I-Lymphoma: kuyini, izimpawu eziyinhloko nokwelashwa

-Delile

• Izimpawu eziyinhloko
• Uyini umehluko phakathi kwe-lymphoma ne-leukemia
• Ziyini izimbangela
• Ungakuqinisekisa kanjani ukuxilongwa
• Yelashwa kanjani
• 1. Ukwelashwa ngamakhemikhali
• 2. I-Radiotherapy
• 3. Ukwelashwa komzimba
• 4. Ukufakelwa umnkantsha wethambo
• 5. Ukwelashwa kwezakhi zofuzo
• 6. Ukuhlinzwa
• Ingabe i-lymphoma ingaphulukiswa?

ILymphoma wuhlobo lomdlavuza oluthinta ama-lymphocyte, okungamaseli abhekele ukuvikela umzimba ezifweni nasezifweni. Lolu hlobo lomdlavuza luqala kakhulu kuma-lymph node, awaziwa nangokuthi ama-lingas, atholakala ekhwapheni, emgodini nasentanyeni, okuholela ekwakhekeni kwezigaxa futhi okungadala izimpawu ezifana nomkhuhlane, ukujuluka ebusuku, ukukhathala ngokweqile nokuncipha komzimba ngaphandle kwesizathu.

Ngokuvamile, i-lymphoma ivame kakhulu kubantu abadala kunezingane, kanti abanye abantu bangase babe sengozini enkulu yokuthola lesi sifo, njengalabo abanomlando womndeni we-lymphoma, abanesifo esibangela ukuzivikela okuncane noma abathelelekile ngamagciwane athile afana ne-HIV, i-Epstein-Barr noma i-HTLV-1.

Kunezinhlobo ezimbili ze-lymphoma, engahlukaniswa ngezici zamaseli amabi atholakala ezivivinyweni zokuxilonga, njenge:

• I-lymphoma kaHodgkin, okungajwayelekile, kuthinta abantu asebekhulile futhi kuhlose amaseli wokuvikela umzimba, thayipha ama-lymphocyte B;
• I-non-Hodgkin's lymphoma, okuvame kakhulu futhi okuvame ukuvela kuma-lymphocyte ka-B no-T. Bheka okwengeziwe nge-non-Hodgkin's lymphoma.

Ukuxilongwa kwalezi zinhlobo zombili ze-lymphoma kwenziwa ngokuhlolwa kwegazi, ukuhlolwa kwe-imaging kanye nomnkantsha wamathambo kanti ukwelashwa kusekelwe ikakhulu ekwelashweni ngamakhemikhali, i-radiotherapy kanye nokufakwa komnkantsha wamathambo. Uma kutholakala kusenesikhathi futhi uma ukwelashwa kuqalwa ngokushesha okukhulu, amathuba okuphulukisa i-lymphoma aphezulu.

Izimpawu eziyinhloko

Izimpawu eziyinhloko ze-lymphoma umkhuhlane oqhubekayo, ukujuluka ebusuku nokuba khona kwama-lymph node akhulisiwe, abonwa ngokuba khona kwezigaxa entanyeni, ekhwapheni noma emgodini. Ezinye izimpawu ezingabonisa ukuthi i-lymphoma yilezi:

• Ukukhathala ngokweqile;
• Ukulunywa;
• Malaise;
• Ukuphelelwa isifiso sokudla;
• Ukuncipha ngaphandle kwesizathu esisobala;
• Ukuphefumula kanzima nokukhwehlela.

Ngaphezu kwalezi zimpawu, ubende, okuyilungu elibhekele ukukhiqizwa kwamaseli wokuvikela, atholakala ohlangothini olungaphezulu kwesobunxele esiswini, angathinteka yi-lymphoma futhi avuvuke abangele nobuhlungu, futhi ngaphezu kwalokho, lapho I-lymph node ikhuliswe kakhulu, ingacindezela inzwa emlenzeni futhi ibangele ukuba ndikindiki noma ukuhayiza. Yazi ezinye izimpawu zomdlavuza we-lymphatic.

Lapho kukhona ezinye zalezi zimpawu, kunconywa ukuya kudokotela ukuze uhlolwe futhi, uma ukuxilongwa kuqinisekisiwe, ukwelashwa okufanele kungaqalwa ngokuyalelwa ngudokotela ojwayelekile, i-hematologist noma i-oncologist.

Uyini umehluko phakathi kwe-lymphoma ne-leukemia

Kwi-leukemia, amangqamuzana abulalayo aqala ukwanda emnkantsheni wethambo, kanti e-lymphoma, umdlavuza uqala kuma-lymph node, noma olimini. Ngaphezu kwalokho, yize ezinye izimpawu zifana, njengomkhuhlane nokujuluka ebusuku, kwi-leukemia kuvame kakhulu ukopha futhi kuvele amabala ansomi emzimbeni, kuthi ku-lymphoma, kube nesikhumba esilumayo.

Ziyini izimbangela

Izimbangela ze-lymphoma azikachazwa kahle, kepha abantu abaneminyaka engaphezu kwengu-60 kungenzeka ukuthi bathuthukise i-non-Hodgkin's lymphoma. Ezinye izinto ezingahle zihlotshaniswe nokuvela kwe-lymphoma ukutheleleka ngegciwane lesandulela ngculaza, igciwane le-Epstein-Barr, elibanga i-mononucleosis, i-HTLV-1, ebhekele izinhlobo ezithile zesifo sokusha kwesibindi, nokutheleleka ngamagciwane I-Helicobacter pylori, lokho kungatholakala esiswini.

Ngaphezu kwalokho, ukuba nesifo esidala amasosha omzimba aphansi, ukuba nesifo sokuzivikela komzimba, njenge-lupus noma isifo se-celiac, kanye nokusebenza ezindaweni ezinokuchayeka okuningi kumakhemikhali, njengezibulala-zinambuzane, kungaba nethonya ekuqaleni kwe-lymphoma . Bona ukuthi yini engadala umdlavuza we-lymphatic.

Ungakuqinisekisa kanjani ukuxilongwa

Ukuxilongwa kwe-lymphoma kwenziwa ngokuhlolwa kwezimpawu ngudokotela ojwayelekile, i-hematologist noma i-oncologist kanye nemiphumela yokuhlolwa okuthile, okufana nalokhu:

• Ukuhlolwa kwegazi: zisetshenziselwa ukuhlola amaseli egazi nama-enzyme, ngoba izinguquko ku-leukogram, njengokunyuka kwama-lymphocyte, kanye nokwanda kwe-lactic dehydrogenase (LDH) kungakhombisa ubukhona be-lymphoma;
• I-X-ray: inikeza izithombe zezingxenye zomzimba ezingathinteka yi-lymphoma;
• I-tomography ebaliwe: ivumela ukubukwa kwezithombe zezitho zomzimba ngokuningiliziwe kune-X-ray, ukwazi ukuthola i-lymphoma;
• Ukucabanga kwemagnetic resonance: kanye ne-computed tomography, isebenza ukuthola izindawo zomzimba ezithintwe yi-lymphoma ngezithombe;
• Ukuskena okufuywayo: wuhlobo lwe-computed tomography, olusiza ekutholeni i-metastasis, okuyilapho i-lymphoma isakazeka ezingxenyeni ezahlukahlukene zomzimba;

Kuyakhonjiswa futhi ngudokotela ukwenza i-bone marrow biopsy equkethe ukususa ingxenye encane yethambo ekhalweni ukuze ahlaziye amaseli omnkantsha athole ukuthi ngabe athintekile yini yi-lymphoma.

Yelashwa kanjani

Kusukela emiphumeleni yezivivinyo, i-hematologist noma i-oncologist izokhombisa ukwelashwa ngokuya ngohlobo, usayizi, izinga kanye nesifunda lapho kutholakala khona i-lymphoma, kanye neminyaka yomuntu nesimo sakhe jikelele. Ngale ndlela, i-lymphoma ingelashwa ngalezi zinketho ezilandelayo:

1. Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelashwa equkethe ukuphathwa kwezidakamizwa ngomthambo, ngokusebenzisa ipayipi, ukuqeda amangqamuzana omdlavuza abangela i-lymphoma. Imithi yokwelapha ngamakhemikhali esetshenziswa kakhulu ukwelapha i-lymphoma i-doxorubicin, i-bleomycin, i-dacarbazine ne-vinblastine futhi ijwayele ukusetshenziswa ngosuku olufanayo, njengengxenye yenqubo yokwelashwa, ukukhetha umthetho olandelwayo udokotela ngokuya ngohlobo lwe-lymphoma etholakele.

Ama-chemotherapy protocols enziwa njalo emavikini amathathu noma amane, njengoba le mithi inemiphumela emibi enamandla, njengokulahleka kwezinwele, isicanucanu nokuhlanza, ukungathandi ukudla nokuncipha kokuzivikela komzimba, kuthatha isikhathi eside ukuthi umzimba ululame. Ngokuya ngohlobo lwe-lymphoma, udokotela uzonquma ukuthi kuzodingeka kangaki ukuphinda imithi, okungukuthi, imijikelezo eminingi yamakhemikhali ezokwenziwa.

2. I-Radiotherapy

I-Radiotherapy yindlela yokwelapha esetshenziselwa ukubhubhisa amangqamuzana omdlavuza ngemisebe ekhishwa ngumshini ngqo kwi-lymph node ethinteka yi-lymphoma, lapho kwenziwa khona ukumaka esikhunjeni ukuze le radiation inikezwe endaweni efanayo ngaso sonke isikhathi.

Ngaphambi kokuqala ukwelashwa nge-radiotherapy, i-radiotherapist, ngosizo lwezivivinyo ze-imaging, yenza ukuhlela kwendawo yomzimba lapho kune-lymphoma khona futhi izokhombisa isilinganiso semisebe, ubuningi nobude bezikhathi.

Isikhathi esiningi, i-radiotherapy isetshenziswa ngokubambisana nezinye izindlela zokwelapha ukukhulisa amathuba okususa amaseli abanga i-lymphoma, futhi ibanga imiphumela emibi njengokulahlekelwa isifiso sokudla, ukugula, ukuzwa ukushisa endaweni esetshenzisiwe. Bona ukuthi uzodlani ukunciphisa imiphumela yokwelashwa ngemisebe.

3. Ukwelashwa komzimba

Ezinye izinhlobo ze-lymphoma zingelashwa ngemithi yokuzivikela emzimbeni, okuyizidakamizwa ezisiza amasosha omzimba ukulwa namaseli e-lymphoma, kanti imiphumela emibi ingaphansi kwaleyo yokwelashwa ngamakhemikhali.

Le mithi isetshenziswa nezinye izindlela zokwelapha, okwandisa amathuba okuphulukisa i-lymphoma. Eminye imishanguzo ye-immunotherapy esetshenziselwa ukwelapha i-lymphoma yi-rituximab, i-bortezomib ne-lenalidomide.

4. Ukufakelwa umnkantsha wethambo

Ukufakelwa komnkantsha wethambo ukwelashwa okuqukethe ukubulala amangqamuzana e-lymphoma agulayo nokuwafaka ngamaseli ama-stem anempilo. Ngaphambi kokuthola ama-stem cells anempilo, kudingeka i-chemotherapy ephezulu yokubulala wonke amangqamuzana omdlavuza emzimbeni. Funda kabanzi mayelana nokuthi ayini ama-stem cells nokuthi angasiza kanjani.

Kunezinhlobo ezimbili zokufakwa komnkantsha wethambo okuyi-autologous, lapho kutholwa ama-stem cell avela kumuntu uqobo, kanye ne-allogeneic, okuyilapho ama-stem cell atholakala komunye umuntu. Ukuze uthole umnkantsha wethambo komunye umuntu, kufanele uhambisane, ngakho-ke ngaphambi kokufakelwa, kwenziwa ukuhlolwa kwegazi, kumuntu one-lymphoma nakumuntu ozonikela ngomnkantsha.

5. Ukwelashwa kwezakhi zofuzo

Njengamanje, kuqala ukwelashwa okusha kwe-lymphoma okubizwa nge-CAR-T-cell, okuyilapho amaseli okuvikela omzimba asuswa futhi ahlelwa kabusha ngohlobo oluthile lwezinhlayiya bese lawo maseli afanayo angeniswa emzimbeni esiza ukwandisa amasosha omzimba nokulwa namaseli omdlavuza. Le ndlela yokwelashwa isacwaningwa futhi ayitholakali kuzo zonke izibhedlela. Thola okuningi mayelana nokuthi ukwelashwa kwenziwa kanjani kusetshenziswa inqubo ye-CAR-T-cell.

6. Ukuhlinzwa

Kwezinye izimo, lapho ama-lymph node enyuka ngosayizi omkhulu, ngenxa ye-lymphoma, angafinyelela kwezinye izitho ezifana nobende ngakho-ke udokotela angancoma ukuhlinzwa ukuze kususwe lesi sitho. Ngaphambi kokwenza ukwelashwa, kwesinye isikhathi kuyadingeka ukwenza ukuhlinzwa okuncane ukuze kususwe i-lymph node, ukuze kwenziwe i-biopsy yokuhlaziya amaseli womdlavuza.

Ingabe i-lymphoma ingaphulukiswa?

Imiphumela yokwelashwa iyahlukahluka ngokuya ngohlobo nezinga le-lymphoma, kepha ezimweni eziningi kuyelapheka uma welashwa ngokwezincomo zezokwelapha. Ngaphezu kwalokho, lapho lesi sifo sitholakala futhi silashwa kusenesikhathi, amathuba okuthi aselapheke maningi nakakhulu.

Imithi emisha yokwelashwa, ucwaningo olusha kanye nokunakekelwa okungcono kokusekelwa komuntu owelaswayo kuyenziwa futhi ngenxa yalokho kuba nemiphumela engcono futhi, ngenxa yalokho, kulindelwe izinga lempilo.