Ingabe une-Peripheral T-cell Lymphoma (PTCL)? Ungakhathazeki, ake sixoxe ngakho!

Ngezinye izikhathi, singaba nezifo esingazicabangi nhlobo, akunjalo? I-Peripheral T-cell Lymphoma, noma i-PTCL ngamafuphi, iyisimo esiyinkimbinkimbi, kodwa kubaluleke kakhulu ukuqaphela. Akusona isifo esisodwa ngempela, kodwa inhlanganisela yezifo eziningana. Ingabe singakhuluma ngalokhu kalula, ngendlela ongayiqonda?

I-Peripheral T-cell Lymphoma (PTCL) akuyona isifo esisodwa ngempela. Iyiqembu lezinhlobo eziningana zomdlavuza wegazi oyingozi . Ngokukhethekile, ithinta uhlelo lwethu lwe-lymphatic . Kungenzeka ukuthi uke wezwa ngayo ngokuthi "i-Non-Hodgkin lymphoma", futhi yilokho eyikho. Into eyodwa nge-PTCL ukuthi ingasakazeka (isakazeke) isuka kwenye ingxenye yomzimba iye kwezinye izingxenye . Lokhu kusho ukuthi ingathinta cishe noma iyiphi ingxenye yomzimba, ngakho izimpawu zingahluka.

Izindaba ezinhle ukuthi odokotela bangalawula ngempumelelo izinhlobo eziningi ze-PTCL. Kodwa-ke, ngezinye izikhathi lesi sifo singaphinde sibuye . Yingakho abacwaningi bezokwelapha behlala befuna izindlela ezintsha zokwelapha ezingasiza abantu baphile isikhathi eside nge-PTCL.

Ingabe lesi sifo esibizwa ngokuthi i-PTCL sivamile?

Cha, empeleni lesi akusona isifo esivame kakhulu . Ucwaningo olwenziwe emhlabeni wonke lubonisa ukuthi abantu ababalelwa ku-200 000 bathola i-PTCL. Cishe u-10% walabo abathola i-`(Non-Hodgkin lymphoma)` bane-PTCL.

Lesi simo sibonakala kaningi emazweni ethu ase-Asia, e-Afrika naseCaribbean kunase-United States. Sivame ukwenzeka kubantu abangaphezu kweminyaka engama-60. Kodwa-ke, ezinye izinhlobo zingavela nasezinganeni ezincane nakubantu abadala abasebasha .

Yiziphi izinhlobo eziyinhloko ze-PTCL?

I-World Health Organization (WHO) ithole izinhlobo ezingaphezu kuka-20 ze-PTCL. Ngayinye yalezi inezimpawu zayo zofuzo ezihlukile. Ake sibheke ezinye zezinhlobo ezivame kakhulu.

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

Lolu uhlobo oluvame kakhulu . ``(PTCL-NOS)`` luyisigaba esihlanganisa amacala angenakuchazwa ngokunembile futhi angangeni kwezinye izinhlobo ezicacile. Cishe ama-30% azo zonke iziguli ze-PTCL awela kulesi sigaba. Kungathinta kakhulu ama-lymph node akho, umongo wamathambo , udende , noma isibindi .

I-Angioimmunoblastic T-cell lymphoma (AITL)

Lokhu kwenzeka naku-15% kuya ku-30% weziguli ze-PTCL emhlabeni jikelele. I-AITL ingathinta futhi ubende, umongo, ubende, noma isibindi sakho.

I-Anaplastic large cell lymphoma (ALCL)

Kukhona nezinhlobo ezahlukene ze-`(ALCL)`.

• Kukhona eyodwa ebizwa ngokuthi i-primary cutaneous ALCL , ethinta isikhumba .
• Kukhona enye futhi.I-ALCL yesistimu, ethinta amaphaphu, isikhumba, nezinye izitho zomzimba. Le ALCL yesistimu ngezinye izikhathi ihlukaniswa ngokwezinguquko ku-gene ethile ebizwa ngokuthi i-ALK (i-anaplastic lymphoma kinase) . Cishe u-15% we-PTCL uwela kulolu hlobo lwe-``(ALCL)```.

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

Lolu lukhethekile kancane. Lolu hlobo luvame ukuvela ezicutshini zekhala lakho , ezimbotsheni zama-sinus , nasemphinjeni ongaphezulu . Kodwa ngezinye izikhathi lungasakazeka esikhumbeni, emgudwini wokugaya ukudla , nakwezinye izitho zomzimba. Lolu hlobo luhlanganisa cishe u-10% we-PTCL.

Ama-lymphoma e-T-cell emathunjini

Igama lisikisela lokho, akunjalo? Lokhu kuthinta uhlelo lokugaya ukudla . Kuhlanganisa cishe u-6% we-PTCL. Kuphinde kube nezinhlobo ezibizwa ngokuthi i-enteropathy-associated T-cell lymphoma (EATL) kanye ne -monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) .

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

Kungathinta isikhumba namathambo. Kunezinhlobo ezine ze-ATLL: i-acute, i-lymphoma, i-chronic, kanye ne-smoldering . Izinhlobo ezimbili ezivame kakhulu yi-acute kanye ne-lymphoma, ezinolaka. Izinhlobo ezingamahlalakhona kanye ne-smoldering zikhula kancane. Uhlobo ngalunye lwe-ATLL luthinta izingxenye ezahlukene zomzimba.

Ziyini izimpawu ze-PTCL?

Nakuba uhlobo ngalunye lwe-PTCL lunezimpawu ezithile, kunezinye ezivamile. Ake sibheke ukuthi ziyini:

• Ama-lymph node avuvukele: Ungase uvuvuke ngaphandle kobuhlungu entanyeni yakho, emakhwapheni, noma embotsheni. Cabanga ngeqhubu elincane entanyeni yakho elizwakala sengathi liyakhula ngokuhamba kwesikhathi, kodwa lingabi buhlungu. Yilokho kuphela.
• Ukwehla kwesisindo okungachazeki: Uma ulahlekelwa cishe u-10% wesisindo sakho sisonke zingakapheli izinyanga eziyisithupha, ngaphandle kokuzama kanzima, kuyinto okufanele uyikhathalele.
• Ubuhlungu besisu noma ukuvuvukala: Lokhu kungenzeka uma ubende lwakho lukhulisiwe. Kungazwakala kungakhululekile, njengokungathi isisu sakho sigcwele.
• Ukukhathala okuqhubekayo: Ukuzizwa ukhathele ngendlela engavamile izinsuku eziningana ngaphandle kwesizathu esibonakalayo. Kunjengokungathi ukukhathala akupheli kungakhathaliseki ukuthi ulala kangakanani.
• Umkhuhlane ongachazeki: Ngokuvamile, umkhuhlane uvela lapho umzimba ulwa nokutheleleka. Kodwa-ke, uma umkhuhlane ongaphezu kwama-degree Celsius angu-39.5 (103 Fahrenheit) uqhubeka isikhathi esingaphezu kwamahora amabili ngemva kokwelashwa ekhaya, noma uma umkhuhlane uqhubeka isikhathi esingaphezu kwezinsuku ezimbili, kungaba uphawu lokuthile okungathi sína kakhulu.

Into ebaluleke kakhulu ukuthi akudingeki ukhathazeke ngokuba ne-PTCL ngoba nje unalezi zimpawu. Zingaba ngenxa yezinye izimbangela ezilula. Kodwa uma lezi zimpawu ziqhubeka,Kubaluleke kakhulu ukubonana nodokotela futhi uthole iseluleko.

Manje ake sibone ukuthi yiziphi izimpawu ezihambisana nezinye izinhlobo ezithile zesifo.

Izici ezengeziwe ze-peripheral T-cell lymphoma, ezingachazwanga ngenye indlela (PTCL-NOS)

Ngaphezu kwezimpawu ezivamile, ungabona futhi:

• Ukwehla kwamangqamuzana abomvu egazi (i-Anemia) - Lokhu kungabangela ukuphaphatheka kanye nokukhathala okukhulu.
• Inani eliphansi lamaplatelet egazini (i-Thrombocytopenia) - Lokhu kungaholela ekuthambekeleni kokuphuma kwegazi.
• Amabala abomvu alumayo esikhumbeni.
• Uma umdlavuza usesifubeni , ubuhlungu besifuba noma ubunzima bokuphefumula (ukuphelelwa umoya).

Izici ezengeziwe ze-angioimmunoblastic T-cell lymphoma (AITL)

Ngaphezu kwezimpawu ezivamile:

• Ukujuluka ebusuku - Ukujuluka kakhulu ngenkathi ulele kangangokuthi amashidi ayamanzi.
• Ukuqhuma kwesikhumba.
• Izinkinga zokuzivikela komzimba ezifana ne- "Autoimmune hemolytic anemia" .

Izici ezengeziwe ze-anaplastic large cell lymphoma (ALCL)

I-ALCL eyinhloko yesikhumba (uhlobo oluthinta isikhumba)

• Izinto ezifana nokushintsha kombala wesikhumba okungavamile okubomvu noma okubomvu ngokunsundu, amaqhubu akhula ngokuhamba kwesikhathi.
• Amabhamuza amakhulu, ayindilinga, alumayo .
• La maqhubu angaba buhlungu futhi agcwale uqweqwe.

I-ALCL ehlelekile (uhlobo oluthinta izitho zangaphakathi)

Kulokhu, izimpawu ezivamile kwi-PTCL ziyabonakala.

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

• Ukuminyana kwamakhala, umuzwa sengathi ikhala livalekile.
• Ukopha ekhaleni .
• Ingaphakathi lempumulo liba lukhuni .
• Ukuvuvukala kobuso okubuhlungu .
• Izinkinga zamehlo njengokuphuma kwamanzi emehlweni kanye nobuhlungu bamehlo.

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

Izimpawu ze-PTCL zivamile kuzo zonke izinhlobo ezine ze-ATLL.

Yiziphi izimbangela ze-PTCL?

Kalula nje, i-peripheral T-cell lymphoma yenzeka lapho amaseli e-T emzimbeni wethu eguquka (`(mutate)`) abe amaseli omdlavuza. Njengoba wazi, lawa maseli e-T awuhlobo lwamaseli amhlophe egazi asivikela kubahlaseli abanjengamagciwane angena emizimbeni yethu. Ngakho-ke, lapho lawa maseli e-T eguquka, aba amaseli omdlavuza futhi aqale ukwanda ngokungalawuleki . Uma ephindaphindeka kanje, aqoqana emaphashini ethu, e-spleen, esibindini, nakwezinye izitho zomzimba futhi akhe izimila ezinomdlavuza .

Ochwepheshe abakasitholi isizathu esiqondile sokuthi kungani la ma-T-cell eshintshashintsha kanje.Kodwa-ke, ucwaningo luthole ukuthi kuhlobene nezinye izimo zezokwelapha.

Ngokwesibonelo:

• Ucwaningo lomhlaba wonke lubonise ukuthi abantu abanesifo esibizwa ngokuthi isifo se-celiac bangase babe nengozi enkulu yokuthola izinhlobo eziningana ze-PTCL, okuhlanganisa ne-ALCL.
• Futhi, abantu abangenwe yigciwane le-Epstein-Barr bangaba nengozi enkulu yokuthola i-extranodal natural killer/T-cell lymphoma.
• Abantu abanegciwane `(igciwane le-Human T-cell lymphotropic Type 1 (HTLV-1))` basengozini enkulu yokuthola `(i-acute T-cell lymphoma/leukemia)`.

I-PTCL ihlolwa kanjani?

Odokotela kungadingeka benze izivivinyo eziningana ezahlukene ukuze bathole uhlobo oluthile lwe-PTCL olubangela izinkinga zempilo yakho. Lokhu kungafaka ukuhlolwa kwegazi, ukuhlolwa kwezithombe, ukuhlolwa kwe-biopsy , kanye nokuhlolwa kwezakhi zofuzo ukuze kufundwe ukwakheka kwezakhi zofuzo zamaseli omdlavuza.

Ukuhlolwa kwegazi

Odokotela benza ukuhlolwa kwegazi ukuze bahlole amagciwane angase ahlotshaniswe ne-PTCL. Lokhu kungafaka:

• Inani legazi eliphelele (i-CBC)
• Iphaneli ephelele ye-metabolic (i-CMP)
• Ukuhlolwa kwe-Lactate dehydrogenase (LDH)
• Ukuhlolwa kwe-Hepatitis B kanye ne -Hepatitis C
• Ukuhlolwa kwegciwane lesandulela ngculaza (i-HIV)
• Ukuhlolwa kwegciwane le-T-cell lymphotropic Type 1 (HTLV-Type 1) lomuntu

Ukuhlolwa kwezithombe

Lezi ziskeni zivumela odokotela ukuthola ulwazi mayelana nengaphakathi lomzimba wakho, ikakhulukazi lapho kutholakala khona amaqhubu anomdlavuza.

• I-computed tomography (CT) scan
• Ukuskena kwe-positron emission tomography (PET)
• Ukuskena kwe-magnetic resonance imaging (MRI)

Ukuhlolwa kwe-Biopsies

Lokhu kuhilela ukuthatha ingxenye encane yezicubu endaweni esolisayo bese uyihlola ngaphansi kwesibonakhulu. Lena yindlela eyinhloko yokuqinisekisa lesi sifo ngokuqinisekile .

• I-biopsy ye-lymph node
• I-biopsy yesikhumba
• Ukuhlolwa komnkantsha wethambo

Yiziphi izigaba ze-PTCL?

Odokotela basebenzisa ukuhlelwa komdlavuza ukuhlela ukwelashwa nokukunikeza umbono walokho ongakulindela ekwelashweni (ukubikezela). Lesi sigaba sinqunywa uhlobo lwe-PTCL kanye nokuthi amaseli e-T anomdlavuza asakazeke kuphi. Nazi izigaba ezine eziyinhloko ze-PTCL:

• Isigaba I: Amaseli e-T anomdlavuza atholakala kuphela kuseli elilodwa noma eqenjini elilodwa lamaseli.
• Isigaba II: Umdlavuza usuthinte ama-lymph node amabili noma ngaphezulu ohlangothini olufanayo lomzimba wakho (isibonelo, ohlangothini ngalunye lwentamo yakho, noma ohlangothini olufanayo ngaphezulu noma ngaphansi kwe-diaphragm).
• Isigaba III: Umdlavuza ususakazekele ezicutshini ezingaphezulu nangaphansi kwe-diaphragm yakho.
• Isigaba IV: Ngaphezu kwamasende, umdlavuza uphinde wathinta nezinye izitho zomzimba, njengamaphaphu, isibindi, umongo wamathambo, noma uhlelo lokugaya ukudla.

Yiziphi izindlela zokwelapha i-PTCL?

Ngenxa yokuthi kunezinhlobo eziningi ze-PTCL kanye nesigaba somdlavuza, akukho ukwelashwa okulingana nakho konke . Izinketho zokwelapha zingahluka kumuntu nomuntu. Udokotela wakho uzonquma ukwelashwa okungcono kakhulu kuwe. Nazi ezinye zezindlela zokwelapha ezivame kakhulu:

• Ukwelashwa ngamakhemikhali: Inhlanganisela yezinhlobo ezahlukene zemithi yamakhemikhali. Lena yindlela yokwelapha eyinhloko esetshenziswa kakhulu.
• Ukwelashwa ngemisebe: Lokhu ngezinye izikhathi kusetshenziswa kanye ne-chemotherapy, ikakhulukazi uma umdlavuza usendaweni ethile.
• Ukwelashwa okuqondiwe: Lokhu ukwelashwa okuqondiswe ezinguqukweni ezithile zofuzo (ukuguqulwa kwezakhi zofuzo) okubangela amangqamuzana aphilile ukuba abe amangqamuzana omdlavuza. Lokhu kuhlukile kumakhemikhali avamile.
• Ukwelashwa ngamakhemikhali kanye nokufakelwa kwamaseli e-stem allogeneic: Lokhu kwelashwa kungasetshenziswa kwi-PTCL engaphenduli ekwelashweni ngamakhemikhali kanye nemisebe, noma ephinde ivele ngemva kokwelashwa. Lokhu kuyindlela yokwelapha eyinkimbinkimbi kakhulu.

Ngezinye izikhathi ungase ukwazi ukuhlanganyela ezivivinyweni zemitholampilo zokwelapha okusha kwe-PTCL. Khuluma nodokotela wakho ngalokhu.

Yimiphi imiphumela emibi evamile yokwelashwa?

Ukwelashwa okuningi komdlavuza kungabangela imiphumela emibi. Kodwa-ke, akuwona wonke umuntu othola yonke le miphumela emibi, futhi ubukhali bungahluka. Isibonelo, imiphumela emibi ye-chemotherapy kanye nokwelashwa ngemisebe ingafaka:

• Ukukhathala
• Inkungu yobuchopho ebangelwa ukwelashwa ngamakhemikhali - umuzwa wenkungu yobuchopho, ukulahlekelwa yinkumbulo, kanye nobunzima bokugxilisa ingqondo.
• Isicanucanu nokuhlanza
• Ukulahlekelwa izinwele
• Izilonda zomlomo
• Kuthambekele kakhulu ezifweni

Manje kunezindlela eziningi zokulawula le miphumela emibi, ngakho-ke khuluma nodokotela wakho nangalokho.

Iyini iphrojekthi ye-PTCL?

Lokhu kuncike kakhulu ohlotsheni lwe-PTCL, isigaba somdlavuza, impilo yakho iyonke, nokuthi umdlavuza usuphelile yini (``ukuxolelwa``) ngokwelashwa."Ukuxolelwa" kusho ukuthi awunazo izimpawu futhi azikho izimpawu zomdlavuza ezingatholakala ekuhlolweni. Kwezinye izimo, i-PTCL ingelapheka ngokuphelele ngokwelashwa okujwayelekile.

Kodwa-ke, izinhlobo eziningi ze-peripheral T-cell lymphoma zingabuya (`(ziphinde zibuye)`) . Uma lokhu kwenzeka, ungadinga ukwelashwa okwengeziwe noma uhlobo oluhlukile lokwelashwa.

Kungokwemvelo ukufuna ukwazi ukuthi yini ongayilindela ekwelashweni kwakho. Udokotela wakho ungumuntu ongcono kakhulu omaziyo ngesimo sakho. Ngakho-ke khuluma naye ngokukhululeka nangokuthembekile ngalokhu futhi ungesabi ukubuza imibuzo.

Ingabe i-PTCL ingavinjelwa?

Ngeshwa, cha, ngokwazi kwethu, ayikho indlela eqondile yokuvimbela lokhu . Le lymphoma ibangelwa ama-T-cell aziphatha kabi futhi abe ngumdlavuza. Akukho esingakwenza ukuvimbela ukuthi kungenzeki. Kodwa-ke, ukugwema izici ezithile eziyingozi (isib. igciwane le-HTLV-1) kunganciphisa ingozi yokuthola izinhlobo ze-PTCL ezihambisanayo.

Ngizinakekela kanjani ? (Ukuphila ne-PTCL)

I-Peripheral T-cell lymphoma uhlobo lomdlavuza olungavamile nolukhula ngokushesha. Uma une-PTCL, nanka amanye amathiphu angakusiza ukuthi uphile nalesi simo:

• Cabanga ngokunakekelwa kokunciphisa ubuhlungu: Lokhu kunakekelwa kungakusiza ukuthi uphathe izimpawu nemiphumela emibi yokwelashwa. Ngaphezu kwalokho, ithimba lakho lokunakekelwa kokunciphisa ubuhlungu lingakusekela ekubhekaneni nezinselele ezingokomzwelo (ukudabuka, ukwesaba, ukukhathazeka) ezihambisana nokuphila nesifo esibi kangaka.
• Thola ukwesekwa: Ngenxa yokuthi i-PTCL ingumdlavuza ongavamile, ungase uzizwe sengathi uwedwa obhekene nawo. Kodwa akudingeki uyenze wedwa. Khuluma nethimba lakho lezokwelapha bese uthola ulwazi ngamaqembu okusekelana lapho ungaxhumana khona nabanye ababhekene nento efanayo nawe. Ukwabelana ngolwazi nokuthola ukwesekwa kwabanye kubaluleke kakhulu ngalesi sikhathi.
• Zinike isikhathi (Ukuzinakekela): Umdlavuza uyinkinga ecindezelayo. Ukuzinakekela kubaluleke kakhulu uma uphila ne-PTCL. Khuluma nethimba lakho lezempilo ngezindlela zokuphatha ukucindezeleka (ukuzindla, ukuzivocavoca ngokuphefumula, ukuzibandakanya nomsebenzi wokuzilibazisa), kanye nendlela yokwakha ukudla okunempilo ukuze uhlale unamandla phakathi nokwelashwa. Lala ngokwanele.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungakhohlwa ukubuza le mibuzo uma ubona udokotela wakho:

• Uhlobo luni lwe-Peripheral T-cell lymphoma enginalo? Lubizwa ngokuthini?
• Siyini isigaba sesifo sami? Sisakazeke kangakanani?
• Yiziphi izindlela zokwelapha enginazo? Yiziphi izinzuzo kanye nokungalungi kokwelashwa ngakunye?
• Hlobo luni lwempumelelo olungalindelwa kulezi zindlela zokwelapha?
• Ziyini imiphumela emibi yokwelashwa? Zingalawulwa kanjani?
• Ingabe kufanele ngicabangele ukwelashwa okusha okusekelwe ocwaningweni (`(isivivinyo somtholampilo)`)? Ingabe kulungile kimi?
• Yiziphi izinguquko okudingeka ngizenze endleleni yami yokuphila?

Umyalezo Wokugcina Wokuya Nasekhaya

I-Peripheral T-cell lymphoma (PTCL) uhlobo lomdlavuza wegazi olungavamile kodwa olubalulekile. Lwenzeka lapho ama-T-cell avikela imizimba yethu eshintshashintsha abe umdlavuza. Nakuba enembangela efanayo, ukwakheka kwezakhi zofuzo kwalowo nalowo kuhlukile. Ngenxa yokuthi i-PTCL ithinta izingxenye ezahlukene zomzimba, ngezinye izikhathi kungaba nzima ukuyixilonga nokwelapha.

Kodwa, hlala unethemba! Abacwaningi bezokwelapha bahlala befuna izindlela zokwelapha ezintsha nezisebenza kahle eziqondisa izinguquko zofuzo ku-PTCL. Uma utholakale une-PTCL, ungesabi, futhi khuluma ngokukhululekile nethimba lakho lezokwelapha . Buza ukuthi kukhona yini izindlela zokwelapha ezintsha ezisekelwe ocwaningweni (izivivinyo zemitholampilo) ezifanele isimo sakho esithile. Ngolwazi olufanele kanye nokusekelwa kwabathandekayo bakho, uzokwazi ukubhekana nale nselele!

I - T-cell Lymphoma, i-PTCL, i-Lymphoma, i-T-cell lymphoma, umdlavuza, umdlavuza wegazi, i-Lymphoma, izimpawu ze-PTCL, ukwelashwa kwe-PTCL