Ngaba sisondele kunyango lweLymphocytic Leukemia?

Umxholo

• I-Immunotherapy izisa uxolelo olude
• Unyango lwe-CAR T-cell
• Amachiza amatsha ekujoliswe kuwo
• Ukufakelwa kweseli
• Yise kude

I-lymphocytic leukemia engapheliyo (CLL)

I-lymphocytic leukemia (CLL) engapheliyo ngumhlaza wamajoni omzimba. Luhlobo lwe-non-Hodgkin lymphoma eqala kusulelo lomzimba olwa neeseli ezimhlophe zegazi, ezibizwa ngokuba zii-B. Lo mhlaza uvelisa iiseli zegazi ezimhlophe ezingaqhelekanga kumongo wethambo kunye negazi elingakwaziyo ukulwa nosulelo.

Ngenxa yokuba i-CLL ngumhlaza okhula kancinci, abanye abantu abazukufuna ukuqala unyango iminyaka emininzi. Kubantu abanomdlavuza osasazekayo, unyango lunokubanceda bafezekise ixesha elide xa kungekho mqondiso womhlaza emzimbeni wabo. Oku kubizwa ngokuba kukuxolelwa. Ukuza kuthi ga ngoku, akukho ziyobisi okanye olunye unyango oluye lwakwazi ukunyanga i-CLL.

Umceli mngeni omnye kukuba inani elincinci leeseli zomhlaza zihlala zihlala emzimbeni emva konyango. Oku kubizwa ngokuba sisifo esincinci esishiyekileyo (MRD). Unyango olunokunyanga i-CLL kuya kufuneka lucime zonke iiseli zomhlaza kwaye luthintele umhlaza ekubeni ubuye kwakhona okanye uphinde ubuye.

Inhlanganisela entsha ye-chemotherapy kunye ne-immunotherapy sele incede abantu abane-CLL baphila ixesha elide kuxolelo. Ithemba kukuba elinye okanye amachiza amatsha kuphuhliso anokubonelela ngonyango abaphandi kunye nabantu abane-CLL abanethemba lokulufumana.

I-Immunotherapy izisa uxolelo olude

Ngaphambi kweminyaka embalwa edlulileyo, abantu abane-CLL babengenalo ukhetho lonyango ngaphaya kwe-chemotherapy. Emva koko, unyango olutsha olunjenge-immunotherapy kunye nonyango ekujoliswe kulo lwaqala ukutshintsha imeko kwaye lwandisa kakhulu amaxesha okusinda kubantu abanomhlaza.

I-Immunotherapy yonyango elinceda amajoni omzimba wakho ukuba afumane kwaye abulale iiseli zomhlaza. Abaphandi bazama ngokudibanisa i-chemotherapy kunye ne-immunotherapy esebenza ngcono kunonyango olunye kuphela.

Ezinye zezi zinto zidibeneyo - njenge-FCR- zinceda abantu ukuba baphile bengenasifo ixesha elide kunakuqala. I-FCR yindibaniselwano yamachiza ekhemotherapy fludarabine (Fludara) kunye necyclophosphamide (Cytoxan), kunye ne-monoclonal antibody rituximab (Rituxan).

Ukuza kuthi ga ngoku, kubonakala ngathi isebenza kakuhle kubantu abancinci, abasempilweni abanotshintsho kuhlobo lwabo lwe-IGHV. Kubantu abangama-300 abane-CLL kunye nokutshintsha kwemfuza, ngaphezulu kwesiqingatha basinda iminyaka eli-13 bengenasifo kwi-FCR.

Unyango lwe-CAR T-cell

Unyango lwe-CAR T-cell luhlobo olukhethekileyo lonyango lwamajoni omzimba olusebenzisa iiseli zomzimba wakho eziguqulweyo ukulwa nomhlaza.

Okokuqala, iiseli zomzimba ezibizwa ngokuba zii-T cell ziqokelelwa kwigazi lakho. Ezo seli ze-T ziguqulwe ngokwemfuza elebhu ukuvelisa ii-chimeric antigen receptors (ii-CARs) - ii-receptors ezizodwa ezibophelela kwiiproteni ngaphezulu kweeseli zomhlaza.

Xa iiseli ze-T eziguqulweyo zibuyiselwe emzimbeni wakho, zifuna zitshabalalise iiseli zomhlaza.

Okwangoku, unyango lwe-CAR T-cell luvunyiwe kwezinye iintlobo ze-non-Hodgkin lymphoma, kodwa hayi i-CLL. Olu nyango lufundelwa ukubona ukuba ngaba lunokuvelisa uxolelo olude okanye unyango lwe-CLL.

Amachiza amatsha ekujoliswe kuwo

Iziyobisi ekujoliswe kuzo njenge-idelalisib (Zydelig), ibrutinib (Imbruvica), kunye ne-venetoclax (Venclexta) zilandela izinto ezinceda iiseli zomhlaza ukuba zikhule kwaye zisinde. Nokuba la machiza akanakunyanga isifo, anokunceda abantu ukuba baphile ixesha elide kuxolelo.

Ukufakelwa kweseli

Ukufakelwa kweseli ye-stem ye-Allogenic kungoku kuphela kwonyango olunika ithuba lokunyanga i-CLL. Ngolu nyango, ufumana iidosi eziphezulu kakhulu ze-chemotherapy ukubulala iiseli zomhlaza ezininzi kangangoko kunokwenzeka.

I-Chemo iphinda itshabalalise iiseli eziphilileyo ezenza igazi kumongo wethambo lakho. Emva koko, ufumana ukutshintshwa kweeseli ezitshisayo ezivela kumnikeli osempilweni ukuzalisa iiseli ezatshatyalaliswayo.

Ingxaki ngokutshintshwa kweeseli zeziqu ziyingozi. Iiseli ezinikelayo zinokuhlasela iiseli zakho ezisempilweni. Le yimeko enzulu ebizwa ngokuba yi-graft-versus-host host.

Ukufakelwa kwakhona kukonyusa umngcipheko wosulelo. Kwakhona, ayisebenzi kuye wonke umntu one-CLL. Ukufakelwa kweseli kwistem kuphucula ukusinda kwezifo ixesha elide malunga neepesenti ezingama-40 zabantu abazifumanayo.

Yise kude

Ukuza kuthi ga ngoku, akukho lunyango lunokuyinyanga i-CLL. Eyona nto ikufutshane kuthi ekufuneka siyinyange kukufakelwa kwe-stem cell, eyingozi kwaye inceda kuphela abanye abantu ukuba baphile ixesha elide.

Unyango olutsha kuphuhliso lunokutshintsha ikamva labantu abane-CLL. Amajoni omzimba kunye namanye amachiza amatsha sele enabisa ubomi. Kwixa elizayo, indibaniselwano entsha yamachiza inokunceda abantu baphile ixesha elide.

Ithemba kukuba ngenye imini, unyango luya kusebenza kangangokuba abantu baya kuba nakho ukuyeka ukuthatha amayeza abo kwaye baphile ubomi obungenamhlaza. Xa oko kusenzeka, abaphandi ekugqibeleni baya kuba nakho ukuthi bayiphilisile i-CLL.