Follicular lymphoma ndechimwe chezvinhu zvakanyanya kufanana neHo -Hodgkin Lymphoma, kana NHL . Icho chinokurumidza kukura-lymphoma, uye kazhinji hachisi kutyisa upenyu pakarepo. Nemhaka yokuti inokura zvishoma nezvishoma uye isinganzwisisiki, vanhu vakawanda havazivi chero matambudziko apo chirwere chacho chiri mumatanho ekutanga. Nenguva iyo chirwere ichi chinowanikwa kuti varwere vazhinji - 80-85 muzana - vakapararira zvirwere zvinowanzobatanidza nzvimbo dzakawanda dzeropa , mafupa marrow , spleen kana dzimwe nhengo.
Kukurumidza Kukura, asi Zvakaoma Kuporesa Zvakakwana
Kunyange mumatunhu akafambira mberi, vanhu vane follicular lymphoma vanowanzogara kwenguva yakareba nekurapa kwakakwana, nekuda kwekukura kwayo. Zvisinei, chirwere hachisi kupora. Vanhu vazhinji vanopindura zvakanaka kurapwa, uye chirwere chinogona kugadziriswa kwemakore mashomanana vasati vadzokazve uye vachida kurapwa zvakare. Varwere vakawanda vanoda kurapwa kazhinji, pamwe chete kwechirwere chakachengetwa mushure mokurapa kwese kunogona kupedza mwedzi kumakore mazhinji.
Vanhu vashomanana vane mukana wekuongororwa apo chirwere chacho chichiri mumatangiro ayo okutanga. Vanhu ava vanogona kuporeswa. Mishonga yemishonga inoshandiswa iri yoga kune vanhu vakawanda. Izvo zvave zvichionekwa kuti kuenzanisa kwakanyanya kwemazuva ano anopiwa kunzvimbo dzakaputika dzomuviri kune avo vane mahara avo vanogona kugadzirisa chirwere zvachose. Icho hachina humwe rubatsiro rwekuwedzera chemotherapy kana biological agents .
Mishonga Inofanirwa mune Chikamu chekuisa
Zviratidzo zvakasiyana-siyana zvinogona kuitwa nekuda kwekutarisa, kusanganisira:
- Kuyera ropa
- Bhuna marora rinonyangadza - kutora chiduku chiduku chezvisikwa kubva mumapfupa emapfupa
- Computed tomography, kana CT scan
- Positron emission tomography, kana PET, scan
Kurongedza kunoreva kusvika pakupararira.
Zvimwe zvakasiyana-siyana maitiro akave ari kushandiswa, asi pano ndiyo inowanzoshandiswa nzira ine zvikamu zvina:
- Nhanho I - Chero imwechete lymph node nzvimbo inobatanidzwa, kana chimiro chimwe chete chinosanganiswa.
- Chikamu II - Zviviri kana kupfuura zvinonzi lymph node zvivako kana zvivako kune rumwe rutivi rwechidimbu zvinosanganiswa.
- Chikamu III - Lymph node zvivako kana zvivako kumativi ose ejaya rinosanganiswa.
- Nhanho IV - Pane kupararira kwezvikamu zvakati nhengo kana mamwe masukisi kunze kwemuviri wemakiromode kana zvivako, zvakadai sefupa remafu.
Inenge 15 kusvika ku20 muzana yevanhu vane FL vane chirwere chechipiri chechipiri kana I chirwere chinorwara.
Vanopfuura 40 muzana vane chirwere chepasite IV pakuongororwa.
Kuchengeta kunoreva kushatirwa kweFF kunoratidzika kunge kwakavakirwa maitiro mashoma. Zvidzidzo 1, 2 ne3 zvinobvira, uye gorosi 3 ndiyo inonyanya kukakavara maererano nezvayo zvinorevei kuti zviitike.
Nzira yekurapa
Kazhinji, FL inokura zvishoma nezvishoma uye inoshayiwa unhu hwakaipa. Zvose chisarudzo chekurapa pamwe chete nekodzero yekutanga yekusarudzwa kwesarudzo inogona kuve nekufurirwa nezviitiko zvakawanda, kusanganisira kubvumirwa kwemunhu kune mishonga yemakiriniki, hutano huzhinji uye nzira yekuratidzira chirwere chacho. Kunyatsoshandiswa kurapwa kunogona kusiyana kune vanhu vakasiyana uye kune marudzi akasiyana-siyana eF - uye kunyange kune vanhu vaviri vane rudzi rumwe rweF.
Maererano nemitemo ye NCCN ya 2015, kutarisa - panzvimbo yekurapa - kunogona kunge kwakakodzera mune mamwe mamiriro ezvinhu. Kana kurapwa kuchiitwa, maererano nezvesarudzo dzokutanga-sarudzo, nhungamiro yeCNCN inosanganisira zvinhu zvakasiyana-siyana zvezviitiko zvakasiyana. Kushandisa bendamustine pamwe nerituximab imwe yega sarudzo. Radiation therapy inogonawo kuita basa. Mukati, chiitiko ini follicular lymphoma inogona kurapwa uchishandisa radiotherapy chete.
Kurapa vanachiremba kunogona kuratidza dzimwe nzira dzokurapa kwokutanga kubva pane zvinotarisirwa pamusoro pokuti munhu angatarisirwa sei kubvumira kurapa kwakapiwa.
Maitiro ekurapwa anowanzobatanidza zvinotevera:
- Kwete pakarepo kurapwa - kungoongorora uye kuongorora zvakare
- Chemotherapy muchimiro chemapiritsi
- Infusion chemotherapy
- Chemotherapy uye therapial therapy
- Bhuna marora kana shini dzemawere dzinoshanduka
- Radioimmunotherapy
Kurapa Kwakaitwa Sei?
Kurapa kunosarudzwa zvichienderana nenhamba dzakasiyana-siyana, kusanganisira chinangwa chekurapa uye kuvapo kwezviratidzo zvechirwere. Mirayiridzo inobva kuNational Comprehensive Cancer Network inopa nzira dzakasiyana-siyana dzekurapa kweFF pamatanho akasiyana-siyana, zvisinei nemitemo yakasiyana inogona kuteverwa munzvimbo dzakasiyana, uye zvirwere zvevarwere uye zvinangwa zvinosanganisirawo.
Zvakadini neGazyva ye Follicular Lymphoma?
Gazyva ija itsva inotorwa nemishonga inogamuchira kushandiswa kwayo mu follicular lymphoma. "Vanhu vane follicular lymphoma vane chirwere chinodzoka kana kuti chinotyisa pasinei nekurapwa neRituxan-regimen regimen vanoda zvimwe zvingasarudzwa nokuti chirwere chinova chakaoma kurapa nguva imwe neimwe inodzoka," akadaro Sandra Horning, MD, chiremba mukuru uye mukuru we Global Product Development. "Gazyva pamwe neBendamustine inopa mushonga mushonga unogona kushandiswa mushure mokudzokerazve kunobatsira zvikuru kuderedza ngozi yekufambira mberi kana kufa."
Chirongwa cheDAA cheGazyva chaibva pamigumisiro inobva kuGlasi III GADOLIN, iyo yakaratidza kuti, kune vanhu vane follicular lymphoma avo vane chirwere chakafambira mukati kana mukati pemwedzi mitanhatu yeRituxan-based therapy, Gazyva pamwe bendamustine yakatevera neGazyva chete yakaratidza 52 kupera kwemazana muhutachiwana hwehutano huri kuwedzera kana kufa (kufambira mberi-kusina kusununguka, PFS), zvichienzaniswa ne bendamustine chete.
Sources
NCCN Clinical Practice Guidelines muOnology. Version 1.2016.
Leibel naPhillips Bhuku Rekutsvayamisa Oncology: Expert Consult; Hoppe R, et al.
Trotman J, Fournier M, Lamy T, et al. Positron emission tomography-computed tomography (PET-CT) mushure mekurovedzwa kwechirwere ichi inonyanya kufungidzira yehutano muhutano mu follicular lymphoma: kuongorora kwePET-CT mune chikamu chevatori vechiitiko che PRIMA . J Clin Oncol 2011; 29: 3194-3200.
Lymphoma: Pathology, Kuziva, uye Kurapa. 2013; Robert Marcus, et al.
Flinn IW, van der Jagt R, Kahl BS, uye al. Vhurai-mavara, randomized, noninferiority kuongorora bendamustine-rituximab kana R-CHOP / R-CVP mumutambo wokutanga wekodzero yepamusoro-soro yeNHL kana MCL: iyo BRIGHT kuongorora. Ropa 2014 ; 123: 2944-2952.