I-follicular lymphoma ingenye yezinhlobo ezivame kakhulu ze- non-Hodgkin Lymphoma, noma i-NHL . Kuyinto i-lymphoma ekhula kancane, futhi ngokuvamile akuyona impilo esongelayo ngokushesha. Ngenxa yokuthi ikhula kancane futhi ingenakuqhathaniswa, abantu abaningi abaqapheli izinkinga ngenkathi lesi sifo sisesimweni sokuqala. Ngenkathi lesi sifo sithola ukuthi iziguli eziningi - amaphesenti angu-80-85 - zinezifo ezivame ukubandakanya izindawo eziningi ze-lymph node , umongo wamathambo , uhlangothi noma ezinye izitho.
Ukukhula kancane, kodwa kunzima ukwelapha ngokuphelele
Ngisho nasezikhungweni ezithuthukile, abantu abane-follicular lymphoma bavame ukuhlala isikhathi eside benokwelashwa okuvamile, ngenxa yemvelo ekhula kancane. Nokho, lesi sifo asiphilwanga. Abantu abaningi basabela kahle ekwelapheni, futhi lesi sifo singagcinwa iminyaka embalwa ngaphambi kokubuyela emuva futhi sidinga ukwelashwa futhi. Iziguli eziningi zidinga ukuthi ziphathwe izikhathi eziningi, ngezikhathi ezithile zesifo esizinzile ngemva kokwelapha okunye okungase kuthathe izinyanga ezinyangeni eziningi.
Bambalwa abantu abanenhlanhla ukutholakala ngenkathi lesi sifo sisesimweni sokuqala. Laba bantu bangaphiliswa. Ukwelashwa kwezidakamizwa kusetshenziselwa yedwa kubantu abaningi. Kuye kwabonwa ukuthi ukulinganisa okulinganiselwe kwemisebe enikezwe ezindaweni ezithintekile zomzimba kulabo abanezifo zendawo kungakwazi ukulawula lesi sifo unomphela. Ayikho inzuzo eyengeziwe yokwengeza i-chemotherapy noma ama-biological agents .
Ukwelashwa Kuxhomeke Engxenyeni yokuThuthukisa
Izivivinyo ezihlukahlukene zingenziwa ngezinhloso zesiteji, kufaka phakathi:
- Ukuhlolwa kwegazi
- I-bone yomnkantsha we-bone - ukuthatha isampula encane yamathambo emnkantsheni wamathambo
- I-computed tomography, noma i-CT scan
- I-Positron emission tomography, noma i-PET, iskena
Ukugxila kubhekisela kwisilinganiso sokusabalala.
Izindlela zokuhlukahluka ezihlukahlukene zisebenziswa, kepha nansi uhlelo oluvame ukusetshenziswa olunezigaba ezine:
- Isigaba I - Isifunda esisodwa se-lymph node sihilelekile, noma isakhiwo esisodwa kuphela sihilelekile.
- Isigaba II - Izifunda ezimbili noma ngaphezulu ze-lymph node noma izakhiwo ezihlangothini olufanayo lwe-diaphragm zihilelekile.
- Isigaba III - Izifunda ze-Lymph node noma izakhiwo ezihlangothini zombili ze-diaphragm zihilelekile.
- Isigaba IV - Kukhona ukubandakanyeka kwezinto eziningana noma izicubu ezingaphandle kwezingxenye ze-lymph node noma izakhiwo, njengomnyosa wethambo.
Abantu abangamaphesenti angama-15 ukuya kwangu-20 abantu abane-FL banesifo sesigaba sesibili noma sesi-I.
Amaphesenti angaphezu kwangu-40 anesifo sesigaba se-IV ekuxilongweni.
Ukubamba kubhekisela ekutheni ukuhlukumeza i-FL kubonakala kuncike ezimeni ezincane. Amabanga 1, 2 no-3 ayakwenzeka, kanti ibanga lesi-3 liyingxabano kakhulu ngokuthi kusho ukuthini umphumela.
Indlela Yokulashwa
Ngokuvamile, i-FL iyakhula kancane futhi ayikho izici ezinonya. Kokubili isinqumo sokwelapha kanye nokwelapha kokuqala kokuzikhethela kungathonywa yizinto eziningana, kuhlanganise nokuzikhethela komuntu ukuthola ukuhlolwa kwemitholampilo, impilo yonke nendlela yokwethulwa kwesifo. Imithi ekhethiwe ngokukhethekile ingashintsha kubantu abahlukene kanye nezinhlobo ezahlukene ze-FL - ngisho nabantu ababili abanehlobo olufanayo lwe-FL.
Ngokwemihlahlandlela ye-NCCN ka-2015, ukubuka - kunokuba ukwelashwa - kungase kudingeke ezimweni ezithile. Uma ukwelashwa kuqhutshwa, ngokuphathelene nokwelashwa kokuqala, imihlahlandlela ye-NCCN ihlanganisa izinhlobo ezihlukahlukene zokukhetha izimo ezahlukene. Ukusetshenziswa kwe-bendamustine kanye ne-rituximab kuyindlela eyodwa enjalo. Ukwelashwa kwezidakamizwa nakho kungaba nendima. Eqinisweni, isigaba I follicular lymphoma singaphathwa nge-radiotherapy yedwa.
Ukwelapha odokotela kungase kusiphakamise ezinye izindlela zokwelashwa kokuqala okususelwe ekulindeni mayelana nokuthi umuntu angalindelwa kanjani ukubekezelela ukwelashwa okunikeziwe.
Izinketho zokwelashwa ngokuvamile zifaka okulandelayo:
- Ayikho ukwelashwa okusheshayo - ukuqapha nokuhlola kabusha
- I-Chemotherapy ngesimo samaphilisi
- Ukuchithwa kwamakhemikhali
- I-Chemotherapy kanye nokwelashwa kwezinto eziphilayo
- I-bone yomnkantsha noma i-stem cell transplants
- Radioimmunotherapy
Indlela Yokwelashwa Ikhethwa Kanjani?
Ukwelashwa kunqunywa ngokusekelwe eziningana zezici ezihlukene, kufaka phakathi umgomo wokwelapha kanye nokuba khona kwezibonakaliso zesifo. Imihlahlandlela evela kuNational Comprehensive Cancer Network inikeza izindlela eziningi zokwelapha i-FL ngezigaba ezihlukene, kodwa imikhuba ehlukene ingalandelwa ezikhungweni ezahlukene, futhi iziphakamiso zesiguli nemigomo zihilelekile.
Kuthiwani NgeGazyva ye-Follicular Lymphoma?
I-Gazyva yilezi zidakamizwa ezishintshayo ezitholakalayo ekutholeni ukusetshenziswa kwayo ku-follicular lymphoma. "Abantu abane-follicular lymphoma abanesifo esibuhlungu noma abagulayo naphezu kokwelashwa ne-Rituxan-containing containing regimen badinga izinketho eziningi ngoba lesi sifo sibe nzima kakhulu ukuphatha ngaso sonke isikhathi lapho siphindela emuva," kusho uSandra Horning, MD, isikhulu sezokwelapha kanye nomholi we-Global Product Ukuthuthukiswa. "I-Gazyva kanye ne-bendamustine inikeza ukhetho olusha olungasetshenziswa ngemuva kokubuyela emuva ukuze kunciphise kakhulu ingozi yokuqhubeka noma yokufa."
Ukugunyazwa kwe-FDA kaGazyva kwakusekelwe emiphumeleni yocwaningo lwesigaba se-III GADOLIN, okubonisa ukuthi, kubantu abane-follicular lymphoma abanesifo esiqhubekayo phakathi nezinyanga eziyisithupha ngaphambi kwe-Rituxan-based therapy, uGazyva plus bendamustine elandelwa uGazyva yedwa yabonisa u-52 ukuncipha kwamaphesenti engozini yezifo ezimbi kakhulu noma ukufa (ukuqhubeka okuqhubekayo okuqhubekayo, PFS), kuqhathaniswa ne-bendamustine yedwa.
Imithombo
I-NCCN Imihlahlandlela Yokusebenza Emtholampilo E-Oncology. Inguqulo 1.2016.
I-Leibel ne-Phillips Bookbook of Radiation Oncology: Consult Consult; I-Hoppe R, et al.
Trotman J, Fournier M, uLamy T, et al. I-Positron emission tomography-computed tomography (i-PET-CT) ngemuva kokuthola ukwelashwa okuyi-induction ukubikezela kakhulu komphumela wesineke ku-follicular lymphoma: ukuhlaziywa kwe-PET-CT engxenyeni yeqembu le-PRIMA . J Clin Oncol 2011; 29: 3194-3200.
I-Lymphoma: I-Pathology, I-diagnosis, ne-Treatment. 2013; Robert Marcus, et al.
UFlinn IW, van der Jagt R, Kahl BS, et al. I-ilebula evuliwe, isifundo esingahleliwe, esingenakulinganiswa, esingenasiprofetho se-bendamustine-rituximab noma i-R-CHOP / R-CVP ekwelapheni kokuqala kwe-NHL noma i-MCL engahlonishwayo: isifundo se-BRIGHT. Igazi lika- 2014 ; 123: 2944-2952.