Masifunde ngomhlaza we-DLBCL (Diffuse Large B-Cell Lymphoma) ngendlela elula.

Ngaba wakha weva ngesifo esithi `Diffuse Large B-Cell Lymphoma` okanye `DLBCL`? Olu luhlobo lomhlaza olusasazeka ngokukhawuleza. Kodwa ungakhathazeki, ukuba lufunyenwe kwangethuba kwaye lunyangwa ngokuchanekileyo , lunokunyangeka . Namhlanje, masithethe ngale `DLBCL` ngokulula.

Yintoni i-DLBCL?

I-DLBCL ngumhlaza wegazi. Kwesi sifo, uhlobo lweseli emhlophe yegazi ebizwa ngokuba zii-B cells (ezikwabizwa ngokuba zii-lymphocytes) emzimbeni wethu luba ngumhlaza. Olu lolona hlobo luqhelekileyo, olukhula ngokukhawuleza, nolunobundlongondlongo lwe-lymphoma ebizwa ngokuba yi-non-Hodgkin lymphoma. Inkqubo yethu ye-lymphatic ilwa neentsholongwane. Xa i-DLBCL ikhula, ezi seli ze-B ziba ngumhlaza kwaye zikhula ngokukhawuleza, zicinezele iiseli eziphilileyo. Emva koko azikwazi ukulwa neentsholongwane. Ezi seli zinomhlaza zinokwakheka naphi na, kuquka ii-lymph nodes, indlela yokugaya ukutya, kunye nengqondo. Nangona inzima, inokunyangeka ukuba ifunyenwe kwangethuba.

Ziziphi iintlobo ze-DLBCL?

I-World Health Organisation (WHO) ichonge iintlobo ezahlukeneyo ze-DLBCL. Oogqirha basebenzisa uhlobo ngalunye ukufumanisa indlela umhlaza oqhubeka ngayo kunye nendlela osabela ngayo kunyango. Olu hluko luphenjelelwa kakhulu zezi:

• Utshintsho kwizakhi zofuzo kwiiseli.
• Indawo emzimbeni apho i-DLBCL iqala khona (umz., inkqubo yemithambo-luvo ephakathi - `CNS`).
• Unxulumano nentsholongwane (umz. intsholongwane ye-Epstein-Barr - i-EBV).

Kubaluleke kakhulu ukubuza ugqirha wakho ngohlobo lwe-DLBCL onayo.

Kuqheleke kangakanani oku?

I-DLBCL lolona hlobo luqhelekileyo lwe-lymphoma. Nangona kunjalo, i-DLBCL ayixhaphakanga kakhulu phakathi komhlaza ngokubanzi. Umzekelo, i-DLBCL iyenzeka kubantu abamalunga ne-6 kwi-100,000. Oku kunqabile xa kuthelekiswa neminye imihlaza.

Zithini iimpawu ze-DLBCL?

Uphawu oluqhelekileyo lwe-DLBCL kukudumba kwee-lymph nodes entanyeni, emakhwapheni, okanye emqolo . Ezi zisenokuqala njengeqhubu, zikhule kancinci kancinci, kwaye zisenokungabi buhlungu.

Abanye abantu (malunga nomnye kwabathathu) banokufumana iimpawu ezikhethekileyo ezibizwa ngokuba yi- "B symptoms" :

• Umkhuhlane (ongaphezulu kwama-39.5 Celsius) ohlala ixesha elingaphezu kweentsuku ezimbini okanye ofika uphinde uphele.
• Ukulahlekelwa ngaphezu kwe-10% yobunzima bomzimba kwiinyanga ezintandathu ngaphandle kwesizathu.
• Ukubila kakhulu ebusuku, kangangokuba amalaphu okulala ayamanzi.

Musa ukoyika ukucinga ukuba yi-DLBCL nokuba unazo ezi mpawu. Nangona kunjalo, ukuba ziyaqhubeka kangangeeveki ezininzi, bona ugqirha.

Kutheni i-DLBCL ikhula? Zithini izinto ezibangela umngcipheko?

I-DLBCL ibangelwa ziinguqu kwiiseli ze-B. Ezi ziinguqu zemfuza ezifunyenweyo ezenzeka ngexesha lobomi . Isizathu esichanekileyo asaziwa, kodwa kukho izinto ezininzi eziye zachongwa ezonyusa umngcipheko:

• Ubudala:Ixhaphake kakhulu kubantu abakwiminyaka yabo engama-60. Ubudala obuqhelekileyo bokuxilongwa bumalunga neminyaka engama-64.
• Isini: Amadoda anokuyihlakulela ngaphezu kancinci kunabafazi.
• Imbali yosapho: Ukuba isalamane sakho esikwinqanaba lokuqala (umzali, umntakwenu, umntwana) sine-DLBCL, usenokuba nomngcipheko okhulayo wokuba nayo (isizathu asikacaci).
• Iintsholongwane: Iintsholongwane ezifana ne-Epstein-Barr virus (EBV), i-human immunodeficiency virus (HIV), kunye ne-hepatitis B kunye ne-C.
• Inkqubo yomzimba yokuzikhusela ebuthathaka: Ukuba `ne-primary immunodeficiency` okanye `i-autoimmune disorder`, okanye ukuthatha `i-immunosuppressants` emva kokufakelwa ilungu. Le yingxaki enkulu.
• I-Higher body mass index (BMI) esemncinci kwaye echaphazeleka zizinto ezinobuthi ezisetyenziswa kwezolimo.

Nangona ezi zinto zikhona, ayingomntu wonke ozenzayo, okanye onokuzenza. Kodwa kubalulekile ukuzazi ezi zinto.

Ifunyaniswa njani i-DLBCL? (Ukuxilongwa)

Oogqirha baqinisekisa i-DLBCL nge -lymph node biopsy (ukuthatha iqhekeza elincinci le-lymph node evuvukileyo ukuze lihlolwe) kunye novavanyo lwemfuza. Ukuba i-DLBCL iqinisekisiwe, kwenziwa olunye uvavanyo ukuze kubonwe ukuba umhlaza usasazekile na:

• Uvavanyo lwegazi: Ubalo olupheleleyo lwegazi (CBC), ukujonga iintsholongwane ezifana ne-HIV, i-EBV, kunye ne-hepatitis.
• Uvavanyo lwe-Lactate dehydrogenase (LDH): Le enzyme ifumaneka kumanqanaba aphezulu kwinkoliso yezigulane ze-DLBCL.
• Uvavanyo lwemifanekiso: i-CT scan, i-MRI scan, i-PET scan.
• `Uvavanyo lomongo wethambo` .
• Ukubhobozwa kwe-Lumbar (ukuhlolwa kolwelo lomqolo).

Oogqirha benza izigqibo malunga nemeko yakho baze bacebe unyango ngokusekelwe kulwazi olufunyenwe kolu vavanyo ngalunye.

Zithini izigaba ze-DLBCL?

Iinkqubo zokulinganisa umhlaza zisetyenziselwa ukufumanisa ukuba umhlaza ukhule kangakanani kwaye usasazeke kangakanani. Oku kunceda ekucwangciseni unyango kunye nokuqikelela ikamva. Amanqanaba e-DLBCL ngala:

• Isigaba I: Umhlaza ukwi-lymph node enye kuphela, ilungu elinye kwinkqubo ye-lymphatic, okanye indawo enye yelungu elinye elingaphandle kwenkqubo ye-lymphatic.
• Isigaba sesiBini: I-Lymphoma ikhona kumaqela aliqela ee-lymph nodes kwicala elinye le-diaphragm.
• Inqanaba lesi-3: Umhlaza ukho kwii-lymph nodes kumacala omabini e-diaphragm.
• Inqanaba lesi-4:Umhlaza we-DLBCL usasazeke kumalungu angaphandle kwenkqubo ye-lymphatic (umz. umongo wethambo, isibindi, imiphunga).

Oogqirha babiza amanqanaba okuQala kunye nawesiBini ngokuthi "amanqanaba okuqala" kwaye amanqanaba esiThathu kunye nelesiNe ngokuthi "amanqanaba aphambili."

Ziziphi iindlela zonyango ze-DLBCL?

Olona nyango luqhelekileyo lwe-DLBCL yi -R-CHOP . Oku kubandakanya indibaniselwano ye-antibody ye-monoclonal ebizwa ngokuba yi-rituximab, iintlobo ezahlukeneyo ze-chemotherapy, kunye ne-corticosteroid. Nokuba olu nyango luphumelele, isifo sinokubuya (malunga ne-30%-40%). Ukuba oku kuyenzeka, ugqirha wakho unokucebisa ezinye iindlela zonyango:

• Unyango lwesibini kunye `nokufakelwa kweeseli ze-stem ze-autologous`.
• `Unyango lweeseli ze-CAR T`: Olu `lunyango lwe-immunotherapy`.
• `Unyango olujoliswe kulo`: Unyango olujolise kutshintsho lwemfuza.

Khumbula, ugqirha wakho uza kukumisela unyango olungcono ngokusekelwe kwimeko yakho ethile.

Ngaba uphuhliso lwe-DLBCL lungathintelwa?

Akukho ndlela yokuthintela ngokupheleleyo i-DLBCL. Kukho izinto ezinobungozi esingenakuzilawula. Nangona kunjalo, kukho amanyathelo esinokuwathatha ukuzikhusela kwiintsholongwane ezinokunxulunyaniswa ne-DLBCL, ezifana ne-hepatitis kunye ne-HIV. Kukwangumbono olungileyo ukuzama ukugcina i-body mass index (BMI) esempilweni. Ezi zinokukunceda ukunciphisa umngcipheko wakho ukuya kuthi ga kwinqanaba elithile.

Yintoni enokulindelwa ngumntu one-DLBCL?

Ezinye iintlobo ze-DLBCL zinokuba yingozi ebomini kwaye kube nzima ukuzinyanga. Nangona kunjalo, oogqirha badla ngokunyanga nokunyanga esi sifo . Kwiimeko ezininzi, unyango oluphambili lunokubangela ukuba i-DLBCL ifikelele esiphelweni esipheleleyo (imeko apho kungekho zimpawu zomhlaza). Malunga nama-60% abantu abane-DLBCL banyangwa ngonyango lokuqala. Ngokomyinge, abantu abangenawo umhlaza emva kweminyaka emibini emva kokufunyaniswa benesifo banokulindela ukuphila ubomi obuqhelekileyo, obufana nabanye abantu abaneminyaka yabo. Izinga lokusinda liphezulu nangakumbi ukuba umhlaza ufunyaniswa kwasekuqaleni .

Nangona kunjalo, amava akho aya kuxhomekeka kwizinto ezininzi, kuquka uhlobo lwe-DLBCL onayo, inqanaba lomhlaza, kunye nempilo yakho iyonke. Ngugqirha wakho kuphela onokukunika ulwazi olungcono malunga noku.

Ndingazinyamekela njani? (Ukuzinyamekela)

Ukuphila nomhlaza akulula, kuyadinisa kakhulu. Kubaluleke kakhulu ukuzinyamekela xa usenza unyango lwe-'DLBCL'.

• Isondlo: Yitya ukutya okunempilo nokunesondlo. Buza ugqirha wakho ukuba utye ntoni kwaye uphephe ntoni.
• Ukuphumla:Unyango lunokubangela ukudinwa. Phumla ngokwaneleyo.
• Ukuzilolonga: Ukuzilolonga kancinci kunokunciphisa uxinzelelo.
• Inkxaso: Le yimeko engaqhelekanga, ngoko ke ingaziva ililolo. Joyina amaqela enkxaso apho kukho abantu abafana nawe. Thetha nosapho kunye nabahlobo.

Kufuneka ubone ugqirha kunye neengxamiseko

Uza kubona ugqirha wakho rhoqo ngexesha lonyango. Nokuba unyango luphelile, kuya kufuneka umbone rhoqo kwiinyanga ezi-3-4 kwiminyaka emibini yokuqala kwaye ungamfumani rhoqo kwiminyaka emithathu ezayo. Oku kukujonga ukuba umhlaza ubuyile na. Ukuba uneempawu zokuba umhlaza ubuyile, xelela ugqirha wakho ngoko nangoko.

Unyango olufana ne-chemotherapy lunokuba nemiphumo emibi kakhulu. Ukuba ezi zinto ziyenzeka , yiya kwigumbi likaxakeka ngokukhawuleza :

• Iziphumo ebezingalindelekanga zimbi kakhulu kunokuba bekulindelwe.
• Umkhuhlane ongaphezulu kwama- 38 Celsius (100.4 Fahrenheit).
• Ukungcangcazela okungenakunqandeka .
• Intlungu ebuhlungu yesisu okanye urhudo olungapheliyo .

Imibuzo omele uyibuze ugqirha wakho malunga ne-DLBCL

Kuqhelekile ukuba nemibuzo emininzi xa ufumanisa ukuba une-DLBCL. Kubalulekile ukuba ubuze ugqirha wakho imibuzo efana nale:

• Loluphi uhlobo lwe-'Diffuse Large B-Cell Lymphoma' endinalo? Yintoni i-'stage'?
• Luhlobo luni lonyango endiludingayo? Zithini iziphumo ebezingalindelekanga?
• Ngaba olu nyango luza kuyinyanga ngokupheleleyo umhlaza?
• Ziziphi iindlela zonyango ezikhoyo xa umhlaza ubuya?
• Ungandithumela kwiqela lenkxaso labantu abanolu hlobo lomhlaza?

Ukongeza kule mibuzo, ungoyiki ukubuza ugqirha wakho nantoni na onayo engqondweni okanye nawaphi na amathandabuzo onokuba nawo.

Okokugqibela, khumbula (Umyalezo Wokuya Ekhaya)

Xa uninzi lwethu lusiva igama elithi "aggressive" xa sithetha ngomhlaza, sicinga ngalo njengesifo esinganyangekiyo nesinzima ukunyanga. Kodwa akunjalo nge-Diffuse Large B-Cell Lymphoma (DLBCL). Nangona i-DLBCL inokusasazeka ngokukhawuleza, unyango lwangoku lomhlaza lunokubulala la maseli e-B anomhlaza. Oogqirha basebenzisa amagama anjengelithi "cure" xa bethetha ngeemeko zabanye abantu.

Eyona nto ibalulekileyo kukubuza ugqirha wakho ukuba ukuxilongwa kwakho kuya kuyichaphazela njani indlela ocinga ngayo ngonyango lwakho. Ngoko ke, ungoyiki, yaziswe, kwaye ulandele icebiso likagqirha wakho. Ungalibali ukuba i-DLBCL inokoyiswa ngokufunyaniswa kwangoko kunye nonyango olufanelekileyo!

Umhlaza , i-lymphoma, iiseli ze-B, ii-lymph nodes, iimpawu, unyango, i-DLBCL, i-chemotherapy, unyango lwe-immunotherapy