Follicular lymphoma ndi imodzi mwa mitundu yofala kwambiri ya non-Hodgkin Lymphoma, kapena NHL . Ndi mliri wopitirira pang'onopang'ono, ndipo nthawi zambiri siwopseza moyo. Chifukwa chakuti imakula pang'onopang'ono komanso mosavuta, anthu ambiri samadziwa mavuto alionse pamene matendawa ali pachiyambi. Panthawi yomwe matendawa amapezeka odwala ambiri - 80-85 peresenti - ali ndi matenda omwe nthawi zambiri amakhala ndi malo ambiri am'mimba , mafupa , nthenda kapena ziwalo zina.
Kukula Pang'onopang'ono, Koma Zovuta Kuchiza Mwathunthu
Ngakhalenso pamayendedwe apamwamba, anthu omwe ali ndi follicular lymphoma amatha kukhala ndi moyo kwa nthawi yayitali ndi mankhwala oyenera, chifukwa cha kukula kwakeko. Komabe, matendawa sachira. Anthu ambiri amayankha bwino kuchipatala, ndipo matendawa amatha kukhazikika kwa zaka zingapo asanayambe kubwezeretsanso ndikusowa mankhwala. Odwala ambiri amafunika kuti azichiritsidwa kangapo, ndi nthawi yeniyeni ya matenda otetezeka pambuyo pa chithandizo chilichonse chimene chingakhale miyezi ingapo kwa zaka zambiri.
Ndi anthu ochepa okha omwe ali ndi mwayi kuti adziwe ngati matendawa akadali pachiyambi. Anthuwa akhoza kuchiritsidwa. Mankhwalawa amagwiritsidwa ntchito okha kwa anthu ambiri. Zakawonetseka kuti miyezo yochepa ya ma radiation operekedwa kwa madera okhudzidwa a thupi mwa iwo omwe ali ndi matenda omwe amapezekako angathe kuchepetsa matendawa. Palibe chopindulitsa china choonjezera mankhwala a chemotherapy kapena opanga mankhwala .
Kuchiza Kumaphatikizapo Gawo pa Staging
Mayesero osiyanasiyana angapangidwe pofuna zolinga, kuphatikizapo:
- Mayeso a magazi
- Ng'oma ya mafupa imakhala yonyansa - kutenga mnofu wazing'ono m'mphuno
- Computed tomography, kapena CT scan
- Positron imatulutsa tomography, kapena PET, yang'anani
Kulemba kumatanthauza kukula.
Machitidwe osiyana siyana akhala akugwiritsidwa ntchito, koma pano pali njira imodzi yogwiritsidwa ntchito yomwe ili ndi magawo anayi:
- Gawo I - Malo amodzi okhawo omwe amachititsa kuti thupi likhale ndi mitsempha, kapena chigawo chimodzi chokha chimakhudzidwa.
- Gawo Lachiwiri - Malo amodzi kapena amodzi opangidwa ndi maselo a mitsempha kapena zinyumba kumbali imodzi ya chiphwando zimakhudzidwa.
- Gawo Lachitatu - Kumalo komwe kumakhala mbali zamphongo zonsezi zimagwiritsidwa ntchito.
- Gawo lachinayi - Pali mbali zambiri za ziwalo kapena ziphuphu zina zomwe zimakhala zosiyana ndi malo am'mimba kapena mafupa, monga mafupa.
Pafupifupi 15 mpaka 20 peresenti ya anthu omwe ali ndi FL ali ndi gawo lachiwiri kapena lachiwiri la matendawa.
Oposa 40 peresenti ali ndi matenda a stade IV pamene akudziŵa.
Kulemba kumatanthawuza momwe kukwiyitsa kwa FL kukuwonekera kuti kumadalira mikhalidwe yaying'ono. Maphunziro 1, 2 ndi 3 amatha, ndipo kalasi yachitatu ndi yotsutsana kwambiri pa zomwe zimatanthauza zotsatira.
Njira ya Chithandizo
Kawirikawiri, FL imakula mofulumira ndipo imakhala yosautsa. Chigamulo chokhalira kuchipatala komanso chithandizo choyamba chotsatira chikhoza kusokonezedwa ndi zinthu zingapo, kuphatikizapo kuvomerezedwa kwa munthu pa mayesero a zachipatala, thanzi labwino komanso momwe angayambitsire matendawa. Mankhwala ovomerezeka apadera akhoza kukhala osiyana kwa anthu osiyanasiyana ndi mitundu yosiyanasiyana ya FL - komanso ngakhale anthu awiri ali ndi mtundu womwewo wa FL.
Malingana ndi malangizo a NCCN a 2015, kuwona - osati mankhwala - kungakhale koyenera nthawi zina. Ngati mankhwala akutsatiridwa, potsata chithandizo choyamba, malamulo a NCCN akuphatikizapo zosankha zosiyanasiyana pazosiyana. Kugwiritsira ntchito bendamustine pamodzi ndi rituximab ndi njira imodzi yokha. Mankhwala othandizira ma ARV angathandizenso. Ndipotu, stage I follicular lymphoma ingaperekedwe pogwiritsa ntchito radiotherapy yokha.
Kuchiritsa madokotala kungapereke njira zina zothandizira oyamba kusankha zoyembekezereka zokhudzana ndi momwe munthu angayembekezere kupirira mankhwala opatsidwa.
Njira zochiritsira zimaphatikizapo zotsatirazi:
- Palibe chithandizo chamankhwala - kuyang'anitsitsa ndikuwongolanso
- Chemotherapy ngati mapiritsi
- Kulowetsedwa mankhwala
- Chemotherapy ndi mankhwala ochizira
- Mafupa a mafupa kapena masentimita ophwanya maselo
- Radioimmunotherapy
Kodi Chithandizochi Chasankhidwa Motani?
Chithandizo chimasankhidwa malinga ndi zifukwa zosiyanasiyana, kuphatikizapo cholinga cha chithandizo ndi kukhalapo kwa zizindikiro za matenda. Malangizo ochokera ku National Comprehensive Cancer Network amapereka njira zosiyanasiyana zochizira matenda a FL pazigawo zosiyana, ngakhale zikhalidwe zosiyana zimatha kutsatiridwa m'madera osiyanasiyana, komanso zofuna za odwala ndi zolinga zimakhudzidwa.
Nanga bwanji Gazyva for Lymphoma Follicular?
Gazyva ndi mankhwala atsopano omwe amagwiritsidwa ntchito pozindikira kuti amagwiritsa ntchito follicular lymphoma. "Anthu omwe ali ndi follicular lymphoma omwe amadwala matendawa kapena amavutika ngakhale atakhala ndi mankhwala a Rituxan amafunikira zina zambiri chifukwa matendawa amakhala ovuta kuchiza nthawi iliyonse," anatero Sandra Horning, MD, wamkulu wa zachipatala komanso a Global Product. Development. "Gazyva kuphatikizapo bendamustine imapereka chithandizo chamankhwala chatsopano chomwe chingagwiritsidwe ntchito pambuyo pobwezeretsa kuchepetsa kwambiri chiopsezo cha kupita patsogolo kapena kufa."
Kuvomereza kwa FDA Gazyva kunachokera ku zotsatira za kafukufuku wa Phase III GADOLIN, zomwe zikuwonetsa kuti, anthu omwe ali ndi follicular lymphoma omwe matenda awo amapita mkati kapena mkati mwa miyezi isanu ndi umodzi yothandizidwa ndi Rituxan, Gazyva plus bendamustine ndi Gazyva okha anasonyezera 52 Peresenti ya kuchepa kwa chiopsezo cha matenda owonjezereka kapena imfa (kupulumuka kwapanda moyo, PFS), poyerekeza ndi bendamustine okha.
Zotsatira
Malangizo a KCCN okhudza njira zothandizira odwala. Version 1.2016.
Buku la Leibel ndi la Phillips Buku la Mafilimu Odziwika ndi Mafilimu: Onetsetsani Akatswiri; Hoppe R, et al.
Trotman J, Fournier M, Lamy T, et al. Mankhwala otchedwa positron emission tomography (PET-CT) atatha kupititsa patsogolo mankhwalawa amadziwika kwambiri ndi zotsatira za odwala mu follicular lymphoma: kufufuza kwa PET-CT mu gawo la otsogolera a PRIMA . J Clin Oncol 2011; 29: 3194-3200.
Lymphoma: Matenda, Matenda, ndi Chithandizo. 2013; Robert Marcus, ndi al.
Flinn IW, van der Jagt R, Kahl BS, ndi al. Mapepala otseguka, osasintha, osapanda phunziro la bendamustine-rituximab kapena R-CHOP / R-CVP mu chithandizo choyamba cha mankhwala apamwamba a NHL kapena MCL. Magazini 2014 ; 123: 2944-2952.