Mina míasrɔ̃ nu tso DLBCL (Diffuse Large B-Cell Lymphoma) kansa ŋu le mɔ bɔbɔe aɖe nu.

Èse dɔléle si nye `Diffuse Large B-Cell Lymphoma` alo `DLBCL` ŋu nya kpɔa? Esia nye kansa ƒomevi aɖe si kaka kabakaba vie. Gake mègatsi dzi o, ne wokpɔe kaba eye wodae nyuie la, woate ŋu adae . Egbea, mina míaƒo nu tso `DLBCL` sia ŋu le nya bɔbɔewo me.

Nukae nye DLBCL?

DLBCL nye ʋu me kansa. Le dɔléle sia me la, ʋumenugbagbevi ɣi ƒomevi aɖe si woyɔna be B cells (si woyɔna hã be lymphocytes) le míaƒe ŋutilã me va zua kansa. Esiae nye ʋumenugbagbeviɣidɔ si bɔ wu, si tsina kabakaba wu, eye wòsẽa ŋu wu si woyɔna be non-Hodgkin lymphoma. Míaƒe ʋukawo wɔa avu kple dɔlékuiwo. Ne DLBCL va do la, lãmenugbagbevi B siawo va zua kansa eye wotsina kabakaba, si wɔnɛ be lãmenugbagbevi siwo le lãmesẽ me la xea mɔ na wo. Emegbe womete ŋu wɔa avu kple dɔlékuiwo o. Kansa lãmenugbagbevi siawo ate ŋu adzɔ le afi sia afi, siwo dometɔ aɖewoe nye ʋukawo, nuɖuɖumeŋusẽ, kple ahɔhɔ̃. Togbɔ be esesẽ hã la, woate ŋu adae ne wokpɔe kaba.

Nukawoe nye DLBCL ƒomeviwo?

Xexeame ƒe Lãmesẽ Habɔbɔ (WHO) de dzesi DLBCL ƒomevi geɖe. Ðɔktawo zãa ƒomevi ɖesiaɖe tsɔ nyaa alesi kansa la yia ŋgɔe kple alesi wòwɔa nui ne ewɔ atike nɛ. Nusiwo koŋ kpɔa ŋusẽ ɖe hatsotso sia dzi koŋ:

• Domenyiŋusẽfianu ƒe tɔtrɔ le lãmenugbagbeviwo me.
• Teƒe si le ŋutilã me si DLBCL dze egɔme tsoe (e.g., titina lãmeka - `CNS`).
• Hadede kple dɔlékui aɖe (e.g. Epstein-Barr dɔlékui - EBV).

Ele vevie ŋutɔ be nàbia wò ɖɔkta tso DLBCL ƒomevi si le ŋuwò ŋu.

Aleke gbegbee esia bɔe?

DLBCL ye nye ʋumenugbagbeviɣidɔ ƒomevi si bɔ wu . Gake DLBCL mebɔ ŋutɔ le kansawo dome le goawo katã me o. Le kpɔɖeŋu me, DLBCL dzɔna le ame siwo ade 6 le 100,000 ɖesiaɖe me dzi. Esia mebɔ kura o ne wotsɔe sɔ kple kansa bubuwo.

Nukae nye DLBCL ƒe dzesiwo?

DLBCL ƒe dzesi si bɔ wue nye ʋuka siwo vuvu le kɔ, akɔta, alo akɔta . Esiawo ate ŋu adze egɔme abe ƒunukpeƒetetedɔ ene, vivivi la, woalolo, eye womase veve o.

Ame aɖewo (anɔ abe ɖeka le etɔ̃ ɖesiaɖe me) hã ateŋu akpɔ dzesi tɔxɛ siwo woyɔna be "B dzesiwo" :

• Asrã (si wu Celsius 39.5) si nɔa anyi wu ŋkeke eve alo va yina.
• Ame ƒe kpekpeme dzi ɖeɖe kpɔtɔ wu 10% le ɣleti ade me susu aɖeke manɔmee.
• Fifia fũ le zã me, ale gbegbe be abadzivɔawo tsina.

Mègavɔ̃ be yeabu be DLBCL ye ne dzesi siawo le ŋuwò gɔ̃ hã o. Gake ne woyi edzi kwasiɖa geɖe la, yi ɖɔkta gbɔ.

Nukatae DLBCL va dona? Nukawoe nye afɔku siwo le eme?

DLBCL tsoa lãmenugbagbeviwo ƒe tɔtrɔ le B lãmenugbagbeviwo me gbɔ. Esiawo nye domenyiŋusẽfianu ƒe tɔtrɔ siwo woxɔ siwo dzɔna le agbe me . Womenya nusi tututu gbɔ wòtso o, gake wode dzesi nu geɖe siwo nana afɔkua dzina ɖe edzi:

• Ƒe:Ame siwo xɔ ƒe 60 kple edzivɔwo mee wòbɔ ɖo wu. Ƒe si woxɔna hafi wokpɔa dɔlélea le mama dedie nu anɔ abe ƒe 64 ene.
• Ŋutsu alo nyɔnu nyenye: Ŋutsuwo te ŋu tsina vie wu nyɔnuwo.
• Ƒome ŋutinya: Ne DLBCL le ƒometɔ si le ɖoƒe gbãtɔ (dzila, nɔviwò, vi) ŋu la, afɔku ate ŋu adzi wò vie be nàxɔe (susu si tae me mekɔ haɖe o).
• Dɔlékuiwo: Dɔlékuiwo abe Epstein-Barr dɔlékui (EBV), amegbetɔ ƒe dɔlélenutsiŋutete ƒe dɔlékui (HIV), kple aklãdɔlékui B kple C ene.
• Dɔlélenutsiŋutete ƒe gbɔdzɔgbɔdzɔ: `Dɔlélenutsiŋutete ƒe gbɔdzɔgbɔdzɔ gbãtɔ` alo `dɔlélenutsiŋutete ƒe dɔléle` ƒe amesinɔnɔ, alo `dɔlélenutsiŋutete ƒe dɔlélenutsiŋutete` nono le ŋutinuwo dodo vɔ megbe. Esia nye afɔku gã aɖe.
• Ŋutilã ƒe lolome ƒe dzesi (BMI) si lolo wu le eƒe ɖevime kple aɖi aɖewo siwo wozãna le agbledede me ƒe amedzidzedze.

Togbɔ be nu siawo li hã la, menye amesiamee tua wo ɖo o, alo woate ŋu atu wo ɖo. Gake ele vevie be míanɔ ŋudzɔ ɖe nusiawo ŋu.

Aleke wowɔa dea dzesi DLBCL? (Dɔléle ƒe dzesi) .

Ðɔktawo ɖoa kpe DLBCL dzi to ʋumenugbagbeviɣidɔ (si xɔa ʋuka si vuvu ƒe akpa sue aɖe hena dodokpɔ) kple domenyiŋusẽfianu dodokpɔ me. Ne woɖo kpe DLBCL dzi la, wogawɔa dodokpɔ bubuwo be woakpɔe ɖa be kansa la kaka hã:

• Ʋudodokpɔ: Woaxlẽ ʋu (CBC) bliboe, be woatsɔ akpɔ dɔlékuiwo abe HIV, EBV, kple aklãdɔ ene hã.
• Lactate dehydrogenase (LDH) dodokpɔ: Wokpɔa enzyme sia le agbɔsɔsɔ gã me le DLBCL dɔnɔ akpa gãtɔ me.
• Nɔnɔmetatawo dodokpɔ: CT scan, MRI scan, PET scan.
• `Ƒuƒu ƒe ʋumenugbagbeviɣidɔ` .
• Lumbar puncture (aklã me tsi dodokpɔ).

Ðɔktawo nɔa te ɖe nyatakaka siwo woxɔ tso dodokpɔ siawo dometɔ ɖesiaɖe me dzi wɔa nyametsotso le wò nɔnɔmea ŋu eye wowɔa ɖoɖo ɖe atikewɔwɔ ŋu.

Nukae nye DLBCL ƒe afɔɖeɖewo?

Wozãa kansa ƒe ɖoɖowɔwɔ ƒe ɖoɖowo tsɔ nyaa afisi kansa tsi ɖo eye wòkakae. Esia kpena ɖe ame ŋu wòwɔa ɖoɖo ɖe atikewɔwɔ ŋu eye wogblɔa nusi ava dzɔ ɖi. DLBCL ƒe afɔɖeɖewoe nye:

• Afɔɖeɖe I: Kansa la le ʋuka ɖeka me, ŋutinu ɖeka le ʋuka me, alo ŋutinu ɖeka ƒe akpa ɖeka si mele ʋuka me o.
• Afɔɖeɖe II: Lãmetsiŋusẽ le ʋumenugbagbeviɣidɔ ƒe hatsotso geɖe me le ʋuka ƒe akpa ɖeka.
• Afɔɖeɖe III: Kansa le ʋuka siwo le lãkusia ƒe akpa eveawo me.
• Afɔɖeɖe IV:DLBCL kansa kaka ɖe ŋutinu siwo mele ʋukawo me o (e.g. ƒumeŋuɖui, aklã, lãkusiwo).

Ðɔktawo yɔa afɔɖeɖe I kple II be "afɔɖeɖe gbãtɔwo" eye afɔɖeɖe III kple IV be "afɔɖeɖe deŋgɔwo."

Nukawoe nye atike siwo wozãna na DLBCL?

Atike si wozãna wu na DLBCL enye R-CHOP . Esia bia be woatsɔ dɔlékuiwutike si nye monoclonal antibody si woyɔna be rituximab, atikewɔmɔnu ƒomevi vovovowo, kple corticosteroid aƒo ƒui ɖe eme. Ne atikewɔwɔ sia kpɔ dzidzedze hã la, dɔlélea ate ŋu atrɔ ava (anɔ abe 30%-40%). Ne edzɔ alea la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã atike bubuwo:

• Atikewɔwɔ le fli evelia me kple `autologous stem cell transplant`.
• `CAR T-cell therapy`: Esia nye `dɔlélenutsiŋutete ƒe atikewɔwɔ`.
• `Targeted therapy`: Atikewɔwɔ siwo ku ɖe domenyiŋusẽfianu ƒe tɔtrɔ ŋu.

Ðo ŋku edzi be wò ɖɔkta anɔ te ɖe wò nɔnɔme tɔxɛa dzi anya atike nyuitɔ kekeake na wò.

Ðe woate ŋu axe mɔ ɖe DLBCL ƒe dzɔdzɔ nua?

Mɔ aɖeke meli si dzi woato axe mɔ ɖe DLBCL nu keŋkeŋ o. Afɔku aɖewo li siwo dzi míate ŋu aɖu o. Gake afɔɖeɖe aɖewo li míate ŋu aɖe atsɔ akpɔ mía ɖokui ta tso dɔlékui siwo ate ŋu ado ƒome kple DLBCL, abe aklãdɔ kple HIV ene, me. Anyo hã be nàdze agbagba alé ŋutilã ƒe lolome ƒe dzesi si le lãmesẽ me (BMI) me ɖe asi. Esiawo ate ŋu akpe ɖe ŋuwò nàɖe wò afɔkua dzi akpɔtɔ va ɖo afi aɖe.

Nukae amesi ŋu DLBCL le ate ŋu akpɔ mɔ na?

DLBCL ƒomevi aɖewo ate ŋu ade ame ƒe agbe afɔku me eye wo dada asesẽ. Gake zi geɖe la, ɖɔktawo ate ŋu ada dɔlélea ahadae . Zi geɖe la, atikewɔwɔ le ŋgɔgbe ate ŋu ana DLBCL nagbɔdzɔ keŋkeŋ (nɔnɔme si me kansa ƒe dzesi alo dzesi aɖeke mele o). Ame siwo ŋu DLBCL le la dometɔ siwo ade 60% daa gbe le wo ŋu to atikewɔwɔ gbãtɔ me. Le mamã dedie nu la, amesiwo ŋu kansa mele o ƒe eve le woƒe dɔlélea kpɔkpɔ vɔ megbe ate ŋu akpɔ mɔ be yewoanɔ agbe si sɔ, abe alesi ame bubu siwo nye yewoƒe ƒemetɔwo ene. Agbetsitsi ƒe agbɔsɔsɔme gasɔ gbɔ wu ne wokpɔ kansa le eƒe gɔmedzedze .

Gake wò nuteƒekpɔkpɔ anɔ te ɖe nu geɖe dzi, siwo dometɔ aɖewoe nye DLBCL ƒomevi si le ŋuwò, afisi kansa la le, kple wò lãmesẽ bliboa. Wò ɖɔkta koe ate ŋu ana nyatakaka nyuitɔ kekeake wò tso esia ŋu.

Aleke malé be na ɖokuinye? (Ðokuidzikpɔkpɔ) .

Agbenɔnɔ kple kansa mele bɔbɔe o, etea ɖeɖi ame ŋu ŋutɔ. Ele vevie ŋutɔ be nàlé be na ɖokuiwò esime nèle `DLBCL` ƒe atike wɔm.

• Nunyiame: Ƒo nuɖuɖu nyui si da sɔ. Bia wò ɖɔkta nusi nàɖu kple nusiwo nàƒo asa na.
• Dzudzᴐ:Atikewɔwɔ ate ŋu ana ɖeɖi nate ame ŋu. Gbɔ ɖe eme geɖe.
• Kamedede: Kamedede bɔbɔe ate ŋu aɖe nuteɖeamedzi dzi akpɔtɔ.
• Kpekpeɖeŋu: Esia nye nɔnɔme si mebɔ o, eyata ate ŋu ase le eɖokui me be yetsi akogo. Wɔ ɖeka kple kpekpeɖeŋunaha siwo me amewo abe wò ene le. Ðo dze kple ƒometɔwo kple xɔlɔ̃wo.

Ehiã be woayi ɖɔkta gbɔ kple nɔnɔme kpatawo

Àkpɔ wò ɖɔkta edziedzi le atikewɔwɔ me. Ne wowu atikewɔwɔ nu gɔ̃ hã la, ahiã be nàkpɔe ɣleti 3-4 ɖesiaɖe le ƒe eve gbãtɔawo me eye menye zi geɖe o le ƒe etɔ̃ siwo gbɔna me. Esia nye be woatsɔ akpɔe ɖa be egadzɔ ake hã. Ne dzesi aɖewo le ŋuwò be kansa la gatrɔ gbɔ la, gblɔe na wò ɖɔkta enumake.

Atikewɔwɔ abe atikewɔmɔnu ene ate ŋu agblẽ nu le ame ŋu vevie. Ne nusiawo dzɔ la , yi xɔ si me wowɔa dɔ kpata le enumake :

• Nusiwo wògblẽna le ame ŋu vevie wu alesi wokpɔ mɔe.
• Asrã si kɔkɔ wu Celsius 38 (Fahrenheit 100.4).
• Ʋuʋu si womate ŋu atɔ te o .
• Dɔgbo ƒe vevesese sesẽ alo aɖuɖɔtoe si nɔa anyi ɖaa .

Nya siwo nàbia wò ɖɔkta tso DLBCL ŋu

Enye nusi sɔ be nyabiase geɖe nanɔ asiwò ne èva nya be DLBCL le ye ŋu. Ele vevie be nàbia wò ɖɔkta nya siawo abe esiawo ene:

• `Diffuse Large B-Cell Lymphoma` ƒomevi kae le ŋunye? Nukae nye `afɔɖeɖe`?
• Atikewɔwɔ ka ƒomevie mehiã? Nukawoe nye eƒe nugbegblẽ le ame ŋu?
• Ðe atikewɔmɔnu siawo ada kansa keŋkeŋa?
• Atikewɔwɔ kawoe li ne kansa la gadze?
• Àte ŋu aɖom ɖe kpekpeɖeŋunaha aɖe si naa amesiwo ŋu kansa sia ƒomevi le la mea?

Tsɔ kpe ɖe biabia siawo ŋu la, mègavɔ̃ be yeabia nya aɖeke wò ɖɔkta si le susu me na wò alo ɖikeke ɖesiaɖe si ate ŋu anɔ mewò o.

Mlɔeba la, ɖo ŋku (Take-Home Message) dzi .

Ne mía dometɔ akpa gãtɔ se nya "aggressive" ne míele nu ƒom tso kansa ŋu la, míebua eŋu be enye dɔléle si womate ŋu ada o eye edada sesẽ. Gake menye nenemae wòle le Diffuse Large B-Cell Lymphoma (DLBCL) gome o. Togbɔ be DLBCL ate ŋu akaka kabakaba hã la, zi geɖe la, kansadɔdamɔnu siwo wozãna fifia ate ŋu awu kansadɔlékui B lãmenugbagbevi siawo. Ðɔktawo zãa nyawo abe "atike" gɔ̃ hã ne wole nu ƒom tso ame aɖewo ƒe nɔnɔmewo ŋu.

Nu vevitɔe nye be nàbia wò ɖɔkta be aleke dɔléle si wokpɔ le ŋuwò akpɔ ŋusẽ ɖe wò atikewɔwɔ ƒe nukpɔsusu dzii hã. Eya ta, mègavɔ̃ o, nàna nyanya wò, eye nàwɔ ɖe wò ɖɔkta ƒe aɖaŋuɖoɖo dzi. Mègaŋlɔ be o be woate ŋu aɖu DLBCL dzi ne wokpɔe kaba eye wowɔ atike nɛ nyuie!

` Kansa, ʋumenugbagbeviɣidɔ, B lãmenugbagbeviwo, ʋukawo, dzesiwo, atikewɔwɔ, DLBCL, atikewɔmɔnu, dɔlélenutsiŋutete ƒe atikewɔwɔ