Tiyeni tiphunzire za zotsatira zoyipa za chithandizo cha immunotherapy, chithandizo cha khansa?

Tikadziwa kuti tili ndi khansa, kenako n’kukamba za chithandizo, nthawi zambiri timachita mantha, sichoncho? Makamaka za zotsatira zake zoyipa. Koma njira yochiritsira yomwe tikambirane lero, yotchedwa immunotherapy, ndi yosiyana pang’ono ndi njira zachikhalidwe monga chemotherapy. Imagwiritsa ntchito gulu lanu lankhondo, ndiko kuti, chitetezo chamthupi, kuti limenyane ndi maselo a khansa. Choncho tiyeni tiwone chithandizo chabwino kwambiri ichi ndi zotsatira zake zoyipa, mwachidule, kuti mumvetse.

Kodi chithandizo cha immunotherapy n'chiyani?

Mwachidule, chithandizo cha immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo chachilengedwe cha thupi lanu, chitetezo chamthupi, kuti chipeze ndikuwononga maselo a khansa. Taganizirani izi ngati apolisi mkati mwa matupi athu. Ntchito yawo ndi kupeza ndikuwononga zinthu zovulaza monga majeremusi, mavairasi, ndi maselo osayenera omwe amakula m'thupi lathu, kutipangitsa kukhala athanzi.

Koma maselo a khansa ndi mtundu wa selo wochenjera kwambiri. Amatha kubisala chitetezo cha mthupi popanda kugwidwa. Monga momwe wakuba amabisalira apolisi. Akabisala motere, amagawanika mwachangu, kufalikira, ndikuyambitsa vuto lalikulu.

Choncho chomwe chithandizo cha immunotherapy chimachita ndi kupatsa chitetezo chamthupi chanu maphunziro apadera ndi mphamvu , zomwe zimapangitsa kuti chikhale champhamvu polimbana ndi maselo a khansa. Izi zitha kuchitika m'njira ziwiri:

• Zimalimbitsa chitetezo chamthupi chanu ndipo zimapangitsa kuti chipange maselo ambiri olimbana ndi khansa.
• Zimathandiza maselo oteteza thupi omwe alipo kale kuzindikira ndikuwononga maselo a khansa obisika.

Chifukwa chakuti imalimbitsa chitetezo cha mthupi lanu, chithandizo cha immunotherapy chakhala chithandizo chopambana kwambiri cha mitundu yambiri ya khansa.

Nchifukwa chiyani chithandizo cha immunotherapy chimayambitsa zotsatirapo zoyipa?

Monga chithandizo chilichonse, chithandizo cha immunotherapy chingakhale ndi zotsatirapo zake. Chifukwa chake n'chosavuta. Monga tanenera kale, chithandizochi chimagwira ntchito powonjezera mphamvu ya chitetezo chamthupi. Chifukwa chake, maselo oteteza thupi awa omwe amagwira ntchito mopitirira muyeso nthawi zina amayamba molakwika kuukira osati maselo a khansa okha, komanso maselo anu athanzi .

Kuukira kumeneku pa minofu yathanzi kumatchedwa `zotsatira zoyipa zokhudzana ndi chitetezo chamthupi (irAE).` Ichi ndi chomwe chimayambitsa kutupa m'minofu yathanzi, ndipo mumayamba kumva ngati zotsatirapo zosiyanasiyana.

Kodi zotsatirapo zake zimakhala zofala bwanji?

Musachite mantha ndi izi. Si aliyense amene amakumana ndi zotsatirapo zoyipa. Pafupifupi 20% ya anthu omwe amatenga chithandizo cha immunotherapy ndi omwe amakumana ndi vuto la `irAE` lamtunduwu. Komanso, zotsatirapo zambiri zomwe zimachitika zimakhala zochepa komanso zosavuta kuzithetsa.

Koma chofunika kwambiri ndi kuuza dokotala wanu nthawi yomweyo za kusintha kulikonse komwe mukuona m'thupi lanu, kaya panthawi ya chithandizo cha immunotherapy kapena pambuyo pake. Kaya ndi kakang'ono bwanji, nthawi zonse ndibwino kudziwa zambiri.

Mungakhale ndi mwayi wokumana ndi zotsatirapo zoyipa ngati mutamwa mankhwala ambiri a immunotherapy nthawi imodzi, kapena ngati muli kale ndi matenda a autoimmune. Matenda a autoimmune ndi vuto lomwe chitetezo cha mthupi chanu chimawononga minofu yanu yathanzi molakwika.

Kodi zotsatirapo zoyipa kwambiri ndi ziti?

Zotsatira zoyipa zofala kwambiri ndi izi:

• Kutopa: Kumva kutopa kwambiri mpaka kufika poti sangathe kuchita chilichonse.
• Kuyabwa: Kuyabwa kofiira, kuyabwa pakhungu.
• Kutsegula m'mimba: Kuyenda kwa matumbo.
• Kusanza ndi kusanza: Kumva kudwala ndi kusanza.
• Kuchepa kwa mahomoni a chithokomiro: Kulephera kugwira ntchito bwino kwa chithokomiro.

Kodi chithandizo cha immunotherapy chimakhudza bwanji ziwalo zosiyanasiyana?

Popeza chitetezo chathu chamthupi chimateteza thupi lonse, dongosololi, lolimbikitsidwa ndi chithandizo cha chitetezo chamthupi, lingakhudze chiwalo chilichonse m'thupi. Ngakhale zizindikiro zambirizi ndi zazing'ono, zina zimatha kukhala zazikulu. Chifukwa chake, ndikofunikira kudziwitsa dokotala wanu za zizindikiro zilizonse .

Kuti timvetse mosavuta, tiyeni tigawane zotsatira izi ndi machitidwe a thupi omwe zingachitike.

Kodi zotsatirapo zake zimasiyana malinga ndi mtundu wa chithandizo cha immunotherapy?

Inde, zotsatirapo zoyipa zomwe mungakumane nazo zingasiyane kutengera mtundu wa chithandizo cha chitetezo chamthupi chomwe mumalandira. Tiyeni tiwone mitundu ina yayikulu.

Zoletsa Kuyang'ana Mthupi (ICI)

Uwu ndi mtundu womwe umagwiritsidwa ntchito kwambiri. Mankhwalawa amagwira ntchito poletsa 'zizindikiro' zomwe maselo a khansa amagwiritsa ntchito kubisala ku maselo a chitetezo chamthupi (ma T-cell). Izi zikutanthauza kuti maselo a khansa sangathenso kubisala. Zotsatira zoyipa kwambiri zamtunduwu ndi kutopa, kutsegula m'mimba, ndi ziphuphu pakhungu.

Chithandizo cha Maselo Otengera (chithandizo cha kusamutsa maselo a T)

Iyi ndi njira yovuta pang'ono. Chomwe mumachita apa ndikutenga ma T-cell (ma cell olimbana ndi khansa) m'thupi lanu, kuwasintha mu labu, "kuwaphunzitsa" kuzindikira bwino ma cell a khansa, kenako nkuwabwezeretsa m'thupi lanu.

• Mu mtundu wa chithandizo cha maselo a CAR T , vuto lotchedwa `Cytokine Release Syndrome (CRS)` lingachitike. Pachifukwa ichi, chitetezo cha mthupi chimayamba kugwira ntchito mopitirira muyeso mwadzidzidzi, zomwe zimayambitsa zizindikiro monga malungo, mutu, komanso kupuma movutikira. Koma madokotala anu amadziwa momwe angathanirane ndi vutoli.

Ma antibodies a monoclonal

Awa ndi mapuloteni apadera opangidwa mu labu. Amapangidwira kuthana ndi kufooka kwina kwa maselo a khansa. Angayambitse zizindikiro zofanana ndi chimfine monga malungo, kupweteka kwa thupi, kusintha kwa kuthamanga kwa magazi, ndi zilonda pakhungu.

Katemera Wochiza

Izi zili ngati katemera amene timalandira tisanadwale. Koma izi zimagwiritsidwa ntchito khansa itatha. Katemerayu "amaphunzitsa" chitetezo cha mthupi kuzindikira ndikuwononga maselo a khansa. Angayambitse zinthu monga zizindikiro zofanana ndi chimfine ndi kuthamanga kwa magazi.

Ma Modulator a Chitetezo cha Mthupi

Mankhwalawa amagwira ntchito posintha momwe chitetezo cha mthupi chimagwirira ntchito, zomwe zimapangitsa kuti chizilimbana ndi khansa. Mankhwala ena angayambitse zotsatirapo zina monga kutopa, kuwonongeka kwa mitsempha (neuropathy), komanso magazi kuundana.

Kodi zotsatirapo zoyipazi zimayamba liti ndipo zimatha liti?

Palibe tsiku kapena nthawi yeniyeni ya izi. Chithandizo cha immunotherapy chimatenga nthawi kuti chigwire ntchito. Chifukwa chake, zimatha kutenga miyezi, nthawi zina kupitirira chaka, kuti zotsatira zake ziwonekere. Komanso, zotsatira zina zimawonekera patatha chaka chimodzi chithandizo chikuyamba.

Zotsatirapo zambiri zimakhala zakanthawi kochepa. Koma nthawi zambiri zimakhala ndi zotsatirapo za nthawi yayitali. Nthawi zina, mungakhale ndi zotsatirapo kwa kanthawi mukamaliza chithandizo. Izi zili choncho chifukwa chithandizo cha immunotherapy si mankhwala omwe amagwira ntchito pokhapokha ngati ali m'thupi lanu. Amasintha chitetezo chamthupi kwa nthawi yayitali .

Kodi mungatani kuti muthane ndi zotsatirapo zake?

Chofunika kwambiri ndi kuuza dokotala wanu za zizindikiro zilizonse zomwe mumakumana nazo, ngakhale zitakhala zazing'ono bwanji . Nthawi zina, ngakhale zitakhala zachilendo kwa inu, zitha kukhala chizindikiro choyambirira cha matenda aakulu.

Dokotala wanu angasinthe chithandizo chanu kapena kukupatsani mankhwala ena kuti achepetse zotsatirapo zake. Izi nthawi zambiri zimachitika ndi:

• Chithandizo chimayimitsidwa kwakanthawi ndipo chitetezo cha mthupi chimapatsidwa nthawi yoti "chikhazikike" pang'ono.
• Mankhwala amaperekedwa kuti achepetse ntchito ya chitetezo chamthupi. Mwachitsanzo, mankhwala monga ma steroids kapena ma immunosuppressants .

Kodi kupezeka kwa zotsatirapo zake kumatanthauza kuti chithandizocho chayenda bwino?

Funso limene anthu ambiri amafunsa ndi ili. Kafukufuku wina wasonyeza kuti kupezeka kwa zotsatirapo zake kungakhale chizindikiro chakuti chithandizocho chikuwononga khansa bwino.

Choncho musadandaule za kusowa kwa zotsatirapo zake. Njira yokhayo yodziwira zoona ndi kudzera mu mayeso ochitidwa ndi dokotala wanu.

Nanga ubwino wa chithandizo cha immunotherapy ndi wotani?

Mukakamba za zotsatirapo zake, mungadzifunse kuti, "Kodi chithandizochi chili ndi phindu?" Koma tiyeneranso kumvetsetsa ubwino wa chithandizo cha immunotherapy.

• Zimawonjezera mwayi wokhala ndi moyo kwa nthawi yayitali mu mitundu yambiri ya khansa.
• Zimathandiza kuwononga zotupa za khansa ndikuletsa khansa kuti isabwererenso .
• Zingathandize kupewa khansa kufalikira ku ziwalo zina za thupi.
• Ngakhale mutasiya kulandira chithandizo, chitetezo chanu cha mthupi chimapitirizabe kulimbana ndi maselo a khansa .
• Poyerekeza ndi mankhwala achikhalidwe monga chemotherapy, zotsatira zoyipa za chithandizo cha immunotherapy nthawi zambiri zimakhala zochepa .

Pomaliza, chithandizo cha immunotherapy si chithandizo cha munthu mmodzi. Zimatengera zinthu zambiri, kuphatikizapo mtundu wa khansa yomwe muli nayo komanso thanzi lanu lonse. Chifukwa chake, lankhulani ndi dokotala wanu za zabwino ndi zoyipa za chithandizochi ndikupanga chisankho chomwe chili chabwino kwa inu.