Xa ufumanisa ukuba unomhlaza, uziva uloyiko olukhulu kunye nexhala. Kodwa ngokuhambela phambili kwesayensi yezonyango, namhlanje kukho iindlela zonyango eziphambili kakhulu zokulwa nomhlaza. Namhlanje, siza kuthetha ngendlela entsha nenamandla kakhulu yonyango eye yaphumelela kakhulu ekunyangeni iintlobo ezahlukeneyo zomhlaza , ingakumbi ezo zikhula egazini.
Yintoni i-CAR T-Cell Therapy?
Ngamafutshane, i-CAR T-Cell Therapy lunyango olusetyenziselwa ukunyanga iintlobo ezithile zomhlaza wegazi . Iiseli zethu zomzimba zifana namajoni emizimbeni yethu. Okwenziwa lolu nyango kukuthatha amanye ala majoni emzimbeni wakho, abizwa ngokuba zii-T cells ( ii-T cells okanye ii-T lymphocytes ) , aze awaguqule abe zii-super fighters ezitshabalalisa iiseli zomhlaza.
Khawuthelekelele uthatha ii-T cells zakho uzise kwilebhu , ufake i-gene entsha kuzo, uze uzinike "ilensi ekhethekileyo" enokuqaphela iiseli zomhlaza. Sizibiza ezi T cells ziguquliweyo ngokuba zii-CAR T-cells . `CAR` imele i-`Chimeric Antigen Receptor`. Emva koko, izigidi zezi super-fighter cells zenziwa kwaye zibuyiselwe emzimbeni wakho. Ezi cells emva koko zihamba emzimbeni wakho wonke, zifuna kwaye zitshabalalise iiseli zomhlaza. Ngamanye amaxesha, olu nyango lunokunyanga umhlaza wegazi ngokupheleleyo.
Lolu nyango lusetyenziselwa ziphi iintlobo zomhlaza?
Okwangoku, i-CAR T-Cell Therapy isetyenziswa kuphela kwiintlobo ezithile zomhlaza wegazi apho ezinye iindlela zonyango ziye zasilela okanye apho umhlaza ubuyile. Itheyibhile engasezantsi idwelisa ezinye zezi ntlobo zomhlaza.
| Uhlobo lomhlaza | Intshayelelo emfutshane |
|---|---|
| I-B-cell acute lymphoblastic leukemia (YONKE) | I-acute lymphoblastic leukemia evela kwii-B-cells. |
| Ukusasaza i-lymphoma enkulu ye-B-cell | Uhlobo lwe-lymphoma olukhula ngokukhawuleza. |
| I-follicular lymphoma | Uhlobo lwe-lymphoma ekhula kancinci. |
| I-Mantle cell lymphoma | Uhlobo olungaqhelekanga, kodwa olunobundlongondlongo lwe-lymphoma. |
| I-myeloma eninzi | Umhlaza womongo wethambo ovela kwiiseli zeplasma. |
| I-lymphoma ye-mediastinal enkulu ye-B-cell lymphoma | Uhlobo lwe-lymphoma oluvela embindini wesifuba. |
Kulungile, ngoku masibone ukuba oku kusebenza njani.
Ukuze sikuqonde oku, masiqale sifunde okungakumbi ngee-T cells kwinkqubo yethu yokuzikhusela. Yonke iseli emzimbeni wethu ineeproteni ezibizwa ngokuba zii-antigens kumphezulu wayo. Ezi zifana nekhadi lesazisi elinalo iseli nganye. Iiseli zomhlaza zinekhadi lesazisi elitshintshileyo nelingaqhelekanga.
Iiseli zethu ze-T zinee -receptors . Ezi receptors zezona ziqaphela abahlaseli njengeeseli zomhlaza ezinee-ID ezingaqhelekanga (ii-antigens). Kodwa ngamanye amaxesha iiseli zomhlaza zinobuqili kakhulu. Ziyazifihla kwezi seli ze-T.
Kulapho ke sidinga khona uncedo lwee-CAR T-cells. Ezi zii-T cells zakho eziqeqeshwe ngokukodwa kwilebhu kwaye zaguqulwa ukuze zibone i-antigen ethile kwiiseli zomhlaza .
Olu nyango luvumela ezi seli ukuba zingabulali nje kuphela iiseli zomhlaza, kodwa zikwahlukane kwaye zande emzimbeni. Oku kuthetha ukuba ufumana unikezelo lwexesha elide lweeseli ezilwa nomhlaza. Yiyo loo nto oogqirha bebiza olu nyango ngokuthi “liyeza eliphilayo.”
Isebenza njani inkqubo yonyango?
Lonke eli nkqubo lenzeka ngezigaba ezahlukeneyo.
Ngaphambi konyango
Okokuqala, kufuneka uqokelele iiseli ezimhlophe zegazi, ingakumbi iiseli ze-T, emzimbeni wakho. Oku kubizwa ngokuba yi -leukapheresis.Le yinkqubo efana nokunikela ngegazi. Umatshini uthatha inxalenye yegazi lakho, wahlukanise iiseli ezimhlophe zegazi kuphela, uze ubuyisele lonke igazi emzimbeni wakho.
Ezi T cells ziqokelelweyo emva koko zithunyelwa kwilebhu ekhethekileyo ukuze ziguqulwe zibe zii-CAR T-cells. Le nkqubo ingathatha malunga neeveki ezi-3 ukuya kwezi-6. Ngeli xesha, unganikwa ezinye iindlela zonyango, ezifana ne -chemotherapy, ukulawula umhlaza.
Xa sele ukulungele ukufumana ii-CAR T-cells, uza kunikwa unyango olubizwa ngokuba yi -lymphodepleting chemotherapy ukuthintela umzimba wakho ukuba ungazamkeli iiseli ezintsha.
Ngexesha lonyango
Unyango lokwenyani lulula kakhulu. Njengokunika i-saline, ezi CAR T-cells zisandul’ ukwenziwa zifakwa emzimbeni wakho ngomthambo (umgca we-IV) kangangemizuzu emi-5 ukuya kwengama-30. Ngeli xesha, kuya kufuneka uhlale esibhedlele.
Emva konyango
Ngenxa yokuba olu lunyango olunamandla kakhulu, ngamanye amaxesha iziphumo ebezingalindelekanga zinokubakho. Ke ngoko, kunokufuneka uhlale esibhedlele malunga neentsuku ezisi-7-10 emva konyango. Kubaluleke kakhulu ukuhlala ukufutshane nesibhedlele apho ufumane khona unyango kwinyanga yokuqala, nokuba sele uphumile esibhedlele. Kwakhona,
- Kufuneka kubekho umntu oza kukunyamekela ukuba uneziphumo ebezingalindelekanga.
- Musa ukuqhuba imoto iinyanga ezimbini emva konyango. Udinga omnye umntu oza kwenza loo nto.
Zithini iziphumo ebezingalindelekanga zolu nyango?
Kukho iintlobo ezimbini zeziphumo ebezingalindelekanga ezixhaphakileyo nezifanele ukuqwalaselwa ngolu nyango. Ezinye iziphumo ebezingalindelekanga eziqhelekileyo zinokubakho.
| Uhlobo lwesiphumo esibi | Iimpawu ezibonakalayo |
|---|---|
| I-Cytokine Release Syndrome | Umkhuhlane, ubunzima bokuphefumla (ukuphelelwa ngamandla), uxinzelelo lwegazi oluphantsi. (Oku kunokuba nzima kakhulu) |
| Iingxaki ze-Neurological | Ukudideka, ubunzima bokuthetha (aphasia), ubunzima bokubhala (dysgraphia), iintloko ezibuhlungu, ukuxhuzula, ukungcangcazela. |
| Okunye | Ngexesha lonyango, kukho umngcipheko we-allergies, ukudinwa, ukopha, umngcipheko ophezulu wosulelo, kunye namanqanaba aphantsi e-potassium (hypokalemia) kunye ne-sodium (hyponatremia). |
Zithini iingenelo kunye namanqanaba empumelelo yolu nyango?
Eyona nzuzo inkulu ye-CAR T-Cell Therapy kukuba inika ithemba elitsha kwizigulana ezingaphumelelanga kwezinye iindlela zonyango. Ngamanye amaxesha inokunyanga ngokupheleleyo umhlaza (ukuxolelwa). Ngaphandle koko, olu nyango lunokwandisa ubomi bezigulana.
Umzekelo, uphando lwango-2020 lubonise ukuba ngaphezulu kwama-85% abantwana abafumene olu nyango lwe-acute lymphoblastic leukemia (ALL) baphiliswa ngokupheleleyo emva konyango. Kwakhona, ama-60% abo ayengenawo umhlaza emva konyaka. Kodwa kubalulekile ukukhumbula ukuba olu asilonyango oluphumeleleyo olupheleleyo kuwo wonke umntu, lunyango lwawo wonke umntu. Nangona kunjalo, eli linyathelo elikhulu eliya phambili kwicandelo lonyango lomhlaza.
Ufanele uye nini kugqirha?
Oku kubaluleke kakhulu. Eminye yemiphumo emibi ye-CAR T-Cell Therapy, ingakumbi i-Cytokine Release Syndrome kunye neengxaki zenkqubo yemithambo-luvo, inokuba yingozi ebomini .
Ngoko ke ngaphambi kokuba uphume esibhedlele, qiniseka ukuba ubuza ugqirha wakho ukuba zeziphi iimpawu ekufuneka uzixhalabise kakhulu ngazo. Ukuba iimpawu ezifana nomkhuhlane, ukugodola, intloko ebuhlungu , kunye nesicaphucaphu ziyaqhubeka, fowunela ugqirha wakho ngoko nangoko, okanye uye kwiSebe lezeMpilo eziNgxamisekileyo lesibhedlele (ETU).
Olu nyango lusengummandla omtsha osaphuhlayo. Ngoko ke ukuba unomhlaza wegazi, thetha nogqirha wakho malunga nokuba olu nyango lukulungele na.
Umyalezo Wokuya Ekhaya
- Unyango lwe-CAR T-Cell lunyango olunamandla kakhulu nolwenzelwe wena olusetyenziselwa iintlobo ezithile zomhlaza wegazi .
- Oku kuquka ukuguqula ii-T-cells zakho kwilebhu uze uzibuyisele emzimbeni wakho ukuze zibulale iiseli zomhlaza.
- Olu nyango lusebenza “njengeyeza eliphilayo,” lilwa nomhlaza ohlala ixesha elide emzimbeni.
- Okubi kakhulu emva konyangoUkubekwa esweni ngokusondeleyo ngugqirha kubalulekile kuba iziphumo ebezingalindelekanga zinokubakho. Naziphi na iimpawu ezirhanelekayo mazixelwe kugqirha ngoko nangoko.
- Nangona oku kunika ithemba elitsha kwizigulana ezingaphumelelanga kwezinye iindlela zonyango, ngugqirha wakho kuphela onokugqiba ukuba kulungile na kuwe.
Unyango lwe-CAR T-Cell, unyango lomhlaza, umhlaza wegazi, unyango lwe-immunotherapy, unyango lwe-immune, ii-T cells, eSri Lanka
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