Ka tuyige ku Anaplastic Large Cell Lymphoma (ALCL) mu bigambo ebyangu.

Wali owuliddeko ku bulwadde bwa Anaplastic Large Cell Lymphoma (ALCL)? Mpozzi erinnya lino liwulikika nga lizibu katono. Naye teweeraliikiriranga, kino kika kya kookolo ekitali kya bulijjo nnyo. Leero tugenda kwogera ku ALCL kye ki, engeri gy’ekula, obubonero bwe buli, obujjanjabi bwe buli, n’ebirala bingi mu ngeri ennyangu ennyo gy’osobola okutegeera. Nga bw’oyogera ne mukwano gwo.

ALCL (Anaplastic Large Cell Lymphoma) kye ki?

Mu ngeri ennyangu, ALCL kika kya kookolo ekitali kya bulijjo, ekitali kya bulijjo, abeera mu kibinja ekinene ekya kookolo ekiyitibwa Non-Hodgkin Lymphoma . Obadde okimanyi nti okufaananako ne Non-Hodgkin Lymphoma zonna, ALCL nayo kika kya kookolo? Kibaawo ng’ekika ky’obutoffaali obweru obuyitibwa lymphocytes mu mubiri gwaffe kikula nga tekifugibwa era ku sipiidi ya mangu okusinga bwe yandibadde.

Lowooza ku lymphocytes zino ng’abaserikale abatono mu mibiri gyaffe. Zino kitundu ku baziyiza baffe, zitukuuma obutakwatibwa buwuka n’endwadde. Waliwo ebika by’obutoffaali obuyitibwa lymphocytes bibiri ebikulu: obutoffaali bwa B n’obutoffaali bwa T . Mu ALCL, T lymphocytes zo oba T cells zikula mu ngeri etaali ya bulijjo.

Kati ka tulabe erinnya lino "anaplastic large cell lymphoma" kye litegeeza.

• Anaplastic : Ekigambo kino kitegeeza nti bwe kitunuulirwa mu microscope, obutoffaali bwa kookolo buno bulabika nga bwa kyewuunyo nnyo era bwa njawulo bw’ogeraageranya n’obutoffaali bwa T lymphocyte obulamu. Kiringa enkula yazo n’endabika yaabwe bikyusiddwa.
• Obutoffaali Obunene : Kino kitegeeza nti obutoffaali bwa T obutali bwa bulijjo bulabika nga bunene okusinga obutoffaali bwa T obwa bulijjo. Enjawulo eno erabika bulungi wansi wa microscope.
• Lymphoma : Lymphoma ye kookolo abeerawo olw’obutoffaali obweru obuyitibwa lymphocytes okukula mu ngeri etafugibwa. ALCL ekula naddala okuva mu T lymphocytes.

Okukifuna? Mu ngeri ennyangu, ALCL kookolo obutoffaali bwa T mwe bufuuka obunene mu ngeri etaali ya bulijjo, ne bukyuka, era ne bukula mu ngeri etafugibwa.

Waliwo ebika bya ALCL eby’enjawulo?

Yee, waliwo ebika bya ALCL eby’enjawulo. Bino bisengekebwa okusinziira ku kifo kookolo w’ali mu mubiri gwo n’engeri obutoffaali bwa kookolo gy’alimu.

ALCL ey’enkola

Kino kye kika ekikulu. "Systemic" kitegeeza nti esobola okukosa omubiri gwonna. Kiyinza okukosa ennywanto zo , oba "endwadde" nga bwe tuziyita, n'ebitundu by'omunda ng'ekibumba kyo n'amawuggwe, n'oluusi olususu lwo.

Systemic ALCL egabanyizibwamu ebika bibiri. Ekimu kyesigamiziddwa ku oba waliwo enkyukakyuka mu buzaale obuyitibwa ``Anaplastic Lymphoma Kinase (ALK)'' gene . Ensengekera z’obuzaale ziringa ebitabo ebitonotono ebiyigiriza obutoffaali bwaffe, era obuzaale buno bubuulira ne T lymphocyte engeri y’okukolamu.

• ALK-positive ALCL: Kino kika kya kookolo alina enkyukakyuka mu ALK gene. Kino kitera okuba kookolo ow’amaanyi. Kyokka, kisinga kubeera mu baana n’abavubuka abakulu . Ekirungi nti ekika kino kikola bulungi ku bujjanjabi bw’eddagala .
• ALK-negative ALCL : Ekika kino tekirina nkyukakyuka ya ALK gene. Ono era kookolo akula amangu (aggressive). Kyokka, kisinga kukwata bakadde , ebiseera ebisinga abo abasukka mu myaka 60. Ekika kino kiyinza okugenda mu kusonyiyibwa oluvannyuma lw’okuweebwa eddagala eriweweeza ku bulwadde ate oluvannyuma ne kiddamu. N’olwekyo, ALK-negative ALCL nzibu nnyo okujjanjaba, era okuteebereza kubi okusinga ALK-positive ALCL.

Ebika ebirala ebya ALCL

Waliwo n’ebika bya ALCL ebikula mpola okusinga ebika by’enkola.

• Primary cutaneous ALCL : Kino kika ekisinga okukosa olususu. Obubonero ng’okuzimba ebizimba, ebizimba, n’okuzimba omubiri buyinza okulabika. Ebiseera ebisinga (nga 90%) tebusaasaana kusukka lususu.
• ALCL ekwatagana n’okuteekebwamu amabeere (BIA-ALCL) : Kino kika kya ALCL ekikula okwetooloola ebisimbibwa amabeere. Ebiseera ebisinga kizuulibwa nga wayise emyaka nga 10 oluvannyuma lw’okugaziya amabeere oba okuddamu okuzimba amabeere.

Ani afuna ALCL?

Wadde nga ALCL esobola okukula mu bantu ab’emyaka gyonna, ebika ebimu bikosa nnyo ebibinja ebimu.

• ALK-positive ALCL : Kino kisinga kukosa baana abali mu myaka egy’obukulu, abatiini, n’abavubuka abakulu abali mu myaka gyabwe egy’obukulu 20 ne 30 . Kisinga kubeera mu basajja .
• ALK-negative ALCL : Kino okusinga kikwata abantu abasukka mu myaka 60. Era kisingako katono mu basajja.
• Primary cutaneous ALCL : Kino kisinga kubeera mu bantu abakulu abasukka mu myaka 40. Kisinga kubeera mu basajja n’abazungu.
• BIA-ALCL : Kino kitera okuzuulibwa mu bantu abali mu myaka gya 50 . Kiyinza okukula mu bantu ababadde bateekeddwa mu mabeere nga silikoni n’omunnyo. Kizuuliddwa nti kikwatagana nnyo n'okuteekebwa mu mabeere mu ngeri ey'obutonde .

ALCL ya bulijjo etya?

ALCL mu butuufu kookolo atatera kulabika nnyo . Ebitundu nga 2% byokka ku bulwadde bwa lymphomas obutali bwa Hodgkin mu bantu abakulu be bazuulibwa nga ALCL. Ekyo kitundu kitono nnyo ku buli kikumi.

Bubonero ki obulaga obulwadde bwa ALCL?

Obubonero bwa ALCL bwawukana okusinziira ku kika.

Obubonero bwa ALCL ey’enkola

Mu ALCL zombi ezirina ALK-positive ne ALK-negative, ennywanto z’amazzi ezizimba zitera okubeerawo kookolo w’akula. Ziyinza okuwulira ng’ebizimba mu bifo ng’ensingo yo , enkwaso oba mu kisambi . Obubonero obulala kuliko:

• Omusujja ogutera okubeerawo.
• Okuwulira nga okooye nnyo (`Fatigue`).
• Okutuuyana ekiro (`Okutuuyana ekiro`).
• Okugejja mu ngeri etategeerekeka.

Abantu abasinga bwe bazuulibwa, kookolo ayinza okuba nga yasaasaana katono, ekitegeeza nti ali mu `ddaala ery'oku ntikko` . Mu mbeera eyo, kookolo ayinza okuba nga yasaasaana mu bitundu by’omubiri ng’amawuggwe, ekibumba oba amagumba. Olwo, obubonero buyinza okulabika okusinziira ku kitundu ekikoseddwa. Okugeza bw’oba ​​olina ekifuba ekinywezeddwa oba ng’osesema enfunda eziwera, ALCL eyinza okuba nga yakosa ekifuba.

Ebifaananyi bya ALCL ey’olususu olusookerwako

Enkyukakyuka mu lususu osobola okuziraba mu kika kino.

• Ebizimba ebitali bya bulijjo ebimyufu oba ebya kitaka omumyufu birabika ku kitundu kimu oba ebisingawo ku lususu, ebiyinza okukula ng’ekiseera kigenda kiyitawo.
• Ebizimba ebigulumivu , ebinene okusinga ekinusu. Bino oluusi biyinza okusiiwa.
• Ebizimba biyinza okulumwa oluvannyuma ne bifuuka ebizimba .

Ebifaananyi bya BIA-ALCL (Breast Implant-Associated ALCL) .

Mu kino, enkyukakyuka ezitegeerekeka mu mabeere zisobola okulabibwa.

• Obulumi mu mabeere.
• Okuzimba amabeere.
• Okusiiyibwa ku lususu oba eczema.
• Okuzimba oba okukuŋŋaanyizibwa kw’amazzi okumpi n’ekifo ky’ossa amabeere.
• Ekizimba ekigumu okumpi n’ekifo awassibwa amabeere.

Enkyukakyuka zino zitera okulabibwa mu bbeere erimu, naye oluusi enkyukakyuka zisobola okulabibwa mu mabeere gombi.

Kiki ekivaako ALCL?

ALCL ebaawo ng’obutoffaali bwa lymphocyte bwe twayogeddeko emabegako bweyongera mu ngeri etafugibwa ne butandika okukula okusukka ebitundu ebiramu ebibyetoolodde. Abanoonyereza n’okutuusa kati tebamanyi bulungi lwaki obutoffaali buno obw’obutoffaali bufuuka kookolo (obutoffaali obubi).

Wabula bazudde enkyukakyuka z’obuzaale eziwerako ezitera okulabibwa ku ALCL. Kirowoozebwa nti enkyukakyuka zino mu buzaale zisobola okuleetera obutoffaali obulamu okukyuka ne bufuuka obutoffaali bwa kookolo.

Okugeza, engeri enkulu eya ALK-positive ALCL ye nkyukakyuka mu ALK gene . Mu ngeri y’emu, enkyukakyuka endala ez’obuzaale nazo zitera okubeerawo mu bika bya ALCL ebirala.

ALCL ezuulibwa etya? (Okuzuula obulwadde)

Omusawo ajja kusooka kukebera omubiri okukebera obubonero bwa ALCL, gamba ng’ennywanto ezizimba. Kino bwe banaakiteebereza, bajja kukola ebigezo n’emitendera egy’enjawulo egiwerako.

• Enkola z’okukuba ebifaananyi: Bino bisobola okuyamba okuzuula kookolo w’ali. Ekika ky’okukebera ebifaananyi by’olina okwetaaga kijja kwawukana okusinziira ku kika kya ALCL. Omusawo ayinza okukola X-ray mu kifuba , CT scan , oba MRI okunoonya ebizimba. PET/CT scan oba PET scan esobola okuyamba okuzuula oba kookolo asaasaanidde mu mubiri gwonna. Singa kiteeberezebwa nti BIA-ALCL, bayinza okukolebwa okukebera amabeere .
• Okukola omusaayi : Omusawo ajja kukola okukebera omusaayi mu ngeri ez’enjawulo, gamba ng’okubala omusaayi mu bujjuvu (CBC), okukebera obubonero bwa ALCL. Singa omuwendo gw’obutoffaali bw’omusaayi (obutoffaali obumyufu, obutoffaali obweru oba obutoffaali obukola omusaayi) guba gwa bulijjo, kiyinza okuba akabonero ka ALCL. Era bajja kunoonya enziyiza ezimu n’obubonero obulala mu musaayi, kuba bino nabyo biyinza okuba obubonero bwa ALCL.
• Biopsy : Engeri yokka ey’okukakasa nti olina ALCL kwe kukebera biopsy. Mu kukebera omubiri (biopsy), omusawo akwata akatundu akatono ak’ebitundu ebiteeberezebwa n’abikebera ng’akozesa microscope. Omusawo bw’asoma obutoffaali buno, asobola okuzuula ddala ekika kya ALCL ky’olina. Kino nakyo kiyamba okuteekateeka obujjanjabi obusinga okukola obulungi.

ALCL ejjanjabwa etya?

Obujjanjabi obutera okukozesebwa ku ALCL ey'enkola (systemic ALCL) kwe kujjanjaba eddagala . Okulongoosa y’obujjanjabi obusinga okukozesebwa ku ALCL y’olususu olusookerwako ne BIA-ALCL.

Obujjanjabi bwa ALCL ey’enkola

ALK-positive ne ALK-negative anaplastic large cell lymphomas zitera okuddamu bulungi obujjanjabi obw’enkola. Enkola y’eddagala eritta kookolo erimu okuwa eddagala eritta kookolo nga liyita mu musuwa, ogutambulira mu mubiri gwonna nga guyita mu musaayi okutta obutoffaali bwa kookolo.

Chemotherapy for systemic ALCL etera okukozesa eddagala erigatta awamu okutta obutoffaali bwa kookolo. Ebimu ku byokulabirako mulimu:

• BV-CHP : Kuno kw’ogatta eddagala lya `Brentuximab Vedotin`, `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, ne `Prednisone`.
• CHOP : Kino kizingiramu okukozesa eddagala eriyitibwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Vincristine (Oncovin®)`, ne `Prednisone`.
• CHEOP : Kino kizingiramu okukozesa eddagala eriyitibwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Etoposide`, `Vincristine (Oncovin®)`, ne `Prednisone`.

Enzijanjaba zino zitera okuvaako obubonero bwonna obwa kookolo okubula mu bbanga ttono (kino tukiyita `okusonyiyibwa`).(Kiyitibwa "okuddamu") Kyokka kookolo asobola okuddamu. Singa omusawo alowooza nti kookolo ayolekedde okuddamu, ayinza okukuwa amagezi okusimbuliza obutoffaali obusibuka mu mubiri ng’oli mu kusonyiyibwa. Okusimbuliza obutoffaali obusibuka mu mubiri (stem cell transplant) kukyusa obutoffaali obubadde busaanyiziddwaawo olw’eddagala eriweweeza ku bulwadde buno ne bussaamu obutoffaali obulamu. Olwo obutoffaali buno obulamu ne bukola obutoffaali bw’omusaayi obulamu (obutali bwa kookolo).

Singa kookolo akomawo, omusawo ayinza okukuwa amagezi ku bujjanjabi obw’enjawulo obw’eddagala obw’enjawulo obutegekeddwa okujjanjaba obulwadde bwa lymphoma.

Obujjanjabi bwa ALCL ey’olususu olusookerwako

Obujjanjabi obusinga okukozesebwa ku kino kwe kulongoosa . Singa kookolo asaasaanidde mu nnywanto, oyinza n’okwetaaga obujjanjabi obw’amasannyalaze . Obujjanjabi bw’amasannyalaze (radiation therapy) bukola nga bulung’amya amaanyi mu butoffaali bwa kookolo ne bubusaanyawo.

Primary cutaneous ALCL etera okuddamu mu myaka etaano oluvannyuma lw’okujjanjabwa. Kino bwe kibaawo, okulongoosa n’obujjanjabi obw’amasannyalaze kijja kuddamu okwetaagisa.

Bw’oba ​​olina ebizimba ebiri mu kitundu ebitasobola kuggyibwawo ng’olongooseddwa, oba kookolo bw’asigala ng’akomawo, oyinza okwetaaga obujjanjabi obulala. Mu bino biyinza okuli:

• Oral Methotrexate : Eddagala erikozesebwa okujjanjaba obulwadde bwa non-Hodgkin lymphoma.
• Bexarotene : Eddagala erikozesebwa okujjanjaba obulwadde bwa T-cell lymphoma obukosa olususu.
• Brentuximab Vedotin : Eddagala erikozesebwa okujjanjaba ALCL ey’enkola n’ebika ebirala ebya ALCL ebiddamu.
• Interferon : Eddagala eriyamba abaserikale b’omubiri okutegeera n’okulwanyisa obutoffaali bwa kookolo omuli n’obulwadde bwa lymphoma.

Obujjanjabi bwa BIA-ALCL

BIA-ALCL ebiseera ebisinga esobola okuwona ng’olongooseddwa okuggyamu ekintu kyo eky’amabeere n’obutoffaali bwonna obwa kookolo obukwetoolodde. Singa okulongoosa tekisoboka, osobola okuweebwa obujjanjabi obw’amasannyalaze okutta obutoffaali bwa kookolo.

Singa kookolo akomawo oba n’asaasaana okusukka ebbeere, omusawo ayinza okukuwa amagezi ku bujjanjabi obw’eddagala obukozesebwa okujjanjaba ALK-negative ALCL. Mu bino biyinza okuli obujjanjabi bwa CHOP n’obujjanjabi nga Brentuximab Vedotin.

ALCL ya maanyi etya?

Ka kibeere kika ki, ALCL kookolo wa maanyi eyeetaaga okulondoola n’obwegendereza n’okujjanjabibwa obulungi. Wabula, enteekateeka yo ey’okuteebereza n’obujjanjabi bisinziira ku bintu ng’ekika kya ALCL ky’olina, engeri gy’okwatamu obujjanjabi, n’obubonero bwo mu International Prognostic Index (IPI) .

IPI yakolebwa abakugu mu by’obulwadde bwa kkansa okuyamba okulagula ebinaava mu bulwadde bwa lymphomas obutali bwa Hodgkin obukula amangu, omuli ne systemic ALCL. Obukodyo buno bwesigamiziddwa ku bintu bino wammanga:

• emyaka gyo.
• Obusobozi bwo okukola emirimu gya buli lunaku.
• Kookolo wo gy’asasaanye (omutendera gwa kookolo).
• Omuwendo gw’endwadde z’amasavu ezikoseddwa.

Bw’oba ​​olina ALCL ey’enkola, buuza omusawo wo engeri obubonero bwo mu IPI gye bukosaamu emikisa gyo egy’okuwona.

Omuwendo gw’okuwangaala ku ALCL guli gutya?

Emiwendo gy’okuwangaala ku systemic ALCL gyawukana nnyo. ALK-positive ALCL ekwatagana n’obudde obuwanvu obw’okuwangaala okusinga ALK-negative ALCL. Okusinziira ku nsonga nga ekika kya kookolo wo n’obubonero bwa IPI, omuwendo gw’okuwangaala kw’emyaka etaano ku ALCL-positive ALCL guyinza okuva ku 33% okutuuka ku 90%. Mu ngeri y’emu, omuwendo gw’okuwangaala kw’emyaka etaano ku ALCL-negative ALCL guyinza okuva ku 13% okutuuka ku 74%.

Primary cutaneous ALCL ne BIA-ALCL zirina emiwendo emirungi ennyo egy’okuwangaala. Wadde nga primary cutaneous ALCL etera okugenda mu remission era n’edda mu myaka etaano, obujjanjabi obugoberera busobola okwongera ku bulamu bwo. Omuwendo gw’abawangaala guli nga 80% oluvannyuma lw’emyaka etaano bukya bazuuliddwa. Mu BIA-ALCL, singa kookolo aggyibwawo ddala ng’alongooseddwa, kookolo atera okuggwaawo ddala.

Bibuuzo ki bye nnina okubuuza omusawo wange?

Bino bye bimu ku bibuuzo ebikulu by’olina okubuuza omusawo wo:

• Nnina kika ki ekya ALCL?
• Kookolo wange akoma mu kifo kimu oba asaasaanye?
• Baani abakugu ku ttiimu yange ey’okulabirira?
• Bujjanjabi ki bw’onteesa?
• Nddukanya ntya ebizibu ebiva mu bujjanjabi?
• Obukodyo bwange obwa IPI bwe buliwa?
• Mikisa ki egya kookolo wange okugenda mu `remission`?
• Mikisa ki egya kookolo wange okudda?
• Mirundi emeka gye nneetaaga okujja okugoberera okulondoola embeera yange?

Kya bulijjo okuwulira ng’otya ng’otegedde nti olina kookolo. Wabula ekisinga obukulu okujjukira nti ALCL si kika kya kookolo kimu ng’alina ebivaamu bye bimu . Ekika kya ALCL ky’olina kye kisalawo oba esaasaana mangu oba mpola. Ekyo kijja kukola engeri gy’oyinza okukozesaamu obujjanjabi n’endowooza yo. ALCL y’abantu abamu esaasaana mangu. Abalala kikula mpola, ne kikuwa obudde obumala okufuna obujjanjabi obuyinza okuyamba okufuga kookolo. Yogerako n’omusawo wo ku biyinza okuvaamu okusinziira ku ngeri gy’ozuddemu.

Ebintu ebikulu by’olina okujjukira (Take-Home Message) .

Okay, kale ka tufunze ebimu ku bintu ebikulu by’olina okujjukira okuva mu bye twogeddeko.

• ALCL kika kya kookolo ekitatera kulabika, era waliwo ebika bya kookolo eby’enjawulo.
• Ebika bya ALCL byonna si bye bimu. Ebimu byasaasaana mangu, ebirala mpola mpola.
• Obujjanjabi n’emikisa gy’okuwona byawukana okusinziira ku kika kya ALCL ky’olina, emyaka gyo, n’obulamu bwo okutwalira awamu.
• Wadde nga ALK-positive ALCL esinga kubeerawo mu bavubuka, ekola bulungi ku bujjanjabi.
• ALK-negative ALCL ekosa abantu abakulu bangi era eyinza okukaluba katono okujjanjaba.
• Okutwalira awamu enteekateeka y’okuteebereza ALCL y’olususu ne ALCL ekwatagana n’okuteekebwamu amabeere (BIA-ALCL) nnungi.
• Tosattira. Bw’oba ​​olina okubuusabuusa oba obubonero bwonna, genda mangu omusawo amagezi.
• Yogerako mu lwatu n’omusawo wo ku mbeera yo, obujjanjabi bwo, n’ebibuuzo byonna by’oyinza okuba nabyo. Bano be basobola okukuyamba obulungi.

Jjukira nti si byonna ebizuulibwa kookolo nti bya maanyi kyenkanyi. Ne bwe baba nga balina ALCL, nga bazuuliddwa bulungi, bafunye obujjanjabi obw’amangu, era nga balondoola bulungi, abantu bangi basobola okutuuka ku bivaamu ebirungi.

` Anaplastic Large Cell Lymphoma, ALCL, Lymphoma, Kookolo, Obutoffaali bwa T, ALK Gene, Obujjanjabi bw’eddagala