Mukazindikira kuti muli ndi khansa, mumamva mantha ambiri komanso nkhawa. Koma chifukwa cha kupita patsogolo kwa sayansi ya zamankhwala, masiku ano pali njira zamakono kwambiri zochiritsira khansa. Lero, tikambirana za njira yatsopano komanso yamphamvu kwambiri yochiritsira yomwe yakhala yopambana kwambiri pochiza mitundu ingapo ya khansa , makamaka yomwe imayamba m'magazi.
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Kodi chithandizo cha CAR T-Cell ndi chiyani?
Mwachidule, CAR T-Cell Therapy ndi chithandizo cha immunotherapy chomwe chimagwiritsidwa ntchito pochiza mitundu ina ya khansa ya m'magazi . Maselo athu oteteza thupi ali ngati asilikali m'thupi lathu. Chomwe chithandizochi chimachita ndikutenga ena mwa asilikaliwa m'thupi lanu, otchedwa maselo a T ( maselo a T kapena ma T lymphocytes ) , ndikuwasandutsa asilikali amphamvu omwe amawononga maselo a khansa.
Tangoganizani kutenga maselo anu a T kupita ku labu , kuyika jini yatsopano mkati mwake, ndikuwapatsa "lenzi yapadera" yomwe imatha kuzindikira maselo a khansa. Timatcha maselo a T osinthidwa awa kuti maselo a CAR T. CAR imayimira Chimeric Antigen Receptor. Kenako, mamiliyoni a maselo amphamvu awa amapangidwa ndikubwezeretsedwanso m'thupi lanu. Maselo awa amayenda m'thupi lanu lonse, kufunafuna ndikuwononga maselo a khansa. Nthawi zina, chithandizochi chimatha kuchiritsa khansa ya m'magazi kwathunthu.
Kodi mankhwalawa amagwiritsidwa ntchito pa mitundu iti ya khansa?
Pakadali pano, CAR T-Cell Therapy imagwiritsidwa ntchito pa mitundu ina ya khansa ya m'magazi pomwe mankhwala ena alephera kapena pomwe khansa yabwerera. Tebulo ili pansipa likuwonetsa mitundu ina ya khansa.
| Mtundu wa Khansa | Chiyambi chachidule |
|---|---|
| B-cell acute lymphoblastic leukemia (ALL) | Matenda a khansa ya m'magazi otchedwa acute lymphoblastic leukemia omwe amachokera ku maselo a B. |
| Kufalitsa lymphoma yaikulu ya B-cell | Mtundu wa lymphoma womwe umakula mofulumira. |
| Follicular lymphoma | Mtundu wa lymphoma yomwe ikukula pang'onopang'ono. |
| Mantle cell lymphoma | Mtundu wa lymphoma womwe nthawi zambiri sudziwika bwino, koma ndi woopsa. |
| Myeloma yambiri | Khansa ya m'mafupa yomwe imapezeka m'maselo a plasma. |
| Matenda a lymphoma a B-cell lymphoma a m'mimba | Mtundu wa lymphoma womwe umapezeka pakati pa chifuwa. |
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Check Availability →Chabwino, tsopano tiyeni tiwone momwe izi zimagwirira ntchito.
Kuti timvetse izi, choyamba tiyeni tiphunzire zambiri za maselo a T m'thupi lathu. Selo lililonse m'thupi lathu lili ndi mapuloteni otchedwa ma antigen pamwamba pake. Izi zili ngati khadi la ID lomwe selo lililonse lili nalo. Maselo a khansa ali ndi khadi la ID losinthidwa komanso losazolowereka.
Maselo athu a T ali ndi ma receptor . Ma receptor amenewa ndi omwe amazindikira ma cell a khansa omwe ali ndi ma ID card osazolowereka (antigens). Koma nthawi zina maselo a khansa amakhala achinyengo kwambiri. Amabisala ku ma cell a T awa.
Apa ndi pamene tikufunika thandizo la maselo a CAR T. Awa ndi maselo anu a T omwe aphunzitsidwa mwapadera mu labu ndi kusinthidwa kuti azindikire antigen yeniyeniyo pamaselo a khansa .
Chithandizochi chimalola maselowa kuti asangopha maselo a khansa okha, komanso kuti agawikane ndikuchulukana m'thupi. Izi zikutanthauza kuti mumapeza maselo olimbana ndi khansa omwe amatha nthawi yayitali. Ichi ndichifukwa chake madokotala amatcha chithandizochi kuti "mankhwala amoyo."
Kodi njira yochizira imagwira ntchito bwanji?
Njira yonseyi imachitika m'magawo angapo.
Musanalandire chithandizo
Choyamba, muyenera kusonkhanitsa maselo oyera a m'magazi, makamaka maselo a T, kuchokera m'thupi lanu. Izi zimatchedwa leukapheresis.Iyi ndi njira yofanana ndi kupereka magazi. Makina amatenga magazi anu ena, amalekanitsa maselo oyera okha, kenako amabwezera magazi otsalawo m'thupi lanu.
Maselo a T osonkhanitsidwawa amatumizidwa ku labotale yapadera kuti akasanduke maselo a CAR T. Izi zitha kutenga milungu itatu mpaka isanu ndi umodzi. Panthawiyi, mutha kupatsidwa mankhwala ena, monga chemotherapy, kuti muchepetse khansa.
Mukakonzeka kulandira maselo a CAR T, mudzapatsidwa chithandizo chotchedwa lymphodepleting chemotherapy kuti thupi lanu lisakane maselo atsopano.
Pa nthawi ya chithandizo
Chithandizo chenichenicho n'chosavuta kwambiri. Monga momwe zimakhalira popereka saline, maselo atsopano a CAR T amalowetsedwa m'thupi lanu kudzera mu mtsempha (IV line) kwa mphindi 5 mpaka 30. Panthawiyi, muyenera kukhala m'chipatala.
Pambuyo pa chithandizo
Popeza chithandizochi ndi champhamvu kwambiri, nthawi zina zotsatirapo zoyipa zimatha kuchitika. Chifukwa chake, mungafunike kukhala m'chipatala kwa masiku pafupifupi 7-10 mutalandira chithandizocho. Ndikofunikira kwambiri kukhala pafupi ndi chipatala chomwe mudalandira chithandizo mwezi woyamba, ngakhale mutatuluka kuchipatala. Komanso,
- Wina ayenera kukhala nanu maola 24 patsiku kuti akuthandizeni ngati muli ndi zotsatirapo zina.
- Musayendetse galimoto kwa miyezi iwiri mutalandira chithandizo. Mukufuna wina kuti achite zimenezo.
Kodi zotsatirapo zake ndi ziti?
Pali mitundu iwiri ya zotsatira zoyipa zomwe zimapezeka kwambiri ndipo ziyenera kuganiziridwa bwino ndi mankhwalawa. Zotsatira zina zoyipa zimathanso kuchitika.
| Mtundu wa zotsatira zoyipa | Zinthu zooneka |
|---|---|
| Matenda Otulutsa Cytokine | Malungo, kuvutika kupuma movutikira), kuthamanga kwa magazi kutsika. (Izi zitha kukhala zoopsa kwambiri) |
| Mavuto a Mitsempha | Kusokonezeka, kuvutika kulankhula (aphasia), kuvutika kulemba (dysgraphia), mutu, khunyu, ndi kunjenjemera. |
| Zina | Pa nthawi ya chithandizo, pamakhala chiopsezo cha ziwengo, kutopa, kutuluka magazi, chiopsezo chowonjezeka cha matenda, komanso kuchepa kwa potaziyamu (hypokalemia) ndi sodium (hyponatremia). |
Kodi ubwino ndi kuchuluka kwa chithandizochi ndi kotani?
Ubwino waukulu wa CAR T-Cell Therapy ndikuti imapereka chiyembekezo chatsopano kwa odwala omwe alephera kulandira chithandizo china. Nthawi zina imatha kuchiritsa khansa kwathunthu (kuchotsa khansa). Kupanda kutero, chithandizochi chingatalikitse moyo wa odwala.
Mwachitsanzo, kafukufuku wa 2020 adawonetsa kuti ana opitilira 85% omwe adalandira chithandizochi cha khansa ya m'magazi (ALL) adachira kwathunthu atalandira chithandizo. Komanso, 60% ya iwo analibe khansa patatha chaka chimodzi. Koma ndikofunikira kukumbukira kuti iyi si njira yopambana 100% ya aliyense, koma njira yochiritsira aliyense. Komabe, iyi ndi sitepe yayikulu yopita patsogolo pankhani yochiza khansa.
Kodi muyenera kupita kwa dokotala liti?
Izi ndizofunikira kwambiri. Zina mwa zotsatirapo za CAR T-Cell Therapy, makamaka Cytokine Release Syndrome ndi mavuto a mitsempha, zitha kukhala zoopsa kwambiri .
Choncho musanatuluke kuchipatala, onetsetsani kuti mwafunsa dokotala wanu zizindikiro zomwe muyenera kuda nkhawa nazo kwambiri. Ngati zizindikiro monga malungo, kuzizira, mutu , ndi nseru zikupitirira, imbani dokotala wanu nthawi yomweyo, kapena pitani ku Dipatimenti Yothandiza Pachipatala (ETU).
Chithandizochi chikadali gawo latsopano lomwe likukulabe. Chifukwa chake ngati muli ndi khansa ya m'magazi, lankhulani ndi dokotala wanu ngati chithandizochi chili choyenera kwa inu.
Uthenga Wopita Nawo Kunyumba
- Chithandizo cha CAR T-Cell ndi chithandizo champhamvu kwambiri komanso chopangidwa mwapadera chomwe chimagwiritsidwa ntchito pa mitundu ina ya khansa ya m'magazi .
- Izi zikuphatikizapo kusintha ma T-cell anu mu labu kenako nkuwabwezeretsa m'thupi lanu kuti aphe maselo a khansa.
- Mankhwalawa amagwira ntchito ngati "mankhwala amoyo," omwe amalimbana ndi khansa yomwe imatenga nthawi yayitali m'thupi.
- Zoopsa pambuyo pa chithandizoKuyang'aniridwa ndi dokotala mosamala n'kofunika chifukwa zotsatirapo zake zingachitike. Zizindikiro zilizonse zokayikitsa ziyenera kufotokozedwa kwa dokotala nthawi yomweyo.
- Ngakhale izi zikupereka chiyembekezo chatsopano kwa odwala omwe alephera kulandira chithandizo china, dokotala wanu yekha ndi amene angasankhe ngati chili choyenera kwa inu.
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