Uhlolojikelele lwe-ATLL
I-T-cell Leukemia-Lymphoma yabadala iwuhlobo oluncane lwe-T olungavamile kakhulu I-Non-Hodgkin Lymphoma (NHL). Kungathinta abantu abadala banoma iyiphi iminyaka kodwa kuvame kakhulu kubantu abaneminyaka engama-60 noma ngaphezulu. Ngenkathi iwuhlobo oluncane lwe-NHL, ingaphinda iqoqwe njengohlobo oluncane lwe I-Peripheral T-cell Lymphoma (PTCL).
Ukwazi i-ATLL kungena ngaphansi kokubili kwezihloko ze-NHL kanye ne-PTCL kungaba usizo uma ufuna izivivinyo zemitholampilo ongakwazi ukuzijoyina, njengoba akuzona zonke izinhlolo ezizofaka ohlwini lwezinhlobo ezincane ze-lymphoma. Ungakwazi ukujoyina izivivinyo zomtholampilo ezifuna abantu abane:
- I-Non-Hodgkin Lymphoma
- I-Peripheral T-cell Lymphoma
- I-T-cell Lymphoma
- I-T-cell Leukemia Lymphoma yabantu abadala.
I-ATLL yenzeka lapho izinguquko zenzeka kuzakhi zofuzo ngaphakathi kwama-T-cell akho, atshela i-T-cell lymphocyte ukuthi ikhule futhi isebenze kanjani. Ngenxa yalezi zinguquko, ama-T-cell akhula abe amangqamuzana anomdlavuza futhi awasakwazi ukusebenza kahle. Ivamise ukuba nolaka, okusho ukuthi iyakhula futhi isabalala emzimbeni wakho ngokushesha.
Kodwa-ke, kunezinhlobo ezi-4 ezihlukene ze-ATLL, futhi ezi-2 zazo zingase zibe nobuvila, okusho ukuthi zikhula kancane futhi zingangena enkathini lapho zingakhuli nhlobo, cishe sengathi zilele. I-Indolent ATLL ayivamile kakhulu, futhi kwezinye izimo ingashintsha ibe enye yama-ATLL anolaka kakhulu ngokuhamba kwesikhathi.
I-ATLL enolaka idinga ukwelashwa ngokushesha ngemva kokutholakala kwakho, kodwa uma une-indolent lymphoma ungase ungakudingi nhlobo ukwelashwa izinyanga noma ngisho neminyaka. Ezimweni ezingavamile kakhulu, ungase ungadingi ukwelashwa.
Mayelana ne-T-cell Lymphocyte
- Ama-T-cell enziwa ngama-stem cells emnkantsheni wethu, ngaphambi kokuthuthela ohlelweni lwethu lwe-lymphatic kanye ne-thymus lapho evuthwa futhi ehlala khona.
- Ngaphakathi kwe-T-cell ngayinye kune-nucleus ephethe yonke i-DNA yethu, eyakhiwe ngezakhi zofuzo ezitshela amangqamuzana ethu ukuthi akhule futhi asebenze kanjani.
- Ngokuvamile ziphumula ku-thymus yakho, ama-lymph nodes noma ezinye izingxenye zesistimu yakho ye-lymphatic, futhi zivuka kuphela futhi zilwe nokutheleleka lapho amanye amangqamuzana omzimba ewazisa ukuthi kukhona ukutheleleka noma isifo okufanele silwe. Lapho evuka, ama-T-cell angahambela kunoma iyiphi ingxenye yomzimba wakho ukuze alwe negciwane noma isifo.
- Amanye ama-T-cell anesibopho "sokulawula" impendulo yokuzivikela komzimba. Lokhu kusho ukuthi uma isifo sesichithiwe, i- “Ama-T-cells alawulayo” tshela amanye amangqamuzana omzimba ukuthi “ame phansi” ukuze angaqhubeki elwa futhi abangele ukulimala kumaseli akho amahle uma isifo sesiphelile.
- Ngemva kokulwa nokutheleleka noma isifo, amanye ama-T-cell aba "Memory T-cells" futhi bakhumbula yonke into ekhona mayelana nalesi sifo nokuthi singalwa kanjani naso. Ngaleyo ndlela, uma kwenzeka uphinde uthole ukutheleleka okufanayo noma isifo, amasosha akho omzimba angalwa naso ngokushesha okukhulu nangempumelelo.
Ibangelwa yini i-ATLL?
I-ATLL yenzeka kuphela kubantu abake baba nokutheleleka ngegciwane elingavamile elibizwa ngokuthi I-Human T-cell Lymphotropic Virus 1 (HTLV-1). Nakuba inqubo okuyiyonayona ingaqondwa ngokugcwele, kubonakala sengathi i-HTLV-1 idala izinguquko kuzakhi zofuzo zakho, ibenze banikeze imiyalelo engalungile yokuthi ama-T-cell kufanele akhule futhi asebenze kanjani. Ngenxa yalokho ama-T-cell anomdlavuza ayaqhubeka nokuphindaphindeka futhi enze ama-T-cell anomdlavuza.
Nokho, abantu abaningi abane-HTLV-1 abakaze bakhe i-ATLL, ngakho-ke kubhekwa njengento eyingozi, kodwa hhayi imbangela. Eqinisweni, cishe oyedwa kuphela kubantu abangu-1 abane-HTLV ozothuthukisa i-ATLL. Asazi ukuthi kungani ithuthuka kwabanye abantu hhayi kwabanye.
Abantu abaningi abane-HTLV-1 bathelelekile ngesikhathi benceliswa ibele, noma ngesikhathi sobungane noma lapho sebekhulile. Ezimweni eziningi, i-ATLL ayithuthuki iminyaka engu-50 noma ngaphezulu ngemva kokuthola i-HTLV-1 okokuqala.
Ukuze uthole ulwazi olwengeziwe ngezimbangela nezici zobungozi Chofoza lapha.
I-Endemic HTLV-1
Amanye amagciwane avame ukuvama ezingxenyeni ezithile zomhlaba, kuyilapho engavamile ukutholakala kwezinye izingxenye zomhlaba. Lapho ijwayeleke khona kuthiwa idlangile. Kungenzeka kakhulu ukuthi uchayeke ku-HTLV-1 uma uke wahlala ezweni noma indawo lapho itholakala khona.
I-HTLV-1 igcwele emazweni angezansi.
- Japan
- China
- eCaribbean
- amaSeychelles
- Papua New Guinea
- Melika emaphakathi naseNingizimu
- emaphakathi nasenyakatho ye-Australia
- Iran
- Romania kanye
- izingxenye ze-Afrika.
Uma uke waxilongwa ukuthi une-HTLV-1 kufanele ngaso sonke isikhathi usebenzise isivikelo esivimbelayo ngesikhathi sokuya ocansini njengamakhondomu angaphakathi noma angaphandle ane-spermacide noma idamu lamazinyo. Lokhu kusiza ukuvikela umlingani wakho.
Uma unengane, ungase welulekwe ukuthi ungayinceli ibele futhi usebenzise okunekhwalithi enhle esikhundleni sobisi lwebele. Uma ufuna ukuba nezingane, khuluma nodokotela wakho mayelana nendlela yokukhulelwa kuyilapho uvikela umlingani wakho nengane ku-HTLV-1.
Kuzodingeka futhi uqinisekise ukuthi wopha, ukuthi noma ubani okusizayo ugqoke amagilavu futhi uyazivikela egazini lakho. Kufanele bageze noma yiliphi igazi ngamanzi agelezayo nensipho uma bechayeke egazini lakho. Basengozini enkulu yokuthola i-HTLV-1 uma benezilonda ezivulekile noma izindawo eziphukile zesikhumba futhi igazi lakho lingena kulezi zindawo eziphukile. Ungalokothi wabelane ngezinaliti zanoma yiluphi uhlobo.
Izimpawu ze-ATLL
Izimpawu ze-ATLL zingase zifane nezimpawu zezinye izinhlobo ze-lymphoma, noma eziqondile ku-subtype ye-ATLL onayo kanye nengxenye yomzimba wakho ekhulayo.
Izimpawu ezivamile zezinhlobo eziningi ezahlukene ze-lymphoma zingabandakanya:
- Ukukhathala
- Izimbali ezivuvukala ze-lymph ezibonakala njengezigaxa ngaphansi kwesikhumba ongakwazi ukuzibona noma ukuzizwa.
- Ubuhlungu nezinhlungu emisipheni nasemalungeni akho.
- Ukuthola izifo eziningi, noma ubunzima bokudlula kuzo.
- Isikhumba esinamahloni
- B-izimpawu
B-izimpawu
Izimpawu Nezimpawu zezinhlobo ezingaphansi ezahlukene ze-ATLL | ||||
Izimpawu | Inani eliphakeme kakhulu lama-ATLL | I-ATLL ye-Lymphomatous | I-ATLL engapheli | I-ATLL eshisayo |
Ama-lymphocyte ekuhlolweni kwegazi | Ukubukeka okuphezulu kakhulu nokungajwayelekile. | Ngokuvamile evamile. | Aphakeme kancane futhi ambalwa ngokubukeka okungavamile. | Okuvamile, kuyaqabukela ukuthi ezinye zibonakale zingajwayelekile. |
I-Lactate dehydrogenase (LDH) ekuhlolweni kwegazi | Phezulu. | Ngokuvamile evamile. | Mhlawumbe ukuphakama kancane. | Okujwayelekile. |
I-calcium ekuhlolweni kwegazi | Phezulu. | Ingase ibe phezulu noma evamile. | Okujwayelekile. | Okujwayelekile. |
Ukukhwabanisa isikhumba | Kwesinye isikhathi. | Kwesinye isikhathi. | Yebo - amabala abomvu noma amnyama esikhumba. | Yebo - izilonda zesikhumba noma amaqhubu amancane esikhumbeni sakho. |
Izimbali ezivuvukala ze-lymph | Ngokuvamile. | Yebo. | Ukuvuvukala kancane. | Cha |
Ukuvuvuka kwesibindi kanye noma ubende | Ngokuvamile. | Ngokuvamile. | Imnene. | Cha |
Amaseli e-Lymphoma emnkantsheni | Kwesinye isikhathi. | Akuvamile kakhulu. | Cha | Cha |
I-ATLL ixilongwa futhi ihlelwe kanjani?
Ukuze uhlole i-lymphoma uzodinga i-biopsy. Uhlobo lwe-biopsy luzoncika ekutheni amaseli akho e-lymphoma okusolakala ukuthi akuphi emzimbeni wakho, kanye nezimpawu onazo.
Izinhlobo ze-biopsies
- I-lymph node biopsy uma unama-lymph nodes avuvukele. Kuya ngokuthi i-lymph node ikuphi, lokhu ungaba nakho ngesibulali-zinzwa sasendaweni emakamelweni odokotela, noma ngaphansi kokubulala izinzwa okuvamile ekuhlinzweni uma kujulile emzimbeni wakho.
- I-Biopsy ye ezinye izicubu ezinjalo njengamaphaphu noma esiswini sakho uma kucatshangwa ukuthi une-lymphoma ekhula kulezi zitho. Lokhu ngokuvamile kwenziwa ekuhlinzweni nge-anesthetic evamile.
- I-bone yomnkantsha i-biopsy uma ukhuphule izibalo zamangqamuzana amhlophe egazini lakho. Lokhu kuvame ukwenziwa ngesibulali-zinzwa sasendaweni, ungase ube nokulaliswa okulula noma ungabi nakho.
- Isikhumba biopsy uma une-rash noma izilonda esikhumbeni sakho. Lokhu kuvame ukwenziwa ngezinzwa zendawo.
Ungase udinge i-biopsy engaphezu kweyodwa. I-biopsies yenaliti enhle ayinconywa ukuxilonga i-lymphoma njengoba ihlinzeka ngezicubu ezanele ukuze zihlolwe kahle. Kunalokho, okungenani kufanele ube ne-core core biopsy. Lokhu kunikeza izicubu eziningi kune-finenele biopsy. Kodwa-ke, ungase udinge i- excisional biopsy , okuyilapho i-lymph node yonke isuswa khona futhi ihlolwe ukugula.
Okunye ukuhlola ongase ukudinge
Uzohlolwa futhi ukuze uhlole inani lamangqamuzana egazi amhlophe kanye namazinga e-calcium. Uzohlolwa futhi igazi ukuze ubone ukuthi unayo noma uke waba ne-HLTV-1. Lezi zivame ukwenziwa ndawonye.
Ungase ube nokunye ukuhlola okufana ne-CT scan, i-ultrasound noma i-MRI. Kwesinye isikhathi ungaba ne-biopsy eyenziwe ngesikhathi sokuskena ukuze bathole, futhi uqiniseke ukuthi bahlola izindawo ezifanele.
Ingozi evumayo (ephansi) noma engathandeki (ephezulu) ye-ATLL
I-ATLL ayenziwa ngendlela efanayo nezinye izinhlobo ezingaphansi ze-lymphoma. Esikhundleni salokho i-ATLL iqoqwe ngengcuphe evumayo noma engafanele. Okuvuzayo kungase futhi kubizwe ngokuthi ubungozi obuphansi, futhi okungekuhle kungabizwa nangokuthi ubungozi obukhulu.
Ukwazi ubungozi bakho kuzosiza ukuqondisa udokotela wakho ukuthi akuncomele izindlela zokwelapha ezingcono kakhulu futhi akunike izeluleko ezingcono kakhulu.
Ingozi yakho ngeke ibe mnandi (phezulu) uma une i-ATLL enolaka noma uma une-ATLL engalapheki futhi ukuhlolwa kwegazi lakho kubonisa:
- i-albhamuin ephansi
- high lactate dehydrogenase (LDH)
- high blood urea nitrogen (BUN).
Ilinde imiphumela
Ilinde imiphumela kungaba isikhathi esinzima futhi kungasiza ukukhuluma nomndeni, abangani noma umhlengikazi onguchwepheshe.
Izinhlobo ezingaphansi ze-ATLL
Kunezinhlobo ezingaphansi ezi-4 ezihlukene ze-ATLL - ezi-2 zinolaka futhi ezi-2 ziyavilapha. Kodwa-ke, abantu abaningi abaxilongwa nge-ATLL bazoba ne-subtype enolaka, futhi cishe umuntu oyedwa kwabangu-1 abane-ATLL evilaphayo uzoqhubekela ohlotsheni olunolaka ngesikhathi esithile.
Chofoza izihloko ezingezansi ukuze ufunde okwengeziwe mayelana nezinhlobo ezihlukene ze-ATLL kanye nezimpawu nezimpawu ongazithola ngezinhlobo ezithile ezincanyana. Ngaphezu kwalokhu, ungathola noma yiziphi izimpawu ezijwayelekile ze-lymphoma okukhulunywe ngenhla.
Ama-ATLL anolaka
Acute kusho ukuthi i-ATLL iqala futhi isakazeka ngokushesha. Kubhekwa njenge-ATLL engathandeki noma engcuphe ephezulu.
Ungathola noma yiziphi izimpawu ezibalwe ngenhla, kodwa kanye nalezo, ezinye izimpawu ongazithola nalolu hlobo oluncane zifaka:
- Ukukhathala okwedlulele okufika ngokushesha futhi okungathuthukisiwe ngokuphumula noma ukulala.
- Ukuqubuka kunoma iyiphi ingxenye yesikhumba sakho.
- Ukuphelelwa umoya.
- Izinguquko ekuhlolweni kwegazi lakho okuhlanganisa nenani eliphezulu lamaseli amhlophe egazi, ama-lymphocyte aphezulu, i-calcium namazinga e-lactate dehydrogenase (LDH).
- Ubuhlungu bamathambo.
- Ukudideka.
- Ukushaya kwenhliziyo okungavamile.
- Ukuqunjelwa - kungaba kubi kakhulu.
- B-izimpawu.
Uma unanoma yiziphi izimpawu nezimpawu ezingenhla bonana nodokotela wendawo (GP) ngokushesha ngangokunokwenzeka. Bazodinga ukukuhlola futhi bakuhlelele izivivinyo nokudluliselwa. Uzodinga ukwelashwa ngokushesha ngemva kokutholakala ukuthi une-Acute ATLL.
Lolu hlobo oluncane luyi-ATLL enolaka neyingozi enkulu. Ibizwa ngokuthi i-lymphomatous ngoba ithinta kakhulu uhlelo lwakho lwe-lymphatic, ngakho-ke izimpawu ezivame kakhulu zihlanganisa:
- Ama-lymph nodes avuvukele ungawabona noma uwazwe entanyeni, emakhwapheni noma emaphethelweni. Lokhu kungenxa yokuthi la ma-lymph nodes aseduze nesikhumba sakho ukuze abonakale futhi azwakale kalula. Ama-lymph nodes avuvukele angatholakala kunoma iyiphi ingxenye yomzimba wakho nge-CT noma i-PET scan.
- Amagciwane okunzima ukuwaqeda noma alokhu ebuya.
- Amazinga aphezulu e-calcium ne-lactate dehydrogenase (LDH) okungenzeka ekuhlolweni kwegazi lakho.
- Isikhumba esiqubukayo noma esilumayo
- Ukuphelelwa umoya.
- Ukudideka.
Uma unanoma yiziphi izimpawu nezimpawu ezingenhla bonana nodokotela wendawo (GP) ngokushesha ngangokunokwenzeka. Bazodinga ukukuhlola futhi bakuhlelele izivivinyo nokudluliselwa. Uzodinga ukwelashwa ngokushesha ngemva kokutholakala ukuthi une-lymphomatous ATLL.
Ama-ATLL angenalutho
I-ATLL engapheli ingaba yingozi enkulu noma ephansi. Ivamise ukukhula kancane ngakho ungase ungaboni noma yiziphi izimpawu ekuqaleni. Izimpawu onazo zingase zibe zimbi kakhulu ngokuhamba kwesikhathi. Ngenxa yalesi sizathu, abantu abaningi babeka izimpawu zabo phansi kwezinye izinto ezifana nokuguga noma ukucindezeleka. Kodwa-ke, izimpawu nezimpawu ezijwayelekile ongazithola uma une-ATLL engapheli yilezi:
- Amazinga aphezulu amaseli amhlophe egazi ekuhlolweni kwegazi. Lezi zingase zibe phezulu ngokuhamba kwesikhathi.
- Ama-lymph nodes avuvukalayo akhula ngosayizi phakathi nesikhathi eside.
- Ubende olukhulisiwe noma isibindi.
- Ukuqubuka noma ukulunywa kwesikhumba sakho.
- Ukuphefumula okuncane okuba kubi kakhulu isikhathi eside (izinyanga kuya eminyakeni).
- Ukukhathala.
- i-albhamuin ephansi
- high lactate dehydrogenase (LDH)
- high blood urea nitrogen (BUN).
Wena ingase ingadingi ukwelashwa ngokushesha uma unengozi ephansi ye-ATLL yezifo ezingamahlalakhona, nokho lokhu kuzoncika ezimpawini zakho nezimpawu zakho futhi uma kuthinta impilo yakho iyonke.
Ngokuvamile uzoqala ukwelashwa ngokushesha ngemva kokuxilongwa kwakho uma usengozini enkulu ye-ATLL.
Ukubhema i-ATLL iwuhlobo oluncane lwe-lymphoma olukhula kancane futhi kuthathwa njengengozi ephansi, noma evumayo ye-ATLL.
Ungase ungazitholi nhlobo izimpawu ngalolu hlobo oluncane. Uma wenza kanjalo, kungenzeka zibe mnene kakhulu futhi zingafaka izilonda noma izilonda (izilonda) esikhumbeni sakho ezingapholi noma ezingapheli. Ungase futhi ube nokuphelelwa umoya okuba kubi kakhulu esikhathini eside (izinyanga kuya eminyakeni).
Ungase ungadingi noma yikuphi ukwelashwa kokushunqa i-ATLL, nokho-ke uma unezilonda esikhumbeni noma imihuzuko ekukhathazayo, ungadinga kuphela ukwelashwa ukuze uthuthukise lezi zimpawu ezifana nokhilimu we-steroid noma imisebe endaweni ethintekile.
Ukwelashwa kwe-T-cell leukemia-lymphoma yabantu abadala (ATLL)
Ukunakekelwa kwe-multidisciplinary
Ezimweni eziningi, i-hematologist yakho izohlangana nabanye odokotela begazi kanye nabanye ochwepheshe bezempilo ukuze baxoxe ngodaba lwakho. Lokhu kuyinto enhle uma une-lymphoma engavamile ngoba uthola abantu abaningi abahlukene, abanolwazi kakhulu ababheka isimo sakho ngabanye ukuze banqume indlela engcono kakhulu yokukusiza, futhi uqiniseke ukuthi uthola okungcono kakhulu okukhethwa kukho kokwelashwa nokunakekelwa okungcono kakhulu.
Ungaphinda ucele udokotela wakho wegazi ukuthi akwethule udaba lwakho ehhovisi I-Australasian Lymphoma T-cell Alliance umhlangano. Lo mhlangano uhlanganisa ndawonye ochwepheshe abavela ezweni lonke abanolwazi lwakamuva ngentuthuko yocwaningo lwama-T-cell lymphomas angavamile. Bangaluleka udokotela wakho wegazi nganoma yiziphi izivivinyo zomtholampilo noma izindlela ezintsha zokwelapha ongakhetha kuzo.
Ngaphambi kokuqala ukwelashwa
Ngaphambi kokuba uqale ukwelashwa kunezinto ezithile okudingeka uzicabangele futhi uzilungiselele. Ukuba nohlu lwezinto okufanele uzenze ngenkathi usalinde ukwelashwa, kungasiza futhi ngokukhathazeka kokulinda, ngoba uzobe usebenza ngokuzimisela ukuze wenze izinto zibe ngcono kuwe.
Ukuzala
Imithi eminingi ingathinta inzalo yakho, ikwenze kube nzima kakhulu noma kungenzeki ukukhulelwa, noma kukhulelise omunye umuntu. Uma uneminyaka yobudala yokuzala, ngisho noma ungacabangi ngokuba nomndeni noma ukwandisa umndeni wakho okwamanje, udinga ukukhuluma nodokotela wakho mayelana nendlela yokulondoloza inzalo yakho, ukuvimbela ukukhulelwa okungafunwa kanye nokuvimbela noma ukulawula ukuphuma esikhathini ngaphambi kwesikhathi noma ukungasebenzi kahle kwe-ovarian.
Imibuzo okufanele uyibuze udokotela wakho
Uma uxilongwa okokuqala, noma uqala ukwelashwa ngemva kokuphinda ugule, kungaba nzima ukucabanga kahle futhi wazi ukuthi imiphi imibuzo okufanele uyibuze. Kodwa kubalulekile ukuthi ube nalo lonke ulwazi olulungile oludingayo ukuze wenze izinqumo mayelana nokunakekelwa kwezempilo kwakho futhi wazi ukuthi yini ongayilindela. Chofoza isixhumanisi esingezansi ukuze ulande Imibuzo ozoyibuza udokotela wakho.
Izinto ezisebenzayo okudingeka uzazi nokuthi uzilungiselela kanjani
Ukuthola ukwelashwa kuzoshintsha impilo yakho kanye nezimpilo zalabo abasondelene nawe okwesikhashana. Kubalulekile ukwazi okufanele ukulindele futhi uzilungiselele. Udinga futhi ukwazi ukuthi yiluphi usizo olutholakalayo kuwe. Senze amanye amathiphu mayelana nezinto ezisebenzayo okufanele uzazi uma wena noma othandekayo une-lymphoma. Chofoza isixhumanisi esingezansi ukuze uthole ulwazi olwengeziwe.
Odokotela bazocabangela izici eziningi mayelana ne-lymphoma kanye nempilo yakho jikelele ukuze banqume ukuthi nini futhi yikuphi ukwelashwa okulungele wena. Bazocabangela:
- Uhlobo oluncane lwe-ATLL onalo - nokuthi kuyingozi ephansi noma ephezulu.
- Noma yiziphi izimpawu onazo.
- Iminyaka yakho yobudala, umlando wezokwelapha odlule, ukuphila kahle ngokomzimba nangokomzwelo.
- Ukuthi wake wathola ukwelashwa kwe-ATLL esikhathini esidlule.
- Ukufaneleka kwakho ukujoyina isilingo somtholampilo.
- Okuncamelayo komuntu siqu ngemva kokuba unikezwe lonke ulwazi oludingayo ukuze wenze isinqumo.
Ukwelashwa komugqa wokuqala
Isikhathi sokuqala uthola ukwelashwa kwe-ATLL kubizwa ngokuthi ukwelashwa komugqa wokuqala. Ivamise ukunikezwa ngemijikelezo futhi ungaba nemijikelezo emi-4, noma emi-6, noma eyi-8 yokwelashwa njengengxenye yokwelashwa kwakho komugqa wokuqala. Mingaki imijikelezo onayo izoncika kuphrothokholi yokwelashwa.
Ukwelashwa okujwayelekile komugqa wokuqala kwe-ATLL engozini enkulu ngokuvamile kuzobandakanya imithi elwa namagciwane ukuze ulawule ukutheleleka kwakho kwe-HTLV-1 futhi kungase kuhlanganise ukwelashwa ngamakhemikhali okungenzeka kube yinoma yikuphi kwalokhu okungezansi.
- CHOP (cyclophosphamide, doxorubicin, vincristine kanye ne-steroid ebizwa ngokuthi i-prednisolone).
- KHETHA (cyclophosphamide, doxorubicin, vincristine, etoposide kanye nesteroid ebizwa ngokuthi i-prednisolone).
- I-Bv-CHP (i-conjugated monoclonal antibody ebizwa ngokuthi i-Brentuximab vedotin, i-cyclophosphamide, i-doxorubicin kanye ne-steroid ebizwa ngokuthi i-prednisolone).
- Umthamo olungisiwe we-EPOCH (i-etoposide, i-vincristine, i-doxorubicin, i-cyclophosphamide kanye ne-steroid ebizwa ngokuthi i-prednisolone).
- I-Hyper-CVAD (i-cyclophosphamide, i-vincristine, i-doxorubicin kanye ne-steroid ebizwa ngokuthi i-dexamethasone) eshintshana nomthamo ophezulu we-methotrexate ne-cytarabine.
- Ukufakelwa kwe-stem cell ingase ifaneleke kwezinye iziguli.
- Cukubamba iqhaza kokuhlolwa kwe-linical.
Uma unengozi ephansi ATLL ngezimpawu ezithambile noma ezingenazo nhlobo, ungase ungadingi nhlobo i-chemotherapy. Kunalokho ungase ube nomuthi ovimbela amagciwane ukwelapha i-HTLV-1 kanye nanoma yiziphi izinketho zokwelapha ezingezansi.
- 'Buka futhi ulinde' (ukuqapha okusebenzayo).
- Ama-steroid creams of lotions ukuthuthukisa izimpawu zokuqubuka kwesikhumba nokuluma.
- I-Radiotherapy.
Ukuphathwa kabusha kwe-ATLL noma okuphikisayo
I-ATLL ivamise ukuphendula kahle ku-Immunochemotherapy, kodwa ivame ukubuya (ebuyela emuva), noma ezimweni ezingavamile ayiphenduli ekwelashweni kokuqala (ephikisayo). Uma lokhu kwenzeka, ungase ufaneleke ukuthola izinhlobo ezahlukene zokwelashwa noma izivivinyo zomtholampilo.
Ezinye izindlela zokwelapha ongase unikezwe zona zibalwe ngezansi, nokho, ngocwaningo oluqhubekayo kanye nezivivinyo zomtholampilo ezithuthukisa ukwelashwa kwabantu abane-lymphomas ebuyele emuva kanye ne-refractory, ungase unikezwe okuthile okuhlukile kulokhu okungezansi.
- I-DHAP (i-dexamethasone, i-cytarabine ne-cisplatin)
- ESHAP (i-detoposide, i-methylprednisolone, i-cytarabine ne-cisplatin)
- I-GDP (i-gemcitabine, i-dexamethasone ne-cisplatin)
- ICE (i-ifosfamide, i-carboplatin ne-etoposide)
Ukuqeda ukwelashwa
Ukuqeda ukwelashwa kungaba okujabulisayo, noma isikhathi esikhathazayo kakhulu kuwe. Kungase kukwenze uzizwe ujabule futhi ukhathazekile. Kungokwemvelo ukuzwa imizwa eminingi eyahlukene lapho uqeda ukwelashwa. Futhi, noma ngabe ubhekane kahle nokwelashwa, ungathola ukuthi lapho yonke into seyehlile futhi usunesikhathi sokucabanga ngalokho odlule kukho, nokuthi ungabuyela kanjani ohlotsheni oluthile lwempilo olufana nempilo yangaphambi kokwelashwa, uba ekhungathekile.
Kufanele futhi ubhekane nemizwa yabanye abakuzungezile kanye nalokho abakulindele. Iziguli eziningi zisho ukuthi kunzima kangakanani lapho abantu abaseduze kwazo belindele ukuthi zibuyele kwesejwayelekile isikhathi eside ngaphambi kokuba zilunge.
Ngakolunye uhlangothi, ezinye iziguli zike zasho ukuzizwa sengathi abantu abaseduze kwazo babambelela ngokuqinile futhi bangabavumeli babuyele esimeni sabo, ngoba besaba ukuthi kungase kwenzeke okunye.
Sinamathiphu wokuthi yini ongayilindela, nendlela yokulawula imizwa, kanye nokulindelwe kwabanye ekhasini lethu lewebhu elithi Ukuqeda ukwelashwa.
Landelela
Uzoqhubeka nokubonana nodokotela wakho wegazi noma i-oncologist njalo ngisho nangemva kokuphela kokwelashwa. Bazokuhlolela noma yimiphi imiphumela emibi eqhubekayo yokwelashwa, nanoma yimiphi imiphumela emibi engase yenzeke ezinyangeni noma ngisho neminyaka ngemva kokuphela kokwelashwa. Ungathola ulwazi olwengeziwe mayelana nemiphumela yakamuva ngokuchofoza ku- imiphumela emibi yokwelashwa isixhumanisi ngenhla.
Bazobe futhi bekuhlola izimpawu zakho zokuthi i-lymphoma ibuyela emuva ukuze noma yikuphi ukwelashwa okudingekile kuqale ngokushesha okukhulu.
Ama-aphoyintimenti akho okulandelela angase ahlanganise noma yikuphi kokungezansi:
- PET noma CT scan kanye nemiphumela
- Ukuhlolwa kwegazi
- Ukuhlolwa ngokomzimba kwama-lymph nodes akho
- Imibuzo mayelana nokuthi uzizwa kanjani, kanye nokuzivumelanisa nempilo ngemva kokwelashwa.
- Ukudluliselwa kokunakekelwa okwengeziwe uma kudingeka.
Isifinyezo
- I-ATLL iwuhlobo olungavamile kakhulu lwe-T-cell Non-Hodgkin Lymphoma. Ingase futhi iqoqwe njenge-subtype ye-Peripheral T-cell Lymphoma.
- I-ATLL inezinhlobo ezincane ezi-4 ezihlukene, futhi zingase zibe amakilasi engcuphe ephansi noma ephezulu kuye ngokuthi inolaka kangakanani, nokuthi iwuthinta kanjani umzimba wakho.
- Ungase ungabi nazo izimpawu, noma izimpawu ezithambile kakhulu kuphela uma unengozi ephansi, i-indolent lymphoma.
- Bika konke okusha noma okubi kakhulu izimpawu kudokotela wakho ukuze aphenywe, ikakhulukazi ama-rashes angapheli, ama-lymph node avuvukile or B-izimpawu.
- I-biopsy iyadingeka ukuze kuqinisekiswe ukuhlonzwa kwe-ATLL - kwesinye isikhathi kudingeka okungaphezu kokukodwa.
- Uma unobungozi obuphansi be-ATLL ungase ungakudingi ukwelashwa, kodwa i-ATLL esengozini enkulu izodinga ukwelashwa ngokushesha okukhulu.
- I-ATLL ingasabela kahle ekwelashweni, kodwa imvamisa iphinda idinga ukwelashwa okwengeziwe.
- Buza udokotela wakho mayelana nezivivinyo zomtholampilo ongase ukufanelekele.
- Uzoqhubeka nokubonana nodokotela wakho we-hematologist noma oncologist ukuze uhlolwe njalo ngisho nangemva kokuphela kokwelashwa.
