Hodgkin lymphoma (HL) chirwere chemasero matsvuku eropa chinogona kukanganisa vaduku vakuru vezera rekubereka. Ichokwadi, kunyange zvazvo HL inomiririra anenge 10 muzana yemakemikari ose, ndiyo imwe yeiyo yakajairika yecymmama subtypes inowanikwa panguva yekuzvitakura. Izvi zvinokonzerwa nekuti chiitiko chepamusoro cheHL chinowirirana nezera rekuberekwa kwevakadzi.
Kuchengetedza Fetus Kuchengeteka
Zvimwe zvezviratidzo nezviratidzo kubva paHL, zvakadai sokuneta uye kupera kwekufema, zvinogona kuwirirana nezviratidzo zvinowanzoonekwa panguva yekuzvitakura, izvo zvinogona kukonzera nyaya, asi kushambadzira kweHL kunoitwa kuitira kupa ruzivo rwakakwana kutungamirira vatungamiri panguva kudzivirira matambudziko kune fetus.
Somuenzaniso, kana x-ray yechipfuva ichiitwa, mimba inodzivirirwa kuitira kudzivirira mwana. Kuongorora mimba, MRI uye ultrasound inogona kuitwa. Pfupa remapfupa rinogona kuve rakachengetedzwa zvakanaka panguva yekuzvitakura kana zvichidiwa.
Kutungamirirwa kweHL panguva yekuzvitakura kunoreva kuenzanisa mukana wekurapa uye kuderedza kuve nekukuvadza kumucheche mwana. Vakadzi vazhinji vane pamuviri vane HL vanorwara panguva yekuzvitakura vanorapwa. Kusanganiswa kwemakemikrasi yakadai seABVD yakagadzirirwa kubudirira mumutatu wekutanga. Zvidzidzo zvakatarisa zviitiko zvekuberekwa mumama zvakarapwa nekuda kweHL zvave zvichikurudzira, zvisingaratidzi musiyano muhutano hwekuberekwa kana kuberekwa kusina kufanana nekuenzaniswa nevana vakaberekerwa vanaamai vasati varapwa. Mumadzimai akasarudzwa, kurapwa kunogona kuderedzwa kusvikira mwana asunungurwa akachengeteka.
Kubereka Mushure mekurapa kweHodgkin Lymphoma
Maererano neshoko rakabudiswa mumagazini yaNovember 2011 ye "Haematologica," chimwe chinhu chinonzi kusakwanisa kupera nguva isati yasvika-kunyanya kumbotangira-kunogona kuitika muna 5 kusvika ku25 muzana yevakadzi vari kurapwa vari pasi pemakore makumi matatu.
Dambudziko rekushaya vana rinowedzera nehuwandu hwechiitiko chekemisotherapies dzinonzi alkylating agents.
Chemotherapy yakabatanidzwawo nekukuvadza kune mavha mavari. Izvozvo zvinonzi myeloablative therapy inowedzera mukana wekuti mukadzi haangakwanisi kubata mushure mekurapa. Iro rudzi rwehutano hunoshandisa high-dose chemotherapy inouraya masero mumapfupa emapfupa, kusanganisira mapepa emukenza.
Iyo inoderedzawo kuwanda kwemasero evanhu vanowanzoita ropa mumapfupa emapfupa, izvo zvinogona kuita kuti zvive nemigumisiro yakakomba. Apo myeloablative chemotherapy inoshandiswa, ichi kazhinji chinoteverwa nefupa remafu kana stem cell transplant kuti idzorere basa remasero emapfupa.
Chidzidzo cheMeirow uye vaaishanda navo chakaratidza kuti kukundikana kwemaawa kusati kwapera kunowanzoitika kune vakadzi vanopfuura makore makumi matatu, uye kuti rimwe regimia remotherapeutic uye imwe nhamba yeirradiation yeplavic ndiyo inobatsira muhutano. Kunyanyisa toxic kune mavhisi evari ari alkylating agents.
Kuongorora kwakasiyana-siyana kwakatarisa kubereka mune varwere vanotevera HL kurapwa. Chimwe chinowanikwa chave chiri chokuti chirongwa-chekuwedzera cheBACACP regimen chave chichibatanidza kune zvakakwirira zvechirwere chechipiri kupfuura yeAVVD regimen. Secondary amenorrhea inotsanangurwa sokusava kwekuenda kwemwedzi kune mukadzi uyo akanga ava kuenda kumwedzi asi gare gare anorega kuenda kumwedzi kwemwedzi mitatu kana kupfuura- uye kushayikwa kwekuenda kumwedzi hakuiti nekuda kwekuita pamuviri, kumwisa mwana, kupererwa kwemhepo nekugadzirisa zvirwere (kuberekwa nekuberekwa) mapiritsi, kana kumisa.
Izvo zvikamu zvehurumende iri pamusoro apa ndeizvi:
- BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, uye prednisone, uko ma-alkylating agents ari cyclophosphamide uye procarbazine)
- ABVD (doxorubicin, vinblastine, dacarbazine, uye bleomycin, uko munhu anogadzirisa dakarbazine)
Kunyange zvazvo mazuva ano kurapwa kwemazuva ano kunowanzobudirira kurwisana neHL, vanogona kutora mararamiro kune gonads uye mavari mavhesi kunyanya. Kune vanachiremba vanoongorora chiitiko ichi, chiitiko chinowanzotsanangurwa se "chemotherapy-induced diminished ovarian reserve," kana chDOR.
Iko chDOR inosanganisira kuva nenhamba yakaderera mazai mumayese emukadzi asi inogonawo kukonzera kukura kwemaawa aripo. Zviratidzo zvinosanganisira chirwere chechipiri uye kusabereka. Kuzadzwa kweporolicles mumapapiro omukati kunogona kutungamirira kune izvo zvinonzi kusakwanisa kusati kwasvika, izvo zvinonyatsotsanangurwa sekurasikirwa kwebasa rekuvhara mazaya musati wava nemakore makumi mana.
Pane humwe uchapupu hwokuti kutungamirirwa kwegonadotropin-kurega hormone yakafanana (GnRH-a) panguva yemakemikirini inogona kubatsira kuchengetedza mavha mavari. Iyo nzira yekuti izvi zvingashanda sei, zvisinei, zvisati zvanyatsonzwisiswa.
Murume Anobereka
Varwere vevarume havasi kunze kwekuberekwa kwechirwere kubva kuchirapa, zvimwe. Aya ma testes anonyanya kunetseka nemigumisiro ine chepachirwere chekenza pane zvikamu zvose zvehupenyu. Maererano nekutsvakurudza kwakaitwa naJahnukainen uye vashandi pamwe navo, vapukunyuka vechidiki vechidiki rwekenza vanenge vangangodarika hafu sezvo vanin'ina vavo vanoridza kubata. Iyo pepa inotaura nezvemishonga inonzi radiation kune ma testes uye kuwedzera kwechirwere chemazana emagetsi echinhu chinonyanya kukonzera mikana yekubereka.
Shoko Rinobva
Munda wekenza kurapwa uye yekuchengetedza kubereka kunowedzera nokukurumidza. Mishonga inopesana nekenza inobuda kazhinji, uye zvose zviri zviviri kurapa kweropa uye kutarisira kwemigumisiro, kusanganisira infertility, inogara iripo yekushanduka. Taura nechiremba wako kuti uone kuti ndeipi nzira yakanakisisa yekurapa iwe.
Sources:
Harel S, Closed C, Poirot C. Kutungamirirwa kwehutano kune varwere vakabata Hodgkin's lymphoma. Haematologica . 2011; 96 (11): 1692-1699.
Hutchings M. PET / CT inobatsira sei pakusarudza chirwere chevarwere vane Hodgkin lymphoma? Hematology Am Soc Hematol Dzidzo Yedzidzo. 2012; 2012: 322-7.
Meirow D, Biederman H, Anderson RA, Wallace WH. Dhiyabhorosi yemakemikrasi uye mazai ekuberekwa kwevakadzi. Clin Obstet Gynecol. 2010; 53: 727-39.