Yintoni i-Angioimmunoblastic T-cell Lymphoma (AITL)? Masithethe ngayo ngokulula!

Ngaba wakha weva ngesifo esinegama elingaqhelekanga kangaka? Mhlawumbi wena okanye umntu omaziyo uxelelwe eli gama ngugqirha. Nangona lisenokubonakala linzima kancinci, masizame ukuliqonda ngokulula. Okwenzekayo kukuba uhlobo oluthile lweseli yokuzikhusela emzimbeni wethu olubizwa ngokuba yi-"T cells" lujika lube ziiseli zomhlaza.

Yintoni i-angioimmunoblastic T-cell lymphoma (AITL)?

Ngamafutshane, i-Angioimmunoblastic T-cell Lymphoma (AITL) luhlobo lomhlaza olukhula kwiiseli ezimhlophe zegazi egazini lethu ezibizwa ngokuba zii-T lymphocytes, okanye ii-T cells. Cinga ngayo njengenkqubo yokuzikhusela yomzimba wethu. Zilwa nezinto ezinobungozi ezifana neentsholongwane kunye neebhaktheriya ezingena emizimbeni yethu kwaye zisikhusele kwizifo. Ngamanye amaxesha, ezi seli ze-T zinokutshabalalisa iiseli zomhlaza.

Nangona kunjalo, ngamanye amaxesha enye yezi 'seli ze-T' inokutshintsha, oko kukuthi, itshintshe, ibe yiseli yomhlaza. Emva koko ezi seli zomhlaza zimbi ziqala ukwahlukana ngokukhawuleza kwaye ziphindaphindeke ngokungalawulekiyo. Kulapho ke le meko ibizwa ngokuba yi-'AITL' isenzeka khona. Lo ngumhlaza owela kwiqela elibizwa ngokuba yi-'peripheral T-cell lymphoma', elikwiqela elikhulu elibizwa ngokuba yi-'non-Hodgkin T-cell lymphoma'. Lo mhlaza ngamanye amaxesha unokusasazeka kwiindawo ezifana nesibindi sethu, imiphunga, okanye 'umongo wamathambo'.

Ixhaphake kangakanani le meko ibizwa ngokuba yi-AITL?

Enyanisweni, i-AITL luhlobo oluqhelekileyo lwe-T-cell lymphoma, kodwa ngokubanzi ngumhlaza ongaqhelekanga . Umzekelo, kwilizwe elifana ne-United States, i-AITL ibandakanya i-4% kuphela yazo zonke izigulana ze-lymphoma. Ikwabandakanya i-1% ukuya kwi-2% yazo zonke izigulana ze-non-Hodgkin lymphoma. Ixhaphake kakhulu kubantu abangaphezu kweminyaka engama-65 ubudala .

Zithini iimpawu ze-AITL?

Ngenxa yokuba i-AITL ngumhlaza okhula ngokukhawuleza, iimpawu zingabonakala ngokukhawuleza. Ukuba ufumana nayiphi na kwezi zilandelayo, kufuneka ukhathazeke:

• Umkhuhlane ofika ubuye uhambe ngaphandle kwesizathu: Umzimba ushushu nje uze umkhuhlane ubuye, uhambe, uze ubuye kwakhona. Akukho sizathu sithile sifumanekayo.
• Ukubila ebusuku: Ukubila kakhulu xa ulele kangangokuba amashiti ayamanzi.
• Ukurhawuzelela okanye ukurhawuzelela ulusu: Kusenokubonakala emzimbeni wonke, kumabala, okanye kusenokusoloko kurhawuzelela.
• Ubunzima bokuphefumla: Ukuziva uphelelwa ngumphefumlo nokuba uchitha ixesha elininzi.
• Ukudumba kwamalungu: Amalungu asemalungeni asenokudumba kwaye mhlawumbi abe buhlungu.
• Iingono ezidumbileyo: Zibonakala njengeziqhuma kwiindawo ezifana nentamo, emakhwapheni, nasemqolo. Ezi zihlala zingenabuhlungu.
• Ukunciphisa umzimba ngaphandle kwesizathu: Nokuba awuyilawuli indlela otya ngayo okanye ungayilolongi kakhulu, ngequbuliso uya kuncipha umzimba.

Ngenxa yokuba i-AITL ichaphazela inkqubo yethu yokuzikhusela komzimba , abanye abantu abanale meko banokuba neemeko ezibizwa ngokuba zizifo zokuzikhusela komzimba, ezizifo apho inkqubo yethu yokuzikhusela komzimba isichasa. Umzekelo, iimeko ezifana ne-immune thrombocytopenia (iiplatelets ezisezantsi zegazi) okanye i-autoimmune hemolytic anemia (ukutshatyalaliswa kweeseli zegazi).

Yintoni ebangela i-AITL?

I-AITL yenzeka xa ii-T cells zethu zingasasebenzi kakuhle kwaye ziqala ukukhula ngendlela engalawulekiyo. Nangona kunjalo, abaphandi abakaqiniseki ukuba kutheni abanye abantu bekhula ngolu hlobo lwe-T-cell lymphoma kanti abanye abayenzi njalo.

Kukho ithuba lokuba kusenokubakho unxibelelwano phakathi kwe-AITL kunye nosulelo lwentsholongwane olufana ne-Epstein-Barr virus. Nangona kunjalo, kufuneka ulwazi oluthe kratya ukuze kuqondwe indlela olu nxibelelwano olusebenza ngayo.

Ifunyaniswa njani i-AITL?

I-AITL idla ngokufunyaniswa nge-lymph node biopsy . Oku kuquka ukuthatha isampuli encinci yezicubu kwi-lymph node evuvukileyo okanye kwindawo erhanelekayo uze uyihlolisise phantsi kwe-microscope. Ukuba iziphumo zovavanyo lwakho zibonisa ii-T lymphocytes ezingaqhelekanga, oogqirha baya kuyirhanela i-AITL.

Nje ukuba uxilongo luqinisekiswe, ugqirha womhlaza uza kukuxilonga aze akubuze ngeempawu zakho. Baza kukubuza nangembali yakho yempilo, njengezifo zangaphambili kunye namayeza akhoyo ngoku.

Ukongeza, ugqirha angenza iimvavanyo ezininzi, ezifana nezi:

• Uvavanyo lwegazi.
• I-biopsy yomongo wethambo.

Usenokuba neemvavanyo zomfanekiso ezifana nezi:

• I-CT scan (CT - i-computed tomography scans).
• I-MRI scan (i-MRI - i-magnetic resonance imaging scans).
• I-PET scan (i-positron emission tomography scans).

I-AITL, njengezinye ii-lymphomas, kunokuba nzima ukuyifumanisa. Oku kungenxa yokuba esi sifo sinzima, kwaye iimpawu zinokukhula kancinci kwaye zinokufana nezezinye izifo. Ngenxa yezi zizathu, uninzi lwezigulane ze-AITL zifunyaniswa zinesifo sele zikhulile . Nangona kunjalo, abaphandi bayaqhubeka befumana iindlela zokuxilonga i-AITL kunye nezinye ii-lymphomas ngokukhawuleza.

Iphathwa njani i-AITL?

Unyango lwe-AITL luxhomekeke kwizinto ezininzi, kuquka iimpawu zakho, ubukhali besifo, kunye nempilo yakho iyonke. Unyango oluphambili lwe-AITL zezi:

• Unyango ngamakhemikhali:Oku kuquka ukunika indibaniselwano yamayeza ahlukeneyo ukubulala iiseli zomhlaza. Ii-steroids zongezwa koku. Unyango olusetyenziswa kakhulu yi-CHOP kunye ne-BV+CHP. Igama elithi CHOP sisifinyezo se-Cytoxan (cyclophosphamide), i-Hydroxydaunorubicin (hydroxydaunorubicin), i-Oncovin (vincristine sulfate), kunye ne-Prednisone. I-BV+CHP yindibaniselwano ye-brentuximab vedotin, i-cyclophosphamide, i-doxorubicin, kunye ne-prednisone. Oku kunzima kancinci, kodwa ugqirha wakho uza kukuchazela.

• Ukufakelwa kweeseli zesiqu: Oku kuquka ukususa iiseli zesiqu ezinomhlaza kunye nokutshintsha kwazo ngeeseli zesiqu eziphilileyo. Ezi seli ziphilileyo zinokuthathwa kuwe (`autologous`) okanye zinganikelwa ngomnye umntu (`allogeneic`).

• Unyango olujoliswe kulo: Olu nyango lugxile kuphela kutshintsho lwemfuza oluguqula iiseli eziphilileyo zibe ziiseli zomhlaza. Oku kuthetha ukuba iyeza liya ngqo kwiiseli ezimbi kwaye lisebenza kuphela kwezo seli zimbi.

Ungaphila ixesha elingakanani ne-AITL?

I-AITL ngumhlaza ohlaselayo. Uphando lubonisa ukuba umlinganiselo wokusinda emva kokuxilongwa ungaphantsi kweminyaka emithathu . "I-median" lixabiso eliphakathi kuluhlu lwamaxabiso. Oku kuthetha ukuba abanye abantu baphila ubomi obufutshane, ngelixa abanye bephila ixesha elide.

Kodwa nantsi ingongoma ebalulekileyo: Malunga nama-30% ukuya kuma-35% abantu abane-AITL basabela kakuhle kunyango kwaye banokunyangwa ngaphandle kokuba umhlaza uphinde ubuye.

Izinga lokusinda kwi-AITL

Izinga lokusinda kweminyaka emihlanu ye-AITL liphakathi kwe-30% kunye ne-35% . Oku kuthetha ukuba kubantu abali-100 abafunyaniswe bene-AITL, phakathi kwe-30 kunye ne-35 basaphila emva kweminyaka emihlanu. Ngokufanayo, izinga lokusinda kweminyaka esixhenxe limalunga ne-29%.

Kuqhelekile ukuba uzive usoyika kwaye uxhalabile xa ubona ezi zibalo. Kodwa khumbula, ezi ziingqikelelo nje. Zisekelwe kumava adlulileyo abanye abantu abaye bafunyaniswa benesifo esifanayo nesakho. Imbali yempilo yomntu wonke kunye nemvelaphi yemfuza zahlukile. Ke ngoko, la manqanaba okusinda awanakuqikelela ngokuthe ngqo ukuba uza kuphila ixesha elingakanani okanye uza kusabela njani kunyango.

Ukuba ukhathazekile ngezi zibalo, okanye ukuba ufuna ukwazi ukuba zinokukuchaphazela njani, qiniseka ukuba uthetha nogqirha wakho. Angachaza imeko yakho aze akunike naluphi na uncedo olufunayo.

Ngaba i-AITL ingathintelwa?

Uninzi lwabantu abane-AITL abanazo izinto ezibangela umngcipheko wokuba nesi sifo. Akukho ndlela ithile yokuthintela i-AITL okanye naluphi na olunye uhlobo lwe-lymphoma. Njengemininzi yomhlaza, oku kwenzeka ngamanye amaxesha. Akuthethi ukuba wenze into engalunganga.

Ndingawunciphisa na umngcipheko wam?

Nangona ungenakukuthintela i-angioimmunoblastic T-cell lymphoma, ungenza ezi zinto ukugcina inkqubo yomzimba yokuzikhusela isempilweni :

• Yitya ukutya okunesondlo esifanelekileyo: Yitya ukutya okutyebileyo kwimifuno, iziqhamo, iimbotyi, iinkozo ezipheleleyo, kunye neeproteni ezifana nenyama engenamafutha kunye nentlanzi.
• Zilolonge rhoqo: Yenza into efana nokuhamba okanye ukubaleka ubuncinane imizuzu engama-30 ngosuku.
• Lala kakuhle: Lala kakuhle ubuncinane iiyure ezisi-7-8 ngosuku.
• Gcina ubunzima obusempilweni obukufaneleyo.
• Kuphephe ukutshaya nokusebenzisa icuba: Njengecuba kunye ne-bidis, icuba elingenamsi (elifana necuba elihlafunwayo kunye netshungama) nalo liyingozi. Ukutshiza nge-vape nako akulunganga.
• Nciphisa ukusetyenziswa kotywala.

Ndifanele ndimbone nini ugqirha?

Ukuba ubonakalisa iimpawu ezifana nokurhawuzelela ngequbuliso, ukudumba kwama-lymph nodes, umkhuhlane ophezulu, okanye ukwehla kobunzima obungacwangciswanga, bonana nogqirha ngoko nangoko.

Ukuba sele unyangwa i-AITL, yazisa ugqirha wakho womhlaza ngokukhawuleza ukuba ubonakalisa iimpawu ezintsha okanye ukuba iimpawu zakho ziya zisiba mandundu. Ngenxa yohlobo lomhlaza, kubaluleke kakhulu ukuqala unyango ngokukhawuleza.

I-AITL ichaphazela wonke umntu ngokwahlukileyo. Ugqirha wakho kuphela komntu onokuchaza indlela ukuxilongwa kwakho okuza kukuchaphazela ngayo. Abanye abantu abafuni ukwazi iinkcukacha zesifo, kwaye kulungile oko. Unelungelo lokwenza izigqibo malunga nonyango lwakho. Nguwe kuphela owaziyo ukuba yintoni ekulungeleyo impilo-ntle yakho yengqondo, yeemvakalelo, neyokomoya.

Ndingayibuza yiphi imibuzo ugqirha wam?

Kuqhelekile ukuba nemibuzo emininzi emva kokuba uxilongiwe ukuba une-AITL. Nazi ezinye zemibuzo onokuyibuza ugqirha wakho we-oncologist:

• Umhlaza wam ukhule kangakanani?
• Ingaba umhlaza usasazeke nakwamanye amalungu omzimba wam?
• Ziziphi iindlela zonyango endinazo?
• Ndingaluqala nini unyango?
• Ndingaqhubeka nomsebenzi wam ngelixa ndifumana unyango?
• Luhlobo luni lwenkxaso noncedo endiya kulufuna ngexesha lonyango?
• Ndingajoyina amaqela enkxaso okanye ezinye izixhobo?
• Ndingayigcina njani impilo yam yengqondo?

Ukuxilongwa komhlaza kunokubangela iimvakalelo ezahlukeneyo ezinzima, kuquka usizi, ixhala, umsindo, nomsindo. Ngenxa yokuba i-AITL sisifo esingaqhelekanga, ungaziva uwedwa kwaye ngathi akukho mntu ukuyiqondayo.Kodwa iqela lakho lezonyango likho ukukunceda. Banokukuxelela ngezixhobo ozidingayo, kunye namaqela enkxaso nabantu abaye badlula kwizinto ezifanayo nezakho. Akunyanzelekanga ukuba uhambe wedwa kolu hambo. Fumana inkxaso kubantu obathandayo kunye noogqirha bakho.

Umyalezo Wokuya Ekhaya

I-AITL ngumhlaza onzima nongaqhelekanga. Nangona kunjalo, kubalulekile ukuqaphela, ukunikel’ ingqalelo kwiimpawu, kunye nokufuna iingcebiso zonyango ngokukhawuleza.

• Qaphela iimpawu: Lumka ngenxa yomkhuhlane ongaziwayo, ukubila ebusuku, ukudumba kwamaqatha, iingxaki zolusu, ubunzima bokuphefumla, ukudumba kwamalungu, kunye nokwehla kobunzima bomzimba.
• Funa ingcebiso kagqirha: Ukuba unamathandabuzo, bonana nogqirha ngokukhawuleza. Ukuxilongwa ngokukhawuleza kunye nonyango kubaluleke kakhulu.
• Kukho iindlela zonyango: Kukho iindlela ezifana ne-chemotherapy, ukufakelwa kweeseli ze-stem, kunye neendlela zonyango ezijoliswe kuzo. Ugqirha wakho uya kugqiba ukuba yeyiphi ekulungeleyo.
• Awuwedwa: Olu hambo lunokuba nzima, kodwa unosapho, abahlobo, kunye neqela lezonyango elinokukunceda. Fumana inkxaso yabo.
• Hlala unethemba: Izibalo aziyonto yonke. Wonke umntu wahlukile. Hlala unethemba.

Ndiyathemba ukuba olu lwazi lukuncedile ukuba uqonde esi sifo. Khumbula, kungcono ukufuna iingcebiso zonyango kuyo nayiphi na ingxaki yempilo.

I- AITL, i-Angioimmunoblastic T-cell Lymphoma, i-T-cell lymphoma, umhlaza, umhlaza wegazi, iimpawu ze-lymphoma, unyango lomhlaza