I-lymphoma yesigxina yenye yezona ntlobo eziqhelekileyo ze- non-Hodgkin Lymphoma, okanye i-NHL . I-lymphoma ekhula ngokukhawuleza, kwaye ngokuqhelekileyo ayisoloko isongela ubomi. Ngenxa yokuba ikhula ngokukhawuleza kwaye ingabonakaliyo, abaninzi abantu abayikubona nayiphi na ingxaki ngelixa isifo sisemagqabini ayo okuqala. Ngethuba le sifo sifumaneka ukuba izigulane ezininzi - iipesenti ezingama-80-85 - ziye zazisasazeka izifo eziqhelekileyo ziquka indawo ezininzi ze-lymph node , umongo wethambo , i-spleen okanye ezinye izitho.
Ukunyuka ukukhula, kodwa kunzima ukuphilisa ngokupheleleyo
Kumazigaba eziphambili, abantu abane-lymphoma ye-follicular bahlala behlala ixesha elide kunye neyonyango ngokuqhelekileyo, ngenxa yobume bayo obukhulayo. Nangona kunjalo, isifo asiphilwanga. Uninzi lwabantu lusabela kakuhle kunyango, kwaye eso sifo sinokuzinza iminyaka embalwa ngaphambi kokubuyela kwakhona kwaye sifuna kwakhona unyango. Izigulane ezininzi zifuna ukunyangwa ngamaxesha amaninzi, kunye nezikhathi zesifo esisisigxina emva kokuba unyango olunokudlulela inyanga ukuya kwiminyaka emininzi.
Bambalwa abantu abanethamsanqa ukuba bafumaneke ngelixa isi sifo siseseziqaleni zayo. Aba bantu banokuhlala beciliswa. Ukunyangwa kwamayeza kusetyenziswa yedwa kubantu abaninzi. Kuye kwabonwa ukuba amaqondo athatyathwayo emirhoxweni enikezelwe kwiindawo ezichaphazelekayo zomzimba kulabo abanezifo ezikulo ndawo angakwazi ukulawula isigulo ngokusisigxina. Akukho nzuzo eyongezelelweyo yokongeza i-chemotherapy okanye i- biological agents .
Unyango luxhomekeke kwiNgxenye kwiSiteji
Iimvavanyo ezahlukeneyo ezinokuthi zenziwe ngeenjongo zokuhamba, kuquka:
- Ukuhlolwa kwegazi
- I-bone yomnkantsha we-Bone - ukuthatha isampuli encinane yeethambo ezivela emnxeni wethambo
- I-tomography ekhompyutheni, okanye i-CT scan
- I-positron ukukhishwa kwe-tomography, okanye i-PET, ukuyihlola
Isalathiso sibhekisela kumlinganiselo wokusasazeka.
Iinkqubo ezahlukeneyo zokusetyenziswa kwezicwangciso ziye zasetyenziswa, kodwa nantsi enye inkqubo esetyenziswa ngokuqhelekileyo enezigaba ezine:
- Isigaba I - Kuphela kubandakanyeka indawo yecliph node, okanye isakhiwo esisodwa kuphela.
- Isigaba II - Imimandla yesibini okanye ngaphezulu ye-lymph node okanye izakhiwo kwicala elifanayo le-diaphragm zibandakanyeka.
- Isigaba III - Iimimandla ze-Lymph node okanye izakhiwo zombini zecrafm zibandakanyeka.
- Isigaba IV - Kukho ukubandakanyeka kweqela lezitho okanye izicubu ezingekho kweemimandla okanye izakhiwo ze-lymph node, ezifana nomnatha wethambo.
Phantse ama-15 ukuya kuma-20 ekhulwini labantu abane-FL banesigaba sesi-II okanye nesifo sam sifo.
Amaphesenti angama-40 anesifo sesigaba se-IV ekuxilongweni.
Ukubamba kubhekisela kwindlela ulaka olubonakalayo lweFL lusekelwe kwiimpawu ezincinci. AmaBakala 1, 2 no-3 anokwenzeka, kwaye ibakala lesi-3 liyinkxalabo ngokubhekiselele kwento ekubhekiselelwe kuyo kwisiphumo.
Indlela yokwelashwa
I-Oftentimes, FL ikhula ngokukhawuleza kwaye ayikho impawu enobudlova. Zombini isigqibo sokwenza unyango kunye nenkqubo yokuqala yokunyanga kukhethwa yinto enokuthi ithinteke kwizinto eziliqela, kubandakanywa nomviwa wokuvavanya izilingo ze-klinikhi, yonke impilo kunye nendlela yokuboniswa kwesifo. Iipilisi ezikhethiweyo ezikhethiweyo ziyahlukahluka kubantu abahlukeneyo kunye neentlobo ezahlukeneyo ze-FL - kunye nabantu ababini abane-FL efanayo.
Ngokwezikhokelo ze-NCCN zika-2015, ukuqwalasela - kunokuba unyango - unokufaneleka kwiimeko ezithile. Xa unyango luqhutywa, ngokubhekiselele kunyango lokuqala, izikhokelo ze-NCCN ziquka iintlobo ezahlukeneyo zezikhetho kwiimeko ezahlukeneyo. Ukusetyenziswa kwe-bendamustine kunye ne-rituximab yinto enye enjalo. Ukunyanga kwamayeza kunokuba nendima. Enyanisweni, isigaba sam follicular lymphoma sinokuphathwa ngokusebenzisa i-radiotherapy yedwa.
Ukunyanga oogqirha kunokuncoma ezinye iindlela zokwelapha kokuqala ngokusekelwe kulindeleke malunga nokuba umntu unokulindela njani ukunyamezela unyango olwenziwe.
Izinketho zokwelapha ziquka oku kulandelayo:
- Akukho unyango olukhawulezileyo - ukubeka iliso nokuhlola kwakhona
- I-Chemotherapy ngesimo seepilisi
- Ukuchithwa kwamakhemikhali
- I-Chemotherapy kunye neyeza zonyango
- Umnkantso we-Bone okanye ukutshintshwa kwe-cell stem
- Radioimmunotherapy
Ukhethwa njani unyango?
Utyando lugqitywa ngokusekelwe kwimiba eyahlukeneyo, kubandakanywa nenjongo yokonyango kunye nobukho beempawu ezivela kwisifo. Izikhokelo ezivela kwi-National Comprehensive Cancer Network zinikezela ngeendlela ezahlukeneyo zokunyangwa kwe-FL kwizigaba ezahlukeneyo, nangona kunjalo iinkqubo ezahlukeneyo zingalandelwa kumaziko ahlukeneyo, kwaye iziphumo zesigulane kunye neenjongo zibandakanyeka.
Kuthiwani ngeGazyva yeLymphoma yeFollic?
I-Gazyva yilezi zilwanyana ezijoliswe ngokutsha ekuqwalaseleni ukusetyenziswa kwayo kwi-lymphoma ye-follicular. "Abantu abane-lymphoma ye-follicular abanesi sifo okanye ababuhlungu nangona unyango lwe-Rituxan ene-regimen idinga ukhetho olungakumbi ngenxa yokuba isifo sinobunzima ukunyanga rhoqo xa sibuya," kusho uSandra Horning, MD, igosa lezempilo kunye nentloko ye-Global Product. Phuhliso. "I-Gazyva kunye ne-bendamustine inikeza inketho entsha yonyango engasetyenziselwa emva kokuphindaphinda ekunciphiseni kakhulu umngcipheko wokuqhubela phambili okanye ukufa."
Imvume ye-FDA yeGazyva yayisekelwe kwiziphumo ezivela kwiSigaba se-III se-GADOLIN, esabonisa ukuba, kubantu abane-lymphoma ye-follicular esinezifo eziqhubekileyo ngexesha okanye ezintandathu ezintandathu ngaphambi kokuba unyango lwe-Rituxan, i- Gazyva kunye ne-bendamustine elandelwa nguGazyva yodwa ibonise i-52 ukunciphisa ipesenti kwengozi yezifo eziqhubekayo okanye ukufa (ukusinda okungaqhubekiyo, i-PFS), xa kuthelekiswa ne-bendamustine yedwa.
Imithombo
Izikhokelo zeNCCN Clinical Practice Guidelines kwi-Oncology. Version 1.2016.
I-Leibel ne-Phillips Inkcazelo ye-Radiation Oncology: I-Consulting Consult; Hoppe R, et al.
Trotman J, Fournier M, uLamy T, et al. I-positron ukukhishwa kwe-tomography-i-computed tomography (i-PET-CT) emva kokunyangwa kwonyango kubaluleke kakhulu kwisiphumo sesigulane kwi-lliphoular follicular: uhlalutyo lwe-PET-CT kwicandelo le-PRIMA . J Clin Oncol 2011; 29: 3194-3200.
I-Lymphoma: I-Pathology, i-Diagnosis, kunye noTyango. 2013; URobert Marcus, et al.
UFlinn IW, van der Jagt R, Kahl BS, et al. I-ilebula evulekileyo, i-randomized, non-degnessity study ye-bendamustine-rituximab okanye i-R-CHOP / R-CVP kunyango lokuqala lwe-NHL okanye i-MCL engaqhubekiyo. Igazi 2014 ; 123: 2944-2952.