cHL. Kuvamise ukutholakala kusesigabeni sokuqala kunezinye izinhlobo ezincane ze-cHL, nakubantu abadala.
Uma usuthole ukwelashwa, abantu abaningi bazokwelapheka – okusho ukuthi mancane amathuba okuthi i-lymphoma ibuye esikhathini esizayo. Ngokuvamile kuvela kuma-lymph nodes entanyeni yakho ngaphansi kwesikhumba sakho, ekujuleni kwezicubu zakho ezinamafutha.
I-Lymphocyte iphelile i-classical Hodgkin lymphoma (cHL) iwuhlobo oluncane oluyivelakancane lwe-cHL olunabantu abangaphansi kuka-5 kwabayi-100 abanalolu hlobo oluncane. I-LD-cHL yenzeka kakhulu ezigulini ezitheleleke nge-Human Immunodeficiency Virus (HIV) noma i-Epstein Barr virus (EBV).
I-LD-cHL ingenzeka ku-:
- umkantsha
- ama-lymph nodes ekujuleni kwesisu sakho (esiswini)
- izitho ezifana nesibindi sakho, amanyikwe, isisu namathumbu.
Okuhlangenwe nakho kwesiguli nge-Hodgkin Lymphoma
Kwesinye isikhathi kungasiza ukuzwa ukwakha umuntu owedlule kulokho obhekene nakho. Kulawa mavidiyo amafushane, u-Briony wabelana ngendaba yakhe emayelana nokuhlala naye, nokushaya isigaba 4 se-Hodgkin Lymphoma.
Chofoza izixhumanisi ezingezansi ukuze uzwe indaba yakhe.
Izimpawu ze-Hodgkin Lymphoma
Uphawu lokuqala noma uphawu lwe-HL kungase kube isigaxa, noma izigaxa ezimbalwa eziqhubeka nokukhula. Ezinye izigaxa zingazwakala ngoba ziseduze nesikhumba sakho, kanti ezinye zingatholakala kuphela uma uneskeni.
Lezi zigaxa zingama-lymph nodes avuvukele, agcwele ama-B-cell anomdlavuza. Ngokuvamile ziqala engxenyeni eyodwa yomzimba wakho, ngokuvamile ikhanda, intamo noma isifuba nesisu, bese zisakazeka kulo lonke uhlelo lwakho lwe-lymphatic. Ingasakazekela kubende, amaphaphu, isibindi, amathambo, umnkantsha noma ezinye izitho.
Ubende lwakho
Ubende lwakho yisitho esihluza igazi lakho futhi siligcine liphilile, futhi singesinye sezitho zakho ezinkulu ze-lymphatic. Isohlangothini lwesobunxele lwesisu sakho esingaphezulu ngaphansi kwamaphaphu akho naseduze kwesisu sakho (isisu). Uma i-HL yakho isakazekela kubende lwakho ingaba nkulu kakhulu futhi ikucindezele esiswini, ikwenze uzizwe usuthi ngisho noma ungakadli kakhulu.
Ezinye izimpawu
Ungase ube nezimpawu ezinjengokucanuzela kwenhliziyo, isifo sohudo noma ukuqunjelwa, kuye ngokuthi i-lymphoma yakho ikhula kuphi.
Ezinye izimpawu, ongazithola zihlanganisa:
- Ukuzizwa ukhathele ngendlela engavamile (ukukhathala, akubi ngcono ngemva kokuphumula noma ukulala).
- Ukuzizwa uphelelwa umoya (uma unama-lymph nodes avuvukele esifubeni sakho).
- Ukukhwehlela (imvamisa ukukhwehlela okomile, uma unama-lymph nodes avuvukele esifubeni sakho).
- Ukulimala noma ukopha kalula kunokuvamile (ngenxa yenani eliphansi leplatelet).
- Isikhumba esilumayo.
- Igazi ephusheni lakho (lokhu kungenzeka uma une-HL esiswini sakho noma emathunjini akho).
- Amagciwane angapheli, noma alokhu ebuya (okuphindaphindayo).
- B-izimpawu.
B Izimpawu
Inothi elibalulekile - Ungaxhumana nini nodokotela wakho
Kubalulekile ukuqaphela ukuthi eziningi zezibonakaliso nezimpawu ze-HL zingahlotshaniswa nezimbangela ngaphandle komdlavuza. Isibonelo, ama-lymph nodes avuvukele angenzeka uma unokutheleleka. Nokho, ngokuvamile, uma unokutheleleka, izimpawu zizoba ngcono futhi ama-lymph nodes azobuyela kusayizi ojwayelekile emasontweni ambalwa.
Nge-lymphoma, lezi zimpawu ngeke ziphele. Zingase zibe zimbi nakakhulu. Kufanele uxhumane nodokotela wakho uma uthola:
- Ama-lymph nodes avuvukele angasuki, noma uma emakhulu kunalokho obungakulindela ekuthelelekeni.
- Ukuphefumula kanzima ngaphandle kwesizathu.
- Ukukhathala kunokujwayelekile futhi akubi ngcono ngokuphumula noma ukulala.
- Ukopha okungajwayelekile noma imihuzuko (kuhlanganise nendle, emakhaleni noma ezinsinini).
- Iluma ngaphezu kokujwayelekile.
- Ukukhwehlela okusha okomile.
- B-izimpawu.
Itholakala kanjani i-Hodgkin Lymphoma
Udokotela wakho angase asole ukuthi une-lymphoma lapho ethola imiphumela yokuhlolwa kwegazi lakho, i-X-ray, noma eminye imiphumela yokuskena. Bangase futhi babone isigaxa uma behlola umzimba. Kodwa ukuze uhlole i-HL, uzodinga i-biopsy. I-biopsy iyinqubo yokukhipha ingxenye, noma yonke ingxenye i-lymph node ethintekile noma umnkantsha. I-biopsy ibe ihlolwa odokotela bezifo elabhorethri, ukuze babone ukuthi azikho yini izinguquko ezisiza udokotela ukuxilonga i-HL.
Kungaba ubuqili ukuhlonza uhlobo oluncane oluqondile lwe-HL onalo, ngakho-ke ungase udinge ukuba ne-biopsy engaphezu kweyodwa. Udokotela wakho uyakwazi ukuxilonga ukuthi yiluphi uhlobo oluncane onalo ngokubheka igazi lakho nawo wonke ama-biopsies ngaphansi kwesibonakhulu, noma embikweni abawuthola ku-pathology. Uma ungazi, buza udokotela wakho ukuthi yiluphi uhlobo oluncane onalo.
Ungase ube nesibulali-zinzwa sasendaweni noma esivamile lapho wenza i-biopsy. Lokhu kuzoncika ekutheni i-biopsy ithathwe kuyiphi ingxenye yomzimba wakho.
Ama-biopsies
Ukuze uhlole i-HL uzodinga ama-biopsies ama-lymph nodes akho avuvukele, nomnkantsha wakho. I-biopsy yilapho ucezu oluncane lwethishu lukhishwa futhi luhlolwe elabhorethri ngesibonakhulu. Udokotela wezifo uyobe esebheka indlela, nokuthi amaseli akho akhula ngokushesha kangakanani.
Kunezindlela ezahlukene zokuthola i-biopsy engcono kakhulu. Udokotela wakho uzokwazi ukuxoxa ngohlobo olungcono kakhulu lwesimo sakho. Ezinye ze-biopsies ezivame kakhulu zihlanganisa:
I-Excisional node biopsy
Lolu hlobo lwe-biopsy lususa yonke i-lymph node. Uma i-lymph node yakho iseduze nesikhumba sakho futhi izwakala kalula, cishe uzoba nesibulala-zinzwa sasendaweni ukuze ube ndikindiki indawo. Khona-ke, udokotela wakho uzokwenza ukusikeka (okubizwa nangokuthi i-incision) esikhumbeni sakho eduze, noma ngaphezu kwe-lymph node. I-lymph node yakho izokhishwa ngokusikwa. Ungase ube nezitishi ngemva kwale nqubo kanye nokugqoka okuncane phezulu.
Uma i-lymph node ijule kakhulu ukuthi udokotela angazizwa, kungase kudingeke ukuba wenze i-excision biopsy yenziwe ethiyetha yokuhlinza esibhedlela. Ungase unikezwe umuthi obulala izinzwa ovamile - okuwumuthi wokulalisa ngesikhathi kukhishwa i-lymph node. Ngemva kokuhlolwa kwe-biopsy, uzoba nenxeba elincane, futhi ungase ube nemithungo enengubo encane ngaphezulu.
Udokotela noma umhlengikazi wakho uzokutshela ukuthi usinakekele kanjani isilonda, futhi uma sebefuna ukukubona futhi ukuze bakhiphe imithungo.
I-Core or fine inaliti biopsy
Lolu hlobo lwe-biopsy luthatha kuphela isampula ku-lymph node ethintekile - aluyisusi yonke i-lymph node. Udokotela wakho uzosebenzisa inaliti noma enye idivayisi ekhethekile ukuthatha isampula. Ngokuvamile uzoba ne-anesthetic yendawo. Uma i-lymph node ijule kakhulu ukuthi udokotela wakho angayibona futhi ayizwe, kungenzeka wenze i-biopsy emnyangweni we-radiology. Lokhu kuyasiza kuma-biopsies ajulile ngoba i-radiologist ingasebenzisa i-ultrasound noma i-X-ray ukuze abone i-lymph node futhi aqinisekise ukuthi bathola inaliti endaweni efanele.
I-core core biopsy inikeza isampula ye-biopsy enkulu kune-biopsy yenaliti enhle.
Isiteji kanye Nokuhlelwa Kwe-Hodgkin Lymphoma
Ukuhlela nokuhlela izindlela udokotela wakho angachaza ngazo ukuthi ungakanani umzimba wakho othintwa i-lymphoma, nokuthi amaseli e-lymphoma akhula kanjani.
Ngenxa yokuthi amaseli e-lymphoma angahambela kunoma iyiphi ingxenye yomzimba wakho ngakho-ke uma une-HL, udokotela wakho uzohlela ukuhlolwa okwengeziwe ukuze ahlole ukuthi ingabe ikwenye indawo yini. Lezi zivivinyo zibizwa “ngesiteji” futhi zingafaka:
Ukuhlolwa kwegazi
Ukuhlolwa kwegazi kungenziwa ukuze kubhekwe izinto ezihlukahlukene ezihlanganisa izibalo zakho zegazi, ukusebenza kwesibindi nezinso kanye nekhono lomzimba wakho lokujiyisa igazi lakho.
Ukuskena kwe-Positron emission tomography (PET)
I-PET scan ukuskena umzimba wonke ukuze ubone lapho i-lymphoma ikhula khona. Uzothola umjovo ngaphambi kokuskena ngesixazululo esimuncwa amaseli e-lymphoma. Lokhu kwenza amaseli e-lymphoma akhanyise ku-PET scan.
Icwecwe le-computer tomography (CT)
CT scan nikeza isithombe esinemininingwane eminingi kune-X-ray evamile futhi sigxile endaweni yendawo efana nesifuba noma isisu sakho
Ukukhishwa kwe-Lumbar
I-Lumbar punctures zisetshenziselwa ukuhlola ukuthi unayo yini i-lymphoma ebuchosheni bakho noma emgogodleni. Udokotela wakho uzosebenzisa inaliti ukuthatha isampula yoketshezi eduze komgogodla wakho.
Ukuhlolwa kwe-Cytogenetic
Ukuhlolwa kwe-Cytogenetic Lokhu ukuhlola izinguquko zofuzo (okubuye kubizwe ngokuthi ukuguqulwa noma ukuhluka) okungase kubandakanyeke esifweni sakho.
I-bone yomnkantsha i-biopsy
A umnkantsha wethambo kwenziwa ukuhlola ukuthi unawo yini amaseli e-lymphoma kumnkantsha wakho lapho amaseli akho egazi enziwa khona. Udokotela wakho uzosebenzisa inaliti ukuthatha isampula yomnkantsha phakathi kwethambo lakho - ngokuvamile inqulu yakho, kodwa ngezinye izikhathi isampula ingase ithathwe kwelinye ithambo. Lokhu kuzokwenziwa nge-anesthetic yendawo.
Ulwazi olwengeziwe ngokuhlolwa, ukuxilongwa kanye nesiteji lungatholakala ngokuchofoza inkinobho engezansi.
Ukwelashwa kwe-Hodgkin Lymphoma
Kusho ukuthini ukwenza isiteji?
Ngemuva kokuthi usuxilongwa, udokotela wakho uzobheka yonke imiphumela yakho yokuhlolwa ukuze athole ukuthi iHodgkin Lymphoma yakho ikusiphi isigaba. Isiteji sitshela udokotela ukuthi ingakanani i-lymphoma emzimbeni wakho, zingaki izindawo zomzimba wakho ezinama-B-cell anomdlavuza, nokuthi umzimba wakho ubhekana kanjani nesifo.
Isiteji sisekelwe kulokhu:
- Inombolo nendawo yama-lymph nodes ethintekile.
- Indawo ye-lymph nodes ethintekile - ingabe ingaphezulu, ngezansi noma izinhlangothi zombili ze-diaphragm.
- Ukuthi isifo sesidlulele kumnkantsha wakho noma kwezinye izitho ezifana nesibindi sakho, amaphaphu, ithambo noma isikhumba.
Izigaba ezine ze-Hodgkin Lymphoma (HL)
Izigaba ezine ze-HL zifaka:
- Isigaba 1 kanye nesigaba 2 zibizwa ngokuthi 'isigaba sokuqala/esikhawulelwe' (okubandakanya indawo elinganiselwe yomzimba).
- Isiteji sesi-3 nesesine zibizwa ngokuthi 'isiteji esithuthukisiwe' (sabalale kakhulu).
- Ngokungafani nezinye izinhlobo zomdlavuza, usengangena ekuxolelweni noma welapheke kusukela esigabeni esithuthukisiwe (3 noma 4) HL.
isigaba 1 | indawo eyodwa ye-lymph node iyathinteka, noma ngaphezulu noma ngaphansi kwe-diaphragm yakho. |
isigaba 2 | izindawo ezimbili noma ngaphezulu zama-lymph node zithinteka ohlangothini olulodwa lwe-diaphragm yakho. |
isigaba 3 | okungenani indawo eyodwa ye-lymph node ngaphezulu futhi okungenani indawo eyodwa ye-lymph node ngaphansi kwe-diaphragm yakho iyathinteka. |
isigaba 4 | i-lymphoma itholakala kuma-lymph nodes amaningi, futhi isisabalele kwezinye izingxenye zomzimba wakho (isb., amathambo, amaphaphu, isibindi). |
Ezinye izindlela zesiteji
Ngaphezu kwenombolo esetshenziselwa ukuchaza isiteji sakho, kunezinye izinto udokotela wakho azozicabangela lapho ekhetha izinketho ezingcono kakhulu zokukuphatha. Bazobheka ukuthi i-lymphoma iwuthinta kanjani umzimba wakho, nokuthi yiziphi izimpawu onazo. Njengomphumela walokhu okutholakele, ngaphezu kwenombolo onayo yesiteji sakho, ungase ube nencwadi. Sicela ubheke ithebula elingezansi ukuze ubone ukuthi izinhlamvu zisho ukuthini.
Incwadi | Okusho | Ukubaluleka |
A noma B |
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E & X |
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S |
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Izwa ngokuqondile kuchwepheshe we-Lymphoma mayelana ne-Staging Lymphoma
Ibanga le-Hodgkin lymphoma yakho yindlela amaseli akho abukeka ngayo ngaphansi kwesibonakhulu, nokuthi akhula ngokushesha kangakanani futhi enze amaseli amasha anomdlavuza. Amabanga amabanga 1-4 (aphansi, aphakathi nendawo, aphezulu).
- I-G1 – ibanga eliphansi – amaseli akho abukeka esondele kokujwayelekile futhi akhula futhi asakazeke kancane.
- I-G2 - ibanga eliphakathi nendawo - amaseli akho aqala ukubukeka ehlukile kodwa amanye amaseli avamile akhona futhi akhula futhi asakazeke ngesilinganiso esimaphakathi.
- I-G3 - ibanga eliphezulu - amaseli akho abukeka ehluke kakhulu ngamaseli ambalwa ajwayelekile futhi akhula futhi asakazeke ngokushesha.
- I-G4 – ibanga eliphezulu – amaseli akho abukeka ehluke kakhulu kokujwayelekile futhi akhula futhi asabalale ngokushesha.
Ezinye Izinto Zokugreda
I-HL ingaphinde ibonakale 'njengethandeka' noma 'engathandeki' kuye ngezici eziphansi, ezimaphakathi noma ezinobungozi obukhulu ongase ube nazo noma ongenabo. Lezi zici zobungozi zingathonya uhlobo lokwelashwa olunikezwayo, kanye nendlela osabela ngayo ekwelashweni. Lokhu kubizwa ngokuthi 'I-Risk Adapted' therapy.
Lonke lolu lwazi lunikeza udokotela wakho isithombe esihle ukusiza ukunquma uhlobo olungcono kakhulu lokwelashwa kwakho.
Kalula nje - isiteji sibheka lapho I-Hodgkin Lymphoma yakho iyakhula, futhi ukugreda kuyabheka Kanjani iHodgkin Lymphoma yakho iyakhula.
Ukuqonda i-lymphoma genetics yakho
Ukuhlolwa kwe-Cytogenetic kuzobheka izinguquko kuma-chromosome noma izakhi zofuzo. Sivame ukuba namapheya angu-23 ama-chromosome, futhi abalwa ngokobukhulu bawo. Uma une-HL, ama-chromosome akho angase abukeke ehluke kancane.
Ayini izakhi zofuzo nama-chromosomes
Ingqamuzana ngalinye elakha umzimba wethu linenucleus, futhi ngaphakathi ku-nucleus kunamapheya angu-23 ama-chromosome.
Ichromosome ngayinye yenziwe ngemicu emide ye-DNA (deoxyribonucleic acid) equkethe izakhi zethu zofuzo.
Izakhi zofuzo zethu zinikeza ikhodi edingekayo ukuze kwenziwe wonke amangqamuzana namaprotheni asemzimbeni wethu, futhi ibatshela ukuthi kufanele babukeke noma benze kanjani.
Uma kunokuguquguquka kulawa ma-chromosome noma izakhi zofuzo, amaprotheni namaseli akho ngeke asebenze kahle.
Ama-lymphocyte angaba amaseli e-lymphoma ngenxa yezinguquko zofuzo (okuthiwa ukuguqulwa noma ukuhluka) ngaphakathi kwamaseli. I-lymphoma biopsy yakho ingase ibhekwe udokotela wezifo ezithile ukuze abone ukuthi awunazo yini izinguquko zofuzo.
Ingabe ukuguqulwa kwe-HL kubukeka kanjani
Ucwaningo luthole ukungalungi kwezakhi zofuzo okuhlukile okungaholela ekukhuleni kwamaprotheni athile ebusweni bamaseli e-HL. Lawa maprotheni angasiza i-lymphoma ukuthi ifihle amasosha akho omzimba noma, enze umdlavuza ukhule ngokungalawuleki.
- amanye amaseli e-Hodgkin lymphoma angase abukeke ehluke kancane ngokuba nephrotheni eningi ebizwa ngokuthi i-CD30 ngaphandle kwendawo yeseli.
- uma une-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL), ungase uveze iphrotheni ebizwa nge-CD20 engaphandle kwamaseli akho.
- amanye amaseli e-Hodgkin Lymphoma angase abe “nendawo yokuhlola amasosha omzimba” ebizwa ngokuthi i-PD-L1 noma i-PD-L2 endaweni yeseli. Lawa ma-immune checkpoint asiza i-lymphoma ukuthi ifihle emasosheni akho omzimba ukuze ingakwazi ukuthola futhi ibulale i-lymphoma njengoba ibingenza ngokujwayelekile.
Lezi zinguquko zibalulekile ngoba zingaba nomthelela ekutheni uthola luphi uhlobo lomuthi.
Ukuguquguquka kwakho kungayithinta kanjani indlela yokwelashwa oyitholayo
Amanye ama-lymphomas e-Hodgkin angelashwa nge-monoclonal antibody (MAB), kodwa kuphela uma amaseli akho e-HL eveza kakhulu izimpawu ezithile zamaprotheni. Uma amaseli akho e-Hodgkin lymphoma edlula ngokweqile:
- I-CD30 ungase unikezwe i-MAB ebizwa nge-brentuximab vedotin, eqondise ngokuqondile i-CD30.
- I-CD20 ungase unikezwe i-MAB ebizwa nge-rituximab, eqonde ngqo i-CD20. I-CD20 ayitholakali kumaseli anomdlavuza we-Hodgkin Lymphoma yakudala, kodwa ingatholakala kumaseli e-Nodular Lymphocyte-predominant Hodgkin Lymphoma (kanye nama-non-Hodgkin lymphomas).
- I-immune checkpoint PD-L1 noma PD-L2 ungase unikezwe i-MAB ebizwa nge-pembrolizumab, eqondise ngokuqondile indawo yokuhlola amasosha omzimba, okwenza i-lymphoma ibonakale kakhudlwana emasosheni akho omzimba.
Ukwelashwa kwe-Hodgkin Lymphoma
Kunezinhlobo eziningi zokwelapha ezitholakalayo ze-Hodgkin Lymphoma. Ukwelashwa okungcono kakhulu kwakho kuzoncika ezintweni eziningi ezihlanganisa iminyaka yakho, impilo yakho yonke, kanye nesiteji kanye nebanga le-lymphoma yakho. Udokotela wakho uzophinde acabangele noma yiziphi ezinye izifo ongase ube nazo kanye nokwelashwa okutholayo kulezo.
Ngaphambi kokuba uqale ukwelashwa, uzobizwa ngokuhlolwa okwengeziwe "Ukuhlolwa Okuyisisekelo". Lezi zivivinyo zenziwa ukuze kuqinisekiswe ukuthi uphile kahle ngokwanele ukubekezelela ukwelashwa, kanye nokuthi udokotela wakho abhekisele kukho kuyo yonke imithi yakho ukuze aqiniseke ukuthi ukwelashwa akubangeli umonakalo omkhulu ezithweni zakho. Ukuhlolwa onakho, kuzoncika ekutheni yiluphi uhlobo lokwelashwa ozobe uluthola.
Uma uke wathola ukwelashwa kwe-lymphoma yakho esikhathini esidlule, udokotela wakho uzocabangela ukuthi ikusebenzele kahle kangakanani, nokuthi imiphi imiphumela emibi ibe mibi kangakanani kuwe. Udokotela wakho uzokwazi ukukunikeza izindlela zokwelashwa ezingcono kakhulu ngokusekelwe ezimeni zakho ngazinye. Uma ungenaso isiqiniseko sokuthi kungani udokotela ethathe izinqumo azenzile, sicela uqiniseke ukuthi umcela ukuthi akuchazele - bakhona ukuze bakusize.
Ungase unikezwe uhlobo olulodwa noma eziningi kulezi ezingezansi zokwelashwa.
Ukunakekelwa okusekelayo kunikezwa iziguli kanye nemindeni ebhekene nokugula okubi kakhulu. Ukunakekelwa okusekelayo kungasiza iziguli zibe nezimpawu ezimbalwa, futhi empeleni zibe ngcono ngokushesha ngokunaka lezo zici zokunakekela kwazo.
Ukwelashwa kwe-HL kungathinta amaseli akho egazi amahle okungaholela ekutheni ungabi nawo amaseli egazi anempilo anele ukuze akugcine uphilile. Ngenxa yalokho, ungase unikezwe igazi eligcwele amangqamuzana abomvu egazi noma ama-platelet ukuze uthuthukise amazinga akho ala mangqamuzana egazi. Uma amangqamuzana akho amhlophe egazi ephansi kakhulu - noma kulindeleke ukuthi ehle kakhulu, ungase unikezwe umjovo ongena esiswini sakho osiza ukugqugquzela umnkantsha wakho ukuthi ukhiqize amanye ala maseli. Ungase futhi udinge ama-antibiotics uma uthola isifo ngenkathi amangqamuzana akho amhlophe ephansi kakhulu, ukuze akusize ulwe nanoma yiziphi izifo.
Ukunakekela okusekelayo kungase kuhlanganise nokubona uchwepheshe abahlukahlukene onobuchwepheshe kwezinye izici zempilo yakho noma ukuhlela ukunakekelwa kwesikhathi esizayo njengokukusiza ukuthi udale Uhlelo Lokunakekela Okuthuthukile ukuze uveze izifiso zakho zokunakekelwa kwezempilo esikhathini esizayo. Uma unezimpawu noma imiphumela engemihle engathuthuki, ungase unikezwe ukubonisana nethimba lokunakekelwa kwe-palliative elingochwepheshe ekulawuleni okunzima ukuzelapha izimpawu ezinjengobuhlungu nesicanucanu esingathuthukisiwe ngokwelashwa okujwayelekile. Lezi zinto ziyingxenye yokuphathwa kwe-lymphoma ye-multidisciplinary.
I-radiation therapy yindlela yokwelapha umdlavuza esebenzisa imithamo ephezulu yemisebe ukubulala amangqamuzana e-lymphoma futhi ashwabene nezimila. Ngaphambi kokuba ube nemisebe, uzoba neseshini yokuhlela. Lesi seshini sibalulekile kubelaphi bemisebe ukuthi bahlele ukuthi bangaqondisa kanjani emisebeni ku-lymphoma, futhi bagweme ukulimaza amaseli anempilo. Ukwelashwa ngemisebe ngokuvamile kuthatha phakathi kwamaviki angu-2-4. Ngalesi sikhathi, uzodinga ukuya esikhungweni semisebe nsuku zonke (ngoMsombuluko-uLwesihlanu) ukuze uthole ukwelashwa.
*Uma uhlala kude nesikhungo se-radiation futhi udinga usizo ngendawo yokuhlala ngesikhathi sokwelashwa, sicela ukhulume nodokotela noma unesi wakho mayelana nokuthi yiluphi usizo ongaluthola. Ungakwazi futhi ukuthintana neCancer Council noma i-Leukemia Foundation esifundeni sakho futhi ubone ukuthi bangasiza yini ngendawo yokuhlala.
Ungase ube le mithi njengethebhulethi futhi/noma unikezwe njengethonsi (ukufakwa) emithanjeni yakho (emgudwini wegazi lakho) emtholampilo womdlavuza noma esibhedlela. Imithi eminingana ehlukene ye-chemo ingase ihlanganiswe nomuthi we-immunotherapy. I-Chemo ibulala amaseli akhula ngokushesha ngakho-ke ingathinta namanye amaseli akho amahle akhula ngokushesha abangele imiphumela engemihle.
Ungase ube ne-MAB infusion emtholampilo womdlavuza noma esibhedlela. Ama-MAB anamathisele kuseli ye-lymphoma futhi ahehe ezinye izifo ezilwa namaseli amhlophe egazi namaprotheni kumdlavuza ukuze amasosha akho omzimba akwazi ukulwa ne-HL.
I-MABS izosebenza kuphela uma unamaprotheni athile noma izimpawu kumaseli akho e-lymphoma.
Ama-immune checkpoint inhibitors (ICIs) awuhlobo olusha lwe-monoclonal antibody (MAB) futhi asebenza ngokuhlukile kancane kwamanye ama-MABS.
Ama-ICI asebenza lapho amaseli wakho wesimila eba “nezindawo zokuhlola amasosha omzimba” kuwo avame ukutholakala kumaseli akho anempilo kuphela. Indawo yokuhlola izivikeli mzimba itshela amasosha akho omzimba ukuthi ingqamuzana liphilile futhi livamile, ngakho amasosha akho omzimba alishiya lodwa.
Ama-ICI asebenza ngokuvimbela i-immune checkpoint ukuze amaseli akho e-lymphoma angabe esakwazi ukuzenzisa anempilo, amaseli avamile. Lokhu kuvumela amasosha akho omzimba ukuthi awabone njengomdlavuza, futhi aqale ukuwahlasela.
I-Chemotherapy ehlanganiswe ne-MAB (isibonelo, i-rituximab).
Ungathatha lezi njengethebhulethi noma ukumnika emithanjeni yakho. Izindlela zokwelapha eziphuzwayo zingase zithathwe ekhaya, nakuba ezinye zizodinga ukuhlala isikhashana esibhedlela. Uma unomuthi, ungawuthola emtholampilo wansuku zonke noma esibhedlela. Izindlela zokwelapha ezihlosiwe zinamathisela kuseli ye-lymphoma futhi zivimbe izimpawu ezidinga ukukhula futhi zikhiqize amaseli amaningi. Lokhu kuvimbela umdlavuza ukuthi ungakhuli futhi kubangela ukuthi amangqamuzana e-lymphoma afe.
I-stem cell noma ukufakelwa komnkantsha wethambo kwenziwa ukuze esikhundleni somnkantsha wakho ogulayo kube namaseli amasha angakhula abe amaseli egazi amasha anempilo. Ukufakelwa komnkantsha wethambo ngokuvamile kwenziwa kuphela ezinganeni ezine-HL, kuyilapho ukufakelwa kwe-stem cell kwenziwa kuzo zombili izingane ezindala.
Ekufakweni komnkantsha, ama-stem cells asuswa ngokuqondile emnkantsheni, lapho njengokufakelwa kwe-stem cell, ama-stem cells asuswa egazini.
Ama-stem cells angase akhishwe kumnikeli noma aqoqwe kuwe ngemva kokwelashwa ngamakhemikhali.
Uma wena ama-stem cell avela kumnikeli, kubizwa ngokuthi i- i-allogeneic stem cell transplant.
Uma ama-stem cells akho eqoqwa, kubizwa ngokuthi i- ukufakelwa kwe-autologous stem cell.
Ama-stem cells aqoqwa ngenqubo ebizwa ngokuthi i-apheresis. Wena (noma umnikezeli wakho) uzoxhunywa emshinini we-apheresis futhi igazi lakho lizokhishwa, ama-stem cells ahlukaniswe futhi aqoqwe esikhwameni, bese lonke igazi lakho libuyiselwa kuwe.
Ngaphambi kwenqubo, uzothola i-chemotherapy yomthamo omkhulu noma i-radiotherapy yomzimba ogcwele ukuze ubulale wonke amaseli akho e-lymphoma. Kodwa-ke lokhu kwelashwa ngethamo eliphezulu kuzophinde kubulale wonke amaseli omnkantsha wakho. Ngakho-ke ama-stem cells aqoqiwe azobe esebuyiselwa kuwe (atshalwe kabusha). Lokhu kwenzeka ngendlela efanayo naleyo yokumpontshelwa igazi, ngokusebenzisa i-drip emthanjeni wakho.
Ukuqala ukwelashwa
Kungaba nzima ukwazi ukuthi yimiphi imibuzo okufanele uyibuze lapho uqala ukwelashwa. Uma ungazi, yini ongayazi, ungazi kanjani ukuthi yini okufanele uyibuze?
Ukuba nolwazi olufanele kungakusiza uzizwe uqiniseka futhi wazi ukuthi yini ongayilindela. Kungakusiza nokuthi uhlele kusengaphambili lokho ongase ukudinge.
Sihlanganisa uhlu lwemibuzo ongayithola iwusizo. Yiqiniso, isimo sawo wonke umuntu sihlukile, ngakho le mibuzo ayihlanganisi yonke into, kodwa inikeza isiqalo esihle.
Chofoza isixhumanisi esingezansi ukuze udawunilode i-PDF ephrintekayo yemibuzo kadokotela wakho.
Chofoza lapha ukuze Ulande Imibuzo ozoyibuza Udokotela wakho
Uma uqala ukwelashwa kubizwa ngokwelashwa komugqa wokuqala. Uma usuqedile ukwelashwa kwakho komugqa wokuqala, ungase ungadingi ukwelashwa futhi, kodwa abanye abantu bangase badinge ukwelashwa okwengeziwe ngokushesha, kanti abanye bangathatha izinyanga noma iminyaka eminingi ngaphandle kokwelashwa, ngaphambi kokudinga ukwelashwa okwengeziwe.
Ukwelashwa komugqa wokuqala we-classical Hodgkin lymphoma
Uhlobo lokwelashwa onalo luzoncika kulokhu:
- uhlobo lwe-Hodgkin lymphoma onalo
- isigaba kanye nebanga le-lymphoma yakho
- iminyaka yakho kanye nempilo yakho iyonke
- noma yiziphi ezinye izifo onazo noma imithi oyiphuzayo
- okuthandayo ngemva kokuba nengxoxo nodokotela wakho mayelana nezinketho zakho.
Ezinye zezindlela zokwelapha ezivame kakhulu ongase uzidinge uma uqala ukwelashwa zichazwe ngezansi.
Ukwelashwa ngemisebe
Imisebe ingase inikezwe nge-chemotherapy, noma ngokwayo.
Ukwelashwa ngamakhemikhali
Uma udinga ukuqala ukwelashwa, ungase ube nemithi engaphezu kowodwa, futhi ungase uhlanganise izinhlobo eziningana ezahlukene ze-chemotherapy i-monoclonal antibody noma i-immune checkpoint inhibitor. Uma unalezi zindlela zokwelapha, uzoba nazo ngemijikelezo. Lokho kusho ukuthi uzothola ukwelashwa, bese uthola ikhefu, bese kuba omunye umzuliswano (umjikelezo) wokwelashwa.
I-ABVD
I-ABVD iyiphrothokholi yokwelapha evamile esetshenziselwa abantu abane-HL. Kuyinhlanganisela yemithi yokwelapha ngamakhemikhali ebizwa ngokuthi i-doxorubicin, i-bleomycin, i-vinblastine ne-dacarbazine.
I-Beacopp Ekhuphukile
I-BEACOPP ekhushuliwe enye iphrothokholi esetshenziselwa abanye abantu abane-HL. Kuyinhlanganisela yemithi yokwelapha ngamakhemikhali ebizwa ngokuthi i-bleomycin, i-etoposide, i-doxorubicin, i-cyclophosphamide, i-vincristine ne-procarbazine. Uzonikezwa futhi umuthi wama-steroid obizwa nge-prednisolone. Ngeke unikezwe yonke le mithi ngosuku olulodwa, kodwa uzoyithola yonke ezinsukwini eziyi-8. Uyoba steroid for 2 amasonto, ke ikhefu, bese uqale umjikelezo wakho olandelayo.
I-BRCADD
I-BRECADD ingasetshenziswa uma unesigaba esithuthukisiwe se-Hodgkin Lymphoma. Ibonise imiphumela emihle kakhulu, nabantu abaningi belashwa noma bangena ekwelashweni isikhathi eside. I-protocol ihlanganisa i-chemotherapy kanye ne-a i-conjugated monoclonal antibody ebizwa ngokuthi i-Brentuximab vedotin. I-vedotin iyikhemikhali exhunywe ku-antibody ye-brentuximab futhi inobuthi kumaseli e-lymphoma.
Imithi yokwelapha ngamakhemikhali kule nqubo ihlanganisa i-etoposide, i-cyclophosphamide, i-doxorubicin ne-dacarbazine. Uzoba ne-steroid ebizwa nge-dexamethasone.
Qaphela
Uma unokwelashwa nge i-bleomycin, kungase kunconywe ukuthi ungabi nawo umoya-mpilo wokugeleza okuphezulu esikhathini esizayo. I-oksijini egeleza kakhulu ibangele izibazi emaphashini abanye abantu abaye bane-bleomycin.
Uma udinga usizo lokuphefumula esikhathini esizayo, usengathola ukwelashwa ngomoya wezokwelapha noma ezinye izindlela. Kwezinye izimo, udokotela wakho angase anikeze ukukunikeza umoya-mpilo ogeleza kakhulu uma izinzuzo zidlula izingozi. Nokho, sincoma lokho uma uke welashelwa i-bleomycin, yazisa bonke odokotela bakho nabahlengikazi.
Ezinye izibhedlela zingase zikunike ibhendi yegama elibomvu futhi zibeke umoya-mpilo phansi njenge-allergies. Kubalulekile ukwazi ukuthi lokhu akukhona ukungezwani komzimba nezinto ezithile, kodwa kuyisikhumbuzo sokuthi ungakuniki umoya-mpilo ngokusebenzisa imaski noma amacici.
Izivivinyo zemitholampilo
Ziningi izivivinyo zomtholampilo ezenzekayo futhi uma uhlangabezana nemibandela edingekayo ungakwazi ukujoyina uhlolo lomtholampilo. Buza udokotela wakho ngalokhu. Uma ungathanda ulwazi olwengeziwe ngezivivinyo zomtholampilo, sicela ubheke ezethu Ukuqonda ikhasi lewebhu lesivivinyo somtholampilo lapha
Ukwelashwa kolayini wesibili
Abantu abaningi belashwa ngokwelashwa kwabo komugqa wokuqala kodwa kwabanye, ukwelashwa komugqa wokuqala kungase kungasebenzi ngendlela abebenethemba ngayo. Lesi sifo sibizwa ngokuthi 'isifo esiphikisayo'. Abanye bangase babe nomphumela omuhle wokwelashwa komugqa wokuqala, kodwa ngemva kwezinyanga noma iminyaka, i-HL ingase ibuye. Lokhu kubizwa 'ukuphinda'. Uma une-HL ye-refractory noma ubuyele kabusha ungase udinge ukwelashwa futhi. Lokhu kubizwa ngokwelashwa komugqa wesibili. Uma udinga ukwelashwa komugqa wesibili, kungase kudingeke ukuthi wenze ukuhlolwa kwesiteji futhi, njengoba nje wenza ngaphambi kokuba uqale ukwelashwa okokuqala.
Izinhlobo zokwelashwa komugqa wesibili
Ukwelashwa komugqa wesibili kungabandakanya:
- I-chemotherapy enedosi ephezulu bese kuba ukufakelwa kwe-stem cell
- Izinhlobo ezahlukene ze-chemotherapy (Ezifana ne-IGEV – prednisolone, vinorelbine, gemcitabine, ifosfamide, ne-mesna ne-pegfilgrastim)
- I-antibody monoclonal noma i-immune checkpoint inhibitor (njenge-brentuximab vedotin noma i-pembrolizumab)
- Radiotherapy
- Noma ungase ufaneleke ukuba nesilingo somtholampilo - Buza udokotela wakho ngalokhu.
Kwezinye izimo ezingavamile kakhulu, lapho i-Hodgkin Lymphoma ibuya, kungenzeka ukuthi ishintshe indlela ebukeka ngayo. Amanye ama-Hodgkin Lymphoma's, lapho ephindela emuva, angase athuthuke neprotheni i-CD20 endaweni yeseli, ngisho noma ungazange uveze i-CD20 ngokweqile ngesikhathi uxilongwa okokuqala. Kulokhu ukwelashwa kungase kushintshe kancane njengoba i-Hodgkin Lymphoma iqala ukubukeka kancane njenge-non-Hodgkin lymphoma. Kodwa futhi, lokhu kuyivelakancane kakhulu, futhi uma kwenzeka kuwe, udokotela wakho uzokwazi ukukhuluma nawe ngendlela engcono kakhulu yokwelapha.
Ukwelashwa komugqa wesithathu
Kwabanye abantu, umugqa wesithathu ngisho nowesine wokwelashwa ungase udingeke. Lokhu kungafaka inhlanganisela yokwelashwa okungenhla. Udokotela wakho uzokwazi ukukhuluma nawe mayelana nezinketho ezingcono kakhulu zesimo sakho ngasinye.
Ulwazi olwengeziwe mayelana nezinqubo zokwelashwa ezihlukene lungabhekwa nge eviQ lapha.
IZIVIVINYO ZEMITHETHO
Izivivinyo zokwelashwa ziyinqubo ebalulekile yokuthola imithi emisha, noma inhlanganisela yemithi yokuthuthukisa ukwelashwa kwabantu abane-Hodgkin Lymphoma esikhathini esizayo. Bangakunikeza nethuba lokuzama umuthi omusha, inhlanganisela yemithi noma ezinye izindlela zokwelapha ongeke ukwazi ukuzithola ngaphandle kohlolo. Ezinye izivivinyo zomtholampilo ze-Hodgkin Lymphoma zibheka ukwelashwa kweseli ye-CAR-T, ukubona ukuthi lokhu kungase kusebenze yini kubantu abane-HL.
Ukwelashwa kwe-HL kungashiya imiphumela emibi ehlala njalo noma izimo zempilo ezingapheli izinyanga kuya eminyakeni ngemva kokwelashwa. Eminye imigomo yezinye izivivinyo zomtholampilo ukubheka ukuthi singayinciphisa kanjani le miphumela sekwephuzile kanye neminye imiphumela engemihle eqhubekayo evela ekwelashweni.
Uma ungathanda ukubamba iqhaza esivivinyweni somtholampilo, buza udokotela wakho ukuthi yiziphi izivivinyo zomtholampilo okufanelekela kuzo. Ungafunda futhi iphepha lethu leqiniso elithi 'Ukuqonda Izivivinyo Zomtholampilo', eliphinde libhale ohlwini lwamawebhusayithi ongawavakashela ukuze uthole ukuhlolwa komtholampilo. Chofoza lapha ukuxhuma ekhasini lethu lamaqiniso.
Imiphumela emibi evamile yokwelashwa
Kunemiphumela emibi eminingi ehlukene ongayithola ekwelashweni kwakho kwe-HL. Ngaphambi kokuba uqale ukwelashwa kwakho, udokotela wakho noma unesi wakho kufanele akuchazele yonke imiphumela engemihle elindelekile ONGASE ube nayo. Ungase ungazitholi zonke, kodwa kubalulekile ukwazi ukuthi yini okufanele uyibheke nokuthi ungamthinta nini udokotela wakho. Qinisekisa ukuthi unemininingwane yokuxhumana yokuthi ubani okufanele uxhumane naye uma ululama phakathi nobusuku noma ngempelasonto lapho udokotela wakho engase angatholakali.
Omunye wemiphumela emibi evame kakhulu yokwelashwa izinguquko ekubalweni kwegazi lakho. Ngezansi kunethebula elichaza ukuthi yimaphi amangqamuzana egazi angase athinteke nokuthi lokho kungase kukuthinte kanjani.
Amaseli egazi athintwa ukwelashwa kwe-HL
Amangqamuzana amhlophe egazi | Amaseli abomvu egazi | Ama-platelet (futhi amaseli egazi) | |
Igama Lezokwelapha | Ama-Neutrophils namaLymphocyte | Ama-erythrocyte | Amapulatifomu |
Benzani? | Ukulwa Nezifo | Phatha umoya-mpilo | Yeka ukopha |
Ukushoda kubizwa ngani? | I-Neutropenia kanye ne-lymphopenia | I-anemia | Thrombocytopenia |
Lokhu kuzowuthinta kanjani umzimba wami? | Uzothola izifo eziningi futhi ungase ube nobunzima bokuqeda ngisho nokuthatha ama-antibiotics. | Ungase ube nesikhumba esiphaphathekile, uzizwe ukhathele, uphelelwa umoya, ugodola kanye nesiyezi. | Ungalimala kalula, noma wophe okunganqamuki ngokushesha uma usikekile. |
Ithimba lami elilapha lizokwenzani ukulungisa lokhu? | Libazisa ukwelashwa kwakho kwe-lymphoma. Angase akunike umjovo esiswini sakho ngomuthi oshukumisa umnkantsha wakho ukukhiqiza amangqamuzana egazi amhlophe amasha. Ukunikeza ama-antibiotics omlomo noma nge-intravenous uma unesifo. | Libazisa ukwelashwa kwakho kwe-lymphoma. Ikunike igazi elibomvu uma isibalo samangqamuzana akho siphansi kakhulu. | Libazisa ukwelashwa kwakho kwe-lymphoma. Ikunikeza ukumpontshelwa kweplatelet uma isibalo sakho samaseli siphansi kakhulu. |
Eminye imiphumela emibi evamile yokwelashwa kwe-HL
Ngezansi kunohlu lweminye imiphumela emibi evamile yokwelashwa kwe-HL. Kubalulekile ukuqaphela ukuthi manje zonke izindlela zokwelapha zizodala lezi zimpawu, futhi kufanele ukhulume nodokotela wakho noma unesi mayelana nokuthi yimiphi imiphumela emibi engase idalwe ukwelashwa kwakho komuntu ngamunye.
- Ukuzizwa ugula esiswini (isicanucanu) nokuhlanza.
- Umlomo obuhlungu (mucositis) nokushintsha ukunambitheka kwezinto.
- Izinkinga zamathumbu njengokuqunjelwa noma isifo sohudo (indle eliqinile noma elinamanzi).
- Ukukhathala, noma ukungabi namandla okuba ngcono ngemva kokuphumula noma ukulala (ukukhathala).
- Imisipha (myalgia) kanye ne-joint (arthralgia) ubuhlungu nobuhlungu.
- Ukulahlekelwa izinwele kanye nokuncipha (i-alopecia) - kuphela ngokwelashwa okuthile.
- Inkungu yengqondo nobunzima bokukhumbula izinto (chemo brain).
- Ukuzwa okushintshile ezandleni nasezinyaweni zakho njengokuluma, izikhonkwane nezinaliti noma ubuhlungu (i-neuropathy).
- Ukuncipha kokuzala noma ukuyeka ukuya esikhathini ngaphambi kwesikhathi (ukushintsha kwempilo).
I-prognosis ye-Hodgkin Lymphoma - nokuthi kwenzekani lapho ukwelashwa kuphela
I-prognosis yigama elisetshenziselwa ukuchaza indlela okungenzeka yesifo sakho, ukuthi sizosabela kanjani ekwelashweni nokuthi uzokwenza kanjani phakathi nangemuva kokwelashwa.
Kunezici eziningi ezinomthelela ekubikezeleni kwakho futhi akunakwenzeka ukunikeza isitatimende esiphelele mayelana nokubikezela. Nokho, i-Hodgkin lymphoma ivamise ukusabela kahle kakhulu ekwelashweni futhi iziguli eziningi ezinalo mdlavuza zingelapheka - okusho ukuthi ngemva kokwelashwa, alukho uphawu lwe-Hodgkin Lymphoma emzimbeni wakho.
Izinto ezingaba nomthelela ku-prognosis
Ezinye izici ezingase zibe nomthelela ekubikezelweni kwakho zihlanganisa:
- Uneminyaka yobudala kanye nempilo yonke ngesikhathi sokuxilongwa.
- Indlela osabela ngayo ekwelashweni.
- Kuthiwani uma kukhona ukuguqulwa kofuzo onakho.
- I-subtype ye-Hodgkin Lymphoma onayo.
Uma ungathanda ukwazi okwengeziwe nge-prognosis yakho siqu, sicela ukhulume nochwepheshe wakho we-hematologist noma i-oncologist. Bazokwazi ukukuchazela izici zakho zobungozi kanye ne-prognosis kuwe.
