Ffenna tumanyi engeri gye kizibu n’okusoomoozebwa okulwanyisa kookolo. Naye olw’okukulaakulana kwa ssaayansi w’obusawo buli lunaku, obujjanjabi obupya era obuyiiya buzuulibwa. Leero, tugenda kwogera ku nkola empya abantu bangi gye balina essuubi ddene, nga tukozesa obutoffaali bw’omubiri gwaffe okujjanjaba kookolo. Kino kiyitibwa TIL Therapy.
Mu ngeri ennyangu, TIL Therapy kye ki?
Okay, kino tukikuume nga kyangu. Oboolyawo owulidde ku bujjanjabi bw'abaserikale b'omubiri . Kikwata ku kusitula abaserikale baffe, eggye lyaffe erirwanyisa endwadde, okuyamba okusaanyaawo obutoffaali bwa kookolo. Obujjanjabi bwa TIL y’emu ku bujjanjabi obwo obw’obusimu obuziyiza endwadde.
Kino kikozesa ekika ky’obutoffaali obuziyiza endwadde obw’enjawulo ennyo, obw’amaanyi mu mubiri gwaffe. Obutoffaali buno buyitibwa tumor-infiltrating lymphocytes , oba TILs mu bufunze.
Lowooza ku kino, emibiri gyaffe girina ebika by’abajaasi (immune cells) eby’enjawulo abalawuna enguudo nga banoonya endwadde. Naye abajaasi bano abayitibwa TILs basingako n’okubeera ab’enjawulo. Zigenda ddala mu bizimba, kwe kugamba, ne zibiyingirira, ne ziyiga ddala obunafu bw’obutoffaali obwo obwa kookolo n’engeri esinga obulungi ey’okubusaanyaawo. Balinga ttiimu y’amagye ag’enjawulo eyeesogga enkambi y’omulabe ne basikawutu.
Kale obuzibu buliwa? Obuzibu buli nti, abaserikale baffe abaserikale tebasobola kukola kimala ku bajaasi bano abagezi, oba TILs. Kizibu abatono abakola balina okulwanyisa kookolo ono bokka ne bawangula.
Awo obujjanjabi bwa TIL we buyingirira Obujjanjabi buno kye bukola kwe kuggyamu abaserikale abo aba TIL abasinga obugezi mu mubiri gwo, ne babakubisaamu obuwumbi, n’okola eggye ery’amaanyi, n’oluvannyuma n’obazza mu mubiri gwo. Olwo eggye lino eddene ne ligenda ne lisaanyaawo obutoffaali bwa kookolo.
Bujjanjabi buno buyinza okukozesebwa ku bika ki ebya kookolo?
Okuva mu mwaka gwa 2024, ekitongole kya U.S. Food and Drug Administration (FDA) kyakkiriza eddagala lya TIL eriyitibwa lifileucel (Amtagvi®) . Ekoleddwa mu ngeri ey'enjawulo okujjanjaba ekika kya kookolo w'olususu ayitibwa melanoma . Wabula tekisaanira bika byonna eby’obulwadde bwa melanoma. Obujjanjabi buno busaanira:
- Tekisobola kuwona kulongoosebwa kwokka, .
- Kookolo asaasaanidde mu bitundu by’omubiri ebirala (metastatic cancer), .
- Era eri abo abataddamu bujjanjabi bwa mutindo abakugu mu by’obulwadde bwa kkansa bwe batera okusooka okuwa.
Bw’oba olina embeera efaananako bwetyo, oyinza okuba omulungi okuweebwa obujjanjabi buno. Olina okwogera n’omusawo wo ku nsonga eno.
Okugatta ku ekyo, abasawo n’abanoonyereza banoonyereza ku buwanguzi bw’obujjanjabi bwa TIL ku bika bya kookolo ebirala ebiwerako, omuli:
- Kookolo w’amabeere
- Kookolo w’omumwa gwa nnabaana
- Kookolo w’olubuto olunene
- Kookolo w’omutwe n’ensingo
- Kookolo w’amawuggwe atali wa butoffaali butono
Obujjanjabi buno bukola butya? Ka tuyige mutendera ku mutendera.
Kino si kintu ekibaawo mu lunaku lumu. Ekikulu kwe kuwa obutoffaali bwo obwa TIL okudda gy’oli. Naye waliwo emitendera egiwerako nga tetunnatuuka ku nsonga eyo. Ka tulabe emitendera egyo mu nsengeka.
| Emitendera | Kiki ekigenda mu maaso? |
|---|---|
| 1. Okuggyawo ekitundu ky’ekizimba (Okuggyawo) . | Okusooka, bakubuzaabuza, omusawo alongoosa n’aggyako akatundu akatono ku kizimba kyo, nga kali nga ka grapefruit. Kino kisindikibwa mu laabu. Tojja kuwulira bulumi bwonna. |
| 2. Okukungula TIL n’okugaziya | Mu laboratory, obutoffaali bwa TIL bwawulwa okuva mu kizimba. Oluvannyuma, nga bakozesa obukodyo obw’enjawulo, zikubisibwamu obuwumbi. Enkola eno etwala wiiki nga ttaano. Olwo, eggye lino ery’obutoffaali lisindikibwa eri omusawo wo. |
| 3. Okufuyira eddagala eriweweeza ku bulwadde bwa Chemotherapy | Ojja kuweebwa ekitanda mu ddwaaliro n’oweebwa eddagala lya Chemotherapy okumala ennaku ttaano ku musanvu. Kino kikoleddwa okuteekateeka omubiri gwo eri eggye eppya ery’obutoffaali bwa TIL. |
| 4. Okuwa omubiri obutoffaali bwa TIL (TIL transfusion) . | Kati kye kitundu ekisinga obukulu. Obutoffaali bwo obwa TIL obukolebwa mu laabu, bufukibwa mu mubiri gwo ng’omunnyo. Kino kikolebwa omulundi gumu gwokka. Kitwala essaawa nga bbiri. |
| 5. Okufuyira ekirungo kya interleukin-2 | Oluvannyuma lw’okuweebwa obutoffaali bwa TIL, ojja kuweebwa eddagala eriyitibwa Interleukin-2 (IL-2) okumala ennaku ssatu oba ttaano. Kino nakyo ddagala lya busimu obuziyiza endwadde. Kino kye kikola kwe kukola obutoffaali bwa TIL obubadde buyingiziddwa mu mubiri ne bubukubiriza okulumba kookolo. |
Oluvannyuma lw’okujjanjabibwa, ojja kwetaaga okubeera mu ddwaaliro okumala ennaku endala ntono. Mu kiseera ekyo, ttiimu y’abasawo ejja kulondoola n’obwegendereza engeri omubiri gwo gye gukwatamu obujjanjabi. Oluvannyuma lw’ekyo, ojja kuweebwa amagezi okubeera mu kifo kyangu okutuukako mu ddwaaliro okumala wiiki ntono. Kino kikolebwa osobole okufuna obujjanjabi mu bwangu singa ofuna ebizibu byonna.
Obujjanjabi buno obujjuvu butwala bbanga ki?
Obujjanjabi bwa TIL bujjanjabi bwa mulundi gumu . Wabula enkola yonna okuva ku lunaku kookolo lw’aggyibwawo, okutuuka ku lunaku obutoffaali lwe butondebwa, okutuuka ku kiseera ky’ojjanjabwa, okutuuka ku kiseera ky’odda mu mbeera eya bulijjo eyinza okutwala wiiki nga 10 . Ojja kuba olina okumala wiiki nga bbiri mu ddwaaliro.
Migaso ki n’akabi akali mu kino?
Emigaso gy’obujjanjabi buno
Buno bujjanjabi bwa maanyi nnyo, obukwata ku muntu yenna.
- Obulumbaganyi obugendereddwamu: Obujjanjabi buno butunuulira butereevu obutoffaali bwa kookolo bwokka. N’olwekyo, waliwo okwonooneka okutono ennyo ku butoffaali obulamu. Kino nakyo kikendeeza ku bulabe bw’ebizibu ebivaamu.
- Obukuumi obw’ekiseera ekiwanvu: Obutoffaali bwa TIL obufukibwa mu mubiri gwo busigala mu mubiri gwo okumala emyaka. Kino kitegeeza nti obujjanjabi ne bwe buba buwedde, obutoffaali buno bweyongera okulwanyisa kookolo.
- Essuubi Empya: Oboolyawo ekisinga obukulu, kino kireeta essuubi ddene eri abantu abalina kookolo wa melanoma eyali alowoozebwa nti tawona.
Okunoonyereza okwakolebwa mu 2023 kwalaga nti oluvannyuma lw’emyaka ena nga bafunye obujjanjabi bwa TIL, abantu 7 ku buli 10 abaafuna obujjanjabi buno tebaalina bulwadde oba okukulaakulana. Mu bantu 3 ku 10, ebizimba byali bikendedde oba nga biweddewo ddala.
Obulabe obuli mu bujjanjabi
Nga bwe kiri ku bujjanjabi bwonna, waliwo akabi akayinza okuvaamu. Ebizibu bino bisinga kuva ku bujjanjabi bwa ddagala n’obujjanjabi bwa interleukin-2 (IL-2) . Ebizibu ebiva mu kugaba obutoffaali bwa TIL tebitera nnyo. Ebizibu ebisinga okuvaamu bye bino:
- Embiro
- Obukoowu
- Omusujja n’okuziyira
- Omutima obutakuba bulungi (arrhythmia) .
- Puleesa ekka
- Okuziyira n’okusiiyibwa
- Okusiiyibwa kw’olususu
Si bulijjo nnyo, obujjanjabi bwa IL-2 buyinza okuleeta ekizibu eky’amaanyi ekiyitibwa capillary leak syndrome . Naye teweeraliikiriranga, omusawo wo ajja kukunnyonnyola akabi kano konna nga tonnatandika kujjanjaba.
Kintwalira bbanga ki okuwona?
Kiyinza okutwala wiiki bbiri oba okusingawo nga tonnatandika kuwulira bulungi oluvannyuma lwa ddoozi yo eyasembayo eya IL-2. Kino kiri bwe kityo kubanga omubiri gwetaaga obudde okudda engulu okuva ku situleesi y’enkola yonna ey’obujjanjabi (okulongoosa, eddagala eriweweeza ku bulwadde, IL-2).
Waliwo kye nsobola okukola okusobola okwanguyiza obujjanjabi?
Eno si nkola nnyangu. Eno y’ensonga lwaki ttiimu yo ey’abasawo ejja kuba ekutunuulira nnyo mu kiseera kyonna ky’onoomala mu ddwaaliro. Bulijjo bajja kukukebera, bakukebere omusaayi, era bakakasa nti omubiri gwo gwetegese okujjanjabibwa. Bajja kukuwa eddagala eryetaagisa okukendeeza ku buzibu obuvaamu, era buli kiseera bajja kukulondoola oba tewali buzibu bwonna. Ky’olina okukola kwe kugoberera ebiragiro ebiweereddwa ttiimu y’abasawo n’obabuulira ku buzibu bwonna bw’owulira.
Nkubire omusawo ku ssaawa mmeka?
Bw’odda eka ng’omaze okujjanjabibwa n’ofuna obubonero bwonna obw’obulwadde (omusujja, okulumwa omubiri), oba n’ofuna ebizibu byonna by’otosuubira oba eby’amaanyi, kuba essimu y’omusawo mu bwangu.
Tolowooza mirundi ebiri. Bw’owulira enkyukakyuka entonotono, ekintu ekiwulira nga ‘kino si kituufu,’ tegeeza omusawo wo amangu ago.
Bw’oba olina obulwadde bwa melanoma obutaddamu bujjanjabi bulala, obujjanjabi bwa TIL buyinza okuba enkola ennungi gy’oli. Singa omusawo akuwa amagezi ku bujjanjabi buno, kakasa nti owuliriza bulungi enkola eno mu bujjuvu, obudde bwe bunaatwala, n’ebiyinza okukosa embeera yo. Omusawo wo asobola bulungi okukunnyonnyola emigaso n’akabi akali mu bujjanjabi buno.
Obubaka Obutwala Awaka
- Obujjanjabi bwa TIL bujjanjabi bupya era bwa maanyi obukozesa obutoffaali bwo obw’abaserikale b’omubiri (TILs) okujjanjaba kookolo.
- Mu kiseera kino kikkirizibwa ku bulwadde bwa kookolo w’olususu (melanoma), ekika kya kookolo w’olususu ataddamu bujjanjabi bulala.
- Enkola eno ey’obujjanjabi erimu okulongoosa okuggyamu ekitundu kya kookolo, okukula obutoffaali mu laboratory, okukozesa eddagala n’obujjanjabi obulala, era enkola yonna esobola okutwala wiiki nga 10.
- Kino kigenderera era ne kisaanyaawo obutoffaali bwa kookolo, nga tewali kwonoona butoffaali bwa bulijjo. Kyokka waliwo ebizibu ebimu n’obulabe.
- Bw’oba olina ekibuuzo kyonna ku bujjanjabi bwo oba ng’ofuna obuzibu bwonna oluvannyuma lw’okujjanjabwa, kikulu nnyo okwogera n’omusawo mu lwatu ku nsonga eno.
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