Iyo umenye ko urwaye kanseri, ukumva ufite ubwoba bwinshi n'amaganya. Ariko hamwe n'iterambere ry'ubumenyi bw'ubuvuzi, muri iki gihe hari uburyo bugezweho bwo kuvura kanseri. Uyu munsi, tugiye kuvuga ku buryo bushya kandi bukomeye bwo kuvura bwagize ingaruka nziza mu kuvura ubwoko butandukanye bwa kanseri , cyane cyane ubwo mu maraso.
Ubuvuzi bwa CAR T-Cell ni iki?
Muri make, CAR T-Cell Therapy ni uburyo bwo kuvura indwara ziterwa n’ubwoko bumwe na bumwe bwa kanseri y’amaraso . Uturemangingo tw’umubiri wacu bwite tumeze nk’abasirikare mu mibiri yacu. Icyo ubu buryo bukora ni ugufata bamwe muri abo basirikare mu mibiri yawe, bitwa T cells ( T cells cyangwa T lymphocytes ) , bakabagira intwari zikomeye zisenya uturemangingo twa kanseri.
Tekereza ujyanye uturemangingo twa T muri laboratwari , ushyiramo gene nshya, hanyuma uduha "lensi yihariye" ishobora kumenya uturemangingo twa kanseri. Utwo turemangingo twa T twahinduwe tuzwi nka CAR T-cells . `CAR` isobanura `Chimeric Antigen Receptor`. Hanyuma, utu turemangingo tubarirwa muri za miriyoni tw’imbaraga zidasanzwe turakorwa hanyuma tugasubizwa mu mubiri wawe. Utwo turemangingo hanyuma tugenda mu mubiri wawe wose, dushaka uturemangingo twa kanseri kandi tukangiza. Hari igihe ubu buryo bwo kuvura bushobora no gukiza kanseri y’amaraso burundu.
Ni ubuhe bwoko bwa kanseri ubu bukoreshwa?
Muri iki gihe, CAR T-Cell Therapy ikoreshwa gusa ku bwoko bumwe na bumwe bwa kanseri y'amaraso aho ubundi buryo bwo kuvura bwananiwe cyangwa aho kanseri yagarutse. Imbonerahamwe iri hepfo igaragaza bumwe muri ubwo bwoko bwa kanseri.
| Ubwoko bwa Kanseri | Intangiriro ngufi |
|---|---|
| Leukemia y'urumogi rw'amaraso mu maraso (BOSE) | Leukemia ikabije ya lymphoblastic ikomoka ku turemangingo twa B. |
| Kurandura lymphoma nini ya B-cell | Ubwoko bwa lymphoma ikura vuba. |
| Lymphoma ya folikuro | Ubwoko bwa lymphoma ikura buhoro buhoro. |
| Lymphoma y'uturemangingo twa Mantle | Ubwoko bwa lymphoma bukunze kugaragara cyane, ariko bukabije. |
| Myeloma nyinshi | Kanseri y'umusemburo w'amagufwa ivuka mu turemangingo twa plasma. |
| Lymphoma y'ibanze ya mediastinal large B-cell lymphoma | Ubwoko bwa lymphoma bugaragara hagati mu gituza. |
Noneho reka turebe uko ibi bikora.
Kugira ngo tubisobanukirwe, reka tubanze twige byinshi ku ngirabuzimafatizo za T mu budahangarwa bwacu bw'umubiri. Buri ngirabuzimafatizo mu mubiri wacu ifite poroteyine zitwa antigens ku buso bwazo. Izi ni nk'ikarita y'indangamuntu buri ngirabuzimafatizo ifite. Uturemangingo twa kanseri dufite ikarita y'indangamuntu yahindutse kandi idasanzwe.
Uturemangingo twacu twa T dufite receptor . Utwo turemangingo ni two dushobora kumenya abatera kanseri nk'uturemangingo dufite indangamuntu zidasanzwe (antigens). Ariko rimwe na rimwe uturemangingo twa kanseri tuba dufite amayeri menshi. Twihisha utu turemangingo twa T.
Aha niho dukeneye ubufasha bw'uturemangingo twa CAR T. Izi ni uturemangingo twa T twahawe imyitozo yihariye muri laboratwari kandi twahinduwe kugira ngo tumenye antigen runaka ku turemangingo twa kanseri .
Ubu buryo bwo kuvura butuma utwo turemangingo tudapfa kwica uturemangingo twa kanseri gusa, ahubwo bunatuma twigabanya kandi tugwira mu mubiri. Ibi bivuze ko ubona uturemangingo twirinda kanseri mu gihe kirekire. Niyo mpamvu abaganga bita ubu buryo “umuti muzima.”
Uburyo bwo kuvura bukora bute?
Iyi gahunda yose iba mu byiciro bitandukanye.
Mbere yo kuvurwa
Ubwa mbere, ugomba gukusanya uturemangingo tw’amaraso twera, cyane cyane uturemangingo twa T, mu mubiri wawe. Ibi byitwa leukapheresis.Iyi ni inzira isa no gutanga amaraso. Imashini ifata amwe mu maraso yawe, igatandukanya uturemangingo tw’amaraso twera gusa, hanyuma igasubiza andi maraso mu mubiri wawe.
Izi selile za T zakusanyijwe zoherezwa muri laboratwari yihariye kugira ngo zihindurwemo selile za CAR T. Iki gikorwa gishobora gufata ibyumweru 3 kugeza kuri 6. Muri icyo gihe, ushobora guhabwa ubundi buryo bwo kuvura, nka chimiotherapie, kugira ngo ugenzure kanseri.
Iyo witeguye kwakira selile za CAR T, uzahabwa ubuvuzi bwitwa lymphodepleting chemotherapy kugira ngo wirinde ko umubiri wawe wanga selile nshya.
Mu gihe cyo kuvurwa
Uburyo nyabwo bwo kuvura buroroshye cyane. Kimwe no gutanga umuti wa saline, izi selile za CAR T zishyirwa mu mubiri wawe binyuze mu mitsi (umurongo wa IV) mu gihe cy'iminota 5 kugeza kuri 30. Muri iki gihe, uzakenera kuguma mu bitaro.
Nyuma yo kuvurwa
Kubera ko ubu ari uburyo bukomeye bwo kuvura, rimwe na rimwe ingaruka mbi zishobora kubaho. Kubwibyo, ushobora kumara iminsi 7-10 mu bitaro nyuma yo kuvurwa. Ni ngombwa cyane kuguma ahantu horoshye ugera mu bitaro aho wavuriwe mu kwezi kwa mbere, ndetse na nyuma yo kuva mu bitaro. Nanone,
- Umuntu agomba kuba ari kumwe nawe amasaha 24 ku munsi kugira ngo akwitaho mu gihe ufite ingaruka mbi.
- Ntugatware imodoka amezi abiri nyuma yo kuvurwa. Ukeneye undi muntu wo kubikora.
Ingaruka mbi z'ubu buvuzi ni izihe?
Hari ubwoko bubiri bw'ingaruka mbi zikunze kugaragara kandi zikwiye kwitabwaho muri ubu buryo. Izindi ngaruka mbi zisanzwe zishobora kubaho.
| Ubwoko bw'ingaruka mbi | Ibiranga bigaragara |
|---|---|
| Indwara yo kurekura cytokine | Umuriro, kugorwa no guhumeka (kubura umwuka), umuvuduko w'amaraso uri hasi. (Ibi bishobora kuba bikomeye) |
| Ibibazo by'imitsi | Kujijinganya, kugorwa no kuvuga (aphasia), kugorwa no kwandika (dysgraphia), kuribwa umutwe, gucika intege, no gutitira. |
| Ibindi | Mu gihe cyo kuvurwa, hari ibyago byo kugira allergie, umunaniro, kuva amaraso, ibyago byo kwandura byiyongera, ndetse n'urugero rwa potasiyumu nke (hypokalemia) na sodium (hyponatremia). |
Ni izihe nyungu n'igipimo cy'ubu buvuzi cyagize ingaruka nziza?
Akamaro gakomeye k'ubuvuzi bwa CAR T-Cell ni uko butanga icyizere gishya ku barwayi bananiwe ubundi buryo bwo kuvura. Hari igihe bushobora gukiza burundu kanseri (remission). Bitabaye ibyo, ubu buryo bushobora kongera igihe cy'ubuzima bw'abarwayi.
Urugero, ubushakashatsi bwakozwe mu 2020 bwagaragaje ko abana barenga 85% bahawe ubu buvuzi bwa kanseri y’urukerera (ALL) bakize burundu nyuma yo kuvurwa. Nanone, 60% muri bo ntibari bafite kanseri nyuma y’umwaka umwe. Ariko ni ngombwa kwibuka ko ubu buvuzi butari 100% bwagenze neza kuri buri wese, ahubwo ni umuti wa buri wese. Ariko, iyi ni intambwe ikomeye mu rwego rwo kuvura kanseri.
Ni ryari ukwiye kujya kwa muganga?
Ibi ni ingenzi cyane. Zimwe mu ngaruka mbi zo kuvura CAR T-Cell Therapy, cyane cyane Cytokine Release Syndrome n'ibibazo by'imitsi, bishobora gushyira ubuzima mu kaga .
Mbere yo kuva mu bitaro, banza ubaze muganga wawe ibimenyetso ugomba kwitaho cyane. Niba ibimenyetso nk'umuriro, ubukonje, umutwe , n'isesemi bikomeje, hamagara muganga wawe ako kanya, cyangwa ujye kwa muganga wita ku barwayi ba ETU (ETU) bo mu bitaro.
Ubu buvuzi buracyari bushya kandi buracyari gutera imbere. Niba rero urwaye kanseri y'amaraso, ganira na muganga wawe niba ubu buvuzi bukubereye.
Ubutumwa bwo kujyana mu rugo
- Ubuvuzi bwa CAR T-Cell ni uburyo bukomeye kandi bwihariye bwo kuvura ubudahangarwa bw’umubiri bukoreshwa ku bwoko bumwe na bumwe bwa kanseri y’amaraso .
- Ibi bikubiyemo guhindura uturemangingo twa T muri laboratwari hanyuma ukazisubiza mu mubiri wawe kugira ngo zice uturemangingo twa kanseri.
- Ubu buvuzi bukora nk' "umuti muzima," burwanya kanseri imara igihe kirekire mu mubiri.
- Bikomeye nyuma yo kuvurwaGukurikiranwa hafi n'abaganga ni ngombwa kuko ingaruka zishobora kubaho. Ibimenyetso byose bikekwa bigomba guhita bitangazwa kwa muganga.
- Nubwo ibi bitanga icyizere gishya ku barwayi bananiwe ubundi buryo bwo kuvura, muganga wawe ni we wenyine ushobora gufata icyemezo niba gikubereye.
Ubuvuzi bwa CAR T-Seli, kuvura kanseri, kanseri y'amaraso, kuvura ubudahangarwa bw'umubiri, kuvura ubudahangarwa bw'umubiri, T-Seli, Sri Lanka
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