Thaum koj paub tias koj muaj mob qog noj ntshav, koj ntshai thiab ntxhov siab heev. Tab sis nrog kev nce qib ntawm kev tshawb fawb kho mob, niaj hnub no muaj cov txheej txheem kho mob siab heev los tawm tsam mob qog noj ntshav. Niaj hnub no, peb yuav tham txog ib txoj kev kho mob tshiab thiab muaj zog heev uas tau ua tiav zoo hauv kev kho ntau hom mob qog noj ntshav , tshwj xeeb tshaj yog cov uas loj hlob hauv cov ntshav.
Kev Kho Mob CAR T-Cell yog dab tsi?
Hais yooj yim xwb, CAR T-Cell Therapy yog kev kho mob siv los kho qee hom mob qog ntshav . Peb cov hlwb tiv thaiv kab mob zoo li cov tub rog hauv peb lub cev. Qhov kev kho mob no ua yog coj qee cov tub rog no hauv koj lub cev, hu ua T cell ( T cell lossis T lymphocytes ) , thiab hloov lawv mus ua cov neeg sib ntaus sib tua zoo heev uas rhuav tshem cov hlwb qog ntshav.
Xav txog seb koj coj koj cov T cell mus rau hauv chav kuaj , muab ib lub gene tshiab rau hauv lawv, thiab muab ib lub "lens tshwj xeeb" rau lawv uas tuaj yeem paub txog cov cell mob qog noj ntshav. Peb hu cov cell T uas tau hloov kho no ua CAR T-cells . `CAR` sawv cev rau `Chimeric Antigen Receptor`. Tom qab ntawd, ntau lab ntawm cov cell super-fighter no tau tsim thiab muab rov qab rau hauv koj lub cev. Cov cell no ces mus ncig thoob plaws koj lub cev, nrhiav thiab rhuav tshem cov cell mob qog noj ntshav. Qee zaum, kev kho mob no tuaj yeem kho cov mob qog ntshav tag nrho.
Cov kev kho mob no siv rau hom mob qog noj ntshav twg?
Tam sim no, CAR T-Cell Therapy tsuas yog siv rau qee hom mob qog ntshav uas lwm yam kev kho mob tsis ua tiav lossis qhov twg mob qog ntshav tau rov qab los. Lub rooj hauv qab no teev qee hom mob qog ntshav no.
| Hom Mob Cancer | Ib qho kev taw qhia luv luv |
|---|---|
| Kab mob B-cell acute lymphoblastic leukemia (ALL) | Kab mob leukemia lymphoblastic uas tshwm sim los ntawm B-cell. |
| Diffuse loj B-cell lymphoma | Ib hom mob lymphoma uas loj hlob sai. |
| Cov kab mob follicular lymphoma | Ib hom mob lymphoma uas loj hlob qeeb. |
| Mantle cell lymphoma | Feem ntau tsis tshua muaj, tab sis hom lymphoma hnyav heev. |
| ntau yam mob myeloma | Mob qog nqaij hlav pob txha uas tshwm sim hauv cov hlwb ntshav. |
| Thawj qhov mediastinal loj B-cell lymphoma | Ib hom lymphoma uas tshwm sim hauv nruab nrab ntawm lub hauv siab. |
Zoo, tam sim no cia peb saib seb qhov no ua haujlwm li cas.
Yuav kom nkag siab qhov no, cia peb kawm ntxiv me ntsis txog cov qe ntshav T hauv peb lub cev tiv thaiv kab mob. Txhua lub qe ntshav hauv peb lub cev muaj cov protein hu ua antigens ntawm nws qhov chaw. Cov no zoo li daim npav ID uas txhua lub qe ntshav muaj. Cov qe ntshav qog muaj daim npav ID uas hloov pauv thiab tsis zoo li qub.
Peb cov T cell muaj cov receptors . Cov receptors no yog cov uas paub txog cov neeg nkag tebchaws xws li cov cell mob qog noj ntshav uas muaj daim npav ID txawv txawv (antigens). Tab sis qee zaum cov cell mob qog noj ntshav ntse heev. Lawv nkaum ntawm cov T cell no.
Nov yog qhov uas peb xav tau kev pab los ntawm CAR T-cells. Cov no yog koj cov T cell uas tau raug cob qhia tshwj xeeb hauv chav kuaj thiab hloov kho kom paub txog ib qho antigen tshwj xeeb ntawm cov cell mob qog noj ntshav .
Kev kho mob no tso cai rau cov hlwb no tsis yog tsuas yog tua cov hlwb qog noj ntshav xwb, tab sis kuj faib thiab loj hlob hauv lub cev. Qhov no txhais tau tias koj tau txais cov hlwb tua kab mob qog noj ntshav mus sij hawm ntev. Qhov no yog vim li cas cov kws kho mob hu qhov kev kho mob no ua "tshuaj muaj sia."
Cov txheej txheem kho mob ua haujlwm li cas?
Tag nrho cov txheej txheem no tshwm sim hauv ntau theem.
Ua ntej kev kho mob
Ua ntej, koj yuav tsum tau sau cov qe ntshav dawb, tshwj xeeb yog cov qe ntshav T, los ntawm koj lub cev. Qhov no hu ua leukapheresis.Qhov no yog ib txoj kev ua zoo ib yam li kev pub ntshav. Lub tshuab yuav siv ib feem ntawm koj cov ntshav, cais tsuas yog cov qe ntshav dawb xwb, thiab tom qab ntawd xa cov ntshav seem rov qab rau koj lub cev.
Cov qe ntshav T uas tau sau los no ces raug xa mus rau chav kuaj mob tshwj xeeb kom hloov mus ua CAR T-cells. Cov txheej txheem no yuav siv sijhawm li 3 txog 6 lub lis piam. Thaum lub sijhawm no, koj yuav tau txais lwm yam kev kho mob, xws li kev siv tshuaj kho mob qog noj ntshav, los tswj tus mob qog noj ntshav.
Thaum koj npaj txhij txais CAR T-cells, koj yuav raug muab kev kho mob hu ua lymphodepleting chemotherapy los tiv thaiv koj lub cev kom tsis txhob tsis lees txais cov cell tshiab.
Thaum lub sijhawm kho mob
Kev kho mob tiag tiag yooj yim heev. Ib yam li kev muab dej ntsev, cov CAR T-cell tshiab no raug txhaj rau hauv koj lub cev los ntawm txoj hlab ntsha (IV line) li ntawm 5 txog 30 feeb. Thaum lub sijhawm no, koj yuav tsum nyob hauv tsev kho mob.
Tom qab kev kho mob
Vim tias qhov no yog kev kho mob muaj zog heev, qee zaum cov kev mob tshwm sim loj heev tuaj yeem tshwm sim. Yog li ntawd, koj yuav tsum nyob hauv tsev kho mob li 7-10 hnub tom qab kev kho mob. Nws yog ib qho tseem ceeb heev uas yuav tsum nyob ze rau tsev kho mob uas koj tau txais kev kho mob rau thawj lub hlis, txawm tias tom qab koj tawm hauv tsev kho mob lawm los xij. Tsis tas li ntawd,
- Yuav tsum muaj ib tug neeg nrog koj nyob 24 teev hauv ib hnub los saib xyuas koj yog tias koj muaj tej yam kev mob tshwm sim.
- Tsis txhob tsav tsheb li ob lub hlis tom qab kho mob tas. Koj xav tau lwm tus los ua qhov ntawd.
Cov kev mob tshwm sim ntawm kev kho mob no yog dab tsi?
Muaj ob hom kev phiv uas feem ntau tshwm sim thiab tsim nyog them sai sai rau kev kho mob no. Lwm yam kev phiv uas tshwm sim kuj tseem yuav tshwm sim.
| Hom kev phiv tshuaj | Cov yam ntxwv pom tseeb |
|---|---|
| Cytokine Release Syndrome | Kub taub hau, ua pa nyuaj (ua tsis taus pa), ntshav qis. (Qhov no tuaj yeem ua rau mob hnyav) |
| Cov Teeb Meem Txog Lub Hlwb | Tsis meej pem, hais lus tsis tau zoo (aphasia), sau ntawv tsis tau zoo (dysgraphia), mob taub hau, qaug dab peg, tshee hnyo. |
| Lwm yam | Thaum lub sijhawm kho mob, muaj kev pheej hmoo ntawm kev ua xua, qaug zog, los ntshav, muaj kev pheej hmoo ntawm kev kis kab mob, thiab cov potassium qis (hypokalemia) thiab sodium qis (hyponatremia). |
Cov txiaj ntsig thiab kev vam meej ntawm kev kho mob no yog dab tsi?
Qhov zoo tshaj plaws ntawm CAR T-Cell Therapy yog tias nws muab kev cia siab tshiab rau cov neeg mob uas tsis tau ua tiav lwm yam kev kho mob. Qee zaum nws tuaj yeem kho tau tag nrho cov mob qog noj ntshav (kev zam txim). Txwv tsis pub, kev kho mob no tuaj yeem ua rau cov neeg mob muaj sia nyob ntev dua.
Piv txwv li, ib txoj kev tshawb fawb xyoo 2020 tau qhia tias ntau dua 85% ntawm cov menyuam yaus uas tau txais kev kho mob no rau mob qog ntshav lymphoblastic (ALL) tau zoo tag nrho tom qab kev kho mob. Tsis tas li ntawd, 60% ntawm lawv tseem tsis muaj mob qog noj ntshav tom qab ib xyoos. Tab sis nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qhov no tsis yog kev kho mob zoo 100% rau txhua tus, kev kho mob rau txhua tus. Txawm li cas los xij, qhov no yog ib kauj ruam loj hauv kev kho mob qog noj ntshav.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Qhov no tseem ceeb heev. Qee qhov kev phiv ntawm CAR T-Cell Therapy, tshwj xeeb tshaj yog Cytokine Release Syndrome thiab teeb meem ntawm lub paj hlwb, tuaj yeem ua rau tuag taus .
Yog li ntawd, ua ntej koj tawm hauv tsev kho mob, nco ntsoov nug koj tus kws kho mob seb koj yuav tsum txhawj xeeb txog cov tsos mob dab tsi. Yog tias cov tsos mob xws li kub taub hau, txias, mob taub hau , thiab xeev siab tseem muaj, hu rau koj tus kws kho mob tam sim ntawd, lossis mus rau chav kho mob ceev (ETU) ntawm tsev kho mob.
Txoj kev kho mob no tseem yog ib qho kev kho mob tshiab uas tseem tab tom txhim kho. Yog li ntawd, yog tias koj muaj mob qog ntshav, nrog koj tus kws kho mob tham txog seb txoj kev kho mob no puas yog rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- CAR T-Cell Therapy yog kev kho mob immunotherapy muaj zog heev thiab siv rau qee hom mob qog ntshav .
- Qhov no suav nrog kev hloov kho koj cov T-cell hauv chav kuaj thiab tom qab ntawd muab lawv rov qab rau hauv koj lub cev kom tua cov cell mob qog noj ntshav.
- Kev kho mob no ua haujlwm zoo li "tshuaj muaj sia," tawm tsam mob qog noj ntshav mus sij hawm ntev hauv lub cev.
- Mob hnyav tom qab kev kho mobYuav tsum tau saib xyuas koj tus kheej kom zoo vim tias tej zaum yuav muaj tej yam tsis zoo tshwm sim. Yog muaj tej yam tsos mob txawv txawv ces yuav tsum qhia rau koj tus kws kho mob tam sim ntawd.
- Txawm hais tias qhov no muab kev cia siab tshiab rau cov neeg mob uas tau ua tsis tiav lwm yam kev kho mob, tsuas yog koj tus kws kho mob thiaj li txiav txim siab tau seb nws puas yog rau koj.
Kev Kho Mob CAR T-Cell, kev kho mob qog noj ntshav, mob qog ntshav hauv cov ntshav, kev kho mob tiv thaiv kab mob, kev kho mob tiv thaiv kab mob, T cell, Sri Lanka
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus