Sonke siyazi ukuthi kunzima futhi kuyinselele kangakanani ukulwa nomdlavuza. Kodwa ngokuthuthuka kwesayensi yezokwelapha usuku nosuku, kutholakala izindlela zokwelapha ezintsha nezintsha. Namuhla, sizokhuluma ngendlela entsha abantu abaningi abanethemba elikhulu ngayo, ukusebenzisa amangqamuzana emizimba yethu ukwelapha umdlavuza. Lokhu kubizwa ngokuthi i-TIL Therapy.
Kalula nje, kuyini i-TIL Therapy?
Kulungile, ake sikwenze lokhu kube lula. Cishe uke wezwa ngokwelashwa nge-immunotherapy . Kumayelana nokuvuselela amasosha omzimba ethu, ibutho lethu elilwa nezifo, ukusiza ekubhubhiseni amangqamuzana omdlavuza. Ukwelashwa nge-TIL kungenye yezindlela ezinjalo zokwelashwa nge-immunotherapy.
Lokhu kusebenzisa uhlobo olukhethekile nolunamandla kakhulu lweseli lokuzivikela emzimbeni wethu. Lawa maseli abizwa ngokuthi ama-lymphocyte angena esimila , noma ama-TIL ngamafuphi.
Cabanga ngakho, imizimba yethu inezinhlobo ezahlukene zamasosha (amangqamuzana omzimba) azulazula emigwaqweni efuna izifo. Kodwa la masosha abizwa ngokuthi ama-TIL akhethekile nakakhulu. Angena ngqo ezimilanjeni, okungukuthi, awahlasele, futhi afunde kahle ukuthi yiziphi izindawo ezibuthakathaka zalawo mangqamuzana omdlavuza nokuthi iyiphi indlela engcono kakhulu yokuwabhubhisa. Afana neqembu lamasosha akhethekile elingena ekamu lesitha kanye nama-scout.
Pho inkinga ikuphi? Inkinga iwukuthi, amasosha ethu omzimba awakwazi ukwanelisa la masosha ahlakaniphile, noma ama-TIL. Kunzima kwabambalwa okumele balwe nalo mdlavuza bodwa futhi banqobe.
Yilapho ukwelashwa kwe-TIL kungena khona. Lokhu kwelashwa okwenziwa yilokhu kukhipha lawo masosha e-TIL ahlakaniphe kakhulu emzimbeni wakho, uwaphindaphinde ngezigidigidi, adale ibutho elinamandla, bese ewabuyisela emzimbeni wakho. Bese leli butho elikhulu liyahamba libhubhise amangqamuzana omdlavuza.
Yiziphi izinhlobo zomdlavuza lokhu kwelashwa okungasetshenziselwa zona?
Kusukela ngo-2024, i-U.S. Food and Drug Administration (FDA) ivumile ukwelashwa kwe-TIL okubizwa ngokuthi i-lifileucel (Amtagvi®) . Kwenzelwe ngqo ukwelapha uhlobo lomdlavuza wesikhumba olubizwa ngokuthi i-melanoma . Kodwa-ke, alufanele zonke izinhlobo ze-melanoma. Lokhu kwelashwa kufaneleka ku:
- Akunakwelashwa ngokuhlinzwa kuphela,
- Umdlavuza osusakazekele kwezinye izingxenye zomzimba (umdlavuza osakazeke kakhulu),
- Futhi kulabo abangasabeli ekwelashweni okuvamile odokotela bomdlavuza abavame ukukunikeza kuqala.
Uma unesifo esifanayo, ungase ube umuntu ofanelekela lolu hlobo lokwelashwa. Kufanele ukhulume nodokotela wakho ngakho.
Ngaphezu kwalokho, odokotela nabacwaningi bafunda ngempumelelo yokwelashwa kwe-TIL kwezinye izinhlobo eziningana zomdlavuza, okuhlanganisa:
- Umdlavuza webele
- Umdlavuza wesibeletho
- Umdlavuza wamathumbu amakhulu
- Umdlavuza wekhanda nentamo
- Umdlavuza wamaphaphu ongewona owamangqamuzana amancane
Lokhu kwelashwa kusebenza kanjani? Ake sifunde isinyathelo ngesinyathelo.
Lokhu akuyona into eyenzeka ngosuku olulodwa. Into eyinhloko ukubuyisela amaseli akho e-TIL kuwe. Kodwa kunezinyathelo eziningana ngaphambi kokuba sifike kulelo qophelo. Ake sibheke lezo zinyathelo ngokulandelana.
| Izinyathelo | Kwenzekani? |
|---|---|
| 1. Ukususwa kwengxenye yesimila (Ukususwa) | Okokuqala, unikezwa i-anesthesia, bese udokotela ohlinzayo esusa ingxenye encane yesimila sakho, esingangegrephuphu. Lokhu kuthunyelwa elabhorethri. Ngeke uzwe ubuhlungu. |
| 2. Ukuvuna nokukhulisa i-TIL | Elabhorethri, amaseli e-TIL ahlukaniswa nesimila. Bese, kusetshenziswa amasu akhethekile, aphindaphindwa ngezigidigidi. Le nqubo ithatha cishe amasonto amahlanu. Bese, leli butho lamaseli lithunyelwa kudokotela wakho. |
| 3. Ukufakwa kwe-Chemotherapy | Uzolaliswa esibhedlela futhi unikezwe ukwelashwa ngamakhemikhali izinsuku ezinhlanu kuya kweziyisikhombisa. Lokhu kwenzelwa ukulungiselela umzimba wakho ibutho elisha lamaseli e-TIL. |
| 4. Ukunikeza umzimba amaseli e-TIL (ukumpontshelwa kwe-TIL) | Manje yingxenye ebaluleke kakhulu. Amaseli akho e-TIL, enziwa elabhorethri, afakwa emzimbeni wakho njengosawoti. Lokhu kwenziwa kanye kuphela. Kuthatha cishe amahora amabili. |
| 5. Ukumnika i-Interleukin-2 | Ngemva kokunikezwa amaseli e-TIL, uzonikezwa umuthi obizwa ngokuthi i-Interleukin-2 (IL-2) izinsuku ezintathu kuya kwezinhlanu. Lokhu futhi kuyindlela yokwelapha ngokuzivikela komzimba. Lokhu okwenzayo ukwenza amaseli e-TIL afakwe emzimbeni futhi awakhuthaze ukuba ahlasele umdlavuza. |
Ngemva kokwelashwa, kuzodingeka uhlale esibhedlela izinsuku ezimbalwa ezengeziwe. Phakathi naleso sikhathi, ithimba lezokwelapha lizoqapha ngokucophelela ukuthi umzimba wakho usabela kanjani ekwelashweni. Ngemva kwalokho, uzokwaziswa ukuthi uhlale eduze nesibhedlela amasonto ambalwa. Lokhu kwenzelwa ukuthi uthole ukwelashwa ngokushesha uma uhlangabezana nanoma yimiphi imiphumela emibi.
Kuthatha isikhathi esingakanani lokhu kwelashwa okuphelele?
Ukwelashwa kwe-TIL kuyindlela yokwelapha kanye kuphela . Kodwa-ke, yonke inqubo kusukela osukwini umdlavuza osuswa ngalo, kuze kube usuku amaseli adalwe ngalo, kuze kube yilapho welashwa, kuze kube yilapho usubuyele esimweni esijwayelekile kungathatha cishe amasonto ayi-10 . Kuzodingeka uhlale esibhedlela cishe amasonto amabili.
Yiziphi izinzuzo nezingozi zalokhu?
Izinzuzo zalokhu kwelashwa
Lokhu kuyindlela yokwelapha enamandla kakhulu, eyenzelwe wena.
- Ukuhlasela okuqondiwe: Lokhu kwelashwa kuhlose ngqo amangqamuzana omdlavuza kuphela. Ngakho-ke, kunomonakalo omncane kakhulu kumaseli anempilo. Lokhu kunciphisa nengozi yemiphumela emibi.
- Ukuvikelwa kwesikhathi eside: Amaseli e-TIL afakwa emzimbeni wakho ahlala emzimbeni wakho iminyaka eminingi. Lokhu kusho ukuthi ngisho nangemva kokuphela kokwelashwa, la maseli ayaqhubeka nokulwa nomdlavuza.
- Ithemba Elisha: Mhlawumbe okubaluleke kakhulu, lokhu kuletha ithemba elikhulu kubantu abanomdlavuza we-melanoma okwakucatshangwa ukuthi awunakuphulukiswa ngaphambili.
Ucwaningo lwango-2023 lubonise ukuthi eminyakeni emine ngemva kokuthola ukwelashwa kwe-TIL, abantu abangu-7 kwabayi-10 abathola ukwelashwa babengenaso isifo noma ukuqhubeka kwaso. Kwabathathu kwabayi-10, izimila zazinciphile noma zinyamalale ngokuphelele.
Izingozi zokwelashwa
Njenganoma yikuphi ukwelashwa, kunezingozi ezithile. Le miphumela emibi ibangelwa kakhulu ukwelashwa ngamakhemikhali kanye ne -interleukin-2 (IL-2) . Imiphumela emibi evela ekuphathweni kwamaseli e-TIL ayivamile kakhulu. Imiphumela emibi evame kakhulu yile:
- Uhudo
- Ukukhathala
- Umkhuhlane kanye nokubanda
- Ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia)
- Umfutho wegazi ophansi
- Isicanucanu nokuhlanza
- Ukuqubuka kwesikhumba
Akuvamile kakhulu, ukwelashwa kwe-IL-2 kungabangela inkinga enkulu ebizwa ngokuthi i-capillary leak syndrome . Kodwa ungakhathazeki, udokotela wakho uzokuchazela zonke lezi zingozi ngaphambi kokuba uqale ukwelashwa.
Kuzongithatha isikhathi esingakanani ukuthi ngilulame?
Kungathatha amasonto amabili noma ngaphezulu ngaphambi kokuba uqale ukuzizwa ungcono ngemva komthamo wakho wokugcina we-IL-2. Lokhu kungenxa yokuthi umzimba udinga isikhathi sokululama ekucindezelekeni kwayo yonke inqubo yokwelashwa (ukuhlinzwa, ukwelashwa ngamakhemikhali, i-IL-2).
Ingabe kukhona engingakwenza ukuze ukwelashwa kube lula?
Lena akuyona inqubo elula. Yingakho ithimba lakho lezokwelapha lizokuqapha kakhulu phakathi nokuhlala kwakho esibhedlela. Bazokuhlola njalo, bahlole igazi, futhi baqinisekise ukuthi umzimba wakho usukulungele ukwelashwa. Bazokunikeza imithi edingekayo yokunciphisa imiphumela emibi, futhi bazokuqapha njalo nganoma yiziphi izinkinga. Okudingeka ukwenze nje ukulandela imiyalelo enikezwe yithimba lezokwelapha futhi ubatshele nganoma yikuphi ukungakhululeki okuzwayo.
Ngingashayela nini udokotela ucingo?
Uma uya ekhaya ngemva kokwelashwa futhi uba nanoma yiziphi izimpawu zokutheleleka (umkhuhlane, ubuhlungu bomzimba), noma uhlangabezana nanoma yimiphi imiphumela emibi engalindelekile noma enzima, shayela udokotela wakho ngokushesha.
Ungacabangi kabili. Uma uzizwa ushintsho oluncane, into ezwakala sengathi 'lokhu akulungile,' yazisa udokotela wakho ngokushesha.
Uma une-melanoma engasabelanga kwezinye izindlela zokwelapha, ukwelashwa kwe-TIL kungaba yindlela enhle kuwe. Uma udokotela wakho encoma lokhu kwelashwa, qiniseka ukuthi ulalela ngokucophelela inqubo ephelele, isikhathi esizoyithatha, kanye nemiphumela engaba nayo esimweni sakho. Udokotela wakho angakuchazela kangcono izinzuzo nezingozi zalokhu kwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa kwe-TIL kuyindlela entsha nenamandla yokwelapha esebenzisa amangqamuzana akho omzimba (ama-TIL) ukwelapha umdlavuza.
- Okwamanje ivunyelwe i-melanoma, uhlobo lomdlavuza wesikhumba olungaphenduli kwezinye izindlela zokwelapha.
- Le nqubo yokwelapha ihlanganisa ukususa ingxenye yomdlavuza ngokuhlinzwa, ukukhulisa amaseli elabhorethri, ukwelashwa ngamakhemikhali, kanye nokunye ukwelashwa, futhi yonke inqubo ingathatha cishe amasonto ayi-10.
- Lokhu kuhlasela futhi kubhubhise amangqamuzana omdlavuza, ngomonakalo omncane kumaseli avamile. Kodwa-ke, kunemiphumela emibi kanye nezingozi ezithile.
- Uma unemibuzo mayelana nokwelashwa kwakho noma uzwa ukungakhululeki ngemva kokwelashwa, kubaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho ngakho.
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