Tiyeni tiphunzire za khansa ya DLBCL (Diffuse Large B-Cell Lymphoma) m'njira yosavuta.

Kodi mudamvapo za matenda otchedwa `Diffuse Large B-Cell Lymphoma` kapena `DLBCL`? Uwu ndi mtundu wa khansa womwe umafalikira mofulumira pang'ono. Koma musadandaule, ngati utapezeka msanga ndikuchiritsidwa bwino , ukhoza kuchiritsidwa . Lero, tiyeni tikambirane za `DLBCL` iyi mwachidule.

Kodi DLBCL ndi chiyani?

DLBCL ndi khansa ya m'magazi. Mu matendawa, mtundu wa maselo oyera a m'magazi otchedwa maselo a B (omwe amatchedwanso ma lymphocyte) m'thupi mwathu umakhala khansa. Uwu ndiye mtundu wa lymphoma wofala kwambiri, womwe umakula mofulumira, komanso woopsa kwambiri wotchedwa non-Hodgkin lymphoma. Dongosolo lathu la lymphatic limalimbana ndi majeremusi. DLBCL ikakula, maselo a B awa amakhala khansa ndipo amakula mofulumira, zomwe zimapangitsa kuti maselo athanzi asatuluke. Kenako sangathe kulimbana ndi majeremusi. Maselo a khansa awa amatha kupangika kulikonse, kuphatikizapo ma lymph nodes, kugaya chakudya, ndi ubongo. Ngakhale kuti ndi oopsa, amatha kuchiritsidwa ngati atapezeka msanga.

Kodi mitundu ya DLBCL ndi iti?

Bungwe la World Health Organization (WHO) lapeza mitundu ingapo ya DLBCL. Madokotala amagwiritsa ntchito mtundu uliwonse kuti adziwe momwe khansa imapitira patsogolo komanso momwe imayankhira chithandizo. Kugawidwa kumeneku kumakhudzidwa kwambiri ndi:

• Kusintha kwa majini m'maselo.
• Malo m'thupi kumene DLBCL imayambira (monga, dongosolo la mitsempha lapakati - `CNS`).
• Kugwirizana ndi kachilombo (monga kachilombo ka Epstein-Barr - EBV).

Ndikofunikira kwambiri kufunsa dokotala wanu za mtundu wa DLBCL womwe muli nawo.

Kodi izi ndizofala bwanji?

DLBCL ndiye mtundu wofala kwambiri wa lymphoma. Komabe, DLBCL si yofala kwambiri pakati pa khansa. Mwachitsanzo, DLBCL imapezeka mwa anthu pafupifupi 6 pa anthu 100,000. Izi zimachitika kawirikawiri poyerekeza ndi khansa zina.

Kodi zizindikiro za DLBCL ndi ziti?

Chizindikiro chofala kwambiri cha DLBCL ndi kutupa kwa ma lymph nodes m'khosi, m'khwapa, kapena m'mimba . Izi zingayambe ngati chotupa, pang'onopang'ono zimakula, ndipo sizingakhale zopweteka.

Anthu ena (pafupifupi m'modzi mwa atatu) amathanso kukhala ndi zizindikiro zapadera zotchedwa "zizindikiro za B" :

• Malungo (opitirira 39.5 Celsius) omwe amakhala kwa masiku opitilira awiri kapena amabwera ndikutha.
• Kuchepetsa thupi ndi 10% m'miyezi isanu ndi umodzi popanda chifukwa chilichonse.
• Kutuluka thukuta kwambiri usiku, kotero kuti machira ogona amanyowa.

Musaope kuganiza kuti ndi DLBCL ngakhale mutakhala ndi zizindikirozi. Komabe, ngati zikupitirira kwa milungu ingapo, pitani kwa dokotala.

N’chifukwa chiyani DLBCL imayamba? Kodi zinthu zoopsa ndi ziti?

DLBCL imayamba chifukwa cha kusintha kwa maselo a B. Izi ndi kusintha kwa majini komwe kumachitika nthawi ya moyo . Chifukwa chenicheni sichikudziwika, koma pali zinthu zingapo zomwe zapezeka zomwe zimawonjezera chiopsezo:

• Zaka:Kawirikawiri matendawa amapezeka mwa anthu azaka za m'ma 60. Avereji ya zaka zomwe munthu amadwala matendawa ndi pafupifupi zaka 64.
• Jenda: Amuna amatha kukhala ndi vutoli pang'ono kuposa akazi.
• Mbiri ya banja: Ngati wachibale wanu wa digiri yoyamba (kholo, m'bale, mwana) ali ndi DLBCL, mungakhale ndi chiopsezo chowonjezeka pang'ono chotenga matendawa (chifukwa chake sichinadziwikebe).
• Matenda: Mavairasi monga kachilombo ka Epstein-Barr (EBV), kachilombo koyambitsa matenda a chitetezo chamthupi (HIV), ndi matenda a chiwindi a mtundu wa B ndi C.
• Kufooka kwa chitetezo chamthupi: Kukhala ndi `primary immunodeficiency` kapena `autoimmune disorder`, kapena kumwa `immunosuppressants` mutaika chiwalo. Ichi ndi chinthu chachikulu chomwe chingayambitse chiopsezo.
• Kuchuluka kwa thupi (BMI) ali wamng'ono komanso kukhudzana ndi zinthu zina zoopsa zomwe zimagwiritsidwa ntchito paulimi.

Ngakhale zinthu zimenezi zilipo, si aliyense amene angazikonze, kapena angathe kuzikonze. Koma ndikofunikira kudziwa izi.

Kodi DLBCL imapezeka bwanji? (Kuzindikira)

Madokotala amatsimikiza DLBCL kudzera mu biopsy ya lymph node (kutenga chidutswa chaching'ono cha lymph node yotupa kuti akachiwone) ndi kuyezetsa majini. Ngati DLBCL yatsimikizika, mayeso ena amachitidwa kuti aone ngati khansa yafalikira:

• Kuyezetsa magazi: Kuwerengera magazi onse (CBC), kuti muwone ngati pali mavairasi monga HIV, EBV, ndi chiwindi.
• Kuyesa kwa Lactate dehydrogenase (LDH): Enzyme iyi imapezeka kwambiri mwa odwala ambiri a DLBCL.
• Mayeso owunikira: CT scan, MRI scan, PET scan.
• `Kufufuza za mafupa` .
• Kuboola kwa msana (kufufuza madzi a msana).

Madokotala amapanga zisankho zokhudza matenda anu ndipo amakonza chithandizo kutengera zomwe apeza kuchokera ku mayeso onsewa.

Kodi magawo a DLBCL ndi ati?

Njira zoyezera khansa zimagwiritsidwa ntchito kudziwa momwe khansa yakulira komanso kufalikira. Izi zimathandiza kukonzekera chithandizo ndi kuneneratu za matenda. Magawo a DLBCL ndi awa:

• Gawo Loyamba: Khansa imapezeka mu lymph node imodzi yokha, chiwalo chimodzi mu lymphatic system, kapena gawo limodzi la chiwalo chimodzi kunja kwa lymphatic system.
• Gawo Lachiwiri: Lymphoma imapezeka m'magulu angapo a ma lymph nodes mbali imodzi ya diaphragm.
• Gawo Lachitatu: Khansa imapezeka m'maselo a lymph mbali zonse ziwiri za diaphragm.
• Gawo Lachinayi:Khansa ya DLBCL yafalikira ku ziwalo zomwe zili kunja kwa dongosolo la lymphatic (monga mafupa, chiwindi, mapapo).

Madokotala amatcha magawo I ndi II "magawo oyambirira" ndipo magawo III ndi IV "magawo apamwamba."

Kodi mankhwala a DLBCL ndi ati?

Chithandizo chofala kwambiri cha DLBCL ndi R-CHOP . Izi zimaphatikizapo kuphatikiza kwa monoclonal antibody yotchedwa rituximab, mitundu ingapo ya chemotherapy, ndi corticosteroid. Ngakhale chithandizochi chikagwira ntchito bwino, matendawa angabwererenso (pafupifupi 30%-40%). Ngati izi zitachitika, dokotala wanu angakulangizeni njira zina zothandizira:

• Chithandizo chachiwiri ndi `kuika maselo oyambira a autologous`.
• `Chithandizo cha maselo a CAR T`: Ichi ndi `chithandizo cha chitetezo chamthupi`.
• `Thandizo lolunjika`: Mankhwala omwe amayang'ana kusintha kwa majini.

Kumbukirani, dokotala wanu adzakukonzerani chithandizo chabwino kwambiri kutengera vuto lanu.

Kodi chitukuko cha DLBCL chingalepheretsedwe?

Palibe njira yopewera DLBCL kwathunthu. Pali zinthu zomwe sitingathe kuziletsa. Komabe, pali njira zomwe tingachite kuti tidziteteze ku matenda omwe angagwirizane ndi DLBCL, monga chiwindi ndi HIV. Ndibwinonso kuyesa kusunga index ya body mass index (BMI) yabwino. Izi zingathandize kuchepetsa chiopsezo chanu pamlingo winawake.

Kodi munthu amene ali ndi DLBCL angayembekezere chiyani?

Mitundu ina ya DLBCL imatha kukhala yoopsa komanso yovuta kuchiza. Komabe, madokotala nthawi zambiri amatha kuchiza ndikuchiritsa matendawa . Nthawi zambiri, chithandizo chamankhwala cham'tsogolo chingapangitse DLBCL kukhala bwino (mkhalidwe womwe palibe zizindikiro kapena zizindikiro za khansa). Pafupifupi 60% ya anthu omwe ali ndi DLBCL amachiritsidwa ndi chithandizo choyamba. Pa avareji, anthu omwe alibe khansa patatha zaka ziwiri atapezeka ndi matendawa amatha kuyembekezera kukhala ndi moyo wabwinobwino, mofanana ndi anthu ena azaka zawo. Chiŵerengero cha kupulumuka chimakhala chokwera kwambiri ngati khansa yapezeka msanga .

Komabe, zomwe mwakumana nazo zidzadalira zinthu zambiri, kuphatikizapo mtundu wa DLBCL womwe muli nawo, gawo la khansa, komanso thanzi lanu lonse. Dokotala wanu yekha ndi amene angakupatseni chidziwitso chabwino kwambiri pankhaniyi.

Kodi ndimadzisamalira bwanji? (Kudzisamalira)

Kukhala ndi khansa sikophweka, n'kotopetsa kwambiri. Ndikofunikira kwambiri kudzisamalira pamene mukulandira chithandizo cha `DLBCL`.

• Zakudya: Idyani zakudya zabwino komanso zopatsa thanzi. Funsani dokotala wanu zomwe muyenera kudya komanso zomwe muyenera kupewa.
• Mpumulo:Chithandizo chingayambitse kutopa. Pumulani mokwanira.
• Kuchita Masewera Olimbitsa Thupi: Kuchita masewera olimbitsa thupi pang'ono kungathandize kuchepetsa nkhawa.
• Thandizo: Ili ndi vuto losowa, kotero limatha kusungulumwa. Lowani m'magulu othandizira komwe kuli anthu ngati inu. Lankhulani ndi achibale ndi abwenzi.

Kufunika kuwona dokotala ndi zadzidzidzi

Mudzaonana ndi dokotala wanu nthawi zonse mukalandira chithandizo. Ngakhale chithandizo chitatha, muyenera kumuona miyezi itatu kapena inayi iliyonse kwa zaka ziwiri zoyambirira ndipo osachepera kawiri pa zaka zitatu zotsatira. Izi ndi zoti muwone ngati khansa yabwereranso. Ngati muli ndi zizindikiro zilizonse zoti khansa yabwerera, uzani dokotala wanu nthawi yomweyo.

Mankhwala monga chemotherapy akhoza kukhala ndi zotsatirapo zoyipa kwambiri. Ngati izi zitachitika , pitani kuchipatala mwamsanga :

• Zotsatirapo zoyipa kwambiri kuposa momwe zimayembekezeredwa.
• Malungo opitirira madigiri 38 Celsius (100.4 Fahrenheit).
• Kugwedezeka kosalekeza .
• Kupweteka kwambiri m'mimba kapena kutsegula m'mimba kosalekeza .

Mafunso oti mufunse dokotala wanu okhudza DLBCL

Ndizachilendo kukhala ndi mafunso ambiri mukazindikira kuti muli ndi DLBCL. Ndikofunikira kuti mufunse dokotala wanu mafunso monga awa:

• Kodi ndi mtundu wanji wa `Diffuse Large B-Cell Lymphoma` yomwe ndili nayo? Kodi `siteji` ndi chiyani?
• Kodi ndikufunika chithandizo chamtundu wanji? Kodi zotsatira zake ndi ziti?
• Kodi mankhwala amenewa adzachiritsa khansa kwathunthu?
• Ndi mankhwala otani omwe alipo ngati khansa yabwerera?
• Kodi munganditumizire ku gulu lothandizira anthu omwe ali ndi khansa yamtunduwu?

Kuwonjezera pa mafunso awa, musaope kufunsa dokotala wanu chilichonse chomwe muli nacho m'maganizo mwanu kapena kukayikira kulikonse komwe mungakhale nako.

Pomaliza, kumbukirani (Uthenga Wopita Nawo Kunyumba)

Ambiri a ife tikamva mawu oti "aggressive" tikamalankhula za khansa, timaganiza kuti ndi matenda osachiritsika komanso ovuta kuchiza. Koma sizili choncho ndi Diffuse Large B-Cell Lymphoma (DLBCL). Ngakhale kuti DLBCL imatha kufalikira mofulumira, mankhwala a khansa omwe alipo pano nthawi zambiri amatha kupha maselo a B omwe ali ndi khansa. Madokotala amagwiritsanso ntchito mawu ngati "cure" akamalankhula za matenda a anthu ena.

Chofunika kwambiri ndikufunsa dokotala wanu momwe matenda anu angakhudzire momwe chithandizo chanu chingakhudzire. Choncho, musachite mantha, dziwani, ndipo tsatirani malangizo a dokotala wanu. Musaiwale kuti DLBCL ikhoza kuthetsedwa mwa kuzizindikira msanga ndi kulandira chithandizo choyenera!

Khansa , lymphoma, maselo a B, ma lymph node, zizindikiro, chithandizo, DLBCL, chemotherapy, chithandizo cha immunotherapy