Txheej txheem cej luam ntawm Chronic Lymphocytic Leukemia (CLL) / Me Lymphocytic Lymphoma (SLL)
CLL yog ntau dua li SLL thiab yog qhov thib ob feem ntau mob qog nqaij hlav B-cell, hauv cov neeg muaj hnub nyoog tshaj 70 xyoo. Nws kuj muaj ntau dua rau cov txiv neej dua li poj niam, thiab tsis tshua muaj tshwm sim rau cov neeg muaj hnub nyoog qis dua 40 xyoo.
Feem ntau cov lymphomas tsis tuaj yeem kho tsis tau, uas txhais tau hais tias thaum koj tau kuaj mob CLL / SLL, koj yuav muaj nws mus tas koj lub neej. Txawm li cas los xij, vim tias nws loj hlob qeeb qee cov neeg tuaj yeem ua lub neej tag nrho yam tsis muaj tsos mob thiab tsis tas yuav muaj kev kho mob. Ntau tus neeg txawm li cas los xij, yuav tau txais cov tsos mob ntawm qee theem thiab xav tau kev kho mob.
Txhawm rau nkag siab CLL / SLL, koj yuav tsum paub me ntsis txog koj cov B-Cell lymphocytes
B-Cell lymphocytes:
- yog tsim nyob rau hauv koj cov pob txha pob txha (qhov spongy nyob rau hauv nruab nrab ntawm koj cov pob txha), tab sis feem ntau nyob rau hauv koj tus po thiab koj cov qog nqaij hlav.
- yog hom ntshav dawb.
- tiv thaiv kab mob thiab kab mob kom koj noj qab haus huv.
- nco ntsoov cov kab mob uas koj tau muaj yav dhau los, yog li yog tias koj kis tau tus kab mob zoo ib yam ntxiv, koj lub cev tiv thaiv kab mob tuaj yeem tua tau zoo dua thiab sai.
- tuaj yeem taug kev los ntawm koj lub cev lymphatic, mus rau txhua qhov ntawm koj lub cev los tiv thaiv kab mob lossis kab mob.
Yuav ua li cas rau koj B-cells thaum koj muaj CLL / SLL?
Thaum koj muaj CLL / SLL koj B-cell lymphocytes:
- ua txawv txav thiab loj hlob uncontrollably, ua rau ntau B-cell lymphocytes.
- tsis txhob tuag thaum lawv yuav tsum ua txoj hauv kev rau cov hlwb tshiab.
- loj hlob sai heev, yog li lawv feem ntau tsis loj hlob zoo thiab tsis tuaj yeem ua haujlwm zoo los tiv thaiv kab mob thiab kab mob.
- tuaj yeem siv ntau chav hauv koj cov pob txha pob txha uas koj cov qe ntshav liab, xws li cov qe ntshav liab thiab platelets yuav tsis tuaj yeem loj hlob zoo.
Nkag siab CLL / SLL
Xibfwb Con Tam, Melbourne raws li CLL / SLL kws kho mob hematologist piav qhia CLL / SLL thiab teb qee cov lus nug uas koj muaj.
Daim vis dis aus no tau ua thaum lub Cuaj Hlis 2022
Kev paub ntawm tus neeg mob nrog CLL
Txawm hais tias koj tau txais cov ntaub ntawv ntau npaum li cas los ntawm koj tus kws kho mob thiab kws saib xyuas neeg mob, nws tseem tuaj yeem pab hnov los ntawm ib tus neeg uas tau ntsib CLL / SLL tus kheej.
Hauv qab no peb muaj ib daim vis dis aus ntawm Warren zaj dab neeg uas nws thiab nws tus poj niam Kate qhia lawv cov kev paub nrog CLL. Nyem rau ntawm qhov video yog tias koj xav saib.
Cov tsos mob ntawm CLL / SLL
CLL / SLL yog cov qog nqaij hlav qeeb qeeb, yog li koj yuav tsis muaj cov tsos mob ntawm lub sijhawm koj kuaj. Feem ntau, koj yuav raug kuaj mob tom qab kuaj ntshav, lossis kuaj lub cev rau lwm yam. Qhov tseeb, ntau tus neeg uas muaj CLL / SLL ua neej nyob ntev. Txawm li cas los xij, koj tuaj yeem tsim cov tsos mob ntawm qee lub sijhawm thaum nyob nrog CLL / SLL.
Cov tsos mob koj yuav tau txais
- nkees nkees (fatigued). Hom kev nkees no tsis zoo tom qab so lossis pw tsaug zog
- tawm ntawm pa
- Ua kom nqaij ntuag lossis ntshav yooj yim dua li niaj hnub
- cov kab mob uas tsis ploj mus, lossis rov qab los
- hws thaum hmo ntuj ntau dua li niaj zaus
- poob phaus yam tsis tau sim
- ib pob tshiab hauv koj lub caj dab, hauv qab koj txhais tes, koj puab tais, lossis lwm qhov chaw ntawm koj lub cev - cov no feem ntau tsis mob
- Cov ntshav qis xws li:
- Anemia - qis hemoglobin (Hb). Hb yog cov protein ntawm koj cov qe ntshav liab uas nqa oxygen nyob ib puag ncig koj lub cev.
- Thrombocytopenia - qis platelets. Platelets pab koj cov ntshav txhaws kom koj tsis txhob los ntshav thiab nkig kom yooj yim. Platelets tseem hu ua thrombocytes.
- Neutropenia - qe qe dawb hu ua neutrophils. Neutrophils tiv thaiv kab mob thiab kab mob.
- B-Symptoms (saib daim duab)
Thaum twg thiaj nrhiav tau kev kho mob
Feem ntau muaj lwm yam laj thawj rau cov tsos mob no, xws li kev kis kab mob, qib kev ua haujlwm, kev ntxhov siab, qee yam tshuaj lossis kev ua xua. Tab sis nws yog ib qho tseem ceeb uas koj mus ntsib koj tus kws kho mob yog tias koj muaj cov tsos mob no ntev tshaj li ib lub lis piam, lossis yog tias lawv tuaj sai sai yam tsis paub qhov laj thawj.
CLL / SLL kuaj tau li cas
Nws tuaj yeem nyuaj rau koj tus kws kho mob kom kuaj tau CLL / SLL. Cov tsos mob feem ntau tsis meej, thiab zoo ib yam li cov uas koj yuav muaj nrog rau lwm yam kab mob ntau dua, xws li kev kis kab mob thiab kev ua xua. Koj kuj yuav tsis muaj tsos mob, yog li nws nyuaj rau paub thaum twg los nrhiav CLL / SLL. Tab sis yog tias koj mus ntsib koj tus kws kho mob nrog ib qho ntawm cov tsos mob saum toj no, lawv yuav xav kuaj ntshav thiab kuaj lub cev.
Yog tias lawv xav tias koj yuav muaj ntshav qog noj ntshav zoo li lymphoma lossis leukemia, lawv yuav pom zoo kom kuaj ntxiv kom tau txais cov duab zoo dua ntawm qhov tshwm sim.
Txawb Txhaum
Txhawm rau kuaj CLL / SLL koj yuav xav tau kev kuaj ntshav ntawm koj cov qog nqaij hlav o, thiab koj cov pob txha pob txha. Ib qho biopsy yog thaum ib qho me me ntawm cov ntaub so ntswg raug tshem tawm thiab tshuaj xyuas hauv chav kuaj hauv qab lub tshuab ntsuas. Tus kws kho mob yuav saib xyuas txoj hauv kev, thiab sai npaum li cas koj cov hlwb loj tuaj.
Muaj ntau txoj hauv kev kom tau txais qhov zoo tshaj plaws biopsy. Koj tus kws kho mob yuav tuaj yeem tham txog hom zoo tshaj plaws rau koj qhov xwm txheej. Qee qhov biopsies feem ntau muaj xws li:
Excisional node biopsy
Hom biopsy no tshem tawm tag nrho cov qog ntshav qab zib. Yog tias koj cov qog ntshav nyob ze rau ntawm koj cov tawv nqaij thiab yooj yim xav, koj yuav muaj tshuaj loog hauv zos kom loog qhov chaw. Tom qab ntawd, koj tus kws kho mob yuav txiav (tseem hu ua kev phais) hauv koj cov tawv nqaij ze, lossis saum cov qog ntshav. Koj cov qog ntshav qab zib yuav raug tshem tawm los ntawm kev phais. Tej zaum koj yuav muaj stitches tom qab cov txheej txheem no thiab hnav khaub ncaws me ntsis rau saum.
Yog tias cov qog ntshav qab zib yog qhov tob heev rau tus kws kho mob xav tias, koj yuav tsum tau kuaj xyuas qhov kev txiav txim siab hauv lub tsev kho mob ua yeeb yam. Tej zaum koj yuav tau txais ib qho tshuaj loog - uas yog ib qho tshuaj ua kom koj tsaug zog thaum lub qog ntshav tawm. Tom qab kuaj biopsy, koj yuav muaj qhov txhab me me, thiab tej zaum yuav muaj stitches nrog me ntsis hnav khaub ncaws saum toj kawg nkaus.
Koj tus kws kho mob lossis tus kws saib xyuas neeg mob yuav qhia koj seb yuav tu lub qhov txhab li cas, thiab thaum twg lawv xav pom koj dua kom tshem tawm cov stitches.
Core los yog koob zoo biopsy
Hom biopsy no tsuas yog siv cov qauv ntawm cov qog nqaij hlav uas cuam tshuam - nws tsis tshem tag nrho cov qog ntshav qog ntshav. Koj tus kws kho mob yuav siv rab koob lossis lwm yam khoom tshwj xeeb los coj tus qauv. Feem ntau koj yuav muaj tshuaj loog hauv zos. Yog tias cov qog ntshav qab zib yog qhov tob heev rau koj tus kws kho mob pom thiab hnov qab, koj tuaj yeem ua rau biopsy hauv chav kuaj hluav taws xob. Qhov no yog qhov muaj txiaj ntsig zoo rau kev txiav txim siab tob dua vim tias tus kws kho hluav taws xob tuaj yeem siv ultrasound lossis X-ray kom pom cov qog nqaij hlav thiab xyuas kom lawv tau txais koob nyob rau hauv qhov chaw.
Ib tug core needle biopsy muab ib tug loj biopsy qauv tshaj ib tug zoo koob biopsy.
Bone Marrow biopsy
Qhov kev kuaj ntshav no siv cov qauv ntawm koj cov pob txha pob txha nyob nruab nrab ntawm koj cov pob txha. Nws feem ntau yog coj los ntawm lub duav, tab sis nyob ntawm koj tus kheej qhov xwm txheej, kuj tseem tuaj yeem raug coj los ntawm lwm cov pob txha xws li koj lub mis pob txha (sternum).
Koj yuav tau txais tshuaj loog hauv zos thiab tej zaum yuav muaj qee qhov sedation, tab sis koj yuav tsaug zog rau qhov txheej txheem. Tej zaum koj kuj yuav tau txais ib co tshuaj kho mob. Tus kws kho mob yuav muab ib rab koob los ntawm koj daim tawv nqaij thiab rau hauv koj cov pob txha kom tshem tawm cov pob txha me me.
Koj tuaj yeem tau txais ib lub tsho los hloov rau hauv lossis tuaj yeem hnav koj tus kheej khaub ncaws. Yog tias koj hnav koj tus kheej cov khaub ncaws, xyuas kom lawv xoob thiab muab kev yooj yim rau koj lub duav.
Ntsuam xyuas koj cov biopsies
Koj qhov kev kuaj ntshav biopsy thiab ntshav yuav raug xa mus rau lub pathology thiab saib hauv lub tshuab ntsuas. Txoj kev no cov kws kho mob tuaj yeem tshawb xyuas seb CLL / SLL puas nyob hauv koj cov pob txha, cov ntshav thiab cov qog ntshav, lossis yog tias nws tsuas yog txwv rau ib lossis ob qho ntawm cov chaw no.
Tus kws kho mob yuav ua lwm yam kev sim ntawm koj cov lymphocytes hu ua "flow cytometry". Qhov no yog ib qho kev kuaj tshwj xeeb los saib cov proteins lossis "cov cim ntawm tes" ntawm koj cov lymphocytes uas pab kuaj CLL / SLL, lossis lwm yam kab mob qog nqaij hlav. Cov proteins thiab cov cim no tuaj yeem muab tus kws kho mob cov ntaub ntawv hais txog hom kev kho mob twg yuav ua haujlwm zoo tshaj rau koj.
Tos rau qhov tshwm sim
Nws tuaj yeem siv li ob peb lub lis piam kom tau txais tag nrho koj cov txiaj ntsig kev xeem rov qab. Tos rau cov txiaj ntsig no tuaj yeem yog lub sijhawm nyuaj heev. Tej zaum nws yuav pab tau tham nrog tsev neeg lossis phooj ywg, ib tus neeg sablaj lossis tiv tauj peb ntawm Lymphoma Australia. Koj tuaj yeem tiv tauj peb Cov Kws Kho Mob Lymphoma los ntawm email Nurse@lymphoma.org.au los yog hu rau 1800.
Tej zaum koj kuj tseem nyiam koom nrog ib qho ntawm peb cov social media pawg sib tham rau lwm tus uas tau nyob hauv qhov xwm txheej zoo sib xws. Koj tuaj yeem nrhiav peb ntawm:
Staging ntawm CLL / SLL
Staging yog txoj kev uas koj tus kws kho mob tuaj yeem piav qhia ntau npaum li cas ntawm koj lub cev raug cuam tshuam los ntawm lymphoma, thiab seb cov qog qog ntshav loj hlob li cas.
Tej zaum koj yuav xav tau qee qhov kev xeem ntxiv txhawm rau txhawm rau paub koj theem.
Txhawm rau paub ntau ntxiv txog kev ua yeeb yam, thov nyem rau ntawm qhov toggles hauv qab no.
Cov kev sim ntxiv koj yuav tau saib seb koj qhov CLL / SLL tau kis mus deb npaum li cas:
- Positron emission tomography (PET) scan. Qhov no yog scan ntawm koj tag nrho lub cev uas teeb rau thaj chaw uas yuav raug cuam tshuam los ntawm CLL / SLL. Cov txiaj ntsig yuav zoo ib yam li daim duab rau sab laug.
- Xam tomography (CT) scan. Qhov no muab cov ncauj lus kom ntxaws dua li X-ray, tab sis ntawm ib qho chaw xws li koj lub hauv siab lossis lub plab.
- Lumbar puncture - Koj tus kws kho mob yuav siv ib rab koob los coj cov kua dej los ntawm ze koj tus txha nraub qaum. Qhov no yog ua los xyuas seb koj cov lymphoma nyob hauv koj lub hlwb lossis qaum qaum. Tej zaum koj yuav tsis xav tau qhov kev kuaj no, tab sis koj tus kws kho mob yuav qhia rau koj paub yog tias koj ua.
Ib qho ntawm qhov sib txawv tseem ceeb hauv CLL / SLL (sib nrug ntawm lawv qhov chaw) yog nyob rau hauv txoj kev uas lawv tau ua.
Staging txhais li cas?
Tom qab koj tau kuaj pom lawm, koj tus kws kho mob yuav saib tag nrho koj cov txiaj ntsig kev xeem kom paub seb koj CLL / SLL nyob rau theem twg. Staging qhia tus kws kho mob:
- CLL / SLL ntau npaum li cas hauv koj lub cev
- pes tsawg thaj chaw ntawm koj lub cev muaj cov qog nqaij hlav B-hlwb thiab
- yuav ua li cas koj lub cev tiv nrog tus kab mob.
Qhov txheej txheem kev teeb tsa no yuav saib koj CLL kom pom tias koj ua, lossis tsis muaj cov hauv qab no:
- Cov qib lymphocytes hauv koj cov ntshav lossis cov pob txha pob txha - qhov no hu ua lymphocytosis (lim-foe-cy-toe-sis)
- lymphadenopathy (limf-a-den-op-ah-thee)
- tus kab mob spleen - splenomegaly (splen-oh-meg-ah-lee)
- Cov qe ntshav liab qis hauv koj cov ntshav - anemia (a-nee-mee-yah)
- qis platelets hauv koj cov ntshav - thrombocytopenia (throm-bow-cy-toe-pee-nee-yah)
- daim siab loj - hepatomegaly (hep-at-o-meg-a-lee)
Txhua theem txhais li cas
| RAI theem 0 | Lymphocytosis thiab tsis muaj qhov loj ntawm cov qog nqaij hlav, spleen, lossis daim siab, thiab nrog ze li cov qe ntshav liab thiab platelet suav. |
| RAI theem 1 | Lymphocytosis ntxiv rau cov qog nqaij hlav loj. Tus po thiab daim siab tsis loj thiab cov qe ntshav liab thiab platelet suav yog qhov qub lossis tsuas yog qis me ntsis. |
| RAI theem 2 | Lymphocytosis ntxiv rau qhov loj spleen (thiab tej zaum yuav ua rau lub siab loj), nrog lossis tsis muaj cov qog ntshav loj. Cov qe ntshav liab thiab platelet suav yog qhov qub lossis tsuas yog qis me ntsis xwb |
| RAI theem 3 | Lymphocytosis ntxiv rau anemia (ntau cov qe ntshav liab dhau), nrog lossis tsis muaj cov qog ntshav loj, tus po, lossis daim siab. Platelet suav ze li qub. |
| RAI theem 4 | Lymphocytosis ntxiv rau thrombocytopenia (ntau cov platelets ntau dhau), nrog lossis tsis muaj ntshav qab zib, cov qog ntshav loj, spleen, lossis daim siab. |
* Lymphocytosis txhais tau tias muaj ntau cov lymphocytes hauv koj cov ntshav lossis pob txha pob txha
Koj qhov theem tau ua tiav raws li:
- tus naj npawb thiab qhov chaw ntawm lymph nodes cuam tshuam
- Yog tias cov kab mob qog noj ntshav nyob rau saum toj, hauv qab lossis ob sab ntawm lub diaphragm (Koj lub diaphragm yog ib qho loj, dome-shaped leeg hauv qab koj lub tawb tawb uas cais koj lub hauv siab ntawm koj lub plab)
- yog tias tus kab mob kis mus rau cov pob txha los yog mus rau lwm yam kabmob xws li lub siab, ntsws, pob txha lossis tawv nqaij
| 1 xyaum ua haujlwm | ib cheeb tsam lymph node raug cuam tshuam, sab saud lossis hauv qab lub diaphragm * |
| 2 xyaum ua haujlwm | ob lossis ntau dua cov qog ntshav qog ntshav tau cuam tshuam rau tib sab ntawm lub diaphragm * |
| 3 xyaum ua haujlwm | tsawg kawg yog ib cheeb tsam lymph node saum toj no thiab tsawg kawg yog ib qho lymph node cheeb tsam hauv qab lub diaphragm * raug cuam tshuam |
| 4 xyaum ua haujlwm | lymphoma nyob rau hauv ntau lub qog thiab kis mus rau lwm qhov ntawm lub cev (piv txwv li, pob txha, ntsws, siab) |
Tsis tas li ntawd, tej zaum yuav muaj tsab ntawv "E" tom qab koj theem. E txhais tau hais tias koj muaj qee qhov SLL hauv ib qho khoom nruab nrog sab nraud ntawm koj lub lymphatic system, xws li koj lub siab, ntsws, pob txha lossis tawv nqaij. | |
Cov lus nug rau koj tus kws kho mob ua ntej koj pib kho
Cov kws kho mob cov sij hawm tuaj yeem ntxhov siab thiab kawm txog koj tus kab mob thiab kev kho mob yuav zoo li kev kawm hom lus tshiab. Thaum kawm
Nws tuaj yeem nyuaj kom paub cov lus nug dab tsi thaum koj tab tom pib kho. Yog koj tsis paub, koj tsis paub dab tsi, koj yuav paub li cas nug?
Muaj cov ntaub ntawv raug cai tuaj yeem pab koj muaj kev ntseeg siab thiab paub tias yuav xav li cas. Nws tseem tuaj yeem pab koj npaj ua ntej rau yam koj xav tau.
Peb muab ib daim ntawv teev cov lus nug uas koj yuav pom muaj txiaj ntsig. Tau kawg, txhua tus neeg qhov xwm txheej yog qhov tshwj xeeb, yog li cov lus nug no tsis npog txhua yam, tab sis lawv pib zoo.
Nyem rau ntawm qhov txuas hauv qab no txhawm rau rub tawm PDF cov lus nug rau koj tus kws kho mob.
Nkag siab koj CLL / SLL noob caj noob ces
Muaj ntau yam genetic yam uas yuav koom nrog koj CLL / SLL. Qee tus yuav tau pab txhawb rau kev txhim kho koj tus kab mob, thiab lwm tus muab cov ntaub ntawv tseem ceeb txog yam kev kho mob zoo tshaj plaws rau koj. Txhawm rau kom paub seb cov caj ces cuam tshuam dab tsi koj yuav tsum tau kuaj cytogenetic ua tiav.
Kev kuaj Cytogenetic
Kev ntsuam xyuas cytogenetics yog ua tiav ntawm koj cov ntshav thiab kuaj ntshav txhawm rau nrhiav kev hloov pauv hauv koj cov chromosomes lossis cov noob. Peb feem ntau muaj 23 khub ntawm chromosomes, tab sis yog tias koj muaj CLL / SLL koj cov chromosomes yuav zoo li txawv me ntsis.
Chromosomes
Tag nrho cov hlwb ntawm peb lub cev (tshwj tsis yog cov qe ntshav liab) muaj cov nucleus uas yog qhov chaw uas peb cov chromosomes pom. Chromosomes nyob rau hauv lub hlwb yog ntev strands ntawm DNA (deoxyribonucleic acid). DNA yog qhov tseem ceeb ntawm chromosome uas tuav cov lus qhia ntawm tes thiab qhov no yog hu ua gene.
noob
Cov noob qhia cov proteins thiab cov hlwb hauv koj lub cev yuav saib lossis ua li cas. Yog tias muaj kev hloov pauv (kev hloov pauv lossis hloov pauv) hauv cov chromosomes lossis cov noob, koj cov protein thiab cov hlwb yuav tsis ua haujlwm zoo thiab koj tuaj yeem tsim cov kab mob sib txawv. Nrog CLL / SLL cov kev hloov pauv no tuaj yeem hloov txoj hauv kev koj B-cell lymphocytes tsim thiab loj hlob, ua rau lawv ua mob qog noj ntshav.
Peb qhov kev hloov pauv tseem ceeb uas tuaj yeem tshwm sim nrog CLL / SLL yog hu ua kev tshem tawm, kev hloov pauv thiab hloov pauv.
Kev hloov pauv ntau hauv CLL / SLL
Kev tshem tawm yog thaum ib feem ntawm koj cov chromosome ploj lawm. Yog tias koj qhov kev tshem tawm yog ib feem ntawm 13th lossis 17th chromosome nws hu ua "del(13q)" lossis "del(17p)". Qhov "q" thiab "p" qhia tus kws kho mob qhov twg ntawm chromosome ploj lawm. Nws yog tib yam rau lwm yam kev tshem tawm.
Yog tias koj muaj kev hloov pauv, nws txhais tau hais tias ib feem me me ntawm ob chromosomes - chromosome 11 thiab chromosome 14 piv txwv li, sib pauv chaw nrog ib leeg. Thaum qhov no tshwm sim, nws hu ua "t(11:14)".
Yog tias koj muaj kev hloov pauv, nws yuav txhais tau tias koj muaj chromosome ntxiv. Qhov no hu ua Trisomy 12 (ib qho ntxiv 12th chromosome). Lossis koj yuav muaj lwm yam kev hloov pauv hu ua IgHV mutation lossis Tp53 kev hloov pauv. Tag nrho cov kev hloov pauv no tuaj yeem pab koj tus kws kho mob ua haujlwm kho qhov zoo tshaj plaws rau koj., yog li thov kom koj nug koj tus kws kho mob kom piav qhia koj tus kheej cov kev hloov pauv.
Koj yuav tsum tau kuaj cytogenetic thaum koj kuaj tau CLL / SLL thiab ua ntej kev kho mob. Kev ntsuam xyuas cytogenetic yog thaum tus kws tshawb fawb saib koj cov ntshav thiab qog cov qauv, los kuaj xyuas cov caj ces txawv (mutations) uas yuav cuam tshuam rau koj tus kab mob.
Txhua tus neeg uas muaj CLL / SLL yuav tsum tau kuaj genetic test ua ntej koj pib kho.
Qee qhov kev sim no koj tsuas yog yuav tsum muaj ib zaug xwb vim tias cov txiaj ntsig tau zoo ib yam hauv koj lub neej. Lwm yam kev ntsuam xyuas, tej zaum koj yuav tsum muaj ua ntej txhua txoj kev kho mob, los yog ntau lub sij hawm nyob rau hauv koj txoj kev nrog CLL / SLL. Qhov no yog vim lub sijhawm dhau los, kev hloov pauv caj ces tshiab tuaj yeem tshwm sim los ntawm kev kho mob, koj tus kab mob lossis lwm yam.
Cov kev kuaj cytogenetic ntau dua koj yuav muaj xws li:
Kev hloov pauv ntawm IgHV
Koj yuav tsum muaj qhov no ua ntej kev kho mob thawj zaug nkaus xwb. IgHV tsis hloov lub sijhawm, yog li nws tsuas yog yuav tsum tau kuaj ib zaug. Qhov no yuav raug tshaj tawm tias yog IgHV hloov pauv lossis IgHV tsis hloov pauv.
FISH xeem
Koj yuav tsum muaj qhov no ua ntej ua ntej thiab txhua yam kev kho mob. Kev hloov caj ces ntawm koj qhov kev xeem FISH tuaj yeem hloov pauv raws sijhawm, yog li nws raug pom zoo tias nws raug kuaj ua ntej pib kho thawj zaug, thiab tsis tu ncua thoob plaws koj txoj kev kho mob. Nws tuaj yeem qhia tau yog tias koj muaj kev tshem tawm, hloov pauv lossis ntxiv chromosome. Qhov no yuav raug tshaj tawm raws li del(13q), del(17p), t(11:14) lossis Trisomy 12. Thaum cov no yog cov kev hloov pauv ntau tshaj plaws rau cov neeg uas muaj CLL / SLL koj yuav muaj qhov sib txawv, txawm li cas los xij qhov kev tshaj tawm yuav yog zoo ib yam li cov no.
(FISH sawv rau Fluorescent In Situ Hybridisation thiab yog cov txheej txheem kuaj ua tiav hauv pathology)
TP53 kev hloov pauv xwm txheej
Koj yuav tsum muaj qhov no ua ntej ua ntej thiab txhua yam kev kho mob. TP53 tuaj yeem hloov pauv raws sijhawm, yog li nws raug pom zoo tias nws raug kuaj ua ntej pib kho thawj zaug, thiab tsis tu ncua thoob plaws koj txoj kev kho mob. TP53 yog cov noob uas muab cov cai rau cov protein hu ua p53 los ua. p53 yog cov qog ua kom muaj protein ntau thiab txwv tsis pub cov qog nqaij hlav qog nqaij hlav loj hlob. Yog tias koj muaj kev hloov pauv TP53, koj yuav tsis tuaj yeem tsim cov protein p53, uas txhais tau hais tias koj lub cev tsis tuaj yeem tiv thaiv cov qog nqaij hlav cancer los ntawm kev tsim.
Vim li cas nws tseem ceeb?
Nws yog ib qho tseem ceeb kom nkag siab txog cov no raws li peb paub tsis yog txhua tus neeg nrog CLL / SLL muaj tib yam kev hloov pauv caj ces. Cov kev hloov pauv muab cov ntaub ntawv rau koj tus kws kho mob txog hom kev kho mob uas yuav ua haujlwm, lossis yuav tsis ua haujlwm rau koj qhov tshwj xeeb CLL / SLL.
Thov tham nrog koj tus kws kho mob txog cov kev kuaj no thiab seb koj cov txiaj ntsig txhais li cas rau koj cov kev xaiv kho mob.
Piv txwv li, peb paub Yog tias koj muaj kev hloov pauv TP53, qhov tsis hloov pauv IgHV lossis del (17p) koj yuav tsum tsis txhob tau txais tshuaj khomob. raws li nws yuav tsis ua haujlwm rau koj. Tab sis qhov no tsis txhais hais tias tsis muaj kev kho mob. Muaj qee qhov kev kho mob uas muaj peev xwm ua tau zoo rau cov neeg uas muaj kev hloov pauv no. Peb yuav tham txog tej no nyob rau ntu tom ntej.
Kev kho mob rau CLL / SLL
Thaum tag nrho koj cov txiaj ntsig tau los ntawm kev kuaj ntshav biopsy, kuaj cytogenetic thiab cov kev kuaj mob tau ua tiav, koj tus kws kho mob yuav tshuaj xyuas cov no los txiav txim siab txog kev kho mob zoo tshaj plaws rau koj. Ntawm qee qhov chaw kho mob qog noj ntshav, koj tus kws kho mob kuj tuaj yeem ntsib nrog pab pawg kws kho mob tshwj xeeb los tham txog kev kho mob zoo tshaj plaws. Qhov no hu ua a Pab pawg neeg sib koom ua ke (MDT) rooj sib tham.
Kuv xaiv txoj kev kho mob li cas?
Koj tus kws kho mob yuav xav txog ntau yam txog koj CLL / SLL. Kev txiav txim siab txog thaum twg lossis yog tias koj xav tau pib thiab qhov kev kho mob twg zoo tshaj yog nyob ntawm:
- Koj tus kheej theem ntawm lymphoma, hloov caj ces thiab cov tsos mob
- koj lub hnub nyoog, keeb kwm kev kho mob yav dhau los thiab kev noj qab haus huv
- koj txoj kev noj qab haus huv ntawm lub cev thiab lub hlwb tam sim no thiab cov neeg mob nyiam.
Lwm yam xeem
Koj tus kws kho mob yuav xaj ntau qhov kev kuaj ua ntej koj pib kho kom paub tseeb tias koj lub plawv, lub ntsws thiab lub raum muaj peev xwm tiv tau nrog kev kho mob. Kev kuaj ntxiv tuaj yeem suav nrog ECG (electrocardiogram), kuaj lub ntsws ua haujlwm lossis sau cov zis 24-teev.
Koj tus kws kho mob lossis tus kws saib xyuas mob qog noj ntshav tuaj yeem piav qhia koj txoj kev npaj khomob thiab cov teebmeem tshwm sim rau koj. Lawv kuj tuaj yeem teb cov lus nug uas koj muaj. Nws yog ib qho tseem ceeb uas koj nug koj tus kws kho mob thiab/lossis tus kws saib xyuas mob cancer cov lus nug txog txhua yam uas koj tsis nkag siab.
Tiv tauj peb
Tos koj cov txiaj ntsig tuaj yeem yog lub sijhawm muaj kev ntxhov siab ntxiv thiab kev ntxhov siab rau koj thiab koj cov neeg koj hlub. Nws yog ib qho tseem ceeb los tsim kom muaj lub network muaj zog ntawm kev txhawb nqa lub sijhawm no. Koj yuav xav tau lawv yog tias koj tau kho thiab.
Lymphoma Australia xav ua ib feem ntawm koj lub network txhawb nqa. Koj tuaj yeem hu xovtooj lossis xa email mus rau Lymphoma Australia Nurse Helpline nrog koj cov lus nug thiab peb tuaj yeem pab koj kom tau txais cov ntaub ntawv raug. Koj tuaj yeem koom nrog peb cov nplooj ntawv social media rau kev txhawb nqa ntxiv. Peb Lymphoma Down Under nplooj ntawv hauv Facebook tseem yog qhov chaw zoo rau kev sib txuas nrog lwm tus nyob ib puag ncig Australia thiab New Zealand uas nyob nrog cov qog ntshav qog ntshav.
Lymphoma care tus neeg saib mob hotline:
Xov tooj: 1800 953 081
Email: Nurse@lymphoma.org.au
Cov kev kho mob tuaj yeem suav nrog ib qho ntawm cov hauv qab no:
Saib thiab Tos (xyuas saib xyuas)
Nyob ib ncig ntawm 1 ntawm 10 tus neeg uas muaj CLL / SLL yuav tsis xav tau kev kho mob. Nws tuaj yeem nyob ruaj khov nrog me me kom tsis muaj tsos mob rau ntau lub hlis lossis xyoo. Tab sis qee tus ntawm koj yuav muaj ntau qhov kev kho mob tom qab kev zam txim. Yog tias koj tsis xav tau kev kho mob tam sim ntawd lossis muaj sijhawm nyob nruab nrab ntawm kev zam txim, koj yuav raug tswj xyuas nrog saib thiab tos (tseem hu ua kev saib xyuas zoo). Muaj ntau yam kev kho mob zoo rau CLL muaj, thiab yog li nws tuaj yeem tswj tau ntau xyoo.
Pab Txhawb Nqa
Muaj kev pab txhawb nqa yog tias koj tab tom ntsib kev mob hnyav. Nws tuaj yeem pab koj muaj cov tsos mob tsawg dua, thiab zoo dua sai dua.
Leukemic cells (cov qog nqaij hlav B-hlwb hauv koj cov ntshav cov pob txha pob txha) tuaj yeem loj hlob tsis tuaj yeem tswj tau thiab ua rau koj cov pob txha, cov hlab ntsha, cov qog nqaij hlav, lub siab lossis tus po. Vim tias cov pob txha pob txha muaj neeg coob nrog CLL / SLL cov hlwb hluas dhau los ua haujlwm kom zoo, koj cov qe ntshav yuav raug cuam tshuam. Kev pab txhawb nqa yuav suav nrog tej yam xws li koj muaj ntshav lossis ntshav ntshav, lossis koj yuav muaj tshuaj tua kab mob los tiv thaiv lossis kho kab mob.
Kev pab txhawb nqa yuav koom nrog kev sab laj nrog pab pawg saib xyuas tshwj xeeb (xws li mob plawv yog tias koj muaj teeb meem nrog koj lub plawv) lossis kev saib xyuas palliative los tswj koj cov tsos mob. Nws kuj tseem tuaj yeem muaj kev sib tham txog koj qhov kev nyiam rau koj xav tau kev kho mob yav tom ntej. Qhov no hu ua Advanced Care Planning.
Palliative kev saib xyuas
Nws yog ib qho tseem ceeb kom paub tias pab neeg Palliative Care tuaj yeem hu tau txhua lub sijhawm thaum koj txoj kev kho mob tsis yog thaum kawg ntawm lub neej. Pab pawg saib xyuas Palliative yog qhov zoo rau kev txhawb nqa tib neeg nrog kev txiav txim siab uas lawv yuav tsum tau ua kom txog thaum kawg ntawm lawv lub neej. Tab sis, lawv tsis yog saib xyuas cov neeg uas yuav tuag xwb. Lawv kuj yog cov kws tshaj lij hauv kev tswj xyuas cov tsos mob ntawm txhua lub sijhawm thaum koj taug kev nrog CLL / SLL. Yog li tsis txhob ntshai nug lawv cov tswv yim.
Yog tias koj thiab koj tus kws kho mob txiav txim siab siv kev pab txhawb nqa, lossis tso tseg kev kho mob rau koj cov qog ntshav qog ntshav, ntau yam tuaj yeem ua tau los pab koj kom noj qab haus huv thiab xis nyob raws li qhov ua tau rau qee lub sijhawm.
Kev kho mob (chemotherapy)
Tej zaum koj yuav muaj cov tshuaj no ua ib ntsiav tshuaj thiab/los yog muab tso rau hauv koj cov hlab ntsha (hauv koj cov hlab ntsha) ntawm lub tsev kho mob cancer lossis tsev kho mob. Ntau cov tshuaj chemo sib txawv tuaj yeem ua ke nrog cov tshuaj tiv thaiv kab mob. Chemo tua cov cell loj hlob sai yog li tuaj yeem cuam tshuam qee yam ntawm koj lub hlwb zoo uas loj hlob sai ua rau muaj kev phiv.
Monoclonal Antibody (MAB)
Tej zaum koj yuav muaj MAB infusion ntawm lub tsev kho mob cancer lossis tsev kho mob. MABs txuas rau lymphoma cell thiab nyiam lwm yam kab mob sib ntaus sib tua cov qe ntshav dawb thiab cov proteins rau cov qog nqaij hlav. Qhov no pab koj tus kheej lub cev tiv thaiv kab mob tiv thaiv CLL / SLL.
Chemo-immunotherapy
Tshuaj kho mob (piv txwv li, FC) ua ke nrog kev tiv thaiv kab mob (piv txwv li, rituximab). Thawj zaug ntawm cov tshuaj tiv thaiv kab mob feem ntau yog ntxiv rau cov ntawv luv rau cov tshuaj kho mob, xws li FCR.
Targeted therapy
Koj tuaj yeem nqa cov no ua ib ntsiav tshuaj hauv tsev lossis hauv tsev kho mob. Cov phiaj xwm kev kho mob txuas mus rau lymphoma cell thiab thaiv cov cim qhia tias nws yuav tsum tau loj hlob thiab tsim ntau lub hlwb. Qhov no txwv tsis pub cov qog nqaij hlav loj tuaj, thiab ua rau cov qog ntshav qog ntshav tuag. Yog xav paub ntxiv txog cov kev kho mob no, thov mus saib peb Qhov ncauj kev kho mob cov ntaub ntawv.
Stem-cell hloov pauv (SCT)
Yog tias koj tseem hluas thiab muaj kev txhoj puab heev (loj hlob sai) CLL / SLL, SCT yuav raug siv, tab sis qhov no tsis tshua muaj. Yog xav paub ntxiv txog kev hloov cov qia cell thov saib cov ntaub ntawv tseeb Kev hloov pauv hauv Lymphoma
Pib Kev Kho Mob
Ntau tus neeg uas muaj CLL / SLL yuav tsis xav tau kev kho mob thaum lawv kuaj pom thawj zaug. Hloov chaw, koj yuav mus saib thiab tos. Qhov no feem ntau tshwm sim rau cov neeg muaj kab mob theem 1 lossis 2, thiab txawm tias qee cov neeg muaj kab mob theem 3.
Yog tias koj muaj theem 3 lossis 4 CLL / SLL koj yuav tau pib kho. Thaum koj pib kho thawj zaug, nws yog hu ua thawj kab kev kho mob. Tej zaum koj yuav muaj ntau dua ib cov tshuaj, thiab cov no yuav suav nrog kev kho mob, tshuaj tua kab mob monoclonal lossis kev kho mob.
Thaum koj muaj cov kev kho mob no, koj yuav muaj lawv nyob rau hauv lub voj voog. Qhov ntawd txhais tau hais tias koj yuav muaj kev kho mob, tom qab ntawd so, tom qab ntawd lwm qhov kev kho mob (lub voj voog). Rau cov neeg feem coob uas muaj CLL / SLL chemoimmunotherapy yog qhov ua tau zoo kom ua tiav qhov kev tshem tawm (tsis pom muaj mob qog noj ntshav).
Genetic mutations thiab kev kho mob
Qee qhov kev txawv txav ntawm caj ces yuav txhais tau tias cov kev kho mob yuav ua haujlwm zoo tshaj plaws rau koj, thiab lwm yam kev txawv txav ntawm caj ces - lossis cov caj ces ib txwm yuav txhais tau tias kev kho mob chemoimmunotherapy yuav ua haujlwm zoo tshaj.
Normal IgHV (unmutated IgHV) LOSSIS 17p rov LUB a Kev hloov pauv hauv koj cov noob TP53
Koj CLL/SLL tej zaum yuav tsis teb rau chemotherapy, tab sis nws tuaj yeem teb rau ib qho ntawm cov kev kho mob no hloov pauv:
- Ibrutinib - ib hom kev kho mob hu ua BTK inhibitor
- Acalabrutinib - lub hom phiaj kho (BTK inhibitor) nrog lossis tsis muaj monoclonal antibody hu ua obinutuzumab
- Venetoclax & Obinutuzumab - venetoclax yog ib hom kev kho mob hu ua BCL-2 inhibitor, obinutuzumab yog monoclonal antibody.
- Idelalisib & rituximab - idelalisib yog ib hom kev kho mob hu ua PI3K inhibitor, thiab rituximab yog monoclonal antibody.
- Tej zaum koj kuj yuav tsim nyog koom nrog hauv kev sim tshuaj - Nug koj tus kws kho mob txog qhov no
Ntaub ntawv tseem ceeb - Ibrutinib thiab Acalabrutinib tam sim no tau pom zoo TGA, txhais tau tias lawv muaj nyob hauv Australia. Txawm li cas los xij, lawv tsis tam sim no PBS tau teev tseg raws li kev kho thawj kab hauv CLL / SLL. Qhov no txhais tau tias lawv raug nqi ntau heev rau kev nkag mus. Tej zaum nws yuav muaj peev xwm tau txais kev nkag mus rau cov tshuaj ntawm "kev muaj siab hlub", txhais tau tias tus nqi yog ib feem lossis tag nrho them los ntawm lub tuam txhab tshuaj. Yog koj muaj ib txwm (tsis hloov pauv) IgHV, lossis 17p tshem tawm, nug koj tus kws kho mob txog kev nkag siab txog kev nkag mus rau cov tshuaj no.
Lymphoma Australia tab tom tawm tswv yim rau cov neeg uas muaj CLL/SLL los ntawm kev xa mus rau Pawg Neeg Saib Xyuas Kev Pabcuam Pharmaceutical Benefits Advisory Committee (PBAC) kom txuas ntxiv PBS cov npe rau cov tshuaj no rau kev kho thawj kab; ua kom cov tshuaj no siv tau rau ntau tus neeg nrog CLL/SLL.
Koj tseem tuaj yeem pab txhawb kev paub thiab muab tso rau hauv koj tus kheej xa mus rau PBAC rau PBS cov npe raws li kev kho thawj kab los ntawm txhaj ntawm no.
Msiv IgHV, los yog variation dua li cov saum toj no
Tej zaum koj yuav tau txais kev kho tus qauv rau CLL/SLL nrog rau cov kws khomob lossis kws khomob. Cov tshuaj tiv thaiv kab mob (rituximab lossis obinutuzumab) tsuas yog ua haujlwm yog tias koj lub hlwb CLL / SLL muaj cov cim ntawm tes hu ua CD20 ntawm lawv. Koj tus kws kho mob tuaj yeem qhia rau koj paub yog tias koj lub hlwb muaj CD20.
Muaj ob peb yam tshuaj sib txawv thiab sib xyaw ua ke koj tus kws kho mob tuaj yeem xaiv los ntawm yog tias koj muaj hloov pauv IgHV . Cov no suav nrog:
- Bendamustine & rituximab (BR) - bendamustine yog kws khomob thiab rituximab yog monoclonal antibody. Lawv ob leeg muab raws li ib tug infusion.
- Fludarabine, cyclophosphamide thiab rituximab (FC-R). Fludarabine thiab cyclophosphamide yog kws khomob thiab rituximab yog monoclonal antibody.
- Chlorambucil & Obinutuzumab - chlorambucil yog tshuaj kho mob ntsiav tshuaj thiab obinutuzumab yog monoclonal antibody. Nws feem ntau yog muab rau cov laus, cov neeg tsis muaj zog.
- Chlorambucil - ib ntsiav tshuaj chemotherapy
- Tej zaum koj kuj yuav tsim nyog koom nrog hauv kev sim tshuaj
Yog tias koj paub lub npe ntawm kev kho mob koj yuav muaj, koj tuaj yeem nrhiav tau cov ntaub ntawv ntau ntawm no.
Remission thiab Relapse
Tom qab kev kho mob feem ntau koj yuav mus rau hauv kev zam txim. Kev tso cai yog lub sijhawm uas koj tsis muaj cov cim qhia ntawm CLL / SLL tshuav hauv koj lub cev, lossis thaum CLL / SLL raug tswj thiab tsis xav tau kev kho mob. Kev tso cai tuaj yeem nyob tau ntau xyoo, tab sis thaum kawg CLL feem ntau rov qab los (relapses) thiab muab kev kho mob sib txawv.
Refractory CLL / SLL
Qee tus ntawm koj yuav tsis ua tiav kev zam txim nrog koj txoj kev kho thawj kab. Yog tias qhov no tshwm sim, koj CLL / SLL hu ua "refractory". Yog tias koj muaj refractory CLL / SLL koj tus kws kho mob yuav xav sim lwm yam tshuaj.
Kev kho mob koj muaj yog tias koj muaj refractory CLL / SLL los yog tom qab ib tug relapse yog hu ua thib ob-kab kho. Lub hom phiaj ntawm kev kho mob thib ob yog ua kom koj rov qab kho dua.
Yog tias koj muaj kev tso cai ntxiv, tom qab ntawd rov qab kho dua thiab muaj kev kho mob ntxiv, cov kev kho tom ntej no hu ua kev kho thib peb, kev kho plaub kab thiab lwm yam.
Tej zaum koj yuav xav tau ntau hom kev kho mob rau koj CLL/SLL. Cov kws tshaj lij tab tom nrhiav kev kho tshiab thiab ua tau zoo dua uas ua rau kom ntev ntawm kev zam txim. Yog tias koj CLL / SLL tsis teb zoo rau kev kho mob lossis muaj qhov rov qab sai sai tom qab kev kho mob (hauv rau lub hlis) qhov no hu ua refractory CLL / SLL thiab lwm yam kev kho mob yuav xav tau.
Yuav xaiv txoj kev kho thib ob li cas
Thaum lub sij hawm rov qab los, kev xaiv ntawm kev kho mob yuav nyob ntawm ntau yam xws li.
- Ntev npaum li cas koj nyob hauv kev zam txim rau
- Koj txoj kev noj qab haus huv thiab hnub nyoog
- Qhov kev kho CLL twg koj tau txais yav dhau los
- Koj nyiam.
Cov qauv no tuaj yeem rov ua nws tus kheej ntau xyoo. Cov kev kho mob tshiab muaj rau cov kab mob rov qab los yog cov kab mob refractory thiab qee cov kev kho mob rau rov qab los CLL / SLL tuaj yeem suav nrog hauv qab no:
- Venetoclax - ib hom kev kho mob (BCL2 inhibitor) - ib ntsiav tshuaj
- Ibrutinib (Ibruvica) - ib hom kev kho mob (BTK inhibitor) - ntsiav tshuaj
- Acalabrutinib - ib hom kev kho mob (BTK inhibitor) - ntsiav tshuaj
- Idelalisib thiab Rituximab - idelalisib yog ib hom kev kho mob (PI3K inhibitor) thiab rituximab yog monoclonal antibody. Idelalisib yog ib ntsiav tshuaj thiab rituximab tau muab tso rau hauv koj cov leeg.
Xav paub ntau ntxiv txog cov hom phiaj kho mob tuaj yeem pom ntawm no.
Yog tias koj tseem hluas thiab haum (tshwj tsis yog muaj CLL / SLL) koj tuaj yeem muaj Allogeneic Stem cell hloov pauv.
Nws raug pom zoo tias txhua lub sijhawm koj yuav tsum pib kho tshiab koj nug koj tus kws kho mob txog kev sim tshuaj koj yuav tsim nyog tau txais. Kev sim tshuaj kho mob yog qhov tseem ceeb los nrhiav cov tshuaj tshiab, lossis kev sib xyaw ntawm cov tshuaj los txhim kho kev kho mob ntawm CLL / SLL yav tom ntej.
Lawv kuj tseem tuaj yeem muab sijhawm rau koj sim tshuaj tshiab, ua ke ntawm cov tshuaj, lossis lwm yam kev kho mob uas koj yuav tsis tuaj yeem tawm sab nraud ntawm kev sim. Yog tias koj xav koom nrog hauv kev sim tshuaj, nug koj tus kws kho mob seb qhov kev sim tshuaj twg koj tsim nyog tau txais.
Qee qhov kev kho mob raug kuaj rau CLL / SLL
Muaj ntau yam kev kho mob thiab kev kho tshiab sib xyaw ua ke uas tam sim no tau sim hauv kev sim tshuaj thoob ntiaj teb rau cov neeg mob uas tau kuaj pom tshiab thiab rov qab los CLL. Qee qhov kev kho mob hauv kev tshawb nrhiav yog;
- Venetoclax ua ke kev kho mob - siv venetoclax nrog lwm hom kev kho mob
- Zanubrutinib - tshuaj ntsiav uas yog kev kho mob (BTK inhibitor)
- Chimeric antigen receptor T-cell therapy (CAR T-cell therapy)
Koj tuaj yeem nyeem peb 'Nkag siab Clinical Trials' daim ntawv tseeb los yog mus ntsib peb webpage yog xav paub ntxiv txog kev sim tshuaj
Kev kuaj mob rau CLL / SLL - thiab yuav ua li cas thaum kev kho mob xaus
Kev kwv yees saib seb qhov kev xav tau ntawm koj CLL / SLL yuav ua li cas, thiab dab tsi cuam tshuam rau koj txoj kev kho mob yuav muaj.
CLL / SLL tsis kho nrog kev kho tam sim no. Qhov no txhais tau hais tias ib zaug koj kuaj tau, koj yuav muaj CLL / SLL rau tag nrho koj lub neej….Tab sis, ntau tus neeg tseem ua neej nyob ntev thiab noj qab haus huv nrog CLL / SLL. Lub hom phiaj, lossis lub hom phiaj ntawm kev kho mob yog ua kom CLL / SLL nyob rau theem tswj tau thiab xyuas kom koj muaj cov tsos mob me me uas cuam tshuam rau koj lub neej zoo.
Txhua tus neeg uas muaj CLL / SLL muaj ntau yam kev pheej hmoo suav nrog hnub nyoog, keeb kwm kho mob thiab caj ces. Yog li ntawd, nws yog ib qho nyuaj heev los tham txog prognosis nyob rau hauv ib qho kev nkag siab dav dav. Nws raug nquahu kom koj tham nrog koj tus kws kho mob tshwj xeeb txog koj tus kheej cov kev pheej hmoo, thiab qhov no yuav cuam tshuam li cas rau koj qhov kev mob tshwm sim.
Survivorship - Nyob nrog mob qog noj ntshav
Txoj kev ua neej noj qab nyob zoo, lossis qee qhov kev hloov pauv ntawm txoj kev ua neej zoo tom qab kev kho mob tuaj yeem pab tau zoo rau koj txoj kev rov zoo. Muaj ntau yam uas koj tuaj yeem ua tau los pab koj ua neej nyob nrog CLL / SLL.
Ntau tus neeg pom tias tom qab kuaj mob qog noj ntshav, lossis kev kho mob, lawv lub hom phiaj thiab qhov tseem ceeb hauv lub neej hloov pauv. Paub seb koj qhov 'ib txwm tshiab' yog dab tsi tuaj yeem siv sijhawm thiab ntxhov siab. Kev cia siab ntawm koj tsev neeg thiab cov phooj ywg yuav txawv rau koj li. Koj tuaj yeem xav tias nyob ib leeg, qaug zog lossis muaj ntau tus cwj pwm txawv uas tuaj yeem hloov pauv txhua hnub. Lub hom phiaj tseem ceeb tom qab kev kho mob rau koj CLL / SLL yog kom rov qab mus rau lub neej thiab:
- ua kom nquag plias li sai tau hauv koj txoj haujlwm, tsev neeg, thiab lwm yam haujlwm hauv lub neej
- txo cov kev mob tshwm sim thiab cov tsos mob ntawm tus mob qog noj ntshav thiab nws txoj kev kho mob
- txheeb xyuas thiab tswj cov kev mob tshwm sim lig
- pab kom koj muaj kev ywj pheej raws li qhov ua tau
- txhim kho koj lub neej zoo thiab tswj kev puas siab puas ntsws zoo
Cancer Rehabilitation
Muaj ntau hom kev kho mob qog noj ntshav tuaj yeem pom zoo rau koj. Qhov no tuaj yeem txhais tau tias muaj ntau yam kev pabcuam xws li:
- kev kho lub cev, kev kho mob
- kev npaj noj haus thiab kev tawm dag zog
- kev xav, kev paub txog kev ua haujlwm thiab nyiaj txiag
Peb muaj qee cov lus qhia zoo hauv peb cov ntaub ntawv hauv qab no:
- Ntshai ntawm mob qog noj ntshav rov qab thiab scan kev ntxhov siab
- Kev tswj kev pw tsaug zog thiab lymphoma
- Kev tawm dag zog thiab lymphoma
- Kev qaug zog thiab lymphoma
- Kev sib deev thiab intimacy
- Kev xav cuam tshuam ntawm lymphoma kuaj thiab kho
- Kev xav cuam tshuam ntawm kev nyob nrog lymphoma
- Kev xav ntawm lymphoma tom qab ua tiav kev kho mob qog noj ntshav
- Kev saib xyuas tus neeg mob Lymphoma
- Kev xav cuam tshuam ntawm relapsed los yog refractory lymphoma
- Ntxiv thiab lwm txoj kev kho mob: Lymphoma
- Kev kho tus kheej thiab Lymphoma
- Khoom noj khoom haus thiab Lymphoma
Transformed Lymphoma (Richter's transformation)
Dab tsi yog kev hloov pauv
Cov qog ntshav hloov pauv yog ib hom qog ntshav qog ntshav uas tau kuaj pom thawj zaug tias tsis muaj zog (loj hlob qeeb) tab sis tau hloov mus rau hauv tus kab mob hnyav (loj hlob sai).
Kev hloov pauv tsis tshua muaj, tab sis tej zaum yuav tshwm sim yog tias cov noob hauv cov kab mob qog nqaij hlav hauv lub cev ua kom puas thaum lub sijhawm. Qhov no tuaj yeem tshwm sim ib txwm muaj, lossis los ntawm qee qhov kev kho mob, ua rau cov hlwb loj hlob sai. Thaum qhov no tshwm sim hauv CLL / SLL nws hu ua Richter's Syndrome (RS).
Yog tias qhov no tshwm sim koj CLL / SLL yuav hloov mus ua ib hom Lymphoma hu ua Diffuse Loj B-cell Lymphoma (DLBCL) lossis tsis tshua muaj T-cell Lymphoma.
Yog xav paub ntxiv txog Transformed Lymphoma thov mus saib peb ntaub ntawv pov thawj ntawm no.
