Kev nrawm nrawm ntawm diffuse loj B-cell lymphoma (DLBCL) hauv cov menyuam yaus
Nqe lus no yog piav qhia luv luv ntawm diffuse loj B cell lymphoma (DLBCL) hauv cov menyuam hnub nyoog 0-14 xyoo. Yog xav paub ntxiv nyob rau hauv qhov tob saib xyuas cov seem ntxiv hauv qab no.
Yuav ua li cas yog nws?
Diffuse loj B-cell lymphoma (DLBCL) yog ib qho mob hnyav (loj hlob sai) B-cell non-Hodgkin lymphoma. Nws tsim los ntawm B lymphocytes (cov qe ntshav dawb) uas loj hlob uncontrollably. Cov kab mob B lymphocytes txawv txav sib sau ua ke hauv cov qog nqaij hlav thiab cov qog nqaij hlav, nyob rau hauv lub lymphatic system, uas yog ib feem ntawm lub cev tiv thaiv kab mob. Vim tias cov ntaub so ntswg muaj nyob thoob plaws lub cev, DLBCL tuaj yeem pib hauv yuav luag txhua qhov ntawm lub cev thiab kis mus rau yuav luag txhua yam kabmob lossis cov ntaub so ntswg hauv lub cev.
Nws ua rau leej twg?
DLBCL suav txog kwv yees li 15% ntawm tag nrho cov lymphoma uas tshwm sim hauv cov menyuam yaus. DLBCL feem ntau tshwm sim hauv cov tub hluas dua li cov ntxhais. DLBCL yog cov lymphoma subtype feem ntau hauv cov neeg laus, suav txog kwv yees li 30% ntawm cov neeg laus cov qog ntshav qog ntshav.
Kev kho thiab ntsuas qhov tseeb
DLBCL nyob rau hauv cov me nyuam muaj ib tug zoo heev prognosis (kev pom). Nyob ib ncig ntawm 90% ntawm cov menyuam yaus raug kho tom qab tau txais cov qauv tshuaj khomob thiab kev tiv thaiv kab mob. Muaj ntau txoj kev tshawb fawb mus rau kev kho tus kab mob lymphoma no, nrog rau qhov tseem ceeb ntawm kev tshawb xyuas yuav ua li cas txo cov kev mob lig, lossis cov kev mob tshwm sim los ntawm kev kho tshuaj lom neeg uas tuaj yeem tshwm sim ntau hli mus rau xyoo tom qab kev kho mob.
Txheej txheem cej luam ntawm diffuse loj B-cell lymphoma (DLBCL) hauv cov menyuam yaus
Lymphomas yog ib pab pawg neeg mob qog noj ntshav cov lymphatic system. Lymphoma tshwm sim thaum lymphocytes, uas yog hom ntshav dawb, nce DNA hloov pauv. Lub luag haujlwm ntawm lymphocytes yog txhawm rau tiv thaiv kab mob, ua ib feem ntawm lub cev tiv thaiv kab mob. muaj B-lymphocytes (B-cells) thiab T-lymphocytes (T-cells) uas ua haujlwm sib txawv.
Hauv DLBCL cov qog ntshav qog ntshav tau faib thiab loj hlob tsis tuaj yeem lossis tsis tuag thaum lawv yuav tsum. Muaj ob hom lymphomas tseem ceeb. Lawv hu ua Hodgkin lymphoma (HL) thiab Non-Hodgkin lymphoma (NHL). Lymphomas tau muab faib ntxiv rau hauv:
- Indolent (loj hlob qeeb) lymphoma
- aggressive (hloov zuj zus) lymphoma
- B-cell qog nqaij hlav cancer yog B-cell lymphocytes txawv txav & yog cov feem ntau. B-cell lymphomas suav txog kwv yees li 85% ntawm tag nrho cov lymphomas
- T-cell lymphoma yog T-cell lymphocytes txawv txav. T-cell lymphomas suav txog kwv yees li 15% ntawm tag nrho cov lymphomas
Diffuse loj B-cell lymphoma (DLBCL) yog ib qho mob hnyav (loj hlob sai) B-cell non-Hodgkin lymphoma. DLBCL suav txog kwv yees li 15% ntawm tag nrho cov lymphomas uas tshwm sim hauv cov menyuam yaus. DLBCL yog cov qog ntshav qog ntau tshaj plaws hauv cov neeg laus, suav txog kwv yees li 30% ntawm tag nrho cov qog ntshav qog ntshav hauv cov neeg laus.
DLBCL tsim los ntawm cov laus B-hlwb los ntawm cov kab mob hauv nruab nrab ntawm cov qog nqaij hlav, lossis los ntawm B-hlwb hu ua activated B-cells. Yog li, muaj ob hom DLBCL feem ntau:
- Germinal Center B-cell (GCB)
- Activated B-cell (ABC)
Tsis paub qhov tseeb ntawm DLBCL hauv cov menyuam yaus. Feem ntau tsis muaj kev piav qhia tsim nyog rau qhov twg lossis tus menyuam tau kis mob qog noj ntshav li cas thiab tsis muaj pov thawj qhia tias cov niam txiv thiab cov neeg saib xyuas tuaj yeem tiv thaiv cov qog qog ntshav los ntawm kev loj hlob, lossis ua rau nws.
Leej twg raug cuam tshuam los ntawm diffuse loj B-cell lymphoma (DLBCL)?
Diffuse loj B-cell lymphoma (DLBCL) tuaj yeem tshwm sim rau cov neeg ntawm txhua lub hnub nyoog lossis poj niam txiv neej. DLBCL feem ntau pom nyob rau hauv cov menyuam yaus thiab cov hluas (cov neeg muaj hnub nyoog 10 - 20 xyoo). Nws tshwm sim ntau zaus hauv cov tub hluas dua cov ntxhais.
Qhov laj thawj ntawm DLBCL tsis paub. Tsis muaj ib yam dab tsi uas koj tau ua lossis tsis tau ua uas tau ua rau qhov no. Nws tsis kis tau thiab tsis tuaj yeem kis mus rau lwm tus neeg.
Txawm hais tias qhov ua tau ntawm DLBCL tsis pom tseeb, muaj qee qhov muaj feem cuam tshuam txog uas tau txuam nrog lymphoma. Tsis yog txhua tus neeg uas muaj cov xwm txheej txaus ntshai no yuav mus tsim DLBCL. Cov kev pheej hmoo muaj xws li (txawm tias qhov kev pheej hmoo tseem tsawg heev):
- Tus kab mob yav dhau los nrog Epstein-Barr virus (EBV) - tus kab mob no yog qhov ua rau kub taub hau
- Tsis muaj zog tiv thaiv kab mob vim muaj kab mob hauv lub cev tsis muaj zog (autoimmune kab mob xws li dyskeratosis congenita, kab mob lupus, mob caj dab rheumatoid)
- HIV mob
- Cov tshuaj tiv thaiv kab mob uas tau noj los tiv thaiv kev tsis lees paub tom qab hloov lub cev
- Muaj ib tug kwv tij lossis tus muam uas muaj cov qog ntshav qog ntshav (tshwj xeeb yog menyuam ntxaib) tau pom tias muaj tsev neeg tsis tshua muaj caj ces txuas rau tus kabmob (qhov no tsis tshua muaj thiab tsis pom zoo rau cov tsev neeg kom kuaj cov caj ces)
Kev muaj tus me nyuam kuaj mob lymphoma tuaj yeem ua rau muaj kev ntxhov siab thiab kev xav, tsis muaj qhov raug lossis tsis yog. Nws feem ntau yog kev puas tsuaj thiab kev poob siab, nws yog ib qho tseem ceeb uas yuav tsum tso cai rau koj tus kheej thiab koj tsev neeg lub sijhawm ua haujlwm thiab tu siab. Nws tseem yog ib qho tseem ceeb uas koj tsis txhob nqa qhov hnyav ntawm qhov kev kuaj mob ntawm koj tus kheej, muaj ntau lub koom haum txhawb nqa uas nyob ntawm no los pab koj thiab koj tsev neeg lub sijhawm no, nias ntawm no kom paub ntau ntxiv txog kev txhawb nqa rau cov tsev neeg uas muaj menyuam lossis cov tub ntxhais hluas uas muaj qog ntshav qog ntshav.
Hom kab mob loj B-cell lymphoma (DLBCL) hauv cov menyuam yaus
Diffuse loj B-cell lymphoma (DLBCL) tuaj yeem muab faib ua subtypes raws li hom B-cell nws tau loj hlob los ntawm (lub npe hu ua "cell of origin").
- Germinal Center B-cell lymphoma (GBC): GCB-hom muaj ntau dua hauv cov neeg mob menyuam yaus dua li ABC-hom. Cov tub ntxhais hluas feem ntau yuav kis tau tus kab mob GCB (80-95% hauv 0-20 xyoo) dua li cov neeg laus thiab nws muaj feem cuam tshuam nrog cov txiaj ntsig zoo dua piv rau ABC-hom.
- Activated B-cell Lymphoma (ABC): ABC-hom los ntawm qhov chaw tom qab kab mob (ntawm lub cell) qhov chaw vim nws yog B-cell malignancy ntau dua. Nws yog hu ua ABC-type vim hais tias B-hlwb tau qhib thiab ua haujlwm ua ntej pab txhawb rau lub cev tiv thaiv kab mob.
DLBCL tuaj yeem muab faib ua cov kab mob hauv nruab nrab B-cell (GCB) lossis qhib B-cell (ABC). Tus kws kho mob kuaj xyuas koj cov qog nqaij hlav qog nqaij hlav tuaj yeem qhia qhov txawv ntawm cov no los ntawm kev nrhiav qee cov proteins ntawm cov qog ntshav qog ntshav. Tam sim no, cov ntaub ntawv no tsis yog siv rau kev kho mob ncaj qha. Txawm li cas los xij, cov kws tshawb fawb tab tom tshawb fawb los tshawb xyuas seb cov kev kho mob sib txawv puas muaj txiaj ntsig zoo rau ntau hom DLBCL uas tsim los ntawm cov hlwb sib txawv.
Cov tsos mob ntawm diffuse loj B-cell lymphoma (DLBCL) hauv cov menyuam yaus
Thawj cov tsos mob uas neeg feem coob pom yog ib pob los yog ntau lub pob uas tsis ploj mus tom qab ob peb lub lis piam. Tej zaum koj yuav hnov ib lossis ntau pob ntawm koj tus menyuam lub caj dab, caj dab, lossis puab tais. Cov qog no yog cov qog nqaij hlav o, qhov chaw lymphocytes txawv txav. Cov pob no feem ntau pib nyob rau hauv ib feem ntawm tus menyuam lub cev, feem ntau yog lub taub hau, caj dab lossis hauv siab thiab tom qab ntawd yuav kis tau zoo los ntawm ib feem ntawm cov kab mob lymphatic mus rau lwm qhov. Nyob rau theem siab, tus kab mob tuaj yeem kis mus rau lub ntsws, daim siab, pob txha, pob txha pob txha lossis lwm yam kabmob.
Muaj ib hom lymphoma uas tsis tshua muaj tshwm sim nrog lub mediastinal mass, nws yog hu ua thawj mediastinal loj B-cell lymphoma (PMBCL). Cov lymphoma no tau muab cais ua ib hom subtype ntawm DLBCL tab sis txij li tau muab cais tawm. PMBCL yog thaum lymphoma los ntawm thymic B-hlwb. Lub thymus yog ib lub cev lymphoid nyob ncaj qha tom qab sternum (lub hauv siab).
Cov tsos mob feem ntau ntawm DLBCL suav nrog:
- Tsis mob o ntawm cov qog nqaij hlav hauv caj dab, hauv qab caj npab, puab tsaig lossis hauv siab
- Ua tsis taus pa - vim loj lymph nodes nyob rau hauv lub hauv siab los yog mediastinal loj
- hnoos (feem ntau yog hnoos qhuav)
- nkees nkees
- Nyuaj rov qab los ntawm tus kab mob
- Cov tawv nqaij khaus (pruritus)
B cov tsos mob yog ib lo lus uas piav txog cov tsos mob hauv qab no:
- Hmo ntuj tawm hws (tshwj xeeb yog hmo ntuj, qhov twg koj yuav tau hloov lawv cov khaub ncaws pw thiab txaj)
- Ua npaws tsis tu ncua
- Unexplained poob phaus
Kwv yees li ntawm 20% ntawm cov menyuam yaus uas muaj DLBCL muaj qhov loj hauv lub hauv siab. Qhov no hu ua "mediastinal mass". , Ib qho loj hauv lub hauv siab tuaj yeem ua rau ua tsis taus pa luv, hnoos lossis o ntawm lub taub hau thiab caj dab vim yog cov qog ntawm cov hlab ntsha los yog cov hlab ntsha loj saum lub plawv.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ntau yam ntawm cov tsos mob no cuam tshuam rau lwm yam uas tsis yog mob qog noj ntshav Qhov no txhais tau tias lymphoma tuaj yeem nyuaj rau kws kho mob kuaj.
Kev kuaj mob ntawm diffuse loj B-cell lymphoma (DLBCL)
A qhov nqaij me ib txwm xav tau rau kev kuaj mob ntawm diffuse loj B-cell lymphoma. A qhov nqaij me yog ib txoj haujlwm tshem tawm a cov qog ntshav los yog lwm yam ntaub so ntswg txawv txav mus saib nws nyob rau hauv lub microscope los ntawm ib tug pathologist. Kev kuaj ntshav biopsy feem ntau yog ua los ntawm kev siv tshuaj loog rau cov menyuam yaus los pab txo kev ntxhov siab.
Feem ntau, ob qho tib si tseem ceeb biopsy lossis ib qho excisional node biopsy yog qhov kev tshawb nrhiav zoo tshaj plaws. Qhov no yog los xyuas kom cov kws kho mob sau cov ntaub so ntswg txaus los ua kom tiav qhov kev sim tsim nyog rau kev kuaj mob.
Tos rau qhov tshwm sim tuaj yeem yog lub sijhawm nyuaj. Tej zaum nws yuav pab tham nrog koj tsev neeg, phooj ywg lossis tus kws saib xyuas neeg mob tshwj xeeb.
Staging ntawm diffuse loj B-cell lymphoma (DLBCL)
Ib zaug a kuaj mob ntawm DLBCL yog tsim, yuav tsum tau kuaj ntxiv kom pom lwm qhov hauv lub cev cov qog ntshav qog ntshav nyob. Qhov no hu ua kauj ruam. cov staging ntawm lymphoma pab tus kws kho mob los txiav txim seb qhov kev kho mob zoo tshaj plaws rau koj tus menyuam.
Muaj 4 theem, los ntawm theem 1 (lymphoma nyob rau hauv ib cheeb tsam) mus txog rau theem 4 (lymphoma uas yog dav los yog siab).
- Thaum ntxov theem txhais tau tias theem 1 thiab qee theem 2 lymphomas. Qhov no kuj tseem hu ua 'localised'. Theem 1 lossis 2 txhais tau hais tias lymphoma pom nyob rau hauv ib cheeb tsam lossis ob peb thaj chaw ze ua ke.
- Qib siab heev txhais tau hais tias cov qog ntshav qog ntshav yog theem 3 thiab theem 4, thiab nws yog cov qog ntshav qog ntshav thoob plaws. Feem ntau, lymphoma tau kis mus rau qhov chaw ntawm lub cev uas nyob deb ntawm ib leeg.
'Advanced' theem lymphoma ua suab hais txog, tab sis lymphoma yog qhov hu ua mob qog noj ntshav. Nws tuaj yeem kis thoob plaws hauv lub cev lymphatic thiab cov ntaub so ntswg nyob ze. Qhov no yog vim li cas kev kho mob (chemotherapy) yuav tsum tau kho DLBCL.
Cov kev xav tau yuav muaj xws li:
- Kev kuaj ntshav (xws li: tag nrho cov ntshav suav, ntshav chemistry thiab erythrocyte sedimentation tus nqi (ESR) los nrhiav pov thawj ntawm o)
- Xoos xoo fais fab - Cov duab no yuav pab txheeb xyuas qhov muaj kab mob hauv siab
- Positron emission tomography (PET) scan - ua kom nkag siab txhua qhov chaw ntawm cov kab mob hauv lub cev ua ntej kev kho mob pib
- Tham tomography (CT) scan
- Pob txha pob txha pob txha (tsuas yog ua tau yog tias muaj pov thawj ntawm tus kab mob siab heev)
- Lumbar puncture - Yog tias lymphoma xav tias nyob rau hauv lub hlwb lossis qaum qaum
Koj tus menyuam kuj yuav raug ntau yam kev ntsuam xyuas hauv paus ua ntej pib kev kho mob. Qhov no yog los xyuas lub cev ua haujlwm. Cov no tuaj yeem rov ua dua thaum thiab tom qab kev kho mob los ntsuas seb qhov kev kho mob puas cuam tshuam rau lub cev ua haujlwm. Cov kev ntsuam xyuas yuav tsum muaj xws li; ;
- Kev kuaj lub cev
- Kev soj ntsuam tseem ceeb (ntshav siab, kub, & mem tes npaum li cas)
- Lub plawv scan
- Lub raum scan
- Kev kuaj ua pa
- Kev kuaj ntshav
Ntau yam ntawm cov no staging thiab kuaj lub cev ua haujlwm rov ua dua tom qab kev kho mob los xyuas seb qhov kev kho mob lymphoma puas tau ua haujlwm thiab los saib xyuas cov txiaj ntsig kev kho mob ntawm lub cev.
Kev kwv yees ntawm diffuse loj B-cell lymphoma (DLBCL)
DLBCL nyob rau hauv cov me nyuam muaj ib tug zoo heev prognosis (kev pom). Nyob ib ncig ntawm 9 ntawm txhua 10 (90%) cov menyuam yaus raug kho tom qab tau txais tus qauv cov kws khomob thiab immunotherapy. Muaj ntau txoj kev tshawb fawb nrhiav kev kho tus kab mob lymphoma no, nrog rau qhov tseem ceeb ntawm kev tshawb xyuas yuav ua li cas txo qis cov teebmeem lig, lossis cov kev mob tshwm sim los ntawm kev kho tshuaj lom neeg uas tuaj yeem tshwm sim ntau hli mus rau xyoo tom qab kho.
Kev muaj sia nyob ntev thiab kev xaiv kho mob nyob ntawm ntau yam, suav nrog:
- Hnub nyoog ntawm koj tus menyuam thaum kuaj mob
- Ntev los yog theem ntawm tus mob qog noj ntshav
- Cov tsos mob ntawm lymphoma hlwb nyob rau hauv lub microscope (cov duab, kev ua haujlwm thiab cov qauv ntawm cov hlwb)
- lymphoma teb li cas rau kev kho mob
Kev kho mob ntawm diffuse loj B-cell lymphoma
Thaum tag nrho cov txiaj ntsig tau los ntawm kev kuaj ntshav biopsy thiab kev soj ntsuam theem tiav lawm, tus kws kho mob yuav tshuaj xyuas cov no los txiav txim siab qhov kev kho mob zoo tshaj plaws rau koj tus menyuam. Ntawm qee qhov chaw kho mob qog noj ntshav, tus kws kho mob yuav ntsib nrog pab pawg kws kho mob tshwj xeeb los tham txog qhov kev kho mob zoo tshaj plaws. Qhov no hu ua a Pab pawg neeg sib koom ua ke (MDT) rooj sib tham.
Cov kws kho mob yuav xav txog ntau yam txog koj tus menyuam lymphoma thiab kev noj qab haus huv los txiav txim siab thaum twg thiab yuav kho li cas. Qhov no yog nyob ntawm;
- Qib thiab qib ntawm lymphoma
- Cov tsos mob
- Hnub nyoog, yav dhau los kev kho mob keeb kwm & kev noj qab haus huv
- Tam sim no lub cev thiab kev puas siab puas ntsws
- Cov xwm txheej
- Tsev neeg nyiam
Txij li DLBCL yog lymphoma loj hlob sai, nws yuav tsum tau kho sai sai - feem ntau nyob rau hauv hnub rau lub lis piam ntawm kev kuaj mob. DLBCL kev kho mob suav nrog kev sib xyaw ua ke cov kws khomob thiab immunotherapy
Qee cov tub ntxhais hluas DLBCL cov neeg mob yuav raug kho nrog cov neeg laus cov kws khomob hu ua R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, & prednisolone). Qhov no feem ntau nyob ntawm seb koj tus menyuam puas raug kho hauv tsev kho mob menyuam yaus lossis tsev kho mob laus.
Kev kho mob rau menyuam yaus thaum ntxov DLBCL (theem I-IIA):
- BFM-90/95: 2 - 4 lub voj voog ntawm kev kho mob raws li kab mob theem
- Cov tshuaj raws tu qauv muaj xws li: cyclophosphamide, cytarabine, methotrexate, mercaptopurine, vincristine, pegaspargase, prednisolone, pirarubicin, dexamethasone.
- COG-C5961: 2 - 4 lub voj voog ntawm kev kho mob raws li kab mob theem
Kev kho mob rau menyuam yaus rau theem DLBCL (theem IIB-IVB):
- COG-C5961: 4 - 8 lub voj voog ntawm kev kho mob raws li kab mob theem
- Cov tshuaj raws tu qauv muaj xws li: cyclophosphamide, cytarabine, doxorubicin hydrochloride, etoposide, methotrexate, prednisolone, vincristine.
- BFM-90/95: 4 - 6 lub voj voog ntawm kev kho mob raws li kab mob theem
- Cov tshuaj raws tu qauv muaj xws li: cyclophosphamide, cytarabine, methotrexate, mercaptopurine, vincristine, pegaspargase, prednisolone, pirarubicin, dexamethasone.
Cov kev mob tshwm sim ntawm kev kho mob
Kev kho mob rau DLBCL los nrog kev pheej hmoo ntawm kev tsim muaj ntau yam kev mob tshwm sim. Txhua txoj kev kho mob muaj cov kev mob tshwm sim ntawm tus kheej thiab koj tus kws kho mob thiab / lossis tus kws kho mob tshwj xeeb yuav piav qhia rau koj thiab koj tus menyuam ua ntej pib kho.
Qee qhov kev mob tshwm sim ntau dua ntawm kev kho mob rau diffuse loj B-cell lymphoma suav nrog:
- Anemia (cov qe ntshav liab qis)
- Thrombocytopenia (tsawg platelets)
- Neutropenia (cov qe ntshav dawb tsawg)
- Xeev thiab ntuav
- Cov teeb meem plab hnyuv xws li cem quav thiab raws plab
- nkees nkees
- Txo fertility
Koj pab neeg kho mob, kws kho mob, tus kws saib xyuas mob qog noj ntshav lossis kws muag tshuaj, yuav tsum muab cov ntaub ntawv qhia txog koj kev kho mob, lub cov kev mob tshwm sim, cov tsos mob dab tsi los qhia thiab hu rau leej twg. Yog tsis yog, thov nug cov lus nug no.
Fertility preservation
Qee qhov kev kho mob rau lymphoma tuaj yeem txo qis fertility. Qhov no muaj feem ntau nrog qee yam kev kho mob raws tu qauv (kev sib xyaw ntawm cov tshuaj) thiab cov tshuaj siv tshuaj kho mob siab siv ua ntej hloov cov qia cell. Radiotherapy rau lub plab mog kuj ua rau muaj feem yuav txo qis fertility. Qee cov tshuaj tiv thaiv kab mob kuj tseem cuam tshuam rau kev xeeb tub, tab sis qhov no tsis tshua meej.
Koj tus kws kho mob yuav tsum tau qhia txog seb kev xeeb tub yuav cuam tshuam li cas Tham nrog tus kws kho mob thiab / lossis tus kws kho mob tshwj xeeb ua ntej kev kho mob pib txog seb kev xeeb tub puas yuav cuam tshuam.
Yog xav paub ntxiv lossis lus qhia txog kev kho mob rau menyuam yaus DLBCL, kev kho mob, kev mob tshwm sim, kev txhawb nqa muaj lossis yuav ua li cas mus rau hauv tsev kho mob, thov hu rau tus kws saib xyuas neeg mob qog noj ntshav ntawm 1800 953 081 los sis email rau peb ntawm Nurse@lymphoma.org.au
Kev saib xyuas tom qab
Tom qab kev kho mob tiav lawm, koj tus menyuam yuav muaj kev kuaj mob. Cov kev tshuaj ntsuam no yog los xyuas seb qhov kev kho mob tau ua haujlwm zoo li cas. Cov tshuaj ntsuam xyuas yuav qhia cov kws kho mob seb tus lymphoma tau teb li cas rau kev kho mob. Qhov no yog hu ua cov lus teb rau kev kho mob thiab tuaj yeem piav qhia raws li:
- Ua tiav cov lus teb (CR lossis tsis muaj cov tsos mob ntawm lymphoma tseem nyob) lossis a
- Teb ib nrab (PR lossis tseem muaj lymphoma tam sim no, tab sis nws tau txo qhov loj)
Tom qab ntawd koj tus menyuam yuav tsum tau mus ntsib lawv tus kws kho mob nrog kev teem sijhawm saib xyuas, feem ntau txhua 3-6 lub hlis. Cov kev teem caij no yog ib qho tseem ceeb kom pab neeg kho mob tuaj yeem tshawb xyuas seb lawv puas rov zoo los ntawm kev kho mob. Cov kev teem caij no muab sijhawm zoo rau koj tham nrog kws kho mob lossis tus kws saib xyuas neeg mob txog txhua yam kev txhawj xeeb uas koj muaj. Pab neeg kho mob yuav xav paub seb koj tus menyuam thiab koj lub cev zoo li cas thiab lub hlwb, thiab rau:
- Saib xyuas qhov ua tau zoo ntawm kev kho mob
- Saib xyuas cov kev mob tshwm sim tsis tu ncua los ntawm kev kho mob
- Saib xyuas cov teebmeem lig los ntawm kev kho mob dhau sijhawm
- Saib xyuas cov tsos mob ntawm lymphoma relapsing
Koj tus menyuam yuav tau kuaj lub cev thiab kuaj ntshav txhua lub sijhawm. Sib nrug los ntawm tam sim tom qab kev kho mob los tshuaj xyuas seb qhov kev kho mob tau ua haujlwm li cas, kev tshuaj ntsuam xyuas feem ntau tsis ua tiav tshwj tsis yog tias muaj qee qhov laj thawj rau lawv. Yog tias koj tus menyuam nyob zoo, qhov kev teem caij yuav ua tsawg dua thaum lub sijhawm.
Relapsed lossis refractory tswj ntawm DLBCL
Rov qab lymphoma yog thaum mob qog noj ntshav rov qab los, ua kom dua lymphoma yog thaum mob qog noj ntshav tsis teb rau thawj kab kev kho mob. Rau qee tus menyuam yaus thiab cov tub ntxhais hluas, DLBCL rov qab los thiab qee qhov tsis tshua muaj tshwm sim nws tsis teb rau kev kho thawj zaug (refractory). Rau cov neeg mob no muaj lwm yam kev kho mob uas tuaj yeem ua tiav, cov no suav nrog:
- Kev siv tshuaj tua kab mob siab ua ke tom qab ntawd autologous qia cell hloov lossis ib qho allogeneic qia cell hloov (tsis haum rau txhua tus neeg)
- Combination tshuaj kho mob
- immunotherapy
- Radiotherapy
- Kev koom tes nrog kev sim tshuaj
Thaum ib tus neeg xav tias muaj tus kab mob rov qab los, feem ntau tib qhov kev kuaj mob tau ua tiav, uas suav nrog cov kev ntsuam xyuas uas tau hais saum toj no hauv kuaj mob thiab staging seem.
Kev kho mob raws li kev tshawb nrhiav
Muaj ntau txoj kev kho mob uas tam sim no raug sim hauv kev sim tshuaj thoob ntiaj teb rau cov neeg mob uas tau kuaj pom tshiab thiab rov qab mob qog ntshav qog ntshav. Qee qhov kev kho mob no suav nrog:
- Ntau qhov kev sim no tab tom kawm txo qis cov tshuaj lom neeg thiab cov teebmeem lig ntawm cov tshuaj kho mob
- Kev kho T-cell kho mob
- Copanlisib (ALIQOPATM - PI3K inhibitor)
- Venetoclax (VENCLEXTATM - BCL2 inhibitor)
- Temsirolimus (TORISOLTM)
- CUDC-907 (kev kho tshiab tshiab)
Yuav ua li cas tom qab kho?
Cov teebmeem lig
Qee zaum cov kev mob tshwm sim los ntawm kev kho mob tuaj yeem txuas ntxiv lossis loj hlob ntau lub hlis lossis xyoo tom qab kev kho mob tiav. Qhov no yog hu ua late effect. Yog xav paub ntxiv, mus rau ntu 'cov teebmeem lig' kom paub ntau ntxiv txog qee qhov teebmeem ntxov thiab lig uas tuaj yeem tshwm sim los ntawm kev kho mob qog noj ntshav.
Cov menyuam yaus thiab cov tub ntxhais hluas tuaj yeem muaj cov kev mob tshwm sim ntsig txog kev kho mob uas tuaj yeem tshwm sim ntau hli lossis xyoo tom qab kev kho mob, suav nrog cov teeb meem ntawm pob txha loj hlob thiab kev loj hlob ntawm cov kab mob sib deev hauv cov txiv neej, kev xeeb tub, thiab cov thyroid, kab mob plawv thiab ntsws. Ntau qhov kev kho mob tam sim no thiab kev tshawb fawb tshawb fawb tam sim no tsom rau kev sim txo qhov kev pheej hmoo rau cov teebmeem lig.
Rau cov laj thawj no nws yog ib qho tseem ceeb rau cov neeg muaj sia nyob ntawm cov kab mob loj B-cell lymphoma (DLBCL) tau txais kev saib xyuas thiab saib xyuas tsis tu ncua.
