Wake wacabanga ukuthi imizimba yethu ingalwa nomdlavuza ngokwayo? Eqinisweni, imizimba yethu inebutho lokuzivikela elimangalisayo elibizwa ngokuthi isimiso somzimba sokuzivikela. Kodwa ngezinye izikhathi, ngenxa yokuthi isitha esibizwa ngokuthi umdlavuza sinolaka kakhulu, kuba nzima ngebutho lethu ukunqoba impi lodwa. Ngezikhathi ezinjalo, sizokhuluma ngokwelashwa okunikeza ibutho lethu ukuqeqeshwa okukhethekile, okwandisa amandla alo, futhi kulibuyisele empini.
Iyini le ndlela yokwelapha i-TIL?
Kalula nje, ukwelashwa kwe-TIL uhlobo olusha lokwelashwa nge-immunotherapy yomdlavuza. Kusebenza ngokusiza amasosha omzimba wakho ukuthi aqaphele futhi abhubhise amangqamuzana omdlavuza.
Iqhawe lalolu hlobo lokwelashwa uhlobo olukhethekile lweseli olubizwa ngokuthi i-Tumor-Infiltrating Lymphocytes , esilubiza ngama -TIL ngamafuphi.
Cabanga ngakho njengamasosha (amangqamuzana omzimba) aqapha imizimba yethu. Kodwa la masosha, abizwa ngokuthi ama-TIL, akhethekile nakakhulu. Angena esimila ngokwaso, afunde ubuthakathaka baso, futhi afunde ukuthi angasibhubhisa kanjani kangcono. Ngamanye amazwi, anjengezimpi ezikhethekile ezingena ngaphakathi ekamu lesitha futhi azihlole.
Kodwa inkinga iwukuthi, imizimba yethu ayikwazi ukukhiqiza amangqamuzana e-TIL anele ukulwa nalezi zinhlayiya ezibulalayo.
Yilapho ukwelashwa kwe-TIL kungena khona. Kuhilela ukwandisa ngokwenziwa inani lamaseli akho e-TIL ngamabhiliyoni. Udokotela ohlinzayo ususa ingxenye encane yesimila sakho. Bese besithumela elabhorethri, bahlukanise amasosha e-TIL, bese bewakhulisa aze abalwe ngamabhiliyoni. Ekugcineni, leli butho elikhulu, elenziwe ngamaseli akho, libuyiselwa emzimbeni wakho.
Yiziphi izinhlobo zomdlavuza eziphathwa yilolu hlobo lokwelashwa?
Ngo-2024, i-US Food and Drug Administration (FDA) isivumile ukwelashwa kwe-TIL okubizwa ngokuthi i-lifileucel (Amtagvi®) . Kuqondene ngqo ne -melanoma, uhlobo lomdlavuza wesikhumba. Okusho ukuthi, i-melanoma engelapheki ngokuhlinzwa kuphela, noma esakazekele kwezinye izingxenye zomzimba (umdlavuza we-metastatic). Lokhu kwelashwa kungafaneleka kumuntu ongaphenduli ekwelashweni okuvame ukunikezwa odokotela be-oncologists.
Ngaphezu kwalokho, odokotela bacwaninga ngempumelelo yalolu hlobo lokwelashwa kwe-TIL kwezinye izinhlobo eziningana zomdlavuza, okuhlanganisa:
- Umdlavuza webele
- Umdlavuza wesibeletho
- Umdlavuza wamathumbu amakhulu
- Umdlavuza wekhanda nentamo
- Umdlavuza wamaphaphu ongewona owamangqamuzana amancane
Isebenza kanjani inqubo yokwelapha?
Lokhu akuyona into eyenziwa ngesikhathi esisodwa. Nakuba into eyinhloko ukufaka amaseli e-TIL, kunezinyathelo eziningana okudingeka zenziwe ngaphambi kwalokho. Ake sibheke yonke le nqubo isinyathelo ngesinyathelo.
| Izinyathelo | Incazelo yalokho okwenzekayo |
|---|---|
| 1. Ukususa ingxenye yesimila somdlavuza | Udokotela ohlinzayo uzosusa ucezu oluncane lwesimila sakho, olucishe lube usayizi we-grapefruit, bese eluthumela elabhorethri. Uzonikezwa i-anesthesia, ngakho ngeke uzwe ubuhlungu phakathi nalesi sikhathi. |
| 2. Ukuhlukaniswa nokukhula kwamaseli e-TIL | Elabhorethri, amaseli e-TIL ahlukaniswa nesimila futhi akhule abe yizigidigidi. Le nqubo ivame ukuthatha cishe amasonto amahlanu. Ngemuva kwalokho, la maseli athunyelwa esibhedlela lapho uzokwelapha khona. |
| 3. Ukunikeza i-chemotherapy | Uzolaliswa esibhedlela futhi unikezwe ukwelashwa ngamakhemikhali izinsuku ezinhlanu kuya kweziyisikhombisa. Lokhu kwenzelwa ukulungiselela umzimba wakho ukufika kwamaseli amasha e-TIL. |
| 4. Ukufakwa kabusha kwamaseli e-TIL | Manje sekuza ingxenye ebalulekile. Amaseli e-TIL akhulile afakwa emzimbeni wakho ngesikhathi esisodwa, njengesixazululo sikasawoti. Lokhu kuthatha cishe amahora amabili. |
| 5. Ukunikeza i-Interleukin-2 | Ekugcineni, izinsuku ezintathu kuya kwezinhlanu, uzonikezwa umuthi obizwa ngokuthi i-interleukin-2 (IL-2). Lolu olunye uhlobo lokwelashwa nge-immunotherapy. Lusebenza "ngokusebenzisa" lawo maseli e-TIL asanda kufakwa futhi luwakhuthaze ukuba alwe nomdlavuza. |
Kuzodingeka uhlale esibhedlela izinsuku ezimbalwa ngemva kokwelashwa. Phakathi nalesi sikhathi, ithimba lezokwelapha lizoqapha ngokucophelela indlela umzimba wakho osabela ngayo ekwelashweni. Emasontweni ambalwa alandelayo, kubalulekile ukuhlala useduze nesibhedlela ukuze uthole ukwelashwa ngokushesha uma kuvela imiphumela emibi.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Yiziphi izinzuzo?
Ukwelashwa kwe-TIL kuyindlela yokwelapha eyenzelwe wena kakhulu futhi enamandla kakhulu. Ngenxa yokuthi isebenzisa amaseli akho, kunomonakalo omncane kumaseli anempilo. Ngakho-ke, ingozi yemiphumela emibi nayo iphansi.
Okubaluleke nakakhulu, imiphumela yalokhu kwelashwa ihlala isikhathi eside . Amaseli e-TIL ajovwayo ahlala emzimbeni wakho iminyaka eminingi, elwa namaseli omdlavuza.
Lokhu kwelashwa kunikeze ithemba elisha ezigulini eziningi ze-melanoma ezazicabanga ukuthi ayikho ikhambi. Ngokusho kocwaningo lwango-2023, eminyakeni emine ngemuva kokuthola ukwelashwa kwe-TIL, abantu abayisikhombisa kwabayishumi baphathwa noma belashwa yisifo sabo.
Izingozi nemiphumela emibi
Njenganoma yikuphi ukwelashwa, kunezingozi kuzo zonke izinyathelo zenqubo. Imiphumela emibi ibangelwa kakhulu ukwelashwa ngamakhemikhali kanye ne-IL-2. Imiphumela emibi evela ekuphathweni kwamaseli e-TIL ayivamile kakhulu.
| Imiphumela emibi evamile | |
|---|---|
| Uhudo | Ukukhathala |
| Umkhuhlane kanye nokubanda | Ukushaya kwenhliziyo okungajwayelekile (i-arrhythmia) |
| Umfutho wegazi ophansi | Isicanucanu nokuhlanza |
| Ukuqhuma kwesikhumba | |
Akuvamile kakhulu, ngenxa yokwelashwa kwe-IL-2Kungaba nenkinga enkulu, njenge-capillary leak syndrome. Kodwa ungakhathazeki, udokotela wakho uzoxoxa nawe ngazo zonke lezi zingozi ngaphambi kokuqala ukwelashwa.
Kuzongithatha isikhathi esingakanani ukubuyela esimweni esijwayelekile?
Uzoqala ukuzizwa ungcono cishe emavikini amabili ngemuva komthamo wakho wokugcina we-IL-2. Njengoba le nqubo yokwelashwa ihilela izinto eziningi, njengokuhlinzwa kanye ne-chemotherapy, kuthatha isikhathi esithile ukuthi umzimba ululame.
Kunini lapho udinga ukubonana nodokotela?
Ngemva kokwelashwa, uma uba nezimpawu zokutheleleka (umkhuhlane, izinhlungu zomzimba), noma uma uhlangabezana nanoma yimiphi imiphumela emibi engalindelekile, shayela udokotela wakho ngokushesha.
Uma uzizwa noma yiziphi izinguquko noma ukungakhululeki, ungangabazi ukutshela udokotela wakho. Ungazami ukunquma ukuthi kuyinto evamile noma cha. Kuphephile kakhulu ukukubika ngokushesha.
Uma une-melanoma engasabelanga kwezinye izindlela zokwelapha, i-TIL ingaba inketho enhle kuwe. Uma udokotela wakho encoma lokhu kwelashwa, buza noma yimiphi imibuzo onayo ngakho. Khuluma nodokotela wakho ngezinzuzo nezingozi. Udokotela wakho ungumthombo wakho wolwazi ongcono kakhulu.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa kwe-TIL kuyindlela entsha nenamandla yokwelapha esebenzisa amasosha omzimba wakho ukulwa nomdlavuza.
- Lokhu kuhilela ukukhulisa izigidigidi zamaseli athathwe esimila somdlavuza elebhu bese efakwa kabusha emzimbeni.
- Njengamanje, ivunyelwe kakhulu umdlavuza we-melanoma ongazange usabele kwezinye izindlela zokwelapha, kodwa futhi isesigabeni sokucwaninga ngezinye izinhlobo zomdlavuza.
- Lena inqubo eyinkimbinkimbi equkethe izinyathelo eziningana, okuhlanganisa ukuhlinzwa, ukwelashwa ngamakhemikhali kanye nemithi.
- Noma nini, xoxa ngezinzuzo, ukungalungi, kanye nezingozi zalokhu kwelashwa ngokukhululekile nodokotela wakho bese wenza izinqumo ezinolwazi.
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