Ngaba une-Peripheral T-cell Lymphoma (PTCL)? Ungakhathazeki, masithethe ngayo!

Ngamanye amaxesha, sinokufumana izifo esingazicingiyo, akunjalo? I-Peripheral T-cell Lymphoma, okanye i-PTCL ngamafutshane, yimeko enzima kancinci, kodwa kubaluleke kakhulu ukuyiqonda. Ayisosifo sinye ngokwenene, kodwa yindibaniselwano yezifo ezininzi. Ngaba singathetha ngale nto ngokulula, ngendlela onokuyiqonda?

I-Peripheral T-cell Lymphoma (PTCL) ayisosifo siqhelekileyo. Liqela leentlobo ezahlukeneyo zomhlaza wegazi. Ngokukodwa, ichaphazela inkqubo yethu ye-lymphatic . Usenokuba ukhe weva ngayo njenge-"Non-Hodgkin lymphoma", kwaye yiyo loo nto iyiyo. Into enye nge-PTCL kukuba inokusasazeka (i-metastasize) ukusuka kwelinye ilungu lomzimba ukuya kwamanye amalungu . Oku kuthetha ukuba inokuchaphazela phantse naliphi na ilungu lomzimba, ngoko ke iimpawu zinokuhluka.

Iindaba ezimnandi zezokuba oogqirha banokulawula ngempumelelo iintlobo ezininzi ze-PTCL. Nangona kunjalo, ngamanye amaxesha esi sifo sinokuphinda sibuye . Yiyo loo nto abaphandi bezonyango besoloko bekhangela unyango olutsha olunokunceda abantu baphile ixesha elide nge-PTCL.

Ingaba esi sifo sibizwa ngokuba yi-PTCL siqhelekile?

Hayi, esi ayisosifo siqhelekileyo . Uphando olwenziwe kwihlabathi liphela lubonisa ukuba abantu abamalunga namakhulu amabini amawaka banesifo se-PTCL. Malunga ne-10% yabo banesifo se-`(Non-Hodgkin lymphoma)` bane-PTCL.

Le meko ibonakala rhoqo kumazwe ethu aseAsia, eAfrika, naseCaribbean kunaseMelika. Ihlala ikhula kubantu abangaphezu kweminyaka engama-60 ubudala. Nangona kunjalo, ezinye iintlobo zinokukhula nakubantwana abancinci nakubantu abadala abancinci .

Ziziphi iintlobo eziphambili zePTCL?

I-World Health Organisation (WHO) ichonge iintlobo ezingaphezu kwama-20 ze-PTCL. Ngayinye kwezi ineempawu zayo zemfuza ezahlukileyo. Makhe sijonge ezinye zezona ntlobo zixhaphakileyo.

I-peripheral T-cell lymphoma, engachazwanga ngenye indlela (PTCL-NOS)

Olu lolona hlobo luqhelekileyo . ``(PTCL-NOS)`` ludidi oluquka iimeko ezingenakuchazwa ngokuchanekileyo kwaye ezingangeni kwezinye iintlobo ezicacileyo. Malunga nama-30% azo zonke izigulana ze-PTCL ziwela kolu didi. Ingachaphazela ikakhulu ii-lymph nodes zakho, umongo wethambo , i-spleen , okanye isibindi .

I-Angioimmunoblastic T-cell lymphoma (AITL)

Oku kwenzeka nakwi-15% ukuya kwi-30% yezigulana ze-PTCL kwihlabathi liphela. I-AITL inokuchaphazela ne-spleen yakho, umongo wethambo, i-spleen, okanye isibindi.

I-Anaplastic large cell lymphoma (ALCL)

Kukwakho neendlela ezahlukeneyo ze-`(ALCL)`.

• Kukho enye ebizwa ngokuba yi -primary cutaneous ALCL , echaphazela ulusu .
• Kukho enye kwakhona.I-ALCL yenkqubo, echaphazela imiphunga, ulusu, kunye nezinye izitho zomzimba. Le ALCL yenkqubo ngamanye amaxesha ihlelwa ngakumbi ngokusekelwe kutshintsho kwijini ethile ebizwa ngokuba yi-ALK (i-anaplastic lymphoma kinase) . Malunga ne-15% ye-PTCL iwela kolu hlobo lwe-``(ALCL)```.

I-Extranodal natural killer/T-cell lymphoma, uhlobo lwempumlo

Le ikhethekile kancinci. Olu hlobo ludla ngokukhula kwizicubu zempumlo yakho , kwimiqolo ye-sinus , nakumqala ongasentla . Kodwa ngamanye amaxesha inokusasazeka eluswini, kwindlela yokugaya ukutya , nakwamanye amalungu omzimba. Olu hlobo lumalunga ne-10% ye-PTCL.

Ii-lymphomas ze-T-cell zamathumbu

Igama lisitsho, akunjalo? Oku kuchaphazela inkqubo yokugaya ukutya . Imalunga ne-6% ye-PTCL. Ikwanazo neentlobo ezibizwa ngokuba yi-enteropathy-associated T-cell lymphoma (EATL) kunye ne -monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) .

I-T-cell lymphoma/leukemia yabantu abadala (ATLL)

Ingachaphazela ulusu namathambo. Kukho iintlobo ezine ze-ATLL: i-acute, i-lymphoma, i-chronic, kunye ne-smoldering . Iintlobo ezimbini eziqhelekileyo yi-acute kunye ne-lymphoma, ezihlaselayo. Iintlobo ezingapheliyo kunye ne-smoldering zikhula kancinci. Uhlobo ngalunye lwe-ATLL luchaphazela amalungu ahlukeneyo omzimba.

Zithini iimpawu ze-PTCL?

Nangona uhlobo ngalunye lwe-PTCL luneempawu ezithile, kukho ezinye eziqhelekileyo. Makhe sijonge ukuba zeziphi:

• Ii-lymph nodes ezidumbileyo: Usenokuba nokudumba okungenabuhlungu entanyeni, emakhwapheni, okanye emathunjini. Khawuthelekelele iqhuma elincinci entanyeni yakho elivakala ngathi liya likhula ngokuhamba kwexesha, kodwa lingabi buhlungu. Yiyo leyo.
• Ukwehla kobunzima ngendlela engachazekiyo: Ukuba ulahlekelwa malunga ne-10% yobunzima bakho buphela kwiinyanga ezintandathu, ngaphandle kokuzama nzima, yinto ekufuneka uyixhalabele.
• Intlungu okanye ukudumba kwesisu: Oku kunokwenzeka ukuba ipleen yakho ikhulisiwe. Kungavakala kungathandeki, ngokungathi isisu sakho sigcwele.
• Ukudinwa okungapheliyo: Ukuziva udinwe ngokungaqhelekanga kangangeentsuku ezininzi ngaphandle kwesizathu esicacileyo. Kufana nokuba ukudinwa akupheli nokuba ulala kangakanani na.
• Umkhuhlane ongachazwanga: Ngokuqhelekileyo, umkhuhlane ubakho xa umzimba ulwa nosulelo. Nangona kunjalo, ukuba umkhuhlane ongaphezulu kwama-39.5 degrees Celsius (103 Fahrenheit) uhlala ixesha elingaphezulu kweeyure ezimbini emva konyango lwasekhaya, okanye ukuba umkhuhlane uhlala ixesha elingaphezulu kweentsuku ezimbini, oko kungaba luphawu lwento enzulu ngakumbi.

Eyona nto ibalulekileyo kukuba ungakhathazeki ngokuba ne-PTCL kuba nje unale mpawu. Zisenokuba zibangelwa zezinye izizathu ezilula. Kodwa ukuba ezi mpawu ziyaqhubeka,Kubaluleke kakhulu ukubona ugqirha kwaye ufumane ingcebiso.

Ngoku makhe sibone ukuba zeziphi iimpawu ezihambisana nezinye iintlobo ezithile zolu hlobo.

Iimpawu ezongezelelweyo ze-peripheral T-cell lymphoma, ezingachazwanga ngenye indlela (PTCL-NOS)

Ukongeza kwiimpawu eziqhelekileyo, ungabona:

• Ukuncipha kweeseli ezibomvu zegazi (i-Anemia) - Oku kunokubangela ukuphaphatheka kunye nokudinwa okwandileyo.
• Inani eliphantsi leeplatelet egazini (i-Thrombocytopenia) - Oku kunokukhokelela ekutyekeleni ekuphumeni kwegazi.
• Amabala abomvu arhawuzelelayo eluswini.
• Ukuba umhlaza usesifubeni , iintlungu zesifuba okanye ubunzima bokuphefumla (ukuphelelwa ngamandla).

Iimpawu ezongezelelweyo ze-angioimmunoblastic T-cell lymphoma (AITL)

Ukongeza kwiimpawu eziqhelekileyo:

• Ukubila ebusuku - Ukubila kakhulu xa ulele kangangokuba amashiti ayamanzi.
• Ukuqhambuka kwesikhumba.
• Iingxaki zokuzikhusela komzimba ezifana ne- "Autoimmune hemolytic anemia "

Iimpawu ezongezelelweyo ze-anaplastic large cell lymphoma (ALCL)

I-ALCL yesikhumba esiphambili (uhlobo oluchaphazela ulusu)

• Izinto ezifana nokutshintsha kombala wesikhumba okungaqhelekanga okubomvu okanye okubomvu-mdaka, amaqhuma akhula ngokuhamba kwexesha.
• Amadyungudyungu amakhulu, angqukuva, arhawuzelelayo .
• La maqhuma anokuba buhlungu aze agqume uqweqwe.

I-ALCL yenkqubo (uhlobo oluchaphazela amalungu angaphakathi)

Kule meko, iimpawu eziqhelekileyo kwi-PTCL ziyabonakala.

I-Extranodal natural killer/T-cell lymphoma, uhlobo lwempumlo

• Ukuxinana kwempumlo , ukuziva ngathi impumlo ivalekile.
• Ukopha kwempumlo .
• Ingaphakathi lempumlo liba rhabaxa .
• Ukudumba okubuhlungu kobuso .
• Iingxaki zamehlo ezifana nokuphuma kwamanzi emehlweni kunye nentlungu yamehlo.

I-T-cell lymphoma/leukemia yabantu abadala (ATLL)

Iimpawu ze-PTCL ziqhelekile kuzo zonke iintlobo ezine ze-ATLL.

Zithini izizathu ze-PTCL?

Ngamafutshane, i-peripheral T-cell lymphoma yenzeka xa ii-T cells emzimbeni wethu zitshintsha (`(mutate)`) zibe ziiseli zomhlaza. Njengoko usazi, ezi T cells luhlobo lweeseli ezimhlophe zegazi ezisikhusela kwiintsholongwane ezifana neentsholongwane ezingena emizimbeni yethu. Ngoko ke, xa ezi T cells zitshintsha, ziba ziiseli zomhlaza kwaye ziqala ukwanda ngokungalawulekiyo . Xa ziphindaphindeka ngolu hlobo, ziqokelelana emiphungeni yethu, kwi-spleen, esibindini, nakwezinye izitho zomzimba kwaye zenze iithumba ezinomhlaza .

Iingcali azikafumani sizathu sicacileyo sokuba kutheni ezi T-cells zitshintsha ngolu hlobo.Nangona kunjalo, uphando lufumanise ukuba inxulumene nezinye iimeko zonyango.

Umzekelo:

• Uphononongo lwehlabathi lubonise ukuba abantu abanesifo esibizwa ngokuba sisifo se-celiac banokuba nomngcipheko omkhulu wokufumana iintlobo ezahlukeneyo ze-PTCL, kuquka i-ALCL.
• Kwakhona, abantu abosulelwe yi -Epstein-Barr virus banokuba nomngcipheko okhulayo wokufumana i-extranodal natural killer/T-cell lymphoma.
• Abantu abanentsholongwane `(i-Human T-cell lymphotropic virus Type 1 (HTLV-1))` basengozini enkulu yokuhlaselwa yi-`(i-acute T-cell lymphoma/leukemia)`.

Ifunyaniswa njani i-PTCL?

Oogqirha banokufuna ukwenza iimvavanyo ezahlukeneyo ukuze bafumane uhlobo oluthile lwe-PTCL olubangela iingxaki zempilo yakho. Ezi zinokubandakanya uvavanyo lwegazi, uvavanyo lwemifanekiso, uvavanyo lwe-biopsy , kunye novavanyo lwemfuza ukuze kufundwe ukwakheka kwemfuza yeeseli zomhlaza.

Uvavanyo lwegazi

Oogqirha benza uvavanyo lwegazi ukujonga iintsholongwane ezinokuthi zidibene ne-PTCL. Ezi zingabandakanya:

• Ubalo lwegazi olupheleleyo (i-CBC)
• Iphaneli epheleleyo ye-metabolic (CMP)
• Uvavanyo lwe-Lactate dehydrogenase (LDH)
• Uvavanyo lweHepatitis B kunye neHepatitis C
• Uvavanyo lwentsholongwane yokungakwazi ukuzikhusela komzimba (i-HIV)
• Uvavanyo lwe -Human T-cell lymphotropic virus Type 1 (HTLV-Type 1)

Uvavanyo lokufota

Ezi scan zivumela oogqirha ukuba bafumane ulwazi malunga nengaphakathi lomzimba wakho, ingakumbi apho kukho amaqhuma anomhlaza.

• Iskeni ye-computed tomography (CT)
• Iskeni se-Positron emission tomography (PET)
• Iskeni se-magnetic resonance imaging (MRI)

Iibhayoloji

Oku kuquka ukuthatha iqhekeza elincinci lesicwili kwindawo ekrokrisayo uze ulihlolisise ngemicroscope. Le yeyona ndlela iphambili yokuqinisekisa ngokuqinisekileyo ukuba isifo sikhona .

• I-lymph node biopsy
• I-biopsy yolusu
• iBone Marrow Biopsy

Zithini izigaba ze-PTCL?

Oogqirha basebenzisa uhlalutyo lomhlaza ukucwangcisa unyango nokukunika umbono wento onokuyilindela kunyango (ukuxela kwangaphambili). Eli nqanaba limiselwa luhlobo lwe-PTCL kunye nendawo apho ii-T-cells ezinomhlaza zisasazeke khona. Nazi izigaba ezine eziphambili ze-PTCL:

• Inqanaba lokuQala: Ii-T-cells ezinomhlaza zikwiseli enye okanye kwiqela elinye leeseli.
• Inqanaba lesiBini: Umhlaza uchaphazele ii-lymph nodes ezimbini okanye ngaphezulu kwicala elinye lomzimba wakho (umzekelo, kumacala omabini entamo yakho, okanye kwicala elinye elingaphezulu okanye ngaphantsi kwe-diaphragm).
• Inqanaba lesi-3: Umhlaza usasazeke kwizicubu ezingaphezulu nangaphantsi kwe-diaphragm yakho.
• Inqanaba lesi-4: Ukongeza kwimiphunga, umhlaza ukwasasazeke nakwamanye amalungu omzimba, afana nemiphunga, isibindi, umongo wamathambo, okanye inkqubo yokugaya ukutya.

Ziziphi iindlela zonyango ze-PTCL?

Ngenxa yokuba kukho iintlobo ezininzi ze-PTCL kunye nesigaba somhlaza, akukho nyango lufanayo . Iindlela zonyango zinokwahluka kumntu nomntu. Ugqirha wakho uya kumisela unyango olulungele wena. Nazi ezinye zezona ndlela zonyango zixhaphakileyo:

• Unyango lweKhemotherapy: Indibaniselwano yeentlobo ezahlukeneyo zamayeza ekhemotherapy. Olu lolona nyango luphambili olusetyenziswa kakhulu.
• Unyango ngemitha: Ngamanye amaxesha olu hlobo lonyango lusetyenziswa kunye ne-chemotherapy, ingakumbi xa umhlaza ungowasekuhlaleni.
• Unyango olujoliswe kulo: Olu lunyango olujolise kutshintsho oluthile lwemfuza (iinguqu) ezibangela ukuba iiseli eziphilileyo zibe ziiseli zomhlaza. Oku kwahlukile kwi-chemotherapy yendabuko.
• Unyango lwe-Chemotherapy kunye nokufakelwa kweeseli ze-stem ze-allogeneic: Olu nyango lungasetyenziselwa i-PTCL engaphenduliyo kwi-chemotherapy kunye nonyango lwe-radiation, okanye ephinda ivele emva konyango. Olu lonyango luyinkimbinkimbi ngakumbi.

Ngamanye amaxesha unokukwazi ukuthatha inxaxheba kuvavanyo lweklinikhi lonyango olutsha lwe-PTCL. Thetha nogqirha wakho ngale nto.

Zithini iziphumo ebezingalindelekanga eziqhelekileyo zonyango?

Unyango oluninzi lomhlaza lunokubangela ezinye iziphumo ebezingalindelekanga. Nangona kunjalo, ayinguye wonke umntu ofumana zonke ezi ziphumo ebezingalindelekanga, kwaye ubukhali bungahluka. Umzekelo, iziphumo ebezingalindelekanga ze-chemotherapy kunye nonyango lwe-radiation zingabandakanya:

• Ukudinwa
• Inkungu yengqondo ebangelwa yi-chemotherapy - imvakalelo yenkungu yengqondo, ukulahlekelwa yinkumbulo, kunye nobunzima bokugxila.
• Isicaphucaphu nokuhlanza
• Ukulahleka kweenwele
• Izilonda zomlomo
• Usulelo lunokufumaneka lula

Ngoku kukho iindlela ezininzi zokulawula ezi ziphumo ebezingalindelekanga, ngoko ke thetha nogqirha wakho ngaloo nto.

Ithini ingqikelelo ye-PTCL?

Oku kuxhomekeke ngokwenene kuhlobo lwe-PTCL, inqanaba lomhlaza, impilo yakho iyonke, nokuba ingaba umhlaza usele uphilile na (``ukukhululwa``) ngonyango.``Ukuxolelwa`` kuthetha ukuba awunazo iimpawu kwaye akukho zimpawu zomhlaza ezinokufunyanwa kwiimvavanyo. Kwezinye iimeko, i-PTCL inokunyangeka ngokupheleleyo ngonyango oluqhelekileyo.

Nangona kunjalo, iintlobo ezininzi ze-peripheral T-cell lymphoma zinokubuya (`(ziphinde zibuye)`) . Ukuba oku kuyenzeka, unokufuna unyango olongezelelweyo okanye uhlobo olwahlukileyo lonyango.

Kungokwemvelo ukufuna ukwazi ukuba ulindele ntoni kunyango lwakho. Ugqirha wakho ngoyena mntu ulungileyo onokumazi ngemeko yakho. Ngoko ke thetha naye ngokukhululekileyo kwaye ungoyiki ukubuza imibuzo.

Ngaba i-PTCL ingathintelwa?

Ngelishwa, hayi, ngokokwazi kwethu, akukho ndlela ithile yokuthintela oku . Le lymphoma ibangelwa zii-T-cells eziziphatha kakubi kwaye zibe ngumhlaza. Akukho nto sinokuyenza ukuthintela ukuba ingenzeki. Nangona kunjalo, ukuphepha izinto ezithile ezinobungozi (umz., intsholongwane ye-HTLV-1) kunokunciphisa umngcipheko wokukhula kweentlobo ze-PTCL ezinxulumene noko.

Ndingazinyamekela njani ? (Ukuphila ne-PTCL)

I-Peripheral T-cell lymphoma luhlobo lomhlaza olungaqhelekanga nolukhula ngokukhawuleza. Ukuba une-PTCL, nazi iingcebiso zokukunceda uphile nale meko:

• Cinga ngonyango oluthomalalisa iintlungu: Olu nyango lunokukunceda ulawule iimpawu kunye nemiphumo emibi yonyango. Ngaphezu koko, iqela lakho lonyango oluthomalalisa iintlungu linokukunceda ekujonganeni nemingeni yeemvakalelo (usizi, uloyiko, ixhala) ehambisana nokuphila nesi sifo esinzima kangaka.
• Fumana inkxaso: Ngenxa yokuba i-PTCL ngumhlaza ongaqhelekanga, ungaziva ngathi nguwe wedwa ojongene nawo. Kodwa akufuneki uye wedwa. Thetha neqela lakho lezonyango kwaye ufumane ulwazi malunga namaqela enkxaso apho unokunxibelelana nabanye abadlula kwinto efanayo nawe. Ukwabelana ngamava nokufumana inkxaso kwabanye kubaluleke kakhulu ngeli xesha.
• Zinike ixesha (Ukuzinyamekela): Umhlaza yimeko ebangela uxinzelelo. Ukuzinyamekela kubaluleke kakhulu xa uphila ne-PTCL. Thetha neqela lakho lezempilo malunga neendlela zokulawula uxinzelelo (ukucamngca, ukuzilolonga ngokuphefumla, ukuzibandakanya kwinto oyithandayo), kunye nendlela yokwenza ukutya okunesondlo ukuze uhlale unamandla kulo lonke unyango. Lala ngokwaneleyo.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungalibali ukubuza le mibuzo xa ubona ugqirha wakho:

• Luhlobo luni lwe-Peripheral T-cell lymphoma endinayo? Ibizwa ngokuba yintoni?
• Ingakanani inqanaba lesi sifo sam? Sisasazeke kangakanani?
• Ziziphi iindlela zonyango endinazo? Zithini iingenelo kunye neengxaki zonyango ngalunye?
• Luhlobo luni lwempumelelo olunokulindelwa kwezi ndlela zonyango?
• Zithini iziphumo ebezingalindelekanga zonyango? Zingalawulwa njani?
• Ngaba ndifanele ndicinge ngonyango olutsha olusekelwe kuphando (`(uvavanyo lweklinikhi)`)? Ngaba zilungile kum?
• Zeziphi iinguqu ekufuneka ndizenze kwindlela endiphila ngayo?

Umyalezo Wokugqibela Wokuya Ekhaya

I-Peripheral T-cell lymphoma (PTCL) luhlobo lomhlaza wegazi olungaqhelekanga kodwa olubalulekileyo. Lwenzeka xa ii-T-cells ezikhusela imizimba yethu zitshintshatshintsha zibe ngumhlaza. Nangona zinesizathu esifanayo, ukwakheka kwemfuza nganye kwahlukile. Ngenxa yokuba i-PTCL ichaphazela amalungu ahlukeneyo omzimba, ngamanye amaxesha kunokuba nzima ukuyixilonga nokunyanga.

Kodwa, hlala unethemba! Abaphandi bezonyango bahlala bekhangela unyango olutsha nolusebenzayo olujolise kutshintsho lwezakhi zofuzo kwi-PTCL. Ukuba ufunyaniswe une-PTCL, ungoyiki, kwaye thetha ngokukhululekileyo neqela lakho lezonyango . Buza ukuba kukho unyango olutsha olusekelwe kuphando (izilingo zeklinikhi) olufanele imeko yakho ethile. Ngolwazi oluchanekileyo kunye nenkxaso yabathandekayo bakho, uya kuba namandla okujongana nalo mceli mngeni!

I- T-cell Lymphoma, i-PTCL, i-Lymphoma, i-T-cell lymphoma, umhlaza, umhlaza wegazi, i-Lymphoma, iimpawu ze-PTCL, unyango lwe-PTCL