Hodgkin lymphoma (HL) ndi khansara ya maselo oyera a magazi omwe angakhudze achinyamata achikulire. Ndipotu, ngakhale kuti HL imakhala pafupifupi 10 peresenti ya maselo onse am'thupi , ndi imodzi mwa machitidwe ambiri omwe amapezeka pa nthawi yomwe ali ndi mimba. Izi zili choncho chifukwa chakuti chiwerengero cha HL chikugwirizana ndi zaka za kubala.
Kuonetsetsa kuti mwanayo ali wotetezeka
Zina mwa zizindikiro za HL, monga kutopa ndi kupuma pang'ono, zingayambane ndi zizindikiro zomwe zimawoneka panthawi yomwe ali ndi mimba, zomwe zingasokoneze nkhani, koma zolemba za HL zatsimikizika kuti zidziwitse zokwanira kuti zitsogolere otsogolera. kuchepetsa kuopsa kwa mwana.
Mwachitsanzo, pamene x-breast imachitika, mimba imatetezedwa kuti muteteze mwanayo. Pofufuza mimba, MRI ndi ultrasound zikhoza kuchitika. Nthenda ya m'mafupa ikhoza kupangidwa mosamala panthawi ya mimba ngati pakufunika.
Kulamulira kwa HL pa nthawi ya mimba kumaphatikizapo kuyanjanitsa mwayi wa machiritso ndi kuchepetsa kuvulaza mwana amene akukula. Amayi ambiri omwe ali ndi pakati omwe ali ndi kachilombo koyambitsa matendawa amapatsidwa chithandizo. Mankhwala othandizira ena monga ABVD aperekedwa mosamala m'zaka zitatu zoyambirira. Kafukufuku akuyang'ana zotsatira za kubadwa kwa amayi omwe amachitikitsidwa kwa HL wakhala akulimbikitsana, osasonyeza kusiyana kwa kulemera kobadwa kapena kubereka kosabadwa poyerekeza ndi makanda obadwa ndi amayi omwe sakhala ndi chithandizo. Kwa amayi osankhidwa, mankhwala amatha kuperekedwa mpaka mwanayo atapulumutsidwa bwinobwino.
Chiberekero Patatha Chithandizo cha Hodgkin Lymphoma
Malinga ndi nkhani imene inafalitsidwa mu "2011" ya "Haematologica" ya November 2011, chinthu china chimene chimatchedwa kuchepa kwa nthawi yoyamba, chomwe chimangoyamba kusamba, chikhoza kukhala 5 mpaka 25 peresenti ya amayi omwe akudwala omwe ali ndi zaka zosakwana 30.
Vuto la kusabereka limakula ndi chiwerengero chokwanira cha chemotherapies chotchedwa alkylating agents.
Chemotherapy imathandizanso kuti zisawonongeke. Mankhwala otchedwa myeloablative treatment amachititsa kuti amayi asatenge mimba atachiritsidwa. Mankhwalawa amagwiritsa ntchito mankhwala akuluakulu a mankhwala omwe amapha maselo pamthambo, kuphatikizapo maselo a khansa.
Zimathandizanso kuchepa kwa maselo omwe amapanga magazi m'magazi a mafupa, omwe angapangitse zotsatira zoyipa. Pamene myeloablative chemotherapy imagwiritsidwa ntchito, izi nthawi zambiri zimatsatiridwa ndi fupa la fupa kapena kusinthanitsa maselo osakaniza kuti abwezeretse ntchito ya mafupa.
Kafukufuku wochokera kwa Meirow ndi anzake adasonyeza kuti kuchepa kwa nthawi yayitali kumakhala kosavuta kwa amayi oposa zaka 30, komanso kuti mankhwala enaake omwe amachititsa kuti magazi asapitirire. Makamaka poizoni kwa ovarian minofu ndi alkylating wothandizila.
Kafukufuku wambiri akuyang'ana pa chonde kwa odwala omwe amatsatira mankhwala a HL. Chimodzi mwapeza ndi chakuti chiwerengero cha BEACOPP chokhudzidwa ndi mlingochi chikugwirizanitsidwa ndi chiwerengero chapamwamba cha mchere wachiwiri kuposa ABVD regimen. Mankhwalawa amadziwika ngati kusapezeka kwa mimba kwa mayi amene adayamba kusamba koma pambuyo pake amasiya kusamba kwa miyezi itatu kapena yoposa. Ndipo kusowa kwa msambo sikumabwera chifukwa cha mimba, kuyamwitsa khanda, kuponderezedwa kwa pulogalamuyo ndi njira yothetsera mahomoni oyenera. (kulera) mapiritsi, kapena kusamba.
Zomwe zimagwiritsidwa ntchito pazigawozi ndi izi:
- BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, ndi prednisone, omwe amagwiritsira ntchito alkylating ndi cyclophosphamide ndi procarbazine)
- ABVD (doxorubicin, vinblastine, dacarbazine, ndi bleomycin, kumene wothandizira ndi dacarbazine)
Ngakhale kuti zamakono zamakono zimakhala zogwira ntchito motsutsana ndi HL, zimatha kutenga phindu pa gonads ndi mazira ambiri. Kwa madokotala amene amaphunzira chodabwitsa ichi, vutoli limatchulidwa kuti "mankhwala ophera tizilombo toyambitsa matenda," kapena chDOR.
Chithandizochi chimaphatikizapo kukhala ndi chiwerengero chochepa cha mazira m'mimba mwa amayi koma chingathandizenso kukula kwa mazira omwe alipo. Zizindikiro zimaphatikiziranso njira yachiwiri yoperewera. Kutha kwathunthu kwa ma follicles m'mimba mwake kumatitsogolera ku zomwe zimatchedwa kuchepa kwa nthawi yoyamba, zomwe zimatanthauzidwa kuti ndikutayika kwa ntchito yoyenera kusanayambe zaka 40.
Pali umboni wina wosonyeza kuti kayendedwe ka gonadotropin-release hormone analogues (GnRH-a) pa mankhwala a chemotherapy angathandize kuteteza mazira. Njira yokha yomwe izi zingagwiritsire ntchito, komabe, imamvetsetsanso bwino.
Chiberekero cha Amuna
Odwala achimuna sakhala ndi zotsatira zowonjezera chithandizo kuchokera kuchipatala, mwina. Mayesowa amapezeka kwambiri poizoni wa khansa pamagulu onse a moyo. Malingana ndi kafukufuku wa Jahnukainen ndi anzake, opulumuka achinyamata a khansa ndi achinyamata pafupifupi theka lachimwene awo kuti azikhala ndi pakati. Papepala lomweli limatchula mankhwala othandiza kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda komanso tizilombo toyambitsa matenda.
Mawu Ochokera
Munda wa chithandizo cha khansa ndi kusungidwa kwa chonde kumakula mofulumira. Mankhwala atsopano a anti-khansa amayamba kawirikawiri, ndipo onse awiri omwe amachiza lymphoma komanso kusamalira zotsatira zake, kuphatikizapo infertility, amakhala osasintha. Lankhulani ndi dokotala wanu kuti mudziwe njira yabwino yothandizira.
Zotsatira:
Harel S, Fermé C, Poirot C. Kulamulira kwa chonde kwa odwala omwe amachitira Hodgkin's lymphoma. Haematologica . 2011; 96 (11): 1692-1699.
Hutchings M. Kodi PET / CT imathandiza motani pakusankha mankhwala kwa odwala Hodgkin lymphoma? Hematology Am Soc Hematol Pulogalamu Yophunzitsa. 2012; 2012: 322-7.
Meirow D, Biederman H, Anderson RA, Wallace WH. Kuwopsa kwa mankhwala a chemotherapy ndi ma radiation pa kubereka kwa akazi. Clin Obstet Gynecol. 2010; 53: 727-39.