Uhlolojikelele lwe-Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL)
I-CLL ivame kakhulu kune-SLL futhi ingumdlavuza we-B-cell ovamile wesibili ovamile, kubantu abangaphezu kweminyaka engama-70 ubudala. Kuvame kakhulu emadodeni kunakwabesifazane, futhi akuvamile ukuthi kuthinte abantu abangaphansi kweminyaka engama-40 ubudala.
Ama-lymphomas amaningi angasebenzi ayelapheki, okusho ukuthi uma usutholwe une-CLL/SLL, uzoba nayo impilo yakho yonke. Nokho, ngenxa yokuthi ikhula kancane abanye abantu bangaphila impilo egcwele ngaphandle kwezimpawu futhi abasoze badinga noma yikuphi ukwelashwa. Abanye abaningi kodwa, bazothola izimpawu ngesikhathi esithile futhi badinga ukwelashwa.
Ukuze uqonde i-CLL/SLL, udinga ukwazi kancane ngama-lymphocyte e-B-Cell akho
I-B-Cell lymphocyte:
- zenziwa emnkantsheni wakho (ingxenye eyisiponji phakathi kwamathambo akho), kodwa ngokuvamile zihlala kubende bakho kanye nama-lymph nodes akho.
- ziwuhlobo lwamangqamuzana amhlophe egazi.
- ukulwa nezifo kanye nezifo ukuze uhlale unempilo.
- khumbula izifo obunazo esikhathini esidlule, ngakho-ke uma uthola isifo esifanayo futhi, amasosha omzimba wakho angalwa nakho ngempumelelo nangokushesha.
- ungahamba ohlelweni lwakho lwe-lymphatic, uye kunoma iyiphi ingxenye yomzimba wakho ukuze ulwe nokutheleleka noma izifo.
Kwenzekani kuma-B-cell akho uma une-CLL/SLL?
Uma une-CLL / SLL yakho ye-B-cell lymphocyte:
- ziba ngendlela engavamile futhi zikhule ngokungalawuleki, okuholela kuma-B-cell lymphocyte amaningi kakhulu.
- angafi lapho kufanele enze amaseli amasha anempilo.
- zikhula ngokushesha kakhulu, ngakho ngokuvamile azikhuli kahle futhi azikwazi ukusebenza kahle ukulwa nokutheleleka kanye nezifo.
- kungathatha indawo enkulu emnkantsheni wakho kangangokuthi amanye amangqamuzana akho egazi, njengamangqamuzana abomvu egazi nama- platelet angase angakwazi ukukhula kahle.
Ukuqonda i-CLL/SLL
USolwazi Con Tam, uchwepheshe we-hematologist ozinze eMelbourne we-CLL/SLL uchaza i-CLL/SLL futhi uphendula eminye yemibuzo ongase ube nayo.
Le vidiyo yaqoshwa ngoSepthemba 2022
Okuhlangenwe nakho kwesiguli nge-CLL
Noma ngabe lungakanani ulwazi oluthola kodokotela nabahlengikazi bakho, kusengasiza ukuzwa kothile oke wahlangabezana ne-CLL/SLL mathupha.
Ngezansi sinevidiyo yendaba kaWarren lapho yena nomkakhe uKate babelana ngolwazi lwabo ne-CLL. Chofoza kuvidiyo uma ungathanda ukuyibuka.
Izimpawu ze-CLL / SLL
I-CLL/SLL iwumdlavuza okhula kancane, ngakho ungase ungabi nazo izimpawu ngesikhathi uxilongwa. Ngokuvamile, uzotholakala ngemva kokuhlolwa kwegazi, noma ukuhlolwa komzimba kokunye. Eqinisweni, abantu abaningi abane-CLL/SLL baphila impilo ende enempilo. Kodwa-ke, ungase ube nezimpawu ngesinye isikhathi ngenkathi uhlala ne-CLL / SLL.
Izimpawu ongase uzithole
- ukhathele ngokungavamile (ukhathele). Lolu hlobo lokukhathala alubi ngcono ngemva kokuphumula noma ukulala
- ephelelwa umoya
- imihuzuko noma ukopha kalula kunokujwayelekile
- izifo ezingapheli, noma ezilokhu zibuya
- ukujuluka ebusuku ngaphezu kokujwayelekile
- ukulahlekelwa isisindo ngaphandle kokuzama
- isigaxa esisha entanyeni yakho, ngaphansi kwezingalo zakho, igroin yakho, noma ezinye izindawo zomzimba wakho - lezi zivame ukungabi nabuhlungu
- Izibalo zegazi eziphansi njenge:
- I-anemia - i-hemoglobin ephansi (Hb). I-Hb iyiphrotheni emangqamuzaneni akho abomvu egazi athwala umoya-mpilo emzimbeni wakho.
- I-Thrombocytopenia - amaplatelet aphansi. Ama-platelet asiza igazi lakho ukuthi lihlule ukuze ungophi futhi ugwaze kalula. Ama-platelet abizwa nangokuthi ama-thrombocyte.
- I-Neutropenia - Amangqamuzana amhlophe egazi aphansi abizwa ngokuthi ama-neutrophils. Ama-neutrophils alwa nokutheleleka kanye nezifo.
- B-Izimpawu (bona isithombe)
Isikhathi sokufuna iseluleko sezokwelapha
Ngokuvamile kuba nezinye izizathu zalezi zimpawu, njengokutheleleka, amazinga okusebenza, ingcindezi, imithi ethile noma ukungezwani komzimba nezinto ezithile. Kodwa kubalulekile ukuthi wena bonana nodokotela wakho uma uhlangabezana nanoma iyiphi yalezi zimpawu ezihlala isikhathi esingaphezu kwesonto, noma uma zivela ngokuzumayo ngaphandle kwesizathu esaziwayo.
Itholwa kanjani i-CLL/SLL
Kungaba nzima kudokotela wakho ukuxilonga i-CLL/SLL. Izimpawu zivame ukungaqondakali, futhi zifana nalezo ongase ube nazo kwezinye izifo ezivame kakhulu, ezifana nezifo kanye nokungezwani komzimba. Ungase ungabi nazo izimpawu, ngakho-ke kunzima ukwazi ukuthi ungayibheka nini i-CLL/SLL. Kodwa uma uya kudokotela wakho nanoma yiziphi izimpawu ezingenhla, angase afune ukuhlola igazi nokuhlola umzimba.
Uma besola ukuthi ungase ube nomdlavuza wegazi njenge-lymphoma noma i-leukemia, bazoncoma ukuhlolwa okwengeziwe ukuze bathole isithombe esingcono salokho okwenzekayo.
Ama-biopsies
Ukuxilonga i-CLL/SLL 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.
I-Bone Marrow biopsy
Le biopsy ithatha isampula emnkantsheni wakho phakathi kwethambo lakho. Ngokuvamile kuthathwa kusukela okhalweni, kodwa kuye ngezimo zakho ngabanye, kungase futhi kuthathwe kwamanye amathambo njengethambo lakho lesifuba (sternum).
Uzonikezwa isibulali-zinzwa sendawo futhi ungase ube nokuthobisa, kodwa uzobe uphaphamele inqubo. Ungase futhi unikezwe imithi yokudambisa izinhlungu. Udokotela uzofaka inaliti esikhumbeni sakho nasethanjeni lakho ukuze akhiphe isampula lomnkantsha wethambo.
Ungase unikezwe ingubo ozoyishintsha noma ukwazi ukugqoka izingubo zakho. Uma ugqoka izingubo zakho, qiniseka ukuthi zikhululekile futhi unikeze ukufinyelela okulula ku-hip yakho.
Ukuhlola ama-biopsies akho
Ukuhlolwa kwe-biopsy kanye negazi kuzothunyelwa ku-pathology futhi kubhekwe ngaphansi kwesibonakhulu. Ngale ndlela odokotela bangathola ukuthi i-CLL/SLL isemnkantsheni wakho, egazini kanye nama-lymph nodes, noma uma ikhawulelwe endaweni eyodwa noma ezimbili kuphela zalezi zindawo.
I-pathologist izokwenza olunye uhlolo kuma-lymphocyte akho olubizwa nge-“flow cytometry”. Lokhu ukuhlola okukhethekile kokubheka noma yimaphi amaprotheni noma “omaka bendawo yeseli” kuma-lymphocyte akho asiza ukuxilonga i-CLL/SLL, noma ezinye izinhlobo ezincane ze-lymphoma. Lawa maphrotheni nomaka anganikeza udokotela ulwazi mayelana nokuthi yiluphi uhlobo lokwelapha olungakusebenzela kangcono.
Ilinde imiphumela
Kungathatha amaviki ambalwa ukuze uthole yonke imiphumela yokuhlolwa kwakho. Ukulinda le miphumela kungaba isikhathi esinzima kakhulu. Kungasiza ukukhuluma nomndeni noma abangani, ikhansela noma ukuxhumana nathi e-Lymphoma Australia. Ungathintana nabahlengikazi bethu beLymphoma ngokuthumela i-imeyili nurse@lymphoma.org.au noma ushayele ku-1800 953 081.
Ungase futhi uthande ukujoyina elinye lamaqembu ethu ezinkundla zokuxhumana ukuze uxoxe nabanye abake baba sesimweni esifanayo. Ungasithola ku:
Ukufakwa kwe-CLL / SLL
Isiteji yindlela udokotela wakho angachaza ngayo ukuthi ungakanani umzimba wakho othintwa yi-lymphoma, nokuthi amangqamuzana e-lymphoma akhula kanjani.
Kungase kudingeke wenze ezinye izivivinyo ezengeziwe ukuze uthole isiteji sakho.
Ukuze uthole okwengeziwe mayelana nesiteji, sicela uchofoze ama-toggles angezansi.
Izivivinyo ezengeziwe ongase ube nazo ukuze ubone ukuthi i-CLL/SLL yakho isisabalale kangakanani zifaka:
- Iskena se-Positron emission tomography (PET). Lesi iskena sakho umzimba wonke ekhanyisa izindawo ezingase zithintwe i-CLL/SLL. Imiphumela ingase ibukeke ifana nesithombe esingakwesokunxele.
- I-Computed tomography (CT) scan. Lokhu kunikeza ukuskena okunemininingwane eminingi kune-X-ray, kodwa yendawo ethile njengesifuba sakho noma isisu.
- I-Lumbar puncture - Udokotela wakho uzosebenzisa inaliti ukuze athathe isampula yoketshezi eduze komgogodla wakho. Lokhu kwenzelwa ukuhlola ukuthi i-lymphoma yakho isengqondweni noma emgogodleni wakho. Ungase ungakudingi lokhu kuhlolwa, kodwa udokotela wakho uzokwazisa uma ukwenza kanjalo.
Omunye umehluko omkhulu ku-CLL/SLL (ngaphandle kwendawo yawo) usendleleni ezihlelwa ngayo.
Kusho ukuthini ukwenza isiteji?
Ngemuva kokuthi usuxilongwa, udokotela wakho uzobheka yonke imiphumela yakho yokuhlolwa ukuze athole ukuthi i-CLL/SLL yakho ikusiphi isigaba. Isiteji sitshela udokotela:
- ingakanani i-CLL/SLL emzimbeni wakho
- zingaki izindawo zomzimba wakho ezinama-B-cell anomdlavuza kanye
- ukuthi umzimba wakho ubhekana kanjani nalesi sifo.
Lolu hlelo lwesiteji luzobheka i-CLL yakho ukubona ukuthi uyakwenza, noma awunakho kwalokhu okulandelayo:
- amazinga aphezulu e-lymphocyte egazini lakho noma emnkantsheni wakho - lokhu kubizwa nge-lymphocytosis (lim-foe-cy-toe-sis)
- ukuvuvukala kwama-lymph nodes - lymphadenopathy (limf-a-den-op-ah-thee)
- i-spleen ekhulisiwe - i-splenomegaly (i-splen-oh-meg-ah-lee)
- amazinga aphansi amangqamuzana egazi abomvu egazini lakho - anemia (a-nee-mee-yah)
- amazinga aphansi eplatelet egazini lakho – thrombocytopenia (throm-bow-cy-toe-pee-nee-yah)
- isibindi esikhulisiwe - i-hepatomegaly (hep-at-o-meg-a-lee)
Kusho ukuthini isigaba ngasinye
| Isigaba se-RAI 0 | I-Lymphocytosis futhi akukho ukwanda kwama-lymph nodes, i-spleen, noma isibindi, kanye nenani legazi elibomvu eliseduze nezibalo zeplatelet. |
| Isigaba se-RAI 1 | I-Lymphocytosis kanye nama-lymph nodes akhulisiwe. Ubende nesibindi akukhulisiwe futhi inani lamangqamuzana egazi abomvu kanye nenani leplatelet livamile noma liphansi kancane. |
| Isigaba se-RAI 2 | I-Lymphocytosis kanye ne-spleen ekhulisiwe (futhi mhlawumbe isibindi esikhulisiwe), noma ngaphandle kwama-lymph nodes. Amangqamuzana egazi abomvu nezibalo zeplatelet zivamile noma ziphansi kancane |
| Isigaba se-RAI 3 | I-Lymphocytosis kanye ne-anemia (amangqamuzana egazi abomvu ambalwa kakhulu), anama-lymph node akhulisiwe, ubende, noma isibindi. Izibalo zamaplatelet ziseduze kokujwayelekile. |
| Isigaba se-RAI 4 | I-Lymphocytosis plus thrombocytopenia (ama-platelet ambalwa kakhulu), ane-anemia noma ngaphandle kwayo, ama-lymph nodes akhulisiwe, i-spleen, noma isibindi. |
*I-Lymphocytosis isho ama-lymphocyte amaningi kakhulu egazini lakho noma umnkantsha
Isiteji sakho sisetshenzwa ku-:
- inombolo kanye nendawo ye-lymph nodes ethintekile
- uma ama-lymph nodes athintekile engaphezulu, ngezansi noma ezinhlangothini zombili ze-diaphragm (I-diaphragm yakho iyisiphakeli esikhulu, esimise okwedome ngaphansi kwezimbambo zakho esihlukanisa isifuba sakho nesisu sakho)
- uma isifo sifinyelele umongo noma kwezinye izitho zesibindi, amaphaphu, ithambo noma isikhumba
| isigaba 1 | indawo eyodwa ye-lymph node iyathinteka, noma ngaphezulu noma ngaphansi kwe-diaphragm* |
| isigaba 2 | izindawo ezimbili noma ngaphezulu zama-lymph node zithinteka ohlangothini olulodwa lwe-diaphragm* |
| isigaba 3 | okungenani indawo eyodwa ye-lymph node ngaphezulu kanye ne-lymph node eyodwa engaphansi kwe-diaphragm* iyathinteka |
| isigaba 4 | i-lymphoma itholakala kuma-lymph nodes amaningi futhi isisakazekele kwezinye izingxenye zomzimba (isb., amathambo, amaphaphu, isibindi) |
Ukwengeza, kungase kube nohlamvu “E” ngemva kokuthatha isiteji. I-E isho ukuthi une-SLL ethile esithweni esingaphandle kwesistimu yakho ye-lymphatic, njengesibindi, iphaphu, amathambo noma isikhumba. | |
Imibuzo kadokotela wakho ngaphambi kokuba uqale ukwelashwa
Ukuqokwa kodokotela kungase kukucindezele futhi ukufunda ngesifo sakho kanye nokwelashwa okungenzeka kufane nokufunda ulimi olusha. Lapho ufunda
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.
Ukuqonda izakhi zofuzo ze-CLL / SLL
Ziningi izici zofuzo ezingase zibandakanyeke ku-CLL/SLL yakho. Abanye kungenzeka babe negalelo ekuthuthukisweni kwesifo sakho, kanti abanye banikeza ulwazi oluwusizo mayelana nokuthi yiluphi uhlobo olungcono kakhulu lokwelapha olulungele wena. Ukuze uthole ukuthi yiziphi izici zofuzo ezihilelekile uzodinga ukuthi kwenziwe ukuhlolwa kwe-cytogenetic.
Ukuhlolwa kwe-Cytogenetic
Ukuhlolwa kwe-Cytogenetics kwenziwa egazini lakho nama-biopsies ukuze ubheke izinguquko kuma-chromosome akho noma izakhi zofuzo. Sivamise ukuba namapheya angama-23 ama-chromosome, kodwa uma une-CLL/SLL ama-chromosome akho angase abukeke ehluke kancane.
Ama-Chromosomes
Wonke amangqamuzana omzimba wethu (ngaphandle kwamangqamuzana egazi abomvu) anenucleus okuyindawo lapho kutholakala khona ama-chromosome ethu. Ama-chromosome angaphakathi kwamangqamuzana ayimicu emide ye-DNA (deoxyribonucleic acid). I-DNA iyingxenye eyinhloko ye-chromosome ephethe imiyalelo yengqamuzana futhi le ngxenye ibizwa ngokuthi isakhi sofuzo.
Izitshalo
Izakhi zofuzo zitshela amaprotheni namaseli emzimbeni wakho ukuthi kufanele abukeke noma enze kanjani. Uma kunoshintsho (ukushintshashintsha noma ukushintshashintsha) kulawa ma-chromosome noma izakhi zofuzo, amaprotheni namangqamuzana akho ngeke asebenze kahle futhi ungahlakulela izifo ezihlukahlukene. Nge-CLL/SLL lezi zinguquko zingashintsha indlela i-B-cell lymphocyte yakho ekhula ngayo futhi ikhule, ibenze babe nomdlavuza.
Izinguquko ezintathu eziyinhloko ezingenzeka nge-CLL/SLL zibizwa ngokuthi ukususwa, ukudluliselwa kanye noguquko.
Izinguquko ezivamile ku-CLL/SLL
Ukususwa yilapho ingxenye ye-chromosome yakho ingekho. Uma ukususwa kwakho kuyingxenye ye-chromosome ye-13 noma ye-17 kubizwa ngokuthi i-“del(13q)” noma i-“del(17p)”. U-“q” kanye no-“p” atshela udokotela ukuthi iyiphi ingxenye yechromosome engekho. Kuyafana nakwezinye izinto ezisusiwe.
Uma une-translocation, kusho ukuthi ingxenye encane yama-chromosomes amabili - i-chromosome 11 kanye ne-chromosome 14 njengesibonelo, ishintshana ngezindawo. Uma lokhu kwenzeka, kubizwa ngokuthi “t(11:14)”.
Uma unokuguquguquka, kungase kusho ukuthi une-chromosome eyengeziwe. Lokhu kubizwa nge-Trisomy 12 (i-chromosome ye-12 eyengeziwe). Noma ungase ube nokunye ukuguqulwa okubizwa nge-IgHV mutation noma Tp53 mutation. Zonke lezi zinguquko zingasiza udokotela wakho ukuthi akutholele ukwelashwa okungcono kakhulu., ngakho-ke sicela uqinisekise ukuthi ucela udokotela wakho ukuthi akuchazele izinguquko zakho ngazinye.
Uzodinga ukuhlolwa kwe-cytogenetic uma kutholakala ukuthi une-CLL/SLL nangaphambi kokwelashwa. Ukuhlolwa kwe-Cytogenetic yilapho usosayensi ebheka igazi lakho nesampula yesimila, ukuze ahlole ukuhlukahluka kofuzo (ukuguqulwa kwezakhi zofuzo) okungenzeka kuhileleke esifweni sakho.
Wonke umuntu one-CLL/SLL kufanele abe nokuhlolwa kofuzo ngaphambi kokuba uqale ukwelashwa.
Okunye kwalokhu kuhlola uzodinga ukuthi ube nakho kanye kuphela ngoba imiphumela ihlala injalo kukho konke ukuphila kwakho. Okunye ukuhlolwa, kungase kudingeke ukuba ube nakho ngaphambi kwakho konke ukwelashwa, noma ngezikhathi ezihlukahlukene kulo lonke uhambo lwakho nge-CLL/SLL. Lokhu kungenxa yokuthi ngokuhamba kwesikhathi, ukuguqulwa kofuzo okusha kungenzeka ngenxa yokwelashwa, isifo sakho noma ezinye izici.
Ukuhlolwa okuvame kakhulu kwe-cytogenetic ozoba nakho kufaka phakathi:
Isimo sokuguqulwa kwe-IgHV
Kufanele ube nalokhu ngaphambi kokwelashwa kokuqala kuphela. I-IgHV ayishintshi ngokuhamba kwesikhathi, ngakho idinga ukuhlolwa kanye kuphela. Lokhu kuzobikwa njenge-IgHV eguquliwe noma i-IgHV engashintshiwe.
Ukuhlolwa kwe-FISH
Kufanele ube nalokhu ngaphambi kokuqala kanye nakho konke ukwelashwa. Izinguquko zofuzo ekuhlolweni kwakho kwe-FISH zingashintsha ngokuhamba kwesikhathi, ngakho-ke kunconywa ukuthi ihlolwe ngaphambi kokuqala ukwelashwa okokuqala, futhi njalo kukho konke ukwelashwa kwakho. Ingabonisa uma unokususwa, ukuthutha noma i-chromosome eyengeziwe. Lokhu kuzobikwa njengokuthi del(13q), del(17p), t(11:14) noma i-Trisomy 12. Nakuba lezi kuyizinhlobonhlobo ezivame kakhulu kubantu abane-CLL/SLL ungase ube nokwehluka okuhlukile, nokho ukubika kuzoba ezifana nalezi.
(INHLANZI imele Fi-luorescent In Situ Hi-ybridation futhi kuyindlela yokuhlola eyenziwa ku-pathology)
Isimo sokuguqulwa kwe-TP53
Kufanele ube nalokhu ngaphambi kokuqala kanye nakho konke ukwelashwa. I-TP53 ingashintsha ngokuhamba kwesikhathi, ngakho-ke kunconywa ukuthi ihlolwe ngaphambi kokuqala ukwelashwa okokuqala, futhi njalo kukho konke ukwelashwa kwakho. I-TP53 iwufuzo oluhlinzeka ngekhodi yephrotheni ebizwa nge-p53 ukuthi yenziwe. I-p53 iyisimila esicindezela amaprotheni futhi ivimba amaseli anomdlavuza ukuthi angakhuli. Uma unokuguqulwa kwe-TP53, ungase ungakwazi ukwenza iphrotheni ye-p53, okusho ukuthi umzimba wakho awukwazi ukuvimba amangqamuzana anomdlavuza ukuthi athuthuke.
Kungani kubalulekile?
Kubalulekile ukukuqonda lokhu njengoba sazi ukuthi akubona bonke abantu abane-CLL/SLL abanokuhlukahluka kofuzo okufanayo. Izinhlobonhlobo zinikeza ulwazi kudokotela wakho mayelana nohlobo lokwelashwa olungase lusebenze, noma okungenzeka lungasebenzi ku-CLL/SLL yakho ethile.
Sicela ukhulume nodokotela wakho mayelana nalokhu kuhlolwa nokuthi imiphumela yakho isho ukuthini ngezinketho zakho zokwelapha.
Ngokwesibonelo, siyazi uma unokuguqulwa kwe-TP53, i-IgHV engashintshiwe noma i-del(17p) akufanele uthole ukwelashwa ngamakhemikhali. njengoba ingeke ikusebenzele. Kodwa lokhu akusho ukuthi akukho ukwelashwa. Kukhona ukwelashwa okuhlosiwe okutholakalayo okungasebenza kahle kubantu abanalokhu kuhluka. Sizoxoxa ngalokhu esigabeni esilandelayo.
Ukwelashwa kwe-CLL/SLL
Uma yonke imiphumela yakho evela ku-biopsy, ukuhlolwa kwe-cytogenetic kanye nezikena zesiteji sekuqediwe, udokotela wakho uzobuyekeza lokhu ukuze anqumele ukwelashwa okungcono kakhulu ongakuthola. Kwezinye izikhungo zomdlavuza, udokotela wakho angase futhi ahlangane nethimba lochwepheshe ukuze baxoxe ngendlela yokwelapha engcono kakhulu. Lokhu kubizwa ngokuthi a ithimba le-multidisciplinary (MDT) umhlangano.
Lukhethwa kanjani uhlelo lwami lokwelapha?
Udokotela wakho uzobheka izinto eziningi mayelana ne-CLL/SLL yakho. Izinqumo zokuthi udinga nini ukuqala nokuthi yikuphi ukwelashwa okungcono kakhulu zisekelwe kulokhu:
- isigaba sakho ngasinye se-lymphoma, izinguquko zofuzo kanye nezimpawu
- iminyaka yakho, umlando wezokwelapha odlule kanye nempilo jikelele
- ukuphila kwakho kwamanje ngokomzimba nangokwengqondo kanye nezintandokazi zakho zesiguli.
Okunye ukuhlolwa
Udokotela wakho uzo-oda ukuhlolwa okwengeziwe ngaphambi kokuba uqale ukwelashwa ukuze aqinisekise ukuthi inhliziyo, amaphaphu nezinso zakho ziyakwazi ukubhekana nokwelashwa. Ukuhlola okwengeziwe kungase kuhlanganise i-ECG (electrocardiogram), ukuhlolwa kokusebenza kwamaphaphu noma ukuqoqwa komchamo wamahora angu-24.
Udokotela wakho noma umhlengikazi womdlavuza angakuchazela ngohlelo lwakho lokwelapha kanye nemiphumela engemihle engase ibe khona kuwe. Bangakwazi futhi ukuphendula noma yimuphi umbuzo ongase ube nawo. Kubalulekile ukuthi ubuze udokotela wakho kanye/noma unesi womdlavuza imibuzo nganoma yini ongayiqondi.
Xhumana nathi
Ukulinda imiphumela yakho kungaba isikhathi sokucindezeleka nokukhathazeka okwengeziwe kuwena nakwabathandekayo bakho. Kubalulekile ukuthuthukisa inethiwekhi eqinile yokusekela ngalesi sikhathi. Uzowadinga uma nawe welashwa.
I-Lymphoma Australia ingathanda ukuba yingxenye yenethiwekhi yakho yosekelo. Ungashayela ucingo noma uthumele i-imeyili ku-Lymphoma Australia Nurse Helpline ngemibuzo yakho futhi singakusiza ukuthi uthole ulwazi olulungile. Ungaphinda ujoyine amakhasi ethu ezinkundla zokuxhumana ukuze uthole ukwesekwa okwengeziwe. Ikhasi lethu le-Lymphoma Down Under ku-Facebook liyindawo enhle yokuxhumana nabanye abase-Australia naseNew Zealand abaphila ne-lymphoma.
Inombolo yocingo yomhlengikazi we-Lymphoma:
Ifoni: 1800 953 081
Email: nurse@lymphoma.org.au
Izinketho zokwelapha zingabandakanya noma yikuphi okulandelayo:
Buka bese ulinda (ukuqapha okusebenzayo)
Cishe abantu abangu-1 kwabayi-10 abane-CLL/SLL kungenzeka bangadingi ukwelashwa. Ingase ihlale izinzile ngaphandle kwezimpawu ezincane noma ezingenazo zonke izinyanga noma iminyaka. Kodwa abanye benu bangase babe nemijikelezo eminingana yokwelashwa elandelwa ukukhululwa. Uma ungakudingi ukwelashwa ngokushesha noma unesikhathi phakathi kokukhishwa, uzophathwa ngewashi nokulinda (okubizwa nangokuthi ukuqapha okusebenzayo). Ziningi izindlela zokwelapha ezinhle ze-CLL ezitholakalayo, ngakho-ke zingalawulwa iminyaka eminingi.
Ukunakekela okusekelayo
Ukunakekelwa okusekelayo kuyatholakala uma ubhekene nesifo esibi. Kungakusiza ube nezimpawu ezimbalwa, futhi ube ngcono ngokushesha.
Amangqamuzana omdlavuza wegazi (ama-B-cell anomdlavuza egazini lakho umnkantsha) angase akhule ngokungalawuleki futhi aminyene umnkantsha wakho, umgudu wegazi, ama-lymph nodes, isibindi noma ubende. Ngenxa yokuthi umnkantsha ugcwele amaseli e-CLL/SLL mancane kakhulu ukuthi angasebenza kahle, amaseli akho egazi ajwayelekile azothinteka. Ukwelashwa okusekelayo kungase kuhlanganise izinto ezifana nokuthi umpontshelwa igazi noma i-platelet, noma ungase ube nama-antibiotics ukuvimbela noma ukwelapha izifo.
Ukunakekelwa okusekelayo kungase kuhilele ukubonisana nethimba lokunakekelwa okukhethekile (njenge-cardiology uma unezinkinga ngenhliziyo yakho) noma ukunakekelwa kwe-palliative ukuze ulawule izimpawu zakho. Kungaba futhi ukuba nezingxoxo mayelana nezintandokazi zakho zezidingo zakho zokunakekelwa kwezempilo esikhathini esizayo. Lokhu kubizwa nge-Advanced Care Planning.
Ukunakekelwa kwe-palliative
Kubalulekile ukwazi ukuthi ithimba Lokunakekela I-Palliative Care lingabizwa noma nini phakathi nendlela yakho yokwelashwa hhayi nje ekupheleni kwempilo. Amathimba okunakekela i-Palliative alungile ekwesekeni abantu ngezinqumo okudingeka bazenze ngasekupheleni kwempilo yabo. Kodwa, abavele babheke abantu abafayo. Futhi bangochwepheshe ekulawuleni kanzima ukulawula izimpawu nganoma yisiphi isikhathi kulo lonke uhambo lwakho nge-CLL / SLL. Ngakho ungesabi ukucela imibono yabo.
Uma wena nodokotela wakho ninquma ukusebenzisa ukunakekelwa okusekelayo, noma ukuyeka ukwelashwa kwe-lymphoma yakho, izinto eziningi zingenziwa ukuze zikusize uhlale unempilo futhi unethezekile ngangokunokwenzeka isikhathi esithile.
I-Chemotherapy (i-chemo)
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.
I-Monoclonal Antibody (MAB)
Ungase ube ne-MAB infusion emtholampilo womdlavuza noma esibhedlela. Ama-MAB anamathela kuseli ye-lymphoma futhi ahehe ezinye izifo ezilwa namangqamuzana egazi amhlophe namaprotheni kumdlavuza. Lokhu kusiza amasosha akho omzimba ukulwa ne-CLL / SLL.
I-Chemo-immunotherapy
I-Chemotherapy (isibonelo, i-FC) ehlanganiswe ne-immunotherapy (isibonelo, i-rituximab). Ukuqala komuthi we-immunotherapy kuvame ukungezwa esifinyezweni somuthi we-chemotherapy, njenge-FCR.
Ukwelapha okuhlosiwe
Ungawathatha njengethebhulethi ekhaya 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 amaseli e-lymphoma afe. Ukuze uthole ulwazi olwengeziwe ngalezi zindlela zokwelapha, sicela ubheke eyethu Iphepha lemininingwane lemithi yokwelapha ngomlomo.
Ukufakelwa kwe-stem cell (SCT)
Uma usemncane futhi unolaka (olukhula ngokushesha) i-CLL/SLL, i-SCT ingasetshenziswa, kodwa lokhu akuvamile. Ukuze ufunde kabanzi mayelana nokufakelwa kwe-stem cell sicela ubheke ama- factsheets Ukufakelwa kwe-Lymphoma
Ukuqala Ukwelapha
Abantu abaningi abane-CLL/SLL ngeke badinge ukwelashwa lapho bexilongwa okokuqala. Kunalokho, uzolinda futhi ulinde. Lokhu kuvamile kubantu abanesifo sesigaba 1 noma sesi-2, ngisho nabanye abantu abanesifo sesigaba sesi-3.
Uma une-stage 3 noma 4 CLL/SLL kungase kudingeke ukuthi uqale ukwelashwa. Uma uqala ukwelashwa okokuqala, kubizwa ngokwelashwa komugqa wokuqala. Ungase ube nemithi engaphezu kowodwa, futhi lokhu kungase kuhlanganise ukwelashwa ngamakhemikhali, i-monoclonal antibody noma ukwelashwa okuhlosiwe.
Uma unalezi zindlela zokwelapha, uzoba nazo ngemijikelezo. Lokho kusho ukuthi uzothola ukwelashwa, bese uthola ikhefu, bese kuba omunye umzuliswano (umjikelezo) wokwelashwa. Kubantu abaningi abane-CLL/SLL chemoimmunotherapy iyasebenza ukuze kuzuzwe ukuxolelwa (akukho zimpawu zomdlavuza).
Ukuguqulwa kofuzo kanye nokwelashwa
Okunye ukuphazamiseka kwezakhi zofuzo kungase kusho ukuthi izindlela zokwelapha ezihlosiwe zizokusebenzela kangcono, kanti okunye ukungahambi kahle kofuzo - noma ufuzo oluvamile lungasho ukuthi i-chemoimmunotherapy izosebenza kangcono kakhulu.
I-IgHV evamile (I-IgHV engashintshiwe) NOMA 17p ukususa NOMA a ukuguqulwa kofuzo lwakho lwe-TP53
I-CLL/SLL yakho cishe ngeke isabele ku-chemotherapy, kodwa ingase iphendule kwenye yalezi zindlela zokwelapha eziqondisiwe kunalokho:
- I-Ibrutinib - ukwelashwa okuhlosiwe okubizwa ngokuthi i-BTK inhibitor
- I-Acalabrutinib – ukwelapha okuhlosiwe (i-BTK inhibitor) ene-monoclonal antibody ebizwa ngokuthi i-obinutuzumab
- I-Venetoclax & Obinutuzumab – i-venetoclax wuhlobo lokwelapha okuhlosiwe olubizwa nge-BCL-2 inhibitor, i-obinutuzumab iyi-monoclonal antibody.
- I-Idelalisib & rituximab – idelalisib iwukwelapha okuhlosiwe okubizwa nge-PI3K inhibitor, kanti i-rituximab iyi-monoclonal antibody.
- Ungase futhi ufaneleke ukubamba iqhaza ocwaningweni lomtholampilo - Buza udokotela wakho ngalokhu
Ulwazi olubalulekile - I-Ibrutinib ne-Acalabrutinib okwamanje zigunyazwe i-TGA, okusho ukuthi ziyatholakala e-Australia. Nokho, okwamanje azikho ohlwini lwe-PBS njengokwelashwa komugqa wokuqala ku-CLL/SLL. Lokhu kusho ukuthi kubiza imali eningi ukufinyelela. Kungenzeka ukuthi uthole ukufinyelela emithini “ngezizathu zozwelo”, okusho ukuthi izindleko ingxenye noma ngokugcwele zimbozwe inkampani eyenza imithi. Uma unayo evamile (engashintshiwe) IgHV, noma ukususwa okungu-17p, buza udokotela wakho mayelana nokufinyelela okuzwelayo kule mithi.
I-Lymphoma Australia imelela abantu abane-CLL/SLL ngokufaka isethulo eKomidini Lokweluleka Ngezinzuzo Zemithi (PBAC) ukwelula uhlu lwe-PBS lwale mithi yokwelashwa komugqa wokuqala; okwenza le mithi ifinyeleleke kalula kubantu abaningi abane-CLL/SLL.
Ungasiza futhi ukuqwashisa nokufaka okwakho okuthumele ku-PBAC ohlwini lwe-PBS njengokwelashwa komugqa wokuqala ngokuchofoza lapha.
Mi-IgHV, noma okuhlukile ngaphandle kwalezi ezingenhla
Ungase unikezwe ukwelashwa okujwayelekile kwe-CLL/SLL okuhlanganisa i-chemotherapy noma i-chemoimmunotherapy. I-immunotherapy (i-rituximab noma i-obinutuzumab) izosebenza kuphela uma amangqamuzana akho e-CLL/SLL enomaka ongaphezulu kweseli okuthiwa. I-CD20 kubo. Udokotela wakho angakwazisa uma amaseli akho ane-CD20.
Kunemithi embalwa ehlukene nezinhlanganisela udokotela wakho angakhetha kuzo uma une-a Shintshanisa amasheya IgHV . Lokhu kufaka:
- I-Bendamustine & ri-ituximab (BR) – i-bendamustine iyi-chemotherapy futhi i-rituximab iyi-antibody e-monoclonal. Zombili zinikezwa njenge-infusion.
- I-Fludarabine, ci-yclophosphamide rituximab (FC-R). I-Fludarabine ne-cyclophosphamide yi-chemotherapy kanti i-rituximab iyi-monoclonal antibody.
- I-Chlorambucil & Obinutuzumab – i-chlorambucil iyithebhulethi yokwelapha ngamakhemikhali futhi i-obinutuzumab iyi-antibody ye-monoclonal. Ngokuyinhloko inikezwa abantu abadala, ababuthaka kakhulu.
- I-Chlorambucil - ithebhulethi ye-chemotherapy
- Ungase futhi ufaneleke ukubamba iqhaza ocwaningweni lomtholampilo
Uma ulazi igama lokwelashwa ozoba nakho, ungalithola eminye imininingwane lapha.
Ukuphumula kanye Nokubuyela Emgogodleni
Ngemva kokwelashwa iningi lenu lizongena eshweni. Ukukhululwa yisikhathi lapho ungenazo izimpawu ze-CLL/SLL ezisele emzimbeni wakho, noma lapho i-CLL/SLL ilawulwa futhi ingakudingi ukwelashwa. Ukuxolelwa kungathatha iminyaka eminingi, kodwa ekugcineni i-CLL ivame ukubuya (iphinde ibuyele emuva) bese kunikezwa ukwelashwa okuhlukile.
I-Refractory CLL / SLL
Bambalwa kini abangase bangakutholi ukuthethelelwa ngokwelashwa kwakho komugqa wokuqala. Uma lokhu kwenzeka, i-CLL/SLL yakho ibizwa ngokuthi “i-refractory”. Uma une-CLL/SLL ye-refractory udokotela wakho cishe uzofuna ukuzama imithi ehlukile.
Ukwelashwa onakho uma une-CLL/SLL ephikisayo noma ngemva kokuphinda ugule kubizwa ngokuthi ukwelashwa komugqa wesibili. Umgomo wokwelashwa komugqa wesibili uwukukufaka ekwephuleni futhi.
Uma unokunye ukuthethelelwa, bese uphinda futhi uthola ukwelashwa okwengeziwe, lokhu kwelashwa okulandelayo kubizwa ngokuthi ukwelashwa komugqa wesithathu, ukwelashwa komugqa wesine nokunye.
Ungase udinge izinhlobo ezimbalwa zokwelapha ze-CLL/SLL yakho. Ochwepheshe bathola izindlela zokwelapha ezintsha nezisebenza ngempumelelo ezikhulisa ubude bokukhululwa. Uma i-CLL/SLL yakho ingasabeli kahle ekwelashweni noma kuba nokuhlehla ngokushesha ngemva kokwelashwa (ezinyangeni eziyisithupha) lokhu kwaziwa ngokuthi i-CLL/SLL ephikisayo futhi kuzodingeka uhlobo oluhlukile lokwelapha.
Kukhethwa kanjani ukwelashwa komugqa wesibili
Ngesikhathi sokubuyela emuva, ukukhetha ukwelashwa kuzoncika ezintweni eziningana ezihlanganisa.
- Isikhathi esingakanani uxolelwe
- Impilo yakho jikelele kanye neminyaka yakho
- Ikuphi ukwelashwa/ukwelashwa kwe-CLL okuthole esikhathini esidlule
- Izintandokazi zakho.
Le phethini ingase iziphindaphinde eminyakeni eminingi. Izindlela zokwelapha ezihlosiwe ezintsha ziyatholakala ezifweni eziphinde zabuyela emuva noma ezingalawuleki futhi ezinye izindlela zokwelapha ezivamile ze-CLL/SLL ezibuyele emuva zingafaka lokhu okulandelayo:
- I-Venetoclax - ukwelashwa okuhlosiwe (BCL2 inhibitor) – ithebhulethi
- Ibrutinib (Ibruvica) - ukwelashwa okuhlosiwe (BTK inhibitor) - ithebhulethi
- I-Acalabrutinib - ukwelashwa okuhlosiwe (BTK inhibitor) - ithebhulethi
- Idelalisib and Rituximab – I-idelalisib iwukwelapha okuhlosiwe (PI3K inhibitor) futhi i-rituximab iyi-monoclonal antibody. I-Idelalisib iyithebhulethi futhi i-rituximab inikezwa njengokuconsa emithanjeni yakho.
Ulwazi olwengeziwe ngemithi yokwelapha ehlosiwe ingatholakala lapha.
Uma usemncane futhi ufanelekile (ngaphandle kokuba ne-CLL/SLL) ungase ukwazi ukuba ne Ukufakelwa kwe-Allogeneic Stem cell.
Kunconywa ukuthi noma nini lapho udinga ukuqala ukwelashwa okusha ubuze udokotela wakho mayelana nezivivinyo zomtholampilo ongase ukufanelekele. Izivivinyo zomtholampilo zibalulekile ukuthola imithi emisha, noma inhlanganisela yemithi yokuthuthukisa ukwelashwa kwe-CLL/SLL esikhathini esizayo.
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.
Ezinye izindlela zokwelapha ezihlolelwa i-CLL/SLL
Kunemithi eminingi kanye nezinhlanganisela ezintsha zokwelapha okwamanje ezihlolwayo ezivivinyweni zemitholampilo emhlabeni wonke ezigulini ezine-CLL esanda kuxilongwa nephinde yabuyela emuva. Ezinye izindlela zokwelapha eziphenywayo yilezi;
- I-Venetoclax inhlanganisela yokwelapha - usebenzisa i-venetoclax nezinye izinhlobo zokwelapha
- I-Zanubrutinib – i-capsule ewukwelapha okuhlosiwe (BTK inhibitor)
- I-Chimeric antigen receptor T-cell therapy (ukwelashwa kwe-CAR T-cell)
Ungafunda futhi yethu 'Ukuqonda Izilingo Zomtholampilo' Iphepha leqiniso noma vakashela yethu Iwebhusayithi ukuze uthole ulwazi olwengeziwe ngezivivinyo zomtholampilo
I-Prognosis ye-CLL / SLL - nokuthi kwenzekani lapho ukwelashwa kuphela
I-prognosis ibheka ukuthi umphumela olindelekile we-CLL/SLL yakho uzoba yini, nokuthi yini ethinta ukwelashwa kwakho okungenzeka ibe nayo.
I-CLL / SLL ayelapheki ngokwelashwa kwamanje. Lokhu kusho ukuthi uma usuxilongwa, uzoba ne-CLL/SLL impilo yakho yonke….Kodwa, abantu abaningi basaphila impilo ende nenempilo nge-CLL/SLL. Inhloso, noma inhloso yokwelashwa ukugcina i-CLL/SLL isezingeni elilawulekayo futhi uqinisekise ukuthi awunazo izimpawu ezithinta izinga lempilo yakho.
Wonke umuntu one-CLL/SLL unezici eziyingozi ezihlukene ezihlanganisa iminyaka, umlando wezokwelapha kanye nofuzo. Ngakho-ke, kunzima kakhulu ukukhuluma nge-prognosis ngomqondo ojwayelekile. Kunconywa ukuthi ukhulume nodokotela wakho onguchwepheshe mayelana nezici zakho eziyingozi, nokuthi zingathinta kanjani ukubikezela kwakho.
Ukusinda - Ukuphila nomdlavuza
Indlela yokuphila enempilo, noma ezinye izinguquko ezinhle zokuphila ngemva kokwelashwa zingaba usizo olukhulu ekululameni kwakho. Ziningi izinto ongazenza ukukusiza ukuthi uphile kahle nge-CLL/SLL.
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 esemqoka ngemuva kokwelashwa kwe-CLL/SLL 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
Ukuvuselelwa Komdlavuza
Izinhlobo ezahlukene zokuvuselela umdlavuza zinganconywa kuwe. Lokhu kungasho noma yiziphi izinsiza eziningi ezifana nalezi:
- ukwelashwa ngokomzimba, ukuphathwa kobuhlungu
- ukuhlela okunomsoco nokuzivocavoca
- ukwelulekwa ngokomzwelo, kwezemisebenzi nakwezezimali
Sinezeluleko ezinhle kumaphepha ethu amaqiniso angezansi:
- Ukwesaba ukuphinda umdlavuza futhi scan ukukhathazeka
- Ukulawulwa kokulala kanye ne-lymphoma
- Ukuzivocavoca kanye ne-lymphoma
- Ukukhathala kanye ne-lymphoma
- Ubulili nokusondelana
- Umthelela womzwelo wokuxilongwa nokwelashwa kwe-lymphoma
- Umthelela womzwelo wokuphila ne-lymphoma
- Umthelela womzwelo we-lymphoma ngemva kokuqeda ukwelashwa kwe-lymphoma
- Ukunakekela umuntu one-Lymphoma
- Umthelela womzwelo we-lymphoma ebuyele emuva noma ephikisayo
- Izindlela zokwelapha ezihambisanayo nezihlukile: iLymphoma
- Ukuzinakekela kanye neLymphoma
- Ukudla okunomsoco kanye ne-Lymphoma
I-Lymphoma eguquliwe (ukuguqulwa kuka-Richter)
Kuyini ukuguqulwa
I-lymphoma eguquliwe iyi-lymphoma eyatholwa ekuqaleni njengevila (ikhula kancane) kodwa isiguquke yaba isifo esinamandla (esikhula ngokushesha).
Uguquko aluvamile, kodwa lungenzeka uma izakhi zofuzo kumaseli e-lymphoma angasebenzi zonakaliswa ngokuhamba kwesikhathi. Lokhu kungenzeka ngokwemvelo, noma ngenxa yezinye izindlela zokwelapha, okubangela ukuthi amaseli akhule ngokushesha. Uma lokhu kwenzeka ku-CLL/SLL kubizwa nge-Richter's Syndrome (RS).
Uma lokhu kwenzeka i-CLL/SLL yakho ingase iguquke ibe uhlobo lwe-Lymphoma olubizwa nge-Diffuse Large B-cell Lymphoma (DLBCL) noma ngisho nangokwengeziwe i-T-cell Lymphoma.
Ukuze uthole ulwazi olwengeziwe nge-Transformed Lymphoma sicela ubheke yethu ishidi lamaqiniso lapha.
