Reka twige kuri Anaplastic Large Cell Lymphoma (ALCL) mu magambo yoroheje.

Ese wigeze wumva Anaplastic Large Cell Lymphoma (ALCL)? Wenda iri zina rishobora kuba rigoye gato. Ariko ntugahangayike, iyi ni kanseri idakunze kugaragara. Uyu munsi turaganira kuri ALCL icyo ari cyo, uko ikura, ibimenyetso byayo, uburyo ivurwa, n'ibindi byinshi mu buryo bworoshye cyane ushobora kumva. Kimwe no kuganira n'inshuti yawe.

ALCL (Anaplastic Large Cell Lymphoma) ni iki?

Muri make, ALCL ni ubwoko bwa kanseri idasanzwe kandi idakunze kugaragara, ikaba iri mu itsinda rinini rya kanseri zitwa Non-Hodgkin Lymphoma . Ese wari uzi ko kimwe n'izindi Non-Hodgkin Lymphoma, ALCL nayo ni ubwoko bwa kanseri? Ibaho iyo ubwoko bw'uturemangingo tw'amaraso twitwa lymphocytes mu mubiri wacu dukura mu buryo butunguranye kandi ku muvuduko urenze uwo bikwiye.

Tekereza kuri izi lymphocytes nk'abasirikare bato mu mibiri yacu. Ni bimwe mu bigize ubudahangarwa bwacu bw'umubiri, biturinda mikorobe n'indwara. Hari ubwoko bubiri bw'ingenzi bwa lymphocytes: Selile B na Selile T. Muri ALCL, lymphocytes T, cyangwa selile T, zikura mu buryo budasanzwe.

Noneho reka turebe icyo iri zina "lymphoma nini ya anaplastic" risobanura.

• Anaplastic : Iri jambo risobanura ko iyo urebye ukoresheje mikorosikopi, izi selile za kanseri zisa n'izidasanzwe kandi zitandukanye ugereranije n'uturemangingo twa T lymphocyte tuzima. Ni nk'aho imiterere yazo n'isura yazo byahindutse.
• Akaremangingo Kanini : Ibi bivuze ko limfozeti za T zikora mu buryo budasanzwe zisa n'izinini kurusha utunyangingo twa T dusanzwe. Iri tandukaniro rigaragara neza hifashishijwe mikorosikopi.
• Lymphoma : Lymphoma ni kanseri iterwa no gukura ku buryo butunguranye kw'uturemangingo tw'amaraso tw'umweru twitwa lymphocytes. ALCL ikura by'umwihariko muri lymphocytes T.

Urabyumva? Mu magambo make, ALCL ni kanseri aho uturemangingo twa T tuba tunini cyane, tugahinduka, kandi tugakura mu buryo butunguranye.

Ese hari ubwoko butandukanye bwa ALCL?

Yego, hari ubwoko butandukanye bwa ALCL. Ubu bwoko bushyirwa mu byiciro hashingiwe ku gace kanseri iherereyemo mu mubiri wawe n'imiterere y'uturemangingo twa kanseri.

ALCL isanzwe

Ubu ni bwo bwoko bw'ingenzi. "Systemic" bivuze ko ishobora kugira ingaruka ku mubiri wose. Ishobora kugira ingaruka ku mitsi yawe, cyangwa "glands" nk'uko tuyita, no ku ngingo z'imbere nk'umwijima n'ibihaha byawe, ndetse rimwe na rimwe n'uruhu rwawe.

ALCL y’umubiri igabanyijemo ubwoko bubiri. Bumwe bushingiye ku kuba hari impinduka mu ngirabuzimafatizo yitwa ``Anaplastic Lymphoma Kinase (ALK)'' . Ingirabuzimafatizo ni nk'ibitabo bito by'amabwiriza ku turemangingo twacu, kandi izi ngirabuzimafatizo zibwira ndetse na lymphocyte ya T uko ikora.

• ALCL ifite ALK: Iyi ni ubwoko bwa kanseri ifite impinduka mu ngirabuzimafatizo ya ALK. Iyi akenshi ni kanseri ikomeye. Ariko, ikunze kugaragara cyane mu bana no mu rubyiruko . Ku bw'amahirwe, iyi kanseri ikira neza imiti ivura kanseri .
• ALCL idakoresha ALK : Ubu bwoko ntabwo bufite ALK mutation. Iyi na yo ni kanseri ikura vuba (itera ubukana). Ariko, yibasira cyane abantu bakuze , akenshi abarengeje imyaka 60. Ubu bwoko bushobora koroherwa nyuma yo guhabwa imiti ya chimiotherapie hanyuma bukagaruka. Kubwibyo, ALCL idakoresha ALK iragoye kuvura, kandi ubwiyongere bw'indwara ni bubi kurusha ALCL idakoresha ALK.

Ubundi bwoko bwa ALCL

Hariho kandi ubwoko bwa ALCL bukura buhoro kurusha ubwoko bwa systemic.

• ALCL y'ibanze y'uruhu : Iyi ni ubwoko bw'indwara yibasira uruhu cyane cyane. Ibimenyetso nk'uduheri, ibibyimba, na eczema bishobora kugaragara. Akenshi (hafi 90%) ntikwirakwira hirya y'uruhu.
• ALCL ifitanye isano na breast implant (BIA-ALCL) : Ubu ni ubwoko bwa ALCL butera hafi ya breast implants. Ubusanzwe irasuzumwa nyuma y'imyaka 10 nyuma yo kongera ibere cyangwa kongera ibere.

Ni nde uhabwa ALCL?

Nubwo ALCL ishobora kugaragara ku bantu b'imyaka iyo ari yo yose, hari ubwoko bumwe na bumwe bugira ingaruka cyane ku matsinda amwe n'amwe.

• ALCL ifite ALK : Ibi bikunze kwibasira abana bo mu kigero cyo kurangiza amashuri y'incuke, ingimbi n'abangavu bari mu kigero cy'imyaka 20 na 30. Bikunze kwibasira abagabo .
• ALCL idakoresha ALK : Ibi byibasira cyane abantu barengeje imyaka 60. Bikunze kandi kugaragara ku bagabo.
• ALCL y'uruhu rw'ibanze : Ibi bikunze kubaho cyane ku bantu bakuru barengeje imyaka 40. Bikunze kugaragara cyane ku bagabo no ku bazungu.
• BIA-ALCL : Ibi bikunze gupimwa ku bantu bari mu kigero cy'imyaka 50. Bishobora kugaragara ku bantu batewe inshinge za silicone na saline. Byagaragaye ko bifitanye isano cyane cyane n'inshinge z'amabere zifite imiterere itandukanye .

ALCL ikunze kugaragara gute?

Mu by’ukuri ALCL ni kanseri idakunze kugaragara cyane . Hafi 2% by’indwara za lymphoma zitari iza Hodgkin mu bantu bakuru ni zo zifatwa nka ALCL. Ni igipimo gito cyane.

Ni ibihe bimenyetso bya ALCL?

Ibimenyetso bya ALCL biratandukanye bitewe n'ubwoko.

Ibimenyetso bya ALCL yo mu mubiri

Muri ALCL ya ALK-positive na ALK-negative, utunyangingo twa lymph tubyimba ni two dukunze kugaragara aho kanseri ikurira. Dushobora kumva nk'utubyimba ahantu nko mu ijosi, mu kwaha, cyangwa mu kibuno . Ibindi bimenyetso birimo:

• Guhorana umuriro.
• Kumva unaniwe cyane (`Umunaniro`).
• Kubira ibyuya nijoro (`Kubira ibyuya nijoro`).
• Kugabanya ibiro mu buryo budasanzwe.

Iyo abantu benshi bapimwe, kanseri ishobora kuba yarakwirakwiriye gato, bivuze ko iri mu cyiciro cyo hejuru . Muri icyo gihe, kanseri ishobora kuba yarakwirakwiriye mu ngingo nko mu bihaha byawe, mu mwijima, cyangwa mu magufwa. Hanyuma, ibimenyetso bishobora kugaragara bitewe n'urugingo rwafashwe. Urugero, niba ufite igituza gifunganye cyangwa inkorora ikunze kugaragara, ALCL ishobora kuba yarafashe igituza.

Ibiranga ALCL y'ibanze y'uruhu

Impinduka z'uruhu zishobora kugaragara muri ubu bwoko.

• Utubyimba tudasanzwe dutukura cyangwa dutukura-umukara tugaragara ku gice kimwe cyangwa byinshi by'uruhu, dushobora kwiyongera uko igihe kigenda gihita.
• Ibibyimba byazamutse , binini kurusha igiceri. Hari igihe bishobora gukurura.
• Ibibyimba bishobora kubabara hanyuma bigahinduka ibisebe .

Ibiranga BIA-ALCL (AlCL ifitanye isano n'ibere)

Muri ibi, impinduka zigaragara mu mabere zishobora kugaragara.

• Kubabara mu ibere.
• Kubyimba amabere.
• Uruhu rurwaye ibisebe cyangwa eczema.
• Kubyimba cyangwa amazi yiyongera hafi y'igitereko cyawe.
• Ikibyimba gikomeye hafi y'aho ibere rishyirwa.

Izi mpinduka zikunze kugaragara mu ibere rimwe, ariko hari igihe impinduka zishobora kugaragara mu mabere yombi.

Ni iki gitera ALCL?

ALCL ibaho iyo uturemangingo twa lymphocyte twavuze mbere twiyongera mu buryo butunguranye kandi tugatangira gukura turenze uturemangingo twiza tuyikikije. Abashakashatsi ntibaramenya neza impamvu utwo turemangingo twa lymphocyte tuba kanseri (uturemangingo twangiza).

Ariko, basanze hari impinduka nyinshi mu ngirabuzimafatizo zikunze kugaragara kuri ALCL. Bikekwa ko izi mpinduka mu ngirabuzimafatizo zishobora gutuma uturemangingo tuzima duhinduka uturemangingo twa kanseri.

Urugero, ikintu cy'ingenzi kiranga ALCL ifite ALK ni impinduka mu ngirabuzimafatizo ya ALK . Mu buryo nk'ubwo, izindi mpinduka mu ngirabuzimafatizo nazo zikunze kugaragara mu bundi bwoko bwa ALCL.

ALCL ipimwa ite? (Isuzuma)

Muganga wawe azabanza gukora isuzuma ry’umubiri kugira ngo arebe ibimenyetso bya ALCL, urugero nk'uturemangingo twa lymph twabyimbye. Niba abikeka, azakora ibizamini n'uburyo butandukanye bwo kuvura.

• Uburyo bwo gufata amashusho: Ibi bishobora gufasha kumenya aho kanseri iri. Ubwoko bw'ibizamini byo gupima ugomba gupima buzatandukana bitewe n'ubwoko bwa ALCL. Muganga wawe ashobora gukora X-ray yo mu gituza , CT scan , cyangwa MRI kugira ngo arebe ko hari ibibyimba. PET scan cyangwa PET scan bishobora gufasha kumenya niba kanseri yarakwirakwiriye mu mubiri wose. Niba bikekwa ko BIA-ALCL ihari, hashobora gukorwa ultrasound yo mu ibere .
• Gupima amaraso : Muganga azakora ibizamini bitandukanye by'amaraso, nko gusuzuma umubare wuzuye w'amaraso (CBC), kugira ngo arebe ibimenyetso bya ALCL. Niba umubare w'uturemangingo tw'amaraso (uturemangingo dutukura, uturemangingo tw'amaraso twera, cyangwa plaquettes) utari usanzwe, bishobora kuba ikimenyetso cya ALCL. Bazashaka kandi enzymes zimwe na zimwe n'ibindi bimenyetso mu maraso, kuko ibi bishobora no kuba ibimenyetso bya ALCL.
• Isuzuma ry'umubiri : Uburyo bwonyine bwo kwemeza ko ALCL yasuzumwe ni ugukora isuzuma ry'umubiri. Mu isuzuma ry'umubiri, muganga afata agace gato k'uturemangingo dukekwaho icyaha akagasuzuma akoresheje mikorosikopi. Mu kwiga utwo turemangingo, muganga ashobora kumenya neza ubwoko bwa ALCL ufite. Ibi kandi bifasha gutegura uburyo bwiza bwo kuvura.

ALCL ivurwa ite?

Uburyo busanzwe bwo kuvura ALCL yo mu mubiri ni imiti ivura indwara ya chimiotherapie . Kubaga ni bwo buryo bwiza bwo kuvura ALCL yo mu bwoko bwa mbere bw'uruhu na BIA-ALCL.

Kuvura ALCL mu mubiri

Imiti ya lymphoma ya ALK-positive na ALK-negative anaplastic cell lymphomas ikunze kwakira neza imiti ya chemotherapy. Imiti ya chemotherapy ikubiyemo gutanga imiti yica kanseri binyuze mu mitsi, ikanyura mu mubiri wose mu maraso kugira ngo yica uturemangingo twa kanseri.

Ubwinshi bw'imiti ikoreshwa mu kwica uturemangingo twa kanseri (chimiotherapie) muri ALCL. Ingero zimwe na zimwe zirimo:

• BV-CHP : Ibi birimo imiti `Brentuximab Vedotin`, `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, na `Prednisone`.
• CHOP : Ibi bikubiyemo ikoreshwa ry'imiti yitwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Vincristine (Oncovin®)`, na `Prednisone`.
• CHEOP : Ibi bikubiyemo ikoreshwa ry'imiti yitwa `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Etoposide`, `Vincristine (Oncovin®)`, na `Prednisone`.

Ubu buryo bwo kuvura bushobora gutuma ibimenyetso byose bya kanseri bishira mu gihe gito (ibi tubyita 'remission').(Byitwa "gusubira inyuma") Ariko, kanseri ishobora kugaruka. Niba muganga wawe atekereza ko kanseri ishobora kugaruka, ashobora kukugira inama yo gutera uturemangingo tw’umubiri mu gihe uri mu kaga. Gutera uturemangingo tw’umubiri bisimbura uturemangingo twangijwe na chimiotherapie hamwe n’uturemangingo tuzima. Utu turemangingo tuzima hanyuma tugakora uturemangingo tw’amaraso tuzima (tutari kanseri).

Iyo kanseri igarutse, muganga wawe ashobora kukugira inama y’ubundi buryo butandukanye bwo kuvura kanseri ya lymphoma.

Kuvura ALCL y'ibanze y'uruhu

Uburyo bukunze kuvura ibi ni ukubagwa . Niba kanseri yarakwirakwiriye mu tunyangingo tw’amaraso, ushobora no gukenera ubuvuzi bushingiye ku mirasire . Ubuvuzi bushingiye ku mirasire bukora binyuze mu kuyobora ingufu ku tunyangingo twa kanseri no kutwica.

ALCL y'ibanze y'uruhu ishobora kongera kugaruka mu myaka itanu nyuma yo kuvurwa. Ibi nibibaho, kubagwa no kuvurwa hakoreshejwe imirasire bizakenerwa nanone.

Niba ufite ibibyimba biri mu gace runaka bidashobora gukurwaho ukoresheje kubagwa, cyangwa niba kanseri ikomeje kugaruka, ushobora gukenera ubundi buryo bwo kuvura. Ibi bishobora kuba birimo:

• Methotrexate yo mu kanwa : Umuti ukoreshwa mu kuvura lymphoma itari iya Hodgkin.
• Bexarotene : Umuti ukoreshwa mu kuvura lymphoma ya T-cell yibasira uruhu.
• Brentuximab Vedotin : Umuti ukoreshwa mu kuvura ALCL yo mu mubiri n'ubundi bwoko bwa ALCL isubira.
• Interferon : Umuti ufasha ubudahangarwa bw'umubiri wawe kumenya no kurwanya uturemangingo twa kanseri, harimo na lymphoma.

Uburyo bwo kuvura BIA-ALCL

BIA-ALCL ishobora gukira hakoreshejwe kubagwa kugira ngo ibere ryawe rikuremo uturemangingo twa kanseri hamwe n'uturemangingo twa kanseri tubikikije. Niba kubagwa bidashoboka, imiti ivura kanseri ishobora gutangwa kugira ngo yica uturemangingo twa kanseri.

Iyo kanseri igarutse cyangwa ikagera hirya y'ibere, muganga wawe ashobora kukugira inama yo gukoresha imiti ya chimiotherapie ikoreshwa mu kuvura ALCL idakoresha ALK. Iyi miti ishobora kuba ikubiyemo imiti ya chimiotherapie ya CHOP n'imiti nka Brentuximab Vedotin.

ALCL ifite uburemere bungana iki?

Uko ubwoko bwa ALCL bwaba buri kose, ni kanseri ikomeye isaba gukurikiranwa neza no kuvurwa neza. Ariko, imiterere y'indwara yawe n'uburyo bwo kuyivura biterwa n'ibintu nk'ubwoko bwa ALCL ufite, uburyo witwara mu kuvurwa, ndetse n'amanota yawe mpuzamahanga yo gupima indwara (IPI) .

IPI yakozwe n'abaganga b'inzobere mu kuvura kanseri kugira ngo bafashe kumenya ingaruka z'indwara ziterwa na limfome zitari iza Hodgkin zikura vuba, harimo na ALCL isanzwe. Amanota ashingiye ku bintu bikurikira:

• imyaka yawe.
• Ubushobozi bwawe bwo gukora imirimo ya buri munsi.
• Uburyo kanseri yawe yakwirakwiriye (icyiciro cya kanseri).
• Umubare w'uturemangingo tw'ibinure byangiritse.

Niba ufite ALCL isanzwe, baza muganga wawe uburyo amanota yawe ya IPI agira ingaruka ku mahirwe yawe yo gukira.

Igipimo cyo kubaho cya ALCL ni ikihe?

Igipimo cy’ubuzima ku bantu barwaye ALCL mu buryo bw’umubiri kiratandukanye cyane. ALCL ifite ALK ifitanye isano n’igihe kirekire cyo kubaho ugereranyije na ALCL ifite ALK. Bitewe n’ibintu nk’ubwoko bwa kanseri yawe n’amanota ya IPI, igipimo cy’ubuzima bw’imyaka itanu ku bantu barwaye ALCL ifite ALK gishobora kuva kuri 33% kugeza kuri 90%. Mu buryo nk’ubwo, igipimo cy’ubuzima bw’imyaka itanu ku bantu barwaye ALCL ifite ALK gishobora kuva kuri 13% kugeza kuri 74%.

ALCL y'uruhu rw'ibanze na BIA-ALCL bifite igipimo cyiza cyane cyo kubaho. Nubwo ALCL y'uruhu rw'ibanze ikunze koroherwa ikagaruka mu myaka itanu, ubuvuzi bukurikira bushobora kongera igihe cyo kubaho. Igipimo cyo kubaho ni hafi 80% nyuma y'imyaka itanu urwaye. Muri BIA-ALCL, iyo kanseri ikuweho burundu ubanje kubagwa, kanseri ikunze kurangira burundu.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Dore ibibazo by'ingenzi ugomba kubaza muganga wawe:

• Ni ubuhe bwoko bwa ALCL mfite?
• Ese kanseri yanjye iherereye ahantu hamwe gusa, cyangwa yakwirakwiriye?
• Ni bande bahanga mu itsinda ryanjye ryita ku barwayi?
• Ni ubuhe buryo bwo kuvura wangiriye inama?
• Ni gute nakwitwara mu guhangana n'ingaruka mbi zo kuvurwa?
• Amanota yanjye ya IPI ni angahe?
• Ni amahirwe angahe yo kuba kanseri yanjye ishobora 'kugabanuka'?
• Ni amahirwe angahe ko kanseri yanjye izagaruka?
• Ni kangahe ngomba kuza gusura muganga kugira ngo nkurikirane uko merewe?

Ni ibisanzwe kumva ufite ubwoba iyo umenye ko urwaye kanseri. Ariko, ikintu cy'ingenzi ugomba kwibuka ni uko ALCL atari ubwoko bumwe bwa kanseri bufite ingaruka zimwe . Ubwoko bwa ALCL ufite bugena niba ikwirakwira vuba cyangwa buhoro. Ibyo bizahindura uburyo bwo kuvura n'uko ubona ibintu. ALCL y'abantu bamwe ikwirakwira vuba. Ku bandi, ikura buhoro buhoro, ikaguha umwanya uhagije wo kubona imiti ishobora gufasha mu kurwanya kanseri. Vugana na muganga wawe ku ngaruka zishobora kubaho bitewe n'uko wanduye.

Ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Sawa, reka tuvuge muri make bimwe mu bintu by'ingenzi ugomba kwibuka mu byo twavuze.

• ALCL ni ubwoko budasanzwe bwa kanseri, kandi hari ubwoko butandukanye bwayo.
• Ubwoko bwose bwa ALCL ntibumeze kimwe. Bumwe bukwirakwira vuba, ubundi buhoro buhoro.
• Uburyo bwo kuvurwa n'amahirwe yo gukira biratandukanye bitewe n'ubwoko bwa ALCL ufite, imyaka yawe, n'ubuzima bwawe muri rusange.
• Nubwo ALCL ifite ALK ikunze kugaragara cyane mu rubyiruko, ikira neza iyo ivuwe.
• ALCL idafite ALK ifata abantu bakuru benshi kandi ishobora kugorana kuyivura.
• Muri rusange, imiterere y’indwara ya ALCL yo mu rutugu n’iya ALCL ifitanye isano n’ibere (BIA-ALCL) ni myiza.
• Ntugatinye. Niba ufite gushidikanya cyangwa ibimenyetso, shaka ubufasha bwa muganga ako kanya.
• Vugana na muganga wawe nta guhisha ku bijyanye n'uburwayi bwawe, uburyo uvurwa, n'ibibazo byose ushobora kuba ufite. Ni bo bashobora kugufasha neza.

Wibuke ko indwara zose ziterwa na kanseri atari ko zingana. Nubwo haba hari ALCL, iyo habayeho gusuzuma neza, kuvurwa vuba no gukurikiranwa neza, abantu benshi bashobora kugera ku musaruro mwiza.

Lymphoma nini ya Anaplastic , ALCL, Lymphoma, Kanseri, T selile, Gene ya ALK, Chimiotherapie