Khawucinge ukuba umntu omaziyo, mhlawumbi ilungu losapho, unyangwa umhlaza. Ingakumbi ngolunye lonyango oluphambili olufumanekayo namhlanje. Emva kweentsuku ezimbalwa eqalile unyango, ngequbuliso uba nomkhuhlane ophezulu, iintlungu zomzimba, kwaye uzive ngathi unomkhuhlane ombi. Sihlala sicinga ukuba oku kubangelwa yinto eqhelekileyo yonyango. Nangona kunjalo, oku kungaba luphawu lwento enzulu ngakumbi. Le yimeko yezonyango esiyibiza ngokuba yiCytokine Release Syndrome (CRS) .
Ngamafutshane, yintoni i-CRS?
Ukuze siqonde oku, masiqale sicinge ngenkqubo yomzimba wethu yokuzikhusela. Ifana nomkhosi okhusela ilizwe lethu. Lo mkhosi unezithunywa ezithumela imiyalezo phakathi kwamajoni awo (iiseli zokuzikhusela). Ngokufanayo, kukho iiproteni ezikhethekileyo ezinceda iiseli zethu zokuzikhusela ukuba zinxibelelane kwaye zilawule imisebenzi yazo, ezibizwa ngokuba zii-cytokines . Ezi zibalulekile kwinkqubo yomzimba yokuzikhusela esempilweni.
Kodwa ngamanye amaxesha, ingakumbi kunyango oluthile lomhlaza, olufana nonyango lwe-immunotherapy , inkqubo yethu yomzimba yokuzikhusela inokuvuselelwa kakhulu. Oku kubangela ukukhululwa ngequbuliso kwezi zithunywa, ezibizwa ngokuba zii-cytokines, egazini. Kufana nomkhosi oqhuba ubundlobongela kwaye uthumela amawaka emiyalezo ngaxeshanye. Oku ngamanye amaxesha kubizwa ngokuba yi-"cytokine storm." Xa ii-cytokines ezininzi zikhutshwa ngaxeshanye, kubangela ukudumba emzimbeni wonke. Yiloo nto siyibiza ngokuba yi-CRS.
Ziziphi izizathu eziphambili ze-CRS?
Eyona nto iphambili neyona ixhaphakileyo ye-CRS zezinye zeendlela zonyango zanamhlanje ezisetyenziswa kumhlaza.
- Unyango lwe-Immunotherapy: Le yeyona nto ixhaphakileyo. Unyango olufana nonyango lweeseli ze-CAR-T kunye nee-antibodies ze-bispecific zisengozini enkulu ye-CRS. Olu nyango luvuselela amasosha omzimba ethu ukuba alwe neeseli zomhlaza. Ngexesha lale nkqubo, amasosha omzimba ngamanye amaxesha asebenza kakhulu.
- Ezinye izizathu: Abantu abaneemeko ezithile zemfuza okanye izifo zokuzikhusela komzimba nabo banokuba semngciphekweni omkhulu. Umzekelo, imeko yemfuza ebizwa ngokuba yiHemophagocytic lymphohistiocytosis (HLH) .
Ziziphi iimpawu ezinokubakho ze-CRS?
Iimpawu ze-CRS zinokufana nezomkhuhlane oqhelekileyo, ngoko ke ngamanye amaxesha kunokuba nzima ukuzibona. Nangona kunjalo, ezi mpawu zinokuba qatha ngokukhawuleza.
| Uphawu | Inkcazo |
|---|---|
| Umkhuhlane ophezulu kunye nokubanda | Olu luphawu lokuqala olubonakala rhoqo. |
| Ukudideka kunye nesiyezi | Iziphumo engqondweni zinokubangela ukudideka kunye nokulahlekelwa yinkumbulo. |
| Isicaphucaphu nokuhlanza | Ezi mpawu zenzeka ngenxa yeziphumo kwinkqubo yokugaya ukutya. |
| Intlungu yesisu/urhudo | Ukurhawuzelela yimpawu eqhelekileyo. |
| Intloko ebuhlungu kunye nomzimba obuhlungu | Iintlungu zamalungu nezihlunu zinokubakho, ezifana nomkhuhlane wedengue. |
| Ukuqhambuka kwesikhumba | Abanye abantu banokuba namabala abomvu eluswini lwabo. |
| Ubunzima bokuginya | Umphimbo obuhlungu unokwenza kube nzima ukuginya. |
| Umsebenzi onzima | Ndiziva ndidiniwe kakhulu ukuba ndingenza nantoni na. |
Ingaba le meko inokuba nzulu kangakanani?
I-CRS yimeko enokuba yingozi kakhulu, ukusuka kwencinci ukuya kwesongela ubomi. Ukuvuvukala okugqithisileyo emzimbeni wonke kunokonakalisa amalungu abalulekileyo afana nezintso, isibindi, imiphunga kunye nentliziyo.
Eyona nto ibalulekileyo kukufumanisa le meko kwangethuba uze uqale unyango, kungenjalo kunokubakho iingxaki ezinkulu.
Nazi ezinye zeengxaki ezinkulu ezinokwenzeka:
- Iziphumo entliziyweni: I-cardiomyopathy kunye nokungaphumeleli kwentliziyo kunokukhula.
- Iziphumo kwimiphunga: Ukungasebenzi kakuhle kwemiphunga kunye namanqanaba aphantsi kakhulu eoksijini egazini kunokwenzeka.
- Ukungasebenzi kakuhle kwezintso nesibindi: Ukonakala kwezi zitho kunokubangela ukuba ziyeke ukusebenza.
- I-Capillary leak syndrome: Ulwelo oluphuma kwimithambo yegazi emincinci lunokubangela ukuba uxinzelelo lwegazi lwehle ngendlela eyingozi.
Oogqirha bayifumana njani le nto?
Iqela lezonyango elikunyangayo linolwazi oluninzi nge-CRS, ngoko ke ukuba ufumana unyango olufana ne-immunotherapy, baya kujonga iimpawu zakho ngokusondeleyo.
Ukuba kuvela iimpawu, ugqirha uya kuyalela iimvavanyo ezininzi ukuqinisekisa imeko.
- Inani elipheleleyo legazi (CBC): Ijonga utshintsho kwiiseli zegazi.
- Amanqanaba e-Cytokine: Linganisa ubungakanani bee-cytokine egazini.
- Uvavanyo lweprotheyini evuselelayo (CRP): Olu vavanyo lunceda ukulinganisa inqanaba lokuvuvukala emzimbeni.
- Ukujonga ukusebenza kwezintso nesibindi: Fumanisa ukuba la malungu onakele na.
Ngokuxhomekeke kubunzima bemeko, oogqirha bayibeka kwiBanga loku-1 ukuya kwelesi-4. Okukhona inani liphezulu, kokukhona imeko iba mandundu ngakumbi. Eli nqanaba limiselwa ngokuqwalasela izinto ezifana nomkhuhlane, uxinzelelo lwegazi, amanqanaba eoksijini, kunye nokusebenza kwamalungu omzimba.
Ziziphi iindlela zonyango ze-CRS?
Unyango luxhomekeke kubukhali beempawu zakho. Kwiimeko ezingephi, izinto ezilula ezifana namayeza okunciphisa umkhuhlane zinokwanela. Kodwa ukuba imeko imbi kakhulu, kunokufuneka unyango olukhethekileyo ngakumbi.
| Indlela yonyango | Kwenzekani? |
|---|---|
| Ii-Corticosteroids | Ilawula ukudumba okugqithisileyo emzimbeni kunye nokusebenza kwenkqubo yomzimba yokuzikhusela. |
| Amayeza ajolise kwii-cytokines ezithile | Ijolise kwaye ithintele ii-cytokines ezivelisa ngokugqithisileyo. Umzekelo: i-tocilizumab, i-siltuximab, i-anakinra. |
| Inkathalo Exhasayo | Nika amayeza oxinzelelo lwegazi oluphantsi, nika ioksijini, kwaye usebenzise umoya ongenisayo ngomatshini ukuba kuyimfuneko. |
Ndingalufuna nini uncedo lwezonyango?
Le yeyona nxalenye ibalulekileyo.
Ukuba ufumana unyango lwe-immunotherapy lomhlaza, kwaye uqalisa ukuba nomkhuhlane okanye ezinye iimpawu ze-CRS (ezifana neentlungu zamalungu, ukudideka) emva konyango, ayingombono ulungileyo ukulibazisa nokuba kuncinci.
Le meko inokuba mandundu ngokukhawuleza. Ngoko ke, yazisa ugqirha wakho okanye isibhedlele sakho ngoko nangoko. Okukhona uqala unyango ngokukhawuleza, kokukhona umngcipheko weengxaki ezinkulu uyancipha.
Kuyaqondakala ukuba uzive usoyika kwaye udanile xa usiva ngento efana nale ngelixa ulwa nomhlaza. Kodwa khumbula, iqela lezonyango elikunyangayo liqhelene kakhulu ne-CRS. Bakujongile kakhulu. Ungoyiki ukubaxelela ngalo naluphi na utshintsho emzimbeni wakho, nokuba lolona luncinci. Ngenkxaso yakho, le meko inokulawulwa ngaphambi kokuba ibe yingozi.
Umyalezo Wokuya Ekhaya
- I-CRS yimeko embi kakhulu ebangelwa kukusebenza kakhulu kwenkqubo yomzimba yokuzikhusela. Inokwenzeka, ingakumbi emva konyango lomhlaza olusebenzisa amasosha omzimba.
- Iimpawu zisenokuqala njengomkhuhlane oqhelekileyo, kodwa zikhawuleza zibe nzima. Iimpawu eziphambili ngumkhuhlane ophezulu, ukugodola, kunye nokudideka.
- Ukuba ufumana unyango lwe-immunotherapy, yazisa ugqirha wakho ngoko nangoko ukuba unesifo somkhuhlane okanye ezinye iimpawu ezingaqhelekanga.
- Kukho unyango olusebenzayo lwe-CRS. Unyango lwakwangoko lunokuthintela iingxaki ezinkulu.
- Yazisa iqela lakho lezonyango ngale nto. Thetha nabo ngokukhululekileyo malunga nezinto ezikuxhalabisayo kunye neempawu zakho.
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