Kuyini iLymphoplasmacytic Lymphoma?

-Delile

• I-LPL namanye ama-lymphomas
• Kwenzekani kumasosha omzimba?
• Ziyini izimpawu?
• Kubangelwa yini?
• Kutholakala kanjani?
• Izinketho zokwelashwa
• Bukela bese ulinda
• Ukwelashwa ngamakhemikhali
• Ukwelashwa kwezinto eziphilayo
• Ukwelashwa okuhlosiwe
• Ukufakelwa kwesitokisi
• Ukuhlolwa kwemitholampilo
• Uyini umbono?

Ukubuka konke

I-Lymphoplasmacytic lymphoma (LPL) uhlobo lomdlavuza olungavamile olukhula kancane futhi luthinte ikakhulukazi abantu abadala. Isilinganiso seminyaka yokuxilongwa sineminyaka engama-60.

AmaLymphomas angumdlavuza wohlelo lwe-lymph, ingxenye yesistimu yakho yomzimba esiza ukulwa nezifo. E-lymphoma, amangqamuzana amhlophe egazi, kungaba ama-lymphocyte B noma ama-T lymphocyte, akhula angalawuleki ngenxa yokuguquka kwezakhi zofuzo. Ku-LPL, ama-lymphocyte B angajwayelekile akhiqiza emnkantsheni wakho wethambo futhi asuse amangqamuzana egazi aphilile.

Kunamacala angaba ngu-8.3 we-LPL kubantu abayisigidi esisodwa e-United States naseNtshonalanga Yurophu. Kuvame kakhulu emadodeni naseCaucasus.

I-LPL namanye ama-lymphomas

I-Hodgkin's lymphoma ne-non-Hodgkin's lymphoma ihlukaniswa ngohlobo lwamangqamuzana aba nomdlavuza.

• Ama-lymphomas kaHodgkin anohlobo oluthile lweseli engavamile, ebizwa nge-Reed-Sternberg cell.
• Izinhlobo eziningi zama-lymphomas angewona ama-Hodgkin zihlukaniswa lapho umdlavuza uqala khona kanye nezakhi zofuzo nezinye izici zamangqamuzana amabi.

I-LPL iyi-lymphoma engeyona ye-Hodgkin eqala kuma-lymphocyte B. I-lymphoma engavamile kakhulu, equkethe kuphela amaphesenti angu-1 kuya kwangu-2 kuwo wonke ama-lymphomas.

Uhlobo oluvame kakhulu lwe-LPL yiWaldenström macroglobulinemia (WM), ekhonjiswa ngomkhiqizo ongajwayelekile we-immunoglobulin (antibodies). I-WM kwesinye isikhathi ibizwa ngephutha ngokufana ne-LPL, kepha empeleni iyisethi engaphansi ye-LPL. Cishe abantu abangu-19 kwabangu-20 abane-LPL bane-immunoglobulin engavamile.

Kwenzekani kumasosha omzimba?

Lapho i-LPL ibangela ama-lymphocyte B (amaseli B) ukuba akhiqize ngokweqile emnkantsheni wakho wethambo, kukhiqizwa amangqamuzana egazi ajwayelekile ambalwa.

Ngokuvamile, amangqamuzana e-B asuka emnkantsheni wakho aya esikhaleni sakho sobende kanye nama-lymph node. Lapho, angaba ngamaseli e-plasma akhiqiza amasosha omzimba ukulwa nezifo. Uma ungenawo amangqamuzana egazi ajwayelekile ajwayelekile, kubeka engozini amasosha akho omzimba.

Lokhu kungaholela ku:

• i-anemia, ukushoda kwamaseli abomvu egazi
• i-neutropenia, ukushoda kohlobo lwamaseli amhlophe egazi (okuthiwa ama-neutrophils), okwandisa ingozi yokutheleleka
• i-thrombocytopenia, ukushoda kwama-platelet egazi, okwandisa ukopha nokulimaza izingozi

Ziyini izimpawu?

I-LPL umdlavuza okhula kancane, futhi cishe ingxenye eyodwa kwezintathu zabantu abane-LPL abanazo izimpawu ngesikhathi betholakala.

Amaphesenti angama-40 abantu abane-LPL banefomu elincane le-anemia.

Ezinye izimpawu ze-LPL zingafaka:

• ubuthakathaka nokukhathala (okuvame ukubangelwa yi-anemia)
• umkhuhlane, ukujuluka ebusuku, nokwehla kwesisindo (okuhambisana kakhulu ne-B-cell lymphomas)
• ukungaboni kahle
• isiyezi
• ukuphuma kwamakhala emakhaleni
• izinsini ezophayo
• imihuzuko
• i-beta-2-microglobulin ephakeme, umaka wegazi wezimila

Cishe amaphesenti ayi-15 kuye kwangama-30 alabo abane-LPL bane:

• i-lymph node evuvukile (i-lymphadenopathy)
• ukukhulisa isibindi (hepatomegaly)
• ukukhulisa ubende (splenomegaly)

Kubangelwa yini?

Isizathu se-LPL asiqondakali ngokuphelele. Abaphenyi baphenya ngamathuba amaningi:

• Kungaba nesakhi sofuzo, cishe umuntu oyedwa kwabahlanu abane-WM abanesihlobo esine-LPL noma uhlobo olufanayo lwe-lymphoma.
• Ezinye izifundo zithole ukuthi i-LPL ingahle ihlotshaniswe nezifo ezizimele njenge-Sjögren syndrome noma negciwane le-hepatitis C, kodwa ezinye izifundo azibonisanga lesi sixhumanisi.
• Abantu abane-LPL ngokuvamile banezinguquko ezithile zofuzo ezingazuzwa njengefa.

Kutholakala kanjani?

Ukuxilongwa kwe-LPL kunzima futhi imvamisa kwenziwa ngemuva kokukhipha amanye amathuba.

I-LPL ingafana namanye ama-B-cell lymphomas anezinhlobo ezifanayo zokuhlukaniswa kwamaseli e-plasma. Lokhu kufaka phakathi:

• ingubo yeseli lymphoma
• i-lymphocytic leukemia engapheli / i-lymphoma encane ye-lymphocytic
• umkhawulo wendawo lymphoma
• i-plasma cell myeloma

Udokotela wakho uzokuhlola ngokomzimba bese ekucela umlando wezokwelapha. Bazo-oda ukusebenza kwegazi futhi mhlawumbe nomnkantsha wamathambo noma i-lymph node biopsy ukubheka amaseli angaphansi kwesibonakhulu.

Udokotela wakho futhi angasebenzisa ezinye izivivinyo ukukhipha umdlavuza ofanayo futhi anqume isigaba sesifo sakho. Lokhu kungafaka i-X-ray yesifuba, i-CT scan, i-PET scan ne-ultrasound.

Izinketho zokwelashwa

Bukela bese ulinda

I-LBL ngumdlavuza okhula kancane. Wena nodokotela wakho ninganquma ukulinda nokuqapha igazi lakho njalo ngaphambi kokuqala ukwelashwa. Ngokwe-American Cancer Society (ACS), abantu ababambezela imishanguzo kuze kube yilapho izimpawu zabo zinenkinga banempilo ende njengabantu abaqala ukwelashwa ngokushesha nje lapho betholakala.

Ukwelashwa ngamakhemikhali

Izidakamizwa eziningana ezisebenza ngezindlela ezahlukene, noma inhlanganisela yezidakamizwa, zingasetshenziswa ukubulala amangqamuzana omdlavuza. Lokhu kufaka phakathi:

• i-chlorambucil (Leukeran)
• i-fludarabine (Fludara)
• i-bendamustine (iTreanda)
• i-cyclophosphamide (iCytoxan, iProcytox)
• i-dexamethasone (i-Decadron, i-Dexasone), i-rituximab (i-Rituxan), ne-cyclophosphamide
• i-bortezomib (i-Velcade) ne-rituximab, ene-dexamethasone noma ngaphandle kwayo
• i-cyclophosphamide, i-vincristine (i-Oncovin) ne-prednisone
• i-cyclophosphamide, i-vincristine (i-Oncovin), i-prednisone, ne-rituximab
• i-thalidomide (Thalomid) ne-rituximab

Uhlobo oluthile lwezidakamizwa luzohluka, kuye ngempilo yakho ejwayelekile, izimpawu zakho, kanye nokwelashwa okungenzeka esikhathini esizayo.

Ukwelashwa kwezinto eziphilayo

Izidakamizwa zokwelashwa kwezinto eziphilayo yizinto ezenziwe ngabantu ezisebenza njengesistimu yakho yomzimba yokubulala amaseli e-lymphoma. Le mithi ingahlanganiswa nezinye izindlela zokwelapha.

Amanye ala ma-antibody enziwe ngezandla, abizwa ngama-antibody monoclonal, yile:

• i-rituximab (Rituxan)
• ofatumumab (i-Arzerra)
• i-alemtuzumab (campath)

Ezinye izidakamizwa zebhayoloji yimithi yokuzivikela emzimbeni (i-IMiDs) nama-cytokines.

Ukwelashwa okuhlosiwe

Imithi yokwelashwa ehlosiwe ihlose ukuvimba izinguquko ezithile zeseli ezibanga umdlavuza. Eminye yale mithi isetshenziselwe ukulwa neminye imidlavuza kanti manje isacwaningelwa i-LBL. Ngokuvamile, le mithi ivimba amaprotheni avumela amangqamuzana e-lymphoma ukuthi aqhubeke nokukhula.

Ukufakelwa kwesitokisi

Lokhu ukwelashwa okusha i-ACS ethi kungaba yindlela yabantu abasha abane-LBL.

Ngokuvamile, ama-stem cells akha igazi asuswa egazini bese egcinwa efriziwe. Bese kuthi umthamo omkhulu wamakhemikhali noma wemisebe usetshenziselwe ukubulala wonke amangqamuzana omnkantsha wamathambo (ajwayelekile futhi anomdlavuza), bese amaseli wangempela akha igazi abuyiselwa egazini. Amaseli esiqu angavela kumuntu owelashwa (i-autologous), noma anganikelwa ngumuntu osondelene kakhulu nomuntu (i-allogenic).

Yazi ukuthi ukufakelwa ama-stem cell kusesigabeni sokuhlola. Futhi, kunemiphumela engemihle yesikhathi esifushane neyesikhathi eside evela kulokhu kufakelwa.

Ukuhlolwa kwemitholampilo

Njengezinhlobo eziningi zomdlavuza, izindlela ezintsha zokwelapha ziyakhiwa, futhi ungathola isilingo somtholampilo ongabamba iqhaza kuso. Buza udokotela wakho ngalokhu bese uvakashela iClinicalTrials.gov ukuthola eminye imininingwane.

Uyini umbono?

I-LPL okwamanje ayikabi nalo ikhambi. I-LPL yakho ingangena ekuxolelweni kodwa iphinde ivele futhi. Futhi, yize kuwumdlavuza okhula kancane, kwezinye izimo ungaba nolaka ngokwengeziwe.

I-ACS iphawula ukuthi amaphesenti angama-78 abantu abane-LPL basinda eminyakeni emihlanu noma ngaphezulu.

Izinga lokusinda kwe-LPL liyathuthuka njengoba kuthuthukiswa imishanguzo emisha kanye nokwelashwa okusha.