Ake sifunde ngomdlavuza we-DLBCL (Diffuse Large B-Cell Lymphoma) ngendlela elula.

Wake wezwa ngesifo esithi `Diffuse Large B-Cell Lymphoma` noma `DLBCL`? Lolu uhlobo lomdlavuza olusakazeka ngokushesha. Kodwa ungakhathazeki, uma lutholakala kusenesikhathi futhi lwelashwa ngendlela efanele , lungelapheka . Namuhla, ake sixoxe ngale `DLBCL` ngamazwi alula.

Kuyini i-DLBCL?

I-DLBCL ingumdlavuza wegazi. Kulesi sifo, uhlobo lweseli elimhlophe legazi elibizwa ngama-B cells (elibizwa nangokuthi ama-lymphocyte) emzimbeni wethu luba ngumdlavuza. Lolu uhlobo lwe-lymphoma oluvame kakhulu, olukhula ngokushesha, futhi olunolaka kakhulu olubizwa ngokuthi i-non-Hodgkin lymphoma. Uhlelo lwethu lwe-lymphatic lulwa namagciwane. Lapho i-DLBCL ikhula, lawa maseli e-B aba ngumdlavuza futhi akhula ngokushesha, aminyanise amangqamuzana anempilo. Abe esehluleka ukulwa namagciwane. Lawa maseli anomdlavuza angakheka noma kuphi, kufaka phakathi ama-lymph node, umgudu wokugaya ukudla, kanye nobuchopho. Nakuba kuyingozi, kungelapheka uma kutholakala kusenesikhathi.

Yiziphi izinhlobo ze-DLBCL?

I-World Health Organization (WHO) ithole izinhlobo eziningana ze-DLBCL. Odokotela basebenzisa uhlobo ngalunye ukuze bathole ukuthi umdlavuza uqhubeka kanjani nokuthi usabela kanjani ekwelashweni. Lokhu kuhlukaniswa kuthonywa kakhulu yilokhu:

• Izinguquko zofuzo kumaseli.
• Indawo emzimbeni lapho i-DLBCL iqala khona (isb., uhlelo lwezinzwa oluphakathi - `CNS`).
• Ukuhlanganiswa negciwane (isib. igciwane le-Epstein-Barr - i-EBV).

Kubaluleke kakhulu ukubuza udokotela wakho ngohlobo lwe-DLBCL onayo.

Kuvamile kangakanani lokhu?

I-DLBCL uhlobo oluvame kakhulu lwe-lymphoma. Kodwa-ke, i-DLBCL ayivamile kakhulu phakathi komdlavuza ngokuvamile. Isibonelo, i-DLBCL iyenzeka kubantu abangaba ngu-6 kwabangu-100,000. Lokhu akuvamile uma kuqhathaniswa neminye imidlavuza.

Ziyini izimpawu ze-DLBCL?

Uphawu oluvame kakhulu lwe-DLBCL ukuvuvukala kwama-lymph node entanyeni, emakhwapheni, noma embotsheni . Lokhu kungase kuqale njengeqhubu, kancane kancane kukhule, futhi kungase kungabi buhlungu.

Abanye abantu (cishe oyedwa kwabathathu) bangase babe nezimpawu ezikhethekile ezibizwa ngokuthi "izimpawu ze-B" :

• Umkhuhlane (ongaphezu kwama-39.5 Celsius) ohlala izinsuku ezingaphezu kwezimbili noma ofika uphinde uphele.
• Ukulahlekelwa isisindo somzimba esingaphezu kuka-10% ezinyangeni eziyisithupha ngaphandle kwesizathu.
• Ukujuluka kakhulu ebusuku, kangangokuthi amashidi okulala awanamanzi.

Ungesabi ukucabanga ukuthi yi-DLBCL noma ngabe unalezi zimpawu. Kodwa-ke, uma ziqhubeka amasonto amaningana, bona udokotela.

Kungani i-DLBCL ikhula? Yiziphi izici eziyingozi?

I-DLBCL ibangelwa izinguquko kumaseli e-B. Lezi izinguquko zezakhi zofuzo ezenzeka ngesikhathi sokuphila . Imbangela eqondile ayaziwa, kodwa kunezici eziningana ezitholakele ezikhulisa ingozi:

• Ubudala:Kuvame kakhulu kubantu abaseminyakeni yabo yo-60. Isilinganiso seminyaka yokuxilongwa sicishe sibe yiminyaka engu-64.
• Ubulili: Amadoda angabuthuthukisa kancane kunabesifazane.
• Umlando womndeni: Uma isihlobo sezinga lokuqala (umzali, umfowabo, ingane) sine-DLBCL, ungase ube nengozi eyengeziwe yokuba nayo (isizathu asikacaci).
• Ukutheleleka: Amagciwane afana negciwane le-Epstein-Barr (EBV), igciwane le-human immunodeficiency (HIV), kanye ne-hepatitis B kanye ne-C.
• Isimiso somzimba sokuzivikela esibuthakathaka: Ukuba nesifo sokuzivikela somzimba esiyinhloko noma isifo sokuzivikela komzimba esizenzakalelayo, noma ukuthatha imithi yokucindezela umzimba ngemva kokufakelwa isitho somzimba. Lesi yisici esikhulu esiyingozi.
• Inkomba yesisindo somzimba ephezulu (i-BMI) esemncane kanye nokuchayeka ezintweni ezinobuthi ezisetshenziswa kwezolimo.

Ngisho noma lezi zici zikhona, akuwona wonke umuntu ozakhayo, noma ongazakha. Kodwa kubalulekile ukuzazi lezi zici.

Itholakala kanjani i-DLBCL? (Ukuxilongwa)

Odokotela baqinisekisa i-DLBCL nge -lymph node biopsy (ukuthatha ucezu oluncane lwe-lymph node evuvukele ukuze luhlolwe) kanye nokuhlolwa kofuzo. Uma i-DLBCL iqinisekisiwe, kwenziwa ezinye izivivinyo ukuze kubonakale ukuthi umdlavuza ususakazeke yini:

• Ukuhlolwa kwegazi: Inani eliphelele legazi (i-CBC), ukuhlola amagciwane anjenge-HIV, i-EBV, kanye ne-hepatitis.
• Ukuhlolwa kwe-Lactate dehydrogenase (LDH): Le enzyme itholakala emazingeni aphezulu ezigulini eziningi ze-DLBCL.
• Ukuhlolwa kwezithombe: i-CT scan, i-MRI scan, i-PET scan.
• `Ukuhlolwa komnkantsha wamathambo` .
• Ukubhoboza i-Lumbar (ukuhlolwa koketshezi lomgogodla).

Odokotela benza izinqumo ngesimo sakho futhi bahlela ukwelashwa ngokusekelwe olwazini olutholakala kulolo nalolo vivinyo.

Yiziphi izigaba ze-DLBCL?

Izinhlelo zokulinganisa umdlavuza zisetshenziselwa ukunquma ukuthi umdlavuza usukhule futhi usakazeke kangakanani. Lokhu kusiza ukuhlela ukwelashwa nokubikezela ukubikezela. Izigaba ze-DLBCL yilezi:

• Isigaba I: Umdlavuza utholakala kuphela ku-lymph node eyodwa, isitho esisodwa ohlelweni lwe-lymphatic, noma endaweni eyodwa yesitho esisodwa ngaphandle kohlelo lwe-lymphatic.
• Isigaba II: I-Lymphoma ikhona emaqenjini amaningana ama-lymph node ohlangothini olufanayo lwe-diaphragm.
• Isigaba III: Umdlavuza ukhona kuma-lymph node kuzo zombili izinhlangothi ze-diaphragm.
• Isigaba IV:Umdlavuza we-DLBCL ususakazekele ezithweni zomzimba ezingaphandle kohlelo lwe-lymphatic (isib. umnkantsha wamathambo, isibindi, amaphaphu).

Odokotela babiza izigaba I no-II ngokuthi “izigaba zokuqala” kanti izigaba III no-IV zibiza ngokuthi “izigaba ezithuthukile.”

Yiziphi izindlela zokwelapha i-DLBCL?

Ukwelashwa okuvame kakhulu kwe-DLBCL yi -R-CHOP . Lokhu kuhilela inhlanganisela ye-antibody ye-monoclonal ebizwa ngokuthi i-rituximab, izinhlobo eziningana ze-chemotherapy, kanye ne-corticosteroid. Ngisho noma lokhu kwelashwa kuphumelele, lesi sifo singase sibuye (cishe ngo-30%-40%). Uma lokhu kwenzeka, udokotela wakho angase ancome ezinye izindlela zokwelapha:

• Ukwelashwa komugqa wesibili kanye `nokufakelwa kweseli le-stem le-autologous`.
• `Ukwelashwa ngamaseli e-CAR T`: Lokhu `ukwelashwa ngamaseli e-immunotherapy`.
• `Ukwelashwa okuqondiwe`: Ukwelashwa okuqondiswe ezinguqukweni zofuzo.

Khumbula, udokotela wakho uzonquma ukwelashwa okungcono kakhulu kuwe ngokusekelwe esimweni sakho esithile.

Ingabe ukuthuthukiswa kwe-DLBCL kungavinjelwa?

Ayikho indlela yokuvimbela ngokuphelele i-DLBCL. Kunezici eziyingozi esingenakuzilawula. Kodwa-ke, kunezinyathelo esingazithatha ukuze sizivikele ezifweni ezingaxhunyaniswa ne-DLBCL, njenge-hepatitis kanye ne-HIV. Kungumqondo omuhle futhi ukuzama ukugcina i-body mass index (BMI) enempilo. Lokhu kungasiza ekunciphiseni ingozi yakho ngezinga elithile.

Yini umuntu one-DLBCL angayilindela?

Ezinye izinhlobo ze-DLBCL zingaba yingozi empilweni futhi kube nzima ukuzelapha. Kodwa-ke, odokotela bavame ukwelapha futhi baphulukise lesi sifo . Ezimweni eziningi, ukwelashwa kwangaphambili kungenza i-DLBCL iphumule ngokuphelele (isimo lapho kungekho zimpawu noma izimpawu zomdlavuza). Cishe abantu abangu-60% abane-DLBCL belashwa ngokwelashwa kokuqala. Ngokwesilinganiso, abantu abangenawo umdlavuza eminyakeni emibili ngemva kokuxilongwa bangalindela ukuphila isikhathi esijwayelekile, njengakwabanye abantu abaneminyaka yabo. Izinga lokusinda liphakeme nakakhulu uma umdlavuza utholakala esiteji sokuqala .

Kodwa-ke, ulwazi lwakho luzoncika ezintweni eziningi, okuhlanganisa uhlobo lwe-DLBCL onayo, isigaba somdlavuza, kanye nempilo yakho iyonke. Udokotela wakho kuphela ongakunikeza ulwazi olungcono kakhulu ngalokhu.

Ngizinakekela kanjani? (Ukuzinakekela)

Ukuphila nomdlavuza akulula, kuyakhathaza kakhulu. Kubaluleke kakhulu ukuzinakekela ngenkathi welashwa i-'DLBCL'.

• Ukudla Okunomsoco: Yidla ukudla okunempilo nokulinganiselayo. Buza udokotela wakho ukuthi yini okufanele uyidle nokuthi yini okufanele uyigweme.
• Ukuphumula:Ukwelashwa kungabangela ukukhathala. Phumula ngokwanele.
• Ukuzivocavoca: Ukuzivocavoca okulula kunganciphisa ukucindezeleka.
• Ukusekela: Lesi yisimo esingavamile, ngakho-ke singazizwa sinesizungu. Joyina amaqembu okusekela lapho kunabantu abanjengawe. Khuluma nomndeni nabangane.

Udinga ukubona udokotela kanye nezimo eziphuthumayo

Uzobona udokotela wakho njalo ngesikhathi sokwelashwa. Ngisho nangemva kokwelashwa, kuzodingeka ukuthi umbone njalo ezinyangeni ezingu-3-4 eminyakeni emibili yokuqala futhi ungambonisi njalo eminyakeni emithathu ezayo. Lokhu kwenzelwa ukuhlola ukuthi umdlavuza uphinde ubuye yini. Uma unezimpawu zokuthi umdlavuza ubuyile, tshela udokotela wakho ngokushesha.

Ukwelashwa okufana ne-chemotherapy kungaba nemiphumela emibi kakhulu. Uma lezi zinto zenzeka , hamba uye ekamelweni eliphuthumayo ngokushesha :

• Imiphumela emibi kakhulu kunalokho obekulindelwe.
• Umkhuhlane uphakeme ngaphezu kwama- 38 Celsius (100.4 Fahrenheit).
• Ukuthuthumela okungenakuvinjelwa .
• Ubuhlungu obukhulu besisu noma isifo sohudo esiqhubekayo .

Imibuzo okufanele uyibuze udokotela wakho mayelana ne-DLBCL

Kuvamile ukuba nemibuzo eminingi uma uthola ukuthi une-DLBCL. Kubalulekile ukuthi ubuze udokotela wakho imibuzo efana nale:

• Uhlobo luni lwe-'Diffuse Large B-Cell Lymphoma' enginalo? Iyini 'isigaba'?
• Hlobo luni lokwelashwa engiludingayo? Yiziphi imiphumela emibi?
• Ingabe lezi zindlela zokwelapha zizowelapha ngokuphelele umdlavuza?
• Yiziphi izindlela zokwelapha ezitholakalayo uma umdlavuza ubuya?
• Ungangithumela eqenjini lokusekela abantu abanalolu hlobo lomdlavuza?

Ngaphezu kwale mibuzo, ungesabi ukubuza udokotela wakho noma yini onayo engqondweni noma ukungabaza ongase ube nakho.

Okokugcina, khumbula (Umyalezo Wokuya Ekhaya)

Uma iningi lethu lizwa igama elithi "ulaka" lapho likhuluma ngomdlavuza, silicabanga njengesifo esingelapheki futhi okunzima ukuselapha. Kodwa akunjalo nge-Diffuse Large B-Cell Lymphoma (DLBCL). Nakuba i-DLBCL ingasakazeka ngokushesha, ukwelashwa kwamanje komdlavuza kuvame ukubulala la maseli e-B anomdlavuza. Odokotela basebenzisa ngisho namagama anjengokuthi "ukwelapha" lapho bekhuluma ngezimo zabanye abantu.

Into ebaluleke kakhulu ukubuza udokotela wakho ukuthi ukuxilongwa kwakho kuzothinta kanjani umbono wakho wokwelashwa. Ngakho-ke, ungesabi, thola ulwazi, futhi ulandele iseluleko sikadokotela wakho. Ungakhohlwa ukuthi i-DLBCL inganqotshwa ngokutholwa kusenesikhathi kanye nokwelashwa okufanele!

Umdlavuza , i-lymphoma, amaseli e-B, ama-lymph node, izimpawu, ukwelashwa, i-DLBCL, i-chemotherapy, i-immunotherapy