Ngatidzidzei nezve Anaplastic Large Cell Lymphoma (ALCL) nenzira iri nyore.

Wakambonzwa nezve Anaplastic Large Cell Lymphoma (ALCL) here? Pamwe zita iri rinonzwika serakaoma zvishoma. Asi usazvidya moyo, iyi imhando yegomarara isingawanzoitiki. Nhasi tichataura nezve ALCL, kuti inokura sei, zviratidzo zvayo, marapirwo ayo, nezvimwe zvinhu zvakawanda nenzira iri nyore yaunogona kunzwisisa. Sekutaura neshamwari.

Chii chinonzi Anaplastic Large Cell Lymphoma (ALCL)?

Zvichitaurwa zviri nyore, ALCL igomarara risingawanzoonekwi, rinowanikwa muboka guru regomarara rinonzi Non-Hodgkin Lymphoma . Waizviziva here kuti semamwe maNon-Hodgkin Lymphoma, ALCL igomararawo? Rinoitika kana rudzi rwemasero machena eropa anonzi malymphocytes mumuviri wedu ruchikura zvisingadzoreki uye nekukurumidza kupfuura zvarunofanira kuita.

Funga nezvemalymphocyte aya semasoja madiki ari mumiviri yedu. Iwo chikamu chemuviri wedu wekudzivirira muviri, achitidzivirira kubva kuhutachiona nezvirwere. Kune mhando mbiri huru dzemalymphocyte: B cells neT cells . MuALCL, maT lymphocyte ako, kana kuti T cells, anokura zvisina kujairika.

Iye zvino ngationei kuti zita iri rekuti "anaplastic large cell lymphoma" rinorevei.

• Anaplastic : Izwi iri rinoreva kuti kana richitariswa nemaikorosikopu, masero aya egomarara anotaridzika seasinganzwisisike uye akasiyana zvikuru kana tichienzanisa nemasero eT lymphocyte ane hutano. Zvinoita sekunge chimiro chawo nechitarisiko chawo zvakanganiswa.
• Sero Guru : Izvi zvinoreva kuti maT lymphocytes asina kujairika anoita seakakura kupfuura maT cells akajairwa. Musiyano uyu unoonekwa zvakajeka pasi pemaikorosikopu.
• Lymphoma : Lymphoma igomarara rinokonzerwa nekukura kusingadzoreki kwemasero machena eropa anonzi malymphocytes. ALCL inokura zvakananga kubva kuT lymphocytes.

Wanzwisisa here? Zvichitaurwa zviri nyore, ALCL igomarara umo masero eT anokura zvisina kujairika, anochinja-chinja, uye anokura zvisingadzoreki.

Kune mhando dzakasiyana dzeALCL here?

Ehe, kune mhando dzakasiyana dzeALCL. Idzi dzinopatsanurwa zvichienderana nenzvimbo yekenza mumuviri wako uye hunhu hwemasero ekenza.

ALCL yemaitiro

Urwu ndirwo rudzi rukuru. "Systemic" zvinoreva kuti inogona kukanganisa muviri wese. Inogona kukanganisa ma lymph nodes ako, kana kuti "glands" sezvatinoadaidza, uye nhengo dzemukati dzakadai sechiropa nemapapu, uye dzimwe nguva ganda rako.

Systemic ALCL yakakamurwa kuita mhando mbiri. Imwe inobva pakuti pane shanduko here mujini inonzi ``Anaplastic Lymphoma Kinase (ALK)'' gene . Majini akafanana nemabhuku madiki emirairo yemasero edu, uye majini aya anoudza kunyange T lymphocyte mashandiro ayo.

• ALCL ine ALK-positive: Iyi imhando yegomarara rine shanduko mujini reALK. Iri rinowanzova gomarara rinotyisa. Zvisinei, rinowanzoonekwa muvana nevechidiki . Nerombo rakanaka, rudzi urwu runopindura zvakanaka kukemikoro .
• ALK-negative ALCL : Rudzi urwu haruna ALK gene mutation. Iyi igomarara rinokura nekukurumidza (rinorwisa). Zvisinei, rinonyanya kubata vanhu vakuru , kazhinji avo vane makore anopfuura makumi matanhatu ekuberekwa. Rudzi urwu runogona kupora mushure me chemotherapy uye rwozodzoka. Saka, ALK-negative ALCL yakaoma kurapa, uye fungidziro yechirwere ichi yakaipa kupfuura ALK-positive ALCL.

Mamwe marudzi eALCL

Kunewo mhando dzeALCL dzinokura zvishoma nezvishoma kupfuura dzemhando dzesystemic.

• ALCL yeganda rekutanga : Iyi imhando inonyanya kukanganisa ganda. Zviratidzo zvakaita semapundu, mapundu, uye eczema zvinogona kuitika. Kazhinji (anenge 90%) hazvipararire kupfuura ganda.
• ALCL inobatanidzwa nekuisa mazamu (BIA-ALCL) : Iyi imhando yeALCL inokura pakuisa mazamu. Inowanzoonekwa mushure memakore angangoita gumi mushure mekuwedzera mazamu kana kugadziriswa kwemazamu.

Ndiani anowana ALCL?

Kunyange zvazvo ALCL ichigona kukura muvanhu vezera ripi zvaro, mamwe marudzi anokanganisa mamwe mapoka zvakanyanya.

• ALCL ine ALK-positive : Izvi zvinonyanya kubata vana vechidiki vari muzera rekuenda kukireshi, vechidiki, uye vechidiki vari mumakore avo ekuma20 ne30 . Zvinowanzoitika kuvarume .
• ALK-negative ALCL : Izvi zvinonyanya kubata vanhu vane makore anopfuura makumi matanhatu. Zvinonyanyawo kuitika kuvarume.
• ALCL yeganda rekutanga : Izvi zvinowanzoitika kuvanhu vakuru vane makore anopfuura makumi mana. Zvinonyanya kuitika kuvarume nevanhu vachena.
• BIA-ALCL : Izvi zvinowanzoonekwa muvanhu vane makore ekuma50 . Zvinogona kuitika muvanhu vakamboiswa mapurasitiki emuzamu esilicone nesaline. Zvakaonekwa kuti zvine chekuita nekuiswa mapurasitiki emuzamu ane mavara .

ALCL yakajairika zvakadii?

ALCL igomarara risingawanzoitiki . Inenge 2% chete yezvirwere zve lymphomas zvisiri zveHodgkin muvanhu vakuru zvinoonekwa seALCL. Iroro chikamu chidiki kwazvo.

Ndezvipi zviratidzo zveALCL?

Zviratidzo zveALCL zvinosiyana zvichienderana nerudzi rwacho.

Zviratidzo zveAlCL yemuviri

Mu ALCL ine ALK-positive neALK-negative, ma lymph nodes akazvimba anowanzoonekwa munzvimbo dzine kenza. Anogona kunzwa semapundu munzvimbo dzakadai semutsipa, muhapwa, kana muhudyu . Zvimwe zviratidzo zvinosanganisira:

• Kugara uchidziya muviri.
• Kunzwa kuneta zvakanyanya ('Kuneta').
• Kudikitira husiku (`Kudikitira husiku`).
• Kudzikira uremu kusingatsananguriki.

Kana vanhu vazhinji vakawanikwa vaine chirwere ichi, kenza inogona kunge yapararira zvishoma, zvichireva kuti yava padanho repamusoro . Kana zvakadaro, kenza inogona kunge yapararira kunhengo dzakadai semapapu, chiropa, kana mapfupa. Zvadaro, zviratidzo zvinogona kuitika zvichienderana nenhengo inenge yabatwa nacho. Semuenzaniso, kana uine chipfuva chakamanikana kana kuti uchikosora nguva nenguva, ALCL inogona kunge yakanganisa chipfuva.

Hunhu hweganda rekutanga reALCL

Kuchinja kweganda kunogona kuonekwa murudzi urwu.

• Mapundu matsvuku kana matsvuku-tsvuku anoonekwa panzvimbo imwe chete kana kupfuura dzeganda, ayo anogona kukura nekufamba kwenguva.
• Mapundu akakura , akakura kupfuura mari. Dzimwe nguva anogona kuvaviwa.
• Mapundu anogona kurwadza obva aita chikwekwe .

Hunhu hweBIA-ALCL (Breast Implant-Associated ALCL)

Muizvi, kuchinja kwakajeka mumazamu kunogona kuonekwa.

• Kurwadziwa kwezamu.
• Kuzvimba kwemazamu.
• Mapundu paganda kana kuti eczema.
• Kuzvimba kana kuungana kwemvura pedyo nepamuchina wepazamu.
• Chigamba chakasimba chiri pedyo nepachinoiswa zamu.

Kuchinja uku kunowanzoonekwa muzamu rimwe chete, asi dzimwe nguva kuchinja kunogona kuonekwa mumazamu ese ari maviri.

Chii chinokonzera ALCL?

ALCL inoitika kana masero elymphocyte atakataura nezvawo kare achiwanda zvisingadzoreki uye otanga kukura kupfuura nyama ine hutano yakavapoteredza. Vaongorori havasati vaziva kuti sei masero aya elymphocyte achizova nekenza (masero anouraya).

Zvisinei, vakaona shanduko dzakasiyana-siyana dzemajini dzinowanzoonekwa neALCL. Zvinofungidzirwa kuti shanduko idzi dzemajini dzinogona kukonzera masero ane hutano kushanduka kuita masero ekenza.

Semuenzaniso, hunhu hukuru hweALK-positive ALCL kuchinja kwemajini eALK . Saizvozvowo, mamwe magene kuchinja akajairikawo mune mamwe marudzi eALCL.

ALCL inoonekwa sei? (Kuongororwa)

Chiremba wako achatanga aita bvunzo yemuviri kuti aone kana paine zviratidzo zveALCL, zvakaita sema lymph nodes akazvimba. Kana vachifungidzira izvi, vachaita bvunzo dzakasiyana-siyana uye maitiro akasiyana.

• Maitiro ekugadzira mifananidzo: Izvi zvinogona kubatsira kuona kuti kenza iri kupi. Mhando dzemiedzo yekufungidzira yaunoda inosiyana zvichienderana nerudzi rweALCL. Chiremba wako anogona kuita X-ray yechipfuva , CT scan , kana MRI kuti aone bundu. PET/CT scan kana PET scan inogona kubatsira kuona kana kenza yapararira mumuviri wese. Kana BIA-ALCL ikafungidzirwa, ultrasound yezamu inogona kuitwa.
• Kuongororwa Kweropa : Chiremba achaita bvunzo dzakasiyana-siyana dzeropa, dzakadai sekuongororwa kweropa rose (CBC), kuti aone kana paine zviratidzo zveALCL. Kana huwandu hwemasero eropa (masero matsvuku eropa, masero machena eropa, kana maplatelet) husina kujairika, chingave chiratidzo cheALCL. Vachatsvagawo mamwe ma enzymes nezvimwe zviratidzo muropa, sezvo izvi zvichigonawo kuva zviratidzo zveALCL.
• Kuongororwa kwemasero : Nzira chete yekusimbisa kuti une ALCL ndeyekuita biopsy. Mukuongorora, chiremba anotora sampuli diki yenyama inofungirwa oiongorora pasi pemaikorosikopu. Nekudzidza masero aya, chiremba anogona kuona kuti rudzii rweALCL yaunayo. Izvi zvinobatsirawo kuronga kurapwa kunoshanda zvakanyanya.

ALCL inorapwa sei?

Kurapa kwakajairika kweALCL mumuviri ndeye chemotherapy . Kuvhiya ndiko kurapwa kunonyanya kufarirwa kune ALCL yeganda yekutanga uye BIA-ALCL.

Kurapa kweAlCL yemuviri

Ma lymphoma e ALK-positive ne ALK-negative anowanzo pindura zvakanaka ku chemotherapy inorwisa kenza mumuviri. Mishonga inorwisa kenza inosanganisa kupa mishonga inouraya kenza kuburikidza netsinga, iyo inofamba mumuviri wese nemuropa kuti iuraye masero ekenza.

Kurapa nemakemikari (chemotherapy) kweALCL mumuviri kunowanzoshandisa musanganiswa wemishonga inoshanda pamwe chete kuuraya masero egomarara. Mimwe mienzaniso inosanganisira:

• BV-CHP : Izvi zvinosanganisira mishonga inonzi `Brentuximab Vedotin`, `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, uye `Prednisone`.
• CHOP : Izvi zvinosanganisira kushandiswa kwemishonga inonzi `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Vincristine (Oncovin®)`, uye `Prednisone`.
• CHEOP : Izvi zvinosanganisira kushandiswa kwemishonga inonzi `Cyclophosphamide`, `Doxorubicin (Hydroxydaunorubicin)`, `Etoposide`, `Vincristine (Oncovin®)`, uye `Prednisone`.

Kurapa uku kunogona kukonzera kuti zviratidzo zvese zvegomarara zvinyangarike mukati menguva pfupi (tinoti izvi 'remission').(Zvinonzi "kudzokazve") Zvisinei, kenza inogona kudzoka. Kana chiremba wako achifunga kuti kenza ingangodzoka, vanogona kukurudzira kuti uisirwe stem cell panguva iyo uri mukupera kwechirwere. Kuisirwa stem cell kunotsiva masero akaparadzwa nechemotherapy nemasero ane hutano. Masero aya ane hutano anobva agadzira masero eropa ane hutano (asiri ekenza).

Kana kenza ikadzoka, chiremba wako anogona kukurudzira mamwe marapirwo ekurapa lymphoma.

Kurapa kweganda rekutanga reALCL

Kurapa kunonyanya kuitika kweizvi kuvhiyiwa . Kana kenza yapararira kusvika kuma lymph nodes, ungangodawo kurapwa nemwaranzi . Kurapa nemwaranzi kunoshanda nekutungamira simba kumasero ekenza nekuaparadza.

ALCL yeganda rekutanga inogona kudzoka mukati memakore mashanu ekurapwa. Kana izvi zvikaitika, kuvhiyiwa uye kurapwa nemwaranzi zvinozodiwa zvakare.

Kana uine bundu riri munzvimbo yako risingabviswi nekuvhiyiwa, kana kuti kenza ikaramba ichidzoka, ungangoda mamwe marapirwo. Izvi zvinogona kusanganisira:

• Methotrexate inonwiwa : Mushonga unoshandiswa kurapa non-Hodgkin lymphoma.
• Bexarotene : Mushonga unoshandiswa kurapa T-cell lymphoma inokanganisa ganda.
• Brentuximab Vedotin : Mushonga unoshandiswa kurapa ALCL yemuviri nedzimwe mhando dzeALCL dzinodzokororwa.
• Interferon : Mushonga unobatsira masoja emuviri wako kuziva nekurwisa masero egomarara, kusanganisira lymphoma.

Kurapa kweBIA-ALCL

BIA-ALCL inogona kurapwa nekuvhiyiwa kubvisa chidya chezamu chako pamwe chete nemasero ekenza akachipoteredza. Kana kuvhiyiwa kusingagoneke, kurapwa nemwaranzi kunogona kupiwa kuuraya masero ekenza.

Kana kenza ikadzoka kana kupararira kupfuura zamu, chiremba wako anogona kukurudzira kurapwa nechemotherapy kunoshandiswa kurapa ALK-negative ALCL. Izvi zvinogona kusanganisira CHOP chemotherapy uye kurapwa kwakadai seBrentuximab Vedotin.

ALCL yakakomba zvakadini?

Pasinei nerudzi rwegomarara, ALCL igomarara rakakomba rinoda kutariswa nekungwarira uye kurapwa kwakakodzera. Zvisinei, fungidziro yako uye hurongwa hwekurapa zvinoenderana nezvinhu zvakaita serudzi rweALCL yaunayo, maitiro ako ekurapwa, uye chibodzwa chako cheInternational Prognostic Index (IPI) .

IPI yakagadzirwa nenyanzvi dzekenza kuti dzibatsire kufanotaura mhedzisiro yezvirwere zve lymphomas zvisiri zveHodgkin zvinokura nekukurumidza, kusanganisira systemic ALCL. Chiyero ichi chakavakirwa pazvinhu zvinotevera:

• zera rako.
• Kugona kwako kuita mabasa ezuva nezuva.
• Kuti kenza yako yapararira kusvika papi (danho rekenza).
• Huwandu hwematumbu emafuta anonhuhwirira hwakakanganiswa.

Kana uine chirwere chemuviri chinonzi systemic ALCL, bvunza chiremba wako kuti IPI score yako inokanganisa sei mikana yako yekupora.

Chiyero chekurarama kweALCL chii?

Mwero wekupona kwechirwere cheALCL chinosiyana zvakanyanya. ALK-positive ALCL inobatanidzwa nenguva yakareba yekupona kupfuura ALK-negative ALCL. Zvichienderana nezvinhu zvakaita serudzi rwekenza yako uye chibodzwa cheIPI, mwero wekupona kwemakore mashanu weALK-positive ALCL unogona kubva pa33% kusvika 90%. Saizvozvowo, mwero wekupona kwemakore mashanu weALK-negative ALCL unogona kubva pa13% kusvika 74%.

ALCL yeganda rekutanga neBIA-ALCL dzine mwero wakanaka wekurarama. Kunyangwe ALCL yeganda rekutanga ichiwanzo pora uye inodzoka mukati memakore mashanu, kurapwa kunotevera kunogona kuwedzera hupenyu hwako. Mwero wekurarama uri anenge 80% makore mashanu mushure mekuonekwa. MuBIA-ALCL, kana kenza ikabviswa zvachose nekuvhiyiwa, kenza inowanzo pera zvachose.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Heano mimwe mibvunzo inokosha yekubvunza chiremba wako:

• Ndine rudzii rweALCL?
• Kenza yangu inongogara panzvimbo imwe chete here, kana kuti yapararira?
• Ndivanaani nyanzvi dziri muchikwata changu chekutarisira varwere?
• Munondikurudzira kurapwa kupi?
• Ndingagadzirisa sei migumisiro yekurapwa?
• Chibodzwa changu cheIPI chii?
• Mikana yekuti kenza yangu irege kupora ndeyei?
• Mikana yekuti kenza yangu ichadzoka ndeipi?
• Kangani kandinofanira kuuya kuzondiona ndichitevera kuti ndione mamiriro angu ezvinhu?

Zvakajairika kuti unzwe kutya kana ukanzwa kuti une kenza. Zvisinei, chinhu chakakosha kuyeuka ndechekuti ALCL haisi mhando imwe chete yekenza ine mhedzisiro yakafanana . Rudzi rweALCL yaunayo runosarudza kana ichipararira nekukurumidza kana zvishoma nezvishoma. Izvozvo zvinoumba sarudzo dzako dzekurapa uye maonero. ALCL yevamwe vanhu inopararira nekukurumidza. Kune vamwe, inokura zvishoma nezvishoma, ichikupa nguva yakakwana yekuwana kurapwa kunogona kubatsira kudzora kenza. Taura nachiremba wako nezvemhedzisiro inogona kuitika zvichienderana nekuongororwa kwako.

Zvinhu zvinonyanya kukosha zvaunofanira kuyeuka (Mharidzo Yekuenda Kumba)

Zvakanaka, ngatipfupisei zvimwe zvezvinhu zvakakosha zvaunofanira kurangarira kubva pane zvatataura nezvazvo.

• ALCL imhando yegomarara isingawanzoitiki, uye kune mhando dzakasiyana dzayo.
• Hadzisi mhando dzese dzeALCL dzakafanana. Dzimwe dzinopararira nekukurumidza, dzimwe zvishoma nezvishoma.
• Kurapwa uye mikana yekupora zvinosiyana zvichienderana nerudzi rweALCL yaunayo, zera rako, uye hutano hwako hwese.
• Kunyange zvazvo ALCL ine ALK-positive ichiwanzoitika muvanhu vechidiki, inopindura zvakanaka kana ikarapwa.
• ALCL isina ALK inokanganisa vanhu vakuru vakawanda uye inogona kuoma kurapa.
• Kufungidzira kuti chirwere cheganda chinonzi ALCL uye ALCL (BIA-ALCL) chinokonzerwa nekugadzirwa kwezamu (breast implant-associated ALCL) zvakanaka.
• Usavhunduke. Kana uine kusava nechokwadi kana zviratidzo, tsvaga rubatsiro rwechiremba nekukasika.
• Taura pachena nachiremba wako nezvechirwere chako, marapirwo ako, uye chero mibvunzo yaungave nayo. Ndivo vanogona kukubatsira zvakanyanya.

Yeuka, hazvisi zvese zvinoonekwa nekenza zvakakomba zvakaenzana. Kunyangwe neALCL, kana kuongororwa kwakarurama, kurapwa nekukurumidza, uye kuongororwa kwakanaka, vanhu vazhinji vanogona kubudirira.

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