Inkqubela Entsha kwiNyango kunye noQwalaselo lweNkqubo yeNervous ePhambili yeLymphoma (PCNSL)
Inkqubo yeNervous ePhambili yePrimary Central Lymphoma (PCNSL) luhlobo olungaqhelekanga lwesifo I-Non-Hodgkin Lymphoma olu luhlu lwezifo oluvela kuphela engqondweni, emgogodleni, emehlweni, nakwizakhiwo ezingqongileyo, apho i-brain parenchyma iyeyona ndawo ixhaphakileyo. Nangona kukho inkqubela phambili enkulu ekuxilongweni nasekunyangweni, i-PCNSL iseyenye yezona ntlobo ze-lymphoma ezinzima kakhulu kwaye ezingachazwanga kakuhle, kwaye amazinga okusinda asasele emva kwezinye iintlobo ze-lymphoma.
Uphando lwakutshanje oluvela kwiSikolo sezonyango saseStanford University lukhanyise iziphumo zamva nje ze-epidemiological, iindlela zokuxilonga, kunye neendlela zonyango lwe-PCNSL. Uphononongo, olupapashwe kwi Iingxelo zangoku zeNeurology kunye neNeuroscience, igxininisa imfuneko ebalulekileyo yokuxilongwa kwangethuba, njengoko i-PCNSL inokuphazamisa ngokukhawuleza ukusebenza kwemithambo-luvo kunye nesimo sokusebenza (PS), nto leyo eyenza kube nzima unyango ngexesha elifanelekileyo.
I-PCNSL idla ngokubonakala kwizigulana ezingaphezulu kweminyaka engama-60 ubudala, kwaye ukwanda kwayo kuyanda kubantu abadala. Esi sifo sidla ngokubonisa iimpawu ezifana nokudideka, intloko ebuhlungu, kunye nokuphazamiseka kwengqondo, nangona ukuxhuzula kunqabile. I-Magnetic Resonance Imaging (MRI) iseyeyona ndlela ibalaseleyo yokuxilonga, kodwa imingeni isekhona ekwahlukaniseni i-PCNSL kwezinye iithumba zobuchopho kunye neemeko ngenxa yeempawu ezifanayo.
Olu phononongo lukwagxininisa indima yeendlela eziphambili zokuxilonga, ezifana neemodeli zokufunda nzulu kuhlalutyo lwe-MRI, ukuphucula ukuchaneka kokuxilonga. Ngaphezu koko, ukubaluleka kotshintsho lwezakhi zofuzo olufana ne-MYD88 L265P kugqanyisiwe njenge-biomarker enokubakho yokuxilonga nokujonga ukuqhubela phambili kwesifo, okubonelela ngendlela entsha yonyango oluchanekileyo ngakumbi.
Kunyango, iMethotrexate (HD-MTX) enedosi ephezulu ihlala ingundoqo, idla ngokudityaniswa nonyango lwemitha yobuchopho obupheleleyo (WBRT). Nangona kunjalo, uphando luyaqhubeka nokuhlola ukusebenza kakuhle kokunciphisa iidosi zemitha ukuze kuncitshiswe ubuthi be-neurotoxicity ngelixa kugcinwa ukusinda okungenankqubela phambili (PFS). Iindlela ezintsha kwi-chemotherapy kunye nonyango olunokuncedisa olufana neGlucarpidase zibonisa ithemba ekunciphiseni ubuthi kunye nokuphucula iziphumo.
I-PCNSL sisifo esintsonkothileyo nesinobundlongondlongo, kodwa uphando oluqhubekayo luvula iindlela ezintsha zonyango kunye nokuphucula ingqikelelo iyonke yezigulane. Njengoko olu phuculo luqhubeka, ithemba kukuba amazinga okusinda kunye nomgangatho wobomi kwizigulane ze-PCNSL ziya kuphucuka kakhulu.