Uhlolojikelele lwe-PCNSL
I-PCNSL iqala lapho ama-B-cell lymphocyte (B-cell) anomdlavuza enza kuzicubu ze-lymphoid zobuchopho kanye/noma intambo yomgogodla. I-PCNSL ingase futhi iqale ezingqimbeni ezakha isembozo sangaphandle sobuchopho (ama-meninges) noma emehlweni (i-ocular lymphoma).
Ngezinye izikhathi i-lymphoma ingaqala kwezinye izindawo zomzimba futhi isakaze ku-CNS. Lokhu akufani ne-PCNSL futhi kuphathwa ngendlela ehlukile futhi. Uma iqale ngaphandle kwe-CNS futhi yasakazekela ku-CNS ibizwa ngokuthi i-CNS lymphoma yesibili.
Imbangela ye-PCNSL ayaziwa njengoba kwenzeka kuma-lymphomas amaningi. Abantu banamathuba amaningi okuthi bathinteke phakathi kweminyaka yobudala engama-50 kuya kwengama-60, ngokwesilinganiso seminyaka yokuxilongwa cishe iminyaka engama-60, nokho kungenzeka kunoma iyiphi iminyaka. I-PCNSL iphinde ivame kakhulu kubantu abanamasosha omzimba abuthakathaka, okungenzeka kubangelwe:
- Ukutheleleka nge-HIV (human immunodeficiency virus) - lokhu akusajwayelekile manje ngenxa yokutholakala kwemithi yokwelapha ephumelelayo
- Imithi - leyo esetshenziselwa ukucindezela amasosha omzimba, njengasemva kokufakelwa isitho somzimba noma ezinye izinhlobo zokwelapha ezivimbela ukuzivikela komzimba ezimeni ezizimele njengesifo samathambo.
Ingabe i-PCNSL iyelapheka?
Ama-lymphomas amaningi anolaka angasabela kahle ekwelashweni nge-chemotherapy ngoba i-chemotherapy isebenza ngokubulala amaseli akhula ngokushesha. Kunezici eziningi nokho, ezinomthelela wokuthi uzolapheka yini ku-lymphoma yakho noma cha. Abantu abaningi bangelapheka, abanye bangase babe nezikhathi zokuthethelelwa - lapho lungekho uphawu lwe-lymphoma esele emzimbeni wakho, kodwa-ke ingaphindela emuva (ibuye) futhi idinga ukwelashwa okwengeziwe.
Ukuze uthole okwengeziwe mayelana namathuba akho okwelashwa, khuluma nodokotela wakho wegazi noma i-oncologist.
Yenzani i-Central Nervous System (CNS)?
The isimiso sezinzwa esiyinhloko (CNS) iyingxenye yomzimba wethu elawula yonke imisebenzi yethu yomzimba. Kuhlanganisa ubuchopho bethu, umgogodla namehlo.
Ubuchopho
Ingqondo yethu yakhiwe:
- I-Cerebrum - lokhu kulawula inkulumo yethu nokuqonda, imizwa yethu nokunyakaza kokuzithandela (ukunyakaza esinquma ukukwenza)
- cerebellum - isiza ngokunyakaza futhi ilawula ibhalansi yethu
- Ubuchopho - ilawula imisebenzi ebalulekile yomzimba, njengokuphefumula kwethu, ukushaya kwenhliziyo nomfutho wegazi
Intambo yomgogodla
Intambo yethu yomgogodla isuka ebuchosheni yehle emhlane wethu ngaphakathi kwamathambo omgogodla. Uchungechunge lwemizwa lujoyina ngqo entanjeni yomgogodla. Izinzwa zithwala ulwazi mayelana nokuzwa okuvela emzimbeni wonke futhi zithwala imiyalezo iye noma isuke ebuchosheni bethu iye kuwo wonke umzimba wethu, ukuze ilawule imisipha yethu, kanye nayo yonke imisebenzi yemizimba yethu.
Ivikelwe kanjani i-CNS yethu?
I-CNS yethu ihlukaniswe kuwo wonke umzimba wethu futhi ivikelwe ekuhlukumezekeni, ekuthelelekeni nasezifweni ngezindlela eziningi.
- The meninges yizingqimba ezivikelayo zezicubu ezivala ubuchopho nomgogodla - yilokhu okuvuvukala 'ku-meningitis'
- Uketshezi olukhethekile olubizwa 'cerebrospinal fluid'(i-CSF) izungeza ubuchopho nomgogodla ukuze kuvikelwe - itholakala esikhaleni esiphakathi kwama-meninges nobuchopho kanye nentambo yomgogodla.
- The umgoqo wegazi-ubuchopho izungeza ubuchopho bethu - iyisithiyo samaseli nemithambo yegazi evumela kuphela izinto ezithile ukuthi zifinyelele ebuchosheni. Lokhu kuyayivikela kumakhemikhali ayingozi nasezifweni, futhi kuvimbela noma kuphazamise imithi eminingi yokwelapha ngamakhemikhali edlula egazini iye ebuchosheni.
Ukuze uqonde i-PCNSL udinga ukwazi kancane ngama-B-Cell lymphocyte akho.
I-B-Cell lymphocyte:
- 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 oluhlanganisa:
- ama-lymph node
- imithambo ye-lymphatic kanye ne-lymph fluid
- izitho zomzimba - i-spleen, thymus, tonsils, appendix
- izicubu ze-lymphoid
- Ungahamba ngohlelo lwakho lwe-lymphatic, uye kunoma iyiphi ingxenye yomzimba wakho ukuze ulwe nokutheleleka noma izifo.
Kwenzekani lapho i-PCNSL ikhula?
I-PCNSL iqala lapho ama-lymphocyte anomdlavuza etholakala ohlelweni lwakho lwezinzwa olumaphakathi (CNS), oluhlanganisa ubuchopho bakho, umgogodla, amehlo, izinzwa ze-cranial kanye nongqimba oluvikelayo lwezicubu ezihlanganisa ubuchopho bakho nomgogodla obizwa ngokuthi ama-meninges.
Uma une-PCNSL, ama-lymphocyte akho anomdlavuza:
- Khula ngokungalawuleki
- Ngeke isebenze ngempumelelo ukulwa nezifo kanye nezifo
- Angaba makhulu kunalokho okufanele futhi abukeke ahlukile kuma-B-cell akho anempilo
- Kungabangela ukuthi i-lymphoma ikhule ebuchosheni bakho, umgogodla namehlo.
- Ngenxa yezithiyo zokuvikela ezizungeze i-CNS yethu, i-PCNSL ayivamisile ukusabalala kwezinye izingxenye zomzimba wakho njengoba ezinye izinhlobo ze-lymphoma zingakwazi nokho, ngezinye izikhathi zingakwazi ukusabalalisa ama-testes kwabesilisa.
Izimpawu lapho i-lymphoma iku-Central Nervous System (CNS)
Izimpawu ze-lymphoma ku-CNS yakho zihlobene nemisebenzi yobuchopho bakho, amehlo kanye nomgogodla. Kuzoncika ekutheni iyiphi ingxenye ye-CNS yakho ethintekile futhi ingafaka okulandelayo:
- izinhlungu zekhanda
- izinguquko embonweni wakho
- ukudideka noma izinguquko zenkumbulo
- ushintsho ekuqondeni (ukuwozela nokungaphenduli)
- ubunzima bokukhuluma noma ukugwinya
- izinguquko esimweni sakho noma ebuntwini bakho
- ukuqunjelwa (ilingana)
- isicanucanu nokuhlanza
- ukulahlekelwa isifiso sokudla (engafuni ukudla) nokulahlekelwa isisindo
- ubunzima bokuya endlini yangasese
- ubunzima bokuhamba, ukungazinzi noma ukuwa
- ubuthakathaka, ukuba ndikindiki noma imizwa elumayo.
Ukuxilongwa, ukuhlelwa kanye nokuhlelwa kwe-PCNSL
Uma udokotela wakho esola ukuthi une-lymphoma uzodinga ukuba kwenziwe ukuhlolwa okuningana. Ngokungafani nezinye izinhlobo ezincane ze-lymphoma, ukuhlelwa akwenziwa uma une-PCNSL ngoba i-lymphoma ivalelwe ohlelweni lwakho lwezinzwa oluphakathi (CNS). Noma yikuphi ukusabalala ngaphandle kwe-CNS kuvamise ukuba kwabesilisa kuphela futhi kumasende kuphela.
I-PCNSL ihlale ibhekwa njenge-lymphoma yezinga eliphezulu okusho ukuthi inolaka. Ikhula ngokushesha futhi ingadlula ku-CNS yakho ngokushesha. Ama-B-cell anomdlavuza (amaseli e-lymphoma) nawo abukeka ehluke kakhulu kuma-B-cell akho anempilo ngoba akhula ngokushesha futhi awabi naso isikhathi sokwakheka ngendlela efanele.
Chofoza isihloko esingezansi ukuze ufunde kabanzi mayelana nohlobo lokuhlola okungenzeka ukuthi ukuhlonze, futhi ufunde kabanzi mayelana ne-PCNSL yakho.
Biopsy
Ukuze uhlole i-PCNSL uzodinga i-biopsy. I-biopsy iyinqubo yokukhipha ingxenye, noma yonke i-lymph node ethintekile noma izicubu ezithintekile. Ngesikhathi senqubo ungase ube nesibulali-zinzwa esivamile noma sasendaweni ukuze ukhululeke kakhudlwana, noma ukuqinisekisa ukuthi awuvuki ngenkathi kwenziwa.
Uhlobo lwe-biopsy okufanele lwenziwe luzoxhomeka lapho i-lymphoma itholakala khona.
Uma kucatshangwa ukuthi i-lymphoma ikuwe:
- Ubuchopho - udokotela ohlinzayo (uchwepheshe ekuxilongeni nasekwelapheni izinkinga nge-CNS) uthatha i-biopsy yobuchopho. Izigaxa (noma amasampula ezigaxa) ngaphakathi kobuchopho bakho zizokhishwa kusetshenziswa i-CT scan ukusiza ukuqondisa inaliti ye-biopsy endaweni efanele. Lokhu kubizwa ngokuthi a 'i-stereotactic biopsy'. Uzothola isibulali-zinzwa esijwayelekile sale nqubo njengoba kubalulekile ukuthi unganyakazi.
- Iso - udokotela wamehlo (uchwepheshe wezifo nokulimala kweso) angathatha i-vitreous (into efana nejeli ngaphakathi kweso lakho) ukuze ahlole amaseli e-lymphoma.
- Umgogodla - udokotela ochwepheshe we-radiologist angase athathe i-biopsy emgogodleni wakho.
Ukuhlolwa kwegazi
Ukuhlolwa kwegazi nakho kuyathathwa uma uzama ukuxilonga i-lymphoma yakho, kodwa futhi kukho konke ukwelashwa ukuze udokotela akwazi ukuqonda kangcono impilo yakho yonke, futhi aqinisekise ukuthi izitho zakho zisebenza kahle ukuze ubhekane nokwelashwa.
Lesi skena ngokuvamile sinikeza izithombe ezinhle kakhulu zobuchopho bakho nezinye izingxenye ze-CNS futhi singakwazi ukubona ukucindezelwa komgogodla.
Lolu hlobo lokuskena luvame ukusetshenziswa ngokuhambisana ne-CT scan ukuze kutholwe i-lymphoma esebenzayo kwenye indawo emzimbeni wakho. Kuthatha isithombe sengaphakathi lomzimba wakho wonke. Uzonikezwa inaliti enomuthi othize amaseli anomdlavuza njengamaseli e-lymphoma, awumunce. Umuthi usiza ukuskena kwe-PET ukubona ukuthi i-lymphoma ikuphi kanye nosayizi nokuma ngokugqamisa izindawo ezinamaseli e-lymphoma. Lezi ngezinye izikhathi zibizwa ngokuthi "zishisayo".
Njengoba i-PCNSL ingathinta amehlo ungase udinge nokuhlolwa kwe-ophthalmic okuhlukahlukene. Udokotela wamehlo (uchwepheshe wamehlo) uzosebenzisa i-ophthalmoscope - ithuluzi elinelensi ekhulisayo ekhanyayo nencane - ukuze ubukeke kahle ngaphakathi kwamehlo akho. Ukuhlola okuthile kwe-imaging kungase kwenziwe futhi lokhu kusiza udokotela wamehlo ukuthi abheke isimila futhi abone ukuthi umdlavuza usabalele yini.
I-biopsy yeso ingadingeka. Lokhu kubizwa ngokuthi i-vitrectomy. Ithuluzi elincane lifakwa esweni futhi lithatha amasampula e-vitreous efana nejeli, okuwuketshezi olugcwalisa phakathi neso.
I-testicular ultrasound yabesilisa ukuhlolwa okuthola izithombe zamasende kanye nezicubu ezizungezile ku-scrotum. Le ultrasound ingase yenziwe njengoba enye i-PCNSL ingasakazekela kumasende.
Imiphumela
Ukulinda ukuthi yonke imiphumela yakho ingene kungaba isikhathi esicindezelayo kakhulu kuwena nakubantu obathandayo. Kubalulekile ukukhuluma ngendlela ozizwa ngayo futhi uvulekele nalabo abaseduze kwakho ngalokho okudingayo. Abantu abaningi bafuna ukusiza, kodwa abazi ukuthi kanjani kanjalo ngokubazisa lokho okudingayo, ungabasiza ekunikezeni ukwesekwa okudingayo.
Kungasiza futhi ukuqala ukuhlela lokho ongase ukudinge ezinyangeni ezizayo uma udinga ukwelashwa. Sihlanganise amathiphu ekhasini lethu lewebhu elithi Living with Lymphoma - The Practical Stuff. Chofoza isixhumanisi esingezansi ukuze uqondiswe kulelo khasi.
Ungaphinde uthinte inombolo yethu yocingo yomhlengikazi ukuze ukhulume nomunye wabahlengikazi bethu bokunakekelwa kwe-Lymphoma. Vele uchofoze inkinobho ethi Xhumana nathi ezansi kuleli khasi.
Ungase futhi uthande ukujoyina elinye lamakhasi ethu ezinkundla zokuxhumana ukuze uxoxe nabanye abantu ohlala nabo. Xhumana namakhasi ethu ezinkundla zokuxhumana ngokuchofoza izixhumanisi phezulu ekhasini.
Ukwelashwa kwe-PCNSL
Ukuba nolwazi olufanele kungakusiza uzizwe uqiniseka ngokwengeziwe futhi wazi ukuthi yini okufanele uyilindele, futhi kungakusiza uhlele kusengaphambili lokho ongase ukudinge. Kodwa kungaba nzima ukwazi ukuthi yimiphi imibuzo okufanele uyibuze lapho uqala ukwelashwa. Uma ungazi, yini ongayazi, ungazi kanjani ukuthi yini okufanele uyibuze?
Sihlanganise uhlu lwemibuzo ongayithola iwusizo. Yiqiniso, isimo sawo wonke umuntu sihlukile, ngakho le mibuzo ayihlanganisi yonke into, kodwa inikeza isiqalo esihle. Chofoza isixhumanisi esingezansi ukuze uthole ikhophi ye-PDF ongayilanda futhi uyiphrinte uma uthanda.
Ukulondolozwa kokuzala
Noma ngabe ungowesilisa noma ungowesifazane, izindlela eziningi zokwelapha umdlavuza zingathinta inzalo yakho - amandla akho okwenza abantwana. Uma ungathanda ukuba nezingane ngemva kokwelashwa, noma ungaqiniseki ukuthi ungathanda yini, khuluma nodokotela wakho mayelana nokuthi yiziphi izinketho ezitholakalayo ukuze usize ukuvikela inzalo yakho ngesikhathi sokwelashwa.
Uhlolojikelele lwezinhlobo zokwelashwa
Chofoza kumaslayidi angezansi ukuze uthole umbono wezinhlobo ezahlukene zokwelapha ongase unikezwe ukuze welaphe i-PCNSL yakho.
Kodwa-ke, uma unezimpawu ezinzima futhi udokotela wakho eqiniseka ukuthi une-PCNSL, angase akhethe ukuqala ama-steroids ukuze athuthukise izimpawu zakho ngisho nangaphambi kwe-biopsy yakho.
I-steroids nayo inobuthi kumaseli e-lymphoma ngakho-ke angasiza ekunciphiseni i-lymphoma ngenkathi elinde okunye ukwelashwa ukuqala.
Ama-steroid anganikezwa nge-intravenously (ngokusebenzisa umthambo) noma ngomlomo (ngomlomo). I-steroid evamile i-dexamethasone.
I-chemo oyitholayo ye-PCNSL ingase yehluke kubantu abanezinye izinhlobo ezincane ze-lymphoma, njengoba imithi idinga ukweqa umgoqo wakho wegazi nobuchopho ukuze ufike ku-lymphoma yakho. Kuvamile ukuba ne-chemotherapy nge-immunotherapy efana ne-rituximab.
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-PCNSL.
I-radiotherapy yobuchopho obuphelele imvamisa isetshenziswa njengokwelashwa kokuhlanganiswa ngemva kokwelashwa ngamakhemikhali.
Kuze kube maphakathi no-nineties bekuyindlela yokwelapha eyinhloko ye-PCNSL, nokho manje isinikezwa ngokuhambisana ne-chemotherapy. Imithi yokwelapha yokuhlanganisa ihlose ukunciphisa ingozi yokubuyela emuva (i-lymphoma ebuyayo). I-Radiotherapy ingasetshenziswa yodwa uma ungakwazi ukubekezelela i-chemotherapy.
I-SCT yenzelwe ukufaka ama-stem cell amasha esikhundleni somnkantsha wakho ongakhula abe amaseli egazi amasha anempilo. Nge-SCT, ama-stem cells akhishwa egazini. Ama-stem cells angase akhishwe kumnikeli noma aqoqwe kuwe ngemva kokwelashwa ngamakhemikhali.
Uma ama-stem cells evela kumnikeli, kubizwa ngokuthi i-allogeneic stem cell transplant. Uma ama-stem cells akho eqoqwe, kubizwa ngokuthi i-autologous stem cell transplant.
Ukwelashwa komugqa wokuqala
Kuzodingeka ukuthi uqale ukwelashwa ngokushesha ngemva kokubuya kwayo yonke imiphumela yokuhlolwa. Kwezinye izimo, ungaqala ngaphambi kokuthi yonke imiphumela yokuhlolwa ingene. Kungaba nzima kakhulu uma uqala ukwelashwa. Ungase ube nemicabango eminingi mayelana nokuthi uzobhekana kanjani nesimo, indlela yokuphatha ekhaya, noma ukuthi ungase ugule kanjani.
Yazisa ithimba lakho labelaphi uma unomuzwa wokuthi ungase udinga ukwesekwa okwengeziwe. Bangase bakwazi ukukusiza ngokukuthumela ukuthi uyobonana nosonhlalakahle noma omunye uchwepheshe wezempilo ukuze akusize uxazulule izinselele zokuphila zansuku zonke ongase ubhekane nazo. Ungakwazi futhi ukufinyelela kubahlengikazi be-Lymphoma Care ngokuchofoza inkinobho ethi "Xhumana nathi" ngaphansi kwaleli khasi.
Uma uqala ukwelashwa okokuqala, kubizwa ngokuthi 'ukwelashwa komugqa wokuqala'. Ungase ube nemithi engaphezu kowodwa, futhi lokhu kungase kuhlanganise i-radiotherapy, i-chemotherapy noma i-monoclonal antibody.
Ukwelashwa okujwayelekile komugqa wokuqala kungabandakanya:
Umthamo omkhulu we-methotrexate
Lokhu kungase kuhlanganiswe noma ngaphandle kwe-monoclonal antibody, i-rituximab.
I-MATRix
Lena inhlanganisela yemithi ehlukene yokwelapha ngamakhemikhali kanye ne-monoclonal antibody - i-methotrexate, i-cytarabine, i-thiotepa ne-rituximab - ye-PCNSL esanda kutholakala.
I-R-MPV (Ingxenye yokuqala nengxenye yesibili)
Ingxenye yokuqala - I-Monoclonal antibody (rituximab) kanye nenhlanganisela ye-chemotherapy ehlanganisa i-methotrexate, i-procarbazine ne-vincristine.
Ingxenye yesibili - I-chemotherapy ephezulu - i-cytarabine
I-Methotrexate ne-cytarabine
Inhlanganisela yamakhemotherapi amabili e-PCNSL esanda kutholwa.
Ukwelashwa ngamakhemikhali kwe-Intrathecal
Lena i-chemotherapy enikezwa oketshezini lomgogodla ngendlela yokubhoboza i-lumbar. Lokhu kwenziwa uma i-lymphoma itholakala oketshezini lwakho lomgogodla.
Ukubamba iqhaza kokuhlolwa komtholampilo
Lokhu kungase kuhlanganise izivivinyo zomtholampilo zemithi yokwelapha eqondiwe nokunye ukwelashwa. Buza udokotela wakho ukuthi uyafaneleka yini ukuthola noma yiziphi izinhlolo zokwelashwa zomugqa wokuqala.
I-Radiotherapy noma i-Stem Cell Transplant
Uma i-lymphoma isabela ekwelapheni ngamakhemikhali, ithimba lakho lezokwelapha lingase liphakamise i-radiotherapy yobuchopho obuphelele noma i- ukufakelwa kwe-autologous stem cell (bheka ngenhla). Lezi zindlela zokwelapha zokuhlanganisa, okusho ukuthi zisetshenziselwa ukunciphisa ingozi yokubuyela emuva ngemva kokwelashwa okuyimpumelelo.
Umugqa wesibili kanye nokwelashwa okuqhubekayo
Uma i-CNS lymphoma yakho iphinda ibuyela emuva (ibuya) noma inqaba (ingaphenduli) ekwelashweni, kungase kube nezinye izindlela zokwelapha ezitholakalayo.
Ukwelashwa onakho uma ubuyela ekuguleni noma une-PCNSL ephikisayo kubizwa ngokuthi ukwelashwa komugqa wesibili. Ukwelashwa kuncike ekutheni uqine kangakanani ngaleso sikhathi, yikuphi ukwelashwa osuvele ukutholile nokuthi i-lymphoma ikuthinta kanjani. Uchwepheshe wakho angakhuluma nawe ngezinketho zakho, ezingafaka:
- Ukwelashwa ngamakhemikhali okuqine kakhulu (okunamandla), okungenzeka kulandelwe ukufakelwa kwe-autologous stem cell (okungabafanele abanye abantu).
- I-Radiotherapy - uma ingakanikezwa.
- Ukwelashwa kwe-palliative okunikezwa ngenhloso yokudambisa izimpawu.
- Ukubamba iqhaza kokuhlolwa komtholampilo.
Izivivinyo zemitholampilo
Kunconywa ukuthi noma nini lapho udinga ukuqala ukwelashwa okusha ubuze udokotela wakho mayelana nezivivinyo zomtholampilo ongase ukufanelekele.
Izivivinyo zomtholampilo ziyindlela ebalulekile yokuthola imithi emisha, noma izinhlanganisela zemithi yokuthuthukisa ukwelashwa kwe-PCNSL ngokuzayo. Bangakunikeza nethuba lokuzama umuthi omusha, inhlanganisela yemithi noma ezinye izindlela zokwelapha ongeke ukwazi ukuzithola ngaphandle kohlolo. Uma ungathanda ukubamba iqhaza esivivinyweni somtholampilo, buza udokotela wakho ukuthi yiziphi izivivinyo zomtholampilo okufanelekela kuzo.
Kukhona izindlela zokwelapha eziningi nezinhlanganisela ezintsha zokwelapha okwamanje ezihlolwayo ezivivinyweni zomtholampilo emhlabeni wonke kubantu abanakho kokubili okusanda kuxilongwa kanye ne-PCNSL ebuyele emuva/ehlanekezelwe. Ezinye izindlela zokwelapha eziphenywayo yilezi:
- I-Ibrutinib (Imbruvica®)
- Zanubrutinib (Brukinsa®) kanye ne-Tiselizumab
- I-Pembrolizumab (Keytruda®)
- I-GB5121 – i-Brain penetable BTK inhibitor
Ukubikezela kwe-PCNSL
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.
Izinto ezingaba nomthelela ku-prognosis
Ezinye izici ezingase zibe nomthelela ekubikezelweni kwakho zihlanganisa:
- Iminyaka yakho kanye nempilo yonke ngesikhathi sokuxilongwa
- Indlela osabela ngayo ekwelashweni
Ngezinye izikhathi izimpawu ze-CNS lymphoma zixazulula ngokushesha ngokwelashwa. Ukwelashwa kokuqala ngama-steroid kungasebenza kakhulu ekudambiseni izimpawu. Nokho, izicubu zezinzwa zikhula kancane kakhulu, futhi ngezinye izikhathi kungathatha isikhashana ukuba izimpawu zibe ngcono. Abanye benu bangabona ukuthuthuka kancane kancane ezimpawu, abanye nokho, bangathola izimpawu zingase zingaxazululeki ngokugcwele, ikakhulukazi uma bezikhona ngaphambi kokwelashwa.
Ukuthola ukwesekwa
Ithimba lakho lezokwelapha lingakweseka ukululama kwakho ngokukudlulisela kochwepheshe abafanelekile. Uma ubhekana nobuthakathaka bemisipha nokuncipha kwamandla noma ungalulami ngokushesha, kufanele ucabangele ukubonana nodokotela womzimba kanye/noma umelaphi wasemsebenzini ngoba angakunikeza usizo nezeluleko zokuthuthukisa izinga lempilo. Usizo lwabo lungase futhi lumise izimpawu ukuthi zibe zimbi kakhulu noma ezinye izinkinga ezikhulayo ngokuhamba kwesikhathi.
Izazi zokusebenza kwengqondo zinganikeza ukwesekwa uma kunezinkinga zokuqonda (zokucabanga), njengezinkinga zenkumbulo noma zokunaka. Izazi zokusebenza kwengqondo kanye nabeluleki nabo bangasekela ngomthelela ongokomzwelo we-lymphoma yakho.
Kubalulekile ukuqaphela ukuthi amasu okwelapha e-PCNSL athuthuke kakhulu eminyakeni yamuva nje. Kodwa-ke, i-PCNSL ingaba nzima ukuyiphatha, futhi ezinye izindlela zokwelapha zinengozi yokubangela izinkinga zesikhathi eside zezinzwa (izinkinga zobuchopho namehlo). Lezi zinkinga ziba nokwenzeka kakhulu uma kutholakala ukuthi une-CNS lymphoma lapho usukhulile.
Ukusinda - Ukuphila nomdlavuza, nangemva kwalokho
Indlela yokuphila enempilo, noma ezinye izinguquko ezinhle zokuphila ngemva kokwelashwa zingaba usizo olukhulu ekululameni kwakho. Ziningi izinto ongazenza ukukusiza ukuthi uphile kahle ngemva kukaBurkitt.
Abantu abaningi bathola ukuthi ngemva kokuxilongwa umdlavuza, noma ukwelashwa, ukuthi izinhloso zabo nezinto eziza kuqala ekuphileni ziyashintsha. Ukwazi ukuthi kuyini 'okujwayelekile kwakho okusha' kungase kuthathe isikhathi futhi kukhungathekise. Okulindelekile komndeni wakho nabangane kungase kwehluke kokwakho. Ungase uzizwe uhlukanisiwe, ukhathele noma iyiphi imizwa ehlukene engashintsha usuku ngalunye.
Imigomo eyinhloko ngemva kokwelashwa kwe-lymphoma yakho wukubuyela ekuphileni futhi:
- khuthala ngangokunokwenzeka emsebenzini wakho, emndenini, nakwezinye izindima zempilo
- nciphisa imiphumela emibi kanye nezimpawu zomdlavuza kanye nokwelashwa kwawo
- khomba futhi ulawule noma yimiphi imiphumela emibi ngemva kwesikhathi
- ukusiza ukugcina uzimele ngangokunokwenzeka
- ngcono izinga lakho lempilo futhi ugcine impilo enhle yengqondo
Izinhlobo ezahlukene zokuvuselela umdlavuza zinganconywa kuwe. Lokhu kungasho noma yiluphi uhlobo olubanzi yezinkonzo ezifana nalezi:
- ukwelashwa ngokomzimba, ukuphathwa kobuhlungu
- ukuhlela okunomsoco nokuzivocavoca
- ukwelulekwa ngokomzwelo, kwezemisebenzi nakwezezimali.
Isifinyezo
- I-Primary Central Nervous System Lymphoma (PCNSL) iwuhlobo oluncane olunolaka lwezinga eliphezulu lwe-Non-Hodgkin Lymphoma eqala ohlelweni lwakho lwezinzwa olumaphakathi (CNS).
- I-PCNSL ayivamisile ukusabalala ngaphandle kwe-CNS kodwa ingasakazekela kumasende kwabesilisa.
- I-PCNSL ihlukile kuma-lymphomas aqala kwenye indawo emzimbeni futhi adlulele ku-CNS (i-CNS lymphoma yesibili) futhi adinga ukuphathwa ngendlela ehlukile.
- Izimpawu ze-PCNSL zihlobene nendawo ye-lymphoma, kuhlanganise nezimpawu ezihlobene nemisebenzi yobuchopho bakho, intambo yomgogodla kanye namehlo.
- Kunezinhlobo eziningana ezihlukene zokuhlola ozozidinga ukuze uhlonze i-PCNSL, futhi lokhu kungase kuhlanganise izinqubo lapho unikezwa khona umuthi obulala izinzwa ovamile noma wendawo.
- Ukwelashwa kwe-PCNSL kuhlukile kwezinye izinhlobo ezincane ze-lymphoma njengoba imithi idinga ukudlula umgoqo wakho wegazi nobuchopho ukuze ifinyelele ku-lymphoma.
- Izimpawu zingase zithathe isikhathi ukuba ngcono ngemva kokwelashwa ngenxa yokukhula kancane kwamangqamuzana ezinzwa, kodwa ezinye izimpawu zingathuthuka ngokushesha.
- Khuluma nodokotela wakho mayelana namathuba akho okwelashwa nokuthi yini ongayilindela ekwelashweni kwakho.
- Awuwedwa. Uma ungathanda ukukhuluma nomunye wabahlengikazi bethu be-Lymphoma mayelana ne-lymphoma yakho, ukwelashwa kanye nezinketho chofoza inkinobho ethi Xhumana nathi ngaphansi kwesikrini.