Mɔnu yeyetɔ si dzi nàto azã wò ŋutɔ wò lãmenugbagbeviwo atsɔ awɔ avu kple kansa (CAR T-cell Therapy) .

Èsusui kpɔ be míaƒe ŋutilã ate ŋu awɔ avu kple kansa le eɖokui sia? Le nyateƒe me la, ametakpɔnu aɖe si me nunya le ŋutɔ si woyɔna be dɔlélenutsiŋutete le míaƒe ŋutilã si. Eƒe akpa tɔxɛ aɖe le esi si woyɔna be T-cells, siwo le abe asrafowo ene. Woƒe dɔe nye be woake ɖe dɔlékui siwo tso duta kple lãmenugbagbevi siwo trɔna siwo gena ɖe ŋutilãa me ŋu ahagblẽ wo dome. Gake ɣeaɖewoɣi la, kansa lãmenugbagbeviwo nyea ayetɔ ŋutɔ. Woɣlana ɖe T lãmenugbagbevi siawo, woblea wo eye wotsina le ŋutilãa me. Le ɣeyiɣi mawo tɔgbe me la, míele nu ƒom tso atikewɔwɔ yeye wɔnuku aɖe si kpena ɖe mía ŋutɔwo ƒe T lãmenugbagbeviwo ŋu be woade dzesi kansa lãmenugbagbeviwo ahagblẽ wo to "hehe tɔxɛ" nana wo me.

Kpuie ko la, nukae nye CAR T-cell dɔdamɔnu?

Togbɔ be ŋkɔa aɖi nya sesẽ hã la, nukpɔsusua le bɔbɔe ŋutɔ. CAR T-cell dɔdamɔnu nye dɔlélenutsiŋutete ƒe dɔdamɔnu ƒomevi aɖe. Ebia be nàxɔ wò ŋutɔ wò T lãmenugbagbevi aɖewo eye nàtrɔ asi le woƒe domenyiŋusẽfianu ŋu le nudokpɔƒe.

Bu wò T lãmenugbagbeviwo be wonye kpovitɔwo. Kansa lãmenugbagbeviwo le abe fiafitɔ siwo ɣla wo ɖokui ene. Zi geɖe la, kpovitɔwo mete ŋu dea dzesi fiafitɔ siawo o. CAR T-cell therapy le abe ŋkumeɖobolo tɔxɛ aɖe nana wò kpovitɔwo (T cells) ene. Woyɔa ahuhɔ̃e sia be ‘Chimeric Antigen Receptor’ (CAR) . Wowɔe le dodokpɔxɔ me eye wotsɔe kpe ɖe T lãmenugbagbeviwo ŋu.

Fifia, ne wotsɔ ahuhɔ̃e tɔxɛ sia de eme la, T lãmenugbagbeviwo te ŋu dea dzesi protein (antigens) tɔxɛ siwo le kansa lãmenugbagbeviwo ƒe anyime pɛpɛpɛ. Fifia kansa lãmenugbagbevi siwo woɣla tsã la dzena nyuie. Emegbe T lãmenugbagbevi siwo si ŋusẽ gã siawo su la yia ɖadzea kansa lãmenugbagbeviwo dzi tẽ hetsrɔ̃a wo. Atikewɔwɔ sia kpena ɖe ame ŋu ŋutɔ le ʋumenugbagbeviɣidɔ ƒomevi aɖewo dada keŋkeŋ me eye wòkpena ɖe ame bubuwo ŋu be woanɔ agbe didi kple kansa.

Ʋumekansa ƒomevi kawoe atikewɔwɔ sia daa?

Fifia la, ʋumenugbagbeviɣidɔ ƒomevi aɖewo siwo mewɔ nu ɖe ​​atikewɔwɔ bubuwo ŋu o (abe atikewɔmɔnu ene) alo esiwo trɔ gbɔ le atikewɔwɔ vɔ megbe koe wozãna na CAR T-cell dɔdamɔnu. Esi wònye be egakpɔtɔ nye atike yeye ŋutɔ ta la, wometsɔnɛ naa kansawo katã o.

Tabla si le ete la ɖe kansa ƒomevi siwo dzi woda asi ɖo fifia na atikewɔwɔ sia fia.

Aleke atikewɔwɔ ƒe ɖoɖo sia dzɔnae?

Dɔ sia katã yia edzi le afɔɖeɖe vovovowo me. Ele abe hehe asrafowo hena aʋawɔwɔ eye emegbe wogbugbɔ wo ɖo ɖe aʋagbedzi ene.

Afɔɖeɖe 1: Wò T lãmenugbagbeviwo nuƒoƒoƒu

Gbã la, ele be wò ŋutilã naƒo ʋumenugbagbevi ɣiwo nu ƒu, vevietɔ T lãmenugbagbeviwo. Wowɔa esia to mɔnu aɖe si woyɔna be leukapheresis dzi. Esia bia be nàɖo wò ʋu to mɔ̃ aɖe dzi, si ɖea ʋumenugbagbevi ɣiawo ɖeɖeko ɖa, eye nàtrɔ ʋu susɔea ayi wò ŋutilã me. Esia le abe ʋudodo ene, gake ʋua ƒe akpa aɖe koe woxɔna eye wogbugbɔa ʋu susɔea nana.

2. Afɔɖeɖe: Ðo T lãmenugbagbeviawo ɖe dodokpɔxɔa me eye nàtrɔ asi le wo ŋu

Eyome woɖoa T lãmenugbagbevi siwo woxɔ le asiwò la ɖe dodokpɔxɔ tɔxɛ aɖe. Le afima la, dzɔdzɔmeŋutinunyalawo zãa domenyiŋusẽfianu tsɔ dea CAR (Chimeric Antigen Receptor) si ŋu míeƒo nu tsoe va yi la T lãmenugbagbeviwo me. Emegbe, wodoa CAR T lãmenugbagbevi yeye siawo siwo ŋu ŋusẽ le ŋutɔ la le dodokpɔxɔ me vaseɖe esime wo dometɔ miliɔn geɖe va su wo si. Dɔ sia xɔa kwasiɖa etɔ̃ va ɖo ade.Ate ŋu axɔ ɣeyiɣi aɖe.

3. Afɔɖeɖe: Dzadzraɖo ɖe wò ŋutilã ŋu

Vaseɖe esime woato CAR T-lãmenugbagbeviwo vɛ le dodokpɔxɔa me la, wò ɖɔkta ate ŋu ana atike bubuwo (bridging therapy), abe atikewɔmɔnu ene, be nàtsɔ aɖu wò kansa dzi.

Emegbe ŋkeke ʋɛ aɖewo hafi woatsɔ CAR T-lãmenugbagbevi yeye siwo wowɔ la ana wò la, woana atike si ƒe agbɔsɔsɔme mede o. Woyɔa esia be atike si naa ʋumenugbagbeviɣidɔ . Esia wɔa dɔ to wò ŋutilã ƒe dɔlélenutsiŋutete ƒe lãmenugbagbevi siwo li fifia dzi ɖeɖe kpɔtɔ me, si wɔnɛ be nɔnɔme nyuitɔ nɔa anyi na CAR T-lãmenugbagbevi yeye siwo de ŋgɔ wu la be woawɔ dɔ.

4. Afɔɖeɖe: Super T cells gbugbɔgaɖo ŋutilãa me

Esiae nye wɔna vevitɔ. Abe alesi woana dzetsi ene la, wodoa CAR T-lãmenugbagbevi yeye siwo wowɔ la ɖe wò ŋutilã me to ʋuka aɖe me (intravenous line - IV). Esia xɔa miniti 5 va ɖo 30. Ne lãmenugbagbevi siawo nya ge ɖe ŋutilãa me ko la, wodzea dzidziɖedzi gɔme le wo ɖokui si, henɔa kansa lãmenugbagbeviwo dim hetsrɔ̃a wo. Esi lãmenugbagbevi siawo nɔa ŋutilãa me ɣeyiɣi didi eye wowɔa avu kple kansa ta la, ame aɖewo yɔa atikewɔwɔ sia be “atike gbagbe.”

Nukae dzɔna le atikewɔwɔ vɔ megbe? Afɔku kawoe le eme?

Esi wònye be esia nye atike si nu sẽ ŋutɔ ta la, ɣeaɖewoɣi la, eƒe nugbegblẽ le ame ŋu sesẽwo ate ŋu ado mo ɖa. Eyata ahiã be nànɔ kɔdzi abe kwasiɖa ɖeka va ɖo ŋkeke ewo ene le atikewɔwɔa megbe. Ðɔktawo kple dɔnɔdzikpɔlawo alé ŋku ɖe ŋuwò nyuie.

Nusiwo wògblẽna le ame ŋu Vevietɔ

Atikewɔwɔ sia ƒe nugbegblẽ le ame ŋu vevi eve kple esiwo bɔ wu. Togbɔ be nusiawo ate ŋu anye afɔku hã la, atikewɔlawo ƒe ƒuƒoƒowo le dzadzraɖoɖi nyuie be woate ŋu ada wo.

Aleke gbegbee atikewɔwɔ sia kpɔa dzidzedzee?

CAR T-cell dɔdamɔnu na mɔkpɔkpɔ yeye va ame geɖe siwo le avu wɔm kple ʋumenugbagbeviɣidɔ, vevietɔ amesiwo mewɔ nu ɖe ​​atikewɔwɔ bubuwo ŋu o.

• Le kpɔɖeŋu me, ɖevi siwo xɔ atike sia na ɖeviwo ƒe ʋumenugbagbeviɣidɔ sesẽ (ALL) la dometɔ siwo wu 85% ƒe kansa nu yi keŋkeŋ le atikewɔwɔ vɔ megbe. Eye, wo dometɔ 60% gakpɔtɔ nye esiwo ŋu kansa mele o ƒe ɖeka le atikewɔwɔ vɔ megbe.

Mɔ̃ɖaŋununya sia gakpɔtɔ le tɔtrɔm. Numekula siwo le xexeame godoo le agbagba dzem ɣesiaɣi be yewoana atike sia nanyo ɖe edzi, aɖe eƒe nugbegblẽ le ame ŋu dzi akpɔtɔ, eye woakpɔe ɖa be woate ŋu azãe na kansa ƒomevi bubuwo hã.

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Atikewɔwɔ sia ƒe nugbegblẽ le ame ŋu, vevietɔ Cytokine Release Syndrome kple ahɔhɔ̃mekawo ƒe kuxiwo, ate ŋu ade ame ƒe agbe afɔku me . Eyata hafi nàdzo le kɔdzi la, bia wò ɖɔkta be dzesi kawoe wòle be nànya vevie.

Ne dzesiwo abe dzoxɔxɔ, vuvɔ, taɖuame, kple ʋuʋudedi ene gakpɔtɔ li la, ate ŋu anye nɔnɔme sesẽ aɖe ƒe dzesi. Ne nenemae la, yɔ wò ɖɔkta enumake alo yi kɔdzi ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU).

Ne ʋumekansa le ŋuwò alo ame aɖe si nènya la, ƒo nu kple wò ɖɔkta tso eŋu nenye be CAR T-cell ƒe atikewɔwɔ sɔ na wò. Togbɔ be menye amesiamee dɔdamɔnu sia nye o hã la, ate ŋu atrɔ ame ƒe agbenɔnɔ na ame si sɔ.