Ngaba wakha wacinga ukuba imizimba yethu ingalwa nomhlaza ngokwayo? Enyanisweni, imizimba yethu inenkqubo yokuzikhusela ekrelekrele kakhulu ebizwa ngokuba yinkqubo yokuzikhusela. Inenxalenye ekhethekileyo yayo ebizwa ngokuba zii-T-cells, ezifana namajoni. Umsebenzi wabo kukufumana nokutshabalalisa iintsholongwane zasemzini kunye neeseli eziguqukileyo ezingena emzimbeni. Kodwa ngamanye amaxesha, iiseli zomhlaza zinobuqhetseba kakhulu. Ziyazifihla kwezi T cells, zizikhohlise kwaye zikhule ngaphakathi emzimbeni. Ngamaxesha anjalo, siza kuthetha ngonyango olutsha nolumangalisayo olunceda ii-T cells zethu ukuba ziqaphele kwaye zitshabalalise iiseli zomhlaza ngokuzinika "uqeqesho olukhethekileyo."
Ngamafutshane, yintoni unyango lweeseli ze-CAR T?
Nangona igama lisenokuvakala liyinkimbinkimbi, le ngcamango ilula kakhulu. Unyango lwe-CAR T-cell luhlobo lwe-immunotherapy. Lubandakanya ukuthatha ezinye zee-T cells zakho uze uziguqule ngokwemfuza kwilebhu.
Cinga ngee-T cells zakho njengamapolisa. Iiseli zomhlaza zifana namasela azifihlileyo. Ngokwesiqhelo, amapolisa awakwazi ukuwabona la masela. Unyango lwee-T cells ze-CAR lufana nokunika amapolisa akho (ii-T cells) iiglasi ezikhethekileyo. Esi sibuko sibizwa ngokuba yi -'Chimeric Antigen Receptor' (CAR) . Senziwe kwilebhu kwaye sinamathele kwii-T cells.
Ngoku, xa esi sibuko sikhethekileyo sifakwa, ii-T cells ziyakwazi ukubona ngokuchanekileyo iiproteni ezithile (ii-antigens) kumphezulu weeseli zomhlaza. Iiseli zomhlaza ezazifihliwe ngaphambili ngoku zibonakala ngokucacileyo. Ii-T cells, ezifumene la mandla angaphaya kwawemvelo, ziye ngqo zihlasele iiseli zomhlaza zize zizitshabalalise. Olu nyango luluncedo olukhulu ekunyangeni ngokupheleleyo ezinye iintlobo zomhlaza wegazi nasekuncedeni abanye ukuba baphile ixesha elide benomhlaza.
Zeziphi iintlobo zomhlaza wegazi ezinyangwa lolu nyango?
Okwangoku, unyango lwe-CAR T-cell lusetyenziswa kuphela kwiintlobo ezithile zomhlaza wegazi ezingasabelanga kwezinye iindlela zonyango (ezifana ne-chemotherapy) okanye ezibuye emva konyango. Ekubeni luselunyango olutsha kakhulu, alunikwa zonke iintlobo zomhlaza.
Itheyibhile engezantsi ibonisa ukuba zeziphi iintlobo zomhlaza olu nyango luvunyiweyo okwangoku.
| Uhlobo lomhlaza | Inkcazo |
|---|---|
| I-B-cell acute lymphoblastic leukemia (YONKE) | I-B-cell acute lymphoblastic leukemia |
| Ukusasaza i-lymphoma enkulu ye-B-cell | Ukusasaza i-lymphoma enkulu ye-B-cell |
| I-follicular lymphoma | I-follicular lymphoma |
| I-lymphoma ye-B-cell ephezulu | I-lymphoma ye-B-cell ephezulu |
| I-Mantle cell lymphoma | I-Mantle cell lymphoma |
| I-myeloma eninzi | I-myeloma eninzi |
| I-lymphoma ye-mediastinal enkulu ye-B-cell lymphoma | I-lymphoma ye-mediastinal enkulu ye-B-cell lymphoma |
Le nkqubo yonyango yenzeka njani?
Lonke eli qhinga lenzeka ngamanyathelo aliqela. Kufana nokuqeqesha amajoni emfazweni aze emva koko awabuyisele edabini.
Inyathelo 1: Ukuqokelela ii-T cells zakho
Okokuqala, umzimba wakho kufuneka uqokelele iiseli ezimhlophe zegazi, ingakumbi iiseli ze-T. Oku kwenziwa ngenkqubo ebizwa ngokuba yi-leukapheresis . Oku kuquka ukuthumela igazi lakho ngomatshini, owahlula iiseli ezimhlophe zegazi kuphela, kwaye ubuyisele lonke igazi emzimbeni wakho. Oku kufana nokunikela ngegazi, kodwa kuthathwa inxalenye yegazi kuphela kwaye lonke eliseleyo libuyiselwe.
2. Inyathelo: Thumela ii-T cells kwilebhu uze uzilungise
Okulandelayo, ii-T cells ezithathwe kuwe zithunyelwa kwilabhoratri ekhethekileyo. Apho, izazinzulu zisebenzisa ubunjineli bemfuza ukufaka i-CAR (Chimeric Antigen Receptor) esathetha ngayo ngaphambili kwii-T cells. Emva koko, ezi CAR T cells zintsha ezinamandla amakhulu zikhuliswa kwilabhoratri zide zibe nezigidi zazo. Le nkqubo ithatha iiveki ezintathu ukuya kwezintandathu.Kungathatha ixesha.
3. Inyathelo: Ukulungiselela umzimba wakho
De kube ii-CAR T-cells ziphuhlisiwe kwilebhu, ugqirha wakho unokukunika ezinye iindlela zonyango (unyango lokudibanisa), ezifana ne-chemotherapy, ukulawula umhlaza wakho.
Emva koko, kwiintsuku ezimbalwa ngaphambi kokuba unikwe ii-T-cells ze-CAR ezisandula ukwenziwa, uza kunikwa i-chemotherapy enomda ophantsi. Ibizwa ngokuba yi -lymphodepleting chemotherapy . Oku kusebenza ngokunciphisa iiseli zomzimba wakho ezikhoyo, kudala indawo engcono yokuba ii-T-cells ezintsha ze-CAR T zisebenze.
4. Inyathelo: Ukubuyisela ii-super T cells emzimbeni
Esi sesona siganeko siphambili. Njengokunika isisombululo setyuwa, ii-CAR T-cells ezisandula ukwenziwa zifakwa emzimbeni wakho ngomthambo (umgca we-intravenous - IV). Oku kuthatha imizuzu emi-5 ukuya kwengama-30. Nje ukuba ezi seli zingene emzimbeni, ziqala ukuzandisa ngokwazo, zifuna kwaye zitshabalalise iiseli zomhlaza. Ngenxa yokuba ezi seli zihlala emzimbeni ixesha elide kwaye zilwa nomhlaza, abanye bathi olu nyango "luyiyeza eliphilayo."
Kwenzeka ntoni emva konyango? Zithini iingozi?
Ngenxa yokuba olu nyango lunamandla kakhulu, ngamanye amaxesha iziphumo ebezingalindelekanga zinokubakho. Ngoko ke, kuya kufuneka uhlale esibhedlele malunga neveki ukuya kwiintsuku ezilishumi emva konyango. Oogqirha kunye nabongikazi baya kukubeka esweni ngokusondeleyo.
Eyona nto ibalulekileyo kukuba uhlale ukufutshane nesibhedlele apho ufumene khona unyango kwinyanga yokuqala emva kokuphuma esibhedlele. Kwakhona, kufuneka ube nomntu oza nawe iiyure ezingama-24 ngosuku . Kwakhona, ayingombono ulungileyo ukuqhuba iinyanga ezimbini .
Iziphumo Eziphambili Ezingalindelekanga
Kukho iziphumo ezimbini eziphambili neziqhelekileyo zolu nyango. Nangona ezi zinokuba yingozi, amaqela ezonyango axhotyiswe kakuhle ukuze azinyange.
| Uhlobo lwesiphumo esibi | Iimpawu ezinokwenzeka |
|---|---|
| I-Cytokine Release Syndrome Impendulo enamandla yomzimba yokuzikhusela eyenzeka emzimbeni xa ii-CAR T-cells zitshabalalisa iiseli zomhlaza. |
|
| Iingxaki ze-Neurological Imiphumo kwingqondo nakwinkqubo yemithambo-luvo. | |
| Ezinye iziphumo ebezingalindelekanga ezinokubakho | |
| |
Luphumelele kangakanani olu nyango?
Unyango lwe-CAR T-cell luzise ithemba elitsha kubantu abaninzi abalwa nomhlaza wegazi, ingakumbi abo bangakhange baphendule kwezinye iindlela zonyango.
- Umzekelo, ngaphezu kwama- 85% abantwana abafumene olu nyango lwe-acute lymphoblastic leukemia (ALL) ebuntwaneni baphulukene nomhlaza wabo emva konyango. Kwaye, ama-60% abo ayengenawo umhlaza emva konyaka omnye emva konyango.
Nangona kunjalo, kufuneka siqonde ukuba olu asilonyango lomlingo—lonke luya kusebenza ngokupheleleyo kuye wonke umntu. Kwabanye abantu, olu nyango luya kuyinyanga ngokupheleleyo i-cancer yabo. Kwabanye, luya kubanceda balawule i-cancer yabo baze baphile ixesha elide. Kwakhona, kwabanye abantu, olu nyango lusenokungaphumeleli.
Le teknoloji isatshintsha. Abaphandi kwihlabathi liphela bazama rhoqo ukuphucula olu nyango, ukunciphisa iziphumo ebezingalindelekanga, kunye nokubona ukuba lungasetyenziswa na kwezinye iintlobo zomhlaza.
Ufanele uye nini kugqirha?
Iziphumo ebezingalindelekanga zolu nyango, ingakumbi iCytokine Release Syndrome kunye neengxaki zemithambo-luvo, zinokuba yingozi ebomini . Ngoko ke ngaphambi kokuba uphume esibhedlele, buza ugqirha wakho ukuba zeziphi iimpawu ekufuneka uzazi ngakumbi.
Ukuba iimpawu ezinje ngomkhuhlane, ukugodola, intloko ebuhlungu, kunye nesicaphucaphu ziyaqhubeka, oko kungaba luphawu lwemeko embi kakhulu. Ukuba kunjalo, tsalela umnxeba ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele.
Ukuba wena okanye umntu omaziyo unomhlaza wegazi, thetha nogqirha wakho malunga nokuba unyango lwe-CAR T-cell lufanelekile na kuwe. Nangona olu nyango lungelulolwawo wonke umntu, lunokuba ngamava atshintsha ubomi bomntu ofanelekileyo.
Umyalezo Wokuya Ekhaya
- Unyango lwe-CAR T-cell "lunyango oluphilayo" oluguqula ii-immune T cells zakho zibe zii-super cells ezibulala iiseli zomhlaza.
- Oku okwangoku kusetyenziswa kuphela kwiintlobo ezithile zomhlaza wegazi apho ezinye iindlela zonyango ziye zasilela.
- Le nkqubo ibandakanya ukuqokelela iiseli zakho, ukuziguqula kwilebhu, nokuzibuyisela emzimbeni wakho.
- Ngenxa yokuba iziphumo ebezingalindelekanga ezinobungozi zinokwenzeka emva konyango, kubalulekile ukuba uhlale phantsi kweliso likagqirha rhoqo esibhedlele.
- Nangona olu nyango luzisa ithemba elitsha kwabaninzi, kubalulekile ukuqonda ukuba aluboneleli ngonyango oluqinisekisiweyo kubo bonke abantu.
- Ngugqirha wakho we-oncologist kuphela onokugqiba ukuba olu nyango lukulungele na, ngoko ke vuleka kwaye unyaniseke kuye ngayo yonke into.
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