Yini iHodgkin Lymphoma (HL)
I-HL wuhlobo lomdlavuza owenza amanye amangqamuzana egazi akho, abizwa ngokuthi ama-B-cell lymphocyte akhule kakhulu, futhi ayeke ukusebenza kahle. Ama-Lymphocyte amangqamuzana akhethekile, amancane kakhulu udinga ukuwabuka ngesibonakhulu. Ziwuhlobo lwamangqamuzana egazi, futhi umsebenzi wazo ukulwa namagciwane angakugulisa. Abanye babo bangalwa ngisho nomdlavuza.
Umdlavuza usho ukuthi amaseli:
- zikhule lapho kungafanele
- bangaziphathi ngendlela okufanele baziphathe ngayo, futhi
- ngezinye izikhathi ukuya ezingxenyeni zomzimba wakho ongahloselwe ukuya kuzo.
Yini eyenza i-B-cell Lymphocyte ikhetheke?
- Zenziwa ngaphakathi kwamathambo akho endaweni ebizwa ngokuthi “umnkantsha”.
- Ama-lymphocyte angahambela kuzo zonke izingxenye zomzimba wakho ukulwa nokutheleleka, kodwa ngokuvamile ahlala ohlelweni lwakho lwe-lymphatic.
- Uhlelo lwakho lwe-lymphatic luhlanganisa ezinye zezitho zakho ezibizwa ngokuthi i-spleen, thymus, tonsils kanye ne-appendix kanye nama-lymph nodes akho atholakala kuwo wonke umzimba wakho. Imithambo ye-lymphatic ifana nemigwaqo ehlanganisa zonke izitho zakho ze-lymphatic nama-lymph nodes ndawonye.
- Ama-lymphocyte asiza ama-neutrophils ukulwa namagciwane.
- Baphinde bakhumbule amagciwane ngakho uma bezama ukubuya, ama-lymphocyte akho angawaqeda ngokushesha okukhulu.
Ama-B-cell kanye ne-lymphoma
Uma une-HL, i-B-cell lymphocyte yakho iba nomdlavuza futhi ibizwa amaseli e-lymphoma. Zibukeka zihlukile, zikhulu futhi ziziphatha ngendlela ehlukile kunama-lymphocyte avamile.
Amaseli e-lymphoma avame ukubizwa ngokuthi amaseli e-Reed-Sternberg. (I-Reed ne-Sternberg kwakungamagama ososayensi abaqala ukuhlonza lawa maseli).
Ibukeka kanjani iseli ye-Reed-Sternberg?
Nasi isithombe esikukhombisa ukuthi amaseli ajwayelekile abukeka kanjani, nokuthi abukeka kanjani amaseli e-Reed-Sternberg lymphoma.
I-Hodgkin lymphoma ivame ukukhula ngokushesha, ngakho ngezinye izikhathi ibizwa ngokuthi i-aggressive. Kodwa okuhle nge-aggressive Hodgkin lymphoma ukuthi ivamise ukuphendula kahle ekwelashweni, ngoba ukwelashwa kuklanyelwe ukuhlasela amaseli akhula ngokushesha.
Ngalesi sizathu, maningi amathuba okuthi welapheke ngemva kokwelashwa. Lokho kusho ukuthi ngeke usaba nomdlavuza.
Izimpawu ze-Hodgkin Lymphoma (HL)
Uphawu lokuqala ongaluthola uma une-HL kungaba isigaxa, noma izigaxa ezimbalwa ezilokhu zikhula. Lezi zigaxa zingaba kuwe:
- intamo (njengalona osesithombeni)
- ikhwapha (ikhwapha lakho)
- i-groin (lapho ingaphezulu lemilenze yakho lijoyina wonke umzimba wakho, kuze kufike okhalweni lwakho)
- noma isisu (indawo yesisu sakho).
Ama-lymph nodes esiswini sakho angase abe nzima ukuwabona nomuzwa, ngoba ajule kakhulu emzimbeni wakho kunamanye ama-lymph node. Udokotela wakho angase azi ukuthi unama-lymph nodes avuvukele lapho ngokuthatha izithombe ezikhethekile (izikena) zangaphakathi emzimbeni wakho.
Izigaxa zibangelwa ama-lymph nodes akho agcwala amaseli e-lymphoma, okuwenza avuvukale. Ngokuvamile akubuhlungu kodwa ngezinye izikhathi, uma ama-lymph nodes avuvukele ecindezela ezinye izingxenye zomzimba wakho kungase kubangele ubuhlungu.
Ikuphi enye i-Hodgkin Lymphoma engatholakala?
Ngezinye izikhathi, i-Hodgkin lymphoma ingasakazeka kwezinye izingxenye zomzimba wakho njengeyakho:
- amaphaphu - amaphaphu akho akusiza ukuthi uphefumule.
- isibindi – isibindi sakho sikusiza ukuthi ugaye ukudla, futhi sihlanze umzimba wakho ukuze ungakhi ubuthi obuyingozi (ushevu) emzimbeni wakho.
- amathambo – amathambo akho akunika amandla ukuze ungantweza yonke indawo.
- umnkantsha (lokhu kuphakathi kwamathambo akho futhi yilapho amangqamuzana egazi akho enziwa khona).
- ezinye izitho ezisiza umzimba wakho ukuthi usebenze kahle.
Uma amaseli akho e-lymphoma esakazekela kwezinye izindawo zomzimba wakho, angabizwa ngokuthi isiteji esithuthukisiwe HL. Sizokhuluma ngezigaba ze-HL kakhulu kamuva, kodwa kuhle ukuthi wazi manje, ukuthi noma ngabe unesiteji esithuthukisiwe se-HL, usengaphulukiswa.
Ezinye izimpawu ongazithola zihlanganisa:
- Ukuzizwa ukhathele ngempela ngaphandle kwesizathu - ngokuvamile usazizwa ukhathele ngisho noma usuphumule noma ulele.
- Ukuphelelwa umoya – noma ngabe ungenzanga lutho.
- Ukukhwehlela okomile okungapheli.
- Ukulimala noma ukopha kalula kunokujwayelekile.
- Isikhumba esilumayo.
- Igazi echibini lakho noma ephepheni lasendlini yangasese lapho uya endlini yangasese.
- Amagciwane angapheli, noma alokhu ebuya (okuphindaphindayo).
- B-izimpawu.
Ezinye izimbangela zezimpawu - nokuthi uzombona nini udokotela wakho
Eziningi zalezi zimpawu nezimpawu zingafana nezinye izinto ezifana nezifo. Ngokuvamile ngenxa yokutheleleka noma esinye isizathu izimpawu ziyaphela ngemva kwamasonto ambalwa.
Uma une-HL nokho, i izimpawu azipheli ngaphandle kokwelashwa.
Udokotela wakho angase acabange ukuthi unokutheleleka ekuqaleni. Kodwa uma bekhathazekile ngokuthi kungase kube uhlobo lwe-lymphoma, bazo-oda ukuhlolwa okwengeziwe. Uma uke waya kudokotela, futhi izimpawu zakho zingabi ngcono, uzodinga abuyele kudokotela.
Itholakala Kanjani I-Hodgkin Lymphoma (HL)?
Kunezinhlobo eziningi ezahlukene ze-lymphoma. Ngokuvamile zihlanganiswa zibe IHodgkin lymphoma or i-non-Hodgkin lymphoma. I-Hodgkin lymphoma ihlukaniswe yaba:
- I-Classical Hodgkin Lymphoma (cHL) noma
- I-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
Iningi lenu lizoba ne-cHL, enengane eyodwa kweziyi-1 kanye nentsha ene-HL ene-NLPHL subtype.
Udokotela wami wazi kanjani ukuthi nginaluphi uhlobo oluncane?
Kubalulekile ukuthi udokotela wakho athole ukuthi iyiphi onayo, ngoba izinhlobo zokwelashwa nemithi oyitholayo ingase yehluke kumuntu onohlobo oluncane oluhlukile. wena.
Ukuze uthole ukuthi yiluphi uhlobo lwe-HL onalo, udokotela wakho uzofuna ukukwenza ezinye izivivinyo ezahlukene. Bazofuna ukuthatha amasampula akho ukuvuvukala kwama-lymph nodes ukuze uwahlole futhi ubone ukuthi hlobo luni lwamaseli Lapho. Lapho udokotela ethatha isampula, ibizwa ngokuthi i-biopsy.
Ungase ube ne-biopsy yakho ekamelweni likadokotela, ekamelweni lokuhlinza esibhedlela noma emnyangweni we-radiology. Lokhu kuzoncika ekutheni uneminyaka emingaki, nokuthi i-lymph yakho evuvukele ikuphi ama-nodes. Udokotela wakho uzokwazisa lapho wena nabazali/ababheki bakho kudingeka ngihambe.
Biopsy
I-biopsy ingenziwa njengokuhlinzwa esibhedlela. Odokotela bakho nabahlengikazi bazocophelela kakhulu, futhi baqinisekise ukuthi ukhululeke ngangokunokwenzeka ngenkathi benza i-biopsy. Ungase uthole ngisho nomuthi othile okusiza ukuthi ulale ngesikhathi sokuhlolwa kwe-biopsy, noma wenze indawo abakwenza kuyo i-biopsy ibe ndikindiki. Lo muthi ubizwa ngokuthi i-anesthetic.
Uma usuyithathile i-biopsy, izothunyelwa ku-pathology, lapho abantu abaqeqeshwe ngokukhethekile ababizwa ngokuthi “I-Pathologists” bezosebenzisa izinhlobo ezahlukene zemishini ukuze babheke amaseli ku-biopsy. Ezinye zezinto abazisebenzisayo kuzoba izibonakhulu ezikhethekile nezibani, ezibasiza babone izingxenye ezihlukene zamangqamuzana e-lymphoma. Wisigqoko abasibonayo sisiza udokotela wakho ukuthi athole ukuthi yiluphi uhlobo oluncane lwe-HL onalo.
Ezinye izinhlobo ze-biopsies ongase ube nazo zihlanganisa:
I-Core or fine inaliti biopsy
Udokotela noma umhlengikazi uzofaka inaliti ku-lymph node yakho evuvukele futhi akhiphe isampula elincane le-lymph node. Uzoba nomuthi wokuthulisa indawo ukuze ingabi buhlungu, futhi kuye ngeminyaka yakho, ungase ube nomuthi wokukwenza ulale ukuze uhlale unganyakazi.
Uma i-lymph node ijulile ngaphakathi emzimbeni wakho futhi bengayizwa, udokotela angase asebenzise i-ultrasound noma i-x-ray ekhethekile ukuze abasize bayibone lapho benza i-biopsy.
Ukuvuma ngekhanda okukhethekilee biopsy
Uzodinga ukuhlinzwa ukuze ube ne-excisional node biopsy. Kwenziwa ukususa yonke i-lymph node kwezinye izindawo zomzimba wakho ezingakwazi ukufinyelelwa ngenaliti. Uzothola isibulali-zinzwa esizokwenza ulale, futhi ngeke uzwe noma ukhumbule ukuhlinzwa. Uzovuka usunemithungo lapho bekhiphe khona i-lymph node.
I-bone yomnkantsha i-biopsy
Nge-biopsy yomnkantsha, udokotela ufaka inaliti emhlane wakho ophansi nasethanjeni le-hip. Lena enye yezindawo lapho amangqamuzana akho egazi enziwa khona, ngakho athanda ukuthatha isampula yalo mnkantsha ukuze abone ukuthi awekho yini amaseli e-lymphoma lapho. Kunamasampula amabili udokotela azowathatha kulesi sikhala okuhlanganisa:
- I-Bone marrow aspirate (BMA): lokhu kuhlolwa kuthatha inani elincane uketshezi olutholakala endaweni yomnkantsha
- I-Bone marrow aspirate trephine (BMAT): lokhu kuhlolwa kuthatha okuncane isampula yezicubu zomnkantsha
Ngokuya ngeminyaka yakho, ungahle uhlinzwe njengomsebenzi wokubulala izinzwa ukuze ulale. Cishe ngeke ube nezitishi ngemva kwalokhu, kodwa uzoba nokugqoka okuncane okufana nebhande losizo likanokusho endaweni lapho inaliti ingene khona.
Ilinde imiphumela
Kungathatha amasonto amabili noma amathathu ukuthola imiphumela yakho.
Ukulinda imiphumela kungase kube isikhathi esicindezelayo kuwe nakwabathandekayo bakho. Kubalulekile ukuthi wena nesixuku sakho noma umndeni nabangane nifinyelele futhi nikhulume nomuntu omethembayo ngalesi sikhathi. Uma ungaqiniseki ukuthi ukhulume nobani, noma uma unemibuzo, ungashayela noma u-imeyili abahlengikazi bethu be-lymphoma.
Ukuze uthole imininingwane yokuthi ungaxhumana kanjani nabo sicela uchofoze okuluhlaza okwesibhakabhaka thintana nathi inkinobho ngezansi kwesikrini.
Izinhlobo ezingaphansi ze-Hodgkin Lymphoma
Njengoba sishilo ngenhla, kunezinhlobo ezahlukene ze-HL - classical Hodgkin Lymphoma kanye I-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL).
I-Classical Hodgkin Lymphoma iphinde ihlukaniswe yaba ezinye izinhlobo ezine ezihlukene. Lokhu kubandakanya:
- I-Nodular Sclerosis Classical Hodgkin Lymphoma (NS-cHL)
- I-Mixed cellularity classical childhood Hodgkin Lymphoma (MC-cHL)
- I-Hodgkin Lymphoma yakudala ecebile ngama-lymphocyte (LR-cHL)
- I-Hodgkin Lymphoma yakudala ene-lymphocyte (LD-cHL)
Ukuze ufunde kabanzi mayelana nalezi zinhlobo ezincane ze-HL, chofoza izihloko ezingezansi.
I-Classical Hodgkin Lymphoma Subtypes
I-NS-cHL ivame kakhulu ezinganeni ezindala kanye nentsha. Cishe ingxenye yawo wonke umuntu one-classical Hodgkin lymphoma uzoba nalolu hlobo oluncane lwe-NS-cHL.
Abafana namantombazane bobabili bangathola i-NS-cHL, kodwa ivame kakhulu emantombazaneni.
I-NS-cHL ngokuvamile iqala kuma-lymph nodes ekujuleni kwesifuba sakho, endaweni ebizwa ngokuthi i-mediastinum yakho. Ungabona i-mediastinum esithombeni esingezansi, yingxenye engaphakathi kwebhokisi elimnyama.
Ungase ungakwazi ukuzwa ukuthi uvuvukele ama-lymph nodes, kodwa ezinye izimpawu ongazithola ngohlobo lwe-HL zihlanganisa:
- ukukhwehlela
- ubuhlungu noma umuzwa ongakhululekile esifubeni sakho
- ukuzwa ukuphelelwa umoya
I-NS-cHL ingaqala, noma isabalale kwezinye izingxenye zomzimba wakho njengobende, amaphaphu, isibindi, ithambo noma umnkantsha.
I-Mixed cellularity classical Hodgkin Lymphoma (MC-cHL) ivame kakhulu ezinganeni ezingaphansi kweminyaka eyi-10 ubudala. Kodwa kusengathinta izingane kanye nentsha yanoma iyiphi iminyaka.
Uma une-MC-cHL, ungase ubone izigaxa ezintsha ngaphansi kwesikhumba sakho. Lokhu kungenxa yokuthi amangqamuzana e-lymphoma aqoqana futhi akhule kuma-lymph nodes ezicutshini ezinamafutha ngaphansi kwesikhumba sakho. Sonke sinalezi zicubu ezinamafutha futhi zisiza ukuvikela izitho zethu ezingaphansi, futhi zisigcine sifudumele uma kubanda. Amanye amaseli e-lymphoma angase atholakale kwezinye izitho zakho.
I-MC-cHL kwesinye isikhathi ingaba luqili kudokotela wakho ukuthi ayixilonge ngoba ibukeka njenge-lymphoma ehlukile ebizwa nge-peripheral T-cell lymphoma. Ngalesi sizathu, udokotela wakho angase afune ukwenza izivivinyo ezengeziwe ukuze aqiniseke ukuthi une-MC-cHL ukuze akwazi ukukunikeza imithi efanele.
I-classical Hodgkin lymphoma (LR-cHL) ecebile nge-lymphocyte ayivamile. Bambalwa kakhulu abantu abathola lolu hlobo oluncane. Kodwa uma wenza kanjalo, ngokuvamile kusabela kahle kakhulu ekwelashweni kwakho. Cishe uzokwelashwa uma uqeda ukwelashwa.
Ungase ubone izigaxa ngaphansi kwesikhumba sakho uma une-LR-cHL, ngoba amaseli e-lymphoma akhula kuma-lymph nodes ngaphansi kwesikhumba sakho.
I-LR-cHL ingase futhi ibe inkohliso kudokotela wakho ukuthi ayihlole ngoba ngezinye izikhathi ibukeka njengohlobo oluhlukile lwe-HL olubizwa ngokuthi i-Nodular lymphocyte predominant Hodgkin Lymphoma (NLPHL). Kokubili i-LR-cHL ne-NLPHL kubukeka kufana, kodwa kusetshenziswa imithi ehlukene ukuyiqeda.
I-Hodgkin Lymphoma (LD0cHL) yakudala ene-lymphocyte (LDXNUMXcHL) cishe iwuhlobo oluncane olujwayelekile lwe-Hodgkin lymphoma ezinganeni nasebancane. Kuvame kakhulu uma unegciwane elibizwa ngokuthi i-human immunodeficiency virus (HIV), noma uma uke waba negciwane elibizwa nge-Epstein-Barr virus (EBV).
I-EBV igciwane elidala i-glaular fever okwenza ube nomphimbo obuhlungu. Futhi ngezinye izikhathi kuthiwa "i-mono" noma i-mononucleosis. Kuze kuthiwe nesifo sokuqabula ngoba sisakazeka ngamathe (kodwa asikho isidingo sokuthi uqabule noma ubani ukuze usithole).
Ungase ungabi nezigaxa ezingavamile noma ama-lymph nodes avuvuke uma une-LD-cHL ngoba ngokuvamile ikhula phakathi kwamathambo akho endaweni ebizwa ngokuthi umnkantsha wakho. Lena indawo lapho amangqamuzana akho egazi enziwa khona. Kodwa-ke, kungase futhi kuqale ekujuleni kwesisu sakho (noma esiswini), ngakho-ke izigaxa zingase zijule kakhulu ukuthi ungazizwa.
I-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
I-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) iwuhlobo oluncane lwe-HL olungavamile kakhulu, kodwa luvame kakhulu ezinganeni ezingaphansi kweminyaka eyi-10 ubudala.
Udokotela wakho angakuxilonga nge-NLPHL uma amaseli akho ebukeka ngendlela ethile. Kungase kubonakale kuhlekisa, kodwa ngezinye izikhathi sithi amaseli e-lymphoma ku-NLPHL abukeka njengama-popcorn. Bheka isithombe uzobona ukuthi siqonde ukuthini.
Ihluke kanjani i-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) kune-Hodgkin Lymphoma yakudala?
I-NLPHL ikhula kancane kune-Classical Hodgkin Lymphoma. Uma une-NLPHL , ungase welapheke ngemva kokwelashwa okusho ukuthi i-lymphoma izohamba futhi ingaphinde ibuye. Kodwa, kwabanye benu, kungase kubuye. Ngezinye izikhathi ingabuya ngokushesha, futhi ngezinye izikhathi ungase uphile ngaphandle kwe-lymphoma iminyaka eminingi.
Uma i-NLPHL yakho ibuya ibizwa ngokuthi ukuphinda. Okuwukuphela kwesibonakaliso sokubuyela emuva kungase kube i-lymph node evuvukele engasuki. Lokhu kungase kube entanyeni yakho, ikhwapha, igroin noma enye indawo yomzimba wakho. Uma uthola ezinye izimpawu, zizofana nalezi zimpawu esizibale ngenhla.
Isiteji kanye Nokuhlelwa Kwe-Hodgkin Lymphoma (HL)
Uma udokotela wakho esekutholile ukuthi une-HL, uzofuna ukwenza izivivinyo ezengeziwe ukuze abone ukuthi zingaki izingxenye zomzimba wakho ezinamaseli e-lymphoma, nokuthi zikhula ngokushesha kangakanani.
Isiteji sibheka lapho i-HL ikuphi. Khumbula ngaphambili sikhulume ngama-lymphocyte akho. Sithole ukuthi nakuba zenziwe emnkantsheni wakho futhi zihlala ohlelweni lwakho lwe-lymphatic, zingahamba futhi kunoma iyiphi ingxenye yomzimba wakho. Ngenxa yokuthi amangqamuzana e-lymphoma yakho angama-lymphocyte anomdlavuza, i-HL ingaba semongweni wakho wamathambo, uhlelo lwe-lymphatic nanoma iyiphi enye ingxenye yomzimba wakho.
Ukuhlolwa Kwesiteji Nezikena
Udokotela wakho uzo-oda izikena ezithile ukuze athathe izithombe zangaphakathi emzimbeni wakho ukuze abone ukuthi la maseli e-HL acashe kuphi. Lezi ziskena zingafaka:
CT scan (lokhu kufushane kwe-computed tomography scan)
Ama-CT scan afana ne-X-ray ekhethekile enikeza isithombe esinemininingwane yakho konke okungaphakathi kwesifuba sakho, isisu (indawo yesisu) noma i-pelvis (eduze kwamathambo enqulu). Udokotela wakho uzokwazi ukubona noma yimaphi ama-lymph nodes avuvukele noma izimila kulezi zindawo kulesi sikena.
Iskena se-PET (lokhu kufushane kwe-Positron Emission Tomography scan)
Ama-PET scan abheka ngaphakathi komzimba wakho wonke. Izindawo ezine-lymphoma zibukeka zikhanya kunezinye izindawo. Kuzodingeka ube nenaliti esandleni sakho noma engalweni yakho ngoba bazojova uketshezi oluthile olusiza amangqamuzana e-lymphoma akhanyise esithombeni sekhompyutha. Abahlengikazi banekhono kakhulu ekwenzeni lokhu futhi bazoqikelela ngokukhethekile ukuthi akulimazi kakhulu.
Ukuskena kwe-MRI (Lokhu kufushane kwe-Magnetic Resonance Imaging)
Lesi skena sisebenzisa omazibuthe abangaphakathi emshinini ukuze sithathe izithombe zengaphakathi lomzimba wakho. Akulimazi, kodwa ngenxa yokuthi kukhona omazibuthe abazungezayo emshinini kungaba nomsindo omkhulu. Abanye abantu abayithandi le misindo ngakho-ke ungase ube nomuthi wokukwenza ulale kancane ngesikhathi sokuskena, ngakho-ke akukukhathazi. Ungase ukwazi nokusebenzisa ama-headphone akhethekile ukuze ulalele umculo.
Isiteji sami se-HL sibalwe kanjani?
Isiteji sibalwa ukusuka kweyokuqala kuye kweyesine. Uma unesiteji sokuqala noma sesibili uzoba ne-HL yesigaba sokuqala. Uma unesiteji sesithathu noma sesine, uzoba nesiteji esithuthukisiwe se-HL.
Isiteji esithuthukisiwe se-HL singazwakala sithusa. Kodwa, ngenxa yokuthi ama-lymphocyte akho ahamba kuwo wonke umzimba wakho, i-lymphoma ibhekwa njengesifo "sesistimu". Ngakho-ke, ama-lymphomas athuthukile afaka i-HL ahluke kakhulu kwamanye ama-cancer anesifo esithuthukile.
Ingabe isiteji sami sinomthelela uma ngingelapheka?
Izimila eziningi eziqinile, njengezimila ebuchosheni, ibele, izinso nezinye izindawo azikwazi ukwelapheka uma sezithuthukile.
Kodwa ama-lymphoma amaningi esiteji esithuthukile angelapheka ngokwelashwa okufanele, futhi lokhu kuvame ukwenzeka ezinganeni nasebancane abane-HL.
Lesi sithombe siyisibonelo esihle sokuthi umehluko izigaba zingase zibukeke. Izingxenye ezibomvu zibonisa lapho i-lymphoma ingase ibe esigabeni ngasinye - eyakho ingase ibe a ihluke kancane, kodwa izolandela cishe ngokufanayo iphethini.
isigaba 1 | I-HL yakho isendaweni eyodwa ye-lymph node, noma ngaphezulu noma ngaphansi kwe-diaphragm yakho |
isigaba 2 | I-HL yakho isezindaweni ezimbili noma ngaphezulu zama-lymph node, kodwa ohlangothini olufanayo lwe-diaphragm yakho |
isigaba 3 | I-HL yakho isendaweni okungenani eyodwa ye-lymph node ngenhla futhi okungenani i-lymph node eyodwa ngaphansi kwe-diaphragm yakho. |
isigaba 4 | I-HL yakho isezindaweni eziningi ze-lymph nodes, futhi isisakazekele kwezinye izingxenye zomzimba wakho, njengamathambo akho, amaphaphu, noma isibindi. |
Ithini i-diaphragm yakho?
I-diaphragm yakho ingumsipha omise okwedome ohlukanisa izitho ezisesifubeni sakho, nezitho ezisesiswini sakho. Kukusiza futhi ukuthi uphefumule ngokusiza amaphaphu akho ehle enyuka.
Ezinye izinto ezibalulekile okufanele uzazi ngesiteji sakho
Kanye nenombolo yesiteji, ungase unikezwe incwadi ngemva kwenombolo.
Uyakhumbula ukuthi sathini ngaphambili mayelana ne-B-symptoms? Ziyiqembu lezimpawu ezingenzeka ndawonye uma une-lymphoma. Zihlanganisa:
- Ukujuluka okumanzi ebusuku okumanzisa izingubo zakho nezingubo zokulala
- Imfiva nokugodola
- Ukwehlisa isisindo ngaphandle kokuzama
Uma unalezi zimpawu ze-B uzoba no-“B” ngemva kwenombolo yakho yesiteji, kodwa uma ungenayo i-B-symptoms uzoba no-“A” ngemva kwenombolo yakho yesiteji.
Uma esinye sezitho zakho, njengamaphaphu, isibindi noma amathambo akho sine-HL uzoba nohlamvu “E” ngemva kwenombolo yakho yesiteji.
Uma une-lymph node noma isimila esingaphezu kuka-10cm ngosayizi sibizwa ngokuthi i-bulky. Uma unesifo esikhulu, uzoba nohlamvu “X” ngemva kwenombolo yakho yesiteji
Ekugcineni, uma ubende lwakho lune-HL phakathi, uzoba nohlamvu “S” ngemva kwenombolo yakho yesiteji. Ubende lwakho lusiza ekugcineni igazi lakho lihlanzekile, futhi liyisitho esikhulu samasosha akho omzimba. Kulapho amangqamuzana amaningi amhlophe egazi ahlala khona nalapho ama-B-cell lymphocyte enza khona amasosha omzimba amaningi ukulwa namagciwane.
Bona ukuthi lezi zinto ezahlukene zingasho ukuthini kulelithebula elingezansi.
Okusho | Ukubaluleka |
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Ukugreda kusiza udokotela wakho ukuthi enze izinqumo ezinhle mayelana nokwelashwa abakunikezayo.
Njengokwenza isiteji, ibanga lakho lizonikezwa njengenombolo ukusuka kweyodwa kuye kweyesine. Kungase kubhalwe ngokuthi G1, G2, G3 noma G4. Lapho ama-lymphocyte akho eba nomdlavuza, aqala ukubukeka ngendlela ehlukile kuma-lymphocyte akho avamile. Uma une-lymphoma yebanga eliphansi njenge-G1, amaseli angase akhule kancane futhi ahluke kancane kuma-lymphocyte akho avamile, kodwa ngebanga eliphakeme, akhula ngokushesha kakhulu futhi awafani neze namaseli akho avamile.
Lapho bebukeka behluke kakhulu, yilapho bekwazi khona ukusebenza kahle.
Nansi ukubuka konke kwebanga ngalinye:
- 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 engane yakho/wakho abukeka ehluke kakhulu ngamaseli ambalwa avamile futhi akhula futhi asakazeke ngokushesha.
- I-G4 – ibanga eliphezulu – amaseli engane yakho/wakho abukeka ehluke kakhulu kwejwayelekile futhi akhula futhi asakazeke ngokushesha
Okunye Ukuhlola
Ungase ube nokunye ukuhlola ngaphambi kokuba uqale ukwelashwa, futhi ngesikhathi sokwelashwa ukuze uqiniseke ukuthi umzimba wakho uyakwazi ukubhekana nemithi ozoba nayo. Lokhu kungafaka:
- Ukuhlolwa kwegazi njalo
- Ama-Ultrasound noma okunye ukuhlola nokuhlolwa kwezinye zezitho zakho ezihlanganisa inhliziyo yakho, amaphaphu nezinso
- Ukuhlolwa kwe-Cytogenetic - lokhu ukuhlolwa okukhethekile ukuze ubone ukuthi kukhona yini izinguquko ezakhini zakho zofuzo. Izakhi zakho zofuzo zitshela amangqamuzana asemzimbeni wakho ukuthi akhule kanjani futhi asebenze kanjani. Uma kukhona uguquko (olubizwa nangokuthi ukuguqulwa noma ukuhluka) ezakhini zofuzo zakho, bangakunikeza imiyalelo engalungile. Le miyalo engalungile ingabangela umdlavuza - njenge-HL ukukhula. Akuwona wonke umuntu ozodinga lokhu kuhlolwa.
- I-Lumbar puncture - Lena inqubo lapho udokotela efaka khona inaliti emhlane wakho eduze nomgogodla wakho futhi akhiphe uketshezi oluthile. Lokhu kuzokwenzeka kuphela uma ebona ukuthi kungenzeka ukuthi i-HL yakho isengqondweni noma emgogodleni wakho, noma ingase isabalele lapho. Ezinye izingane noma intsha ingase ibe ne-sedation ethile ukuze ikwenze ulale ngesikhathi sokulala ukuze kungalimazi, futhi uqiniseke ukuthi awunyakazi phakathi nenqubo.
Imibuzo kadokotela wakho ngaphambi kokuba uqale ukwelashwa
Uma udokotela wakho eseqoqe lonke ulwazi kuma-biopsies akho, amaskeni nokunye ukuhlola; bazokwazi ukuhlanganisa uhlelo lokuphatha ukwelashwa kwakho futhi bakugcine uphephile. Kwesinye isikhathi odokotela bazokhuluma nabanye odokotela noma abanye ochwepheshe ukuze baqinisekise ukuthi benza uhlelo olungcono kakhulu olungakhona kuwe. Lapho laba chwepheshe behlangana ndawonye ukuze benze uhlelo, lubizwa ngokuthi umhlangano wethimba lezinhlaka eziningi - noma umhlangano we-MDT.
Sizokhuluma ngezinhlobo zokwelashwa ongase ukuthole ngokuqhubekayo kuleli khasi. Kodwa okokuqala kubalulekile ukuthi uzizwe ukhululekile ukubuza udokotela wakho noma imiphi imibuzo onayo ngaphambi kokuba uqale ukwelashwa. Lokhu kuzokusiza ukwazi ukuthi yini okufanele uyilindele, futhi uzizwe uqiniseka ngokwengeziwe.
Kungaba nzima ukwazi ukuthi yimiphi imibuzo okufanele uyibuze. Kodwa uma sikhuluma iqiniso, ayikho imibuzo efanele noma engalungile. Wonke umuntu uhlukile futhi imibuzo onayo ingase yehluke emibuzweni enye ingane noma osemusha enayo. Okubaluleke kakhulu ukuthi ayikho imibuzo engenangqondo uma kuziwa empilweni yakho kanye nokwelashwa kwakho. Ngakho zizwe uqiniseka ukubuza nganoma yini esemqondweni wakho.
Eminye Imibuzo ukuze uqalise
Ukukusiza ukuthi uqalise sihlanganise imibuzo ethile wena noma abazali/ababheki bakho eningase nithande ukuyibuza. Uma ungakakulungeli, noma ukhohlwe ukubuza imibuzo ngaphambi kokwelashwa, kulungile, ungabuza udokotela noma unesi wakho noma nini. Kodwa ukwazi izimpendulo ngaphambi kokuba uqale ukwelashwa, kungase kukusize uzizwe uqiniseka ngokwengeziwe.
Ukugcina inzalo yakho (ikhono lakho lokwenza izingane uma usukhulile)
Ngaphambi kokuqala ukwelashwa kunezinye izinto okufanele ucabange ngazo. Ngiyazi ukuthi kungenzeka ukuthi usunokuningi ongacabanga ngakho, kodwa ukulungisa izinto ngaphambi kokuba uqale ukwelashwa kungasiza kakhulu kamuva.
Omunye wemiphumela emibi yokwelashwa kwe-HL ungenza kube nzima ukukhulelwa, noma ukhulelwe umuntu kamuva ekuphileni. Ukuze ufunde ngezinye zezinto ezingenziwa ukwandisa amathuba akho okuba nezingane kamuva ekuphileni, ungabuka le vidiyo ngokuchofoza isithombe esingezansi.
Ukwelashwa kwe-Hodgkin Lymphoma
Ithimba lakho lokunakekelwa kwezempilo lizobheka izinto eziningi ngawe ngaphambi kokwenza isinqumo esingujuqu mayelana nokuthi licabanga ukuthi iluphi uhlobo lokwelapha olungcono kakhulu kuwe. Ezinye zezinto abazocabanga ngazo zihlanganisa:
- Ukuthi une-classical subtype ye-HL noma i-NI-odular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)
- Uneminyaka emingaki
- Uma unezinye izifo noma ukukhubazeka
- Uma une-allergies
- Yeka ukuthi uzizwa kahle kangakanani ngokomzimba (umzimba wakho) nangokwengqondo (imizwa yakho nemicabango).
Udokotela wakho noma unesi uzokuchazela ngohlelo lwakho lokwelapha kanye nemiphumela engemihle engase ibe khona kuwe. Imiphumela engemihle yizinto ezingenzeka ngenxa yokwelashwa kwakho, njengokuzizwa ugula, noma izinwele zakho ziqothuka noma ezinye izinto eziningi. Uma unemiphumela engemihle, kubalulekile ukwazisa unesi noma udokotela wakho ukuze bakusize uzizwe ungcono.
Uma kukhona ongakuqondi, noma uzizwa ukhathazekile, khuluma nodokotela noma unesi wakho ubacele ukuthi bakuchazele izinto.
Ungaphinda ushayele ucingo noma uthumele i-imeyili I-Lymphoma Australia Nurse Helpline ngemibuzo yakho. Singakusiza ukuthi uthole ulwazi olulungile. Vele uchofoze inkinobho ethi Xhumana nathi ngaphansi kwalesi sikrini.
Kunezinhlobo ezahlukene zokwelashwa. Ungase ube nohlobo olulodwa, noma izinhlobo eziningana kuye ngesimo sakho. Lokhu kubandakanya:
Ukunakekela okusekelayo
Ukunakekelwa okusekelayo kunikezwa ukuze uzizwe ungcono ngesikhathi sokwelashwa, futhi ululame ngokushesha.
Kwabanye benu, amaseli akho e-lymphoma angase akhule ngokushesha futhi abe makhulu kakhulu. Lokhu kwenza umongo wakho wethambo, ukugeleza kwegazi, ama-lymph nodes, isibindi noma ubende kuminyene kakhulu. Ngenxa yalokhu, ungase ungabi nawo amangqamuzana egazi anempilo anele. Ukwelashwa okusekelayo kungahlanganisa ukukunikeza igazi noma ukufakwa kwe-platelet ukuze uqiniseke ukuthi unamangqamuzana egazi anempilo anele.
Uma unokutheleleka, ungase ube nama-antibiotics ukukusiza ukuba ube ngcono ngokushesha. Kwezinye izimo ungase ube nomuthi obizwa ngokuthi i-GCSF ukusiza umzimba wakho wenze amangqamuzana egazi amhlophe engeziwe ukuze alwe nokutheleleka.
Ukwelashwa okusekelayo kungase kuhlanganise nokuletha elinye ithimba elibizwa ngokuthi ithimba lokunakekelwa kwe-palliative. Ithimba lokunakekelwa kwe-palliative lihle kakhulu ekuqinisekiseni ukuthi ukhululekile, futhi uthuthukise izimpawu zakho noma imiphumela emibi. Ezinye zezinto abangakusiza ngazo zihlanganisa ubuhlungu, ukugula noma ukuzwa ukhathazekile noma ukukhathazeka. Bangasiza futhi ukuhlela indlela yokuphatha ukunakekelwa kwezempilo kwakho esikhathini esizayo.
Kungumqondo omuhle ukubuza udokotela noma unesi wakho ukuthi iziphi izindlela zokwelapha ezisekelayo ezingakusiza.
Ukwelashwa ngemisebe (radiotherapy)
I-Radiotherapy isebenzisa imisebe ukuze ibulale amangqamuzana omdlavuza. Kufana namaX-reyi anamandla amakhulu futhi ungase ube nawo nsuku zonke amasonto ambalwa, ngokuvamile kusukela ngoMsombuluko kuya kuLwesihlanu. Ingase isetshenziselwe ukwelapha umdlavuza, ukuze ikusize ekuxoliseni - lapho umdlavuza ungasabonakali (kodwa ungase ufike kamuva), noma ungasetshenziswa ukulawula ezinye izimpawu.
Ezinye izimpawu ezingase zelashwe nge-radiotherapy zihlanganisa ubuhlungu noma ubuthakathaka. Lokhu kungenzeka uma i-lymphoma yakho icindezela izinzwa zakho, umgogodla noma ezinye izingxenye zomzimba wakho. I-radiotherapy yenza i-lymphoma (isimila) sibe sincane ukuze ingahlali icindezela izinzwa noma izingxenye zomzimba wakho ezibangela ubuhlungu.
I-Chemotherapy (i-chemo)
Ungase ube nekhemo njengethebhulethi futhi/noma ube nayo njengethonsi (ukufakwa) emthanjeni wakho (emgudwini wegazi lakho) emtholampilo womdlavuza noma esibhedlela. Ngokuvamile ubuzoba nezinhlobo ezingaphezu kweyodwa ze-chemo. I-Chemo ibulala amaseli akhula ngokushesha, ngakho-ke ingathinta namanye amaseli akho amahle akhula ngokushesha abangela imiphumela engemihle.
I-Monoclonal Antibody (MAB)
Ama-MAB anikezwa njenge-infusion futhi anamathisele kuseli ye-lymphoma futhi ahehe ezinye izifo ezilwa namangqamuzana egazi amhlophe namaprotheni kumaseli e-lymphoma. Lokhu kusiza amasosha akho omzimba akwazi ukulwa ne-HL. Kwezinye izimo, i-MAB ingase ihlanganiswe nomunye umuthi obulala ngokuqondile amaseli e-lymphoma anomdlavuza. Lawa ma-MAB abizwa nge-conjugated MABS.
Iama-mmune checkpoint inhibitors (ICIs)
Ama-IC anikezwa njengomuthi futhi asebenzela ukuthuthukisa amasosha akho omzimba, ukuze umzimba wakho ulwe nomdlavuza wakho. Lokhu bakwenza ngokuvimbela ezinye zezithiyo zokuzivikela ze-lymphoma ezifakwayo, ezibenza bangabonakali emasosheni akho omzimba. Uma izithiyo sezisusiwe, amasosha akho omzimba angabona futhi alwe nomdlavuza. Lezi ngokuvamile azisetshenziselwa izingane kanye nentsha ene-Hodgkin Lymphoma, ngaphandle uma usovivinyweni lomtholampilo.
Ukufakelwa kwe-stem cell (SCT)
Uma usemncane futhi unolaka (okhula ngokushesha) i-HL a SCT ingasetshenziswa. Ama-stem cell asiza ukufaka esikhundleni samaseli akho amabi ama-stem cells amahle, anempilo angakhula abe yinoma yiluphi uhlobo lwengqamuzana legazi olidingayo.
I-CAR T-cell Therapy
Ukuze ufunde kabanzi mayelana nokwelashwa kwe-CAR T-cell, sicela ubheke ikhasi lethu lewebhu I-Chimeric antigen receptor (CAR) T-cell therapy.
Abazali nezingane ezindala - Uma ungathanda ulwazi olwengeziwe ngalezi zindlela zokwelapha, sicela ubheke ikhasi lethu lewebhu ku Ukwelashwa lapha.
Ukwelashwa Komugqa Wokuqala
Ukuqala Ukwelashwa kwe-Hodgkin Lymphoma (HL)
Uma uqala ukwelashwa, ungase uzizwe ufana nendoda ekulesi sithombe. Kodwa ukwazi ukuthi yini ongayilindela kungenza kube lula. Ngakho qhubeka ufunda futhi sikutshele ngalokho okungenzeka.
Uma uqala ukuthola uhlobo lokwelashwa kubizwa ngokuthi ukwelashwa komugqa wokuqala. Uma uqala ukwelashwa, uzoba nakho ngemijikelezo. Lokho kusho ukuthi uzothola ukwelashwa, bese uthola ikhefu, bese kuba omunye umzuliswano (umjikelezo) wokwelashwa.
Ngokuvamile kunikezwa njengokufakwa emithanjeni yakho. Iningi lezingane kanye nentsha kuyodingeka libe nethuluzi elibizwa nge-tunneled catheter lapho umuthi ufakwa khona. I-catheter eneshubhu isetshenziswa ngakho-ke ngeke udinge ukuba ube nenaliti njalo lapho uthola ukwelashwa noma ukuhlolwa kwegazi. Ungathola imininingwane ngama-catheter ashunwe ngokuchofoza inkinobho engezansi.
Ukuze ubone okwengeziwe mayelana nezinhlobo zokwelapha zomugqa wokuqala okungenzeka ube nazo, sicela uchofoze kusibhengezo kuye ngokuthi unayo yini I-Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL), noma i-classical Hodgkin lymphoma. Khumbula ukuthi i-Hodgkin Lymphoma yakudala ihlanganisa:
- I-Nodular sclerosis classical Hodgkin lymphoma (NS-cHL)
- I-Mixed cellularity classical Hodgkin lymphoma (MC-cHL)
- I-classical Hodgkin lymphoma (LR-cHL) ecebile nge-lymphocyte
- I-Hodgkin lymphoma (LD- cHL) ephelelwe yi-lymphocyte
Ukwelashwa kwe-Nodular Lymphocyte Predominant Hodgkin lymphoma (NLPHL) kwehluke kakhulu kune-classical Hodgkin lymphoma (cHL). Uma unesigaba sokuqala se-NLPHL ukwelashwa kwakho kungase kuhlanganise okukodwa noma ngaphezulu kwalokhu okulandelayo:
- Buka futhi ulinde ukuqapha okusebenzayo kuze kube yilapho izimpawu sezidinga ukwelashwa.
- I-Radiotherapy kuphela.
- Ukuhlinzwa, uma isimila singasuswa ngokuphelele.
- Inhlanganisela yokwelapha ngamakhemikhali enethamo eliphansi noma ngaphandle kwe-radiotherapy yangaphandle ye-beam. I-Chemotherapy ingase ihlanganise imithi ebizwa ngokuthi:
- I-AVPC (i-doxorubicin, i-vincristine, i-cyclophosphamide ne-steroid ebizwa ngokuthi i-prednisone)
- I-CVP (i-cyclophosphamide, i-vincristine ne-steroid ebizwa ngokuthi i-prednisone)
- I-COG-ABVE-PC (i-doxorubicin, i-bleomycin, i-vincristine, i-etoposide, i-cyclophosphamide kanye ne-steroid ebizwa ngokuthi i-prednisone).
- I-Rituximab - lo muthi uphathwa nge-intravenously. Kuyi-monoclonal antibody eqondise isamukeli esibizwa nge-CD20 kuma-B-cell, futhi sisebenze kahle kakhulu ukwelapha ezinye izinhlobo ze-B-cell lymphoma.
- Ukubamba iqhaza esivivinyweni somtholampilo - lapho ungathola khona ukuzama izinhlobo ezintsha noma ezehlukene zemithi noma ukwelashwa.
I-Classical Hodgkin lymphoma (cHL) iyi-lymphoma ekhula ngokushesha, ngakho-ke ukwelashwa kufanele kuqale ngokushesha ngemva kokutholakala kwakho. Ukwelashwa okujwayelekile kwezingane kanye nentsha ene-cHL inhlanganisela yokwelapha ngamakhemikhali. Ezinye izingane kanye nentsha nazo zithola i-radiotherapy ezindaweni ezithile ze-lymphoma ngemva kwe-chemotherapy.
Udokotela angase atuse okunye komugqa wokuqala wokwelashwa okulandelayo kwe-Hodgkin lymphoma yezingane:
I-COG-ABVE-PC
Le nqubo ihlanganisa i-steroid ebizwa ngokuthi i-prednisolone kanye nemithi ye-chemotherapy ebizwa
- i-doxorubicin
- i-bleomycin
- i-vincristine
- etoposide
- i-cyclophosphamide
Uzoba nalokhu njalo ezinsukwini ezingama-21 (amaviki ama-3) imijikelezo emi-4-6.
I-Bv-AVECP
Le nqubo ihlanganisa i-steroid prednisolone, kanye ne-MAB ehlanganisiwe ebizwa ngokuthi i-brentuximab vedotin kanye nemithi ye-chemotherapy ebizwa ngokuthi:
- I-Doxorubicin
- UVincristine
- I-Etoposide
- i-cyclophosphamide
Uma uneminyaka engu-15 noma ngaphezulu ungase uthole ukwelashwa kwakho esibhedlela sezingane noma esibhedlela sabadala. Izinqubo zokwelapha esibhedlela sabadala zingase zehluke kunalezi esizibale ngenhla. Uma uthola ukwelashwa kwakho esibhedlela sabadala, ungathola ulwazi olwengeziwe kwethi I-Hodgkin Lymphoma yabantu abadala ikhasi lapha.
Umugqa Wesibili kanye nokwelashwa okuqhubekayo kwe-Hodgkin Lymphoma (HL)
Ngemva kokwelashwa iningi lenu lizongena eshweni. Ukukhululwa yinkathi yesikhathi lapho ungenazo khona izimpawu ze-HL emzimbeni wakho, noma lapho i-HL ilawulwa futhi ingadingi ukwelashwa. Lesi sikhathi singahlala iminyaka eminingi, kodwa kuyaqabukela, i-HL yakho ingaphindeka (buya). Uma lokhu kwenzeka, udokotela wakho angase afune ukukunikeza okunye ukwelashwa.
Kwezinye izimo, awukwazi ukungena ekwelashweni ngokwelashwa kwakho komugqa wokuqala. Uma lokhu kwenzeka, i-HL yakho ibizwa ngokuthi “i-refractory”. Uma une-HL ye-refractory udokotela wakho cishe uzofuna ukuzama imithi ehlukile. I-HL yakho ingase futhi ibizwe ngokuthi i-refractory uma uthola ukwelashwa futhi ungena ekuxolelweni, kodwa ukuxolelwa kuthatha isikhathi esingaphansi kwezinyanga eziyisi-6.
Ukwelashwa kwe-Refractory kanye ne-Relapsed Hodgkin Lymphoma (HL)
Ukwelashwa onakho uma une-HL ye-refractory noma ngemva kokuphinda ugule kubizwa ngokuthi ukwelashwa komugqa wesibili. Umgomo wokwelashwa komugqa wesibili uwukukufaka ekwephuleni futhi, noma okokuqala ngqa futhi kungasebenza kakhulu.
Uma unokunye ukuthethelelwa, bese uphinda futhi uthola ukwelashwa okwengeziwe, lokhu kwelashwa okulandelayo kubizwa ngokuthi ukwelashwa komugqa wesithathu, ukwelashwa komugqa wesine nokunye.
Ungase udinge izinhlobo eziningana zokwelapha ze-HL yakho. Ochwepheshe bathola izindlela zokwelapha ezintsha nezisebenza ngempumelelo kakhulu ezikhulisa ubude bokukhululwa futhi okusiza ukukugcina unempilo phakathi nangemuva kokwelashwa.
Udokotela uzongikhethela kanjani ukwelashwa okungcono kakhulu?
Ngesikhathi sokubuyela emuva, ukukhetha ukwelashwa kuzoncika ezintweni eziningana ezihlanganisa.
- Isikhathi esingakanani uxolelwe
- Impilo yakho jikelele kanye neminyaka yakho
- Ikuphi ukwelashwa/ukwelashwa kwe-HL okuthole esikhathini esidlule
- Izintandokazi zakho.
Udokotela wakho uzokwazi ukukhuluma nawe nabazali bakho noma ababheki bakho mayelana nokwelashwa komugqa wesibili okungcono kakhulu kuwe.
Imiphumela Emibi Evamile Yokwelashwa kwe-Hodgkin Lymphoma
Nakuba ukwelashwa kwe-HL kusebenza kahle kakhulu ekususeni i-HL, ngezinye izikhathi kungabizwa ngemiphumela emibi. Lokho kusho ukuthi bangase benze izinguquko ezingafuneki noma izimpawu. Lokhu kuvame ukuhlala isikhathi esifushane, kodwa okunye kungahlala isikhathi eside, ngakho-ke kubalulekile ukuthi wazise udokotela noma umhlengikazi wakho nganoma yimiphi imiphumela emibi onayo.
Imiphumela yakho emibi ingase yehluke komunye umuntu one-HL ngoba sonke sihlukile futhi sisabela ngendlela ehlukile ekwelashweni. Imiphumela engemihle ingase futhi incike ekutheni hlobo luni lokwelashwa onalo.
Udokotela wakho noma unesi uzokwazi ukukutshela mayelana nemiphumela engemihle ongase ukuthole ngokusekelwe ekwelashweni onakho.
Eminye yemiphumela emibi ejwayelekile yokwelashwa kwe-Hodgkin lymphoma ukubalwa kwegazi eliphansi, ngakho-ke kubalulekile ukwazi kancane kancane kulawa maseli egazi.
Amaseli abomvu egazi
Amangqamuzana egazi abomvu amangqamuzana enza igazi lakho libukeke libomvu. Anephrotheni kuwo okuthiwa i-hemoglobin (Hb) esebenza kancane njengetekisi. Icosha umoya-mpilo emaphashini akho lapho uphefumula, bese ithatha umoya-mpilo iwuyise kwezinye izingxenye zomzimba wakho ukuze ikunikeze amandla. Bese icosha i-carbon dioxide emzimbeni wakho bese ikubuyisela emaphashini akho ukuze uyikhiphe lapho uphefumula.
Uma amangqamuzana akho abomvu egazi noma i-Hb iphansi ungase uzizwe ukhathele, unesiyezi, uphelelwa umoya futhi ngezinye izikhathi ube nenkinga yokugxilisa ingqondo. Uma unalezi zimpawu, sicela utshele udokotela wakho.
Amapulatifomu
Ama-Platelets amangqamuzana akhethekile egazini lakho anombala ophuzi. Zibaluleke kakhulu uma uzilimaza noma uziqhumisa. Zisiza ukukuvimba ukuthi ungophi noma ugwaze kakhulu. Uma uzilimaza, ama-platelet akho agijimela endaweni elimele futhi anamathelane phezu kwesilonda noma isilonda ukuze avimbele ukopha. Uma ama-platelet ethu ephansi kakhulu, ungopha noma ulimele kalula kunalokho obuvame ukukwenza. Ngakho-ke uma ubona igazi elincane lapho uxubha amazinyo, uya endlini yangasese noma ushaya umoya, noma unemihuzuko eminingi kunokuvamile, kubalulekile ukukwazisa udokotela.
Amangqamuzana amhlophe egazi
Ama-lymphocyte akho awuhlobo lwamangqamuzana amhlophe egazi, kodwa futhi unezinye izinhlobo zamangqamuzana amhlophe egazi. Okubalulekile ozodinga ukwazi ngakho ama-neutrophils nama-lymphocyte akho. Wonke amangqamuzana akho amhlophe egazi ayingxenye yamasosha akho omzimba. Lokhu kusho ukuthi, wonke angamagciwane angakugulisa. Bahle kakhulu ekulweni nala magciwane, ngakho-ke isikhathi esiningi sinempilo. Kodwa, uma amangqamuzana akho amhlophe egazi engasebenzi kahle, noma uma ungenawo anele, ungagula.
Ama-neutrophils akho angawokuqala kumangqamuzana akho amhlophe egazi ukubona nokulwa namagciwane. Bese bevumela amanye amangqamuzana amhlophe, njengama-lymphocyte akho azi ukuthi kukhona amagciwane emzimbeni wakho. Uma lezi ziphansi ungagula ngokutheleleka. Uma lokhu kwenzeka ungase:
- Ngiyagula
- uthole umkhuhlane (38° noma ngaphezulu) futhi isikhumba sakho singase sizwe kushisa
- ube nokuqhaqhazela noma ukugodola (uzizwe ubanda ngempela ngaphakathi emzimbeni wakho bese uqala ukuqhaqhazela)
- abe nesilonda esibukeka sibomvu noma i-pusey
- inhliziyo yakho ingase ishaye ngokushesha kunokwejwayelekile
- uzizwa unesiyezi futhi ukhathele
Kubalulekile ukuthi utshele udokotela wakho ngokushesha uma lokhu kwenzeka uma une-Hodgkin Lymphoma, ngisho noma kwenzeka phakathi nobusuku. Uma udokotela wakho engekho, kufanele uye esibhedlela ukuze uthole umuthi othile obizwa ngokuthi ama-antibiotic ukusiza ukulwa nalesi sifo.
Nali ithebula elisheshayo nelilula elinolwazi olwengeziwe ngamaseli akho egazi.
Amaseli amhlophe | Amaseli Abomvu | Amapulatifomu | |
Igama Lezokwelapha | Ama-leukocyte. Amanye ama-leukocyte abalulekile okufanele uwakhumbule Ama-Neutrophils namaLymphocyte | Ama-erythrocyte | Ama-thrombocyte |
Benzani? | Ukulwa Nezifo | Phatha umoya-mpilo | Yeka ukopha |
Kubizwa ngani uma ungenawo anele kulawa maseli? | I-Neutropenia kanye ne-lymphopenia | I-anemia | Thrombocytopenia |
Kungawuthinta kanjani umzimba wami uma ngingenakho okwanele? | 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? |
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** Uma konke amaseli akho egazi aphansi kubizwa ngokuthi 'i-pancytopenia futhi ungadinga ukulaliswa esibhedlela ukuze uzilungise** | |||
Eminye imiphumela emibi ongayithola yile:
- ukuzizwa ugula esiswini (isicanucanu) kanye nokuhlanza
- umlomo obuhlungu noma izilonda. Izinto zingase futhi ziqale ukunambitha ngokwehlukile
- izinguquko uma uya endlini yangasese. Ungase ube nendle eliqinile (ukuqunjelwa) noma indle elithambile nelimanzi (uhudo)
- ukukhathala noma ukungabi namandla okungasizwa ukuphumula noma ukulala (ukukhathala)
- izinhlungu nezinhlungu emisipha nasemalungeni akho
- Izinwele zakho ekhanda lakho, nezinye izingxenye zomzimba wakho zingase ziwe
- kungase kube nzima ukugxilisa ingqondo noma ukukhumbula izinto
- imizwa eyinqaba ezandleni nasezinyaweni zakho njengokuluma, izikhonkwane nezinaliti, ukushisa noma ubuhlungu
- izinguquko emangqamuzaneni akho egazi amahle (bheka ithebula elingenhla).
Izivivinyo zemitholampilo
Siphakamisa ukuthi uhlale ubuza udokotela wakho mayelana nanoma yiziphi izivivinyo zomtholampilo ongase ukufanelekele.
Izivivinyo zomtholampilo zibalulekile ukuthola imithi emisha, noma izinhlanganisela zemithi yokuthuthukisa ukwelashwa kwe-HL esikhathini esizayo. Bangakunikeza nethuba lokuzama umuthi omusha, inhlanganisela yemithi noma ezinye izindlela zokwelapha ongazithola kuphela uma usovivinyweni. Ukwelashwa kwe-CAR T-cell kuyisibonelo sohlobo lokwelashwa okwamanje osekuhlolweni komtholampilo.
Uma ungathanda ukubamba iqhaza esivivinyweni somtholampilo, buza udokotela wakho ukuthi akhona yini ofaneleka ukuwathola.
Ukubikezela, Ukunakekelwa Kokulandelela Nokusinda - ukuhlala kanye nangemva kuka-HL
Isibikezelo
Ukubikezela kwakho kubhekisela ekutheni i-HL yakho izosabela kanjani ekwelashweni nokuthi uzophila kanjani ngemva kokwelashwa.
Abantu abaningi abane-Hodgkin lymphoma belashwa ngemva kokwelashwa komugqa wokuqala. Nokho, lokhu akunjalo kuwo wonke umuntu. Uma i-HL yakho ingasuki ngemva kokwelashwa (awuyi ekuxolelweni), uzoba ne-HL “refractory”. Lokhu kusho ukuthi i-HL yakho ayiphenduli ekwelashweni kwamanje, ngakho udokotela wakho uzozama enye into.
Uma kwenzeka ungena ekwelapheni ngemva kokwelashwa, kodwa kubuya ngemva kwesikhashana kubizwa ngokuthi ukuphindela emuva. Okusha okuhle wukuthi, i-Hodgkin lymphoma ehlanekezela futhi ephinde yavela ivamise ukuphendula kahle ekwelashweni komugqa wesibili.
Kunezici ezihlukene ezingathinta ukubikezela kwakho, kodwa udokotela wakho ungumuntu ongcono kakhulu ongakhuluma naye ngalokhu njengoba azi yonke imininingwane yakho. Uma ungaqiniseki ukuthi yini ukubikezela kwakho, vele ubabuze ngokuzayo uma ubabona.
Ukunakekelwa kokulandelela
Ukunakekelwa okuthola kodokotela bakho nabahlengikazi akupheli lapho uqeda ukwelashwa. Eqinisweni, basazofuna ukukubona njalo ukuze bazi ukuthi uhamba kanjani futhi bahlole ukuthi awunayo yini imiphumela emibi ehlala njalo yokwelashwa. Bazophinde bahlele amaskena ukuze uqiniseke ukuthi i-HL yakho ayibuyi.
Kubaluleke kakhulu ukuthi uye kuwo wonke lawa ma-aphoyintimenti abakwenzela wona, ukuze noma iluphi uphawu lokuphindela emuva noma imiphumela engemihle emisha ibanjwe kusenesikhathi futhi ugcinwe uphilile futhi uphephile.
Eminye imiphumela emibi yokwelashwa ingaqala isikhathi eside ngemva kokuqeda ukwelashwa. Eminye imiphumela emibi yesikhathi eside ingase ihlanganise:
- ukukhathala okuqhubekayo
- umlomo owomile - lokhu kungandisa ingozi yesifo samazinyo
- izinkinga ngokukhula kwamathambo kanye nokuthuthukiswa kwezitho zobulili kwabesilisa
- izinkinga ze-thyroid, inhliziyo namaphaphu
- ukwanda kwengozi yomunye umdlavuza njengomdlavuza webele (uma ubunemisebe esifubeni sakho), i-non-Hodgkin lymphoma, i-acute leukemia noma umdlavuza wegilo
- ukungazali
Ukutholwa kusenesikhathi ngokuhlolwa njalo nodokotela wakho, nokukhetha impilo enempilo kunganciphisa umthelela wemiphumela yesikhathi eside neyokwephuzile kwabasinde be-HL besikhathi eside.
Ukusinda - ukuhlala kanye nangemva kwe-Hodgkin Lymphoma
Imigomo eyinhloko ngemva kokwelashwa kwe-HL wukubuyela ekuphileni futhi:
- khuthala ngangokunokwenzeka esikoleni sakho, emndenini, ezixukwini nakwezinye izindima zempilo
- nciphisa imiphumela emibi kanye nezimpawu ze-HL kanye nokwelashwa kwayo
- khomba futhi ulawule noma yimiphi imiphumela emibi ngemva kwesikhathi
- ukukusiza ukuthi uzimele ngangokunokwenzeka
- ngcono izinga lakho lempilo futhi ugcine impilo enhle yengqondo
Ukwenza izinqumo ezinempilo
Indlela yokuphila enempilo, noma ezinye izinguquko ezinhle zokuphila ngemva kokwelashwa zingaba usizo olukhulu ekululameni kwakho. Ziningi izinto ongazenza ukukusiza ukuthi uphile kahle no-HL. Zihlanganisa:
- zivocavoce njalo - gcina umzimba wakho unyakaza
- idla ukudla okunempilo isikhathi esiningi
- khuluma ngendlela ozizwa ngayo nabantu obathembayo
- gwema ugwayi (ukubhema)
- phumula lapho umzimba wakho ukhathele
- vumela udokotela wakho uma ubona noma yiziphi izinguquko, ezifana nesinye isigaxa esikhulayo, ukuthola ukushisa noma ukujuluka ebusuku.
Ukuvuselelwa komdlavuza
Kungase kuthathe isikhathi ukubuyela esimeni esijwayelekile, uzibekezelele, umzimba wakho udlule ezintweni eziningi. Uma udonsa kanzima ngempela ukubuyela esimeni esijwayelekile, ungakhuluma nodokotela wakho mayelana nokuthi yiluphi uhlobo lokululama lomdlavuza olutholakalayo kuwe.
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
Ama-Factsheets esinawo ngawe kuwebhusayithi
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
