Ma'anar, cututtukan cututtuka, jiyya da hangen nesa na Lymphoma Follicular
Lymphoma mai ba da ƙwayar cuta shine nau'in wadanda ba Hodgkin Lymphoma (NHL) ba . Yawancin lokaci ne lymphoma mai raguwa wanda ya fito ne daga B-sel (B lymphocytes) , irin nau'in jini.
Lymphoma mai laushi kuma ana kiranta lymphoma mai laushi ko ƙananan ƙwayar jiki saboda yanayin jinkirinsa, dukansu biyu game da ci gaban halayyar jiki-da kuma yadda yake gani a karkashin ƙananan microscope-marasa ƙaranci (mafi bambanta) fiye da rashin lafiya.
Dalili na Hadarin
Follicular zai iya shafar kowane mutum, duk da haka ya fi kowa a cikin tsofaffi. Wannan matsakaicin shekaru a lokacin ganewar asali yana kusa da 55, kuma yana tasiri maza da mata daidai.
Tsarin jima'i
Lymphoma mai laushi shine mafi yawan kwayar lymphoma mai raguwa, tare da kimanin mutane 15,000 a Amurka da aka gano a kowace shekara.
Alamai da cututtuka
Harshen lymphoma mai banƙyama yana da sauƙi sau da yawa, tare da wasu alamun gargaɗin da ba za a iya gane su ba na dogon lokaci. Kwayar cututtuka na iya haɗawa da:
- Ƙara ƙaddamar da ƙwayoyin lymph - Kashe ƙwayar lymph nodes a wani yanki na jiki shine alama mafi yawan gaske na lymphoma follicular. Wadannan nodes zasu iya ji a wuyan wuyansa , mai hawan katako , ko maiguwa, ko kuma za'a iya lura da su akan gwaje-gwaje a cikin wasu sassan jiki (kamar su a cikin ƙwayoyin lymph a cikin ƙwayar ko kuma retroperitoneal lymph nodes a cikin ciki). (Cibiyar nazarin kumburi na lymph ta tattauna batun aikin lymph nodes da wurare a zurfi.)
- Fuskantar da asalin da ba a sani ba (FUO) - Duka da zazzabi (fiye da 100.4 digiri F ko 38 digiri C) wanda yake samuwa ga kwana uku ko fiye da baya ba tare da wata hujja ba mai iya zama alama ce ta lymphoma. Maimakon kasancewa da alaka da kamuwa da cuta wanda ba a tabbatar da ita ba, anyi tunanin cewa FUO yana haifar da hanyoyi masu amfani da sinadaran da ke da nasaba da ciwon daji wanda hakan ya kara yawan zafin jiki.
- Rashin hasara marar kyau - Bacewar asarar rashin daidaituwa an bayyana shi azaman asarar kashi 5 zuwa 10 na nauyin jiki (misali, 7.5 zuwa 15 fam a cikin mutum 150) a tsawon watanni 6 ko žasa.
- Shawaran dare - Gudun dare sun bambanta da walƙiya da kuma shawagi a lokuta da yawa suna taƙamawa kuma mutane suna buƙatar canza tufafinsu da kwanciya, wani lokaci sau da yawa a cikin dare.
- Dama - Rashin ciwon canji sau da yawa ya bambanta da "gajiya mai wuya" a cikin cewa ba ta inganta tare da barci mai kyau ba ko kopin kofi.
- Rawancin numfashi
- Tsarin Gizan Tsakanin - Itching yana tsammanin yana faruwa a jiki duka kuma zai iya zama mai tsanani.
Harsoyin B na lymphoma sun hada da manyan alamomi guda uku waɗanda zasu taimaka wajen tsinkaya yadda ciwon zai ci gaba da amsa maganin kuma ya hada da:
- Fever
- Rashin asarar rashin nauyi
- Drenching dare Sats
Sanin asali
Yawancin lymphoma mai yawan ƙwayar cuta ana yawan gano shi tare da kwayar cutar kwayar lymph . Ana iya yin hakan a matsayin mai cututtuka (tare da nodes da ke da wuyansa irin su a cikin wuyansa) ko a matsayin asalin magungunan buƙatar ƙwayoyin cuta (domin nodes a cikin jiki).
An dauki ƙananan samfurin ƙwaƙwalwar da aka shafi kuma an gwada shi a karkashin na'urar microscope ta hanyar likita. Ayyukan dabbar da ke ciki ta nuna cewa akwai lymphoma.
Bugu da ƙari ga bayyanar a karkashin na'urar ƙwayoyin microscope, an yi gwaje-gwajen immunohistochemistry don duba samfurin lymphoma CD da kuma ƙayyade irin lymphoma ba Hodgkin .
Me yasa ake kira 'Follicular' Lymphoma?
Kamar yawancin lymphomas, lymphomas na follicular yafi rinjayar lymph nodes . Yayin da aka gano lymph nodes da wannan lymphoma ke gani a ƙarƙashin microscope, suna nuna nauyin jikin da ake kira "follicles". Lymphoma haka ake kira lymphoma follicular.
Gwaje-gwaje Bayan Bincike
Bugu da ƙari, game da shafukan da suka shafi biopsy a sama, an yi amfani da yawancin gwaje-gwajen da ake bukata a lokacin da aka fara bincikar lymphoma.
Wadannan suna ba da damar likita don ganin yadda cutar ta kasance daidai kuma wane nau'i ne aka shafa. Gwaje-gwaje na jini, CT scans da kasusuwa daga kasusuwa na yawanci ana buƙatar.
Sabuwar bincike ya kuma bincika mai amfani da PET / CT don bincika kwayar lymphoma, kamar misali, lokacin da sakamakon binciken CT ba shi da tabbas. A PET-CT, an yi amfani da tagitan rediyo (18F-fluorodeoxyglucose) a cikin mai haƙuri kafin CT dubawa kuma yankunan da ke fama da cutar ya haskaka idan sun dauki glucose na rediyo. Wannan yana taimakawa wajen rarraba yankuna masu aiki na ciwon daji daga yankunan da ke da wuya wanda zai iya kama da CT scans.
Tsarin
Lamarin lymphoma mai yaduwa ya nuna yadda cutar ta yadu kuma yana da muhimmanci a zabar mafi kyawun maganin kuma a tantance ƙaddamar da cutar. Lymphoma ya yada zuwa ga kwayoyin lymph da sauran kwayoyin jiki ciki har da ƙashin kasusuwa. Akwai hudu matakai na lymphoma wanda sun hada da:
- Matsayi Na - Kashi ɗaya ne kawai (ko lymph structure).
- Stage na II - Kwayoyin lymph biyu ko fiye (ko lymph structures) suna da hannu amma a gefe daya (sama ko žasa) diaphragm.
- Sashe na III - Lambobin Lymph (ko sifofi) a bangarorin biyu na diaphragm suna da hannu.
- Sashe na IV - Lymphoma ne a cikin kasusuwan kasusuwan da / ko kyallen takarda ko gabobin jiki banda gabobi ko lymph.
Bugu da ƙari, an ba da lambar lymphomas a matsayin A ko B, tare da Ma'anar cewa babu alamun B da B da ke nuna kasancewar B na alamun lymphoma (wanda aka lissafa a sama a karkashin alamun bayyanar).
Ci gaba
Yawancin lymphoma mai laushi shine yawancin ciwo mai ciwo da sau da yawa kuma sau da yawa ya kasance ba a gane shi ba har tsawon lokaci a jikinsa kafin a gano shi. Yayinda alamar cututtuka ta yi ta da hankali, cutar ta sau da yawa kafin a gane asali, tare da yawancin mutanen da aka bincikar su lokacin lymphoma shine mataki III ko IV.
Ko da a cikin ci gaba da ci gaba da cutar, duk da haka, yawancin lokaci ba a barazana ga rayuwa a lokacin ganewar asali. Kwayar tana da tsayayyar hanya, yana ma'ana cewa yana tasowa kuma yana da yawa sau da dama a tsawon shekaru. Duk da cewa babu wani magani wanda ya dace a cikin matakai na ci gaba, yawancin marasa lafiya suna rayuwa har zuwa shekaru 8 zuwa 10 ko fiye da magani.
Canzawa
Yawancin lymphoma mai laushi sukan shawo kan sauyawa a wani lokaci, daga mummunan cututtuka zuwa cutar mai ci gaba. Wannan ana kiransa canji. Canji zai iya faruwa a cikin dukkan kwayoyin, ko kawai a wani bangare na ciwon daji. Kasancewar cututtuka na B yana ƙaruwa da cewa ƙwayar za ta sake canzawa a nan gaba. Bayan wani lymphoma mai laushi ya "canzawa" ana sau da yawa kamar yadda ake yaduwa babban lymphoma B-cell .
Dalilin
Ba mu san abin da ke haifar da lymphomas ba, ko da yake akwai wasu matsaloli masu haɗari da haɗari da yawa. Wasu matsaloli masu alaka da lymphoma , da lymphoma follicular (FL) musamman, sun hada da:
- A rage cin abinci rage a cikin 'ya'yan itatuwa da kayan marmari
- Ƙananan matakan aiki na jiki
- Shan taba - Ba kamar sauran lymphoma ba na Hodgkin, haɗarin FL ya karu a cikin mutanen da ke shan taba.
- Yin amfani da barasa - Yin amfani da giya zai iya shafar hadarin a kowace hanya; ƙananan ruwan inabi suna haɗuwa da ƙananan ƙananan haɗari kuma yawancin giya na yau da kullum suna haɗuwa da haɗarin haɗari.
- Shekaru (kamar yadda aka gani a sama, FL yana ƙaruwa da shekaru)
- Kiba
- Immunosuppression
- Bayyanar muhalli ga magunguna, magungunan masana'antu, da hydrocarbons
- Tsarin kwayoyin halitta zai iya taimakawa ga wasu lokuta.
- Sabanin sauran nau'in lymphoma ba na Hodgkin, FL ba nasaba da cututtuka na Epstein-Barr, H.pylori.
- Shafin haske na UV yana haɗi da haɗarin hadari. (Vitamin D na iya taka rawa wajen kare FL).
Jiyya
Akwai sauye-shiryen maganin da za a samu don lymphoma na follicular , tare da mafi kyawun zabi da ke da mataki na ciwon daji, da ƙyama (sifa), da sauran yanayin kiwon lafiya, da lafiyar lafiyarka, da kuma wace jiyya da ka samu a baya. Domin cutar ta farko, radiation kadai shine duk abin da ake bukata. Tare da ciwon maganin ci gaba, ana amfani da kwayoyi da ke ƙasa a cikin haɗuwa (duba haɗin haɗuwa da ke ƙasa). Zabuka zasu iya haɗawa da:
Jira da kallo - Idan lymphoma mai yaduwa ba ya haifar da alamun alamun, jiran jira yana iya kasancewa "magani" na zabi. Tare da jiran jira, za a kula da ku sosai tare da gwaje-gwaje da gwaje-gwajen hotunan don a iya farawa da magani idan cutar ta fara ci gaba. Wannan zai iya jin tsoro, ko da yake an gano cewa rabon rayuwa ba zai canza ba lokacin da ake amfani da wannan hanya.
Tsarin radiation - Domin mataki, zan yi amfani da lymphomas, magungunan radiation na iya zama kawai hanyar da ake bukata, kuma zai iya warkar da cutar. Fasahar radiation filin (IFRT) sau da yawa hanyar amfani da radiation. Ya bambanta da farfadowa na filin radiation, IFRT tana ba da radiation ga nau'in abin da ya shafi abin ya shafa, don kare lafiyar jiki. (Harkokin radiation yana ɗauke da hadarin ƙwayar cututtuka kuma wannan ya rage wannan hadarin.)
Chemotherapy - An yi amfani da cutar shan-jijiyo tare da amsa mai kyau. Ana amfani dashi a matsayin ɓangare na maganin hade (duba ƙasa).
Farfesa da aka fizge - Magunguna da aka yi amfani da su suna amfani da magani wanda ke kai tsaye kan ciwon ciwon daji ko alamun alamar shiga cikin ciwon tumo. An yi amfani da Rituxan (rituximab) guda daya wanda aka saba amfani dashi (duba hanyoyin hadewa) tare da chemotherapy kuma ya haifar da mahimmanci a cikin yawan rayuwa. Magungunan monoclonal irin su rituximab su ne kayan kare mutum wanda aka tsara don haɗawa da takamaiman alamomi a kan kwayoyin lymphoma (alamar CD). Dukkansu rituximab da Gazyva (obinutuzumab) sun kai hari ga magungunan CD 20 .
An gano Treanda (bendamustine) don bunkasa rayuwa mai ci gaba amma yana da mummunan tasiri na tasiri. Gazyva (obinutuzumab) da bendamustine na iya aiki ga waɗanda ba su amsa rituximab ba.
Radioimmunotherapy - Radioimmunotherapy wani magani ne wanda ake amfani da kwayoyi (yawanci magunguna guda daya) tare da ƙwayoyin radiation wanda ya bar likitancin ya ba da radiation daidai ga kwayoyin cutar kanjamau. Misali ne Zevalin (yttrium-90 ibritumomab tiuxetan).
Gwaje-gwaje-gwaje - Anyi amfani da kwayoyi da hanyoyin da yawa a gwaji , ciki har da magungunan immunotherapy na Keytruda (pembrolizumab), ƙaddara cell transplants , da sauransu. Ga wasu daga cikin sababbin binciken binciken da ke kan lymphoma.
Hanyoyin Hanya
Akwai hanyoyi masu yawa da aka hade wanda za'a iya amfani dasu a farko ko kuma lokacin da lymphoma mai fadi ya ci gaba. Wadannan sun hada da
- R-Bendamustine (rituximab da bendamustine) - Wannan haɗin yana nuna cewa yana da ƙananan sakamako (ƙananan ƙwayoyin neuropathy da gashin gashi).
- Treanda (bendamustine) kadai
- Rituximab kadai
- R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, da prednisone)
- R-CVP (rituximab, cyclophosphamide, vincristine, da prednisone)
- Fludara (fludarabine) da rituximab
- Zydelig (idelalisib) tare da ko ba tare da rituximab ba
- Revlimid (lenalidomide) tare da ko ba tare da rituximab ba
Magance Tsarewa - Lokacin da lymphoma mai ɗorewa ke amsawa, za'a iya ci gaba da maganin farfadowa irin su rituximab don 'yan shekaru don taimakawa wajen tsaftacewa.
Hanyoyin Gaba
Sakamakon sakamako na jiyya zai dogara ne akan takamaiman magani da ka karɓa. Tare da maganin farfadowa irin su rituximab, sakamakon da yafi dacewa shi ne rashin lafiyan halayen a lokacin rituximab infusions . Sauran cututtuka na iya haɗuwa da ƙananan jini da kuma tari ko ƙuƙalar ɗa.
Faɗakarwa
Idan an gano lymphoma a cikin farkon matakai, zai iya zama mai dorewa tare da maganin radiation. Duk da haka duk da haka tare da ci gaba da ci gaba da cutar, mutane suna iya tsira da yawa shekaru da yawa tare da magani. Wani kayan aikin da ake kira Follicular Lymphoma International Prognostic Index ko FLIPI ana amfani dashi don amfani da wani bayani game da ƙayyadaddun bayaninka. Wannan fassarar ya ɗauki abubuwa daban-daban kuma ya ba da lambar da zata kiyasta lafiyar shekaru 10 na cutar.
Ka tuna cewa akwai wasu abubuwa daban-daban wadanda ke shafar maganin da ciwon daji, kuma wasu lokuta mutane suna rayuwa fiye da yadda aka tsammanin, ko kuma mataimakin. Mun sani cewa yin amfani da taba, kiba, da kuma amfani da giya suna hade da rashin talauci, sabili da haka salon lafiya yana da matukar muhimmanci.
Ciyarwa
Kula da lymphoma yana canzawa da sauri. Yana da muhimmanci a koyi duk abin da zaka iya game da ciwon daji. Bincika waɗannan shawarwari don bincike kan ciwon daji akan layi . Nazarin ya gaya mana cewa mutanen da suke ilmantarwa game da ciwon daji ba kawai suna jin dadi ba kuma suna da iko, amma kuma suna da kyakkyawan sakamako.
Tambayi taimako kuma bari wasu su taimake ka. Yi la'akari da shiga tsakani a cikin ƙungiyar tallafi da / ko layi na lymphoma na kan layi. Duk yadda ƙaunar abokananka da iyalinka suke ƙauna, ba zai iya zama mai mahimmanci don yin magana da wasu waɗanda suke fuskantar matsalolin da kake fuskanta ba.
Yawancin haka, ka tuna cewa ci gaba mai girma yana faruwa a wajen maganin cututtuka irin su lymphoma na follicular. Ka kasance mai ba da shawara a matsayin mai ciwon daji kuma ka koyi game da waɗannan binciken. Akwai sa zuciya.
Caregiving
Idan kana tunanin abin da mai ƙauna zai iya faruwa, za ka iya so ka duba abin da masu tsira da ciwon daji suka fada a lokacin da aka tambayi wannan tambaya: me kake son zama tare da ciwon daji ? Lymphoma mai laushi, a cikin ciwon ciwon daji mai ciwo, yana kasancewa a cikin shekaru masu yawa. A wasu kalmomi, yana da marathon kuma ba wani gwanin ba. Yi ɗan lokaci don koyi yadda zaka kula da kanka yayin da kake kula da wanda kake auna da ciwon daji.
Sources
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Ambinder, A., Shenoy, P., Malik, N. et al. Binciken Faɗar Hanyoyin Hanyoyi don Lymphoma Follicular. Ci gaba a Hematology . 2012. 2012: 626035.
Burke, J., van der Jagt, R., Kahl, B. et al. Differences a Rayuwa na Rayuwa tsakanin Bendamustine-Rituximab da R-CHOP / R-CVP a cikin Marasa lafiya Tare da Tsohon Kwararrun Ƙwararrun Cutar Lymphoma ko Mantle Cell Lymphoma. Lymphoma Clinical, Myeloma, da kuma cutar sankarar bargo . 2016 16 (4): 182-190.
Flinn, I., van der Jagt, R., Kahl, B. et al. Gwajin Randomed na Bendamustine-Rituximab ko R-CHOP / R-CVP a Layin Zama na farko na NHL ko MCL: Binciken BRIGHT. Jinin jini . 2014. 123 (19): 2944-52.
Gascoyne, R., Nadel, B., Pasqualucci, L. et al. Lymphoma Follicular: Harkokin Cikin Gida na ICML a Lugano 2015. Hematologic Oncology . 2017 Apr 4. (Epub gaba da bugu).