Aia kekahi pilikia me nā pūnaewele lymph i loko o kou kino? E kamaʻilio kākou e pili ana i nā maʻi Lymphoproliferative (LPDs)!

Ua lohe paha ʻoe aia nā koa liʻiliʻi i loko o ko kākou kino e pale aku iā kākou mai nā maʻi? Ua kapa ʻia kēlā mau koa he mau keʻokeʻo koko. Ma waena o kēia mau keʻokeʻo koko, aia kekahi ʻano kūikawā i kapa ʻia he lymphocytes . ʻO kā lākou hana nui ka mālama ʻana i ko kākou ʻōnaehana pale ma ke kaua ʻana i nā ʻenemi e like me nā virus a me nā bacteria e komo i loko o ko kākou kino, a me ka luku ʻana i nā keʻena kanesa. Eia naʻe, i kekahi manawa e pau ana kēia mau lymphocytes i ka hana pono, a hoʻomaka paha lākou e hoʻonui nui. ʻO ia ka manawa e kapa ai mākou i kahi hui o nā maʻi i kapa ʻia ʻo Lymphoproliferative Disorders (LPDs) . He ʻano kakaikahi kēia. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku, ea?

He aha nā maʻi Lymphoproliferative (LPDs)? Aia kekahi mau ʻano?

I ka ʻōlelo maʻalahi, ʻo nā LPD kahi hui o nā maʻi e kū mai ana i ka wā e hana pono ʻole ai kā mākou mau lymph cell, i kapa ʻia ʻo lymphocytes, a ulu paha me ke kāohi ʻole ʻia. Hiki ke hoʻokaʻawale ʻia kēia mau mea i ʻelua mau māhele nui.

1. Nā LPD (Nā maʻi Immunologic) e pili ana i ka ʻōnaehana pale

Hoʻopilikia kēia mau ʻano LPD i ke ʻano o ka pane ʻana o kā mākou ʻōnaehana pale i nā mea komo hewa mai nā ʻāina ʻē. ʻOi aku ka nui o ka pilikia o ka poʻe me kēia mau kūlana i ka loaʻa ʻana o nā maʻi kanesa e like me ka lymphoma .

• ʻO ka maʻi lymphoproliferative i hoʻopili ʻia me X (XLP): Inā loaʻa i kahi kanaka me kēia maʻi ka maʻi Epstein-Barr , hiki iā ia ke holomua i ka lymphoma.
• ʻO ka maʻi lymphoproliferative Autoimmune (ALPS): ʻO kēia ka wā e hōʻiliʻili ai ka nui o nā lymphocytes ma nā wahi e like me ko mākou mau lymph nodes, spleen, a me ke ake, e hoʻoulu ai i kēlā mau ʻōpū e pehu. Me he mea lā e hōʻiliʻili wale ana ko mākou mau cell ponoʻī ma nā wahi i waho o ke kaohi.
• Nā maʻi lymphoproliferative ma hope o ke kāpili ʻana (PTLD): He kūlana kakaikahi kēia akā koʻikoʻi. Hiki ke hana ma hope o ka hoʻoili ʻana o ke kino (e.g., puʻupaʻa, akepaʻa) a i ʻole ka hoʻoili ʻana o nā cell kumu allogeneic . He ʻoiaʻiʻo loa kēia inā ua loaʻa iā ʻoe a i ʻole ka mea nāna i hāʻawi i ke kino a i ʻole nā ​​cell kumu i ka maʻi Epstein-Barr, ka mea e hoʻopilikia ai i nā cell-B.

2. Nā maʻi ʻaʻai koko Lymphoid

ʻO kēia nā maʻi koʻikoʻi a mākou e lohe pinepine ai, e like me ka Leukemia a me ka Lymphoma . ʻO ka mea e hana ʻia ma ʻaneʻi, ua hōʻino ʻia nā hunaola koko keʻokeʻo i loko o ko kākou iwi iwi a me ke koko, ʻo ia hoʻi nā pūnaewele B, nā pūnaewele T a me nā pūnaewele pepehi kanaka kūlohelohe (nā pūnaewele NK).ʻO nā loli ʻana, nā pūnaewele ʻē e hoʻonui nui ʻole ʻia. Hoʻopilikia kēia mau pūnaewele ʻē i nā pūnaewele koko olakino. ʻOiai hiki ke ho'ōla ʻia kēia mau mea i kekahi manawa, he mau maʻi koʻikoʻi lākou e hiki ke hoʻoweliweli i ke ola.

Nā maʻi ʻaʻai e pili ana i nā cell B

ʻO kekahi mau ʻano lymphoma non-Hodgkin ʻē aʻe e hāʻule ana i loko o kēia māhele:

• ʻO ka lymphoma B-cell nui e hoʻolaha
• ʻO ka lymphoma follicular
• ʻO ka lymphoma cell mantle

Aia kekahi mau ʻano o ka leukemia B-cell:

• ʻO ka maʻi leukemia lymphocytic mau loa (CLL): Maanei, hoʻonui nui ʻia nā pūnaewele B maʻamau i loko o ka iwi iwi, e hoʻokuke ana i nā hunaola koko olakino a me nā platelets.
• ʻO ka leukemia prolymphocytic B-cell: Maanei hoʻi, hōʻiliʻili nā cell-B maʻamau ʻole i loko o ka iwi iwi, e hoʻokuke ana i nā cell olakino.
• ʻO ka leukemia cell huluhulu: E like me ka inoa e hōʻike nei, ua kapa ʻia kēia mau hunaola koko keʻokeʻo maʻamau ʻole no ka mea ua like lākou me ka lauoho ke nānā ʻia ma lalo o kahi microscope. Hoʻokumu pū lākou i loko o ka iwi iwi a hoʻonui nui ʻia.

Nā maʻi ʻaʻai e pili ana i nā cell T

Ua māhele nui ʻia nā maʻi e pili ana i nā cell T i ʻelua mau ʻano:

• Nā lymphomas T-cell systemic: Hiki i kēia mau mea ke hoʻopilikia i kāu mau lymph nodes, spleen, bone bone, koko, a me nā ʻōpū ʻē aʻe o ke kino.
• ʻO nā lymphomas T-cell ʻili: Hoʻopilikia nui kēia i ka ʻili, akā hiki i kekahi manawa ke hoʻopilikia i nā lymph nodes, ke koko, ka iwi iwi, a me nā ʻōpū o loko.

Aia kekahi mau ʻano lymphomas T-cell systemic. ʻO kekahi o nā ʻano maʻamau:

• ʻO ka lymphoma T-cell peripheral, ʻaʻole i kuhikuhi ʻia ma kekahi ʻano ʻē aʻe (PTCL NOS)
• ʻO ka lymphoma T-cell angioimmunoblastic (AITL)
• ʻO ka lymphoma pūnaewele nui anaplastic

Aia kekahi mau ʻano like ʻole:

• ʻO ka lymphoma T-cell Hepatosplenic (HSTCL)
• ʻO ka lymphoma T-cell e pili ana i ka enteropathy (EATL)

Ua kapa ʻia kekahi mau lymphoma T-cell systemic he leukemia T-cell mau . Nā laʻana:

• ʻO ka maʻi leukemia prolymphocytic T-cell (T-PLL)
• ʻO ka maʻi leukemia lymphocytic granular nui o nā cell T (T-LGL)

Aia ʻelua mau ʻano nui o ka lymphoma T-cell cutaneous:

• ʻO ka fungoides Mycosis
• ʻO ka maʻi Sézary

Nā maʻi e pili ana i nā cell NK

He mea kākaʻikahi loa kēia a hoʻopilikia i nā pūnaewele NK.

• ʻAno ihu lymphoma NK T-cell Extranodal
• ʻO ka leukemia NK-cell ikaika (AKNL)
• ʻO ka maʻi leukemia lymphocytic granular nui o nā cell NK (NK-LGL)

I kēia manawa hiki iā ʻoe ke ʻike i ka nui o nā kūlana like ʻole i uhi ʻia ma lalo o nā LPD. ʻAʻole pono ʻoe e hele hohonu e pili ana i kēlā me kēia, akā he mea nui e ʻike e pili ana kēia kūlana.

He aha nā hōʻailona o nā LPD? Pehea ʻoe e ʻike ai iā lākou?

Hiki ke ʻokoʻa loa nā hōʻailona o kēia mau LPD, ma muli o ke ʻano o ka LPD āu e loaʻa ai. Akā, aia kekahi mau hōʻailona maʻamau āu e ʻike ai. E nānā kākou i ke ʻano o lākou:

• Ka hou nui ʻana i ka pō: ʻAʻole wale ka hou ʻana, akā, ka hou nui ʻana a pulu nā moena.
• Nā ʻōpū lymph pehu, akepaʻa, a i ʻole spleen: Inā ʻike ʻoe i nā puʻupuʻu ma nā wahi e like me ka ʻāʻī, nā armpits, a i ʻole ka ʻūhā, a inā he pehu ʻē kou i loko o kou ʻōpū, pono ʻoe e hopohopo.
• Ke kahe koko a me ka ʻeha maʻamau ʻole a nui paha: Inā nui kou kahe koko ʻana mai kahi ʻeha liʻiliʻi, a inā he mau ʻeha polū wale nō kou ma nā wahi o kou kino.
• Luhi pinepine: Manaʻo luhi ʻole me ka nānā ʻole i ka nui o kāu hiamoe ʻana.
• Kuni pinepine: Inā loaʻa iā ʻoe ke kuni mau me ke kumu ʻole.
• Nā maʻi viral pinepine: Ma muli o ka palekana haʻahaʻa, hiki iā ʻoe ke loaʻa pinepine i nā maʻi e like me ke anu a me ka maʻi palū.
• Anorexia: Ka manaʻo o ka makemake ʻole e ʻai.
• ʻO ka pohō kaumaha i wehewehe ʻole ʻia: Inā pohō koke kou kaumaha me ka ʻole o ka ʻai ʻana a i ʻole ka hoʻoikaika kino ʻana, he hōʻailona nō hoʻi kēlā e makaʻala ai.

Mea nui: Mai hopohopo inā loaʻa iā ʻoe kekahi a ʻelua paha o kēia mau hōʻailona. Hiki ke hana ʻia e nā kumu ʻē aʻe a maʻalahi hoʻi. Eia nō naʻe, inā hoʻomau kēia mau hōʻailona, ​​​​he manaʻo maikaʻi mau ke ʻike i ke kauka no ka ʻōlelo aʻo.

He aha nā kumu o nā LPD?

He mea paʻakikī ke kuhikuhi i hoʻokahi kumu no ka hapa nui o nā LPD, akā hiki i nā kumu like ʻole ke kōkua.

• Nā maʻi: Hiki ke hana ʻia kekahi ʻano LPD e nā maʻi e like me ka maʻi Epstein-Barr a i ʻole ka bacteria H. pylori . E noʻonoʻo, ʻo kēia mau ʻano microorganism e komo ana i loko o ko kākou kino e hoʻopilikia nei i kā kākou ʻōnaehana cellular.
• ʻO kekahi mau maʻi autoimmune: Rheumatoid arthritis, lupusʻO ka poʻe me kekahi mau maʻi e pilikia ana i ka hoʻomohala ʻana i kekahi mau ʻano LPD (e.g. marginal zone lymphomas). ʻO kēia ka manawa e hoʻouka ai ka ʻōnaehana pale o ko mākou kino i kā mākou mau cell ponoʻī.
• Lāʻau lapaʻau: ʻO kekahi mau lāʻau immunosuppressant (e laʻa, nā lāʻau i hāʻawi ʻia e kāohi i ka ʻōnaehana pale ma hope o kahi hoʻoili kino) hiki ke hana i nā kūlana e like me ka hepatosplenic T-cell lymphoma.
• ʻO kekahi mau hoʻololi genetic: He mea kākaʻikahi loa, hiki iā ʻoe ke hoʻoilina i kahi hoʻololi genetic e hoʻoulu ai i kēia ʻano LPD. No ka laʻana, ʻo ka poʻe me ka maʻi lymphoproliferative X-linked (XLP) he mau hoʻololi i loko o ʻelua mau genes. ʻO kēia ka mea e ʻoi aku ai ka nui o ko lākou loaʻa ʻana o kahi pane koʻikoʻi i ka maʻi Epstein-Barr a hoʻomohala i ka lymphoma. ʻO nā hoʻololi genetic e hoʻopilikia i ka ulu ʻana o nā keʻokeʻo koko e pili pū ana me ka lymphoma a me ka leukemia.

Pehea e ʻike ai nā kauka i nā LPD? (Diagnosis)

No ka mea he nui nā ʻano LPD, i ka wā e hana ai i kahi hōʻailona, ​​​​​​nānā mua nā kauka e ʻike i ke ʻano o LPD e hoʻoulu nei i kāu mau hōʻailona.

No ka hana ʻana i kēia, e noʻonoʻo ke kauka i kāu mau hōʻailona, ​​​​e like me nā lymph nodes pehu, nā hōʻailona e ʻoi aku ka nui o kou ake a i ʻole ka spleen ma mua o ka maʻamau, a e nīnau e pili ana i kou mōʻaukala olakino i hala a inā paha he mau kūlana like kekahi o kou ʻohana.

A laila hiki ke hana i nā hoʻokolohua penei:

• Biopsy: Hiki ke hana ʻia kahi biopsy iwi e nānā i nā hōʻailona o nā maʻi ʻaʻai koko e like me ka leukemia a i ʻole lymphoma. Pili kēia i ka lawe ʻana i kahi hāpana liʻiliʻi o ka iwi a hoʻāʻo iā ia. I kekahi manawa hiki ke lawe ʻia kahi ʻāpana liʻiliʻi o kahi lymph node pehu.
• Nā hoʻāʻo koko: Helu koko piha (CBC) , Comprehensive metabolic panel (CMP) , hoʻāʻo antibody Epstein-Barr, hoʻāʻo hepatitis, hoʻāʻo HIV, hoʻāʻo Lactate dehydrogenase (LDH) , a pēlā aku. Hiki i kēia mau mea ke haʻi iā ʻoe i nā mea he nui e pili ana i nā loli i nā hunaola koko, nā maʻi, a me ka hana ate a me nā puʻupaʻa.
• Nā hoʻāʻo kiʻi: Hiki ke hana ʻia nā hoʻāʻo e like me nā scan computed tomography (CT) a me nā scan positron emission tomography (PET) . Hiki i kēia ke nānā i nā mea e like me nā ʻōpū i loko o ke kino, ke kūlana o nā lymph nodes, a inā ua laha nā hunaola kanesa. Ua like ia me ke kiʻi ʻana i loko o ke kino.
• Nā hoʻokolohua Lab: Hiki i nā hoʻokolohua kūikawā e like me ke kahe cytometry ke kōkua i ka ʻike ʻana i ke ʻano kikoʻī o LPD.

Pehea e mālama ʻia ai nā LPD?

ʻO ke ʻano o ka mālama ʻana no nā LPD e pili ana i ke ʻano kikoʻī o ka LPD āu e loaʻa ai. ʻAʻole like ka mālama ʻana o nā kānaka a pau. No ka laʻana, inā he leukemia a lymphoma paha kou, hiki iā ʻoe ke loaʻa nā lāʻau lapaʻau e like me kēia:

• Chemotherapy: Nā lāʻau lapaʻau i hāʻawi ʻia e luku i nā hunaola kanesa.
• Immunotherapy: He lāʻau lapaʻau e hoʻoulu ai i kāu ʻōnaehana ponoʻī e hakakā i nā pūnaeho kanesa.
• Lapaʻau radiation: Ke luku ʻana i nā hunaola kanesa me ka hoʻohana ʻana i nā kukuna ikehu kiʻekiʻe.
• Ke hoʻoili ʻana o nā pūnaewele kumu (iwi iwi): Ke hoʻoili ʻana o nā pūnaewele kumu olakino e pani i ka iwi iwi i hōʻino ʻia.
• Lapaʻau i hoʻolālā ʻia: Nā lāʻau lapaʻau e hoʻolālā ana i nā molekala kikoʻī e kōkua ana i nā pūpū kanesa e ulu a ola.

E hoʻomanaʻo, na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nāu. ʻO ia ka mea ʻike maikaʻi loa i kou kūlana.

Pehea ke ʻano o ka ʻike no kekahi me LPD? Hiki ke ho'ōla ʻia?

He nīnau paʻakikī kēia e pane ʻia no ka mea he nui nā ʻano LPD, a he nui nā mea e like me kou olakino, makahiki, a me ke kahua o ka maʻi e hiki ke hoʻopilikia i ka hopena.

Hiki ke ho'ōla piha ʻia kekahi mau ʻano LPD. No ka laʻana, hiki i ka chemo-immunotherapy ke ho'ōla i kekahi mau ʻano lymphoma, e like me ka lymphoma B-cell nui a me ka lymphoma Burkitt. ​​Hiki ke ho'ōla ʻia ke kanaka me ka maʻi lymphoproliferative X-linked (XLP) me kahi hoʻoili cell stem.

Akā i kekahi manawa, hiki i ka lāʻau lapaʻau ke hoʻokuʻu i kekahi mau lymphoma i ka hoʻomaha ʻana , ʻo ia hoʻi, nalowale nā ​​​​hōʻailona a ʻaʻole hiki i nā hoʻokolohua ke ʻike hou i ka maʻi. Akā, ʻaʻole i ho'ōla loa ʻia ka maʻi. Hiki i kekahi mau LPD ke hoʻi mai i nā mahina a i ʻole nā ​​​​makahiki ma hope o ka pau ʻana o ka lāʻau lapaʻau.

Inā loaʻa iā ʻoe ka LPD, ke noʻonoʻo nei paha ʻoe inā hiki ke ho'ōla ʻia a pehea ka lōʻihi o kou ola ʻana. ʻO kahi maikaʻi loa e loaʻa ai ka ʻike e pili ana i kēia mai kāu kauka mai. ʻIke maikaʻi ʻo ia iā ʻoe a me kou kūlana. No laila, mai makaʻu e nīnau iā ia i kāu mau nīnau.

Pehea e mālama ai iaʻu iho? (Mālama ponoʻī)

He mau maʻi koʻikoʻi nā LPD. ʻOiai hiki i ka lāʻau lapaʻau ke hōʻemi i nā hōʻailona a alakaʻi i kahi lāʻau lapaʻau, hiki nō iā ʻoe ke kū i nā pilikia i ka wā o ka lāʻau lapaʻau. Eia kekahi mau manaʻo e kōkua paha iā ʻoe:

• E nīnau e pili ana i ka mālama palliative: Pono paha kekahi me LPD i ke kōkua i ka mālama ʻana i nā hōʻailona a me nā hopena ʻaoʻao o ka lāʻau. ʻO ka mālama palliative kahi ʻano mālama kūikawā e kōkua i ka hoʻomaikaʻi ʻana i ke ʻano o ke ola o ke kanaka a hōʻemi i ka ʻeha a me nā ʻoluʻolu ʻole ʻē aʻe, ma mua o ka hoʻāʻo ʻana e hoʻōla i ka maʻi. Hiki i kāu hui mālama palliative ke hāʻawi iā ʻoe i nā ʻōlelo aʻoaʻo maikaʻi.
• ʻAi maikaʻi: Hiki iā ʻoe ke nalowale i ka makemake ke maʻi ʻoe a i ʻole ke mālama ʻia. Inā pēlā, e kūkākūkā me kahi meaʻai meaʻai . E aʻo aku ʻo ia iā ʻoe i nā meaʻai a me nā mea inu kūpono nāu.
• E hoʻoikaika kino: Hiki i ka hoʻoikaika kino māmā ke kōkua i ka hōʻemi ʻana i ke kaumaha e hele mai me kahi maʻi koʻikoʻi. Akā e kamaʻilio me ke kauka ma mua o ka hoʻomaka ʻana i kahi papahana hoʻoikaika kino hou.
• E pale iā ʻoe iho mai nā maʻi: Hiki ke hoʻonāwaliwali ʻia kou ʻōnaehana pale ma muli o ka maʻi a i ʻole ka lāʻau lapaʻau. No laila e nīnau i kāu kauka e pili ana i nā ala e pale aku ai i nā maʻi viral. He mea nui ka pale ʻana i nā wahi i piha ai ka poʻe a me ka holoi pinepine ʻana i kou mau lima.

Āhea wau e ʻike ai i ke kauka?

Inā ʻoe e mālama ʻia no kahi LPD, e nīnau i kāu kauka i nā hōʻailona e hōʻike ana e ʻoi aku ka ʻino o kou kūlana (e laʻa, he kuni mau) i ʻike ʻoe i ka manawa e hoʻokaʻaʻike aku ai iā ia.

Ke hoʻohana ke kauka i ka huaʻōlelo lapaʻau "lymphoproliferation" a i ʻole "lymphoproliferative disorders (LPDs)," ke kamaʻilio nei lākou e pili ana i kahi hui o nā maʻi e pili ana i nā keʻokeʻo keʻokeʻo kikoʻī e hiki ke hoʻopilikia i kāu ʻōnaehana pale a lilo paha i maʻi kanesa.

Inā loaʻa iā ʻoe kekahi ʻano maʻi e like me kēia, makemake paha ʻoe e ʻike i nā kikoʻī o kou ʻano ma mua o ka huaʻōlelo lapaʻau. Akā i kou maʻi ʻana, he mana ka ʻike. I kēia hihia, ʻo ka ʻike ʻana i ke ʻano ma hope o ka inoa e hiki ke kōkua iā ʻoe e loaʻa kahi ʻike maikaʻi o ka mea e hana nei i loko o kou kino.

Eia kekahi laʻana, loaʻa i nā LPD nā hōʻailona a me nā lāʻau lapaʻau maʻamau. Akā, ʻaʻole like lākou a pau. Eia kekahi, ʻokoʻa paha kou ʻike mai nā poʻe ʻē aʻe. Inā hoʻohana kāu kauka i ka huaʻōlelo "lymphoproliferative disorder (LPD), e noi no nā kikoʻī hou aku e pili ana i kou kūlana kikoʻī. E hauʻoli lākou e pane i kāu mau nīnau.

ʻO ka mea hope loa, leka lawe i ka home:

ʻO nā maʻi Lymphoproliferative (LPD) he hui o nā kūlana paʻakikī a koʻikoʻi hoʻi i hoʻokumu ʻia e nā ʻano ʻē i ka hana o nā lymphocytes, nā hunaola pale o ko mākou kino.

• E makaʻala i nā hōʻailona: Mai palaualelo inā loaʻa iā ʻoe ke kuni mau, ka luhi nui, ka pohō kaumaha, a i ʻole nā ​​​​​​kīnā lymph.
• He mea nui e ʻimi i ke kōkua lapaʻau: Inā kānalua, e ʻike koke i ke kauka no ka nānā ʻana. ʻO ka wā ma mua o ka ʻike ʻia ʻana o ka maʻi, ʻo ka nui o ka kūleʻa o ka lāʻau lapaʻau.
• ʻAʻole like nā LPD āpau: aia nā ʻano like ʻole, a he ʻokoʻa nā lāʻau lapaʻau a kēlā me kēia. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe.
• ʻAʻole ʻoe hoʻokahi: ​​Ke kū nei i kahi kūlana e like me kēia, he mea waiwai nui ke kākoʻo o ka ʻohana, nā hoaaloha, a me nā limahana lapaʻau.

ʻO ka mea nui loa, ʻaʻole e makaʻu, e noho ikaika, a e hahai i nā ʻōlelo aʻo a nā kauka. Me ka mālama kūpono a me ka ikaika noʻonoʻo maikaʻi, hiki iā ʻoe ke lanakila ma luna o kēia pilikia.

nā maʻi lymphoproliferative, LPDs, nā pūnaewele lymph, nā lymphocytes, ʻōnaehana pale, maʻi ʻaʻai, leukemia, lymphoma