The Lymphoma Guide 림프종의안내 Part 1. Understanding Lymphoma 림프종의이해 Lymphoma is the general term for many different types of blood cancer. Non-Hodgkin lym

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1 The Lymphoma Guide 림프종의안내 Part 1. Understanding Lymphoma 림프종의이해 Lymphoma is the general term for many different types of blood cancer. Non-Hodgkin lymphoma and Hodgkin lymphoma are the two main types. 림프종은매우다양한혈액암의일반적인항목으로호지킨과비호지킨의두형태가있다 About Marrow, Blood and Blood Cells 골수, 혈액, 혈액세포에대해서 The information in this section about normal blood and marrow may help you understand the lymphoma information in the rest of this Guide. 정상적인혈액및골수에대한이장의정보는가이드의나머지부분에있는림프종정보를이해하는데도움이될수있습니다. Marrow is the spongy center inside of bones where blood and immune cells are made. 골수는혈액과면역세포가만들어뼈의내부에작은구멍이많은센터입니다. Blood cells are made in the marrow. They begin as stem cells. Stem cells become red cells, white cells and platelets in the marrow. Then the red cells, white cells and platelets enter the blood. 혈액세포는골수에서만들어집니다. 그들은줄기세포로시작합니다. 줄기세포는적혈구, 백혈구와골수에서혈소판이됩니다. 그런다음적혈구, 백혈구와혈소판은피에들어갑니다. Platelets form plugs that help stop bleeding at the site of an injury. 혈소판은부상의상황에서지혈을도와주는플러그의형태입니다. Red cells carry oxygen around the body. When the number of red cells is below normal, the condition is called anemia. Anemia may make you feel tired or short of breath. It may make your skin look pale. 적혈구는몸주위에산소를운반. 적혈구수가정상적인이하인경우, 이상태를 " 빈혈 " 이라고합니다. 빈혈은피곤하거나숨쉬는것이짧아질수있으며피부가창백해보이는수있습니다. White cells fight infection in the body. There are two major types of white cells: germ-eating cells (neutrophils and monocytes) and infection-fighting cells called lymphocytes (B cells, T cells and natural killer [NK] cells). 백혈구는체내에감염과싸우며세균을먹는세포 ( 호중구와단핵세포 ) 와 림프구 라는감염차단세포 (B 세포, T 세포, 자연킬러 [NK] 세포 ) 의두가지주요유형이있습니다

2 Plasma is the liquid part of the blood. It is mostly water. It also has some vitamins, minerals, proteins, hormones and other natural chemicals in it. 혈장은혈액의액체부분입니다. 그것은주로물이다. 또한일부비타민, 미네랄, 단백질, 호르몬과다른자연화학물질이있습니다. Normal Blood Cell Count Fast Facts The ranges of blood cell counts below are for adults. They may be a little different from lab to lab and for children and teens. 아래의혈액세포카운트의범위는성인입니다. 그값은실험실간에그리고아동및청소년에서는약간차이가있을수있습니다. Red blood cell (RBC) count 적혈구계산 Men: 4.5 to 6 million red cells per microliter of blood 남자 : 4백5십만 ~6백만 / 마이크로리터혈액 Women: 4 to 5 million red cells per microliter of blood 여자 : 4백만 ~6백만 / 마이크로리터혈액. Hematocrit (the part of the blood made up of red cells) 적혈구용적율 Women: 36% to 45% Men: 42% to 50% Hemoglobin (amount of the red cell pigment that carries oxygen) 헤모글로빈 ( 혈색소 ) Men: 14 to 17 grams per 100 milliliters of blood 남자 : 14~17 그램 / 100밀리리터 Women: 12 to 15 grams per 100 milliliters of blood 여자 : 12~15 그램 / 100밀리리터. Platelet count 혈소판 150,000 to 450,000 platelets per microliter of blood White blood cell (WBC) count 백혈구 4,500 to 11,000 white cells per microliter of blood Differential 차이 Shows the part of the blood made up of different types of white cells. 다른형태의백혈구로구성된혈액의일부를보여줍니다. The types of white cells counted are neutrophils, lymphocytes, monocytes, eosinophils and basophils. 백혈구의형태는호중구 ( 과립백혈구 ), 림프구, 단핵백혈구, 호산구, 호염구입니다 Adults usually have about 60% neutrophils, 30% lymphocytes, 5% monocytes, 4% - 2 -

3 eosinophils and less than 1% basophils in the blood. 성인은일반적으로이것들이 60%, 30%, 5%, 4% 와 1% 미만의호염구의비율로있습니다 The Immune System 면역체계 The immune system is the body s defense against infection. 면역체계는감염에대한신체의방어입니다. The marrow and the lymphocytes are part of the immune system. 골수와림프구는면역체계의일부입니다. Here are some other parts of the immune system: 다음은면역체계의또다른부분입니다 Lymph nodes are bean-sized collections of lymphocytes. There are about 600 lymph nodes found throughout the body-in the neck, armpits, chest, abdomen, groin and some other parts of the body. Lymphatic vessels connect the lymph nodes. They contain lymph, a fluid that carries lymphocytes. 림프절은림프구의콩-크기만한모임입니다. 몸에서목, 겨드랑이, 가슴, 복부, 사타구니및신체의다른부분에걸쳐발견 600 림프절이있습니다. 림프혈관은림프절을연결합니다. 그들은림프와림프구를운반하는액체가포함되어있습니다. The spleen is an organ found on the left side of the body, near the stomach. It contains lymphocytes and removes worn-out cells from the blood. 비장은위근처에있는몸의왼쪽에발견되는기관이다. 림프구를포함하고혈액에서낡은세포를제거합니다. Some Parts of the Immune System 면역체계의일부 Spleen 비장, Marrow 골수, Lymph nodes 림프절 - 3 -

4 The normal immune system helps to protect the body from infection. 정상적인면역체계는감염으로부터몸을보호하는것을도웁니다. About Lymphoma 림프종에관해서 Lymphoma starts with a change to a lymphocyte (a type of white cell). 림프종은림프구 ( 백혈구의일종 ) 로변경에서시작됩니다. The change to the lymphocyte causes it to become a lymphoma cell. The lymphoma cells pile up and form lymphoma cell masses. These masses gather in the lymph nodes or other parts of the body. 림프구에대한변경사항은림프종세포가하게됩니다. 림프종세포가뭉쳐서림프종세포덩어리를형성합니다. 이덩어리는림프절이나신체의다른부분에모입니다. Choosing a Specialist 전문의선택 Choose a doctor who specializes in treating lymphoma and knows about the most up-to-date treatments. This type of specialist is usually called a hematologist / oncologist. Or, your local cancer specialist can work with a lymphoma specialist. 림프종치료를전문으로하며최신치료에대해알고의사를선택합니다. 전문가의이러한유형은일반적으로 혈액종양전문의 라고하던지해당지역의암전문의가림프종전문가로작업할수있습니다 Ways to Find a Lymphoma Specialist 림프종전문의찾기. Ask your primary care doctor. 처음진료한의사에게의논하기. Contact your community cancer center. 암관리센터에문의. Reach out to health plan referral services. 건강보험서비서의추천. Call LLS for a list of cancer centers or go to 림프종학회홈페이지에있는암센터. Use online doctor-finder resources, such as 인터넷으로찾기 - The American Medical Association s (AMA) Doctor Finder - The American Society of Hematology s (ASH) Find a Hematologist. Ask Your Doctor 의사에게물어보기 Talk with the doctor about how he or she plans to treat your lymphoma. This will help you to be actively involved in your care and to make decisions. This Guide includes questions to ask your doctor about lymphoma treatment (see the inside back cover). 당신의림프종을치료하는계획방법에대해의사와상담하십시오. 이것은당신이적극적으로치료에참여하는데도움이되며결정을내릴수있습니다. 이안내서는 ( 내부뒷면커버를참조 ) 림프종치료에대해의사에게물어볼질문이포함되어있습니다

5 It may be helpful to write down the answers to your questions and review them later. You may want to have a caregiver, family member or friend with you when you talk to your doctor. This person can listen, take notes and offer support. Some people like to record information from the doctor and then listen to the recording later on. 질문에대한답변을적어두었다나중에보면도움이될수있습니다. 당신은의사와얘기할때간병인, 가족이나친구와함께할수있습니다. 그사람이들어메모를가지고도와줄수도있습니다. 어떤사람들은의사로부터정보를기록하고나중에기록들을것을좋아합니다. People with lymphoma who are unsure about their treatment options may want to get a second opinion. 자신의치료옵션에대해잘모르는림프종을가진사람들은다른의견을할수있습니다. Pretreatment Considerations. 치료전고려할것들 Adults of childbearing age and parents of children diagnosed with lymphoma should ask their doctors for information that may lessen the risk for infertility. 림프종을가진출산연령층의성인과어린이의부모는불임위험을줄이기위해정보를가진주치의에게물어해야합니다. About 90 percent of people with lymphoma have non-hodgkin lymphoma (NHL). The rest have Hodgkin lymphoma. There are many different kinds of NHL. See Non-Hodgkin Lymphoma, beginning on page 24 for more information about NHL. 림프종환자의약 90 % 가비호지킨림프종 (NHL) 이며나머지는호지킨림프종입니다. NHL 에는여러종류가있습니다. NHL에대한자세한내용은 24페이지 ( 영문 ) 에시작되는비호지킨림프종을참조하십시오

6 Part 2. Hodgkin Lymphoma Part 호지킨림프종 Hodgkin lymphoma (HL) is one of the most curable forms of cancer. 호지킨림프종 (HL) 은가장치료할수있는암의형태중하나입니다. Doctors don t know what causes most cases of Hodgkin lymphoma. There is no way to prevent lymphoma and you can t catch lymphoma from someone else. It is most likely to be diagnosed when a person is in his or her 20s or 30s. It is less common in middle age and becomes more common again after age 60. 의사들은호지킨림프종의발병원인에대해서는대부분은모릅니다. 또한림프종예방의방법도없으며당신이다른사람의림프종을알아내는것도가능하지않습니다. 이병은 20대또는 30 대에진단될가능성이가장높습니다. 중년일때많이발병하고다시 60 세이후에더증가됩니다 Signs and Symptoms 조짐 ( 징후 ) 및증상 The most common sign of Hodgkin lymphoma is one or more enlarged (swollen) lymph nodes. The enlarged lymph node may be in the neck, upper chest, armpit, abdomen or groin. It is usually painless. 호지킨림프종의가장흔한조짐은하나또는그이상의림프절이붓는것입니다. 부은림프절은목, 상단가슴, 겨드랑이, 복부또는사타구니에있습니다. 그것은일반적으로통증이있습니다. A sign is a change in the body that the doctor sees in an exam or a test result. 조짐은의사가시험이나테스트결과에서본몸의변화입니다. A symptom is a change in the body that a patient can see or feel. 증상은환자가보고느낄수있는몸의변화입니다. Signs and symptoms of Hodgkin lymphoma may include 호지킨림프종의조짐및증상은아래에있습니다. - Swollen lymph nodes 림프절이붓는다. - Cough and shortness of breath 기침과짧은호흡 - Fever 발열 - Night sweats 잘때나오는땀 - Tiredness 피로 - Weight loss 체중감소 - Itchy skin 피부가려움 Diagnosis and Staging 진단및병기 Having the correct diagnosis is important for getting the right treatment. Some patients may need to get a second medical opinion about the diagnosis before they begin treatment. Talk to the doctor about the tests used to make the diagnosis. 정확한진단을하는것은올바른치료를받기위한중요한사항입니다. 일부환자들은치료를 - 6 -

7 시작하기전에진단에대한두번째의료의견을해야할수도있습니다. 진단을하기위해 사용되는검사에대해의사와상담하십시오. Doctors do a test called a lymph node biopsy to find out if a patient has Hodgkin lymphoma. 의사는환자가호지킨림프종이있는지를찾기위해 " 림프절생검 " 라는검사를합니다. How is a Lymph Node Biopsy Done? 림프절생검은어떻게? - A surgeon removes all or part of an enlarged lymph node. 림프절의일부또는전체를외과수술로제거함 - The lymph node is examined under a microscope by a pathologist (a doctor who identifies diseases by studying cells and tissues under a microscope). 병리학자가림프절을현미경시험수행 It may be important to get another opinion about the biopsy results from a second pathologist. 이두번째병리학에서생검결과에대한다른의견을하는것이중요할수있습니다. The doctor will do other tests to stage the disease (to see how far the disease has spread). See Lymphoma Stages on page 17 for descriptions of the stages. 의사는병이얼마니전이됐는지병기를확인하기위해다른검사를할것입니다. 병기에대한설명은림프종병기장을참조하십시오. The tests for staging include 병기확인시험은아래의것을행한다.. Blood tests -to check red cell, white cell and platelet counts; 혈액검사 적혈구, 백혈구, 혈소판수량 blood tests are also done to check for other signs of disease 혈액검사로다른질병의조짐은없는지. Bone marrow tests - to look for Hodgkin lymphoma cells in the marrow 골수검사 호지킨림프종이골수에있는지살핀다.. Imaging tests - to create pictures of the chest and abdomen to see if there are lymphoma masses in the lymph nodes, liver, spleen or lungs. Examples of imaging tests include a 영상검사 - 림프절, 간, 비장및폐의림프종덩어리가있는지가슴과복부의사진보며다음과같은영상검사를한다. - Chest x-ray - CT (computed tomography) scan - MRI (magnetic resonance imaging) - PET (positron emission tomography) scan

8 How are the Blood and Bone Marrow Tests Done? 혈액및골수검사는어떻게하는가 Blood tests( 혈액검사 ). Usually a small amount of blood is taken from the patient s arm with a needle. The blood is collected in tubes and sent to a lab. 환자의팔에서소량의혈액을주사기로채취하여병리실에서수행 Bone marrow aspiration.( 골수채취 ) A liquid sample of cells is taken from the marrow. 골수에서액체성세포를추출 Bone marrow biopsy.( 골수생검 ) A very small amount of bone filled with marrow cells is taken from the body. 몸에서골수로채워진뼈를소량추출 Blood and marrow tests may be done in the doctor s office or in a hospital. A bone marrow aspiration and a bone marrow biopsy are almost always done together. Both tests are done with a special needle. Some patients are awake for the procedure. They get medication first to numb the skin where the procedure will take place. This is usually the area near the patient s hip bone. The hip bone holds the cells needed to be examined. Some patients are sedated (asleep) for the procedure. 혈액및골수검사는의사의사무실이나병원에서수행할수있습니다. 골수채취및골수생검은함께이루어집니다. 두시험은특별한바늘로이루어집니다. 일부환자는시술중깨어있습니다. 그것의절차는채취할곳의피부를마취합니다. 일반적으로는환자의엉덩이뼈근처에있는지역입니다. 엉덩이뼈는검사에필요한세포를보유하고있습니다. 일부환자는수면으로진정시킵니다. Blood and marrow tests may also be done both during and after treatment. The tests are repeated to see if treatment is destroying lymphoma cells. 혈액및골수검사는치료동안과치료후모두수행할수있습니다. 검사는치료로림프종세포가파괴되는지확인하기위해반복됩니다. Lymphoma Stages 림프종병기 Stage I (1기) : One lymph node region or a single organ. 한개의지역에서림프절 Stage II (2기) : Two or more lymph node regions on the same side of the diaphragm. 횡경막윗부분지역에서 2개이상의림프절 Stage III (3기) : Two or more lymph node regions above and below the diaphragm. 횡경막위아래에서 2개이상의림프절이발견 Stage IV (4기) : Widespread disease in lymph nodes and/or other parts of the body. 신체의다른부분에광범위하게림프절발견 Patients are also divided into A or B categories. B category patients have fever, a lot of sweating and/or weight loss. A patients do not. 환자는또한 "A" 또는 "B" 카테고리로나누어집니다. "B" 카테고리환자는발열, 땀, 또는체중감소가있습니다. "A" 환자는그렇지않습니다. All stages of lymphoma can be treated. 림프종의모든병기는치료할수있습니다

9 Hodgkin Lymphoma Subtypes 호지킨림프종의하위유형 Knowing your subtype helps the doctor make treatment decisions. Below are the names of the different Hodgkin lymphoma subtypes. 여러분이하위유형을아는것은의사의치료결정에도움이되며다음은호지킨림프종의하위유형의이름입니다 1) Classic Hodgkin Lymphoma - about 95 percent of patients have this type, which has been further subdivided into 대부분환자의 95% 가이 type이며아래와같이세분된다 * Nodular sclerosis * Mixed cellularity * Lymphocyte-depleted * Lymphocyte-rich classic. 2) Nodular Lymphocyte-Predominant Hodgkin Lymphoma Treatment for these subtypes may vary. For more information, see the Treatment section below and our free LLS booklet Hodgkin Lymphoma. 이것에대한치료는다양하며자세한내용은아래의치료섹션과무료로재편된책자호지킨림프종을참조하십시오

10 Treatment 치료 Hodgkin lymphoma can be cured in about 75 percent of all patients. The cure rate in younger patients is over 90 percent. 호지킨림프종은모든환자의약 75 % 를완치할수있습니다. 젊은환자의치료속도는 90 % 가넘습니다. There are different types of Hodgkin lymphoma. Talk to your doctor about the type of Hodgkin lymphoma that you have and your treatment choices. 호지킨림프종에는다양한종류가있습니다. 당신이발병한호지킨림프종과치료선택의유형에대해의사와상담하십시오. Factors that may affect treatment include 치료에영향을미치는인자는아래에 - The type of Hodgkin lymphoma 호지킨림프종의 type - The stage and category of the disease 병기및카테고리 - Disease that has not responded to treatment 치료에질병이반응이없을때 - Disease that has come back after treatment 치료후재발 - Other medical problems, such as a very low red cell count (anemia), diabetes mellitus, heart or kidney disease. 다른의학적문제들, 적혈구감소 ( 빈혈 ), 당뇨병, 심장또는신장질환. Combination chemotherapy along with involved field radiation therapy is the most common treatment. Involved field radiation therapy uses high-energy rays to target the Hodgkin lymphoma cells. Other parts of the body are protected to reduce harm to healthy cells. " 병변부위방사선요법 ' 과함께조합화학요법 ( 항암 ) 은가장일반적인치료입니다. 병변부위방사선요법은호지킨림프종세포를표적으로고에너지광선을사용합니다. 몸의다른부분이건강한세포에해를줄이기위해보호됩니다. Chemotherapy without radiation therapy may be the treatment for patients with widespread Hodgkin lymphoma, fever, night sweats or weight loss. 화학요법 ( 방사선요법없이 ) 은발열, 밤에땀이나거나체중감소되는호지킨림프종환자에대한치료로수행할수있습니다. Chemotherapy is given in cycles, usually several weeks apart. A number of cycles are needed. The treatment may last from six to 10 months. It is outpatient treatment for most patients. Some patients may have to stay in the hospital for a short time if they develop a fever or have other signs of infection. Some patients who need antibiotics may stay in the hospital until the infection is gone. 화학요법은보통몇주간의간격으로되는 " 사이클 " 로주어집니다. 사이클의횟수가필요합니다. 치료는최소 6~10 개월에서지속할수있습니다. 그것은대부분의환자에대한외래치료입니다. 열이오르던지다른감염의증상이있는경우일부환자는짧은시간동안병원에입원해야할수도있습니다. 감염이사라질때까지항생제가필요한일부환자는병원에입원할수있습니다

11 Nodular Lymphocyte-Predominant Hodgkin Lymphoma(NLPHL). Patients with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) need different treatment than patients with other HL subtypes. NLPHL is slow-growing (indolent) and close to 100 percent of patients see long-term survival. The treatment for patients with NLPHL is involved field radiation. Patients do respond to chemotherapy, but the disease tends to come back more often after chemotherapy. For more information, see the free LLS booklet Hodgkin Lymphoma. NLPHL 환자는다른 HL의하위유형이있는환자와는다른치료가필요합니다. NLPHL는느린성장을하며환자가 100% 가까운장기생존을합니다. NLPHL 환자에대한치료는병변부위방사선으로행합니다. 환자는화학요법에반응하지만, 질병은화학요법후더자주재발되는경향이있습니다. 자세한내용은무료로재편된책자호지킨림프종을참조하십시오.. Examples of Chemotherapy Combinations Used to Treat Hodgkin Lymphoma 호지킨림프종의화학치료예 - ABVD : Adriamycin (doxorubicin), bleomycin, vinblastine and dacarbazine - BEACOPP : bleomycin, etoposide, Adriamycin (doxorubicin), cyclophosphamide, Oncovin (vincristine), procarbazine and prednisone - Stanford V : mechlorethamine, doxorubicin, vinblastine, vincristine, bleomycin, etoposide and prednisone High-dose chemotherapy may also kill normal blood-forming cells in the marrow. Chemotherapy may cause very low counts of red cells, white cells or platelets. 높은복용량화학요법은골수에서정상적인혈액세포형성을죽일수있습니다. 화학요법은적혈구, 백혈구또는혈소판의매우낮은수치의원인이될수있습니다. Some patients may need a blood transfusion or drugs called blood cell growth factors until the side effects of chemotherapy wear off. Examples of red cell growth factors are Aranesp (darbepoetin alfa) and Procrit (epoetin alfa). These can increase red cell counts. 어떤환자는화학요법의부작용이사라질때까지 " 혈액세포의성장인자 " 라는수혈이나약을복용할수도있습니다. 적혈구생성요인의예는 Aranesp (darbepoetin 알파 ) 와 Procrit (epoetin 알파 ) 입니다. 이러한적혈구수를증가시킬수있습니다. Hodgkin lymphoma affects the body s ability to fight infection. Chemotherapy and radiation can add to the problem. Good treatment and following the doctor s advice will help lower the risk of infection. White cell growth factors may be part of treatment. 호지킨림프종은면역력에영향을미칩니다. 화학요법과방사선이문제에추가될수있습니다. 좋은치료와의사의조언은감염의위험을낮추는데도움이됩니다. 백혈구생성인자는치료의일부가될수있습니다

12 Neupogen or Neulasta (also called granulocyte-colony stimulating factor or G-CSF ) and Leukine (also called granulocyte-macrophage colony stimulating factor or GM-CSF ) can increase the number of neutrophils (white cells). Neupogen 와r Neulasta 와 Leukine 는백혈구증가를시킬수있는약입니다 See Treatment Side Effects on page 39, for more information. 자세한내용은원문페이지 39 의치료부작용을참조하십시오. Relapsed Hodgkin Lymphoma. 호지킨림프종의재발 In some patients, Hodgkin lymphoma may come back (called a recurrence or relapse ). The doctor will treat these patients again with chemotherapy. The treatment often gives patients very long disease-free periods. 일부환자는재발될수있으며이때의사는화학요법을다시시술할것입니다치료는환자에게오랫동안은질병이없게해줄것입니다 Stem Cell Transplantation 조혈모세포이식 When doctors are planning treatment, they use a number of factors to determine a patient s need for a stem cell transplant. These factors may include the patient s disease, subtype, stage, other treatment received and the patient s physical ability to have the transplant. While a stem cell transplant is not an option for every patient, it can be an important addition to the treatment plan for some patients. 의사가치료를계획할때, 그들은조혈모세포이식에대한환자의필요를결정하는요인을사용합니다. 이러한요소는환자의질병, 하위유형, 병기및다른치료와이식을할수있는환자의신체적기능을포함할수있습니다. 조혈모세포이식은모든환자에대한선택사항은아니지만, 몇몇환자에대한치료계획에중요한추가요소가될수있습니다. Additional information about the different kinds of transplants that are available for some HL patients start on the next page. Talk to your doctor about whether a stem cell transplant is a treatment option for you. 일부 HL 환자에사용할수있는이식의다양한종류에대한추가정보는다음페이지에시작합니다. 조혈모세포이식이당신의치료에있어옵션항목인지에대해서는의사와상담하십시오. Autologous Stem Cell Transplantation. 자가조혈모세포이식 Autologous transplantation is more frequently used than allogeneic transplantation for Hodgkin lymphoma patients. 자가조혈모세포이식은호지킨림프종환자에게있어동종이식 ( 형제간이식 ) 보다더자주사용되어진다

13 The goal of autologous stem cell transplantation is to help the body start a new supply of blood cells after high-dose chemotherapy. 자가조혈모세포이식은고농도의화학치료후몸에새로운혈액세포를공급하는데도움이된다. With an autologous transplant - The patient s own stem cells are collected from the patient s blood or marrow and stored after the first cycles of drug therapy are completed. 환자자신의조혈모세포는환자의혈액이나골수에서수집하고약물요법의첫번째사이클이완료된후저장합니다. - Then, the patient is given high-dose chemotherapy to kill the lymphoma cells. This treatment also kills normal stem cells in the marrow. 그런다음환자는림프종세포를죽일높은복용량화학요법이주어집니다. 이치료는또한골수에서정상적인줄기세포를죽입니다. - Next, the stem cells collected before chemotherapy are infused back into the patient s blood through a central line. 다음으로는화학요법전에수집된줄기세포는중앙라인을통해환자의혈액에다시주입합니다. Allogeneic Stem Cell Transplantation. 동종조혈모세포이식 ( 형제간이식 ) An allogeneic transplant uses stem cells from a donor. The donor may be a brother or sister. Or, the donor can be an unrelated person with stem cells that match the patient s. Stem cells may also come from a cord blood unit (the blood in the umbilical cord after a baby s birth). 동종이식은기증자의줄기세포를사용합니다. 기증자는남동생이나여동생이될수있습니다. 또는기증자는환자 일치 " 하는줄기세포를가진남이될수도있습니다. 줄기세포는탯줄혈액단위 ( 아기의출생후탯줄의혈액 ) 에서올수있습니다. Allogeneic transplants may be done in the hospital. First, the patient is given high-dose chemotherapy and/or radiation therapy to kill the lymphoma cells in the body. Stem cells are collected from a donor. The donor stem cells are given to the patient through an intravenous (IV) line or central line. The donor stem cells go from the patient s blood to the marrow and help start a new supply of red cells, white cells and platelets. 동종이식은병원에서수행할수있습니다. 첫째, 환자는몸에림프종세포를죽일높은복용량화학요법및 / 또는방사선치료를제공하고있습니다. 줄기세포는기증자로부터수집합니다. 기증자의줄기세포는정맥주사 (IV) 줄또는중앙라인을통해환자에게주어집니다. 기증자의줄기세포는환자의혈액에서골수로가며적혈구, 백혈구와혈소판의새로운공급을도와줍니다

14 Reduced-Intensity Stem Cell Transplantation. Reduced-Intensity 조혈모세포이식 Reduced-intensity allogeneic stem cell transplantation (also called a nonmyeloablative transplant ) uses lower doses of chemotherapy than a standard allogeneic transplant. Some older and sicker patients may be helped by this treatment. Many centers use 70 years as the upper age limit for patients being considered for a reduced-intensity allogeneic transplant. Reduced-intensity 이식 (nonmyeloablative 이식이라고하는 ) 은표준동종이식보다낮은용량의화학요법을사용합니다. 일부고령의환자들은이치료가도움이될수있습니다. 대부분의센터는 70세이상의환자에게 Reduced-intensity 이식을고려합니다. Talk to your doctor about whether stem cell transplantation is a treatment option for you. 조혈모세포이식이치료의옵션인지는주치의와상의하십시오 Childhood Hodgkin Lymphoma. 소아호지킨림프종 Children and teens with Hodgkin lymphoma should be treated at medical centers that have a pediatric oncology team. 어린이와청소년호지킨림프종환자는소아혈액종양학팀의의료센터에서치료를해야합니다. It is important for young adults and parents of children to talk to members of the oncology team about the Stage of the disease, Type of Hodgkin lymphoma, Lab test results. 종양학팀원들이병기, 림프종의타입과검사결과에관해말하는것은아이들의부모와청소년 ( 청장년 ) 을위해서중요합니다 Doctors use this information about the patient s disease in order to determine the most effective therapy. Children and young adults with Hodgkin lymphoma are usually treated with combination chemotherapy, sometimes with the addition of radiation therapy to increase local control of the disease. 의사는가장효과적인치료를결정하기위해환자의질환에대한정보를사용합니다. 화학요법으로치료받는호지킨림프종의어린이와젊은성인은일반적으로질병의국지제어를높이기위해때때로방사선치료를추가로합니다. See Clinical Trials on page 38 for more information. 더자세한정보는원문 38 페이지를보십시오

15 Part 3. Non-Hodgkin Lymphoma Part 비호지킨림프종 There are many types of non-hodgkin lymphoma (NHL). Most people with NHL have a B-cell type of NHL (about 85 percent). The others have a T-cell type or an NK-cell type of lymphoma. 비호지킨림프종 (NHL) 은여러종류가있습니다. NHL의대부분사람들은 B-cell 유형 ( 약 85 %) 이며나머지는 T-cell 유형이나림프종의 NK-cell 유형입니다. NHL that is NHL 은다음과같음 - Slow-growing is called indolent or low-grade indolent 또는 low-grade 라부르는저속성장형 - Fast-growing is called aggressive or high-grade. aggressive 또는 high-grade. 라부르는고속성장형 Talk to your doctor about the type of NHL that you have and your treatment choices. 형태에따른치료선택은주치의와상의하십시오 There are treatments for every type of NHL. Some patients with fast-growing NHL can be cured. For patients with slow-growing NHL, treatment may keep the disease in check for many years. This can be true even when tests show that disease remains in some parts of the body. NHL의모든유형에대한치료방법은있습니다. 빠르게성장하는 NHL 일부환자는치료가될수있습니다. 느린성장 NHL 환자의경우, 치료는몇년동안질병을감시하는것일수있습니다. 검사시질병이몸의일부에남아것이보여지는경우도맞습니다. Some Types of Non-Hodgkin Lymphoma (NHL 의일부형태 ) 1) Slow-Growing or Indolent NHL 저속성장형 - Follicular lymphoma : the most common slow-growing NHL 일반적인것 - Cutaneous T-cell lymphoma - Lymphoplasmacytic lymphoma - Marginal zone lymphoma - Mucosa-associated lymphoid tissue (MALT) lymphoma - Small cell lymphocytic lymphoma/chronic lymphocytic leukemia - Waldenstrom macroglobulinemia 2) Fast-Growing or Aggressive NHL 저속성장형 - Diffuse large B-cell lymphoma : the most common fast-growing NHL 일반적인것 - AIDS-associated lymphoma - Anaplastic large cell lymphoma

16 - Burkitt lymphoma - Central nervous system (CNS) lymphoma - Follicular lymphoma (transformed) - Lymphoblastic lymphoma - MALT lymphoma (transformed) - Mantle cell lymphoma (most types) - Peripheral T-cell lymphoma (most types) Signs and Symptoms 징후및조짐 The most common sign of NHL is one or more enlarged lymph nodes in the neck, armpit or groin. Enlarged lymph nodes also can be near the ears or elbow. NHL의가장흔한징후는목, 겨드랑이나사타구니에서하나이상의확대림프절입니다. 확대림프절은귀또는팔꿈치근처가될수있습니다. A sign is a change in the body that the doctor sees in an exam or a test result. 조짐은의사가시험이나테스트결과에서본몸의변화입니다. A symptom is a change in the body that a patient can see or feel. 증상은환자가보고느낄수있는몸의변화입니다. Signs and symptoms of NHL may include NHL의조짐및증상은아래에있습니다 - Swollen lymph nodes 림프절이붓는다 - Fever 발열 - Night sweats 잘때나오는땀 - Tiredness 피로 - Loss of appetite 식욕감소 - Weight loss 체중감소 - Rash 발진 Diagnosis and Staging 진단및병기 Having the correct diagnosis is important for getting the right treatment. Some patients may need to get a second medical opinion about the diagnosis before they begin treatment. Talk to the doctor about the tests used to make the diagnosis. 정확한진단을하는것은올바른치료를받기위한중요한사항입니다. 일부환자들은치료를시작하기전에진단에대한두번째의료의견을해야할수도있습니다. 진단을하기위해사용되는검사에대해의사와상담하십시오. Doctors do a test called a lymph node biopsy to find out if a patient has NHL. 의사는환자가 NHL이있는지를찾기위해 " 림프절생검 " 라는검사를합니다. Sometimes a biopsy is done to examine cells from other parts of the body, such as the lungs. 때때로생검은페와같은다른부위에도수행될것이다

17 How is a Lymph Node Biopsy Done? 림프절생검은어떻게? - A surgeon removes all or part of an enlarged lymph node. 림프절의일부또는전체를외과수술로제거함 - The lymph node is examined under a microscope by a pathologist (a doctor who identifies diseases by studying cells and tissues under a microscope). 병리학자가림프절을현미경시험수행 - The doctor may look at the cells from the biopsy to see if there are changes in the chromosomes of the NHL cells. (Each cell in the body has chromosomes that carry genes. Genes give the instructions that tell each cell what to do.) 의사는 NHL 세포의염색체의변화가있는지확인하기위해조직검사에서세포를볼수있습니다. ( 몸의각세포는유전자를운반염색체가있습니다. 유전자는각세포가무엇을할것인지를안내합니다.) It may be important to get another opinion about the biopsy results from a second pathologist. 이두번째병리학에서생검결과에대한다른의견을하는것이중요할수있습니다. Immunophenotyping is done to find out if the patient s NHL cells are B cells or T cells. This is a lab test that can be done using the sample of cells from the lymph node biopsy or with blood or bone marrow biopsy samples. 면역형검사는환자의 NHL 세포는 B 세포나 T 세포여부를확인하기위한것입니다. 이것은림프절생검이나혈액또는골수생검표본으로세포의샘플을사용하여수행할수있는검사입니다. The doctor will do other tests to stage the disease (to see how far the disease has spread). See Lymphoma Stages on page 17 for descriptions of the stages. 의사는병이얼마니전이됐는지병기를확인하기위해다른검사를할것입니다. 병기에대한설명은림프종병기장을참조하십시오. A physical exam, lab and imaging tests help the doctor to see how widespread the disease is. The doctor will check 물리검사, 실험실및영상검사는질병이얼마나전이되었는지여부를의사가보는데도움이죄며의사는아래사항을검토할것이다. The number of lymph nodes that are affected 영향을받은림프절의수. Where the affected lymph nodes are (for example, in the abdomen or the chest or in both parts of the body) 어디영향을받는림프절이있는지 ( 예를들어, 복부또는가슴이나몸의부분 ). Whether any cancer cells are in other parts of the body besides the lymph nodes or lymphatic system, such as the lungs or liver. 어떤암세포가폐또는간으로림프절이나림프체계, 이외의몸의다른부분에있는지여부

18 The tests for staging include 병기확인시험은아래의것을행한다. Blood tests -to check red cell, white cell and platelet counts; 혈액검사 적혈구, 백혈구, 혈소판수량 blood tests are also done to check for other signs of disease 혈액검사로다른질병의조짐은없는지. Bone marrow tests - to look for NHL cells in the marrow 골수검사 NHL이골수에있는지살핀다. Imaging tests - to create pictures of the chest and abdomen to see if there are lymphoma masses in the lymph nodes, liver, spleen or lungs. Examples of imaging tests include a 영상검사 - 림프절, 간, 비장및폐의림프종덩어리가있는지가슴과복부의사진보며다음과같은영상검사를한다 - Chest x-ray - CT (computed tomography) scan - MRI (magnetic resonance imaging) - PET (positron emission tomography) scan. Other staging tests may be done for some types of NHL. 다른병기확인검사는 NHL 의일부유형에수행할수있습니다. Treatment 치료 The doctor has to take into account many factors to make a treatment plan for a patient with NHL, including 의사는다음과같은여러가지인자를고려하여 NHL 환자들에대한치료계획을만듭니다. The type of NHL NHL의형태. The stage and category of the disease 질병의병기및카테고리. The patient s overall health. 전반적인환자의건강상태 Types of treatment are 치료의형태. Watch and wait : an approach for some types of NHL 관찰하며기다리기. Chemotherapy : the main type of treatment for NHL 화학요법. Drug therapy : Rituxan (rituximab) and certain other drugs are used to treat some types of NHL 약물요법. Radiation therapy : an important added treatment given along with chemotherapy for some types of NHL 방사선요법. Stem cell transplantation : a procedure used for some types of NHL 조혈모세포이식. New types of treatment : now under study in clinical trials. 새로운치료법

19 Chemotherapy is given in cycles, usually several weeks apart. Patients need a number of cycles of treatment. The treatment may last from six to 10 months. 화학요법은보통몇주간격으로주어지는 " 사이클 " 을합니다. 환자의치료사이클의수가필요합니다. 치료는 6~10개월에서지속할수있습니다. High-dose chemotherapy may also kill normal blood-forming cells in the marrow. Chemotherapy may cause very low counts of red cells, white cells or platelets. 높은복용량화학요법은골수에서정상적인혈액세포형성을죽일수있습니다. 화학요법은적혈구, 백혈구또는혈소판의매우낮은수치의원인이될수있습니다. A red cell transfusion or drugs called blood cell growth factors may be needed until the side effects of chemotherapy wear off. 화학요법의부작용이사라질때까지 " 혈액세포의성장요인 " 이라고하는적혈구수혈이나약물이필요할수있습니다. Examples of these growth-factor drugs are 관련약물의예시 - Aranesp (darbepoetin alfa ) and Procrit (epoetin alfa) : these can increase the red cell count 적혈구증가 - Neupogen or Neulasta (also called granulocyte-colony stimulating factor or G-CSF ) and Leukine (also called granulocyte-macrophage colony stimulating factor or GM-CSF ) : these can increase the number of neutrophils (white cells). 백혈구증가약물 Most treatment for NHL usually takes place in an outpatient setting. Some patients may need to stay in the hospital for a short time. for example, if they develop a fever or have other signs of infection. Some patients who need antibiotics may stay in the hospital until the infection is gone. NHL에대한대부분의치료는일반적으로외래환경에서이루어집니다. 일부환자는열을발생하거나감염의증상이있으면단기간동안병원에입원해야할수도있습니다. 감염이사라질때까지항생제가필요일부환자는병원에입원할수있습니다. Some Drug Combinations Used to Treat NHL NHL 치료에사용되는약제조합 Many drug combinations are used to treat NHL. The drug choice depends on the type of NHL and the stage of treatment. 많은약물조합은 NHL을치료하는데사용됩니다. 약물선택은 NHL의종류및치료의단계에따라달라집니다. A number of drug combinations include Rituxan -a monoclonal antibody therapy. Monoclonal antibody therapies kill certain types of cancer cells. They can cause side effects but do not cause many of the side effects caused by chemotherapy. 약물의조합수는 Rituxan 를포함하여 Monoclona 항체요법으로암세포의특정유형을

20 죽이는것이다. 그들은부작용을일으킬수있지만, 화학요법으로인한부작용의많은원인이되지않습니다. R-CHOP: Rituxan, cyclophosphamide, hydroxydoxorubicin(doxorubicin), Oncovin (vincristine) and prednisone R-FCM: Rituxan, fludarabine, cyclophosphamide and mitoxantrone R-CVP or F-CVP: Rituxan or fludarabine, plus cyclophosphamide, vincristine and prednisone R-HCVAD: Rituxan, cyclophosphamide, vincristine, Adriamycin (doxorubicin) and dexamethasone alternating with R-MTXAraC: Rituxan, methotrexate, cytarabine (ara-c)

21 Watch and Wait for Slow-Growing NHL. 저속성정 NHL의관찰 In most cases, a patient begins treatment for NHL right away. But when a patient has NHL that is not growing or is growing slowly, the doctor may recommend a watch-and-wait approach. 대부분의경우, 환자는즉시 NHL 치료를시작합니다. 그러나환자의 NHL이성장하지않거나느리게성장하며의사는관찰접근방식을권장할수있습니다. The watch-and-wait approach means that a doctor watches a patient s condition but does not treat with drugs or radiation therapy. Patients may think that they should have treatment right away. But for patients with slow-growing disease and no symptoms, it is common not to start treatment. This allows the patient to avoid side effects of therapy until treatment is needed. 관찰접근방식은의사가환자의상태를관찰하지만약물또는방사선요법으로치료하지않습니다. 환자들은즉시치료를해야한다고생각할수있습니다. 그러나느린성장질환및증상이있는환자에대한치료를시작하지않는것이일반적입니다. 치료가필요한때까지환자가치료의부작용을방지할수있습니다 Patients in a watch-and-wait protocol need follow-up visits with the doctor. At each office visit the doctor will check for any health changes. The results of exams and lab tests over time will help the doctor advise the patient about when to start treatment with drugs or radiation. 관찰프로토콜의환자는의사와방문후속이필요합니다. 각사무실방문시의사는건강변경사항을확인합니다. 시간이지남에따라시험및실험실테스트의결과는의사가약물또는방사선치료를시작하는경우에대해환자를조언하는데도움이됩니다. Treatment will begin if a patient develops symptoms or there are signs that the NHL is starting to grow. 환자의증상을발전되거나 NHL 성장하기시작하고있다는징후가있는경우치료가시작됩니다. Patients may be treated with one to five drugs. The goal of treatment is a series of remissions-each lasting a number of years. This can be true even when tests show that disease remains in some parts of the body. Many patients lead active, good-quality lives. 환자는 1~5가지약물로치료받습니다. 치료의목표는몇년의 remissions으로합니다. 검사로질병이몸의일부에남아것이보이는지확인합니다. 많은환자가활동적이며양질의삶을영위합니다. Maintenance for Slow-Growing NHL. 저속성정 NHL의보수 People with some types of slow-growing lymphoma may continue treatment to stay in remission. This is called maintenance therapy. Rituxan is a drug that is approved for maintenance therapy for patients with follicular lymphoma

22 느린성장림프종의어떤유형을가진사람들은 Remission 상태에머물며지속적인치료를 해야합니다이것은 "maintenance therapy." 라고합니다. Rituxan 은 follicular 림프종환자 에대한 maintenance 치료에승인된약입니다. Radiation Therapy. 방사선치료 Radiation uses high-energy rays to kill lymphoma cells in one area. Radiation can be used along with chemotherapy when there are very large masses of lymphoma cells in a small area of the body. 방사선은고에너지광선을사용하여어떤지역의림프종세포를죽입니다. 몸의작은영역에림프종세포의매우큰질량이있을때방사선과화학요법과함께사용할수있습니다. Radiation can also be used when large lymph nodes are pressing on an organ (such as the bowel) and chemotherapy cannot control the problem. Radiation usually isn t the only treatment for NHL because the lymphoma cells are likely to be in many areas of the body. 방사선은장기에 ( 예 : 장 ) 있는큰림프절을제거하거나화학요법이문제를제어할수없을때사용할수있습니다. 림프종세포는신체의여러부분에전이될가능성이있기때문에방사선은일반적으로 NHL의유일한치료이지는않습니다. Some Other Drugs Used to Treat NHL NHL 치료의다른약 Treanda (bendamustine) : a drug that is FDA-approved to treat patients with relapsed, slow-growing B-cell NHL that has progressed during or within six months of treatment with Rituxan or a Rituxan-containing regimen. Treanda is also approved to treat patients with chronic lymphocytic leukemia (CLL). 느린성장 B-cell NHL에환자치료로 FDA 승인된약물이며만성림프백혈병 (CLL) 환자를치료하기위해승인을받은것입니다. Bexxar (tositumomab) and Zevalin (ibritumomab): two monoclonal antibodies that are FDA-approved to treat NHL. These are called radioimmunotherapies. This means that these drugs carry a radioactive substance that targets the lymphoma cells, reducing radiation side effects to normal cells. Both Bexxar and Zevalin are approved for relapsed or refractory CD20-positive, low-grade, follicular or transformed B-cell lymphomas. Zevalin is also approved for previously untreated follicular non-hodgkin lymphoma patients who achieve a partial or complete response to initial chemotherapy. 이약물은정상세포에방사선부작용으로림프종세포를대상으로방사성물질을운반것을의미합니다. follicular 또는변형 B-cell 림프종에승인됩니다. Zevalin는 follicular 비호지킨림프종환자에대한승인을받은것입니다. Velcade (bortezomib) : a drug that is FDA-approved to treat mantle cell lymphoma and is also being studied in clinical trials for some other types of NHL. 맨틀세포림프종을치료하는약으로 FDA 승인되고있으며 NHL의다른유형의임상실험에서연구되고있습니다

23 Relapsed or Refractory NHL. 재발및난치성 NHL Disease can come back months or years after treatment ends. This condition is called relapsed NHL. Some patients may not respond to treatment. This condition is called refractory NHL. 병은치료가끝나고도몇달또는몇년후에되돌아오며이것을 relapsed( 재발 ) NHL이라합니다. 또한몇몇의환자는치료가잘듣지않으며이것을 refractory( 난치성 ) NHL이라합니다. Doctors can either change the patient s treatment or give added treatment. There are many drug choices and approaches to treatment. If relapse occurs long after treatment, the same drugs that were used for the patient before may be effective. In other cases, new drugs or treatment approaches are used. Patients with refractory NHL should talk with the doctor about the risks and benefits of participating in a clinical trial. 의사는환자의치료를변경하거나추가치료를제공할수있습니다. 많은약물선택및치료방법이있습니다. 재발은치료후오랜시간이지나발생하는경우는이전에환자에사용된동일한약이효과가있을수있습니다. 다른경우에, 새로운약물또는치료방법이사용됩니다. 난치성 NHL 환자는임상시험에참여의위험과이로움에대해의사와상담해야합니다. Stem Cell Transplantation 조혈모세포이식 When doctors are planning treatment, they use a number of factors to determine a patient s need for a stem cell transplant. These factors may include the patient s disease, subtype, stage, other treatment received and the patient s physical ability to have the transplant. While a stem cell transplant is not an option for every patient, it can be an important addition to the treatment plan for some patients. 의사가치료를계획할때, 그들은조혈모세포이식에대한환자의필요를결정하는요인을사용합니다. 이러한요소는환자의질병, 하위유형, 병기및다른치료와이식을할수있는환자의신체적기능을포함할수있습니다. 조혈모세포이식은모든환자에대한선택사항은아니지만, 몇몇환자에대한치료계획에중요한추가요소가될수있습니다. Additional information about the different kinds of transplants that are available for some NHL patients start on the next page. 일부 NHL 환자에사용할수있는이식의다양한종류에대한추가정보는다음페이지에시작합니다. Some of these transplants are for patients with slow-growing lymphomas, some are more appropriate for patients with fast-growing lymphomas. 이러한이식중일부는느린성장림프종환자에있으며, 일부는빠르게성장하는림프종환자에대해더근접합니다

24 Talk to your doctor about whether a stem cell transplant is a treatment option for you. 조혈모세포이식이당신의치료에있어옵션항목인지에대해서는의사와상담하십시오. Autologous Stem Cell Transplantation. 자가조혈모세포이식 Autologous transplantation is more frequently used than allogeneic transplantation for non-hodgkin lymphoma patients. 자가조혈모세포이식은비호지킨림프종환자에게있어동종이식 ( 형제간이식 ) 보다더자주사용되어진다 The goal of autologous stem cell transplantation is to help the body start a new supply of blood cells after high-dose chemotherapy. 자가조혈모세포이식은고농도의화학치료후몸에새로운혈액세포를공급하는데도움이된다. With an autologous transplant - The patient s own stem cells are collected from the patient s blood or marrow and stored after the first cycles of drug therapy are completed. 환자자신의조혈모세포는환자의혈액이나골수에서수집하고약물요법의첫번째사이클이완료된후저장합니다. - Then, the patient is given high-dose chemotherapy to kill the lymphoma cells. This treatment also kills normal stem cells in the marrow. 그런다음환자는림프종세포를죽일높은복용량화학요법이주어집니다. 이치료는또한골수에서정상적인줄기세포를죽입니다. - Next, the stem cells collected before chemotherapy are infused back into the patient s blood through a central line. 다음으로는화학요법전에수집된줄기세포는중앙라인을통해환자의혈액에다시주입합니다. Allogeneic Stem Cell Transplantation. 동종조혈모세포이식 ( 형제간이식 ) An allogeneic transplant uses stem cells from a donor. The donor may be a brother or sister. Or, the donor can be an unrelated person with stem cells that match the patient s. Stem cells may also come from a cord blood unit (the blood in the umbilical cord after a baby s birth). 동종이식은기증자의줄기세포를사용합니다. 기증자는남동생이나여동생이될수있습니다. 또는기증자는환자 일치 " 하는줄기세포를가진남이될수도있습니다. 줄기세포는탯줄혈액단위 ( 아기의출생후탯줄의혈액 ) 에서올수있습니다. Allogeneic transplants may be done in the hospital. First, the patient is given high-dose chemotherapy and/or radiation therapy to kill the lymphoma cells in the body. Stem cells are collected from a donor. The donor stem cells are given to the patient through an intravenous (IV) line or central line. The donor stem cells go from the patient s blood to the marrow and help start a new supply of red cells, white cells and platelets. 동종이식은병원에서수행할수있습니다. 첫째, 환자는몸에림프종세포를죽일높은복용

25 량화학요법및 / 또는방사선치료를제공하고있습니다. 줄기세포는기증자로부터수집합니다. 기증자의줄기세포는정맥주사 (IV) 줄또는중앙라인을통해환자에게주어집니다. 기증자의줄기세포는환자의혈액에서골수로가며적혈구, 백혈구와혈소판의새로운공급을도와줍니다. Reduced-Intensity Stem Cell Transplantation. Reduced-Intensity 조혈모세포이식 Reduced-intensity allogeneic stem cell transplantation (also called a nonmyeloablative transplant ) uses lower doses of chemotherapy than a standard allogeneic transplant. Some older and sicker patients may be helped by this treatment. Many centers use 70 years as the upper age limit for patients being considered for a reduced-intensity allogeneic transplant. Reduced-intensity 이식 (nonmyeloablative 이식이라고하는 ) 은표준동종이식보다낮은용량의화학요법을사용합니다. 일부고령의환자들은이치료가도움이될수있습니다. 대부분의센터는 70세이상의환자에게 Reduced-intensity 이식을고려합니다. Talk to your doctor about whether stem cell transplantation is a treatment option for you. 조혈모세포이식이치료의옵션인지는주치의와상의하십시오 Childhood Non-Hodgkin Lymphoma. 소아비호지킨림프종 Burkitt lymphoma is the most common type of NHL in children aged five through 14 years. Diffuse large B-cell lymphoma is the most common type in 15- to 29-year-olds. Burkitt 림프종은 5~14세어린이 NHL의가장일반적인유형입니다. 확산된대형 B-cell 림프종은 15~29세에서가장일반적인유형입니다 Children and teens with Hodgkin lymphoma should be treated at medical centers that have a pediatric oncology team. 어린이와청소년호지킨림프종환자는소아혈액종양학팀의의료센터에서치료를해야합니다. It is important for young adults and parents of children to talk to members of the oncology team about the Stage of the disease, Type of Non-Hodgkin lymphoma, Lab test results. 종양학팀원들이병기, 림프종의타입과검사결과에관해말하는것은아이들의부모와청소년 ( 청장년 ) 을위해서중요합니다 Doctors use this information about the patient s disease in order to determine the most effective therapy. Treatments used for children with NHL may be different from those used for adults with NHL. 의사는가장효과적인치료를결정하기위해환자의질환에대한정보를사용합니다. NHL있는어린이에사용되는치료는 NHL 성인의사용방법과다를수있습니다

26 Part 4. Clinical Trials 임상실험 There are new treatments under study for lymphoma patients of all ages. New treatments are studied in clinical trials. Clinical trials are also used to study new uses for approved drugs or treatments. For example, changing the amount of the drug or giving the drug along with another type of treatment might be more effective. Some clinical trials combine drugs for lymphoma in new sequences or dosages. 모든연령대의림프종환자에대한연구에따라새로운치료법이있습니다. 새로운치료는임상실험에서연구되고있습니다. 임상실험은승인약물이나치료에대한새로운용도를연구하는데사용됩니다. 예를들어, 약물의양을변경하거나치료의다른유형과함께약물을제공하는것은더효과적일수있습니다. 일부임상시험은새로운시퀀스또는복용량에서이루어지고있습니다. There are clinical trials for 임상살험. Newly diagnosed lymphoma patients 새로운진단림프종환자. Patients who do not get a good response to treatment 치료가잘듣지않는환자. Patients who relapse after treatment 치료후재발된환자. Patients who continue treatment after remission (maintenance). maintenance 후치료를계속하는환자. A carefully conducted clinical trial may provide the best available therapy. 신중히실시하는임상실험이가장적합한치료를제공할수있습니다. You can call our Information Specialists to learn more about clinical trials. 당신은우리의정보전문가가임상시험에대한자세한내용을보려면호출할수있습니다

27 Part 5. Side Effects and Follow-Up Care 부작용및후속관리 Treatment Side Effects 치료부작용 The term side effect is used to describe the way that treatment affects healthy cells. 부작용이라는것은치료가건강한세포에영향을끼치는것을이른다. The aim of treatment for Hodgkin lymphoma and non-hodgkin lymphoma is to kill the lymphoma cells. Treatment for lymphoma also affects healthy cells. Side effects of lymphoma treatment may be severe or mild, but they usually go away once treatment ends. Ask your doctor about the side effects you can expect from your treatment. 호지킨림프종과비호지킨림프종치료의목적은림프종세포를죽일것입니다. 림프종에대한치료도건강한세포에영향을미칩니다. 림프종치료의부작용은심각한또는경미할수있지만일반적으로치료가종료되면사라집니다. 치료에서예상될수있는부작용에대해의사에게물어보십시오. Lymphoma treatment may affect your blood counts. 림프종치료는혈액 count 에영향을끼친다. - The number of red cells may decrease (this is called anemia ). Blood transfusions or growth factors to increase red cells may be needed. Aranesp and Procrit are drugs that might be given to increase the red cell count. 적혈구수가감소할수있습니다 ( 빈혈발생 ). 적혈구수혈이나증가요소가필요할수있습니다. Aranesp 및 Procrit 는적혈구수를증가시키는약물입니다. - Patients may also have a drop in the number of platelets. A platelet transfusion may be needed to prevent bleeding if a patient s platelet count is very low. 환자는혈소판의수의감소가있을수있습니다. 환자의혈소판이매우낮은경우혈소판수혈은출혈을방지하기위해필요합니다. - A severe drop in white cells may lead to an infection. Infections caused by bacteria or fungi are treated with antibiotics. 백혈구수치의심각한감소는감염으로이어질수있습니다. 박테리아나곰팡이에의한감염은항생제로치료하고있습니다. To help improve a patient s white cell count. 백혈구수치개선에도움이되는방법 1) The amount of chemotherapy drugs may be reduced. 화학요법약물의총량을감소 2) The time between treatments may be increased. 치료사이의시간을증가 3) Growth factors, such as Neupogen, Neulasta and Leukine may be given to increase neutrophil counts. 호중구수를높이는약을사용

28 Common Side Effects. 일반적부작용 Some of the common side effects of treatment for Hodgkin lymphoma and NHL may include 치료후흔한부작용은아래의것들입니다. Mouth sores 입염증. Nausea 구역질. Vomiting 구토. Diarrhea 설사. Constipation 변비. Bladder irritation 방광자극. Blood in the urine. 소변에피가 Other side effects of treatment may include 치료의또다른부작용들. Extreme tiredness 극도의피로. Fever 열. Cough 기침. Rash 발진. Hair loss 탈모. Weakness 쇠약. Tingling sensation 손발및신체의저림현상. Lung, heart or nerve problems. 폐, 심장또는신경문제. Not all patients have these side effects. Treatment to prevent or manage nausea, vomiting, diarrhea and other side effects can help patients feel more comfortable. 모든환자는이러한부작용이있는것은아니지만메스꺼움, 구토, 설사등의부작용을방지하거나관리하는치료는환자를더편안하게할수있습니다. Long-Term and Late Effects 장기및향후부작용 ( 후유증 ) Long-term effects are medical problems that last for months or years after treatment ends. Fatigue is an example. 장기부작용은몇달또는몇년의치료종료후의료문제입니다. 피로가예입니다. Late effects are medical problems that do not show up until years after treatment ends. Heart disease is an example. 향후부작용은치료종료후몇년이될때까지표시되지않는의료문제입니다. 심장질환이예입니다. Not everyone who is treated for lymphoma develops long-term or late effects. It depends on the patient s age, overall health and treatment. 림프종치료를받은모든환자에게이런문제 ( 후유증 ) 가발생되지는않습니다. 그것은환자의나이, 건강관리, 치료방법에따라다릅니다 Patients should talk with their doctors about any long-term or late effects that may be related to their treatment. Parents should talk to the doctor about when their child s learning skills should be checked. 환자는자신의치료와관련이있을수있는후유증에대해의사와상담해야합니다. 부모는자녀의학습기술을선택해야할때에대해의사에게이야기해야합니다

29 Follow-up Care 후속관리 Medical follow-up is important for every lymphoma patient. Follow-up care helps the doctor to see if more treatment is needed. 의학적후속관리는모든림프종환자에게중요한사항입니다후속관리는만약더이상의치료가요구되어질때의사에게도움이됩니다. Children and adults who have been treated for lymphoma should see their primary care doctor and an oncologist (cancer specialist) for follow-up care. Patients should talk to the doctor about how often to have follow-up visits. They can ask what tests they will need and find out how often to have the tests. It is important to get a record of the cancer treatment you received so that your doctor can follow up on specific late effects that may be associated with your treatment. 림프종치료를받은어린이와성인은처음치료를한의사와후속관리를위한종양햑의사와 ( 암전문의 ) 와만나게해야한다. 환자는후속관리를위해얼마나자주방문해야하는지의사와의논해야합니다그리고필요한검사와시기를의사에게물어야합니다. 암치료에대해서기록하는것은당신의의사가치료에관련된후속관리를하는것에매우중요한일입니다 Follow-up care includes physical exams and blood tests. Sometimes marrow tests are also needed. The doctor may advise longer periods of time between follow-up visits if a patient 후속관리는물리적시험및혈액검사가포함되어있습니다. 때때로골수검사도필요합니다. 의사는환자의후속방문사이의기간이긴경우충고할수있습니다.. Continues to be free of signs of lymphoma 영원히림프종의증상으로부터해방되기위해. Does not need medical care for any long-term or late effects. 어떤후유증은의료관리가필요하지않기도하다. Tracking Your Lymphoma Tests 당신의림프종테스트추적 These tips may help you save time and know more about your health. 이도움말은시간을절약하고건강에대한자세한내용을아는데도움이될수있습니다. - Ask your doctor why certain tests are being done and what to expect. 어떤검사를왜수행했는지그리고예측되는것이무엇인지의사에게물어보기 - Discuss test results with your doctor. 의사와검사결과에대해의논. - Ask for and keep copies of lab reports in a file folder or binder. Organize test reports by date.. 검사결과서사본요청및검사보고서를날짜별로보관 - Find out if and when follow-up tests are needed. 언제후속검사가필요한지알기 - Mark appointments that are coming up on your calendar. 달력에표시하기

30 Take Care of Yourself 스스로관리하기. Keep all appointments with the doctor. 의사와한모든약속은지키자. Discuss how you feel with the doctor at each visit. 각방문시당신이느끼는것을의사와의논하자. People with lymphoma may have more infections. Follow the doctor s advice for preventing infection. 림프종이있는사람들은더많은감염이있을수있으므로감염예방 을위해의사의조언에따르자. Eat healthy foods each day. It is okay to eat four or five smaller meals instead of three bigger ones. 매일건강음식을먹는다. 하루세끼씩많이먹는것보다는 4~5 회로 나누어서먹는것이좋다. Contact the doctor about fatigue, fever or other symptoms. 피로, 발열또는기타증상에대해의사에게문의하십시오.. Do not smoke. Patients who smoke should get help to quit. 금연필수. Get enough rest and exercise. Talk with your doctor before starting an exercise program. 충분한휴식과운동. 운동프로그램을시작하기전에의사와상담하기. Keep a healthcare file with copies of lab reports and treatment records. 임상보고서및치료기록의사본과의료파일을보관.. See the family doctor to keep up with other healthcare needs. Talk with family and friends about how you feel. When family and friends know about lymphoma and its treatment, they may worry less. 림프종외의건강관리를유지하기위해가정의를만나기. 당신은느끼는것에대해서가족및친구들과이야기하기. 가족과친구들은림프종과치료에대해알게되면염려를덜수있습니다. Seek medical advice if you feel sad or depressed and your mood does not improve over time. For example, if you feel sad or depressed every day for a two-week period, seek help. Depression is an illness. It should be treated even when a person is being treated for lymphoma. Treatment for depression has benefits for people living with cancer. 슬프거나우울한기분이시간이지나도개선하지않을경우의료조언을구합니다. 예로 2주동안매일슬프거나우울하다면도움을구하세요. 우울증은질병입니다. 그것은림프종치료중인경우이라도치료를해야합니다. 우울증에대한치료는암을가진사람에게이롭습니다

31 Medical Terms 의학용어 Antibiotics. 항생제 Drugs that are used to treat infections caused by bacteria and fungi. Penicillin is one type of antibiotic. 박테리아와곰팡이로인한감염을치료하는데사용되는약. 페니실린은항생제의일종입니다. Antibodies. 항체 Proteins that help fight infection in the body. 몸에감염과의싸움을도우는단백질. Bone marrow aspiration. 골수천자 A procedure to remove and examine marrow cells to see if they are normal. A liquid sample of cells is taken from the marrow and then the cells are looked at under a microscope. 골수가정상인지를알기위해골수세포를채취하고시험하는절차입니다. 골수에서액체성샘플을채취하고그것을현미경으로관찰합니다. Bone marrow biopsy. 골수생검 A procedure to remove and examine marrow cells to see if they are normal. A very small amount of bone filled with marrow cells is taken from the body and the cells are looked at under a microscope. 골수가정상인지를알기위해골수세포를채취하고시험하는절차입니다. 소량의골수가채워진뼈를채취하고그것을현미경으로관찰합니다. Central line. 중심정맥관 Special tubing the doctor puts into a large vein in the upper chest to prepare a patient for chemotherapy treatment. The central line is used to give the patient chemotherapy drugs and blood cells, and to remove blood samples. Also called indwelling catheter. 의사가환자에게화학요법치료를위해특별튜브를환자상단가슴의큰정맥에삽입합니다. 중심정맥관은환자에게화학요법약물과혈액세포를제공하고, 혈액샘플을채취하는데사용됩니다. 이것은 indwelling catheter 라고하기도합니다. Chemotherapy or drug therapy. 화학또는약물치료 Treatment with chemical agents to treat lymphoma and other diseases. 림프종및기타질병을치료하기위해화학약품으로치료

32 Chromosomes. 염색체 Any of the 23 pairs of certain basic structures in human cells. Chromosomes are made up of genes. Genes give the instructions that tell each cell what to do. The number or shape of chromosomes may be changed in blood cancer cells. 인간의세포는 23쌍어떤기본구조로구성되어있습니다. 염색체는유전자로구성되어있습니다. 유전자는각세포에게할일을지시합니다. 염색체의수또는모양은혈액암세포에서변경될수있습니다. Clinical trials. 임상실험 Careful studies done by doctors for new drugs or treatments or new uses for approved drugs or treatments. The goal of clinical trials for blood cancers is to improve treatment and quality of life and to find cures. 의사들에의해서약물이나치료방법의승인을위해새로운약물, 치료또는사용에대해연구를수행하는것을말합니다. 혈액암에대한임상시험의목표는치료를개선시키고삶의질과좋은치료를찾는것입니다. Combination chemotherapy or drug therapy. 조합화학요법또는약물요법 The use of two or more drugs together to treat lymphoma and other diseases. 림프종과다른질병치료를위해 2 가지이상의약을합께사용하는것 Diagnose. 진단 To detect a disease from a person s signs, symptoms and test results. The doctor diagnoses a patient. 사람의조짐, 증상및검사로질병을감지합니다. 의사가환자를진단합니다. FDA. The short name for the U.S. Food and Drug Administration. Part of the FDA s job is to assure the safety and security of drugs, medical devices, and the U.S. food supply. 미국식품과약물기구의약자로 FDA 업무의일부는약물, 의료기기, 미국식품공급의안전성과보안을보증하는것입니다. Hemoglobin. 헤모글로빈 The part of the red cell that carries oxygen. 적혈구에서산소를운반하는부분입니다 Hematologist. 혈액학자 A doctor who treats blood cell diseases. 혈액세포질환을치료하는의사