Ke ʻike ʻoe ua loaʻa iā ʻoe ka maʻi kanesa, nui kou makaʻu a me ka hopohopo. Akā me ka holomua o ka ʻepekema lapaʻau, i kēia lā aia nā ʻano lapaʻau holomua loa e hakakā ai i ka maʻi kanesa. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau hou a ikaika loa i kūleʻa loa i ka mālama ʻana i kekahi mau ʻano maʻi kanesa , ʻoiai nā mea e ulu ana i loko o ke koko.
He aha ka CAR T-Cell Therapy?
I ka ʻōlelo maʻalahi, ʻo ka CAR T-Cell Therapy kahi immunotherapy i hoʻohana ʻia e mālama i kekahi mau ʻano maʻi kanesa koko . ʻO kā mākou mau cell immune ponoʻī e like me nā koa i loko o ko mākou kino. ʻO ka hana a kēia lāʻau lapaʻau, ʻo ia ke lawe i kekahi o kēia mau koa i loko o kou kino ponoʻī, i kapa ʻia ʻo nā T cell ( nā T cell a i ʻole nā T lymphocytes ) , a hoʻolilo iā lākou i mau mea hakakā nui e luku i nā cell cancer.
E noʻonoʻo e lawe ana i kāu mau pūnaewele T i kahi keʻena hoʻokolohua , e hoʻokomo ana i kahi gene hou i loko o lākou, a hāʻawi iā lākou i kahi "lens kūikawā" e hiki ke ʻike i nā pūnaewele maʻi kanesa. Kāhea mākou i kēia mau pūnaewele T i hoʻololi ʻia he mau pūnaewele T CAR . ʻO `CAR` ke kū nei no `Chimeric Antigen Receptor`. A laila, hana ʻia nā miliona o kēia mau pūnaewele super-fighter a hoʻihoʻi ʻia i loko o kou kino. A laila hele kēia mau pūnaewele i loko o kou kino, e ʻimi a luku i nā pūnaewele maʻi kanesa. I kekahi manawa, hiki i kēia lāʻau ke ho'ōla loa i nā maʻi kanesa koko.
He aha nā ʻano maʻi kanesa e hoʻohana ʻia ai kēia lāʻau lapaʻau?
I kēia manawa, hoʻohana wale ʻia ka CAR T-Cell Therapy no kekahi mau ʻano maʻi kanesa koko kahi i hāʻule ʻole ai nā lāʻau ʻē aʻe a i ʻole kahi i hoʻi hou mai ai ke kanesa. Ua papa inoa ka papa ma lalo nei i kekahi o kēia mau ʻano maʻi kanesa.
| ʻAno Kanesa | He hoʻolauna pōkole |
|---|---|
| ʻO ka maʻi leukemia lymphoblastic koʻikoʻi o nā cell B (ALL) | ʻO ka maʻi leukemia lymphoblastic koʻikoʻi e kū mai ana mai nā pūnaewele B. |
| ʻO ka lymphoma B-cell nui e hoʻolaha | He ʻano lymphoma e ulu wikiwiki ana. |
| ʻO ka lymphoma follicular | He ʻano lymphoma ulu lohi. |
| ʻO ka lymphoma cell mantle | He ʻano lymphoma kakaʻikahi akā ikaika. |
| ʻO ka myeloma lehulehu | ʻO ke ʻano maʻi ʻaʻai iwi e kū mai ana i loko o nā pūnaewele plasma. |
| ʻO ka lymphoma B-cell nui mediastinal mua | He ʻano lymphoma e kū ana ma ka ʻaoʻao waena o ka umauma. |
ʻAe, e nānā kākou pehea e hana ai kēia.
I mea e hoʻomaopopo ai i kēia, e aʻo mua kākou e pili ana i nā pūnaewele T i loko o kā kākou ʻōnaehana pale. Loaʻa i kēlā me kēia pūnaewele i loko o ko kākou kino nā protein i kapa ʻia he antigens ma kona ʻili. Ua like kēia me kahi kāleka ID i loaʻa i kēlā me kēia pūnaewele. Loaʻa i nā pūnaewele maʻi kanesa kahi kāleka ID i hoʻololi ʻia a ʻano ʻē.
Loaʻa i kā mākou mau pūnaewele T nā mea loaʻa . ʻO kēia mau mea loaʻa ka mea e ʻike ai i nā mea hoʻouka kaua e like me nā pūnaewele maʻi kanesa me nā kāleka ID ʻokoʻa (antigens). Akā i kekahi manawa he maalea loa nā pūnaewele kanesa. Peʻe lākou mai kēia mau pūnaewele T.
ʻO kēia kahi e pono ai ke kōkua o nā CAR T-cell. ʻO kēia kāu mau T cell ponoʻī i hoʻomaʻamaʻa kūikawā ʻia ma ka lab a hoʻololi ʻia e ʻike i kahi antigen kikoʻī ma nā cell cancer .
ʻO kēia lāʻau lapaʻau e ʻae i kēia mau cell ʻaʻole wale e pepehi i nā cell kanesa, akā e māhele a hoʻonui pū i loko o ke kino. ʻO ia hoʻi, loaʻa iā ʻoe kahi lako lōʻihi o nā cell e hakakā ana i ka maʻi kanesa. ʻO ia ke kumu e kapa ai nā kauka i kēia lāʻau lapaʻau he "lāʻau ola."
Pehea e hana ai ke kaʻina hana lapaʻau?
Hana ʻia kēia kaʻina holoʻokoʻa ma nā pae he nui.
Ma mua o ka mālama ʻana
ʻO ka mea mua, pono ʻoe e hōʻiliʻili i nā hunaola koko keʻokeʻo, ʻoiai nā hunaola T, mai kou kino. Ua kapa ʻia kēia he leukapheresis.He hana like kēia me ka hāʻawi ʻana i ke koko. Lawe kahi mīkini i kekahi o kou koko, hoʻokaʻawale i nā hunaola koko keʻokeʻo wale nō, a laila hoʻihoʻi i ke koena o ke koko i kou kino.
A laila hoʻouna ʻia kēia mau pūnaewele T i hōʻiliʻili ʻia i kahi keʻena hoʻokolohua kūikawā e hoʻololi ʻia i mau pūnaewele CAR T. Hiki i kēia kaʻina hana ke hala ma kahi o 3 a 6 mau pule. I loko o kēia manawa, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau ʻē aʻe, e like me ka chemotherapy, e kāohi i ke kanesa.
Ke mākaukau ʻoe e loaʻa i nā CAR T-cell, e hāʻawi ʻia ʻoe i kahi lāʻau i kapa ʻia ʻo lymphodepleting chemotherapy e pale aku i kou kino mai ka hōʻole ʻana i nā cell hou.
I ka wā o ka mālama ʻana
He maʻalahi loa ka lāʻau maoli. E like me ka hāʻawi ʻana i ka saline, hoʻokomo ʻia kēia mau CAR T-cell i hana hou ʻia i loko o kou kino ma o kahi aʻa (laina IV) ma luna o 5 a 30 mau minuke. I loko o kēia manawa, pono ʻoe e noho ma ka haukapila.
Ma hope o ka mālama ʻana
No ka mea he lāʻau lapaʻau ikaika loa kēia, i kekahi manawa hiki ke loaʻa nā hopena ʻaoʻao koʻikoʻi. No laila, pono paha ʻoe e noho i ka haukapila no kahi o 7-10 mau lā ma hope o ka lāʻau lapaʻau. He mea nui loa ia e noho ma kahi kokoke i ka haukapila kahi i loaʻa ai iā ʻoe ka lāʻau lapaʻau no ka mahina mua, ʻoiai ma hope o kou haʻalele ʻana i ka haukapila. Eia kekahi,
- Pono kekahi e noho pū me ʻoe i nā hola he 24 o ka lā e mālama iā ʻoe inā loaʻa kekahi mau hopena ʻaoʻao.
- Mai hoʻokele no ʻelua mahina ma hope o ka lāʻau lapaʻau. Pono ʻoe i kekahi e hana i kēlā.
He aha nā hopena ʻaoʻao o kēia lāʻau lapaʻau?
ʻElua ʻano hopena ʻaoʻao i maʻamau loa a kūpono ke nānā ʻia me kēia lāʻau lapaʻau. Hiki nō hoʻi ke loaʻa nā hopena ʻaoʻao maʻamau ʻē aʻe.
| ʻAno o ka hopena ʻaoʻao | Nā hiʻohiʻona i ʻike ʻia |
|---|---|
| ʻO ka maʻi hoʻokuʻu cytokine | Kuni, paʻakikī ka hanu ʻana (dyspnea), haʻahaʻa ke koko. (Hiki ke koʻikoʻi kēia) |
| Nā pilikia Neurological | Huikau, paʻakikī i ka ʻōlelo ʻana (aphasia), paʻakikī i ke kākau ʻana (dysgraphia), ʻeha poʻo, hopu ʻana, haʻalulu. |
| ʻĒ aʻe | I ka wā o ka mālama ʻana, aia kahi pilikia o nā maʻi allergies, luhi, kahe koko, hoʻonui ʻia ka pilikia o ka maʻi, a me ka haʻahaʻa o ka potassium (hypokalemia) a me ka sodium (hyponatremia). |
He aha nā pōmaikaʻi a me nā pae holomua o kēia lāʻau lapaʻau?
ʻO ka pōmaikaʻi nui o ka CAR T-Cell Therapy ʻo ia ka hāʻawi ʻana i ka manaʻolana hou i nā poʻe maʻi i hāʻule i nā lāʻau ʻē aʻe. I kekahi manawa hiki iā ia ke ho'ōla loa i ke kanesa (remission). A i ʻole, hiki i kēia lāʻau ke hoʻolōʻihi i ke ola o nā poʻe maʻi.
Eia kekahi laʻana, ua hōʻike ʻia kahi noiʻi 2020 ua ʻoi aku ma mua o 85% o nā keiki i loaʻa i kēia lāʻau no ka leukemia lymphoblastic acute (ALL) ua ho'ōla loa ʻia ma hope o ka lāʻau. Eia kekahi, 60% o lākou i noho ʻole i ka maʻi kanesa ma hope o hoʻokahi makahiki. Akā he mea nui e hoʻomanaʻo ʻaʻole kēia he lāʻau lapaʻau 100% holomua no nā mea āpau, he lāʻau lapaʻau no nā mea āpau. Eia nō naʻe, he ʻanuʻu nui kēia i mua i ke kahua o ka mālama ʻana i ka maʻi kanesa.
Āhea ʻoe e ʻike ai i ke kauka?
He mea nui loa kēia. ʻO kekahi o nā hopena ʻaoʻao o ka CAR T-Cell Therapy, ʻoiai ka Cytokine Release Syndrome a me nā pilikia o ka ʻōnaehana nerve, hiki ke hoʻoweliweli i ke ola .
No laila, ma mua o kou haʻalele ʻana i ka haukapila, e nīnau pono i kāu kauka i nā hōʻailona āu e hopohopo nui ai. Inā hoʻomau nā hōʻailona e like me ke kuni, ke anu, ka ʻeha poʻo , a me ka nausea , e kāhea koke i kāu kauka, a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila.
He kahua hou kēia lāʻau lapaʻau e ulu mau nei. No laila, inā loaʻa iā ʻoe ka maʻi ʻaʻai koko, e kamaʻilio me kāu kauka e pili ana inā kūpono kēia lāʻau lapaʻau iā ʻoe.
Leka Lawe-Home
- He lāʻau lapaʻau immunotherapy ikaika loa ka CAR T-Cell Therapy a pilikino hoʻi i hoʻohana ʻia no kekahi mau ʻano maʻi kanesa koko .
- Hoʻopili kēia i ka hoʻololi ʻana i kāu mau pūnaewele T ponoʻī i loko o kahi lab a laila e hoʻihoʻi iā lākou i loko o kou kino e pepehi i nā hunaola kanesa.
- Hana kēia lāʻau lapaʻau ma ke ʻano he "lāʻau ola," e hakakā ana i ka maʻi kanesa i loko o ke kino i ka wā lōʻihi.
- Koʻikoʻi ma hope o ka mālama ʻanaHe mea nui ka nānā pono ʻana o ke kauka no ka mea hiki ke loaʻa nā hopena ʻaoʻao . Pono e hōʻike koke ʻia i ke kauka inā he mau hōʻailona kānalua.
- ʻOiai ke hāʻawi nei kēia i ka manaʻolana hou no nā poʻe maʻi i hāʻule ʻole i nā lāʻau ʻē aʻe, hiki i kāu kauka ke hoʻoholo inā kūpono ia iā ʻoe.
ʻO ka lāʻau lapaʻau CAR T-Cell, ka lāʻau lapaʻau maʻi kanesa, ke kanesa koko, immunotherapy, ka lāʻau lapaʻau pale kino, nā pūnaewele T, Sri Lanka
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