Menene Lymphoplasmacytic Lymphoma?

Wadatacce

• LPL vs. sauran lymphomas
• Menene ya faru da tsarin rigakafi?
• Menene alamun?
• Me ke kawo shi?
• Yaya ake gane shi?
• Zaɓuɓɓukan magani
• Kalli kuma jira
• Chemotherapy
• Magungunan ilimin halitta
• Ciwon da aka yi niyya
• Dasa ƙwayoyin cell
• Gwajin gwaji
• Menene hangen nesa?

Bayani

Lymphomalasmacytic lymphoma (LPL) wani nau'in nau'in ciwon daji ne wanda ke saurin tasowa a hankali kuma yana shafar yawancin tsofaffi. Matsakaicin shekaru a ganewar asali shine 60.

Lymphomas sune cututtukan daji na ƙwayar ƙwayar ƙwayar cuta, wani ɓangare na tsarin rigakafin ku wanda ke taimakawa wajen yaƙar cututtuka. A lymphoma, fararen ƙwayoyin jini, ko dai lymphocytes B ko lymphocytes na T, suna girma ne ta hanyar sarrafawa saboda maye gurbi. A cikin LPL, ƙwayoyin lymphocytes na al'ada B suna hayayyafa a cikin kashin ku kuma suna cire ƙwayoyin jini masu lafiya.

Akwai kusan shari'o'in 8.3 na LPL a cikin mutane miliyan 1 a Amurka da Yammacin Turai. Ya fi yawa a cikin maza da kuma a cikin Caucasians.

LPL vs. sauran lymphomas

Kwayar lymphoma ta Hodgkin da wadda ba ta Hodgkin ba ana rarrabe ta da nau'in kwayar halitta da ke zama ta kansa.

• Kwayoyin lymphomas na Hodgkin suna da takamaiman nau'in kwayar halitta mara kyau, wanda ake kira cell Reed-Sternberg.
• Yawancin nau'ikan ƙwayoyin cuta waɗanda ba Hodgkin ba ana rarrabe su ta inda masu cutar kansa ke farawa da ƙwayoyin halitta da sauran halaye na ƙwayoyin cuta.

LPL ita ce lymphoma ba ta Hodgkin ba wacce ke farawa a cikin ƙwayoyin lymphocytes na B. Yana da babban ƙwayar lymphoma, wanda ya ƙunshi kusan 1 zuwa 2 bisa ɗari na duka lymphomas.

Mafi yawan nau'ikan LPL shine Waldenström macroglobulinemia (WM), wanda ke da alaƙa da rashin kayan aiki na immunoglobulin (antibodies). WM wani lokacin ana kuskuren kira shi da suna daidai da LPL, amma a zahiri rukunin LPL ne. Kimanin mutane 19 cikin 20 da ke da cutar LPL suna da cutar rashin lafiyar immunoglobulin.

Menene ya faru da tsarin rigakafi?

Lokacin da LPL ke haifar da ƙwayoyin lymphocytes B (ƙwayoyin B) don yalwata cikin ƙashin kashin ku, ana samar da ƙananan ƙwayoyin jini na yau da kullun.

A yadda aka saba, ƙwayoyin B suna motsawa daga ɓacin ranka zuwa ƙwayarku da ƙwayoyin lymph. A can, suna iya zama ƙwayoyin jini wanda ke samar da ƙwayoyin cuta don yaƙar cututtuka. Idan baka da wadatattun ƙwayoyin jini na al'ada, yana lalata tsarin garkuwar ka.

Wannan na iya haifar da:

• karancin jini, karancin jajayen kwayoyin jini
• neutropenia, karancin wani nau'in farin jini (wanda ake kira neutrophils), wanda ke kara kamuwa da cutar
• thrombocytopenia, karancin platelets na jini, wanda ke ƙara zub da jini da haɗarin rauni

Menene alamun?

LPL shine ciwon sannu a hankali, kuma kusan kashi ɗaya bisa uku na mutanen da ke da LPL ba su da wata alama a lokacin da aka gano su.

Har zuwa kashi 40 na mutanen da ke da LPL suna da ƙananan cutar anemia.

Sauran alamun LPL na iya haɗawa da:

• rauni da gajiya (galibi cutar karancin jini ke haifar da ita)
• zazzaɓi, zufa na dare, da raunin nauyi (galibi ana alakanta shi da ƙwayoyin B-cell)
• hangen nesa
• jiri
• hanci yayi jini
• zubar da gumis
• raunuka
• daukaka beta-2-microglobulin, alamar jini don ciwace-ciwace

Game da 15 zuwa 30 bisa dari na waɗanda ke tare da LPL suna da:

• kumburin lymph node (lymphadenopathy)
• hanta fadada (hepatomegaly)
• saifa fadada (splenomegaly)

Me ke kawo shi?

Ba a fahimci dalilin LPL sosai ba. Masu bincike suna bincika hanyoyi da yawa:

• Zai iya kasancewa akwai wata kwayar halitta, kamar yadda kusan 1 a cikin mutane 5 da ke tare da WM suna da dangi wanda ke da LPL ko kuma irin wannan kwayar cutar ta lymphoma.
• Wasu nazarin sun gano cewa LPL na iya kasancewa tare da cututtukan autoimmune kamar Sjögren syndrome ko tare da cutar hepatitis C, amma sauran nazarin basu nuna wannan haɗin ba.
• Mutanen da ke da LPL galibi suna da wasu maye gurbi waɗanda ba a gāda su.

Yaya ake gane shi?

Binciken asali na LPL yana da wuya kuma yawanci ana yin sa ne bayan banda wasu hanyoyin.

LPL na iya kama da sauran ƙwayoyin lymphomas na B tare da nau'ikan nau'ikan bambancin ƙwayar plasma. Wadannan sun hada da:

• kwayar cutar lymphoma
• cutar sankarar bargo ta lymphocytic / ƙaramin lymphocytic lymphoma
• yankin yankin lymphoma
• ƙwayar myeloma na ƙwayar plasma

Likitanku zai bincika ku a jiki kuma ya nemi tarihin lafiyar ku. Zasuyi odar aikin jini kuma mai yiwuwa kashin kashi ko lymph node biopsy don kallon ƙwayoyin a ƙarƙashin microscope.

Hakanan likitan ku na iya amfani da wasu gwaje-gwajen don kawar da irin wannan cutar kansa da kuma sanin matakin cutar ku. Wadannan na iya haɗawa da rayukan kirji, CT scan, PET scan, da duban dan tayi.

Zaɓuɓɓukan magani

Kalli kuma jira

LBL shine ciwon daji mai saurin hankali. Ku da likitanku na iya yanke shawarar jira da lura da jininka a kai a kai kafin fara jiyya. A cewar Cibiyar Ciwon Sankara ta Amurka (ACS), mutanen da ke jinkirta magani har sai alamominsu na da matsala suna da tsawon rai kamar mutanen da suka fara jiyya da zarar an gano su.

Chemotherapy

Za a iya amfani da ƙwayoyi da yawa waɗanda ke aiki ta hanyoyi daban-daban, ko haɗakar magunguna, don kashe ƙwayoyin kansa. Wadannan sun hada da:

• Chlorambucil (Leukeran)
• fludarabine (Fludara)
• bendamustine (Treanda)
• cyclophosphamide (Cytoxan, Procytox)
• dexamethasone (Decadron, Dexasone), rituximab (Rituxan), da kuma cyclophosphamide
• bortezomib (Velcade) da rituximab, tare da ko ba tare da dexamethasone ba
• cyclophosphamide, vincristine (Oncovin), da kuma prednisone
• cyclophosphamide, vincristine (Oncovin), prednisone, da kuma rituximab
• thalidomide (Thalomid) da rituximab

Tsarin musamman na kwayoyi zai bambanta, ya danganta da lafiyar ku gabaɗaya, alamun ku, da kuma yiwuwar jiyya ta gaba.

Magungunan ilimin halitta

Magungunan maganin ilimin halittu abubuwa ne da aka yi da mutum wanda yake aiki kamar tsarin garkuwar ku don kashe ƙwayoyin lymphoma. Wadannan kwayoyi na iya haɗuwa da sauran jiyya.

Wasu daga cikin wadannan kwayoyin cuta, wadanda ake kira kwayoyin cuta, sune:

• rituximab (Rituxan)
• oftumumab (Arzerra)
• alemtuzumab (sansanin)

Sauran magungunan ilimin halittu sune magungunan rigakafi (IMiDs) da cytokines.

Ciwon da aka yi niyya

Abubuwan da aka yi niyya don magance ƙananan ƙwayoyin cuta waɗanda ke haifar da cutar kansa. Anyi amfani da wasu daga cikin waɗannan magungunan don yaƙi da wasu cututtukan kansa kuma yanzu ana binciken su game da LBL. Gabaɗaya, waɗannan kwayoyi suna toshe sunadarai waɗanda ke bawa ƙwayoyin lymphoma ci gaba da girma.

Dasa ƙwayoyin cell

Wannan sabon magani ne wanda ACS ta ce na iya zama zaɓi ga samari masu LBL.

Gabaɗaya, ana cire ƙwayoyin halittar jini da ke cikin jini kuma a daskarar dasu. Sannan ana amfani da kashi mai yawa na chemotherapy ko radiation don kashe dukkan ƙwayoyin ƙashi (na al'ada da na daji), kuma asalin ƙwayoyin halittar jini suna komawa cikin jini. Kwayoyin jijiyoyin na iya zuwa daga wanda ake yiwa magani (autologous), ko kuma wani wanda yake kusa da mutum (allogenic) na iya ba shi gudummawar.

Yi la'akari da cewa dashen ƙwayoyin halitta har yanzu suna cikin matakin gwaji. Hakanan, akwai illoli na gajere da na dogon lokaci daga waɗannan dashen.

Gwajin gwaji

Kamar yadda yake tare da yawancin nau'o'in ciwon daji, sababbin hanyoyin kwantar da hankali suna kan bunƙasa, kuma kuna iya samun gwajin gwaji don shiga. Tambayi likitanku game da wannan kuma ziyarci ClinicalTrials.gov don ƙarin bayani.

Menene hangen nesa?

LPL har yanzu ba shi da magani. LPL naka na iya shiga cikin gafara amma daga baya ya sake bayyana. Har ila yau, kodayake yana da ciwon sannu-sannu, a wasu lokuta yana iya zama mai saurin tashin hankali.

ACS ta lura cewa kashi 78 na mutanen da ke da LPL suna rayuwa shekara biyar ko fiye.

Adadin rayuwa don LPL yana inganta yayin da ake haɓaka sabbin magunguna da sabbin magunguna.