Paunoziva kuti une kenza, unonzwa kutya kukuru uye kunetseka. Asi nekufambira mberi kwesainzi yezvekurapa, nhasi uno kune nzira dzekurapa dzepamusoro-soro dzekurwisa kenza. Nhasi, tichataura nezvenzira itsva uye ine simba kwazvo yekurapa yakabudirira zvikuru mukurapa mhando dzakasiyana dzekenza , kunyanya idzo dzinokura muropa.
Chii chinonzi CAR T-Cell Therapy?
Zvichitaurwa zviri nyore, CAR T-Cell Therapy inzira yekurapa kenza yeropa inoshandiswa kurapa mamwe marudzi ekenza yeropa . Masero edu ekudzivirira muviri akafanana nemasoja ari mumiviri yedu. Kurapa uku kunotora mamwe emasoja aya mumuviri wako, anonzi T cells ( T cells kana T lymphocytes ) , uye kuashandura kuita ma superfighters anoparadza masero ekenza.
Fungidzira uchiendesa masero ako eT kurabhoritari , uchiisa gene idzva maari, woapa "lenzi yakakosha" inogona kuziva masero ekenza. Tinodaidza masero aya eT akagadziriswa kuti CAR T-cells . `CAR` inomirira `Chimeric Antigen Receptor`. Zvadaro, mamiriyoni emasero aya ehondo huru anogadzirwa uye anodzoserwa mumuviri wako. Masero aya anobva afamba mumuviri wako wese, achitsvaga uye achiparadza masero ekenza. Dzimwe nguva, kurapwa uku kunogona kutorapa kenza yeropa zvachose.
Mushonga uyu unoshandiswa pamhando dzipi dzegomarara?
Parizvino, CAR T-Cell Therapy inoshandiswa chete kune mamwe marudzi ekenza yeropa apo mamwe marapirwo akakundikana kana apo kenza yakadzoka. Tafura iri pazasi inoratidza mamwe emhando idzi dzekenza.
| Rudzi rweKenza | Sumo pfupi |
|---|---|
| B-cell acute lymphoblastic leukemia (ALL) | Chirwere cheAcute lymphoblastic leukemia chinokonzerwa neB-cells. |
| Kupararira kweB-cell lymphoma yakakura | Rudzi rwe lymphoma runokura nekukurumidza. |
| Follicular lymphoma | Rudzi rwe lymphoma inokura zvishoma nezvishoma. |
| Lymphoma yemasero eMantle | Rudzi rwe lymphoma runowanzova rusingawanzoitiki, asi rune hasha. |
| Multiple myeloma | Kenza yemubofu inomuka mumasero eplasma. |
| Chikamu chekutanga che mediastinal large B-cell lymphoma | Rudzi rwe lymphoma runoitika pakati pechipfuva. |
Zvakanaka, ngationei kuti izvi zvinoshanda sei.
Kuti tinzwisise izvi, ngatitangei tadzidza zvakawanda nezvemasero eT ari muimmune system yedu. Sero rega rega mumuviri wedu rine mapuroteni anonzi maantigen pamusoro paro. Aya akafanana nekadhi reID rine sero rega rega. Masero ekenza ane kadhi reID rakachinjwa, risingawanzoitiki.
Masero edu eT ane mareceptor . Mareceptor aya ndiwo anoziva masero ekenza ane makadhi eID asingawanzoitiki (antigens). Asi dzimwe nguva masero ekenza anonyengera zvikuru. Anovanda kubva kumasero eT aya.
Apa ndipo patinoda rubatsiro rwemaCAR T-cells. Aya ndiwo maT-cells enyu akadzidziswa zvakanyanya murabhoritari uye akagadziriswa kuti aone antigen chaiyo pamasero ekenza .
Kurapa uku kunobvumira masero aya kuuraya masero egomarara chete, asiwo kupatsanurana nekuwanda mumuviri. Izvi zvinoreva kuti unowana masero anorwisa gomarara kwenguva refu. Ndosaka vanachiremba vachidana kurapwa uku kuti "mushonga mupenyu."
Maitiro ekurapa anoshanda sei?
Maitiro ese aya anoitika mumatanho akati wandei.
Usati warapwa
Kutanga, unofanira kuunganidza masero machena eropa, kunyanya masero eT, kubva mumuviri wako. Izvi zvinonzi leukapheresis.Iyi nzira yakafanana nekupa ropa. Muchina unotora rimwe ropa rako, woparadzanisa masero machena eropa chete, wozodzosera rimwe ropa rose mumuviri wako.
Masero eT aya anounganidzwa anozotumirwa kurabhoritari yakasarudzika kuti ashandiswe kuita masero eCAR T. Maitiro aya anogona kutora mavhiki angangoita matatu kusvika matanhatu. Munguva iyi, unogona kupihwa mamwe marapirwo, akadai sechemotherapy, kudzora kenza.
Kana wagadzirira kugamuchira CAR T-cells, uchapihwa mushonga unonzi lymphodepleting chemotherapy kudzivirira muviri wako kuti usarambe masero matsva.
Panguva yekurapwa
Kurapa chaiko kuri nyore kwazvo. Kufanana nekupa mushonga wemunyu, aya maCAR T-cells matsva anopinzwa mumuviri wako kuburikidza netsinga (IV line) kwemaminetsi mashanu kusvika makumi matatu. Munguva iyi, uchafanira kugara muchipatara.
Mushure mekurapwa
Nekuti iyi imishonga ine simba guru, dzimwe nguva migumisiro yakaipa inogona kuitika. Saka, ungafanira kugara muchipatara kwemazuva angangoita 7-10 mushure mekurapwa. Zvakakosha kuti ugare uri pedyo nechipatara kwawakagamuchira kurapwa kwemwedzi wekutanga, kunyangwe mushure mekunge wabuda muchipatara. Zvakare,
- Mumwe munhu anofanira kunge ari newe maawa makumi maviri nemana pazuva kuti akubatsire kana uine zvimwe zvinokanganisa.
- Usatyaira mota kwemwedzi miviri mushure mekurapwa. Unoda mumwe munhu kuti akuitire izvozvo.
Ndezvipi migumisiro yekurapwa uku?
Kune mhando mbiri dzemigumisiro yakaipa inonyanya kuwanikwa uye yakakodzera kutariswa nekurapwa uku. Dzimwe migumisiro yakaipa inogonawo kuitika.
| Rudzi rwemhedzisiro yakaipa | Zvinhu zvinoonekwa |
|---|---|
| Cytokine Release Syndrome | Fivha, kunetseka kufema (kushaya simba), BP yakaderera. (Izvi zvinogona kunge zvakakomba) |
| Matambudziko eHuropi | Kuvhiringidzika, kuoma kutaura (aphasia), kuoma kunyora (dysgraphia), musoro, pfari, kudedera. |
| Zvimwe | Munguva yekurapwa, pane njodzi yekurwara nepfungwa, kuneta, kubuda ropa, njodzi yakawedzera yehutachiona, uye mazinga e potassium akaderera (hypokalemia) uye sodium (hyponatremia). |
Ndezvipi zvakanakira uye mwero wekubudirira kwekurapwa uku?
Chinhu chikuru chinobatsira neCAR T-Cell Therapy ndechekuti inopa tariro itsva kuvarwere vakakundikana mamwe marapirwo. Dzimwe nguva inogona kurapa kenza zvachose (remission). Kana zvisina kudaro, kurapwa uku kunogona kuwedzera hupenyu hwevarwere.
Semuenzaniso, ongororo yakaitwa muna 2020 yakaratidza kuti vana vanopfuura 85% vakagamuchira mushonga uyu we acute lymphoblastic leukemia (ALL) vakaporeswa zvachose mushure mekurapwa. Zvakare, 60% yavo vakanga vachiri vasina kenza mushure megore. Asi zvakakosha kuyeuka kuti uyu hausi mushonga unobudirira 100% kune munhu wese, mushonga wemunhu wese. Zvisinei, iri idanho guru rekufambira mberi munyaya yekurapa kenza.
Unofanira kuona chiremba rini?
Izvi zvakakosha zvikuru. Mimwe migumisiro yeCAR T-Cell Therapy, kunyanya Cytokine Release Syndrome nematambudziko etsinga dzemuviri, inogona kuisa hupenyu panjodzi .
Saka usati wabuda muchipatara, iva nechokwadi chekubvunza chiremba wako kuti zviratidzo zvipi zvaunofanira kunyanya kunetseka nazvo. Kana zviratidzo zvakaita sefivha, dzihwa, musoro , uye kuda kurutsa zvikaramba zviripo, fonera chiremba wako nekukasika, kana kuenda kuEmergency Department (ETU) yechipatara.
Kurapa uku kuchiri kutsva kuri kukura. Saka kana uine kenza yeropa, taura nachiremba wako kuti mushonga uyu wakakunakira here.
Mharidzo Yekuenda Nayo Kumba
- Kurapa kweCAR T-Cell inzira yakasimba uye inogadzirwa nemunhu wese inoshandiswa kune mamwe marudzi ekenza yeropa .
- Izvi zvinosanganisira kugadzirisa maT-cell ako murabhoritari wozoadzosera mumuviri wako kuti auraye masero egomarara.
- Kurapa uku kunoshanda se "mushonga mupenyu," uchirwisa kenza kwenguva refu mumuviri.
- Zvakakomba mushure mekurapwaKutarisirwa kwakasimba kwechiremba kwakakosha sezvo migumisiro inogona kuitika. Chero zviratidzo zvinofungidzika zvinofanira kuziviswa kuna chiremba nekukasika.
- Kunyange zvazvo izvi zvichipa tariro itsva kuvarwere vakakundikana kurapwa nedzimwe nzira, chiremba wako chete ndiye anogona kusarudza kana zvakakunakira.
Kurapa neCAR T-Cell, kurapwa nekenza, kenza yeropa, immunotherapy, immune therapy, T cells, Sri Lanka
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