Tiyeni tiphunzire za Anaplastic Large Cell Lymphoma (ALCL) mwachidule.

Kodi mudamvapo za Anaplastic Large Cell Lymphoma (ALCL)? Mwina dzinali likumveka lovuta pang'ono. Koma musadandaule, iyi ndi khansa yosowa kwambiri. Lero tikambirana za ALCL, momwe imakulira, zizindikiro zake, mankhwala ake, ndi zina zambiri m'njira yosavuta yomwe mungamvetse. Monga momwe mungalankhulire ndi mnzanu.

Kodi ALCL (Anaplastic Large Cell Lymphoma) ndi chiyani?

Mwachidule, ALCL ndi mtundu wa khansa wosowa komanso wosazolowereka womwe uli m'gulu lalikulu la khansa yotchedwa Non-Hodgkin Lymphoma . Kodi mukudziwa kuti monga Non-Hodgkin Lymphoma yonse, ALCL ndi mtundu wa khansa? Imachitika pamene mtundu wa maselo oyera a m'magazi otchedwa lymphocytes m'thupi lathu umakula mosalamulirika komanso mwachangu kuposa momwe uyenera kuchitira.

Taganizirani za ma lymphocyte awa ngati asilikali ang'onoang'ono m'thupi lathu. Ndi gawo la chitetezo chathu chamthupi, chomwe chimatiteteza ku majeremusi ndi matenda. Pali mitundu iwiri ikuluikulu ya ma lymphocyte: maselo a B ndi maselo a T. Mu ALCL, ma lymphocyte anu a T, kapena maselo a T, amakula modabwitsa.

Tsopano tiyeni tiwone tanthauzo la dzina lakuti "anaplastic large cell lymphoma".

• Anaplastic : Mawuwa amatanthauza kuti akayang'aniridwa ndi maikulosikopu, maselo a khansa awa amawoneka achilendo kwambiri komanso osiyana poyerekeza ndi maselo athanzi a T lymphocyte. Zili ngati mawonekedwe ndi mawonekedwe awo asokonekera.
• Selo Lalikulu : Izi zikutanthauza kuti ma lymphocyte a T omwe amachita zinthu molakwika amaoneka aakulu kuposa ma T cell wamba. Kusiyana kumeneku kumaonekera bwino pogwiritsa ntchito maikulosikopu.
• Lymphoma : Lymphoma ndi khansa yomwe imachitika chifukwa cha kukula kosalamulirika kwa maselo oyera amagazi otchedwa lymphocytes. ALCL imachokera makamaka ku ma lymphocytes a T.

Mwachidule, ALCL ndi khansa yomwe maselo a T amakhala aakulu kwambiri, amasinthasintha, ndipo amakula mosalamulirika.

Kodi pali mitundu yosiyanasiyana ya ALCL?

Inde, pali mitundu yosiyanasiyana ya ALCL. Izi zimagawidwa m'magulu kutengera komwe khansa ili m'thupi lanu komanso mawonekedwe a maselo a khansa.

ALCL Yadongosolo

Uwu ndiye mtundu waukulu. "Systemic" amatanthauza kuti ingakhudze thupi lonse. Ingakhudze ma lymph nodes anu, kapena "glands" monga momwe timawatchulira, ndi ziwalo zamkati monga chiwindi ndi mapapo anu, ndipo nthawi zina khungu lanu.

Systemic ALCL imagawidwa m'mitundu iwiri. Chimodzi chimadalira ngati pali kusintha kwa majini otchedwa ``Anaplastic Lymphoma Kinase (ALK)'' . Majini ndi ngati mabuku ang'onoang'ono ophunzitsira maselo athu, ndipo majini amenewa amauza ngakhale T lymphocyte momwe angagwirire ntchito.

• ALCL yokhala ndi ALK: Iyi ndi khansa yamtundu womwe uli ndi kusintha kwa majini a ALK. Iyi nthawi zambiri imakhala khansa yoopsa. Komabe, imapezeka kwambiri mwa ana ndi achinyamata . Mwamwayi, mtundu uwu umayankha bwino ku chemotherapy .
• ALK-negative ALCL : Mtundu uwu ulibe kusintha kwa majini a ALK. Iyi ndi khansa yomwe ikukula mofulumira (yoopsa). Komabe, imakhudza kwambiri okalamba , nthawi zambiri omwe ali ndi zaka zoposa 60. Mtundu uwu ukhoza kuchira pambuyo pa chemotherapy kenako nkubwereranso. Chifukwa chake, ALCL yopanda ALK ndi yovuta kuchiza, ndipo matenda obwera chifukwa cha ALK ndi oipa kuposa ALCL yokhala ndi ALK.

Mitundu ina ya ALCL

Palinso mitundu ya ALCL yomwe imakula pang'onopang'ono kuposa mitundu ya systemic.

• ALCL yoyambirira ya khungu : Iyi ndi mtundu womwe umakhudza kwambiri khungu. Zizindikiro monga matuza, ziphuphu, ndi eczema zimatha kuchitika. Nthawi zambiri (pafupifupi 90%) sizifalikira kupitirira khungu.
• ALCL yokhudzana ndi kulowetsedwa m'mawere (BIA-ALCL) : Uwu ndi mtundu wa ALCL womwe umayamba kuzungulira kulowetsedwa m'mawere. Nthawi zambiri umapezeka patatha zaka 10 kuchokera pamene bere lawonjezeka kapena kukonzedwanso.

Ndani amapeza ALCL?

Ngakhale kuti ALCL imatha kufalikira mwa anthu azaka zilizonse, mitundu ina imakhudza kwambiri magulu ena.

• ALCL yokhala ndi ALK : Izi nthawi zambiri zimakhudza ana azaka zomaliza za sukulu ya ana aang'ono, achinyamata, komanso achinyamata azaka za m'ma 20 ndi 30. Zimapezeka kwambiri mwa amuna .
• ALCL yopanda ALK : Izi zimakhudza kwambiri anthu azaka zopitilira 60. Zimapezekanso pang'ono mwa amuna.
• ALCL yoyambirira ya khungu : Izi zimachitika kawirikawiri mwa akuluakulu azaka zopitilira 40. Zimapezeka kwambiri mwa amuna ndi azungu.
• BIA-ALCL : Izi nthawi zambiri zimapezeka mwa anthu azaka za m'ma 50. Zitha kupezeka mwa anthu omwe adapangidwapo ma implants a silicone ndi saline breast. Zapezeka kuti zimagwirizana kwambiri ndi ma implants a breast texture .

Kodi ALCL ndi yofala bwanji?

ALCL ndi khansa yosowa kwambiri . Pafupifupi 2% yokha ya ma lymphomas omwe si a Hodgkin mwa akuluakulu ndi omwe amapezeka kuti ndi ALCL. Ndi chiwerengero chochepa kwambiri.

Kodi zizindikiro za ALCL ndi ziti?

Zizindikiro za ALCL zimasiyana malinga ndi mtundu wake.

Zizindikiro za ALCL ya m'thupi

Mu ALCL yonse ya ALK-positive ndi ALK-negative, ma lymph nodes otupa amapezeka kwambiri komwe khansa ikukula. Amatha kumveka ngati ziphuphu m'malo monga khosi lanu, m'khwapa, kapena m'mimba . Zizindikiro zina ndi izi:

• Malungo obwerezabwereza.
• Kumva kutopa kwambiri (`Kutopa`).
• Kutuluka thukuta usiku (`Thukuta la usiku`).
• Kuchepetsa thupi kosamveka bwino.

Anthu ambiri akapezeka ndi khansa, khansayo ikhoza kufalikira pang'ono, zomwe zikutanthauza kuti ili pamlingo wapamwamba . Zikatero, khansayo ikhoza kufalikira ku ziwalo monga mapapo anu, chiwindi, kapena mafupa. Kenako, zizindikiro zimatha kubwera kutengera chiwalo chomwe chakhudzidwacho. Mwachitsanzo, ngati muli ndi chifuwa cholimba kapena chifuwa chobwerezabwereza, ALCL ikhoza kukhudza chifuwacho.

Zizindikiro za ALCL yoyambirira ya khungu

Kusintha kwa khungu kungaonekere mu mtundu uwu.

• Ziphuphu zosazolowereka zofiira kapena zofiira-zofiirira zimawonekera pakhungu limodzi kapena angapo, zomwe zimatha kukula pakapita nthawi.
• Ziphuphu zokwezeka , zazikulu kuposa ndalama. Izi nthawi zina zimatha kuyabwa.
• Ziphuphu zimatha kupweteka kenako n’kukhala chiphuphu .

Makhalidwe a BIA-ALCL (ALCL Yogwirizana ndi Kuyika M'mimba)

Mu izi, kusintha koonekera bwino m'mabere kungawonekere.

• Kupweteka m'mawere.
• Kutupa kwa bere.
• Kutupa pakhungu kapena eczema.
• Kutupa kapena madzimadzi ochulukirapo pafupi ndi choyikamo cha bere lanu.
• Chidutswa cholimba pafupi ndi choyikamo bere.

Kusintha kumeneku nthawi zambiri kumawoneka m'bere limodzi, koma nthawi zina kusintha kumatha kuoneka m'mabere onse awiri.

Kodi n’chiyani chimayambitsa ALCL?

ALCL imachitika pamene maselo a lymphocyte omwe tidalankhula kale amachulukana mosalamulirika ndikuyamba kukula kupitirira minofu yathanzi yowazungulira. Ofufuza sakudziwabe chifukwa chake maselo a lymphocyte awa amakhala khansa (maselo oopsa).

Komabe, apeza kusintha kwa majini angapo komwe kumachitika kawirikawiri ndi ALCL. Akuganiza kuti kusintha kwa majini kumeneku kungapangitse maselo athanzi kusintha kukhala maselo a khansa.

Mwachitsanzo, khalidwe lalikulu la ALCL yokhala ndi ALK ndi kusintha kwa majini mu jini ya ALK . Mofananamo, kusintha kwa majini ena kumachitikanso m'mitundu ina ya ALCL.

Kodi ALCL imapezedwa bwanji? (Kuzindikira)

Dokotala wanu adzachita kaye mayeso akuthupi kuti aone ngati pali zizindikiro za ALCL, monga kutupa kwa ma lymph nodes. Ngati akukayikira izi, adzachita mayeso ndi njira zosiyanasiyana.

• Njira zojambulira zithunzi: Izi zingathandize kudziwa komwe khansa ili. Mtundu wa mayeso ojambulira omwe mukufuna udzasiyana malinga ndi mtundu wa ALCL. Dokotala wanu akhoza kuchita X-ray pachifuwa , CT scan , kapena MRI kuti aone zotupa. PET/CT scan kapena PET scan ingathandize kudziwa ngati khansa yafalikira m'thupi lonse. Ngati mukukayikira kuti BIA-ALCL, ultrasound ya m'mawere ikhoza kuchitidwa.
• Kuyeza Magazi : Dokotala adzachita mayeso osiyanasiyana a magazi, monga kuwerengera magazi onse (CBC), kuti aone zizindikiro za ALCL. Ngati kuchuluka kwa maselo a magazi (maselo ofiira a magazi, maselo oyera a magazi, kapena ma platelet) sikwachilendo, kungakhale chizindikiro cha ALCL. Adzafufuzanso ma enzyme ena ndi zizindikiro zina m'magazi, chifukwa izi zitha kukhala zizindikiro za ALCL.
• Kufufuza za maselo : Njira yokhayo yotsimikizira kuti muli ndi ALCL ndikuchita kafukufuku wa maselo. Mu kafukufuku wa maselo, dokotala amatenga chitsanzo chaching'ono cha minofu yokayikitsa ndikuiyang'ana pansi pa maikulosikopu. Mwa kuphunzira maselo amenewa, dokotala amatha kudziwa mtundu weniweni wa ALCL yomwe muli nayo. Izi zimathandizanso kukonzekera chithandizo chothandiza kwambiri.

Kodi ALCL imachiritsidwa bwanji?

Chithandizo cha ALCL cha m'thupi ndi chemotherapy . Opaleshoni ndiyo njira yabwino kwambiri yothandizira ALCL yoyambirira ya khungu ndi BIA-ALCL.

Chithandizo cha ALCL ya m'thupi

Matenda a ALK-positive ndi ALK-negative anaplastic large cell lymphomas nthawi zambiri amayankha bwino mankhwala a chemotherapy. Mankhwala a chemotherapy amaphatikizapo kupereka mankhwala opha khansa kudzera m'mitsempha, yomwe imayenda m'thupi lonse kudzera m'magazi kuti iphe maselo a khansa.

Mankhwala a chemotherapy a ALCL nthawi zambiri amagwiritsa ntchito mankhwala osakaniza omwe amagwira ntchito limodzi kuti aphe maselo a khansa. Zitsanzo zina ndi izi:

• BV-CHP : Izi zikuphatikizapo mankhwala a `Brentuximab Vedotin`, `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, ndi `Prednisone`.
• CHOP : Izi zikuphatikizapo kugwiritsa ntchito mankhwala otchedwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Vincristine (Oncovin®)`, ndi `Prednisone`.
• CHEOP : Izi zikuphatikizapo kugwiritsa ntchito mankhwala otchedwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Etoposide`, `Vincristine (Oncovin®)`, ndi `Prednisone`.

Mankhwalawa nthawi zambiri amatha kupangitsa kuti zizindikiro zonse za khansa zithe mkati mwa nthawi yochepa (timatcha izi kuti 'kukhululukidwa').(Amatchedwa "kubwereranso") Komabe, khansa ikhoza kubwereranso. Ngati dokotala wanu akuganiza kuti khansayo ingabwererenso, angakulangizeni kuti muyike maselo oyamba pamene mukuchira. Kuyika maselo oyamba m'malo mwa maselo omwe awonongedwa ndi chemotherapy ndi maselo athanzi. Maselo athanzi amenewa amapanga maselo athanzi (osakhala khansa).

Ngati khansa yabwereranso, dokotala wanu angakulangizeni mankhwala ena owonjezera a chemotherapy omwe amapangidwira kuchiza lymphoma.

Chithandizo cha ALCL yoyambirira ya khungu

Chithandizo chofala kwambiri cha izi ndi opaleshoni . Ngati khansa yafalikira ku ma lymph nodes, mungafunikenso chithandizo cha radiation . Chithandizo cha radiation chimagwira ntchito potsogolera mphamvu ku maselo a khansa ndikuwononga.

ALCL yoyambirira ya khungu nthawi zambiri imatha kubwereranso mkati mwa zaka zisanu kuchokera pamene chithandizo chachitika. Ngati izi zitachitika, opaleshoni ndi chithandizo cha radiation zidzafunika kachiwiri.

Ngati muli ndi zotupa zomwe sizingachotsedwe ndi opaleshoni, kapena ngati khansa ikubwereranso, mungafunike chithandizo china. Izi zingaphatikizepo:

• Methotrexate Yomwa : Mankhwala ogwiritsidwa ntchito pochiza non-Hodgkin lymphoma.
• Bexarotene : Mankhwala ogwiritsidwa ntchito pochiza T-cell lymphoma yomwe imakhudza khungu.
• Brentuximab Vedotin : Mankhwala ogwiritsidwa ntchito pochiza ALCL ya m'thupi ndi mitundu ina ya ALCL yobwerezabwereza.
• Interferon : Mankhwala omwe amathandiza chitetezo cha mthupi lanu kuzindikira ndikulimbana ndi maselo a khansa, kuphatikizapo lymphoma.

Chithandizo cha BIA-ALCL

BIA-ALCL nthawi zambiri imatha kuchiritsidwa ndi opaleshoni yochotsa choyikamo cha m'mawere ndi maselo aliwonse a khansa ozungulira. Ngati opaleshoniyo siingatheke, chithandizo cha radiation chingaperekedwe kuti chiphe maselo a khansa.

Ngati khansa yabwerera kapena kufalikira kupitirira bere, dokotala wanu angakulangizeni mankhwala a chemotherapy omwe amagwiritsidwa ntchito pochiza ALK-negative ALCL. Izi zitha kuphatikizapo mankhwala a CHOP chemotherapy ndi mankhwala monga Brentuximab Vedotin.

Kodi ALCL ndi yoopsa bwanji?

Kaya mtundu wa khansa ndi wotani, ALCL ndi khansa yoopsa yomwe imafuna kuyang'aniridwa mosamala ndi chithandizo choyenera. Komabe, nthawi yomwe mukuyembekezera matenda ndi dongosolo la chithandizo zimadalira zinthu monga mtundu wa ALCL yomwe muli nayo, momwe mumayankhira chithandizo, ndi chigoli chanu cha International Prognostic Index (IPI) .

IPI idapangidwa ndi akatswiri a khansa kuti athandize kuneneratu zotsatira za matenda a non-Hodgkin lymphomas omwe akula mofulumira, kuphatikizapo ALCL ya m'thupi. Ziwerengerozo zimachokera pazifukwa zotsatirazi:

• zaka zanu.
• Luso lanu lochita ntchito za tsiku ndi tsiku.
• Kufikira pati khansa yanu yafalikira (gawo la khansa).
• Chiwerengero cha ma sebaceous glands omwe akhudzidwa.

Ngati muli ndi matenda a ALCL, funsani dokotala wanu momwe chiwerengero chanu cha IPI chimakhudzira mwayi wanu wochira.

Kodi chiŵerengero cha moyo wa ALCL ndi chotani?

Kuchuluka kwa moyo wa ALCL yokhazikika kumasiyana kwambiri. ALCL yokhala ndi ALK imagwirizanitsidwa ndi nthawi yayitali yopulumuka kuposa ALCL yopanda ALK. Kutengera ndi zinthu monga mtundu wanu wa khansa ndi chigoli cha IPI, kuchuluka kwa moyo wa zaka zisanu wa ALCL yokhala ndi ALK kumatha kuyambira 33% mpaka 90%. Mofananamo, kuchuluka kwa moyo wa zaka zisanu wa ALCL yopanda ALK kumatha kuyambira 13% mpaka 74%.

ALCL yoyambirira ya khungu ndi BIA-ALCL imakhala ndi kuchuluka kwabwino kwambiri kwa moyo. Ngakhale kuti ALCL yoyambirira ya khungu nthawi zambiri imachira ndipo imabwereranso mkati mwa zaka zisanu, chithandizo chotsatira chingakulitse moyo wanu. Kuchuluka kwa moyo kumakhala pafupifupi 80% patatha zaka zisanu mutapezeka ndi matendawa. Mu BIA-ALCL, ngati khansa yachotsedwa kwathunthu ndi opaleshoni, khansa nthawi zambiri imatha kwathunthu.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Nazi mafunso ofunikira omwe mungafunse dokotala wanu:

• Kodi ndili ndi mtundu wanji wa ALCL?
• Kodi khansa yanga yangofalikira pang'ono, kapena yafalikira?
• Kodi akatswiri mu gulu langa losamalira odwala ndi ndani?
• Kodi mukundilangiza chithandizo chanji?
• Kodi ndingathe bwanji kuthana ndi zotsatirapo zoyipa za chithandizo?
• Kodi chigoli changa cha IPI ndi chiyani?
• Kodi mwayi woti khansa yanga ibwerere mwakale ndi wotani?
• Kodi pali mwayi wotani woti khansa yanga ibwererenso?
• Kodi ndiyenera kubwera kangati kudzandionanso kuti ndione momwe ndikumvera?

Ndizachilendo kuchita mantha mukazindikira kuti muli ndi khansa. Komabe, chofunika kwambiri kukumbukira ndichakuti ALCL si mtundu umodzi wa khansa womwe uli ndi zotsatira zofanana . Mtundu wa ALCL womwe muli nawo umatsimikizira ngati umafalikira mofulumira kapena pang'onopang'ono. Zimenezi zidzasintha njira zanu zochiritsira komanso momwe mukuonera. ALCL ya anthu ena imafalikira mofulumira. Kwa ena, imakula pang'onopang'ono, zomwe zimakupatsani nthawi yokwanira yopezera chithandizo chomwe chingathandize kuwongolera khansa. Lankhulani ndi dokotala wanu za zotsatira zomwe zingachitike kutengera matenda anu.

Zinthu zofunika kwambiri zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, tiyeni tifotokoze mwachidule zina mwa zinthu zofunika kwambiri zomwe muyenera kukumbukira kuchokera pa zomwe takambirana.

• ALCL ndi mtundu wa khansa wosowa kwambiri, ndipo pali mitundu yosiyanasiyana ya khansa.
• Si mitundu yonse ya ALCL yomwe ndi yofanana. Ina imafalikira mofulumira, ina pang'onopang'ono.
• Chithandizo ndi mwayi wochira zimasiyana malinga ndi mtundu wa ALCL womwe muli nawo, zaka zanu, komanso thanzi lanu lonse.
• Ngakhale kuti ALCL yokhala ndi ALK imapezeka kawirikawiri mwa achinyamata, imayankha bwino ikalandira chithandizo.
• ALCL yopanda ALK imakhudza akuluakulu ambiri ndipo ikhoza kukhala yovuta kuchiza.
• Nthawi zambiri, zizindikiro za matenda a ALCL a pakhungu ndi ALCL yolumikizidwa ndi bere (BIA-ALCL) zimakhala zabwino.
• Musachite mantha. Ngati muli ndi kukayikira kapena zizindikiro zilizonse, funsani upangiri wa dokotala nthawi yomweyo.
• Kambiranani momasuka ndi dokotala wanu za matenda anu, chithandizo chanu, ndi mafunso aliwonse omwe mungakhale nawo. Iwo ndi omwe angakuthandizeni bwino kwambiri.

Kumbukirani, si matenda onse a khansa omwe ali oopsa mofanana. Ngakhale ndi ALCL, ndi matenda olondola, chithandizo chachangu, komanso kuyang'aniridwa bwino, anthu ambiri amatha kupeza zotsatira zabwino.

` Anaplastic Large Cell Lymphoma, ALCL, Lymphoma, Khansa, T Cells, ALK Gene, Chemotherapy