Kodi Lymphoplasmacytic Lymphoma ndi chiyani?

Zamkati

• LPL motsutsana ndi ma lymphomas ena
• Kodi chimachitika ndi chiyani ku chitetezo cha mthupi?
• Zizindikiro zake ndi ziti?
• Zimayambitsa chiyani?
• Kodi amapezeka bwanji?
• Njira zothandizira
• Yang'anirani ndipo dikirani
• Chemotherapy
• Thandizo lachilengedwe
• Chithandizo chofuna
• Kusintha kwama cell
• Mayesero azachipatala
• Maganizo ake ndi otani?

Chidule

Lymphoplasmacytic lymphoma (LPL) ndi khansa yosawerengeka yomwe imayamba pang'onopang'ono ndipo imakhudza makamaka achikulire. Ausinkhu wazaka zakupeza ndi 60.

Lymphomas ndi khansa yam'magazi, yomwe ndi gawo lamthupi lanu lomwe limathandiza kuthana ndi matenda. Mu lymphoma, maselo oyera amagazi, kaya ma lymphocyte a B kapena ma T lymphocyte, amakula chifukwa cha kusintha kwa thupi. Mu LPL, ma lymphocyte B osazolowereka amaberekana m'mafupa anu ndikuchotsa maselo amwazi wathanzi.

Pali milandu pafupifupi 8.3 ya LPL pa anthu 1 miliyoni ku United States ndi Western Europe. Ndizofala kwambiri mwa amuna komanso ku Caucasus.

LPL motsutsana ndi ma lymphomas ena

Hodgkin's lymphoma ndi non-Hodgkin's lymphoma amadziwika ndi mtundu wa maselo omwe amakhala ndi khansa.

• Ma lymphomas a Hodgkin ali ndi khungu linalake lachilendo, lotchedwa Reed-Sternberg cell.
• Mitundu yambiri yama non-Hodgkin's lymphomas imasiyanitsidwa ndi komwe khansa imayambira komanso majini ndi mawonekedwe ena am'magazi oyipa.

LPL ndi non-Hodgkin's lymphoma yomwe imayamba mu ma lymphocyte a B. Ndi lymphoma yosowa kwambiri, yomwe imangokhala ndi 1 mpaka 2 peresenti ya ma lymphomas onse.

Mtundu wofala kwambiri wa LPL ndi Waldenström macroglobulinemia (WM), womwe umadziwika ndi kupanga kwamagulu antimoglobulin (ma antibodies). WM nthawi zina amatchedwa molakwika chimodzimodzi ndi LPL, koma kwenikweni ndi gawo laling'ono la LPL. Pafupifupi anthu 19 mwa 20 omwe ali ndi LPL ali ndi vuto la immunoglobulin.

Kodi chimachitika ndi chiyani ku chitetezo cha mthupi?

LPL ikapangitsa ma lymphocyte B (ma B maselo) kuti achulukane m'mafupa anu, m'maselo ochepa amwazi amapangidwa.

Nthawi zambiri, ma B amachoka m'mafupa anu kupita ku ndulu ndi ma lymph node. Kumeneko, amatha kukhala maselo am'magazi opanga ma antibodies kuti athane ndi matenda. Ngati mulibe maselo abwinobwino amwazi, zimasokoneza chitetezo chamthupi chanu.

Izi zitha kubweretsa:

• kuchepa magazi, kuchepa kwa maselo ofiira amwazi
• neutropenia, kuchepa kwa mtundu wama cell oyera (omwe amatchedwa neutrophils), zomwe zimawonjezera chiwopsezo cha matenda
• thrombocytopenia, kuchepa kwa magazi othandiza magazi kuundana, komwe kumawonjezera kuwopsa kwa magazi ndi mabala

Zizindikiro zake ndi ziti?

LPL ndi khansa yomwe ikukula pang'onopang'ono, ndipo pafupifupi gawo limodzi mwa atatu mwa anthu omwe ali ndi LPL alibe zisonyezo panthawi yomwe amapezeka.

Mpaka 40 peresenti ya anthu omwe ali ndi LPL ali ndi vuto lochepa la kuchepa kwa magazi.

Zizindikiro zina za LPL zitha kuphatikiza:

• kufooka ndi kutopa (nthawi zambiri kumayambitsidwa ndi kuchepa kwa magazi m'thupi)
• malungo, kutuluka thukuta usiku, ndi kuchepa thupi (komwe kumalumikizidwa ndi B-cell lymphomas)
• kusawona bwino
• chizungulire
• mphuno kutuluka magazi
• nkhama zotuluka magazi
• mikwingwirima
• okwera beta-2-microglobulin, cholemba magazi pamatenda

Pafupifupi 15 mpaka 30% mwa iwo omwe ali ndi LPL ali ndi:

• kutupa ma lymph node (lymphadenopathy)
• kukulitsa chiwindi (hepatomegaly)
• kukulitsa kwa nthenda (splenomegaly)

Zimayambitsa chiyani?

Zomwe zimayambitsa LPL sizikumveka bwino. Ochita kafukufuku akufufuza njira zingapo:

• Pakhoza kukhala chibadwa, monga pafupifupi munthu mmodzi mwa anthu asanu aliwonse omwe ali ndi WM ali ndi wachibale yemwe ali ndi LPL kapena mtundu wofanana wa lymphoma.
• Kafukufuku wina apeza kuti LPL itha kukhala yolumikizidwa ndi matenda omwe amadzitchinjiriza ngati Sjögren syndrome kapena matenda a hepatitis C, koma kafukufuku wina sanawonetse ulalowu.
• Anthu omwe ali ndi LPL nthawi zambiri amakhala ndi zosintha zina zomwe sizibadwa nazo.

Kodi amapezeka bwanji?

Kuzindikira kwa LPL kumakhala kovuta ndipo nthawi zambiri kumachitika pambuyo pakupatula zina zotheka.

LPL imatha kufanana ndi ma B-cell lymphomas omwe ali ndi mitundu yofananira yama cell ya plasma. Izi zikuphatikiza:

• chovala cell lymphoma
• Matenda a m'magazi a lymphocytic / ochepa a lymphocytic lymphoma
• m'mphepete mwa zone lymphoma
• maselo a plasma myeloma

Dokotala wanu amakupimitsani mwakuthupi ndikufunsani mbiri yanu yazachipatala. Adzayitanitsa ntchito yamagazi ndipo mwina mafupa kapena lymph node biopsy kuti ayang'ane maselo omwe ali ndi microscope.

Dokotala wanu amathanso kugwiritsa ntchito mayeso ena kuti athetse khansa yofananira ndikudziwitsa gawo la matenda anu. Izi zingaphatikizepo chifuwa cha X-ray, CT scan, PET scan, ndi ultrasound.

Njira zothandizira

Yang'anirani ndipo dikirani

LBL ndi khansa yomwe ikukula pang'onopang'ono. Inu ndi dokotala mungasankhe kudikirira ndikuwunika magazi anu nthawi zonse musanayambe kumwa mankhwala. Malinga ndi American Cancer Society (ACS), anthu omwe amazengereza kulandira chithandizo mpaka zizindikiro zawo zikakhala zovuta amakhala ndi moyo wautali wofanana ndi anthu omwe amayamba kulandira chithandizo akangopezedwa.

Chemotherapy

Mankhwala angapo omwe amagwira ntchito m'njira zosiyanasiyana, kapena kuphatikiza mankhwala, atha kugwiritsidwa ntchito kupha ma cell a khansa. Izi zikuphatikiza:

• chlorambucil (Leukeran)
• fludarabine (Fludara)
• bendamustine (Treanda)
• cyclophosphamide (Cytoxan, Procytox)
• dexamethasone (Decadron, Dexasone), rituximab (Rituxan), ndi cyclophosphamide
• bortezomib (Velcade) ndi rituximab, wokhala ndi dexamethasone kapena wopanda
• cyclophosphamide, vincristine (Oncovin), ndi prednisone
• cyclophosphamide, vincristine (Oncovin), prednisone, ndi rituximab
• thalidomide (Thalomid) ndi rituximab

Mankhwala amtundu wa mankhwala amasiyana, kutengera thanzi lanu, zizindikiritso zanu, komanso momwe mungadzathandizire mtsogolo.

Thandizo lachilengedwe

Mankhwala othandizira tizilombo ndi zinthu zopangidwa ndimunthu zomwe zimakhala ngati chitetezo chamthupi chanu kupha ma lymphoma cell. Mankhwalawa atha kuphatikizidwa ndi mankhwala ena.

Ena mwa ma antibodies opangidwa ndi anthu, otchedwa monoclonal antibodies, ndi awa:

• rituximab (Rituxan)
• ofatumumab (Arzerra)
• alemtuzumab (msasa)

Mankhwala ena obwera ndi mankhwala ndi ma immunomodulating drug (IMiDs) ndi cytokines.

Chithandizo chofuna

Mankhwala othandizira omwe cholinga chake chimayang'ana ndikuletsa kusintha kwamaselo komwe kumayambitsa khansa. Ena mwa mankhwalawa akhala akugwiritsidwa ntchito kuthana ndi khansa zina ndipo pano akufufuzidwa za LBL. Kawirikawiri, mankhwalawa amaletsa mapuloteni omwe amalola maselo a lymphoma kupitiriza kukula.

Kusintha kwama cell

Awa ndi chithandizo chatsopano chomwe ACS imanena kuti atha kukhala mwayi kwa achinyamata omwe ali ndi LBL.

Mwambiri, timaselo timene timapanga magazi timachotsedwa m'magazi ndikusungidwa ndi mazira. Kenako mankhwala amphamvu kwambiri a chemotherapy kapena radiation amagwiritsidwa ntchito kupha ma cell onse am'mafupa (abwinobwino komanso khansa), ndipo maselo oyambilira opanga magazi amabwezeretsedwanso m'magazi. Maselo otumphukira atha kubwera kuchokera kwa munthu yemwe amuthandiziridwayo (autologous), kapena atha kuperekedwa ndi munthu yemwe amafanana kwambiri ndi munthuyo (allogenic).

Dziwani kuti kusintha kwa maselo amdontho kumayesabe. Komanso, pali zovuta zakanthawi kochepa komanso zazitali zomwe zimadza kuchokera kuziyika izi.

Mayesero azachipatala

Monga mitundu yambiri ya khansa, njira zatsopano zamankhwala zikupangika, ndipo mutha kupeza mayeso azachipatala kuti mutenge nawo mbali. Funsani dokotala wanu za izi ndipo pitani ku ClinicalTrials.gov kuti mumve zambiri.

Maganizo ake ndi otani?

LPL pakadali pano alibe mankhwala. LPL yanu imatha kukhululukidwa koma kenako imadzapezekanso. Komanso, ngakhale ndi khansa yomwe ikukula pang'onopang'ono, nthawi zina imatha kukhala yankhanza.

ACS ikuti 78 peresenti ya anthu omwe ali ndi LPL amakhala ndi moyo zaka zisanu kapena kupitilira apo.

Kuchuluka kwa opulumuka ku LPL kukuyenda bwino pomwe mankhwala atsopano ndi mankhwala atsopano akupangidwa.