Kodi Tili Pafupi ndi Chithandizo cha Matenda Oopsa a Khansa Yam'magazi?

Zamkati

• Immunotherapy imabweretsa kuchotsera kwakutali
• Chithandizo cha CAR T-cell
• Mankhwala osokoneza bongo atsopano
• Kupanga khungu la tsinde
• Tengera kwina

Matenda a m'magazi a lymphocytic (CLL)

Matenda a lymphocytic leukemia (CLL) ndi khansa ya chitetezo cha mthupi. Ndi mtundu wa non-Hodgkin lymphoma womwe umayambira m'matenda amthupi-kumenyana ndi ma cell oyera, otchedwa B cell. Khansara iyi imapanga maselo oyera amtundu wambiri am'mafupa ndi magazi omwe sangathe kulimbana ndi matenda.

Chifukwa CLL ndi khansa yomwe ikukula pang'onopang'ono, anthu ena safunika kuyamba kumwa mankhwala kwa zaka zambiri. Mwa anthu omwe khansa imafalikira, chithandizo chitha kuwathandiza kuti azikhala ndi nthawi yayitali pomwe palibe chizindikiro cha khansa mthupi lawo. Uku kumatchedwa kukhululukidwa. Pakadali pano, palibe mankhwala kapena mankhwala omwe atha kuchiritsa CLL.

Vuto limodzi ndiloti ma cell ochepa a khansa nthawi zambiri amakhala mthupi atalandira chithandizo. Izi zimatchedwa matenda ochepa otsalira (MRD). Chithandizo chomwe chingachiritse CLL chiyenera kufafaniza maselo onse a khansa ndikutchinjiriza khansa kuti isabwerere kapena kuyambiranso.

Kuphatikiza kwatsopano kwa chemotherapy ndi immunotherapy kwathandiza kale anthu omwe ali ndi CLL kukhala ndi moyo wautali kuti akhululukidwe. Chiyembekezo ndikuti imodzi kapena zingapo zamankhwala atsopano omwe akupanga akhoza kupereka chithandizo chomwe ofufuza ndi anthu omwe ali ndi CLL akuyembekeza kuchipeza.

Immunotherapy imabweretsa kuchotsera kwakutali

Zaka zingapo zapitazo, anthu omwe ali ndi CLL analibe njira zothandizira kuposa chemotherapy. Kenako, chithandizo chamankhwala chatsopano monga immunotherapy ndi chithandizo chothandizidwa chinayamba kusintha malingaliro ndikuwonjezera kwambiri nthawi zopulumukira anthu omwe ali ndi khansa.

Immunotherapy ndi mankhwala omwe amathandiza chitetezo cha mthupi lanu kupeza ndikupha ma cell a khansa. Ochita kafukufuku akhala akuyesera mitundu ingapo ya chemotherapy ndi immunotherapy yomwe imagwira ntchito bwino kuposa mankhwala okha.

Zina mwa izi - monga FCR - zikuthandiza anthu kukhala opanda matenda kwanthawi yayitali kuposa kale. FCR ndi mankhwala osakaniza a chemotherapy fludarabine (Fludara) ndi cyclophosphamide (Cytoxan), kuphatikizapo monoclonal antibody rituximab (Rituxan).

Pakadali pano, zikuwoneka kuti zikuyenda bwino kwambiri mwa achinyamata, athanzi omwe asintha mtundu wawo wa IGHV. Mwa anthu 300 omwe ali ndi CLL komanso kusintha kwa majini, opitilira theka adapulumuka pazaka 13 zopanda matenda pa FCR.

Chithandizo cha CAR T-cell

Chithandizo cha CAR T-cell ndi mtundu wina wa mankhwala amthupi omwe amagwiritsa ntchito maselo anu osunthika olimbana ndi khansa.

Choyamba, maselo amthupi otchedwa T cell amatengedwa kuchokera m'magazi anu. Maselo a T amenewo amasinthidwa mu labu kuti apange chimeric antigen receptors (CARs) - zolandilira zapadera zomwe zimamangiriza mapuloteni pamwamba pa maselo a khansa.

Maselo a T osinthidwa akabwezeretsedwanso m'thupi lanu, amafufuza ndikuwononga ma cell a khansa.

Pakadali pano, mankhwala a CAR T-cell amavomerezedwa ndi mitundu ingapo ya non-Hodgkin lymphoma, koma osati CLL. Mankhwalawa akuwerengedwa kuti awone ngati angapangitse kuchotseredwa kwakutali kapena mankhwala a CLL.

Mankhwala osokoneza bongo atsopano

Mankhwala oyenera monga idelalisib (Zydelig), ibrutinib (Imbruvica), ndi venetoclax (Venclexta) amatsata zinthu zomwe zimathandiza kuti ma cell a khansa akule ndikukhala ndi moyo. Ngakhale mankhwalawa sangachiritse matendawa, atha kuthandiza anthu kukhala ndi moyo wautali kuti akhululukidwe.

Kupanga khungu la tsinde

Allogenic stem cell kumuika pakadali pano ndi mankhwala okhawo omwe amapereka kuthekera kochiritsa CLL. Ndi mankhwalawa, mumalandira mankhwala osokoneza bongo kwambiri kuti muphe maselo ambiri a khansa momwe mungathere.

Chemo imawononganso maselo athanzi opanga magazi m'mafupa anu. Pambuyo pake, mumalandira ma stem cell kuchokera kwa wopereka wathanzi kuti mudzaze maselo omwe anawonongeka.

Vuto lomwe limakhalapo chifukwa chakuika maselowo ndi oopsa. Maselo opereka amatha kuwononga maselo anu athanzi. Ichi ndi vuto lalikulu lotchedwa matenda olumikizidwa ndi otsutsana.

Kuthira kumathandizanso kuti mutenge kachilombo. Komanso, sizigwira ntchito kwa aliyense amene ali ndi CLL. Kusintha kwa maselo amadzimadzi kumapangitsa kuti anthu azikhala opanda matenda kwa nthawi yayitali pafupifupi 40 peresenti ya anthu omwe amawapeza.

Tengera kwina

Kuyambira pano, palibe mankhwala omwe angachiritse CLL. Chinthu choyandikira kwambiri chomwe tiyenera kuchiritsidwa ndikubzala maselo a tsinde, omwe ndi owopsa ndipo amangothandiza anthu ena kukhala ndi moyo wautali.

Chithandizo chatsopano pakukula chikhoza kusintha tsogolo la anthu omwe ali ndi CLL. Ma immunotherapies ndi mankhwala ena atsopano akupititsa patsogolo kupulumuka. Posachedwa, kuphatikiza kwatsopano kwa mankhwala kungathandize anthu kukhala ndi moyo wautali.

Chiyembekezo ndikuti tsiku lina, chithandizo chithandizire kwambiri kuti anthu athe kusiya kumwa mankhwala ndikukhala moyo wathunthu wopanda khansa. Izi zikachitika, ofufuza pamapeto pake adzatha kunena kuti achiritsa CLL.