Chii chinonzi Lymphoplasmacytic Lymphoma?

Zvemukati

• LPL vs. mamwe lymphomas
• Chii chinoitika ku immune system?
• Ndezvipi zviratidzo?
• Chii chinokonzera?
• Inoonekwa sei?
• Kurapa nzira
• Tarisa uye mirira
• Chemotherapy
• Biological kurapa
• Targeted kurapwa
• Stem cell transplants
• Kliniki miedzo
• Ndeapi maonero?

Mhedziso

Lymphoplasmacytic lymphoma (LPL) iri mhando isingawanzoitika yekenza inokura zvishoma uye inobata vanhu vakuru. Avhareji zera pakuongororwa ndeye makumi matanhatu.

Lymphomas ndiwo kanzura yeiyo lymph system, chikamu chemuviri wako chinobatsira kurwisa hutachiona. Mu lymphoma, masero machena eropa, angave maB lymphocyte kana T lymphocyte, anokura kunze kwekudzora nekuda kwekuchinja. MuLPL, zvisizvo B lymphocyte zvinoberekana mumapfupa ako uye zvinodzora masero eropa ane hutano.

Kune angangoita masere masere nemakumi matatu nematatu emakesi eLPL pamamiriyoni gumi evanhu muUnited States nekuMadokero kweEurope. Izvo zvinowanzoitika muvarume uye muCaucasians.

LPL vs. mamwe lymphomas

Hodgkin's lymphoma uye isiri Hodgkin's lymphoma inosiyaniswa nerudzi rwemasero anova cancer.

• Hodgkin's lymphomas ine imwe mhando yemasero asina kujairika aripo, anonzi Reed-Sternberg cell.
• Mhando dzakawanda dzisiri-Hodgkin's lymphomas dzinosiyaniswa nekanzuru inotanga uye magene uye zvimwe hunhu hwemaseru akaipa.

LPL isiri-Hodgkin's lymphoma iyo inotanga muB lymphocyte. Iyo isingawanzoitika lymphoma, inongova neinenge 1 kusvika 2 muzana yeawo ese ma lymphomas.

Rudzi rwakanyanya kuzivikanwa rweLPL iWaldenström macroglobulinemiaemia (WM), inozivikanwa nekugadzirwa zvisina kujairika kwemaunoglobulin (antibodies). WM dzimwe nguva inokanganisa kunzi yakafanana neLPL, asi ichokwadi subset yeLPL. Vanenge makumi maviri nevatanhatu pavanhu makumi maviri vane LPL vane immunoglobulin isina kujairika.

Chii chinoitika ku immune system?

Kana LPL ichikonzera maL lymphocyte (B maseru) kuwanda mumapfupa ako, mashoma masero eropa anogadzirwa.

Kazhinji, maseru B anofamba kubva pamafupa ako kuenda kune spleen yako uye lymph node. Ikoko, anogona kuve masero eplasma anoburitsa masoja ekudzivirira hutachiona. Kana iwe usina masero eropa akaenzana, zvinokanganisa immune system yako.

Izvi zvinogona kukonzera:

• kupererwa neropa, kushomeka kwemasero matsvuku eropa
• neutropenia, kushomeka kwerudzi rwechena reropa (inonzi neutrophils), izvo zvinowedzera hutachiona hutachiona
• thrombocytopenia, kushomeka kwemaplatelet eropa, ayo anowedzera kubuda ropa nekupwanya njodzi

Ndezvipi zviratidzo?

LPL kenza inononoka kukura, uye chinenge chikamu chimwe muzvitatu chevanhu vane LPL havana zviratidzo panguva yavanowanikwa.

Kusvika pamakumi mana muzana yevanhu vane LPL vane fomu yakapfava yekushaya ropa.

Zvimwe zviratidzo zveLPL zvinogona kusanganisira:

• kushaya simba uye kupera simba (zvinowanzo kukonzerwa neanemia)
• fivha, husiku kudikitira, uye kuonda (zvinowanzoenderana neB-cell lymphomas)
• kusaona zvakanaka
• dzungu
• mhino inobuda ropa
• maronda anobuda ropa
• mavanga
• yakakwidziridza beta-2-microglobulin, mucherechedzo weropa wemamota

Vanenge gumi nemashanu kusvika makumi matatu kubva muzana yeavo vane LPL vane:

• kuzvimba lymph nodes (lymphadenopathy)
• kuwedzera kwechiropa (hepatomegaly)
• kuwedzera kwepleen (splenomegaly)

Chii chinokonzera?

Chikonzero cheLPL hachina kunyatsonzwisiswa. Vatsvakurudzi vari kuongorora mikana yakawanda:

• Panogona kunge paine hutachiona, seanenge munhu mumwe muvashanu vanhu vane WM vane hama ine LPL kana imwe yakafanana lymphoma.
• Zvimwe zvidzidzo zvakaona kuti LPL inogona kuve yakabatana nezvirwere zve autoimmune seSjögren syndrome kana nehutachiona hwehepatitis C, asi zvimwe zvidzidzo hazvina kuratidza kubatana uku.
• Vanhu vane LPL vanowanzove nehumwe hutachiona husina kugarwa nhaka.

Inoonekwa sei?

Kuongororwa kweLPL kwakaoma uye kazhinji kunoitwa mushure mekusiya mamwe mikana.

LPL inogona kufanana nemamwe B-cell lymphomas ane akafanana marudzi eplasma maseru kusiyanisa. Izvi zvinosanganisira:

• jasi cell lymphoma
• chisingaperi lymphocytic leukemia / diki lymphocytic lymphoma
• marginal zone lymphoma
• yeplasma cell myeloma

Chiremba wako achakuongorora panyama uye obvunza nhoroondo yako yekurapa. Vachaodha basa reropa uye pamwe mwongo wepfupa kana lymph node biopsy kutarisa masero ari pasi pe microscope.

Chiremba wako anogona zvakare kushandisa mimwe miedzo kutonga kunze kwakafanana kenza uye kuona danho rechirwere chako. Izvi zvinogona kusanganisira chipfuva X-ray, CT scan, PET scan, uye ultrasound.

Kurapa nzira

Tarisa uye mirira

LBL kenza inononoka kukura. Iwe nachiremba wako mungasarudza kumirira uye kuongorora ropa renyu nguva dzose musati matanga kurapwa. Sekureva kweAmerican Cancer Society (ACS), vanhu vanononoka kurapwa kusvikira zviratidzo zvavo zvave kunetsa vane hupenyu hwakaenzana sevanhu vanotanga kurapwa nekukurumidza pavanenge vaonekwa.

Chemotherapy

Mishonga yakati wandei inoshanda nenzira dzakasiyana, kana musanganiswa wemishonga, inogona kushandiswa kuuraya masero egomarara. Izvi zvinosanganisira:

• chlorambucil (Leukeran)
• fludarabine (Fludara)
• bendamustine (Treanda)
• cyclophosphamide (Cytoxan, Procytox)
• dexamethasone (Decadron, Dexasone), rituximab (Rituxan), uye cyclophosphamide
• bortezomib (Velcade) uye rituximab, iine kana isina dexamethasone
• cyclophosphamide, vincristine (Oncovin), uye prednisone
• cyclophosphamide, vincristine (Oncovin), prednisone, uye rituximab
• thalidomide (Thalomid) uye rituximab

Iyo chaiyo regimen yemishonga ichasiyana, zvinoenderana nehutano hwako hwese, zviratidzo zvako, uye zvinogona kurapwa kurapwa mune ramangwana.

Biological kurapa

Biological kurapa zvinodhaka zvinhu zvakagadzirwa nevanhu zvinoita senge yako immune system kuuraya iyo lymphoma maseru. Iyi mishonga inogona kusanganiswa nemamwe marapirwo.

Mimwe yeaya maantimmoth antibody, anonzi monoclonal antibodies, ndeaya:

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

Mimwe mishonga yemakemikari ndeyekuzvidzivirira kwemuviri (IMiDs) uye cytokines.

Targeted kurapwa

Targeted therapy mishonga ine chinangwa chekuvharira chaiwo maseru maseru anokonzera cancer. Mimwe yemishonga iyi yakashandiswa kurwisa mamwe magomarara uye izvozvi zviri kuongororwa kweLBL. Kazhinji, izvi zvinodhaka zvinodzivirira mapuroteni anotendera maseru e lymphoma kuti arambe achikura.

Stem cell transplants

Uku ndiko kurapwa kutsva uko ACS inoti inogona kunge iri sarudzo kune vechidiki vane LBL.

Kazhinji, maseru-anogadzira maseru anobviswa muropa uye akachengetwa nechando. Zvino muyero wepamusoro wemakemikari kana mwaranzi unoshandiswa kuuraya ese masora emongo (akajairika uye ane gomarara), uye masero ekutanga anogadzira ropa anodzorerwa muropa. Masero emadzinde anogona kubva kumunhu ari kurapwa (autologous), kana anogona kupihwa nemumwe munhu ari padyo nemunhu (allogenic).

Ziva kuti stem masendende anochinja achiri muchikamu chekuyedza. Zvakare, kune epfupi-kwenguva uye kwenguva refu-mhedzisiro mhedzisiro kubva kune izvi zvinoshandurwa.

Kliniki miedzo

Sezvo nemarudzi mazhinji ekenza, marapirwo matsva ari kuvandudzwa, uye unogona kuwana kiriniki yekuedzwa kuti utore chikamu. Bvunza chiremba wako nezve izvi uye shanyira ClinicalTrials.gov kuti uwane rumwe ruzivo.

Ndeapi maonero?

LPL seazvino haina mushonga. Yako LPL inogona kupinda mukuregererwa asi gare gare ichionekazve. Zvakare, kunyangwe iri kenza inononoka kukura, mune dzimwe nguva inogona kuita hasha.

ACS inoti 78 muzana yevanhu vane LPL vanorarama makore mashanu kana kudarika.

Kupona kwehuwandu hweLPL kuri kuvandudzika apo mishonga mitsva nemishonga mitsva inogadzirwa.