E aʻo kākou e pili ana i ke kanesa DLBCL (Diffuse Large B-Cell Lymphoma) ma ke ala maʻalahi.

Ua lohe paha ʻoe i ka maʻi ʻo `Diffuse Large B-Cell Lymphoma` a i ʻole `DLBCL`? He ʻano maʻi ʻaʻai kēia e pālahalaha wikiwiki iki ana. Akā, mai hopohopo, inā ʻike mua ʻia a mālama pono ʻia , hiki ke ho'ōla ʻia . I kēia lā, e kamaʻilio kākou e pili ana i kēia `DLBCL` ma nā ʻōlelo maʻalahi.

He aha ka DLBCL?

He maʻi ʻaʻai koko ʻo DLBCL. I loko o kēia maʻi, lilo kahi ʻano o ke koko keʻokeʻo i kapa ʻia ʻo nā cell B (i kapa ʻia hoʻi he lymphocytes) i loko o ko kākou kino i maʻi kanesa. ʻO kēia ke ʻano lymphoma maʻamau, ulu wikiwiki loa, a ʻoi loa ka ikaika i kapa ʻia ʻo non-Hodgkin lymphoma. Ke kaua nei kā mākou ʻōnaehana lymphatic i nā germs. Ke ulu ʻo DLBCL, lilo kēia mau cell B i maʻi kanesa a ulu koke, e hoʻokuke ana i nā cell olakino. A laila ʻaʻole hiki iā lākou ke hakakā i nā germs. Hiki i kēia mau cell cancerous ke hana ma nā wahi āpau, me nā lymph nodes, digestive tract, a me ka lolo. ʻOiai he koʻikoʻi, hiki ke ho'ōla ʻia inā ʻike mua ʻia.

He aha nā ʻano o DLBCL?

Ua ʻike ka World Health Organization (WHO) i kekahi mau ʻano DLBCL. Hoʻohana nā kauka i kēlā me kēia ʻano e hoʻoholo ai pehea e holomua ai ke kanesa a me ka pane ʻana i ka lāʻau lapaʻau. Hoʻopili nui ʻia kēia hoʻokaʻawale ʻana e:

• Nā loli genetic i loko o nā cell.
• ʻO kahi i loko o ke kino kahi e hoʻomaka ai ʻo DLBCL (e.g., ʻōnaehana nerve waena - `CNS`).
• ʻO ka pilina me kahi maʻi (e.g. Epstein-Barr virus - EBV).

He mea nui loa e nīnau i kāu kauka e pili ana i ke ʻano o DLBCL āu.

Pehea ka maʻamau o kēia?

ʻO DLBCL ke ʻano maʻamau o ka lymphoma. Eia nō naʻe, ʻaʻole maʻamau loa ka DLBCL i waena o nā maʻi kanesa ma ke ʻano laulā. No ka laʻana, loaʻa ka DLBCL ma kahi o 6 i loko o 100,000 poʻe. He mea kākaʻikahi kēia i hoʻohālikelike ʻia me nā maʻi kanesa ʻē aʻe.

He aha nā hōʻailona o DLBCL?

ʻO ka hōʻailona maʻamau o DLBCL, ʻo ia ka pehu ʻana o nā lymph nodes ma ka ʻāʻī, nā armpits, a i ʻole ka groin . Hiki ke hoʻomaka kēia me he puʻupuʻu lā, e ulu mālie, a ʻaʻole paha e ʻeha.

Hiki i kekahi poʻe (ma kahi o hoʻokahi i loko o ʻekolu) ke ʻike i nā hōʻailona kūikawā i kapa ʻia ʻo "nā hōʻailona B" :

• Ke kuni (ma luna o 39.5 Celsius) e mau ana no nā lā ʻelua a ʻoi aʻe a i ʻole e hele mai a nalo.
• ʻO ka lilo ʻana ma mua o 10% o ke kaumaha o ke kino i loko o ʻeono mahina me ke kumu ʻole.
• E hou nui ana i ka pō, a pulu loa nā pepa moe.

Mai makaʻu e manaʻo he DLBCL ia ʻoiai inā loaʻa iā ʻoe kēia mau hōʻailona. Eia nō naʻe, inā hoʻomau lākou no kekahi mau pule, e ʻike i ke kauka.

No ke aha e ulu ai ʻo DLBCL? He aha nā kumu pilikia?

Hoʻokumu ʻia ʻo DLBCL e nā mutations i loko o nā pūnaewele B. ʻO kēia nā mutations genetic i loaʻa i ka wā o ke ola . ʻAʻole ʻike ʻia ke kumu pololei, akā ua ʻike ʻia kekahi mau kumu e hoʻonui ai i ka pilikia:

• Makahiki:ʻO ka mea maʻamau ia i nā poʻe i ko lākou mau makahiki 60. ʻO ka makahiki awelika o ka maʻi ma kahi o 64 mau makahiki.
• Kāne: Hiki i nā kāne ke ulu nui iki ma mua o nā wahine.
• Moʻolelo ʻohana: Inā loaʻa iā DLBCL kahi hoahānau mua (makua, kaikaina, keiki), loaʻa paha iā ʻoe kahi pilikia iki o ka loaʻa ʻana (ʻaʻole maopopo ke kumu).
• Nā maʻi: ʻO nā maʻi e like me ka maʻi Epstein-Barr (EBV), ka maʻi pale ʻole kanaka (HIV), a me ka hepatitis B a me C.
• ʻŌnaehana pale kino nāwaliwali: Loaʻa i kahi 'primary immunodeficiency' a i ʻole 'autoimmune disorder', a i ʻole ka lawe ʻana i nā 'immunosuppressants' ma hope o kahi hoʻoili kino. He kumu pilikia nui kēia.
• ʻO ke kiʻekiʻe o ka helu o ke kino (BMI) i ka wā ʻōpiopio a me ka ʻike ʻana i kekahi mau mea ʻawahia i hoʻohana ʻia i ka mahiʻai.

ʻOiai aia kēia mau mea, ʻaʻole hiki i nā kānaka a pau ke hoʻomohala iā lākou, a i ʻole hiki iā lākou ke hoʻomohala iā lākou. Akā, he mea nui e makaʻala i kēia mau mea.

Pehea e ʻike ʻia ai ka DLBCL? (Diagnosis)

Ua hōʻoia nā kauka iā DLBCL ma o kahi biopsy lymph node (e lawe ana i kahi ʻāpana liʻiliʻi o kahi lymph node pehu no ka hoʻokolokolo ʻana) a me ka hoʻāʻo genetic. Inā ua hōʻoia ʻia ʻo DLBCL, hana ʻia nā hoʻokolohua hou aʻe e ʻike ai inā ua laha ka maʻi kanesa:

• Nā hoʻāʻo koko: Helu koko piha (CBC), e nānā i nā maʻi e like me ka HIV, EBV, a me ka hepatitis.
• Hoʻāʻo Lactate dehydrogenase (LDH): Loaʻa kēia enzyme i nā pae kiʻekiʻe i ka hapa nui o nā maʻi DLBCL.
• Nā hoʻāʻo kiʻi: CT scan, MRI scan, PET scan.
• ʻO ka biopsy iwi
• ʻO ke kī ʻana o ka lumbar (ka nānā ʻana i ke wai o ka iwi kuamoʻo).

Hoʻoholo nā kauka e pili ana i kou kūlana a hoʻolālā i ka mālama ʻana ma muli o ka ʻike i loaʻa mai kēlā me kēia o kēia mau hoʻokolohua.

He aha nā pae o DLBCL?

Hoʻohana ʻia nā ʻōnaehana hoʻonohonoho maʻi kanesa e hoʻoholo ai i ka mamao o ka ulu ʻana a me ka laha ʻana o kahi maʻi kanesa. Kōkua kēia i ka hoʻolālā ʻana i ka lāʻau lapaʻau a me ka wānana ʻana i ka wānana. ʻO nā pae o DLBCL:

• Pae I: Aia ke kanesa ma hoʻokahi node lymph wale nō, hoʻokahi ʻōkana i loko o ka ʻōnaehana lymphatic, a i ʻole hoʻokahi wahi o hoʻokahi ʻōkana ma waho o ka ʻōnaehana lymphatic.
• Pae II: Aia ka Lymphoma ma nā hui he nui o nā lymph nodes ma ka ʻaoʻao like o ka diaphragm.
• Pae III: Aia ke kanesa i loko o nā lymph nodes ma nā ʻaoʻao ʻelua o ka diaphragm.
• Pae IV:Ua pālahalaha ke kanesa DLBCL i nā ʻōpū ma waho o ka ʻōnaehana lymphatic (e.g. iwi ʻiʻo, akepaʻa, māmā).

Kāhea nā kauka i nā pae I a me II he "mau pae mua" a me nā pae III a me IV he "mau pae holomua."

He aha nā lāʻau lapaʻau no DLBCL?

ʻO ka lāʻau lapaʻau maʻamau no DLBCL ʻo R-CHOP . Pili kēia i ka hui pū ʻana o kahi antibody monoclonal i kapa ʻia ʻo rituximab, kekahi mau ʻano chemotherapy, a me kahi corticosteroid. Inā holomua kēia lāʻau lapaʻau, hiki ke hoʻi hou mai ka maʻi (ma kahi o 30%-40%). Inā hana ʻia kēia, hiki i kāu kauka ke paipai i nā lāʻau lapaʻau ʻē aʻe:

• ʻO ka lāʻau lapaʻau laina ʻelua a me ka 'hoʻoili cell kumu autologous'.
• ʻO ka lāʻau lapaʻau CAR T-cell: He lāʻau lapaʻau immunotherapy kēia.
• 'Lapaʻau i hoʻolālā ʻia': Nā lāʻau lapaʻau e hoʻolālā ana i nā loli hoʻoilina.

E hoʻomanaʻo, na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nāu ma muli o kou kūlana kūikawā.

Hiki ke pale ʻia ka ulu ʻana o DLBCL?

ʻAʻohe ala e pale loa ai i ka DLBCL. Aia nā mea pilikia i hiki ʻole iā mākou ke kaohi. Eia nō naʻe, aia kekahi mau hana e hiki ai iā mākou ke hana e pale iā mākou iho mai nā maʻi i hiki ke pili i ka DLBCL, e like me ka hepatitis a me ka HIV. He manaʻo maikaʻi nō hoʻi e hoʻāʻo e mālama i kahi helu helu kino olakino (BMI). Hiki i kēia mau mea ke kōkua i ka hōʻemi ʻana i kou pilikia i kekahi ʻano.

He aha ka mea e hiki i kekahi me DLBCL ke manaʻo?

Hiki i kekahi mau ʻano DLBCL ke hoʻoweliweli i ke ola a paʻakikī ke mālama. Eia nō naʻe, hiki i nā kauka ke mālama a ho'ōla i ka maʻi . I nā hihia he nui, hiki i ka lāʻau lapaʻau mua ke lawe mai i ka DLBCL i ke kala piha (kahi kūlana kahi ʻaʻohe hōʻailona a i ʻole nā ​​​​hōʻailona o ke kanesa). Ma kahi o 60% o ka poʻe me DLBCL i ho'ōla ʻia me ka lāʻau lapaʻau mua. Ma ka awelika, ʻo ka poʻe i ʻole ka maʻi kanesa i ʻelua mau makahiki ma hope o ka hōʻoia ʻana e hiki ke manaʻo e ola i kahi ola maʻamau, e like me nā poʻe ʻē aʻe i ko lākou mau makahiki. ʻOi aku ka kiʻekiʻe o ka helu ola inā ʻike ʻia ka maʻi kanesa i ka wā mua .

Eia nō naʻe, e hilinaʻi kou ʻike i nā kumu he nui, me ke ʻano o ka DLBCL āu, ke kahua o ke kanesa, a me kou olakino holoʻokoʻa. ʻO kāu kauka wale nō ke hāʻawi iā ʻoe i ka ʻike maikaʻi loa e pili ana i kēia.

Pehea e mālama ai iaʻu iho? (Mālama ponoʻī)

ʻAʻole maʻalahi ka noho ʻana me ke kanesa, he mea luhi loa ia. He mea nui loa ka mālama ʻana iā ʻoe iho i ka wā e mālama ʻia ai no ka `DLBCL`.

• ʻIke Meaʻai: E ʻai i ka meaʻai maikaʻi a kaulike. E nīnau i kāu kauka i ka mea e ʻai ai a me ka mea e pale aku ai.
• Hoʻomaha:Hiki i ka lāʻau lapaʻau ke hoʻoulu i ka luhi. E hoʻomaha nui.
• Hoʻoikaika Kino: Hiki i ka hoʻoikaika kino māmā ke hōʻemi i ke kaumaha.
• Kākoʻo: He kūlana kakaikahi kēia, no laila hiki ke manaʻo mehameha. E hui pū me nā hui kākoʻo kahi e loaʻa ai nā poʻe e like me ʻoe. E kamaʻilio me ka ʻohana a me nā hoaaloha.

Pono e ʻike i ke kauka a me nā pilikia

E ʻike mau ʻoe i kāu kauka i ka wā o ka mālama ʻana. ʻOiai ma hope o ka pau ʻana o ka mālama ʻana, pono ʻoe e ʻike iā ia i kēlā me kēia 3-4 mahina no nā makahiki ʻelua mua a emi pinepine no nā makahiki ʻekolu e hiki mai ana. ʻO kēia ke nānā no ka hoʻi hou ʻana. Inā loaʻa iā ʻoe kekahi mau hōʻailona ua hoʻi mai ke kanesa, e haʻi koke i kāu kauka .

Hiki i nā lāʻau lapaʻau e like me ka chemotherapy ke loaʻa nā hopena ʻaoʻao koʻikoʻi. Inā hana ʻia kēia mau mea , e hele koke i kahi lumi pilikia :

• Nā hopena ʻaoʻao ʻoi aku ka koʻikoʻi ma mua o ka mea i manaʻo ʻia.
• Ke kuni i ʻoi aku ma mua o 38 Celsius (100.4 Fahrenheit).
• Ka haʻalulu paʻa ʻole .
• ʻEha nui o ka ʻōpū a i ʻole ka maʻi palahē mau .

Nā nīnau e nīnau ai i kāu kauka e pili ana iā DLBCL

He mea maʻamau ka loaʻa ʻana o nā nīnau he nui ke ʻike ʻoe he DLBCL kou. He mea nui iā ʻoe ke nīnau i kāu kauka i nā nīnau e like me kēia:

• He aha ke ʻano o ka `Diffuse Large B-Cell Lymphoma` i loaʻa iaʻu? He aha ke `stage`?
• He aha ke ʻano o ka lāʻau lapaʻau e pono ai iaʻu? He aha nā hopena ʻaoʻao?
• E ho'ōla loa anei kēia mau lāʻau i ka maʻi kanesa?
• He aha nā lāʻau lapaʻau e loaʻa ana inā hoʻi mai ke kanesa?
• Hiki iā ʻoe ke kuhikuhi iaʻu i kahi hui kākoʻo no ka poʻe me kēia ʻano maʻi kanesa?

Ma waho aʻe o kēia mau nīnau, mai makaʻu e nīnau i kāu kauka i kekahi mea āu e noʻonoʻo nei a i ʻole kekahi kānalua āu e loaʻa ai.

ʻO ka mea hope loa, e hoʻomanaʻo (Leka Lawe-Home)

Ke lohe ka hapa nui o mākou i ka huaʻōlelo "aggressive" i ka wā e kamaʻilio ai e pili ana i ka maʻi kanesa, manaʻo mākou he maʻi ia e hiki ʻole ke ho'ōla ʻia a paʻakikī hoʻi e ho'ōla. Akā, ʻaʻole pēlā ka hihia me ka Diffuse Large B-Cell Lymphoma (DLBCL). ʻOiai hiki i ka DLBCL ke pālahalaha koke, hiki i nā lāʻau lapaʻau kanesa o kēia manawa ke pepehi pinepine i kēia mau cell B cancerous. Hoʻohana pū nā kauka i nā huaʻōlelo e like me "cure" i ka wā e kamaʻilio ai e pili ana i nā kūlana o kekahi poʻe.

ʻO ka mea nui loa, ʻo ia ke nīnau i kāu kauka pehea e pili ai kāu hōʻailona i kāu nānā ʻana i ka lāʻau lapaʻau. No laila, mai makaʻu, e ʻike pono, a e hahai i nā ʻōlelo aʻoaʻo a kāu kauka. Mai poina e hiki ke lanakila ʻia ʻo DLBCL me ka ʻike mua ʻana a me ka lāʻau kūpono!

ʻO ke kanesa, lymphoma, nā pūnaewele B, nā lymph node, nā hōʻailona, ​​​​​​ka lāʻau lapaʻau, DLBCL, chemotherapy, immunotherapy