He aha ʻo Rituximab-abbs: Nā hoʻohana, ka nui o ka lāʻau, nā hopena ʻaoʻao a me nā mea hou aku

ʻO Rituximab-abbs he lāʻau lapaʻau biosimilar e kōkua ana i ka mālama ʻana i kekahi mau maʻi koko a me nā maʻi autoimmune ma ka hoʻopaʻa ʻana i nā cell i loko o kou ʻōnaehana pale. Hana kēia lāʻau lapaʻau infusion ma ka hoʻopaʻa ʻana i kahi protein i kapa ʻia ʻo CD20 i loaʻa ma nā B-cell, he ʻano keʻokeʻo keʻokeʻo e hiki ke lilo i mea pilikia i nā maʻi like ʻole.

E noʻonoʻo e like me ka lāʻau lapaʻau i manaʻo ʻia e kōkua i kou kino e hoʻonohonoho hou i kāna pane immune ke hana pono ʻole. E nānā pono kāu hui mālama ola iā ʻoe i ka wā o ka mālama ʻana e hōʻoia e loaʻa ana iā ʻoe ka mālama maikaʻi loa.

He aha ʻo Rituximab-abbs?

ʻO Rituximab-abbs he mana biosimilar o ka lāʻau lapaʻau rituximab mua, ʻo ia hoʻi, hana like ia me ka lāʻau kuhikuhi akā hana ʻia e kahi hui ʻē aʻe. He monoclonal antibody ia e kuhikuhi pono ana i nā protein CD20 ma B-lymphocytes (he ʻano keʻokeʻo keʻokeʻo).

Hāʻawi ʻia ka lāʻau lapaʻau ma o ka IV infusion, maʻamau i ka haukapila a i ʻole ke kikowaena infusion kahi e hiki ai i nā limahana lapaʻau ke nānā pono iā ʻoe. He ʻāpana ia o kahi papa o nā lāʻau i kapa ʻia ʻo immunotherapy, ʻo ia hoʻi, hana ia me kāu ʻōnaehana pale ma mua o ke kūʻē ʻana.

Hiki i kāu kauka ke ʻōlelo aku iā rituximab-abbs ke ʻole nā lāʻau lapaʻau ʻē aʻe i lawa a i ʻole ma ke ʻano he ʻāpana o kahi hoʻolālā lapaʻau piha. Hōʻike wale ka ʻāpana

• Lymphoma ʻaʻole-Hodgkin (he ʻano maʻi maʻi koko e pili ana i nā ʻōpū lymph)
• Leukemia lymphocytic maʻi (CLL), he maʻi maʻi koko e ulu mālie ana
• Rheumatoid arthritis ke hāʻawi ʻole nā lāʻau lapaʻau ʻē aʻe i ka hōʻoluʻolu lawa
• Granulomatosis me polyangiitis (GPA), he maʻi autoimmune laha ʻole e pili ana i nā kīʻaha koko
• Microscopic polyangiitis (MPA), kekahi maʻi autoimmune kīʻaha koko laha ʻole

I kekahi mau hihia, hiki i kāu kauka ke noʻonoʻo i ka rituximab-abbs no nā maʻi autoimmune ʻē aʻe kahi e hana nei nā B-cells i nā pilikia. He mea kū hoʻokahi kēlā me kēia kūlana, a e hoʻopilikino ʻia kāu hoʻolālā lapaʻau i kāu mau pono.

Pehea e hana ai ʻo Rituximab-abbs?

Hana ʻo Rituximab-abbs ma ka hoʻopili ʻana i nā protein CD20 ma ka ʻili o nā B-cells, e hōʻailona ana iā lākou no ka luku ʻia e kāu ʻōnaehana pale. Kōkua kēia hana i ka hōʻemi ʻana i ka helu o nā B-cells pilikia e kōkua ana i kou maʻi.

Ke hoʻopaʻa ka lāʻau lapaʻau i kēia mau cell, nui nā mea e hana. Hoʻomaopopo kāu ʻōnaehana pale i nā cell i hōʻailona ʻia e like me nā pahuhopu a hoʻopau iā lākou ma o nā kaʻina hana maoli. Hiki i kēia hōʻemi ʻana i nā B-cells ke kōkua i ka hoʻomaha ʻana i nā pane pale nui a i ʻole e hōʻemi i nā heluna cell maʻi.

ʻAʻole koke nā hopena, he mea maʻamau loa. He mau pule a i ʻole mau mahina paha e ʻike ai ʻoe i nā hoʻomaikaʻi ʻana i ka wā e emi mālie ai kāu pae B-cell a hoʻomaka kāu maʻi e pane i ka lāʻau lapaʻau.

Ua manaʻo ʻia kēia lāʻau lapaʻau he mea ikaika loa, no laila e nānā pono kāu hui mālama ola iā ʻoe i ka wā o ka lāʻau lapaʻau. ʻO ka ikaika o ka rituximab-abbs kekahi kumu e pono ai no nā maʻi koʻikoʻi, akā ʻo ia hoʻi ke koi ʻia ka mālama ʻana i ka lāʻau lapaʻau.

Pehea wau e lawe ai iā Rituximab-abbs?

Hāʻawi mau ʻia ʻo Rituximab-abbs ma ke ʻano he intravenous (IV) infusion i loko o kahi keʻena lapaʻau, ʻaʻole loa ma ke ʻano he pill a i ʻole injection āu e hāʻawi ai iā ʻoe iho ma ka home. E mālama kāu hui mālama ola i nā mea a pau o ka hoʻomākaukau a me ka lawelawe ʻana.

Ma mua o kāu hoʻokomo ʻana, e loaʻa iā ʻoe nā lāʻau lapaʻau ma mua e kōkua i ka pale ʻana i nā hopena maʻi. Hiki i kēia mau mea ke komo i nā antihistamines, acetaminophen, a i ʻole corticosteroids. E hoʻomaka kāu kahu maʻi i kēia mau mea ma kahi o 30-60 mau minuke ma mua o ka hoʻomaka ʻana i ka hoʻokomo ʻana o rituximab-abbs.

ʻO ka hoʻokomo maoli ʻana e lawe maʻamau i kekahi mau hola, e hoʻomaka mālie a hoʻonui mālie i ka helu inā ʻoe e ʻae maikaʻi. ʻO kāu hoʻokomo mua ʻana e lawe pinepine i ka lōʻihi loa, i kekahi manawa 4-6 mau hola, ʻoiai ʻo nā hoʻokomo ma hope e pōkole paha inā ʻaʻole ʻoe e ʻike i nā hopena.

ʻAʻole pono ʻoe e hoʻokē ʻai ma mua o ka mālama ʻana, akā ʻo ka ʻai ʻana i ka meaʻai māmā ma mua e hiki ke kōkua iā ʻoe e ʻoluʻolu i ka wā o ke kaʻina hana hoʻokomo lōʻihi. ʻO ka noho ʻana i ka wai maikaʻi i nā lā e alakaʻi ana i ka mālama ʻana he mea kōkua nō hoʻi.

E hoʻolālā e hoʻolilo i ka hapa nui o ka lā ma ke kikowaena lapaʻau, a e noʻonoʻo e lawe mai i ka leʻaleʻa a i ʻole e loaʻa i kekahi e noho pū me ʻoe no ke kākoʻo. E nānā kāu hui lapaʻau i kāu mau hōʻailona koʻikoʻi a nānā i nā hopena i ka wā o ke kaʻina holoʻokoʻa.

Pehea ka lōʻihi e lawe ai au i ka Rituximab-abbs?

ʻO ka lōʻihi o ka mālama ʻana i ka rituximab-abbs e ʻokoʻa loa ma muli o kou kūlana kikoʻī a me ka maikaʻi o kou pane ʻana i ka lāʻau lapaʻau. E hana kāu kauka i kahi papa hana lapaʻau pilikino e pili ana i nā protocols i hoʻokumu ʻia no kāu maʻi kikoʻī.

No nā maʻi koko e like me ka lymphoma, hiki iā ʻoe ke loaʻa nā hoʻokomo ʻana i hoʻokahi manawa i ka pule no 4 mau pule, a laila e hoʻomaha, a i ʻole e loaʻa iā lākou i kēlā me kēia 3 pule no kekahi mau pōʻai. Hiki ke loli ka manawa lapaʻau holoʻokoʻa mai kekahi mau mahina a i hoʻokahi makahiki, ma muli o kāu pane a me ke ʻano o ka lāʻau lapaʻau.

Inā ʻoe e mālama ʻia nei no ka maʻi rheumatoid arthritis, e loaʻa iā ʻoe ʻelua mau hoʻokomo ʻana i hāʻawi ʻia i 2 pule kaʻawale. Hiki i kāu kauka ke ʻōlelo e hana hou i kēia pōʻaiapuni i kēlā me kēia 6-12 mau mahina ma muli o ke ʻano o ka pane ʻana o kāu mau hōʻailona a hoʻi mai i ka manawa.

No nā maʻi autoimmune laha ʻole e like me GPA a i ʻole MPA, hoʻopilikino pinepine ʻia nā papa hana lapaʻau. Pono kekahi poʻe i nā infusions maʻamau no ka mālama ʻana, a ʻo nā poʻe ʻē aʻe paha he mau manawa lōʻihi ma waena o nā lapaʻau ke hoʻomalu ʻia ko lākou maʻi.

E loiloi mau kāu kauka i kou pane ʻana ma o nā hoʻokolohua koko, nā haʻawina kiʻi, a me ka loiloi ʻana i nā hōʻailona. Ma muli o kēia mau hopena, e hoʻoponopono lākou i kāu papa manawa lapaʻau e hāʻawi iā ʻoe i nā hopena maikaʻi loa me ka hōʻemi ʻana i ka ʻike pono ʻole i ka lāʻau lapaʻau.

He aha nā hopena ʻaoʻao o Rituximab-abbs?

E like me nā lāʻau lapaʻau ikaika a pau, hiki i ka rituximab-abbs ke hana i nā hopena ʻaoʻao, ʻoiai he nui ka poʻe e ʻae maikaʻi iā ia me ka mālama olakino kūpono. ʻO ka hoʻomaopopo ʻana i ka mea e manaʻo ai hiki ke kōkua iā ʻoe e mākaukau a ʻike i ka manawa e hoʻopili ai i kāu hui mālama ola.

ʻO nā hopena ʻaoʻao maʻamau āu e ʻike ai, ʻo ia:

• Nā hopena infusion e like me ke kuni, nā anu, a i ʻole ka nausea i ka wā a i ʻole ma hope koke o ka lapaʻau
• ʻO ka luhi e hiki ke mau no kekahi mau lā ma hope o ka infusion
• Nā helu keʻokeʻo koko haʻahaʻa, e hoʻolilo iā ʻoe i mea maʻalahi i nā maʻi
• ʻO ke poʻo a i ʻole ka noʻonoʻo
• ʻO nā ʻeha ʻiʻo a i ʻole nā hui
• Nā hopena ʻili e like me ka ʻōpala a i ʻole ka ʻili
• Nā pilikia digestive e like me ka nausea, ka luaʻi, a i ʻole ka maʻi maʻi

Hiki ke mālama ʻia kēia mau hopena me ka pre-medication kūpono a me ka mālama kākoʻo. ʻIke kāu hui lapaʻau i ka pale ʻana a me ka mālama ʻana i ka hapa nui o kēia mau hopena ʻaoʻao.

Pono nā hopena ʻaoʻao koʻikoʻi akā ʻaʻole maʻamau i ka nānā ʻana i ka lāʻau lapaʻau koke:

• Nā hopena maʻi maʻi koʻikoʻi me ka pilikia o ka hanu ʻana a i ʻole ka pehu
• Nā hōʻailona o nā maʻi koʻikoʻi e like me ke kuni mau, ka luhi maʻamau, a i ʻole nā pilikia hanu
• Nā pilikia o ka naʻau me ka puʻuwai puʻuwai ʻole a i ʻole ka ʻeha o ka umauma
• Nā pilikia o ke akepaʻa i hōʻike ʻia e ka melemele o ka ʻili a i ʻole nā maka
• Nā pilikia o ka puʻupaʻa e hoʻoulu ana i nā loli i ka mimi a i ʻole ka pehu

Hiki i nā pilikia laha ʻole akā koʻikoʻi ke komo pū i ka progressive multifocal leukoencephalopathy (PML), he maʻi lolo, a me ka maʻi lysis tumor i nā maʻi maʻi maʻi. ʻOiai he mea maʻamau ʻole kēia mau mea, e nānā pono kāu hui mālama ola iā ʻoe no nā hōʻailona mua a e hana i nā hana pale ke hiki.

ʻO wai ka mea ʻaʻole pono e lawe iā Rituximab-abbs?

ʻAʻole kūpono ʻo Rituximab-abbs no nā mea a pau, a e loiloi pono kāu kauka i kāu moʻolelo olakino a me ke kūlana olakino o kēia manawa ma mua o ka ʻōlelo ʻana i kēia lapaʻau. ʻO kekahi mau maʻi e hoʻoweliweli loa ai kēia lāʻau a i ʻole e hōʻino paha.

ʻAʻole pono ʻoe e loaʻa iā rituximab-abbs inā loaʻa iā ʻoe:

• He maʻi maʻi koʻikoʻi i ʻike ʻia i ka rituximab a i ʻole kekahi mau mea o ka lāʻau lapaʻau
• He maʻi koʻikoʻi ikaika e hakakā nei kou kino i kēia manawa
• ʻO ka puʻuwai nui a i ʻole ka puʻuwai i loaʻa i kēia manawa
• Nā lāʻau lapaʻau virus ola i hoʻonohonoho ʻia i loko o ka manawa lapaʻau

E hoʻohana kāu kauka i ka akahele hou aʻe a hiki ke pale i kēia lapaʻau inā loaʻa iā ʻoe kekahi mau maʻi e hoʻonui ai i kou pilikia o nā pilikia.

ʻO nā kūlana e koi ana i ka noʻonoʻo pono e komo pū ana:

• Moʻolelo o ka hepatitis B a i ʻole C, no ka mea, hiki i ka rituximab ke hoʻāla hou i kēia mau maʻi
• Hoʻopilikia ʻia ka ʻōnaehana pale mai nā lāʻau lapaʻau ʻē aʻe a i ʻole nā ​​maʻi
• Moʻolelo o ka maʻi puʻuwai a i ʻole nā ​​puʻuwai puʻuwai ʻole
• Maʻi kīkī a i ʻole ka maʻi ate
• ʻO ka ʻoki ʻana i kēia manawa a i ʻole i hoʻolālā ʻia
• Hāpai a hānai paha

Inā hāpai ʻoe a i ʻole e hoʻolālā ana e hāpai, hiki i ka rituximab-abbs ke hōʻino i kāu pēpē e ulu nei. E kūkākūkā kāu kauka i nā lapaʻau ʻē aʻe a i ʻole e kōkua iā ʻoe e hoʻolālā i ka manawa o ka lapaʻau a puni ka hāpai ʻana. Hiki nō hoʻi i ka lāʻau lapaʻau ke hele i loko o ka waiū umauma, no laila ʻaʻole ʻōlelo ʻia ka hānai ʻana i ka wā lapaʻau.

Nā inoa inoa o Rituximab-abbs

Ua kūʻai ʻia ʻo Rituximab-abbs ma lalo o ka inoa inoa ʻo Truxima ma ʻAmelika Hui Pū ʻIa. Aia i loko o kēia mana biosimilar ka mea hana like me ka rituximab kumu (Rituxan) akā ua hana ʻia e kahi hui lāʻau lapaʻau ʻē aʻe.

ʻO ka inoa

Ke hilinaʻi nei ke koho ʻana i nā koho ʻē aʻe i nā mea he nui, me kāu maʻi kikoʻī, nā lāʻau lapaʻau i hala, nā maʻi olakino ʻē aʻe, a me kāu mau makemake pilikino. E hana pū kāu hui mālama ola me ʻoe e ʻimi i ke koho lapaʻau kūpono loa inā ʻaʻole ʻo rituximab-abbs ke koho kūpono.

Ua ʻoi aku ka maikaʻi o Rituximab-abbs ma mua o Rituximab (Rituxan)?

Ua manaʻo ʻia ʻo Rituximab-abbs (Truxima) a me rituximab kumu (Rituxan) he mea like i ka lāʻau lapaʻau, ʻo ia hoʻi e hana like lākou no ka mālama ʻana i kou maʻi. Aia nā ʻokoʻa nui i ka hana ʻana a me ke kumukūʻai ma mua o ka pono.

Loaʻa i nā lāʻau ʻelua ka mea hana like a hana ma o nā hana like i loko o kou kino. Ua hōʻike nā haʻawina lapaʻau i ka hana ʻana o ka rituximab biosimilar i nā hopena lapaʻau like, nā ʻano palekana, a me nā ʻano hopena ʻaoʻao i hoʻohālikelike ʻia i ka hoʻohui kumu.

ʻO nā mea maikaʻi nui o rituximab-abbs he waiwai pinepine. ʻOi aku ka liʻiliʻi o nā lāʻau lapaʻau biosimilar ma mua o kā lākou huahana kuhikuhi, hiki ke maʻalahi ka lapaʻau a hoʻemi i nā kumukūʻai mālama ola. Hiki nō hoʻi i kāu ʻinikua ke makemake e uhi i ka mana biosimilar.

Mai kahi manaʻo lapaʻau, ʻaʻole pono ʻoe e manaʻo i kahi ʻokoʻa i ka maikaʻi o ka hana ʻana o ka lāʻau a i ʻole pehea e pane ai kou kino iā ia. E koho kāu kauka ma waena o nā mea ʻelua ma muli o ka loaʻa, nā manaʻo kumukūʻai, a me nā makemake o kāu hale lapaʻau ma mua o nā ʻokoʻa i ka pono therapeutic.

Inā ua loaʻa mua iā ʻoe ka rituximab kumu a ke hoʻololi nei i ka mana biosimilar, ua manaʻo ʻia kēia hoʻololi he palekana a ʻaʻole pono e hoʻopilikia i kāu hopena lapaʻau. E nānā kāu hui mālama ola iā ʻoe me ka mālama like ʻole o ka mana āu e loaʻa ai.

Nā nīnau i nīnau pinepine ʻia e pili ana iā Rituximab-abbs

Ua palekana ʻo Rituximab-abbs no ka poʻe me ka maʻi puʻuwai?

Pono e loiloi pono ʻia ka rituximab-abbs i ka poʻe me nā maʻi puʻuwai, no ka mea, hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka puʻuwai a me ke koko i ka wā o ka hoʻokomo ʻana. E hana pū kāu cardiologist a me ka oncologist a i ʻole rheumatologist e hoʻoholo inā ʻoi aku ka maikaʻi ma mua o nā pilikia i kāu kūlana.

Inā loaʻa iā ʻoe ka maʻi puʻuwai, e mālama kāu hui lapaʻau i nā hana hou i ka wā o ka mālama ʻana. Hiki i kēia ke komo i ka nānā pinepine ʻana i kāu puʻuwai, ka hoʻoponopono ʻana i ka helu o ka hoʻokomo ʻana, a i ʻole ka hāʻawi ʻana i nā lāʻau lapaʻau hou e kākoʻo i kāu ʻōnaehana cardiovascular i ka wā o ka mālama ʻana.

Hiki i ka nui o ka poʻe me nā maʻi puʻuwai maʻalahi a maʻalahi ke loaʻa palekana i ka rituximab-abbs me ka nānā pono. Eia naʻe, inā loaʻa iā ʻoe ka puʻuwai nui a i ʻole ka puʻuwai i hala koke nei, hiki i kāu kauka ke ʻōlelo aku i nā lāʻau lapaʻau ʻē aʻe e hōʻemi i ka pilikia cardiovascular.

He aha kaʻu e hana ai inā hoʻohana hewa au i ka nui o ka Rituximab-abbs?

No ka mea, hāʻawi ʻia ka rituximab-abbs i nā keʻena lapaʻau e nā poʻe loea mālama ola i aʻo ʻia, ʻaʻole hiki ke loaʻa ka overdose. Hoʻoholo ʻia ka lāʻau lapaʻau ma muli o ke kaumaha o kou kino a me ke kūlana olakino, a laila nānā ʻia ma mua o ka lawelawe ʻana.

Inā hopohopo ʻoe e pili ana i ka loaʻa ʻana o ka lāʻau lapaʻau nui i ka wā o kāu hoʻokomo ʻana, mai kānalua e kamaʻilio me kāu kahu hānai a i ʻole ke kauka i kēia manawa. Hiki iā lākou ke hōʻoia i ka dosage pololei a pane i nā hopohopo āu e pili ana i kāu mālama ʻana.

I ka hanana kakaʻikahi o ka overdose, e hāʻawi kāu hui lapaʻau i ka mālama kākoʻo a nānā pono iā ʻoe no nā hopena ʻaoʻao i hoʻonui ʻia. ʻAʻohe antidote kikoʻī no ka rituximab-abbs, no laila e kālele ana ka mālama ʻana i ka mālama ʻana i nā hōʻailona e hiki ke ulu.

He aha kaʻu e hana ai inā hala wau i kahi mahele o Rituximab-abbs?

Inā ʻoe e hala i ka hoʻokomo ʻana i ka rituximab-abbs i hoʻonohonoho ʻia, e hoʻokaʻaʻike i kāu hui mālama ola i ka wā hiki ke hoʻonohonoho hou. Mai hoʻāʻo e hoʻoponopono i ka mahele i hala ma ka pāpālua ʻana i kāu lapaʻau aʻe, no ka mea, hiki i kēia ke hoʻonui i kou pilikia o nā hopena ʻaoʻao.

Na kāu kauka e hoʻoholo i ke ala maikaʻi loa e hoʻihoʻi ai i kāu papa hana lapaʻau. Hiki i kēia ke hoʻonohonoho hou i kāu mahele i hala a i ʻole ka hoʻoponopono ʻana i kāu papa manawa lapaʻau holoʻokoʻa ma muli o ka lōʻihi o ka lohi a me kahi āu i loko o kāu pōʻai lapaʻau.

ʻO ka hala ʻana i hoʻokahi hoʻokomo ʻana ʻaʻole ia e hoʻopilikia nui i kāu hopena lapaʻau holoʻokoʻa, ʻoiai inā hiki iā ʻoe ke hoʻonohonoho hou i loko o kahi manawa kūpono. Eia naʻe, he mea nui e mālama i kāu papa hana lapaʻau e like me ka hiki no nā hopena maikaʻi loa.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka Rituximab-abbs?

ʻO ka hoʻoholo e hooki i ka rituximab-abbs e hana mau ʻia ma ke kūkākūkā ʻana me kāu hui mālama ola, ʻaʻole ma kāu iho. E hoʻokumu kāu kauka i kēia hoʻoholo ma ke ʻano o ka maikaʻi o ka pane ʻana o kou maʻi i ka lapaʻau a me kou kūlana olakino holoʻokoʻa.

No ka lapaʻau ʻana i ka maʻi kanesa, e hoʻopau ʻoe i ka helu o nā pōʻai i hoʻonohonoho mua ʻia ma muli o nā protocols i hoʻokumu ʻia no kāu ʻano maʻi kanesa. E loiloi kāu kauka i kāu pane ma o nā scans, nā hoʻokolohua koko, a me nā hoʻokolohua kino ma mua o ka hoʻoholo ʻana inā pono ʻoe i ka lapaʻau hou.

Inā loaʻa iā ʻoe ka rituximab-abbs no nā maʻi autoimmune, ʻaʻole i wehewehe ʻia ka wahi e hooki ai. Loaʻa i kekahi poʻe ka remission lōʻihi ma hope o ka moʻo o nā lapaʻau, aʻo nā mea ʻē aʻe e pono paha i nā hoʻokomo mālama manawa e mālama i ko lākou maʻi ma lalo o ka mana.

Mai hooki i ka lapaʻau ma mua no ka mea e maikaʻi ana ʻoe a i ʻole e ʻike ana i nā hopena ʻaoʻao me ka kūkākūkā ʻole ʻana me kāu kauka mua. Hiki iā lākou ke kōkua iā ʻoe e kaupaona i nā pōmaikaʻi a me nā pilikia o ka hoʻomau ʻana i ka hoʻōki ʻana i ka lapaʻau ma muli o kou kūlana pilikino.

Hiki iaʻu ke loaʻa i nā lāʻau lapaʻau i ka wā e lawe ana i ka Rituximab-abbs?

Hoʻopilikia ʻo Rituximab-abbs i ka hiki ʻana o kāu ʻōnaehana pale e pane i nā lāʻau lapaʻau, no laila pono ka hoʻolālā pono ʻana me kāu hui mālama ola i ka manawa a me ke ʻano o nā lāʻau lapaʻau. Pono e pale loa ʻia nā lāʻau lapaʻau ola i ka wā o ka mālama ʻana a no kekahi mau mahina ma hope.

E ʻōlelo maʻamau kāu kauka e hoʻopau i nā lāʻau lapaʻau e pono ai ma mua o ka hoʻomaka ʻana i ka mālama ʻana iā rituximab-abbs ke hiki. Aia kēia i nā lāʻau lapaʻau maʻamau e like me nā pana flu, a me nā lāʻau lapaʻau huakaʻi āu e pono ai.

Inā pono ʻoe i nā lāʻau lapaʻau i ka wā o ka mālama ʻana, e koho kāu hui mālama ola i nā lāʻau lapaʻau i hoʻopau ʻia (make) ma mua o nā mana ola. Eia naʻe, ʻaʻole paha e hāʻawi kēia mau lāʻau lapaʻau i ka pae like o ka pale e like me ka wā e hana maʻamau ana kāu ʻōnaehana pale, no laila e lilo nā hana hou e kūʻē i ka maʻi i mea nui.