Kubata uye Kurapa kwePas-Kutunga Non-Hodgkin's Lymphoma
Ngozi yekuvandudza lymphoma inonyanya kuwedzera mushure mekunyatsogadziriswa kwemuviri, semafungiro epfungwa, chiropa chinoputika, kuchinja kwemwoyo kana kuputika kwemapapu. Izvi zvipembenene zvinonzi zvirwere zvinonzi "post-transplant lymphoproliferative disorders" kana PTLDs.
Inowanzove yakakosha sei Lymphoma mushure mekugadzira yenyama?
PTLD inosanganisira zvirwere zvakasiyana-siyana zvinokonzera lymphoproliferative nhengo yakasimba kana hematopoietic stem cell transplantation (HSCT) uye inogona kuitika 10 muzana yevanhu vakuru mushure mekugadzirwa.
Mhando ye1 kusvika ku20 muzana yakashandiswawo kuenzana nharaunda yese yekushambadzira kweLPD.
Nei Lymphomas Inoitika Pashure Pemutsipa Wemuviri?
Post-transplant lymphomas inenge iine nguva dzose yakabatana nehutachiona neEpstein Barr Virus (EBV) . Kuvharirwa ne Epstein Barr Virus kunokonzera kushandurwa kweB-seli (rudzi rwechirwere chetachiona kana chechenzi yeropa rega) rinova kenza. Muvanhu vakajairika mamwe masero ezvirwere zvemuviri anokwanisa kutarisana nehutachiona hweEBV, asi kune vanhu vane zviputi zvemuviri, kukwirira kwezvinodhaka zvinoderedza maitiro ezvirwere zvemuviri zvinofanira kupiwa. Pasina chinhu chinogona kudzora utachiona, mikana yekuvandudza lymphomas inowedzera.
Ndezvipi Zvinowedzera Kuwedzera Kwengozi yeKushure-Kuwedzera Lymphoma?
Zvinhu zviviri izvi zvinonyanya kukosha mikana yekuwana lymphoma ndezvekuti:
- Kuwanda kwekufanirwa kurapwa kwemunosuppressive kunotarisirwa - Kuwedzera kwekudzivirira muviri, kunyanya mikana yehutachiona hweEBV.
- Mamiriro eEBV serology yeakagamuchira kubatanidzwa - Kana munhu wacho akambopindwa neEBV (ane nhoroondo yekuva nemono) mikana ndeyokuti muviri unoyeuka utachiona uye ropa rave rine mapuroteni chaiwo anonzi antibodies anogona kuziva uye kuuraya chirwere. Izvozvo zvinogona kuedzwa kuburikidza nokutora muenzaniso weropa.
Ko-Post-Kupinda Makomba Masikati Anobata Sei?
Pakati pevamwe, kana PTLD ichangoitika, nguva chaiyo yekuti iite saizvozvo inenge mwedzi mitatu mushure mekugadziriswa mune zvakasimba nhengo yekufambisa varwere uye mwedzi 2-3 muHSCT vagamuchiri, asi yakataurwa mushure mevhiki imwechete uye kunopera makore gumi mushure mekutapurika.
Post-transplant lymphomas inowanzosiyana nemamwe maitiro e-Non-Hodgkin lymphomas . Masero emukenza weiyi lymphoma ndeyekusanganiswa kwezvimiro zvakasiyana uye hukuru. Kunyange zvazvo varwere vakawanda vane kubatana zvikuru kwemakirini, dzimwe nhengo dzinowanzobatwa pamwe chete - chimwe chinhu chinonzi 'extranodal' kubatanidzwa . Izvi zvinosanganisira uropi, mapapu uye mumatumbo. Nhengo iyo inoshandiswa inogonawo kubatanidzwa.
Ko Post-Kutunga Lymphoma Yakaitwa Sei?
Pose pazvinenge zvichibvira, kurapwa kwemununosuppressive kunofanira kuderedzwa kana kumiswa. Mune avo vane zviduku uye vanoona zvirwere, kuvhiyiwa kana kupiswa kwezuva kunogona kuedzwa. Kana zvisingaiti, mutsara wekutanga wemishonga unowanzoitwa Rituxan (rituximab) , anorochenal monoclonal anonyanya kukanganisa lymphoma masero. Chero bedzi izvi zvinokundikana ikemotherapy yakaedzwa. Chemotherapy inoderedzwa kusvikira zvichidikanwa sezvinenge zvisingatauri mafungiro evamwe vanhu chemotherapy inogona kuwedzeredza njodzi yezvirwere .
Mune avo vanovandudza lymphomas mushure mekunge marrow transplants, kupiwa ropa reukokote kunogona kuva yakabudirira zvikuru.
Ndezvipi Migumisiro neMashure-Kuwedzera Lymphomas?
Nenzira yakawanda, PTLD ndiyo chikonzero chikuru chekurwara nekufa, munhau yepamusoro nehuwandu hwekufa kwehuwandu hunosvika kusvika 40-70 muzana kune varwere vane hutano hwakasimba uye 90 inotanga kune varwere vanotevera HSCT. Non-Hodgkin lymphomas inowanikwa mushure mekunyorwa kwechimiro ine urombo hwakanyanya kupfuura dzimwe NHLs. Chimwe chimiro chakabudiswa chave chekuti gore rinenge 60-80% pakupedzisira rakakundwa nemaronda avo. Zvisinei, kushandiswa kweRituxan kwakashandura kurarama, uye vamwe vanhu vanofambira zvakanaka uye vanogona kurapwa.
Kubatanidzwa kwevamwe nhengo, kunyanya uropi, kune hutachiona husina kunaka.
Sources:
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Katabathina, V., Menias, C., Pickhardt, P., Lubner, M., uye S. Prasad. Matambudziko eThe Immunosuppressive Therapy in Solid Organ Transplantation. Radiology Makliniki eNorth America . 2016. 54 (2): 303-19.
> Metser U, Lo G. FDG-PET / CT mucheche mushure mekunyora chirwere chinonzi lymphoproliferative. Br J Radiol . 2016; 89 (1057): 20150844.
Petrara, M., Giunco, S., Serraino, D., Dolcetti, R., uye A. De Rossi. Post-transplant lymphoproliferative disorders: kubva kune epidemiology kusvika kune pathogenesis-inotungamirirwa kurapwa. Cancer Tsamba . 2015. 369 (1): 37-44.