Kuti unzwisise FL, unofanirwa kuziva zvishoma nezveB-Cell lymphocytes yako.
B-Cell lymphocytes:
- Imhando yemasero machena eropa
- Rwisa utachiona nezvirwere kuti uchengetedze hutano.
- Rangarira utachiona hwawaiva nahwo munguva yakapfuura, saka kana ukawana utachiona humwe chetehwo zvakare, immune system yemuviri wako inogona kurwisa zvakanyanya uye nekukurumidza.
- Inogadzirwa mumwongo wako (iyo spongy chikamu pakati pemapfupa ako), asi kazhinji inogara muspleen yako uye lymph nodes yako. Vamwe vanogara mu thymus neropa rako zvakare.
- Inogona kufamba kuburikidza ne lymphatic system yako, kune chero chikamu chemuviri wako kurwisa hutachiona kana chirwere.
Follicular lymphoma (FL) inokura apo B-masero ako anova kenza
FL inokura apo mamwe eB-cell lymphocytes ako akadanwa follicular centre B-masero kuva kenza. Kana chiremba wezvirwere achitarisa ropa rako kana biopsies, pasi pemaikorosikopu vanokuona uine musanganiswa wemasero ecentrocyte, madiki kusvika pakati nepakati B-cells, uye centroblasts ari maB-cell makuru.
Lymphoma inoitika apo masero aya anokura asingadzoreki, asina kujairika, uye haafe paanofanira.
Paunenge uine FL kenza B-masero:
- Hazvishande zvinobudirira kurwisa hutachiona uye zvirwere.
- Inogona kutaridzika zvakasiyana kune ako ane hutano B-lymphocyte masero.
- Inogona kukonzera lymphoma kukura uye kukura mune chero chikamu chemuviri wako.
FL ndiyo inonyanya kukura inononoka (indolent) lymphoma uye nekuda kwekusaziva kweiyo lymphoma inowanzoitika kana iri nhanho yepamusoro. Yepamberi nhanho yeFL hairapi, asi chinangwa chekurapa kudzora kwechirwere kwemakore mazhinji. Kana FL yako ikaonekwa mumatanho ekutanga, unogona kurapwa nemamwe marudzi ekurapa.
Nguva nenguva, Follicular lymphoma (FL) inogona kuratidza musanganiswa wemaseru ayo anosanganisirawo hutsinye (kukura nekukurumidza) B-Cell Lymphoma. Kuchinja kwemaitiro uku kunogona kuitika nekufamba kwenguva uye kunonzi 'shanduko'. Yakashandurwa FL inoreva kuti masero ako anotaridzika uye anozvibata zvakanyanya Kuparadzira hombe B cell lymphoma (DLBCL) kana kashoma, Burkitt's lymphoma (BL).
Ndiani anowana follicular lymphoma (FL)?
FL ndiyo yakajairika subtype yekukura zvishoma nezvishoma (indolent) Non-Hodgkin's Lymphoma (NHL). Vanenge vaviri kubva kune gumi vanhu vane indolent lymphomas vane subtype yeFL. Inowanzoonekwa muvanhu vanopfuura makore makumi mashanu, uye vakadzi vanoiwana zvishoma kakawanda kupfuura varume.
Pediatric follicular lymphoma haiwanzo asi inogona kuitika muvana, vechidiki uye vechidiki. Inozvibata zvakasiyana kune yevakuru subtype uye inogona kazhinji kurapwa.
Chii chinokonzera follicular lymphoma?
Hatizive kuti chii chinokonzeresa FL, asi zvakasiyana zvine njodzi zvinofungidzirwa kuwedzera njodzi yako yekuigadzira. Zvimwe, zvinhu zvengozi zveFL zvinofungidzirwa kuti zvinosanganisira:
- mamiriro anokanganisa immune system yako senge Celiac chirwere, Sjogren's syndrome, lupus, rheumatoid arthritis kana human immunodeficiency virus (HIV)
- kurapwa kenza kwekare, nechemotherapy kana radiation therapy
- nhengo yemhuri ine lymphoma
*Zvakakosha kuziva, havasi vanhu vese vane njodzi idzi vanozogadzira FL, uye vamwe vanhu vasina kana chimwe chezvinhu izvi zvine njodzi vanogona kugadzira FL.
Chiitiko chemurwere ne follicular lymphoma (FL)
Zviratidzo zve follicular lymphoma (FL)
Iwe unogona kunge usina chero zviratidzo paunotanga kubatwa neFL. Vanhu vazhinji vanongoonekwa chete kana vakaongororwa ropa, mascans, kana kuongororwa kwemuviri kune chimwe chinhu. Izvi zvinokonzerwa neusimbe - kunonoka kukura kana kurara hunhu hweFL.
Kana iwe ukaona zviratidzo, zviratidzo zvekutanga zveFL zvinogona kuva bundu, kana mapundu akawanda anoramba achikura. Unogona kunzwa kana kuzviona pamutsipa wako, muhapwa, kana kugomba. Mapundu aya akakurisa malymph nodes (glands), akazvimba nekuwanda maB-cell ane gomarara ari kukura maari. Dzinowanzotanga muchikamu chimwe chemuviri wako, dzobva dzapararira mu lymphatic system yako.
Aya ma lymph nodes anogona kukura zvishoma nezvishoma kwenguva yakareba, izvo zvinogona kuita kuti zvive zvakaoma kuona kana pane shanduko.
Follicular Lymphoma (FL) inogona kupararira kune chero chikamu chemuviri wako
FL inogona kupararira kune yako
- spleen
- thymus
- mapapu
- chiropa
- mafupa
- bone marrow
- kana mimwe mitezo.
Spleen inhengo inosefa ropa rako richirichengetedza. Iyo zvakare inhengo ye lymphatic system yako uko B-masero ako anogara uye kugadzira masoja ekudzivirira chirwere. Iri kuruboshwe rwedumbu rako repamusoro pasi pemapapu ako uye pedyo nedumbu rako (tummy).
Kana spleen yako yanyanya kukura, inogona kuisa simba padumbu rako uye kuita kuti unzwe wakaguta, kunyange usina kudya zvakanyanya.
Thymus yako zvakare chikamu che lymphatic system yako. Inhengo yakaita shavishavi inogara kuseri kwepfupa rechipfuva kumberi kwechipfuva chako. Mamwe masero eB anoraramawo uye anopfuura nepakati pe thymus yako.
General zviratidzo zve lymphoma
Zviratidzo zvakawanda zveFL zvinogona kufanana nezviratidzo zvinowanikwa muvanhu chero subtype ye lymphoma izvi zvinogona kusanganisira:
- kunzwa kuneta zvisingaite (kuneta)
- kunzwa kupera simba
- ganda rinonhuwa
- zvirwere zvisingapere kana kuramba zvichidzoka
- kuchinja pakuongororwa ropa rako
- masero matsvuku akaderera uye maplatelet
- akawandisa lymphocytes uye/kana lymphocytes asingashande nemazvo
- akadzikira masero machena (kusanganisira neutrophils)
- high lactic acid dehydrogenase (LDH) - rudzi rweprotein inoshandiswa kugadzira simba. Kana masero ako akakuvadzwa ne lymphoma yako, LDH inogona kubuda mumasero ako uye muropa rako
- high beta-2 microglobulin - rudzi rweprotein yakagadzirwa nemasero e-lymphoma. Inogona kuwanikwa muropa rako, weti kana cerebral spinal fluid
- B-zviratidzo
Zvimwe zviratidzo zve follicular lymphoma zvinogona kuenderana nekuti chirwere chako chiri kupi mumuviri wako
Nzvimbo yakakanganiswa | zviratidzo |
Ura - kusanganisira dumbu rako uye ura | Nausea nekurutsa kana kusarutsa (kunzwa kurwara mudumbu mako kana kurutsa) Diarrhea kana kuvimbiswa (mvura kana yakaoma poo) Ropa paunoenda kuchimbuzi Kunzwa kuguta nyangwe usina kudya zvakanyanya |
Central nervous system (CNS) - kusanganisira uropi hwako uye musana | Kuvhiringidzika kana kushanduka kwendangariro Unhu hunochinja Kugumburwa Kushaya simba, chiveve, kupisa kana mapini netsono mumawoko ako nemakumbo |
bhokisi | Kupfupika kwemhepo Chipfuva chepfu Chikosoro chakaoma |
Bone marora | Kuderera kweropa kunosanganisira masero matsvuku, masero machena uye maplatelet zvichiita kuti: o Kutadza kufema o Hutachiona hwakadzama hunodzoka kana hunonetsa kubvisa o Kubuda ropa zvisina kujairika kana mavanga
|
ganda | Tsvuku kana yepepuru inotarisa rash Mapundu uye Mapundu paganda rako anogona kunge ane ruvara rweganda kana dzvuku kana pepuru Itching |
Nguva yekusangana nachiremba wako
Pane zvimwe zviratidzo zvinogona kuratidza kuti FL yako iri kutanga kukura kana kuita zvehasha. Kana ukasangana nechimwe chezviratidzo zviri pasi apa, taura nachiremba wako. Usamirira kuonana kunotevera. Zvakakosha kuvaregedza nekukurumidza kuitira kuti vagoita zvirongwa zvekurapwa kana ungazopedzisira wavakuda.
Bata yako kana iwe:
- ane lymph nodes akazvimba asingaendi, kana kuti akakura kudarika iwe waungatarisira kune utachiona
- vanowanzotadza kufema pasina chikonzero
- kunzwa kuneta kupfuura nguva dzose uye hazviiti nani nekuzorora kana kurara
- cherechedza kubuda ropa kusina kujairika kana maronda (kusanganisira mupoo yedu, kubva mumhino dzako kana mazamu)
- kuita rash isina kujairika (pepuru yered spotty rash inogona kureva kuti une kubuda ropa pasi peganda rako)
- kuvava zvakanyanya kupfuura zvamazuva ese
- gadzira chikosoro chitsva chakaoma
- kuona B zviratidzo.
Zvakakosha kuziva kuti zvizhinji zvezviratidzo nezviratidzo zveFL zvinogona kuenderana nezvimwe zvinokonzera kunze kwekenza. Semuenzaniso, kuzvimba lymph nodes kunogonawo kuitika kana uine hutachiona. Kazhinji zvakadaro, kana uine hutachiona, zviratidzo zvinova nani, uye lymph nodes inodzokera kune yakajairika saizi mumavhiki mashoma. Ne lymphoma, zviratidzo izvi hazvizoperi. Vanogona kutowedzera.
Ko follicular lymphoma (FL) inoratidzwa sei?
Kuongorora FL dzimwe nguva kunogona kuoma uye kunogona kutora mavhiki akati wandei.
Kana chiremba wako achifunga kuti unogona kunge une lymphoma, vachada kuronga miedzo yakawanda inokosha. Iyi miedzo inodiwa kusimbisa kana kubvisa lymphoma sechikonzero chezviratidzo zvako. Kusimbisa rudzi rweNon-Hodgkin's Lymphoma (NHL) kwakakosha zvikuru sezvo hutungamiri nemabatirwo erudzi rwako runogona kusiyana nemamwe madiki eNHL.
Kuti uongorore FL iwe uchada biopsy. Biopsy inzira yekubvisa chikamu, kana yese ye lymph node yakakanganisika uye/ kana mwongo. Iyo biopsy inotariswa nemasayendisiti murabhoritari kuti vaone kana paine shanduko dzinobatsira chiremba kuongorora FL.
Paunenge uine biopsy, unogona kuve neanotindivadza emunharaunda kana general. Izvi zvinoenderana nerudzi rwebiopsy uye kuti chikamu chipi chemuviri wako chinotorwa kubva. Kune mhando dzakasiyana dzebiopsies, uye ungangoda anopfuura imwe chete kuti uwane yakanakisa sampuli.
Kuyera ropa
Uchaongororwa ropa rakawanda nekufamba kwenguva. Iwe uchatanga nekuongororwa ropa kunyangwe usati waonekwa kuti une FL. Uchava nawo zvakare usati uye panguva yekurapwa kana uchida kurapwa. Vanopa chiremba wako mufananidzo wehutano hwako hwose, saka vanogona kuita sarudzo dzakanakisisa newe pamusoro pehutano hwako hwehutano uye kurapwa.
Tsono yakanaka kana core biopsy
A core biopsy inosanganisira chiremba kushandisa tsono uye kuiisa mu lymph node yako yakazvimba kana bundu kuitira kuti vabvise sampuli yetishu kuti vaongorore lymphoma. Izvi zvinowanzoitwa pasi peanesthetic yemunharaunda, iwe wakasvinura.
Kana lymph node yakakanganiswa yakadzika mukati memuviri wako, biopsy inogona kuitwa nerubatsiro rwe ultrasound kana nyanzvi x-ray (imaging) kutungamira.
Excisional node biopsy
An excisional biopsy inoitwa kana malymph nodes ako akazvimba akadzika zvakanyanya kuti asasvikwe netsono, kana chiremba wako achida kubvisa uye kutarisa lymph node yese.
Zvinowanzoitwa semaitirwo ezuva muimba yekuvhiya uye uchave neanorarisa kuti urare kwechinguva chidiki ichiitwa. Paunomuka unenge uine ronda diki uye matinji. Chiremba wako kana mukoti achakwanisa kukuzivisa iwe kuti ungachengeta sei ronda racho, uye nguva yekubvisa zvibodzwa zvako.
Chiremba achasarudza yakanakisa biopsy kwauri.
Results
Kana chiremba wako achinge awana mhinduro kubva pakuongororwa kweropa rako uye biopsies ivo vanozokwanisa kukuudza kana uine FL uye vangangokwanisawo kukuudza kuti ndeupi subtype yeFL yaunayo. Ivo vanozoda kuita mimwe bvunzo padanho uye giredhi FL yako.
Kuronga uye kugadzika follicular lymphoma
Kana uchinge waonekwa kuti une FL, chiremba wako achava nemimwe mibvunzo nezve lymphoma yako. Izvi zvinosanganisira:
- Ndeipi nhanho lymphoma yako?
- Nderipi giredhi lymphoma yako?
- Ndeipi subtype yeFL yaunayo?
Dzvanya pamisoro iri pazasi kuti udzidze zvakawanda nezve staging uye giredhi.
Staging inoreva kuwanda kwemuviri wako kukanganiswa ne lymphoma yako - kana, kuti yakapararira zvakadii kubva kwayakatanga.
B-masero anogona kufamba kune chero chikamu chemuviri wako. Izvi zvinoreva kuti masero e-lymphoma (kenza B-masero), anogonawo kuenda kune chero chikamu chemuviri wako. Iwe unozofanirwa kuita bvunzo dzakawanda kuti uwane ruzivo urwu. Iyi bvunzo inodaidzwa kunzi staging tests uye kana wawana mhinduro, unozoona kana uine nhanho yekutanga (I), nhanho yechipiri (II), nhanho yetatu (III) kana nhanho yechina (IV) FL.
Yako nhanho yeFL ichaenderana ne:
- Ingani nzvimbo dzemuviri wako dzine lymphoma
- Apo lymphoma inosanganisira kana iri pamusoro, pasi kana kumativi ose maviri e diaphragm yako (musuru mukuru, wakaita dome pasi pembabvu inoparadzanisa chipfuva kubva mudumbu rako)
- Kunyangwe iyo lymphoma yakapararira kumapfupa ako emapfupa kana dzimwe nhengo dzakadai sechiropa, mapapu, ganda kana pfupa.
Matanho I uye II anonzi 'kutanga kana nhanho diki' (inosanganisira nzvimbo shoma yemuviri wako).
Matanho III neIV anonzi 'advanced stage' (yakawanda).
Stage 1 | Imwe lymph node area inobatwa, kungave pamusoro kana pasi pe diaphragm*. |
Stage 2 | Nzvimbo mbiri kana kupfuura dze lymph node dzinobatwa kune rimwe divi re diaphragm *. |
Stage 3 | Inenge imwe lymph node nzvimbo kumusoro uye imwe lymph node nzvimbo iri pasi pe diaphragm* inobatwa. |
Stage 4 | Lymphoma iri mumalymph nodes akawanda uye yapararira kune dzimwe nhengo dzemuviri (semumapfupa, mapapu, chiropa). |
Kuwedzera ruzivo rwekuita
Chiremba wako anogonawo kutaura nezvedanho rako achishandisa tsamba, senge A, B, E, X kana S. Mavara aya anopa mamwe mashoko pamusoro pezviratidzo zvaunazvo kana kuti muviri wako uri kukanganiswa sei ne lymphoma. Ruzivo rwese urwu runobatsira chiremba wako kuwana chirongwa chekurapa chakanakira iwe.
tsamba | zvichireva | kukosha |
A kana B |
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E & X |
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S |
|
(Spleen yako inhengo iri mu lymphatic system yako inosefa nekuchenesa ropa rako, uye inzvimbo yako B-cells kuzorora uye kugadzira masoja ekudzivirira chirwere) |
Miedzo yekutamba
Kuti uzive kuti ndeipi nhanho yauinayo, unogona kukumbirwa kuti uite mamwe eanotevera nhanho bvunzo:
Computed tomography (CT) scan
Aya ma scans anotora mifananidzo yemukati mechipfuva chako, dumbu kana pelvis. Vanopa mifananidzo yakadzama inopa ruzivo rwakawanda kupfuura yakajairwa X-ray.
Positron emission tomography (PET) scan
Iyi scan inotora mifananidzo yemukati memuviri wako wese. Iwe uchapihwa uye tsono nemumwe mushonga masero ane kenza - senge lymphoma masero anotora. Mushonga unobatsira PET scan kuona kuti lymphoma iripi uye saizi uye chimiro nekusimbisa nzvimbo dzine lymphoma masero. Nzvimbo idzi dzimwe nguva dzinonzi "zvinopisa".
Lumbar kubaya
A lumbar puncture inzira yakaitwa yekutarisa kana uine chero lymphoma mune yako yepakati tsinga system (CNS), iyo inosanganisira uropi hwako, musana uye nzvimbo yakapoteredza maziso ako. Iwe unozofanira kutaura zvakadzikama panguva yekuitwa, kuitira kuti vacheche nevana vanogona kuve neanotindivadza kuti varare kwechinguva chidiki ichiitwa. Vazhinji vanhu vakuru vanongoda mushonga wekutindivadza wepanzvimbo kuitira kuti maitiro aite chiveve nzvimbo.
Chiremba wako achaisa tsono kumusana kwako, uye oburitsa mvura shoma inonzi “cerebral spinal fluid” (CSF) kubva pakatenderedza musana wako. CSF imvura inoita zvishoma sechinhu chinokatyamadza kuCNS yako. Inotakurawo mapuroteni akasiyana uye hutachiona hunorwisa masero edziviriro senge lymphocytes kuchengetedza uropi hwako uye musana. CSF inogonawo kubatsira kubvisa chero mvura yakawedzerwa yaungave uine muuropi hwako kana kutenderedza musana wako kudzivirira kuzvimba munzvimbo idzodzo.
Sampuli yeCSF inozotumirwa kune pathology uye kuongororwa chero zviratidzo zve lymphoma.
Bone marora bhiopsy
- Bone marrow aspirate (BMA): bvunzo iyi inotora shoma shoma yemvura inowanikwa munzvimbo yemwongo.
- Bone marrow aspirate trephine (BMAT): bvunzo iyi inotora diki diki yemwongo tishu.
Iwo masampuli anobva atumirwa kune pathology uko anotariswa zviratidzo zve lymphoma.
Maitirwo emuwongo biopsies anogona kusiyana zvichienderana nekuti uri kurapwa kupi, asi kazhinji anozosanganisira mushonga wekutindivadza wepanzvimbo kuti uite chiveve nzvimbo.
Mune zvimwe zvipatara, unogona kupihwa light sedation iyo inokubatsira kuti uzorore uye inogona kukumisa kuyeuka maitiro. Zvisinei vanhu vazhinji havadi izvi uye vanogona kunge vaine "muridzo yegirinhi" yekuyamwa. Iyi muridzo yegirinhi ine mushonga wekuuraya marwadzo mairi (unonzi Penthrox kana methoxyflurane), waunoshandisa sezvinodiwa mukati memaitiro ese.
Ita shuwa kuti unobvunza chiremba wako izvo zviripo kuti uwedzere kugadzikana panguva yekuita, uye taura navo pamusoro pezvaunofunga kuti ichava sarudzo yakanakira iwe.
Ruzivo rwakawanda pamusoro pemapfupa biopsies anogona kuwanikwa pane yedu peji rewebhu pano.
Masero ako e-lymphoma ane maitiro akasiyana ekukura uye anotarisa zvakasiyana nemasero akajairwa. Giredhi yeFollicular lymphoma yako ndiyo maratidziro ako masero e lymphoma pasi pe microscope. Magiredhi 1-2 (giredhi yakaderera) ane nhamba shoma ye centroblasts (mahombe B-masero). Magiredhi 3a ne3b (giredhi repamusoro) ane nhamba yakakura ye centroblasts (mahombe B-cell), uye kazhinji centrocytes (madiki kusvika epakati B masero) anoonekwa zvakare. Masero ako anozotaridzika akasiyana kune akajairwa maseru uye anokura zvakasiyana. Iyo yakawanda centroblast masero ari kuratidza hukasha (kukurumidza kukura) bundu rako richava. Mhedziso yemagiredhi iri pazasi.
World Health Organisation (WHO) giredhi yefollicular lymphoma (FL)
giredha | tsananguro |
1 | Giredhi yakaderera: 0-5 centroblasts inoonekwa mumasero e-lymphoma. 3 kubva pamasero mana haana indolent (kukura zvishoma nezvishoma) follicular B-masero |
2 | Low giredhi: 6-15 centroblasts inoonekwa mumasero e-lymphoma. 3 kubva pamasero mana haana indolent (kukura zvishoma nezvishoma) follicular B-masero |
3A | Giredhi repamusoro: Kupfuura 15 centroblasts uye zvakare centrocytes iripo mune lymphoma masero. Kune musanganiswa weindolent (inokura zvishoma) follicular lymphoma masero uye ane hukasha (kukurumidza kukura) lymphoma masero anonzi diffuse makuru B masero. |
3B | Giredhi repamusoro: Kupfuura 15 centroblasts ne HERE centrocytes inowanikwa mumasero e-lymphoma. Kune musanganiswa weindolent (inokura zvishoma) follicular lymphoma masero uye ane hukasha (kukurumidza kukura) lymphoma masero anonzi diffuse makuru B masero. nekuda kweGiredhi 3b iyi inobatwa seDiffuse Large B Cell Lymphoma subtype (DLBCL) ADD: Link kuDLBCL |
Magiredhi nematanho eFL yako akakosha zvakanyanya sezvo zvichiratidza kuti unoda kurapwa uye rudzii rwekurapa.
- Stage IV FL inogona kusada kurapwa nekukasira uye iwe unogona kuiswa kune inoshanda yekutarisa (tarisa uye kumirira) sezvo uine yakaderera giredhi (inononoka kukura) FL.
- giredha FL- 3A uye 3B inogara ichibatwa zvakafanana kune DLBCL inova ine hukasha subtype yeNHL.
Zvakakosha kuti utaure nachiremba wako nezve njodzi yako pachako kuitira kuti uve neruzivo rwakajeka rwezvaunotarisira kubva mukurapwa kwako.
Subtypes yeFollicular lymphoma (FL)
Kana chiremba wako angowana mhinduro dzako dzese, vanozokwanisa kukuzivisa iwe kuti ndeipi nhanho uye giredhi reFL raunaro. Iwe unogona zvakare kuudzwa kuti une chaiyo subtype yeFL, asi izvi hazvisizvo kune wese munhu.
Kana iwe ukaudzwa kuti une chaiyo subtype, tinya pane zvinongedzo pazasi kuti udzidze zvakawanda nezve iyo subtype.
Duodenal-type follicular lymphoma inonziwo primary gastrointestinal follicular lymphoma (PGFL). Iyo inononoka-kukura FL uye inowanzoonekwa mumatanho ayo ekutanga.
Inokura muchikamu chekutanga chemukati mako (duodenum), ichangopfuura dumbu rako. PGFL inonyanya kuwanikwa munzvimbo, zvinoreva kuti inongowanikwa munzvimbo imwe chete, uye kazhinji haina kupararira kune dzimwe nhengo dzemuviri wako.
zviratidzo
Zvimwe zviratidzo zvaungave nazvo nePGFL zvinosanganisira kurwadziwa mudumbu uye chirungurira, kana kuti ungasave nezviratidzo zvachose. Kurapa kungave kuvhiyiwa kana kutarisa uye kumirira (kunyatsotarisisa). zvichienderana nezviratidzo zvako.
Kunyangwe kana kuvhiyiwa kuchidikanwa, mhedzisiro kune vanhu vane Duodenal-mhando FL yakanaka kwazvo.
Inonyanya kupararira inoratidzika FL iboka reakapararira (diffuse) lymphoma masero anonyanya kuwanikwa muchikamu chimwe chemuviri wako. Chiratidzo chikuru ihombe huru (bundu) inoratidzika sebundu munzvimbo yako yezvidya (inguinal).
Paediatric-type follicular lymphoma inzira isingawanzoitiki yefollicular lymphoma. Chinonyanya kubata vana asi chinogona kubata vanhu vakuru vanosvika makore makumi mana ekuberekwa.
Tsvagiridzo inoratidza kuti P-TFL yakasarudzika uye yakasiyana kune yakajairwa follicular lymphoma. Inoita senge benign (isina kenza) bundu uye inowanzowanikwa muchikamu chimwe chete chemuviri wako. Haiwanzopararira kubva panzvimbo iyo inotanga kukura.
PTFL inonyanya kuwanda mumalymph nodes pedyo nemusoro wako nemutsipa.
Kurapa kwepaediatric-type follicular lymphoma kunogona kusanganisira kuvhiyiwa kubvisa malymph nodes akakanganisika, kana tarisa & kumirira (kushingaira kutarisa). Mushure mekubudirira kurapwa, iyi subtype haiwanzo kudzoka.
Kunzwisisa yako lymphoma cytogenetics
Pamwe chete nemiedzo yose iri pamusoro, unogonawo kuva ne cytogenetic tests. Apa ndipo panotariswa ropa rako nebundu remusiyano wemajini anogona kunge ari muchirwere chako. Kuti uwane rumwe ruzivo nezve izvi ndapota ona chikamu chedu pakunzwisisa yako lymphoma genetics zvakare pasi peji ino. Miedzo inoshandiswa kutarisa chero genetic mutations inonzi cytogenetic tests. Iyi bvunzo inotarisa kuona kana iwe uine chero shanduko mumakromosomes uye majini.
Kazhinji tine 23 mapeya emachromosome, uye anoverengwa zvichienderana nekukura kwawo. Kana uine FL, machromosomes ako anogona kutaridzika zvakasiyana.
Chii chinonzi majini uye chromosomes?
Sero rimwe nerimwe rinoumba muviri wedu rine nucleus, uye mukati memukati mune mapeya 23 emakromosomes. Chromosome imwe neimwe inogadzirwa netambo refu dzeDNA (deoxyribonucleic acid) ine majini edu.
Majini edu anopa kodhi inodiwa kugadzira masero ese nemapuroteni ari mumuviri wedu uye anovaudza maitiro ekutarisa kana kuita.
Kana pane shanduko (kusiyana) mumakromosomes aya kana majini, mapuroteni ako nemasero haashande nemazvo.
Lymphocytes inogona kuva masero e-lymphoma nekuda kwekuchinja kwemajini (kunonzi kushanduka kana kusiyana) mukati memasero. Yako lymphoma biopsy inogona kutariswa nenyanzvi yepathologist kuona kana uine chero gene mutations.
Ko FL mutations inotaridzika sei?
Kunyanya kutaura
Tsvagiridzo yakawana akasiyana genetic shanduko (mutations) inogona kukonzera an kunyanya kutaura (yakawandisa) yemamwe mapuroteni ari pamusoro peFL masero. Kana mapuroteni aya akanyanya kutaurwa, ivo batsira cancer yako kukura.
Mapuroteni akasiyana chikamu cheboka rinowanzoudza maseru kuti akure, kana kufa uye kuchengetedza hutano hwakanaka. Ivowo vanowanzo ziva kana sero rikakuvara, kana kutanga kuita gomarara, voudza maseru aya kuti azvigadzirise, kana kufa. Asi kuwandisa kwemamwe mapuroteni anoudza masero elymphoma kuti akure, anoita kuti hurongwa uhu huve husina kuenzana, uye hunoita kuti masero egomarara arambe achikura uye achiwanda.
Mamwe mapuroteni anogona kunge akawedzeredzwa pamasero ako eFL anosanganisira:
- CD5
- CD10
- CD20
- CD23
- CD43
- BCL6
- IRF4
- MUM1
Translocation
Majini anogonawo kukonzera chiitiko uye shanduko yekukura nekuda kwe translocation. Kuchinja kunoitika apo majini ari pamakromosomes maviri akasiyana anochinjana nzvimbo. Kuchinjana kwakajairika muvanhu vane FL. Kana iwe uine translocation mumaseru ako eFL, inogona kunge iri pakati pekromosome yako yechi14 neyegumi nesere. Kana iwe uine kufambiswa kwemajini pa18 uye 14th chromosomes inonyorwa se t(14:18).
Sei zvakakosha kuziva nezve shanduko yemajini yandinayo?
Genetic shanduko yakakosha nekuti inogona kubatsira chiremba wako kufanotaura kuti FL yako ichaita sei uye kukura. Zvinovabatsirawo kuronga kuti ndeipi tratment inogona kukushandira zvakanyanya.
Kuyeuka zita rekuchinja kwemajini ako hakuna kukosha zvakanyanya. Asi, kuziva kuti une mamwe ekuchinja kwemajini kunotsanangura kuti sei ungade kurapwa kwakasiyana kana mishonga kune vamwe vane FL.
Kuwanikwa kwekuchinja kwemajini mu lymphoma kwakatungamira mukutsvagisa nekuvandudzwa kwemishonga mitsva inonangana nemapuroteni kana majini anobatanidzwa. Tsvakurudzo iyi iri kuenderera mberi sezvo dzimwe shanduko dziri kuwanikwa.
Dzimwe nzira dzekuchinja kwako genetic dzinogona kukanganisa kurapwa kwako dzinosanganisira:
- Kana CD20 yakanyanyowandisa pamaseru eFL uye uchida kurapwa, unogona kuwana mushonga unonzi rituximab (unonziwo Mabthera kana Rituxan). CD20 overexpression yakajairika muvanhu vane follicular lymphoma.
- Kana iwe uine overexpression yeIRF4 kana MUM1, zvinogona kuratidza kuti FL yako ine hukasha pane indolent, uye ingangoda kurapwa.
- Kumwe kushanduka kwemajini kunogona kureva kuti kurapa kwakanangwa kuchave kunoshanda kurapa FL yako.
Mibvunzo yekubvunza chiremba wako
Zvinogona kunetsa kuziva kuti ndeipi mibvunzo yekubvunza paunenge uchitanga kurapwa. Kana iwe usingazive, zvausingazive, ungaziva sei zvekubvunza?
Kuva neruzivo rwakakodzera kunogona kukubatsira kuti unzwe uine chivimbo uye kuziva zvekutarisira. Inogonawo kukubatsira kuronga pachine nguva pane zvaungade.
Tinoisa pamwe chete rondedzero yemibvunzo yaungawana inobatsira. Zvechokwadi, mamiriro ezvinhu emunhu wose akasiyana, saka mibvunzo iyi haitauri zvose, asi inopa mavambo akanaka.
Dzvanya pane iyi link iripazasi kuti utore inodhinda PDF yemibvunzo yachiremba wako
Kurapa kweFollicular Lymphoma (FL)
Kana zvese zvabuda kubva kubiopsies yako, cytogenetic test uye staging scans zvauya, chiremba wako achakwanisa kuronga nezve maitiro ekugadzirisa FL yako. Muzviitiko zvakawanda izvi zvinogona kureva kutora "Rinda uye Mirira" nzira. Izvi zvinoreva kuti lymphoma yako haidi chero kurapwa, asi ivo vachada kuramba vakarinda kuti vaone kana lymphoma inotanga kukura zvakanyanya, kana kuita kuti iwe uve nezviratidzo kana kusanzwa zvakanaka. Unogona kudhawunirodha pepa redu rechokwadi pa Tarisa uye Mirira nekudzvanya iyi link iripazasi.
Inguva yekutanga kurapwa
Chiremba wako anozoongorora izvi kuti asarudze kurapwa kwakanakira iwe. Kune dzimwe nzvimbo dzegomarara, chiremba achasanganawo nechikwata chenyanzvi kuti vakurukure nzira yekurapa yakanakisa. Izvi zvinonzi a Multidisciplinary team (MDT) musangano.
Chiremba wako achafunga zvakawanda nezve FL yako. Sarudzo dzekuti riini kana kana iwe uchifanira kutanga uye kuti ndeupi kurapwa kwakanyanya kunobva pane:
- Yako yega nhanho ye lymphoma, genetic shanduko, uye zviratidzo
- Zera rako, nhoroondo yekurapa yakapfuura, uye hutano hwese
- Hupenyu hwako hwazvino hwemuviri nepfungwa uye zvido zvemurwere.
Mimwe miedzo inogona kurairwa usati watanga kurapwa kuti uve nechokwadi chekuti moyo wako, mapapu neitsvo zvinokwanisa kurarama nekurapwa. Izvi zvinogona kusanganisira ECG (electrocardiogram), lung function test kana 24-awa yekuunganidza weti.
Chiremba wako kana mukoti wegomarara anogona kukutsanangurira hurongwa hwekurapa kwako uye zvinogona kuitika kwauri uye aripo kuti apindure chero mubvunzo waungave uine. Zvakakosha kuti ubvunze chiremba wako uye/kana mukoti wegomarara mibvunzo nezve chero chausinganzwisise.
Chinangwa chekurapa FL ndecheku:
- Rebesa kuregererwa
- Ipa kudzora chirwere
- Kuvandudza hupenyu hwehupenyu
- Deredza zviratidzo kana maside effects nerutsigiro kana palliative care
Unogonawo kufonera kana kutumira email kune Lymphoma Australia Mukoti Helpline nemibvunzo yako uye tinogona kukubatsira kuti uwane ruzivo rwakakwana.
Tarisa uye Mira
Mune zvimwe zviitiko chiremba wako angasarudza kuti haufanirwe kuwana chero kurapa kunoshanda. Izvi zvinodaro nekuti kazhinji, Follicular Lymphoma inorara (kana kurara) uye inokura zvishoma nezvishoma zvekuti haisi kukonzera chero matambudziko mumuviri wako. Tsvakurudzo yakaratidza izvozvo hapana chakanakira kutanga kurapwa panguva iyi, uye zvinouya nenjodzi yemhedzisiro kubva mukurapwa.
Kana lymphoma "inomuka" kana kuti ikatanga kukura nekukurumidza, ipapo iwe unogona kupihwa kurapa kunoshanda.
Lymphoma care nurse hotline:
Foni: 1800 953 081
Email: nurse@lymphoma.org.au
Ndeipi nguva yekurapa inodiwa kune Follicular Lymphoma (FL)?
Sezvataurwa pamusoro apa, havasi vese vane FL vachada kutanga kurapwa ipapo. Kuti ubatsire vanachiremba vako kuona kana yava nguva yekutanga kurapwa nzira inonzi 'GELF criteria' yakatangwa. Kana uine chimwe kana zvimwe zvezviratidzo izvi, ungangoda kurapwa:
- Bundu rakakura kudarika 7cm muhukuru.
- 3 kuzvimba lymph nodes munzvimbo 3 dzakasiyana zvakasiyana, ese akakura kupfuura 3cms muhukuru.
- Zvisingaperi B zviratidzo.
- Yakawedzera spleen (splenomegaly)
- Dzvinyiriro pane chero nhengo dzako dzemukati semhedzisiro yekuzvimba lymph nodes.
- Fluid ine lymphoma masero mumapapu ako kana dumbu (Pleural effusions kana ascites).
- FL masero anowanikwa muropa rako kana bone marrow (leukemic shanduko) kana kuderera mune mamwe masero ehutano eropa (cytopenias). Izvi zvinoreva kuti FL yako iri kumisa mwongo wako kubva pakukwanisa kuburitsa hutano hwakakwana masero eropa.
- Yakakwira LDH kana Beta2- microglobulin (idzi bvunzo dzeropa).
Dzvanya pamisoro iri pazasi kuti uone marudzi akasiyana ekurapa anogona kushandiswa kubata FL yako.
Rutsigiro runopiwa kuvarwere nemhuri dzinotarisana nechirwere chakakomba. Tsigiro yekuchengeta inogona kubatsira varwere kuve nezviratidzo zvishoma, uye kuita zvirinani nekukurumidza nekuteerera kune izvo zvikamu zvekuchengeta kwavo.
Kune vamwe vako vane FL, masero ako eukemic anogona kukura asingadzoreki uye akazara pfupa rako, ropa, lymph nodes, chiropa kana spleen. Nekuti mwongo wakazara neFL masero achiri mudiki kuti ashande nemazvo, masero ako eropa akajairika anokanganiswa. Kurapa kwekutsigira kunogona kusanganisira zvinhu zvakaita sewe kuisirwa ropa kana kuisirwa maplatelet pawadhi kana kuti intravenous infusion suite muchipatara. Unogona kuva nemishonga inorwisa mabhakitiriya kudzivirira kana kurapa zvirwere.
Zvinogona kusanganisira kubvunzana neboka revanochengeta kana kunyange nerubatsiro. Inogonawo kunge iri kuita hurukuro pamusoro pekutarisira ramangwana, iyo inonzi Advanced Care Planning. Izvi zvinhu chikamu che multidisciplinary manejimendi ye lymphoma.
Rutsigiro rwekutarisira runogona kusanganisira palliative care iyo inobatsira kuvandudza zviratidzo zvako uye mhedzisiro, pamwe nekupera kwehupenyu kutarisira kana zvichidikanwa.
Zvakakosha kuziva kuti boka rePalliative Care rinogona kudaidzwa chero nguva panguva yako yekurapwa kwete pakupera kweupenyu. Vanogona kubatsira kudzora nekugadzirisa zviratidzo (sezvakaoma kudzora marwadzo uye kusvotwa) iwe unogona kunge uchisangana nawo nekuda kwechirwere chako kana kurapwa kwacho.
Kana iwe nachiremba wako ukasarudza kushandisa rubatsiro rwekutsigira kana kumisa kurapa kwekurapa lymphoma yako, zvinhu zvakawanda zvinogona kuitwa kuti zvikubatsire kugara uine hutano uye wakasununguka sezvinobvira kwenguva yakati.
Radiation therapy kurapwa kwegomarara kunoshandisa huwandu hwakanyanya hwemwaranzi kuuraya lymphoma masero uye kuderedza mamota. Usati wava neradiation, unenge uine nguva yekuronga. Ichi chikamu chakakosha kuti varapi veradiation varonge nzira yekunangana nemwaranzi kune lymphoma, uye kudzivirira kukuvadza masero ane hutano. Radiation therapy inowanzotora pakati pemavhiki e2-4. Munguva iyi, iwe uchafanirwa kuenda kunzvimbo yeradiation mazuva ese (Muvhuro-Chishanu) kunorapwa.
*Kana uchigara kure neradiation centre uye uchida rubatsiro nenzvimbo yekugara panguva yekurapwa, ndapota taura nachiremba wako kana mukoti nezverubatsiro rwaunowana. Iwe unogona zvakare kubata Cancer Council kana Leukemia Foundation iri mudunhu rako uye uone kana vachigona kubatsira nenzvimbo yekugara.
Unogona kunwa mishonga iyi sehwendefa uye/kana kupihwa sedhipu (kupinza) mutsinga yako (muropa rako) kukiriniki yegomarara kana kuchipatara. Mishonga yakawanda yakasiyana yekemo inogona kusanganiswa nemushonga we immunotherapy. Chemo inouraya masero ari kukurumidza kukura saka anogona zvakare kukanganisa mamwe masero ako akanaka anokura nekukurumidza achikonzera mhedzisiro.
Unogona kunge uine MAB infusion kukiriniki yegomarara kana kuchipatara. MaMAB anonamatira kune lymphoma cell uye anokwezva zvimwe zvirwere zvinorwisa masero machena eropa uye mapuroteni kune kenza kuitira kuti immune system yako kurwisa FL.
MABS inongoshanda chete kana uine mapuroteni chaiwo kana mamaki pamasero ako elymphoma. Mucherechedzo wakajairika muFL iCD20. Kana iwe uine iyi marker unogona kubatsirwa nekurapwa neMAB.
Chemotherapy yakasanganiswa neMAB (semuenzaniso, rituximab).
Unogona kutora izvi sepiritsi kana infusion mutsinga yako. Kurapa nemuromo kunogona kutorwa kumba, asi kumwe kunoda kugara muchipatara kwenguva pfupi. Kana uine infusion, unogona kuva nayo kukiriniki yezuva kana muchipatara. Targeted therapies inonamira kune lymphoma cell uye inovhara masaini iyo inoda kukura uye kugadzira mamwe masero. Izvi zvinomisa gomarara kukura uye zvinoita kuti masero e-lymphoma afe.
A stem cell kana bone marrow transplant inoitwa kutsiva bhonzo rako rine chirwere nemasero matsva anogona kukura kuita masero matsva eropa ane hutano. Bone marrow transplants kazhinji inongoitirwa vana vane FL, nepo stem cell transplants inoitwa kune vese vana vakuru.
Mune pfupa rekuisa pfupa, stem masero anobviswa zvakananga kubva mumwongo, uko sekunge ne stem cell transplant, stem masero anobviswa kubva muropa.
Masero e stem anogona kubviswa kubva kune anopa kana kutorwa kubva kwauri mushure mekunge waita chemotherapy.
Kana iwe stem masero achibva kune anopa, inonzi allogeneic stem cell transplant.
Kana masero ako ega akaunganidzwa, anonzi autologous stem cell transplant.
Masero emazita anounganidzwa kuburikidza nenzira inonzi apheresis. Iwe (kana mupi wako) uchabatanidzwa kusvika kumuchina weapheresis uye ropa rako richabviswa, masero e stem akaparadzaniswa uye anounganidzwa mubhegi, uye ropa rako rose rinodzoserwa kwauri.
Usati waitwa, iwe uchawana yakakwira-dose chemotherapy kana yakazara-muviri radiotherapy kuuraya ese ako lymphoma masero. Zvakadaro kurapwa kwedosi yakakwirira kunourayawo maseru ese ari mumwongo wako. Saka masero akaunganidzwa anozodzoserwa kwauri (akasimwa). Izvi zvinoitika mune zvakangofanana nekuwedzerwa ropa kunoitwa, kuburikidza nekudonha mutsinga yako.
CAR T-cell therapy mushonga mutsva unozopihwa chete kana uchinge watove nemamwe marapirwo maviri eFL yako.
Mune zvimwe zviitiko, unogona kukwanisa kuwana CAR T-cell therapy nekujoinha muyedzo wekiriniki.
CAR T-cell therapy inosanganisira yekutanga maitiro akafanana ne stem cell transplant, uko T-cell lymphocytes yako inobviswa kubva paropa rako panguva yeapheresis maitiro. Kufanana newe B-cell lymphocytes, T-masero chikamu chemuviri wako wemuviri uye anoshanda neB-masero ako kukudzivirira kubva kuhosha nekurwara.
Kana maT-seli abviswa, anoendeswa ku laboratori uko anogadziridzwa zvakare. Izvi zvinoitika nekubatanidza T-sero kune antigen iyo inobatsira kuti ione lymphoma zvakajeka uye kuirwisa zvakanyanya.
Chimeric zvinoreva kuva nezvikamu zvine mabviro akasiyana saka kujoinwa kweantigen kuT-cell kunoita kuti ive chimeric.
Kana ma-T-seli agadziridzwa zvakare anodzoserwa kwauri kuti atange kurwisa lymphoma.
Kurapa kwekutanga - Kutanga kurapwa
Kutanga Therapy
Kekutanga kurapwa, kunonzi kurapwa kwekutanga. Kana wapedza kurapwa kwako kwekutanga, ungasada kurapwa zvakare kwemakore akawanda. Vamwe vanhu vanoda kurapwa kwakawanda pakarepo, uye vamwe vanogona kutora mwedzi kana makore, vasati vada kumwe kurapwa.
Paunotanga kurapwa, unogona kuva nemishonga inodarika mumwe. Izvi zvinogona kusanganisira chemotherapy, monoclonal antibody kana kurapa kwakanangwa. Mune zvimwe zviitiko, unogona kurapwa nemwaranzi kana kuvhiyiwa zvakare, kana pachinzvimbo chemishonga.
Kurapa kutenderera
Paunenge uchinge uine marapirwo aya, unoave nawo mumacycles. Izvi zvinoreva kuti iwe uchave nekurapwa, wozozorora, uyezve imwe kutenderera (kutenderera) kwekurapa. Kune vanhu vazhinji vane FL, chemoimmunotherapy inoshanda kuti iwane kuregererwa (hapana zviratidzo zvekenza).
Kana chirongwa chako chese chekurapa chaiswa pamwechete, chinodaidzwa kuti chirongwa chako chekurapa. Dzimwe nzvimbo dzinogona kuzvidaidza kuti chirongwa chekurapa.
Chiremba wako achasarudza yakanakisa kurapwa protocol kwauri zvichibva pane zviri pasi apa zvinhu
- Nhanho uye giredhi reFL yako.
- Chero genetic shanduko yaunayo.
- Zera rako uye hutano hwese.
- Zvimwe zvirwere kana mishonga yaungave uchitora.
- Zvaunofarira mushure mekukurukura zvaungasarudza nachiremba wako.
Mienzaniso yechemoimmunotherapy protocols iwe unogona kuwana kurapa FL
- BR musanganiswa weBendamustine neRituximab (a MAB).
- BO kana GB- musanganiswa weBendamustine neObinutuzumab (a MAB).
- RCHOP musanganiswa we rituximab (a MAB) ine chemotherapy mishonga cyclophosphamide, doxorubicin, vincristine uye prednisolone. Iyi protocol inongoshandiswa kurapa FL kana iri giredhi repamusoro, rinowanzo giredhi 3a uye pamusoro.
- O- CHOP musanganiswa weObinutuzumab, cyclophosphamide, vincristine, doxorubicin uye prednisolone. Iyi protocol inongoshandiswa kurapa FL kana iri giredhi repamusoro, rinowanzo giredhi 3a uye pamusoro.
Clinical trials
Kune miyedzo yakawanda yekiriniki muAustralia nepasirese, vachitsvaga nzira dzekuvandudza marapirwo evanhu vane lymphoma. Kana iwe uchida kudzidza zvakawanda nezve kliniki miedzo, tinya bhatani riri pazasi. Unogona zvakare kutaura nachiremba wako ane mazvikokota - wako wehematologist kana oncologist nezve zviedzo zvekiriniki zvaungakodzere.
Maintenance therapy
Maintenance therapy inopiwa nechinangwa chekukuchengetedza mukuregererwa kwenguva yakareba, mushure mekurapa kwako kwekutanga.
Kuregererwa kwakakwana
Vanhu vazhinji vane mhinduro yakanaka kune yekutanga kurapwa uye kuwana kuregererwa kwakakwana. Izvi zvinoreva kuti kana wapedza kurapa kwako, hapana chinooneka FL chasara mumuviri wako. Izvi zvinogona kusimbiswa mushure mePET scan. Nekudaro zvakakosha kuti unzwisise kuti kuregererwa kwakakwana hakuna kufanana nekurapa. Nekurapa, lymphoma yaenda uye haigoni kudzoka.
Asi isu tinoziva ne indolent lymphomas senge FL, vanowanzouya mushure menguva yakati. Izvi zvinogona kuva mwedzi kana makore mushure mekurapwa kwako, asi zvinokwanisika kudzoka. Izvi zvinonzi kudzoka zvakare. Kana zvikaitika, ungangoda kurapwa kwakawanda, kana kuti unogona kuenda ku "tarisa uye kumirira" kana ikaramba isingaiti pasina zviratidzo.
Chikamu chekuregererwa
Kune vamwe vanhu, kurapwa kwekutanga hakukonzeri kuregererwa kwakakwana, asi kuregererwa kwechikamu. Izvi zvinoreva kuti ruzhinji rwechirwere chaenda, asi pachine zvimwe zviratidzo zvasara mumuviri wako. Ichiri mhinduro yakanaka, nekuti rangarira kuti FL indolent lymphoma isingarapike. Asi kana iwe uine chikamu chemhinduro, inogona kudzokera kuhope, uye iwe ungasazoda kurapwa kwakasimba asi enderera uchiona uye kumirira.
Kunyangwe uine kuregererwa kwakakwana kana kusara kunogona kuonekwa pakutevera kwako PET scan.
Kuedza kukuchengetedza mukuregererwa kwenguva yakareba sezvinobvira, chiremba wako anogona kukukurudzira kuti uende kuchipatara chekuchengetedza kwemakore maviri mushure mekurapa kwako kwekutanga.
Kurapa kwekuchengetedza kunosanganisirei?
Maintenance therapy inowanzopiwa kamwe chete pamwedzi 2-3 uye ndeye monoclonal antibody. Masoja ekudzivirira chirwere anonzi monoclonal anoshandiswa kugadzirisa ndee rituximab kana obinutuzumab. Mishonga miviri iyi inoshanda kana uine puroteni CD20 pamasero ako elymphoma, ayo anowanikwa neFL.
Mutsara wechipiri Kurapa
Kana FL yako ikadzokorora kana ikaramba kurapwa kwekutanga, ungangoda kurapwa kwechipiri. Refractory FL ndeye apo iwe usina kuregererwa kwakakwana kana chikamu kubva pakurapa kwako kwekutanga.
Kana iwe uri pasi pemakore makumi manomwe, unogona kupihwa misanganiswa yakasiyana yemishonga, ichiteverwa ne stem-cell transplant. Nekudaro, stem cell transplants haina kukodzera munhu wese. Chiremba wako achakwanisa kutaura newe zvakanyanya nezvekukodzera kwako wega pamhando yekurapa iyi.
Kana iwe usina stem-cell transplant, kune mamwe maprotocol ekurapa aunogona kupihwa.
Mishonga iyi inoshandiswa kukudzosera mukuregererwa uye kutonga lymphoma yako kwenguva refu.
Kurapa maprotocol kana iwe uine stem-cell transplant
RICE
RICE ikemikari yakasimba yezvikamu (yakatsemuka) kana infusional (kuburikidza nedrip) dosi reifosfamide, carboplatin uye etoposide. Iwe unogona kunge uine izvi kana iwe wadzokera kumashure kana usati waita autologous stem cell transplant. Unozoda kurapwa uku muchipatara
R-GDP
R-GDP musanganiswa we gemcitabine, dexamethasone uye cisplatin. Iwe unogona kunge uine izvi kana iwe wadzokera kumashure kana usati waita autologous stem cell transplant.
Kurapa maprotocol kana iwe usina stem-cell transplant
R-CHOP/ O-CHOP
R-CHOP kana O-CHOP musanganiswa we rituximab kana obinutuzumab (a MAB) ine chemo mishonga cyclophosphamide, doxorubicin, vincristine uye prednisolone link kune eviQ.
R-CVP
R-CVP musanganiswa we rituximab, cyclophosphamide, vincristine uye prednisolone. Iwe unogona kunge uine izvi kana wakura uine dzimwe nyaya dzehutano.
O-CVP
O-CVP musanganiswa weobinutuzimab, cyclophosphamide, vincristine uye prednisolone. Iwe unogona kunge uine izvi kana wakura uine dzimwe nyaya dzehutano.
Radiation
Radiation therapy inogona kushandiswa kana FL yako yadzoka zvakare. Zvinowanzoitwa kana ikadzokera kune imwe nzvimbo yemunharaunda uye inobatsira kudzora FL yako uye kuderedza zvimwe zviratidzo zvaungave uchiwana.
Mutsara wechitatu kurapwa
Mune zvimwe zviitiko, ungangoda kurapwa kwakawanda mushure mekudzoka kwechipiri kana kunyange chechitatu. Mutsara wechitatu kurapwa kunowanzofanana nekurapa kuri pamusoro.
Mune zvimwe zviitiko, kana FL yako "ichishandura" uye ichitanga kuita senge ine hukasha subtype ye lymphoma inonzi Diffuse yakakura B-cell lymphoma, unogona kunge uchikodzera kurapwa neCAR T-cell semutsetse wechitatu kana wechina. Chiremba wako achakuzivisa iwe kana FL yako inotanga kuchinja.
Yakashandurwa Lymphoma
Lymphoma yakashandurwa inonzi lymphoma yakatanga kuonekwa seine indolent (kukura zvishoma nezvishoma) asi yave (yakashandurwa kuita) lymphoma ine hutsinye (inokurumidza kukura).
Shanduko yeFL yako inogona kuitika kana uine mamwe genetic shanduko kune yako lymphoma maseru nekufamba kwenguva, zvichikonzera kumwe kukuvara. Izvi zvinogona kuitika zvega, kana semhedzisiro yemamwe marapirwo. Uku kukuvadza kwakawedzerwa kune majini kunoita kuti masero akure nekukurumidza.
Ngozi yekushandura yakaderera. Tsvagiridzo inoratidza kuti mumakore gumi kusvika gumi nemashanu mushure mekuongororwa, vanhu vangangosvika 10-15 kubva pa2 vane FL gore rega rega, vanogona kuve neshanduko kune yakawedzera hukasha subtype.
Ivhareji yenguva kubva pakuongororwa kusvika pakushandurwa ndeye 3-6 makore.
Kana iwe uine shanduko kubva kuFL, zvingangoita kuti ichashanduka kuita subtype ye lymphoma inonzi Diffuse yakakura B-cell lymphoma (DLBCL) kana, kazhinji kacho Burkitt lymphoma. Iwe uchada chemoimmunotherapy kurapwa pakarepo.
Nekuda kwekufambira mberi mukurapa, mhedzisiro yekushandurwa follicular lymphoma yakavandudza zvakanyanya mumakore achangopfuura.
Zvakajairwa nemishonga
Kune akawanda akasiyana mhedzisiro aunogona kuwana kubva mukurapwa kwako kweFL. Usati watanga kurapwa kwako, chiremba wako kana mukoti anofanira kutsanangura zvese zvinotarisirwa zvinokonzeresa zvaungasangana nazvo. Iwe unogona kusazviwana zvese, asi zvakakosha kuziva zvekutarisa uye nguva yekusangana nachiremba wako. Ita shuwa kuti une ruzivo rwekuti ndiani waunofanirwa kubata kana ukapora pakati pehusiku kana pakupera kwevhiki apo chiremba wako angave asipo.
Chimwe chezvakanyanya kukonzeresa kurapwa ndechekuchinja kwehuwandu hweropa rako. Pazasi pane tafura inotsanangura kuti ndeapi masero eropa anogona kukanganiswa uye kuti izvo zvingakubata sei iwe.
Masero eropa akabatwa neFL kurapwa
Maso matsvuku eropa | Masero matsvuku eropa | Platelets (uyewo masero eropa) | |
Zita Rezvokurapa | Neutrophils uye Lymphocytes | Erythrocytes | Platelets |
Vanoitei? | Kurwisa Utachiona | Takura oxygen | Regedza kubuda ropa |
Kushomeka kunonzi chii? | Neutropenia uye lymphopenia | Anemia | Thrombocytopenia |
Izvi zvichakanganisa sei muviri wangu? | Iwe uchawana humwe hutachiona uye unogona kunetseka kuzvibvisa kunyangwe nekutora mishonga inorwisa mabhakitiriya | Unogona kuva neganda rakachenuruka, kunzwa kuneta, kufema, kutonhora uye dzungu | Unogona kukuvara nyore, kana kubuda ropa risingamire nekukurumidza kana wachekwa |
Chii chichaitwa neboka rangu rekurapa kugadzirisa izvi? | ● Kunonotsa kurapwa kwako nelymphoma ● Kukupa mishonga inorwisa mabhakitiriya kana uine utachiona | ● Kunonotsa kurapwa kwako nelymphoma ● Kukupa ropa rered cell kana nhamba yako yemasero yakaderera zvikuru | ● Kunonotsa kurapwa kwako nelymphoma ● Kukupa ropa re<em>platelet kana nhamba yako yemasero yakaderera zvikuru |
Zvimwe zvakajairika mhedzisiro yekurapa kweFL
Pazasi pane rondedzero yezvimwe zvakajairika mhedzisiro yeFL marapirwo. Zvakakosha kuziva kuti kurapwa kwese kwava kukonzera zviratidzo izvi, uye unofanira kutaura nachiremba wako kana mukoti kuti ndezvipi zvinokonzeresa zvinogona kukonzereswa kurapwa kwako wega.
- Kunzwa kurwara mudumbu (nausea) uye kurutsa.
- Muromo unorwadza (mucositis) uye kuchinja kune kuravira kwezvinhu.
- Matambudziko emudumbu akadai sekuvhara kana manyoka (poo yakaoma kana ine mvura).
- Kuneta, kana kushaya simba risingaite zvakanaka mushure mekuzorora kana kurara (kuneta).
- Tsandanyama (myalgia) uye majoini (arthralgia) aches uye marwadzo.
- Kupera kwebvudzi uye kuonda (alopecia) - chete nemamwe marapirwo.
- Mind fogginess uye kuoma mukurangarira zvinhu (chemo brain).
- Shanduko yekunzwa mumaoko ako netsoka senge kurira, mapini netsono kana kurwadziwa (neuropathy).
- Kuderedza kubereka kana kutanga kuenda kumwedzi (kuchinja kwehupenyu).
Kutarisirwa kwekutevera - Chii chinoitika kana kurapwa kwapera?
Paunopedza kurapwa, ungada kukanda shangu dzako dzekutamba, isa maoko ako mumhepo uye bati senge murume uyu (kana uine simba), kana iwe ungave wakazadzwa nekunetseka uye kunetseka pamusoro pezvinotevera.
Manzwiro ose ari maviri akajairika uye akajairika. Zvakajairikawo kunzwa neimwe nzira, imwe nguva, uye neimwe nzira nguva inotevera.
Hausi wega kana kurapwa kwapera. Iwe uchange uchiri kusangana neako nyanzvi timu, uye unokwanisa kuvafonera kana uine chero chirikunetsa.
Ucharamba uchitariswa nekuongororwa ropa uye nekuongororwa kwepanyama kutarisa chero zviratidzo kana kudzoka zvakare kana zvinogara kwenguva refu-zvinokonzerwa kubva mukurapwa kwako. Mune zvimwe zviitiko, unogona kunge uine scan yakadai sePET kana CT, asi izvi kazhinji hazvidikanwi kana mimwe miedzo yose yakajairika uye iwe usiri kuwana zviratidzo.
Prognosis
Prognosis ishoko rinoshandiswa kutsanangura nzira ingangove yechirwere chako, kuti chichapindura sei kurapwa uye kuti uchaita sei panguva uye mushure mekurapwa.
Pane zvakawanda zvinokonzeresa kufungidzira kwako uye hazvigoneke kupa chirevo chakazara nezve prognosis. Zvisinei, FL inowanzopindura zvakanaka pakurapwa uye varwere vakawanda vane kenza iyi vanogona kuva nekuregererwa kwenguva refu - zvinoreva kuti mushure mekurapa, hapana chiratidzo cheFL mumuviri wako.
Zvinhu zvinogona kukanganisa prognosis
Zvimwe zvinhu zvinogona kukanganisa prognosis yako zvinosanganisira:
- Iwe zera uye hutano hwese panguva yekuongororwa.
- Mapinduriro aunoita pakurapwa.
- Ko kana paine genetic mutations iwe unayo.
- Iyo subtype yeFL yaunayo.
Kana iwe uchida kuziva zvakawanda nezve fungidziro yako, ndapota taura nenyanzvi yako yehematologist kana oncologist. Vachakwanisa kutsanangura njodzi yako uye fungidziro kwauri.
Kupona - kurarama nefollicular lymphoma
Mararamiro ane hutano, kana mamwe mararamiro akanaka anochinja mushure mekurapwa anogona kubatsira zvikuru kupora kwako. Pane zvakawanda zvaunogona kuita kuti ugare zvakanaka nazvo DLBCL.
Vanhu vazhinji vanoona kuti mushure mekuongororwa kenza, kana kurapwa, kuti zvinangwa zvavo uye zvavanokoshesa muhupenyu zvinoshanduka. Kusvika pakuziva kuti 'itsva yako yakajairika' chii kunogona kutora nguva uye kushungurudza. Zvinotarisirwa nemhuri yako neshamwari zvinogona kunge zvakasiyana nezvako. Iwe unogona kunzwa uri wega, wakaneta kana chero nhamba yemanzwiro akasiyana anogona kuchinja zuva rega rega.
Zvinangwa zvikuru mushure mekurapa kwako DLBCL ndiko kudzokera kuhupenyu uye:
- Iva nekushingaira sezvinobvira mubasa rako, mhuri, uye mamwe mabasa ehupenyu.
- Deredza mhedzisiro uye zviratidzo zvegomarara uye kurapwa kwayo.
- Ziva uye gadzirisa chero mhedzisiro yekunonoka.
- Batsira kuti urambe wakasununguka sezvinobvira.
- Kuvandudza hupenyu hwako uye chengetedza hutano hwakanaka hwepfungwa.
Mhando dzakasiyana dzekugadzirisa kenza dzinogona kukurudzirwa kwauri. Izvi zvinogona kureva chero yemhando dzakasiyana zvemasevhisi akadai se:
- Kurapa kwepanyama, kugadzirisa marwadzo.
- Kuronga kwekudya kunovaka muviri uye kurovedza muviri.
- Emotional, basa uye mazano emari.
