Umbhali: John Stephens
Umhla Wokudalwa: 2 Eyomqungu 2021
Hlaziya Umhla: 14 Eyenkanga 2024
Anonim
GLEEVEC (IMATINIB) MOA
Ividiyo: GLEEVEC (IMATINIB) MOA

Umxholo

Yintoni iGleevec?

I-Gleevec ligama lonyango elinegama lophawu. Isetyenziselwa ukunyanga iintlobo ezithile zomhlaza wegazi kubantu abadala nasebantwaneni. I-Gleevec ikwasetyenziselwa ukunyanga uhlobo lomhlaza wolusu kunye nohlobo lomhlaza wamathumbu.

I-Gleevec iqulethe ichiza imatinib mesylate, eyeklasi yamachiza abizwa ngokuba yi-tyrosine kinase inhibitors.

I-Gleevec iza njengecwecwe olithathayo ngomlomo. Uthatha ichiza kube kanye okanye kabini ngosuku, kuxhomekeke kumthamo ugqirha ugqirha.

Into eyenzayo

Ulawulo lwezoKutya kunye neDrug (i-FDA) luvumile iGleevec ukunyanga iintlobo ezithile zomhlaza wegazi, kubandakanya:

  • IPhiladelphia chromosome-positive (Ph +) chronic myeloid leukemia (CML) kubantu abadala nasebantwaneni
  • I-Ph + acute lymphocytic leukemia (ZONKE) ezibuyileyo kwakhona * okanye ezokuphikisa * kubantu abadala
  • esandula kuvavanywa i-Ph + BONKE ebantwaneni
  • Izifo ze-myelodysplastic / myeloproliferative (umhlaza womongo wethambo) kubantu abadala abane-platelet-derived factor factor receptor (PDGFR)
  • i-hypereosinophilic syndrome okanye i-leosemia engapheliyo ye-eosinophilic leukemia kubantu abadala
  • Inkqubo ye-mastocytosis enobundlongondlongo kubantu abadala ngaphandle koguquko lwe-D816v c-Kit

Umhlaza obuyileyo ubuyile emva kokuxolelwa, nokuhla kweempawu zomhlaza kunye neempawu. Umhlaza obonakalisayo awuphendulanga kunyango lwangaphambili lomhlaza.


I-Gleevec ikwavunyiwe ukuba inyange:

  • uhlobo lomhlaza wolusu obizwa ngokuba yi-dermatofibrosarcoma protuberans (DFSP) kubantu abadala
  • uhlobo lomhlaza wamathumbu obizwa ngokuba yi-Kit-positive gastrointestinal stromal tumors (GIST) kubantu abadala

Ngeenkcukacha, jonga amacandelo e "Gleevec ye-CML" kunye "nolunye usetyenziso lweGleevec."

Ukusebenza kweGleevec

I-Gleevec ifunyenwe isebenza kunyango lweentlobo ezahlukeneyo zomhlaza wegazi.

Kwisifundo esinye seklinikhi, abantu abadala abane-CML esandula ukufunyanwa kwisigaba esinganyangekiyo bathatha uGleevec iminyaka esixhenxe. Kweli qela, i-96.6% yabantu babenempendulo epheleleyo kwichiza. Oku kuthetha ukuba akukho iiseli zomhlaza zafunyanwa egazini labo, kwaye babengenazo iimpawu zomhlaza.

Impendulo epheleleyo yenye yeendlela zokuchaza inqanaba lempumelelo. Kwiqela labantu abafumene ichemotherapy esemgangathweni, i-56.6% ibinempendulo epheleleyo.

I-Gleevec ikwafunyenwe isebenza ngokunyanga amathumbu esisu (GIST) kwizifundo zeklinikhi. Iqondo lokusinda lilonke lalimalunga neminyaka emine. Oku kuthetha ukuba isiqingatha sabantu kolu phononongo baphila malunga neminyaka emine emva kokuba beqalisile ukuthatha iGleevec. Abantu abathathe iGleevec emva kotyando baphila isithuba seminyaka emihlanu emva kokuqala ichiza.


Ukufunda ukuba isebenza njani iGleevec ekunyangeni ezinye iintlobo zomhlaza, jonga kwicandelo "Olunye usetyenziso lweGleevec".

Gleevec generic

I-Gleevec iyafumaneka njengeyeza elinegama lophawu kunye nefom yohlobo oluqhelekileyo.

I-Gleevec inesithako esisebenzayo seziyobisi imatinib mesylate.

Iziphumo ebezingalindelekanga zeGleevec

I-Gleevec inokubangela iziphumo ebezingalindelekanga ezinobulali okanye ezinobuzaza. Olu luhlu lulandelayo luqulathe ezinye zeziphumo ebezingalindelekanga ezinokubakho ngelixa uthatha iGleevec. Olu luhlu alubandakanyi zonke iziphumo ebezingalindelekanga ezinokubakho.

Ngolwazi oluthe kratya malunga neziphumo ebezingalindelekanga ezinokubakho zeGleevec, thetha nogqirha wakho okanye usokhemesti. Banokukunika iingcebiso malunga nendlela yokujongana nayo nayiphi na imiphumela emibi enokuthi ikhathaze.

Iziphumo eziqhelekileyo ezichaphazelekayo

Iziphumo eziqhelekileyo eziqhelekileyo zeGleevec zingabandakanya:

  • urhudo
  • isisu esibuhlungu
  • ukudinwa (ukunqongophala kwamandla)
  • i-edema (ukudumba, imilenze yakho, amaqatha, okanye iinyawo kunye namehlo akho)
  • izihlunu okanye iintlungu
  • isicaphucaphu
  • ukugabha
  • irhashalala

Uninzi lweziphumo ebezingalindelekanga zinokuhamba zingaphelanga iintsuku okanye iiveki ezimbalwa. Ukuba zinzima kakhulu okanye azihambi, thetha nogqirha wakho okanye usokhemesti.


Iziphumo ebezingalindelekanga ezimandundu

Iziphumo ebezingalindelekanga ezimandundu ezivela kwiGleevec aziqhelekanga, kodwa zinokwenzeka. Shayela ugqirha wakho ngokukhawuleza ukuba unemiphumo emibi. Tsalela umnxeba ku-911 ukuba iimpawu zakho ziziva zisongela ubomi okanye ukuba ucinga ukuba unempilo kaxakeka.

Iziphumo ebezingalindelekanga ezimandundu kunye neempawu zazo zinokubandakanya oku kulandelayo:

  • Ukugcina ulwelo olunamandla (ulwelo oluninzi okanye amanzi) ngaphakathi nakwintliziyo yakho, imiphunga (ukungxengxeka kwembumba), kunye nesisu (ascites). Iimpawu zingabandakanya:
    • ngokungalindelekanga, ngokukhawuleza ukufumana ubunzima
    • iintlungu zesifuba
    • ukuqhawukelwa ngumphefumlo
    • ingxaki yokuphefumla nzulu
    • ingxaki yokuphefumla xa ulele phantsi
    • ukukhohlela owomileyo
    • isisu esidumbileyo
  • Ukuphazamiseka kwegazi, kubandakanya i-anemia (amanqanaba asezantsi eeseli ezibomvu zegazi), i-neutropenia (amanqanaba asezantsi eeseli ezimhlophe zegazi), kunye ne-thrombocytopenia (amanqanaba asezantsi eeplatelets). Iimpawu zingabandakanya:
    • ukudinwa (ukunqongophala kwamandla)
    • ukukhawuleza kwentliziyo
    • ukuqhawukelwa ngumphefumlo
    • usulelo rhoqo
    • ifiva
    • ukutyumka ngokulula
    • iintsini ezophayo
    • igazi kumchamo okanye ilindle
  • Ukungaphumeleli kwentliziyo kunye nezinye iingxaki zentliziyo, ezifana nokusilela kwentliziyo ekhohlo. Iimpawu zingabandakanya:
    • ukutyeba okungalindelekanga
    • i-edema (ukudumba kweenyawo zakho, amaqatha, kunye nemilenze)
    • isantya sentliziyo esingaqhelekanga okanye isingqisho (ukubetha kwentliziyo okukhawulezayo kakhulu, okucothayo, okanye okungaqhelekanga)
    • iintlungu zesifuba
    • ukuqhawukelwa ngumphefumlo
  • Ukonakala kwesibindi okanye ukusilela kwesibindi. Iimpawu zingabandakanya:
    • isicaphucaphu
    • urhudo
    • Ukuphelelwa ngumdla wokutya
    • ukurhawuzelela ulusu
    • i-jaundice (umbala omthubi wolusu lwakho kunye namhlophe ngamehlo akho)
    • i-edema (ukudumba kwemilenze yakho, amaqatha neenyawo)
    • I-ascites (i-fluid buildup esiswini sakho)
    • ukutyumza rhoqo
    • ukopha rhoqo
  • Ukopha okumandla (ukopha okungayeki), rhoqo kumathumbu akho. Iimpawu zingabandakanya:
    • igazi esitulweni
    • isitulo esimnyama okanye sokulinda
    • ukudinwa (ukunqongophala kwamandla)
    • ukhohlela igazi
    • Ukukhohlela udaka olumnyama
    • isicaphucaphu
    • isisu esiswini
  • Iingxaki zesisu, kubandakanya ukubola (iinyembezi) esiswini sakho okanye emathunjini. Iimpawu zingabandakanya:
    • isicaphucaphu
    • ukugabha
    • iintlungu eziqatha esiswini sakho
    • ifiva
    • ukuqhawukelwa ngumphefumlo
    • ukubetha kwentliziyo ngokukhawuleza
  • Iingxaki ezinzima zesikhumba. Iimpawu zingabandakanya:
    • i-erythema multiforme (iipatches ezibomvu okanye i-blisters, rhoqo kwiinyawo zakho okanye ezintendeni zezandla zakho)
    • I-Stevens-Johnson syndrome (umkhuhlane; izilonda ezibuhlungu emlonyeni wakho, emqaleni, emehlweni, kwizitho zangasese, okanye emzimbeni wonke)
    • ifiva
    • iintlungu zomzimba
  • I-Hypothyroidism (amanqanaba aphantsi e-thyroid) kubantu abaye basuswa i-thyroid kwaye bathatha unyango lwe-thyroid. Iimpawu zingabandakanya:
    • ukudinwa (ukunqongophala kwamandla)
    • ukuqhina
    • ukudakumba
    • ndiziva ndibanda
    • isikhumba esomileyo
    • ukutyeba kwakho
    • iingxaki zememori
  • Ukukhula kancinci kubantwana. Iimpawu zingabandakanya:
    • ayikhuli kwinqanaba eliqhelekileyo
    • sincinci kunabanye abantwana abakubudala babo
  • I-Tumor lysis syndrome (xa iiseli zomhlaza zikhupha imichiza eyingozi egazini lakho). Iimpawu zingabandakanya:
    • ukudinwa (ukunqongophala kwamandla)
    • isicaphucaphu
    • ukugabha
    • urhudo
    • izihlunu zemithambo
    • isingqi sentliziyo esingaqhelekanga (ukubetha kwentliziyo okukhawulezayo kakhulu, okucothayo, okanye okungaqhelekanga)
    • ukuxhuzula
  • Ukonakala kwezintso. Iimpawu zingabandakanya:
    • ukuchama amaxesha ngamaxesha kunesiqhelo
    • i-edema (ukudumba kwemilenze yakho, amaqatha neenyawo)
    • ukudinwa (ukunqongophala kwamandla)
    • isicaphucaphu
    • ukudideka
    • igazi elonyukayo
  • Iziphumo ezingakhokelela kwiingozi zeemoto. Iimpawu zingabandakanya:
    • isiyezi
    • ukozela
    • ukungaboni kakuhle

Iinkcukacha zesiphumo

Unokuzibuza ukuba zenzeka kangaphi iziphumo ebezingalindelekanga ngeli chiza, okanye nokuba ngaba ezinye iziphumo ebezingalindelekanga zinxulumene nalo.Nazi ezinye iinkcukacha kwiziphumo ebezingalindelekanga ezinokubangela okanye ezingabangeli.

Ukuphendula ngokuchaseneyo

Njengoninzi lweziyobisi, abanye abantu banokuba neempendulo ezingafunekiyo emva kokuthatha iGleevec. Iimpawu zokuphendula kancinci kunokubandakanya:

  • irhashalala
  • ukucheba
  • ukucoca (ukufudumala nokubomvu kwesikhumba sakho)

Impendulo eyingozi kakhulu inqabile kodwa inokwenzeka. Iimpawu zokungaziphathi kakuhle kunokubandakanya:

  • i-angioedema (ukudumba phantsi kolusu lwakho, ubukhulu becala kwiinkophe zakho, imilebe, izandla, okanye iinyawo)
  • ukudumba kolwimi lwakho, umlomo, okanye umqala
  • ingxaki yokuphefumla

Fowunela ugqirha ngoko nangoko ukuba unegalelo elibukhali kuGleevec. Tsalela umnxeba ku-911 ukuba iimpawu zakho ziziva zisongela ubomi okanye ukuba ucinga ukuba unempilo kaxakeka.

Iziphumo ebezingalindelekanga zexesha elide

Ezinye zeziphumo ebezingalindelekanga ezibonakalayo kwizifundo zeklinikhi zinokwenzeka ngokusetyenziswa kwexesha elide kweGleevec. Oku kubandakanya iingxaki zentliziyo, ezinje ngokusilela kwentliziyo kunye nokusilela kwentliziyo ekhohlo.

Kwisifundo seklinikhi, ngaphezulu kwama-500 abantu abathathe i-Gleevec ye-myeloid leukemia (CML) engapheliyo belandelwa ukuya kuthi ga kwi-11 iminyaka. Abantu kolu phononongo lwexesha elide banemiphumela efanayo efanayo echazwe kwizifundo ezifutshane. Nangona kunjalo, ezi ziphumo bezingalindelekanga zibonakala ziphucuka ngokuhamba kwexesha.

Iziphumo ezibi kakhulu ezibonwe ngokusetyenziswa kwexesha elide zibandakanyiwe:

  • Ukuphazamiseka kwegazi okunzima (amanqanaba asezantsi eeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, okanye iiplatelets) kubantu abathandathu
  • iingxaki zentliziyo, kubandakanya ukungaphumeleli kwentliziyo, kubantu abasixhenxe
  • amatyala amathandathu omhlaza omtsha, kubandakanya uninzi lwe-myeloma kumntu omnye kunye nomhlaza wekolon komnye umntu

Iziphumo ebezingalindelekanga zixhaphake kakhulu kunyaka wokuqala kunyango ngeGleevec. Kodwa okude ukuba abantu bathathe iGleevec, kuncinci ukuba babeneziphumo ebezingalindelekanga ezininzi. Umzekelo, kunyaka wokuqala wesifundo, abantu abathathu babenengxaki yegazi, kodwa emva konyaka wesihlanu, mnye kuphela umntu owayenayo.

Kwisifundo seminyaka emihlanu sabantu abanezilonda zesisu esiswini (GIST), i-16% yabantu bayeka ukuthatha i-Gleevec ngenxa yeziphumo ebezingalindelekanga. Iziphumo ebezingalindelekanga ziye zafana nezo zichazwe kwisifundo se-CML apha ngasentla. Amashumi amane eepesenti abantu kolu phononongo banikwa idosi ezisezantsi zamachiza ukunciphisa iziphumo ebezingalindelekanga.

Ukuba unomdla malunga nemiphumo emibi yexesha elide le-Gleevec, thetha nogqirha wakho. Banokucebisa ngeendlela zokunciphisa umngcipheko weziphumo ebezingalindelekanga ezithile.

Iziphumo ezichaphazelekayo zamehlo

Kwizifundo zeklinikhi zeGleevec, abanye abantu baneziphumo ebezingalindelekanga ezinxulumene neliso ezinjengokudumba nokungaboni kakuhle.

Ukudumba kweenkophe kunye nokudumba okujikeleze amehlo zezinye zezona zinto zichaphazeleka kakhulu. Ukuya kuthi ga kwi-74.2% yabantu abathathe i-Gleevec babene-periorbital edema (ukudumba kwendawo yamehlo).

Ukuba unale mpembelelo yecala, ugqirha wakho unokumisela i-diuretic (edla ngokubizwa ngokuba yipilisi yamanzi). I-diuretics inceda umzimba wakho ukuba ulahle amanzi kunye netyuwa eyongezelelweyo xa uchama. Oku kunciphisa ulwakhiwo lwamanzi. Ugqirha wakho unokuhlisa idosi yakho yeGleevec, ukuba iyafuneka.

Ukongeza, uphononongo lweklinikhi luxele ukuba ukuya kuthi ga kwi-11.1% yabantu abathathe iGleevec banombono ongacacanga. Ukuba unombono omfiliba, musa ukuqhuba okanye usebenzise oomatshini abanzima. Kwaye qiniseka ukuxelela ugqirha wakho ukuba awukwazi ukubona ngokucacileyo.

Ezinye iziphumo ebezingalindelekanga eziqhelekileyo ezinxulumene neliso zibandakanya:

  • iliso elomileyo
  • Amehlo amanzi
  • ukucaphuka kwamehlo
  • i-conjunctivitis (edla ngokubizwa ngokuba liliso elipinki)
  • imithambo yegazi eyaphukileyo esweni
  • ukudumba kwe-retina (ungqimba lweethishu ngasemva kweliso lakho)

Ukuba uthatha iGleevec kwaye unazo naziphi na iziphumo ebezingalindelekanga ezinxulumene neliso, thetha nogqirha wakho. Banokucebisa ngeendlela zokunciphisa iimpawu zakho.

Ukulahleka kweenwele

Ukulahleka kweenwele (alopecia) sisiphumo esibi sokuthatha iGleevec.

Olunye uphononongo luvavanye indlela iGleevec esebenza ngayo kubantu abane-chromosome-positive (Ph +) engapheliyo ye-myeloid leukemia (CML). Ipesenti ezisixhenxe zaba bantu baphulukene neenwele emva kokuba bethathe iyeza.

Kwesinye isifundo, abantu bathathe i-Gleevec ukunyanga amathumbu esisu (GIST). Phakathi kwe-11.9% kunye ne-14.8% yaba bantu baphulukene neenwele. Iziphumo ebezingalindelekanga zibonwa rhoqo ebantwini abathathe iidosi eziphezulu zeGleevec.

Ukulahleka kweenwele ngenxa yonyango lomhlaza kuhlala okwethutyana. Ukuba unomdla ngale mpembelelo, thetha nogqirha wakho. Banokucebisa ngeengcebiso zokukunceda ukunciphisa ukulahleka kweenwele ngexesha lonyango lwakho.

Irhashalala kunye nezinye iziphumo ebezingalindelekanga zolusu

I-Gleevec inokubangela iziphumo ebezingalindelekanga ezinobuzaza kunye nezibi kakhulu kulusu lwakho.

Ukuphendula okuqhelekileyo kolusu

Irhashalala kunye nolunye ulusu olunempembelelo oluqhelekileyo luxhaphake kakhulu kubantu abathatha iGleevec.

Kwizifundo zeklinikhi, abantu bathathe iGleevec ukunyanga i-Ph + chronic myeloid leukemia (CML). Ukuya kuthi ga kwi-40.1% yaba bantu banerhashalala okanye olunye ulusu emva kokuphatha iyeza.

Kwezinye izifundo zeklinikhi, abantu bathathe i-Gleevec yamathumba esisu esiswini (GIST). Emva kokuthatha iyeza, ukuya kuthi ga kwi-49.8% yaba bantu banerhashalala okanye olunye ulusu. Oku kubandakanya:

  • ukuxobuka kolusu
  • isikhumba esomileyo
  • ukuguqulwa kolusu (umbala oluhlaza okwesibhakabhaka kulusu)
  • Usulelo lwezixhobo zeenwele (iingxowa phantsi kolusu lwakho ezibambe iingcambu zeenwele zakho)
  • i-erythema (ukubomvu kwesikhumba)
  • i-purpura (amabala anombala omfusa eluswini)

Iziphumo ebezingalindelekanga zixhaphakile ebantwini abathathe idosi eziphezulu zeGleevec.

Ukuba unomdla malunga nerhashalala okanye olunye ulusu olunempembelelo ngenxa yeGleevec, thetha nogqirha wakho. Banokucebisa ngeendlela zokunceda ukunciphisa iimpawu zakho.

Ukuphendula kakubi kolusu

Kwizifundo zeklinikhi, iimpendulo zolusu ezinqabileyo zazinqabile kunene kubantu abathathe iGleevec. Ukuya kuthi ga kwi-1% yabantu abathathe eli chiza bebephethe ulusu olunobuzaza. Imizekelo yeziphumo ezibi zolusu ezinxulumene neziyobisi zibandakanya:

  • I-Stevens-Johnson syndrome (umkhuhlane; izilonda ezibuhlungu emlonyeni wakho, emqaleni, emehlweni, kwizitho zangasese, okanye emzimbeni wonke)
  • I-exfoliative dermatitis (ulusu luxobuka amalungu amakhulu omzimba wakho)
  • Ukukhawuleza kwe-vesicular (i-blisters encinci kunye nokugqithisa)

Irhashalala kunye namadyungudyungu kunokuba buhlungu kakhulu. Kwaye ukuba azinyangwa, zinokubambisa iintsholongwane kwaye zikhokelele kusulelo olubi. Ke ukuba uthatha iGleevec kwaye unerhashalala okanye iblisters enomkhuhlane okanye awuziva mnandi, xelela ugqirha ngoko nangoko. Chaza nokuba loluphi na olunye ulusu onalo.

Iziphumo ezichaphazela ukuqhuba

Kwizifundo zeklinikhi, abanye abantu abathathe iGleevec baneziphumo ebezingalindelekanga ezinokuchaphazela amandla abo okuqhuba. Oku kubandakanya:

  • isiyezi: ukuya kuthi ga kwi-19.4% yabantu
  • umbono ongenangqondo: ukuya kuthi ga kwi-11.1% yabantu
  • ukudinwa: kwi-74.9% yabantu

Iziphumo ebezingalindelekanga zinokuchaphazela amandla akho okuqhuba okanye ukusebenzisa oomatshini abanzima. Kubekho ingxelo ngeengozi zeemoto ngabantu abathathe iGleevec. Ke kuya kufuneka usebenzise ulumkiso xa uqhuba okanye usebenzisa oomatshini ngelixa uthatha iGleevec.

Ukuphulukiswa kokupholisa amanxeba (hayi isiphumo esisecaleni)

Ukuphulukiswa kokupholisa amanxeba akuzange kuchazwe kwizifundo zeklinikhi zaseGleevec.

Ezinye iintlobo zonyango lomhlaza, ezinje ngemitha kunye nonyango ngamakhemikhali, zinokuwenza buthathaka amajoni akho omzimba. Oku kunokwenza ukuba amanxeba aphole kancinci.

Ukuba unenkxalabo malunga nokunyanga okucothayo kwenxeba, buza ugqirha wakho ukuba unengozi ephezulu kule ngxaki ngokusekwe kwimeko yakho yonyango.

Umhlaza wesibindi (ayinakuba sisiphumo esecaleni)

Umhlaza wesibindi awuzange uxelwe njengempembelelo yecala kwizifundo zeklinikhi zaseGleevec. Nangona kunjalo, ukonakala kwesibindi kwenzeke kokubini okufutshane kunye nokusetyenziswa kwexesha elide kweGleevec. Ezinye iimeko zomonakalo wesibindi zikhokelele ekusileleni kwesibindi kunye nokufakelwa kwesibindi.

Umonakalo wesibindi uhlala ufumaneka xa oogqirha bejonga ii-enzymes (iiproteni ezikhethekileyo) ezenziwe esibindini. Amanqanaba e-enzyme aphezulu kunesiqhelo anokuba luphawu lomonakalo wesibindi.

Ezinye zeempawu zomonakalo wesibindi zibandakanya:

  • isicaphucaphu
  • urhudo
  • Ukuphelelwa ngumdla wokutya
  • ukurhawuzelela ulusu
  • i-jaundice (umbala omthubi wolusu lwakho kunye namhlophe ngamehlo)
  • i-edema (ukudumba kwemilenze yakho, amaqatha neenyawo)
  • I-ascites (i-fluid buildup esiswini sakho)
  • ukutyumza rhoqo
  • ukopha rhoqo

Ngexesha lezifundo zeklinikhi, ukuya kuthi ga kwi-5% yabantu abane-leukemia engapheliyo ye-myeloid (CML) babenamanqanaba aphezulu e-enzyme yesibindi ngexesha lonyango lwe-Gleevec. Ukuya kuthi ga kwi-6.8% yabantu abanezilonda zesisu esiswini (GIST) babenamanqanaba aphezulu e-enzyme yesibindi ngexesha lonyango. Kwaye ukuya kuthi ga kwi-0.1% yabantu abathathe i-Gleevec benesibindi.

Ngelixa uthatha iGleevec, ugqirha wakho uya kujonga indlela isibindi sakho esisebenza ngayo. Ukuba unempawu zomonakalo wesibindi ngelixa uthatha iGleevec, ugqirha wakho unokunciphisa idosi yakho. Oku kunokuthintela umonakalo onokubangela ukusilela kwesibindi.

Iziphumo ebezingalindelekanga ebantwaneni

Abantwana kwizifundo zeklinikhi abathathe i-Gleevec baneziphumo ebezingalindelekanga ezifanayo nezo zabantu abadala. Kodwa abaphandi bafumene oku kungafaniyo:

  • bambalwa abantwana abaneentlungu zethambo okanye zethambo kunabantu abadala
  • i-edema (ukudumba kwemilenze, amaqatha, iinyawo, kunye nendawo ejikeleze amehlo) ayichazwanga ebantwaneni

Iziphumo ebezona zixeliweyo zixeliweyo ebantwaneni yayisisicaphucaphu nokugabha. Iziphumo ebezingalindelekanga ezibi kakhulu zazingamanqanaba asezantsi eeseli ezimhlophe zegazi kunye neeplatelets.

Ukuba umntwana wakho uneziphumo ebezingalindelekanga, thetha nogqirha womntwana wakho ngeendlela zokuzilawula.

I-Gleevec ye-CML

Ulawulo lwezoKutya kunye neDrug (i-FDA) luvumile iGleevec kubantu abathile abane-chromosome-positive (Ph +) engapheliyo ye-myeloid leukemia (CML). I-chromosome yaseFiladelphia iyinombolo ye-chromosome engama-22 enesiphene. Abantu abane-Ph + CML banotshintsho oluthile kwi-DNA yabo ebangela ukuba iiseli ezimhlophe zegazi ezininzi zenze.

I-CML yahlulwe yangamanqanaba amathathu:

  • Isigaba esingapheliyo. Eli linqanaba lokuqala le-CML. Uninzi lwabantu lufunyaniswa ukuba lune-CML ngexesha lesigaba esingapheliyo. Iimpawu zihlala ziphakathi, ukuba zikhona kwaphela.
  • Isigaba esikhawulezayo. Kweli nqanaba lesibini, inani leeseli zomhlaza kwigazi lakho liyanda. Unokuba neempawu ezininzi, ezinje ngomkhuhlane kunye nokwehla kobunzima.
  • Isigaba seengxaki. Kweli nqanaba lihambele phambili, iiseli zomhlaza egazini lakho ziye zasasazeka kwamanye amalungu nakwizihlunu. Iimpawu zakho zinokuba nzima kakhulu.

I-Gleevec ivunyiwe ukuba inyange i-Ph + CML esandula ukufunyanwa kwisigaba esingapheliyo kubantu bayo yonke iminyaka.

Kukwamkelwe kwakhona ukunyanga i-Ph + CML kwisigaba seengxaki esinganyangekiyo, esikhawulezayo, okanye esidubulayo kubantu abangakhange baphumelele kunyango lwe-interferon-alpha. I-Interferon-alpha sisiyobisi ebesisetyenziswa rhoqo ngaphambili ukunyanga i-CML. Yatshintshwa ngamachiza afana neGleevec abonakaliswe ukuba asebenza ngakumbi.

Ukusebenza ngempumelelo

Kwisifundo sonyango seminyaka esixhenxe, inqanaba lokusinda kwabantu abadala abathathe i-Gleevec kwi-Ph + CML esandula kufunyaniswa yayiyi-86.4%. Oku kuthetha ukuba i-86.4% yabantu abadala basinda kangangeminyaka esixhenxe emva kokuba beqalisile ukuthatha iGleevec. Oku kwafaniswa nama-83.3% abantu abathathe amachiza amayeza e-chemotherapy.

Kwisifundo seklinikhi, abantu ababekhe bazama i-interferon-alpha ye-CML bathatha iGleevec. Abanye baba bantu baphendule ngokupheleleyo kunyango lwe-Gleevec. Oku kuthetha ukuba akukho iiseli zomhlaza zafunyanwa egazini labo, kwaye babengenazo iimpawu zomhlaza. Nantsi bangaphi abantu abane-CML abanempendulo epheleleyo ekuthatheni iGleevec:

  • I-95% yabantu kwisigaba esinganyangekiyo
  • I-38% yabantu kwisigaba esikhawulezayo
  • I-7% yabantu kwinqanaba lokudubula

Isifundo seklinikhi sikwabandakanya abantwana abane-Ph + CML kwisigaba esingapheliyo. Kwiqela elithathe i-Gleevec, i-78% yabantwana babenempendulo epheleleyo kwichiza.

Olunye usetyenziso lweGleevec

Ukongeza i-leukemia engapheliyo (jonga apha ngasentla), uLawulo lokuTya kunye noLawulo lweziyobisi (i-FDA) yamkele iGleevec ukunyanga ezinye iimeko ezininzi.

I-Gleevec yegazi le-lymphocytic leukemia (ZONKE)

I-Gleevec ivunyiwe yi-FDA ukunyanga:

  • IPhiladelphia chromosome-positive (Ph +) acute lymphocytic leukemia (ALL) that relapsed * or refractory * kubantu abadala
  • esandula kufunyaniswa i-Ph + BONKE ebantwaneni xa isetyenziswa ngekhemotherapy

Umhlaza obuyileyo ubuyile emva kokuxolelwa, nokuhla kweempawu zomhlaza kunye neempawu. Umhlaza obonakalisayo awuphendulanga kunyango lwangaphambili lomhlaza.

Kuphononongo lweklinikhi, i-19% yabantu abadala ababuyele kwakhona okanye abachasayo BONKE abathathe iGleevec banempendulo epheleleyo egazini labo kunyango. Oku kuthetha ukuba babengenazo iimpawu zomhlaza.

Uphononongo lweklinikhi luye lwajonga abantwana BONKE abathathe i-Gleevec kunye ne-chemotherapy. Kwi-70% yabantwana, umhlaza wabo awuzange ube mandundu kangangeminyaka emine.

Gleevec kwezinye iintlobo zomhlaza wegazi

I-Gleevec ivunyiwe yi-FDA ukunyanga ezinye iintlobo zomhlaza wegazi, kubandakanya:

  • Izifo ze-Myelodysplastic / myeloproliferative (umhlaza womongo wethambo) kubantu abadala abane-platelet-derived factor factor receptor (PDGFR). Kwisifundo esincinci sonyango, i-45% yabantu abanyangwe uGleevec banempendulo epheleleyo kunyango lwabo kunyango. Oku kuthetha ukuba akukho iiseli zomhlaza zafunyanwa egazini labo, kwaye babengenazo iimpawu zomhlaza.
  • I-Hypereosinophilic syndrome kunye / okanye i-leosemia engapheliyo ye-eosinophilic kubantu abadala, kubandakanya abantu abane-FIP1L1-PDGFRcy fusion kinase. Kwizifundo ezincinci zeklinikhi, i-100% yabantu abane-PDGFR yokutshintsha kwemfuza abathathe uGleevec babenempendulo epheleleyo egazini labo kunyango. Phakathi kwe-21% kunye ne-58% yabantu ngaphandle kokutshintsha kwemfuza okanye imeko engaziwayo yokuthabatha uGleevec wayenempendulo epheleleyo egazini labo.
  • Inkqubo ye-mastocytosis enobundlobongela kubantu abadala ngaphandle kokutshintsha kwe-D816v c-Kit. Kwisifundo esincinci sonyango, i-100% yabantu abane-FIP1L1-PDGFRcy fusion kinase mutation abaye baphathwa nge-Gleevec babenempendulo epheleleyo kunyango.

Gleevec yomhlaza wolusu

I-Gleevec ivunyiwe yi-FDA ukunyanga i-dermatofibrosarcoma protuberans, uhlobo olunqabileyo lomhlaza wolusu, kubantu abadala. Iyavunywa kubantu abanomhlaza:

  • ayinakuhlinzwa
  • ubuyile emva konyango
  • i-metastatic (isasazekile kwamanye amalungu omzimba)

Inani elincinci labantu liphathwe nge-Gleevec kule meko kwizifundo zeklinikhi. Kula bantu bathathe i-Gleevec, i-39% ibe nempendulo epheleleyo kunyango. Oku kuthetha ukuba i-biopsy yolusu (ukususa kunye nokuvavanya isampulu encinci yesikhumba) ayibonisanga zimpawu zomhlaza.

Gleevec yomhlaza wamathumbu

I-Gleevec ivunyiwe yi-FDA ukunyanga i-Kit-positive gastrointestinal stromal tumors (GIST) kubantu abadala ezingenakuhlinzwa okanye zi-metastatic (zisasazeke kwamanye amalungu omzimba). I-Gleevec ikwavunyiwe ukuba inyange i-GIST kubantu abadala abaye batyandwa ukuze basuse amathumba. Olu hlobo lonyango (unyango oluncedisayo) lusetyenziselwa ukuthintela umhlaza ekubuyeni emva kotyando.

Kwizifundo zeklinikhi, abantu abane-GIST engenakususwa ngotyando bathathe i-400 okanye i-800 mg yeGleevec. Basinda malunga neminyaka emine.

Abanye abantu abane-GIST baye benza utyando. Phakathi kwe-14 kunye neentsuku ezingama-70 kamva, baqala ukuthatha uGleevec kwisifundo. Babenomngcipheko ophantsi wama-60% wokufa okanye wokubuya komhlaza kwisithuba seenyanga ezili-12. Oku kwafaniswa nabantu abathathe i-placebo (unyango ngaphandle kwamayeza asebenzayo).

Ukusetyenziswa kwelebheli engasebenziyo kwiGleevec

Ukongeza kusetyenziso oludweliswe apha ngasentla, i-Gleevec inokusetyenziselwa ngaphandle kwelebheli yolunye usetyenziso. Ukusetyenziswa kweziyobisi ezingekho kwilebheli kuxa ichiza elivunyiweyo ukuba lisetyenziswe ngendlela enye limiselwe elahlukileyo nelingavunyelwanga.

I-Gleevec inokusetyenziselwa ngaphandle kwelebheli kwezinye i-cancer, kubandakanya:

  • Umhlaza wedlala lobudoda, ngokophando luka-2015
  • i-melanoma, ngokwe-National Comprehensive Cancer Network izikhokelo zonyango
  • Chwetheza isifo seswekile se-1, ngovavanyo lweklinikhi ka-2018

Nangona kunjalo, akukho phando lukhulu malunga nendlela iGleevec esebenza ngayo ebantwini abanezi meko. Izifundo ezingakumbi ziyafuneka ukumisela ukuba ngaba iGleevec iyanceda na ukunyanga imeko nganye.

Gleevec yabantwana

I-Gleevec ivunyiwe yi-FDA njengonyango lwabantwana abanezi meko zilandelayo:

  • esandula ukufumanisa ukuba iPhiladelphia-positive (Ph +) engapheliyo ye-myeloid leukemia (CML) kwisigaba esinganyangekiyo (isigaba sokuqala sesifo)
  • I-Ph + acute lymphocytic leukemia (YONKE) xa isetyenziswa ngamachiza

I-Gleevec ivunyiwe ukuba isetyenziswe kubantwana bayo yonke iminyaka. Nangona kunjalo, khange kubekho zifundo malunga nokuba ikhuselekile okanye isebenza njani i-Gleevec kubantwana abangaphantsi kweminyaka eyi-1.

Iindleko zeGleevec

Njengawo onke amayeza, iindleko zeGleevec zingahluka.

Ixabiso eliza kuhlawulwa lixhomekeke kwi-inshurensi yakho kunye nekhemisi oyisebenzisayo.

Uncedo lwezezimali kunye neinshurensi

Ukuba ufuna inkxaso yemali ukuhlawula i-Gleevec, okanye ukuba ufuna uncedo lokuqonda i-inshurensi yakho, uncedo luyafumaneka.

INovartis Pharmaceutical Corporation, umvelisi weGleevec, ibonelela ngenkqubo ebizwa ngokuba yiNkqubo yeNhlawulo kaRhulumente yeNovartis. Ngolwazi oluthe kratya kunye nokufumanisa ukuba uyilungele na inkxaso, tsalela umnxeba ku-877-577-7756 okanye undwendwele iwebhusayithi yenkqubo.

Umthamo weGleevec

Idosi ye-Gleevec ugqirha oyimiselayo iya kuxhomekeka kwizinto ezininzi. Oku kubandakanya:

  • uhlobo kunye nobukhali bemeko oyisebenzisayo ukunyanga iGleevec
  • ubudala
  • ubunzima (kubantwana)
  • ubukho bokutshintsha kwemfuza
  • ezinye iimeko zonyango onokuba nazo
  • amanye amayeza onokuwathatha
  • iziphumo ebezingalindelekanga onokuba nazo

Idosi oza kuyifumana ixhomekeke kumhlaza wakho. Kweminye imihlaza, ugqirha wakho unokukuqala kumthamo ophantsi. Ke baya kuyilungisa ngokuhamba kwexesha ukufikelela kumthamo olungele wena.

Olu lwazi lulandelayo luchaza iidosi eziqhelekileyo ezisetyenziswayo okanye ezicetyiswayo. Nangona kunjalo, qiniseka ukuthatha idosi ekumisela ugqirha wakho. Ugqirha wakho uya kumisela eyona idosi ilungele iimfuno zakho.

Iifom zamachiza kunye namandla

I-Gleevec iza njengethebhulethi oyithatha ngomlomo (uyayiginya). Ifumaneka kwiipilisi ze-100-mg kunye neepilisi ezingama-400-mg.

Iipilisi ze-100-mg kunye ne-400-mg ziza ngeebhotile. Amacwecwe angama-400-mg nawo angena kwiipakethi ze-blister ekunzima ukuba abantwana bazivule.

Iidosi zeGleevec

Ezi dosi zilandelayo ziidosi zokuqala kwimeko nganye:

  • Abantu abadala abane-Philadelphia-positive (Ph +) ye-myeloid leukemia (CML) engapheliyo kwisigaba esingapheliyo (isigaba sokuqala sesifo): 400 mg / ngosuku
  • Abantu abadala abane-Ph + CML kwinqanaba lokukhawulezisa okanye lokudubula (isigaba sesibini nesesithathu sesi sifo): 600 mg / ngosuku
  • Abantu abadala abane-Ph + acute lymphocytic leukemia (BONKE): 600 mg / ngosuku
  • Abantu abadala abane-myelodysplastic / isifo se-myeloproliferative: 400 mg / ngosuku
  • Abantu abadala abane-mastocytosis enobundlongondlongo: 100 mg okanye 400 mg / ngosuku
  • Abantu abadala abane-hypereosinophilic syndrome kunye / okanye i-leosemia engapheliyo ye-eosinophilic: 100 mg / ngosuku okanye 400 mg / ngosuku
  • Abantu abadala abane-dermatofibrosarcoma protuberans: 800 mg / ngosuku
  • Abantu abadala abanezilonda zesisu esiswini (GIST): 400 mg / ngosuku

Ugqirha wakho unokukunika idosi eyahlukileyo. Bayakuyisekela kwindlela ophendula ngayo umzimba wakho kwichiza, ukuba zibi kangakanani iziphumo zakho ebezingalindelekanga, kunye nezinye izinto. Ukuba unemibuzo malunga nedosi efanelekileyo yeGleevec yakho, thetha nogqirha wakho.

Idosi yabantwana

Iidosi zabantwana zezi zilandelayo:

  • abantwana abane-Ph + CML kwisigaba esingapheliyo (isigaba sokuqala sesifo): 340 mg / m2 / ngosuku
  • abantwana abane-Ph + BONKE: I-340 mg / m2 / ngosuku iya kuthathwa ngekhemotherapy

Ugqirha womntwana wakho uya kuseka idosi kubude kunye nobunzima bomntwana wakho. (Ke i-340 mg / m2 ithetha i-340 mg kwisikwere semitha yommandla womzimba.) Umzekelo, ukuba umntwana wakho zii-4 iinyawo ubude kwaye unobunzima be-49 lbs., Umzimba wabo umphezulu umalunga ne-0.87 m2. Ke idosi ye-Ph + CML iya kuba ngama-300 mg.

Kuthekani ukuba ndiphose idosi?

Ukuba uphosa idosi ye-Gleevec, yithathe kwangoko xa ukhumbula. Ukuba phantse lixesha ledosi yakho elandelayo, linda kwaye uthathe idosi elandelayo njengoko kucwangcisiwe. Musa ukuthatha iidosi ezimbini ukwenza idosi ephosiweyo. Oku kunokunyusa umngcipheko weziphumo ebezingalindelekanga ezimandundu.

Ngaba kuya kufuneka ndisebenzise eli chiza ixesha elide?

I-Gleevec yenzelwe ukuba isetyenziswe njengonyango lwexesha elide. Ukuba wena nogqirha wakho nigqiba ekubeni i-Gleevec ikhuselekile kwaye iyasebenza kuwe, uya kuyithatha ixesha elide.

Olunye uhlobo lweGleevec

Amanye amachiza akhoyo anokuyinyanga imeko yakho. Abanye banokukulungela ngcono kunabanye. Ukuba unomdla ekufumaneni enye indlela ye-Gleevec, thetha nogqirha wakho ukuze ufunde ngakumbi ngamanye amayeza anokukusebenzela.

Phawula: Amanye amachiza adweliswe apha asetyenziswa ngaphandle kwelebheli ukunyanga le miqathango.

Ezinye iindlela ze-CML

Imizekelo yezinye iziyobisi ezingasetyenziselwa ukunyanga i-Philadelphia-positive (Ph +) ezingapheliyo ze-myeloid leukemia (CML) zezi:

  • idasatinib (Sprycel)
  • I-nilotinib (iTasigna)
  • bosutinib (Bosulif)
  • iponatinib (Iclusig)
  • i-omacetaxine (iSynribo)
  • daunorubicin (Cerubidine)
  • cytarabine
  • I-interferon-alpha (Intron A)

Olunye uhlobo lwe-GIST

Imizekelo yezinye iziyobisi ezinokuthi zisetyenziselwe ukunyanga amathumbu esisu (GIST) zezi:

  • sunitinib (Sutent)
  • regorafenib (Stivarga)
  • sorafenib (Nexavar)
  • I-nilotinib (iTasigna)
  • idasatinib (Sprycel)
  • ipazopanib (Votrient)

Ezinye iindlela zezinye iimeko uGleevec anokuzinyanga zingafumaneka. Thetha nogqirha wakho malunga nawaphi amayeza angasetyenziselwa imeko yakho.

Gleevec vs Tasigna

Usenokuzibuza ukuba iGleevec ithelekiswa njani namanye amayeza amiselwe ukusetyenziswa ngokufanayo. Apha sijonga indlela iGleevec kunye neTasigna ezifanayo kunye ezahlukeneyo.

Sebenzisa

Ukutya kunye noLawulo lweeDrug (i-FDA) ivumile zombini i-Gleevec kunye neTasigna ukunyanga iintlobo ezithile zomhlaza wegazi.

Omabini la machiza agunyazisiwe yi-FDA ukunyanga i-Philadelphia-positive (Ph +) engapheliyo ye-myeloid leukemia (CML) kwisigaba esingapheliyo kubantu abadala nasebantwaneni.

I-myeloid leukemia engapheliyo (i-CML) yahlulwe yangamanqanaba amathathu:

  • Isigaba esingapheliyo. Eli linqanaba lokuqala le-CML. Uninzi lwabantu lufunyaniswa ukuba lune-CML ngexesha lesigaba esingapheliyo. Iimpawu zihlala ziphakathi, ukuba zikhona kwaphela.
  • Isigaba esikhawulezayo. Kweli nqanaba lesibini, inani leeseli zomhlaza kwigazi lakho liyanda. Unokuba neempawu ezininzi, ezinje ngomkhuhlane kunye nokwehla kobunzima.
  • Isigaba seengxaki. Kweli nqanaba lihambele phambili, iiseli zomhlaza egazini lakho ziye zasasazeka kwamanye amalungu nakwizihlunu. Iimpawu zakho zinokuba nzima kakhulu.

I-Gleevec ivunyiwe ukuba inyange i-Philadelphia-positive (Ph +) CML kubantu abadala abakwisigaba esinganyangekiyo, esikhawulezayo, okanye esibuhlungu xa unyango lwe-interferon-alpha lungakhange lusebenze.

I-Interferon-alpha sisiyobisi esasidla ngokusetyenziswa ukunyanga i-CML kwixa elidlulileyo. Sisiyobisi esenziwe ngumntu esisebenza njengeeprotein ezithile zenkqubo yomzimba yokuzikhusela kwaye sithintela ukukhula kweeseli zomhlaza.

I-Tasigna yamkelwe ekunyangeni i-Ph + CML kwizigaba ezingapheliyo okanye ezikhawulezayo kubantu abadala ukuba ezinye iindlela zonyango azisebenzi, kubandakanya unyango neGleevec. I-Tasigna ayivunyelwanga kwinqanaba lokudubula.

I-Tasigna ikwavunyiwe ukuba inyange i-Ph + CML kubantwana abaneminyaka eli-1 nangaphezulu ukuba ezinye iindlela zonyango azisebenzi. I-Gleevec ivunyiwe ukuba inyange i-Ph + CML esandula ukufunyanwa ebantwaneni.

I-Gleevec ikwavunyiwe ukuba inyange ezinye iintlobo zomhlaza. Jonga icandelo “lolunye usetyenziso lweGleevec” ukufunda okungakumbi.

Iifom zeziyobisi kunye nolawulo

I-Gleevec iqulethe ichiza imatinib. I-Tasigna iqulethe ichiza nilotinib.

IGleevec iza njengecwecwe. I-Tasigna iza njengecapsule. Omabini la machiza athathwa ngomlomo.

I-Gleevec ithathwa kanye okanye kabini ngemini, kuxhomekeke kwidosi yakho. I-Tasigna ithathwa kabini ngemini.

I-Gleevec iza njenge-100-mg kunye neepilisi ezingama-400-mg. I-Tasigna iza njenge-50-mg, 150-mg, kunye ne-200-mg capsules.

Iziphumo kunye neengozi

I-Gleevec kunye neTasigna ziqulathe iziyobisi ezifanayo. Ke ngoko, omabini la mayeza anokubangela iziphumo ezifanayo. Apha ngezantsi kunemizekelo yeziphumo ebezingalindelekanga.

Iziphumo eziqhelekileyo ezichaphazelekayo

Olu luhlu lunemizekelo yeziphumo ebezingalindelekanga ezinokubakho ngeGleevec, kunye neTasigna, okanye zombini iziyobisi (xa zithathwa ngokwahlukeneyo).

  • Ngaba kunokwenzeka ngeGleevec:
    • i-edema (ukudumba kwemilenze yakho, amaqatha, kunye neenyawo, kunye namehlo akho)
    • izihlunu zemithambo
    • iintlungu zemisipha
    • iintlungu zethambo
    • isisu esibuhlungu
  • Ngaba kunokwenzeka ngeTasigna:
    • intloko ebuhlungu
    • ukurhawuzelela ulusu
    • ukukhohlela
    • ukuqhina
    • intlungu edibeneyo
    • i-nasopharyngitis (ingqele eqhelekileyo)
    • ifiva
    • ukubila ebusuku
  • Inokwenzeka kunye neGleevec kunye neTasigna:
    • isicaphucaphu
    • ukugabha
    • urhudo
    • irhashalala
    • ukudinwa (ukunqongophala kwamandla)

Iziphumo ebezingalindelekanga ezimandundu

Olu luhlu lunemizekelo yeziphumo ebezingalindelekanga ezinokubakho ngeGleevec, kunye neTasigna, okanye zombini iziyobisi (xa zithathwa ngokwahlukeneyo).

  • Ngaba kunokwenzeka ngeGleevec:
    • ukungaphumeleli kwentliziyo okanye iingxaki zentliziyo ezinje ngokusilela kwentliziyo ngasekhohlo
    • isisu esiswini (imingxunya esiswini sakho okanye emathunjini)
    • ulusu olunamandla, kubandakanya isifo sikaStevens-Johnson (umkhuhlane; izilonda ezibuhlungu emlonyeni wakho, emqaleni, emehlweni, kwizitho zangasese, okanye emzimbeni wonke)
    • umonakalo kwizintso
    • i-hypothyroidism (amanqanaba e-thyroid aphantsi) kubantu abaye basuswa i-thyroid
  • Ngaba kunokwenzeka ngeTasigna:
    • Ixesha elide le-QT (umbane ongaqhelekanga entliziyweni yakho), onqabileyo kodwa onokukhokelela ekufeni ngequbuliso
    • kuthintele imithambo yegazi entliziyweni
    • ukudumba komzimba
    • ukungalingani kwe-electrolyte (amanqanaba aphezulu okanye asezantsi ezimbiwa ezithile)
  • Inokwenzeka kunye neGleevec kunye neTasigna:
    • Ukuphazamiseka kwegazi, kubandakanya i-anemia (amanqanaba asezantsi eeseli ezibomvu zegazi), i-neutropenia (amanqanaba asezantsi eeseli ezimhlophe zegazi), kunye ne-thrombocytopenia (amanqanaba asezantsi eeplatelets)
    • ukulimala kwesibindi
    • I-tumor lysis syndrome (iiseli zomhlaza zikhupha iikhemikhali eziyingozi egazini lakho)
    • Ukopha (ukopha okungayeki)
    • ukugcinwa kwamanzi amaninzi (amaninzi amaninzi okanye amanzi)
    • ukukhula okucothayo ebantwaneni

Ukusebenza ngempumelelo

I-Gleevec kunye neTasigna banezinto ezahlukileyo ezamkelweyo ze-FDA. Kodwa bobabini baphatha i-Ph + CML kwizigaba ezingapheliyo nezikhawulezayo ukuba ezinye iindlela zonyango azisebenzi. I-CML inezigaba ezithathu: ezingapheliyo (isigaba 1), ukukhawulezisa (isigaba 2), kunye nokuqhushumba kwentlekele (isigaba 3).

Ukusetyenziswa kwe-Gleevec kunye neTasigna ekunyangeni i-Ph + CML esandula ukufunyanwa kubantu abadala kuthelekiswa ngqo kufundo lweklinikhi. Abaphandi bathelekisa abantu abathathe i-400 mg yeGleevec kanye ngemini okanye i-300 mg yaseTasigna kabini ngemini.

Emva kweenyanga ezili-12 zonyango, i-65% yabantu abathathe i-Gleevec babengenazo iiseli ze-Ph + kumongo wethambo (apho iiseli zomhlaza ze-CML zikhula khona). Kubantu abathathe iTasigna, iipesenti ezingama-80 zazingenazo iiseli ze-Ph + kumongo wethambo.

Emva kweminyaka emihlanu yonyango, i-60% yabantu abathathe i-Gleevec babenenani elincitshisiweyo lokufumana umhlaza egazini labo. Oku kwafaniswa ne-77% yabantu abathathe iTasigna.

Kananjalo emva kweminyaka emihlanu yonyango, i-91.7% yabantu abathathe i-Gleevec basaphila. Oko kuthelekiswa ne-93.7% yabantu abathathe iTasigna.

Iziphumo zolu phononongo zibonisa ukuba iTasigna inokusebenza ngakumbi kune-Gleevec kunyango lwe-Ph + CML esandula kufunyaniswa kwisigaba esingapheliyo.

Iindleko

I-Gleevec kunye neTasigna bobabini abasebenzisa iziyobisi. I-Tasigna ayinayo ifom ye-generic, kodwa i-Gleevec ine-generic form ebizwa ngokuba yi-imatinib. Amayeza egama leBrand ahlala exabisa ngaphezu kwegeneric.

Ngokwengqikelelo yeGoodRx.com, igama lophawu lweGleevec linokubiza imali encinci kuneTasigna. Ifom yesiGleevec (imatinib) nayo ixabisa ngaphantsi kweTasigna. Elona xabiso uzakuhlawula ngalo naliphi na ichiza lixhomekeke kwidosi yakho, isicwangciso seinshurensi, indawo okuyo, kunye nekhemesti oyisebenzisayo.

Gleevec vs. Sprycel

Usenokuzibuza ukuba iGleevec ithelekiswa njani namanye amayeza amiselwe ukusetyenziswa okufanayo. Apha sijonga indlela iGleevec kunye neSprycel ezifanayo kunye ezahlukeneyo.

Sebenzisa

Ulawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) luvumile zombini i-Gleevec kunye ne-Sprycel ukunyanga iintlobo ezithile zomhlaza wegazi.

Omabini la machiza avunyiwe yi-FDA ukunyanga isifo esandula ukufumanisa ukuba isifo sePhiladelphia-positive (Ph +) esingapheliyo se-myeloid leukemia (CML) kwisigaba esingapheliyo kubantu abadala nasebantwaneni.

I-CML yahlulwe yangamanqanaba amathathu:

  • Isigaba esingapheliyo. Eli linqanaba lokuqala le-CML. Uninzi lwabantu lufunyaniswa ukuba lune-CML ngexesha lesigaba esingapheliyo. Iimpawu zihlala ziphakathi, ukuba zikhona kwaphela.
  • Isigaba esikhawulezayo. Kweli nqanaba lesibini, inani leeseli zomhlaza kwigazi lakho liyanda. Unokuba neempawu ezininzi, ezinje ngomkhuhlane kunye nokwehla kobunzima.
  • Isigaba seengxaki. Kweli nqanaba lihambele phambili, iiseli zomhlaza egazini lakho ziye zasasazeka kwamanye amalungu nakwizihlunu. Iimpawu zakho zinokuba nzima kakhulu.

I-Gleevec kunye ne-Sprycel zisetyenziselwa ukunyanga i-Ph + CML kubantu abadala kwisigaba esinganyangekiyo.

I-Gleevec ikwasetyenziselwa ukunyanga i-Ph + CML kubantu abadala kwizigulo ezinganyangekiyo, ezikhawulezayo, okanye ezothusayo ukuba unyango lwe-interferon-alpha aluzange lusebenze. I-Interferon-alpha sisiyobisi esasidla ngokusetyenziswa ukunyanga i-CML kwixa elidlulileyo. Sisiyobisi esenziwe ngumntu esisebenza njengeeprotein ezithile zenkqubo yomzimba yokuzikhusela kwaye sithintela ukukhula kweeseli zomhlaza.

I-Sprycel ikwasetyenziselwa ukunyanga i-Ph + CML kubantu abadala kwizigaba ezinganyangekiyo, ezikhawulezayo, okanye zodubulo lokuba uGleevec akasebenzi.

Zombini i-Gleevec kunye ne-Sprycel zivunyiwe ukuba zinyange i-Ph + CML kwisigaba esingapheliyo ebantwaneni. Zombini zivunyiwe ukunyanga i-Ph + acute lymphocytic leukemia (BONKE) kubantwana kunye ne-chemotherapy.

I-Gleevec ikwavunyiwe ukuba inyange ezinye iintlobo zomhlaza. Jonga icandelo “lolunye usetyenziso lweGleevec” ukufunda okungakumbi.

Iifom zeziyobisi kunye nolawulo

I-Gleevec iqulethe ichiza imatinib. I-Sprycel iqulethe ichiza le-dasatinib.

I-Gleevec kunye ne-Sprycel zombini ziza njengeetafile ozithatha ngomlomo (uyaziginya).

Iipilisi zeGleevec ziza ngamandla amabini: 100 mg kunye no-400 mg. Ithathwa kanye okanye kabini ngosuku, kuxhomekeke kwidosi yakho.

Iipilisi zeSprycel ziza kula mandla alandelayo: 20 mg, 50 mg, 70 mg, 80 mg, 100 mg, kunye ne-140 mg. I-Sprycel ithathwa kanye ngemini.

Iziphumo kunye neengozi

I-Gleevec kunye ne-Sprycel ziyafana kodwa ziqulathe iziyobisi ezahlukeneyo. Ke ngoko, omabini la mayeza anokubangela iziphumo ezifanayo. Apha ngezantsi kunemizekelo yeziphumo ebezingalindelekanga.

Iziphumo eziqhelekileyo ezichaphazelekayo

Olu luhlu lunemizekelo yeziphumo ebezingalindelekanga ezinokubakho ngeGleevec, ngeSprycel, okanye ngamachiza omabini (xa ethathwe ngokwahlukeneyo).

  • Ngaba kunokwenzeka ngeGleevec:
    • ukugabha
    • izihlunu zemithambo
    • isisu esibuhlungu
    • indawo edema (ukudumba ngapha nangapha kwamehlo)
  • Ngaba kunokwenzeka ngeSprycel:
    • ingxaki yokuphefumla
    • intloko ebuhlungu
    • ukopha
    • amajoni omzimba abuthathaka (umzimba wakho awunako ukulwa nosulelo ngokunjalo)
  • Inokwenzeka kunye neGleevec kunye neSprycel:
    • i-edema (ukudumba kwemilenze yakho, amaqatha neenyawo)
    • isicaphucaphu
    • iintlungu zemisipha
    • iintlungu zethambo
    • urhudo
    • irhashalala
    • ukudinwa (ukunqongophala kwamandla)

Iziphumo ebezingalindelekanga ezimandundu

Olu luhlu lunemizekelo yeziphumo ebezingalindelekanga ezinokubakho ngeGleevec, ngeSprycel, okanye ngamachiza omabini (xa ethathwe ngokwahlukeneyo).

  • Ngaba kunokwenzeka ngeGleevec:
    • iingxaki zentliziyo, ezinje ngokusilela kwentliziyo
    • ukulimala kwesibindi
    • isisu esiswini (imingxunya esiswini sakho okanye emathunjini)
    • umonakalo kwizintso
    • i-hypothyroidism (amanqanaba e-thyroid aphantsi) kubantu abaye basuswa i-thyroid
  • Ngaba kunokwenzeka ngeSprycel:
    • uxinzelelo lwegazi lwe-pulmonary (uxinzelelo lwegazi oluphezulu kwimithambo yegazi kwimiphunga yakho)
    • Ixesha elide le-QT (uhlobo lomsebenzi wombane ongaqhelekanga entliziyweni yakho)
    • ukuhlaselwa kwentliziyo ye-ischemic (ukunqongophala kweoksijini kwimisipha yentliziyo)
  • Inokwenzeka kunye neGleevec kunye neSprycel:
    • Ukugcina ulwelo olunamandla (ulwelo oluninzi okanye amanzi) malunga nemiphunga, intliziyo kunye nesisu
    • Ukuphazamiseka kwegazi okunzima (amanqanaba asezantsi eeseli ezibomvu zegazi, iiplatelets, okanye iiseli ezimhlophe zegazi)
    • Ukopha kakhulu (ukopha okungayeki)
    • ulusu olunamandla, kubandakanya isifo sikaStevens-Johnson (umkhuhlane; izilonda ezibuhlungu emlonyeni wakho, emqaleni, emehlweni, kwizitho zangasese, okanye emzimbeni wonke)
    • I-tumor lysis syndrome (iiseli zomhlaza zikhupha iikhemikhali eziyingozi egazini lakho)
    • isantya sentliziyo esingaqhelekanga okanye isingqisho (ukubetha kwentliziyo okukhawulezayo kakhulu, okucothayo, okanye okungaqhelekanga)
    • ukukhula okungaginyisi mathe ebantwaneni

Ukusebenza ngempumelelo

I-Gleevec kunye ne-Sprycel banezinto ezahlukileyo ezamkelweyo ze-FDA. Kodwa bobabini baphatha i-Ph + CML esandula ukufunyanwa kwisigaba esingapheliyo (isigaba sokuqala se-CML) kubantu abadala nasebantwaneni. I-Gleevec kunye ne-Sprycel bobabini banyanga i-Ph + BONKE ebantwaneni xa isetyenziswa ngokudibanisa ne-chemotherapy.

Ukongeza, zombini i-Gleevec kunye ne-Sprycel banyanga i-Ph + CML kwizigaba eziphambili kunye nokudubula kubantu abadala, okanye kwi-Ph + BONKE, ukuba ezinye iziyobisi azisebenzi kubo.

Ukusetyenziswa kwe-Gleevec kunye ne-Sprycel kunyango lwe-Ph + CML esandula ukufunyanwa kubantu abadala kuthelekiswa ngqo kufundo lweklinikhi. Abaphandi bathelekisa abantu abathathe i-400 mg ye-Gleevec ngosuku okanye i-100 mg ye-Sprycel ngosuku.

Kwisithuba seenyanga ezili-12, ama-66.2% abantu abathathe i-Gleevec babengenazo iiseli ze-Ph + kumongo wethambo labo (apho iiseli zomhlaza ze-CML zikhula khona). Kwiqela elithathe iSprycel, i-76.8% yabantu ayinazo iiseli ze-Ph + kumongo wethambo.

Emva kweminyaka emihlanu yonyango, kuqikelelwa ukuba i-89.6% yabantu abathathe i-Gleevec basaphila. Oko kuthelekiswa noqikelelo lwe-90.9% yabantu abathathe iSprycel.

Iziphumo zolu phononongo zibonisa ukuba i-Sprycel inokusebenza kancinci kune-Gleevec kunyango lwe-Ph + CML esandula kufunyaniswa kwisigaba esingapheliyo.

Iindleko

I-Gleevec kunye ne-Sprycel zizo zombini iziyobisi ezinamagama. I-Sprycel ayinayo ifom yegeneric, kodwa i-Gleevec inefom generic ebizwa ngokuba yi-imatinib. Amayeza egama leBrand ahlala exabisa ngaphezu kwegeneric.

Ngokwengqikelelo yeGoodRx.com, igama lophawu lweGleevec linokubiza ngaphantsi kweSprycel. Uhlobo oluqhelekileyo lweGleevec (imatinib) lunokuxabisa ngaphantsi kweSprycel. Elona xabiso uzakuhlawula ngalo naliphi na ichiza lixhomekeke kwidosi yakho, isicwangciso sakho seinshurensi, indawo okuyo, kunye nekhemesti oyisebenzisayo.

Gleevec kunye notywala

Ayaziwa nokuba iGleevec kunye notywala bayasebenzisana na.

Nangona kunjalo, isibindi sakho sidibanisa (sophula) zombini i-Gleevec kunye notywala. Ke ukusela kakhulu utywala ngelixa uthatha iGleevec kunokuthintela isibindi sakho ekwaphuleni iyeza. Oku kunganyusa amanqanaba eGleevec emzimbeni wakho kwaye kwandise umngcipheko weziphumo ebezingalindelekanga ezibi, kubandakanya ukonakala kwesibindi.

Zombini i-Gleevec kunye notywala zinokubangela iziphumo ebezingalindelekanga ezinje:

  • isicaphucaphu
  • urhudo
  • intloko ebuhlungu
  • ukudinwa (ukunqongophala kwamandla)

Ukusela utywala ngexesha lonyango lwakho lwe-Gleevec kunokunyusa umngcipheko wokuba neziphumo ebezingalindelekanga.

Ukuba usela utywala, thetha nogqirha wakho malunga nokuba kukhuseleke kangakanani kuwe ngexesha lonyango lwakho lwe-Gleevec.

Ukudibana kweGleevec

I-Gleevec inokusebenzisana namanye amayeza. Inokuphinda inxibelelane nezinye izongezo kunye nokutya okuthile.

Unxibelelwano olwahlukileyo kunokubangela iziphumo ezahlukeneyo. Umzekelo, ezinye zinokuphazamisa ukusebenza kakuhle kwesiyobisi, ngelixa ezinye zinokubangela ukwanda kweziphumo ebezingalindelekanga.

Gleevec kunye namanye amayeza

Apha ngezantsi kukho uluhlu lwamayeza anokusebenzisana neGleevec. Olu luhlu alunazo zonke iziyobisi ezinokuthi zisebenzisane neGleevec.

Ngaphambi kokuba uthathe iGleevec, thetha nogqirha wakho kunye nosokhemesti. Baxelele ngawo onke amayeza kagqirha, ekhawuntareni, kunye nezinye iziyobisi ozithathayo. Baxelele malunga nazo naziphi na iivithamini, amayeza esintu kunye nezixhasi ozisebenzisayo. Ukwabelana ngolu lwazi kunokukunceda uphephe unxibelelwano olunokubakho.

Ukuba unemibuzo malunga nokunxibelelana kweziyobisi okunokuchaphazela, buza ugqirha wakho okanye usokhemesti.

Gleevec kunye neTylenol

Ukuthatha i-Gleevec ngeTylenol (i-acetaminophen) kunokunyusa umngcipheko weziphumo ebezingalindelekanga ezimandundu, ezinjengomonakalo wesibindi.

I-Enzymes (iiproteni ezikhethekileyo) kwisibindi sakho zihlahlela zombini i-Gleevec kunye neTylenol. Ngokudibeneyo, la machiza mabini anokugqitha ii-enzymes kunye nokonakalisa iiseli kwisibindi sakho.

Buza ugqirha wakho ukuba kukhuselekile na ukuba uthathe iTylenol ngexesha lonyango lwakho lwe-Gleevec.

Gleevec kunye namayeza athile okuthatha

Ukuthatha iGleevec ngamayeza athile okuhlutha kunokunciphisa amanqanaba eGleevec emzimbeni wakho. Oku kunokwenza ukuba iGleevec ingasebenzi kakuhle (isebenze kancinci).

Imizekelo yokuthatha amayeza anokunciphisa amanqanaba eGleevec kubandakanya:

  • I-phenytoin (iDilantin, iPhenytek)
  • icarbamazepine (iCarbatrol, iTegretol)
  • ifumanobarbital

Ukuba uthatha i-Gleevec kunye namayeza athile okuthatha, ugqirha wakho unokuyalela ichiza lokuthimba elahlukileyo okanye uhlengahlengise idosi yeGleevec.

Gleevec kunye namayeza athile

Ukuthatha iGleevec ngamayeza athile okubulala iintsholongwane (amayeza anyanga usulelo lwebacteria) kunganyusa amanqanaba eGleevec emzimbeni wakho. Amayeza okubulala iintsholongwane athintela iGleevec ukuba ingaphuli emzimbeni wakho. Oku kwandisa umngcipheko weziphumo ebezingalindelekanga ezimandundu.

Umzekelo weyeza lokubulala iintsholongwane elinokunyusa amanqanaba e-Gleevec yi-clarithromycin (Biaxin XL).

Ukuba uthatha iGleevec kwaye ufuna isibulali zintsholongwane, ugqirha wakho unokukujonga ngeziphumo ebezingalindelekanga. Banokunciphisa idosi yakho yeGleevec kangangexesha.

Gleevec kunye ne-antifungal ezithile

Ukuthatha i-Gleevec ngezixhobo ezithile zokubulala ukungunda (amayeza anyanga usulelo lokungunda) kunokuthintela ukonakala kweGleevec emzimbeni wakho. Oku kunganyusa amanqanaba eGleevec egazini lakho kwaye kwandise umngcipheko weziphumo ebezingalindelekanga ezibi.

Imizekelo yokubola enokunyusa amanqanaba e-Gleevec yile:

  • Itraconazole (Onmel, Sporanox, Tolsura)
  • ketoconazole (Extina, Ketozole, Xolegel)
  • I-voriconazole (Vfend)

Ukuba uthatha i-Gleevec kwaye ufuna unyango lwe-antifungal, ugqirha wakho uya kukujonga ngemiphumela. Banokunciphisa idosi yakho yeGleevec kangangexesha.

Gleevec kunye neopioids

Ukuthatha i-Gleevec ngamayeza athile kunyusa amanqanaba okuphelisa iintlungu emzimbeni wakho. Oku kunokukwenza ukuba ube neziphumo ebezingalindelekanga ezimandundu ezinje ngokuthamba (ukuziva usozela nokungalumkisi kangako) kunye nokudakumba komphefumlo (ukuphefumla kancinci).

Imizekelo yeyeza zonyango ze-opioid ezinokunyusa amanqanaba e-Gleevec zibandakanya:

  • Oxycodone (Oxycontin, Roxicodone, Xtampza ER)
  • iTramadol (i-ConZip, i-Ultram)
  • imethadone (iDolophine, iMethadose)

Thetha nogqirha wakho malunga nokuba kukhuselekile na ukuthatha amayeza eentlungu ngexesha lonyango lwakho lwe-Gleevec. Banokucebisa ngezinye iindlela zokunciphisa iintlungu.

Gleevec kunye namayeza athile e-HIV

Ukuthatha iGleevec ngamayeza athile e-HIV kunokunyusa umngcipheko weziphumo ebezingalindelekanga ezimandundu. Amachiza athile e-HIV anokuthintela i-Gleevec ekuqhekekeni, ekhokelela kumanqanaba aphezulu eGleevec emzimbeni wakho.

Imizekelo yamayeza e-HIV anokunyusa amanqanaba e-Gleevec abandakanya:

  • atazanavir (Reyataz)
  • nevirapine (Viramune)
  • i-saquinavir (i-Invirase)

Elinye iyeza le-HIV, i-efavirenz (Sustiva), lingawehlisa amanqanaba eGleevec emzimbeni wakho. Oku kunokubangela ukuba iGleevec ingasebenzi kakuhle.

Amayeza amaninzi e-HIV eza neepilisi zokudibanisa, oko kuthetha ukuba zibandakanya ngaphezulu kwesiyobisi esinye. Qiniseka ukuba uthetha nogqirha wakho ngawo onke amayeza owathathayo.

Ukuba ufuna ukuthatha iGleevec ngamayeza athile e-HIV, ugqirha wakho angayitshintsha idosi ye-Gleevec.

Gleevec kunye noxinzelelo lwegazi

Ukuthatha iGleevec ngamayeza athile oxinzelelo lwegazi kunokunyusa okanye kunciphise amanqanaba esiyobisi emzimbeni wakho. Oku kunokukwenza ukuba ube neziphumo ebezingalindelekanga okanye ukunciphisa indlela amayeza asebenza ngayo.

Umzekelo wezi ziyobisi zibandakanya i-verapamil (Calan, Tarka).

Ukuba ufuna ukuthatha iGleevec nangaliphi na la mayeza, ugqirha wakho uya kukujonga ngakumbi kwiziphumo ebezingalindelekanga. Banokuhlengahlengisa idosi yamayeza okanye bacebise ichiza elahlukileyo.

Gleevec kunye ne-warfarin

Ukuthatha iGleevec nge-warfarin (Coumadin, Jantoven) kunokunyusa umngcipheko wokopha. I-Gleevec ithintela i-warfarin ekuqhekekeni emzimbeni wakho. Oku kwandisa amanqanaba e-warfarin kwaye kunokubangela ukopha okunzima ukulawula.

Ukuba ufuna i-anticoagulant (igazi elincinci) ngelixa uthatha iGleevec, ugqirha wakho unokuyalela ichiza ngaphandle kwe-warfarin.

Gleevec kunye neSt

Ukuthatha iGleevec nge-St. John's wort kunganciphisa amanqanaba eGleevec emzimbeni wakho. Oku kunokwenza ukuba iGleevec ingasebenzi kakuhle (ayisebenzi ngokunjalo).

Buza ugqirha wakho ukuba ingaba i-wort yaseSt. John ikhuselekile ukuba ungayithatha na xa unyanga iGleevec. Banokucebisa enye into eSt John's Wort okanye bandise idosi yakho yeGleevec.

I-Gleevec kunye ne-grapefruit

Ukutya igrapefruit okanye ukusela ijusi yeediliya ngexesha lonyango lwakho lwe-Gleevec kunokunyusa umngcipheko weziphumo ebezingalindelekanga ezibi. I-Grapefruit iqulethe imichiza ethintela i-Gleevec ukuba ingaphuli emzimbeni wakho. Oku kubangela ukunyuka kwamanqanaba eGleevec, anokukhokelela kwiziphumo ebezingalindelekanga ezibi kakhulu.

Qiniseka ukuthintela ukutya igrapefruit kunye nokusela ijusi yegrapefruit ngexesha lonyango lwakho lwe-Gleevec.

Ungayithatha njani iGleevec

Qiniseka ukuba uthatha iGleevec ngokwemiyalelo kagqirha wakho okanye yezempilo.

Nini ukuthatha

Kwiidosi zeGleevec ezingama-600 mg okanye ngaphantsi, ichiza kufuneka lithathwe kube kanye ngemini. Ungayithatha nanini na.

Ukuba ugqirha wakho umisela i-800 mg yeGleevec ngosuku, uya kuyithatha ngeedosi ezimbini: 400 mg ekuseni kunye ne-400 mg ngokuhlwa.

Ugqirha wakho uya kukunika imiyalelo xa kufuneka uthathe idosi yakho.

Ukuthatha iGleevec ngokutya

Thatha iGleevec ngesidlo kunye neglasi enkulu yamanzi. Oku kunokunceda ukukhusela isisu esibuhlungu.

Ngaba iGleevec inokutyunyuzwa, yahlulwe, okanye ihlafunwe?

Akufanele utyumze, wahlule, okanye uhlafune iipilisi zeGleevec. Amacwecwe atyunyuziweyo nokwahlulahlulwayo anganobungozi kulo naluphi na ulusu okanye amanye amalungu omzimba adibana nawo.

Ukuba unengxaki yokuginya iipilisi zeGleevec, beka itafilethi kwiglasi enkulu yamanzi okanye incindi yeapile. Gquba amanzi ngecephe ukunceda inyibilike. Emva koko usele lo mxube kwangoko.

Isebenza njani iGleevec

I-Gleevec iqulethe ichiza imatinib, eyeklasi yeziyobisi ebizwa ngokuba yi-tyrosine kinase inhibitors (TKIs). Amayeza kwiklasi yeziyobisi ze-TKI zijolise kunyango. Zichaphazela iiproteni ezithile kwiiseli zomhlaza.

I-Gleevec yamkelwe ukunyanga iimeko ezahlukeneyo. Apha siza kuvavanya indlela iGleevec esebenza ngayo ukunyanga ezimbini zazo.

Ye-Ph + CML

Kwi-Philadelphia-positive (Ph +) chronic myeloid leukemia (CML), iiseli ezenza iiseli ezimhlophe zegazi zinempazamo kwimfuzo yazo. Le mpazamo yemfuza ifumaneka kumtya we-DNA obizwa ngokuba yi-chromosome yaseFiladelphia.

I-chromosome yaseFiladelphia iqulethe i-gene engavumelekanga (i-BCR-ABL1) ebangela ukuba iiseli ezimhlophe zegazi ezininzi zenze. Ezi seli zegazi zimhlophe azivuthwa kwaye ziyafa njengoko kufanelekile. Iiseli ezimhlophe zegazi ezimhlophe ekuthiwa zii "blast" zixinanise ezinye iintlobo zeeseli zegazi ekufuneka ukuba igazi lakho zisebenze ngokuchanekileyo.

I-Gleevec isebenza ngokuncamathisela kwiprotein, ebizwa ngokuba yi-tyrosine kinase, kwiiseli ezenziwe yi-BCR-ABL1. Xa uGleevec ebopha kule protein, ichiza lithintela iseli ekuthumeleni imiqondiso exelela iseli ukuba ikhule. Ngaphandle kwale miqondiso yokukhula, iiseli zegazi ezinomhlaza ziyafa. Oku kunceda ukubuyisela inani leeseli zokuqhushumba kwinani elisempilweni.

Kwi-GIST

I-Gleevec ikwanceda ukunyanga isisu esibuhlungu (GIST). Kwiiseli ezininzi zesifo se-GIST, kukho inani eliphezulu leeproteni ezithile, ezibizwa ngokuba yiKit kunye neplatelet-derived growth factor (PDGF), kuneeseli eziqhelekileyo. Ezi proteni zinceda iiseli zomhlaza ukukhula kunye nokwahlulahlula.

I-Gleevec ijolise kwezi proteni kwaye ibathintele ekusebenzeni. Oku kunciphisa ukukhula komhlaza. Ikwabangela ukuba iiseli zomhlaza zife.

Kuthatha ixesha elingakanani ukusebenza?

Kuyaxhomekeka. Ixesha lokuqalisa ukusebenza kweGleevec lahlukile kumntu ngamnye.

Izifundo zonyango ziye zajonga abantu abane-CML abathathe iGleevec. Ngenyanga enye, inani leeseli ezinomhlaza egazini lancitshiswa malunga nesiqingatha sabantu kwinqanaba lokudubula (inqanaba eliphambili le-CML). Kwizifundo zabantu abane-GIST abathathe iGleevec, amathumba ayekile ukukhula okanye ancipha kwiinyanga ezintathu.

Ugqirha wakho uya kubeka esweni igazi lakho rhoqo ukuze abone ukuba uGleevec uyasebenzela na.

Gleevec kunye nokukhulelwa

Kuya kufuneka uyiphephe iGleevec ukuba ukhulelwe. Kukho iingxelo zokuphuphuma kwesisu kunye nokwenzakalisa umntwana ongekazalwa kwabafazi abathathe iGleevec ngelixa bekhulelwe. Kwaye kwizifundo zezilwanyana, abantu ababhinqileyo abakhulelweyo abanikwa iGleevec babenomngcipheko okhulayo wokukhubazeka kokuzalwa.

Ukuba ukhulelwe, ugqirha wakho unokukucebisa ukuba ulinde de emva kokuba ubelekile ukuze uqale ukuthatha iGleevec. Okanye baya kuncomela ichiza elahlukileyo.

Ukuba uthatha iGleevec, kubalulekile ukusebenzisa ulawulo lokuzalwa olusebenzayo ukuze ungakhulelwa. Emva kokuba uthathe idosi yakho yokugqibela yeGleevec, qhubeka usebenzisa ulawulo lokuzalwa kangangeentsuku ezili-14.

Gleevec kunye nokuncancisa

Izifundo zibonisa ukuba i-Gleevec idlula kubisi lwebele lomntu. Oku kunokubangela ingozi enkulu kubantwana abancancisayo.

Ukuba uncelisa kwaye ucinga ukuthatha iGleevec, ugqirha wakho unokukucebisa ukuba uyeke ukuncancisa xa uqala unyango.

Emva kokuba uthathe idosi yakho yokugqibela yeGleevec, linda okungenani inyanga enye ngaphambi kokuba uqale ukuncancisa.

Ukugqithisa kweGleevec

Ukuthatha kakhulu iGleevec kunokunyusa umngcipheko weziphumo ebezingalindelekanga ezibi.

Iimpawu libanda

Iimpawu zokudlula ngaphezulu zinokubandakanya:

  • isicaphucaphu
  • ukugabha
  • urhudo
  • isisu esibuhlungu
  • Irhashalala elibi
  • ukuphazamiseka kwemisipha (ukujija)
  • intloko ebuhlungu
  • ukungabikho komdla
  • ubuthathaka bemisipha
  • ukudinwa (ukunqongophala kwamandla)
  • ukudumba
  • Ukuphazamiseka kwegazi, njengamanqanaba asezantsi eeplatelets, iiseli ezibomvu zegazi, okanye iiseli ezimhlophe zegazi
  • ifiva

Kufuneka wenze ntoni xa uthe wagqithisa?

Ukuba ucinga ukuba uthathe kakhulu eli chiza, tsalela ugqirha wakho. Ungabiza uMbutho waseMelika wamaZiko oLawulo lweTyhefu ku-800-222-1222 okanye usebenzise isixhobo esikwi-Intanethi. Kodwa ukuba iimpawu zakho zinzima, tsalela umnxeba ku-911 okanye uye kwigumbi likaxakeka elikufutshane ngoko nangoko.

Imibuzo eqhelekileyo malunga neGleevec

Nazi iimpendulo kwimibuzo ebuzwa rhoqo malunga neGleevec.

Ngaba uGleevec luhlobo lwechemotherapy?

I-Gleevec ayilulo uhlobo lobuchwephesha. I-Gleevec lonyango ekujoliswe kulo oluchaphazela iimolekyuli ezithile kwiiseli zomhlaza.

Ngokukhetha iimolekyuli ezithile, unyango ekujoliswe kulo njengeGleevec lunceda ukunciphisa ukukhula kunye nokusasazeka kweeseli zomhlaza. Ugqirha wakho uya kukuyalela unyango ekujolise kulo ngenxa yohlobo lomhlaza onawo.

Amachiza e-Chemotherapy ahlukile kunyango ekujoliswe kubo. Unyango lweChemotherapy lusebenza kuzo zonke iiseli emzimbeni ezikhula ngokukhawuleza, hayi iiseli zomhlaza kuphela. Amachiza e-Chemotherapy ahlala ebulala iiseli ezikhulayo kwaye zichaphazela iiseli ezininzi emzimbeni kunonyango ekujolise kulo.

Ngaba uhlobo oluqhelekileyo lweGleevec lusebenza njengesiyobisi-igama lechiza?

Ulawulo lokutya kunye neziyobisi (i-FDA) lufuna abenzi bamachiza enziwe afana nalawo aveliswe ngumenzi ukubonisa ukuba imveliso yabo:

  • into efanayo esebenzayo njengegama lophawu lwegama
  • amandla afanayo kunye nefom yethamo njengegama lophawu
  • indlela efanayo yolawulo (indlela olithatha ngayo ichiza)

Iyeza elenza lafana nalawo aveliswe ngumenzi liyafuneka ukuba lisebenze ngendlela efanayo kunye negama lebrendi.

Ngokwe-FDA, uhlobo oluqhelekileyo lweGleevec luyazifezekisa ezi mfuno. Oku kuthetha ukuba i-FDA iqinisekisa ukuba ifom yesiqhelo iyasebenza njengesiyobisi segama.

Ngaba ndinokukhulisa ukunganyangeki kunyango lwe-Gleevec?

Ewe. Kungenzeka ukuba uhlakulele ukuchasana neGleevec. Ukuxhathisa kuthetha ukuba iyeza liyayeka ukusebenza ngokuhamba kwexesha. Kucingelwa ukuba oku kubangelwa lutshintsho kwimfuza yeeseli zomhlaza.

Ukuba uhlakulela ukumelana neGleevec, ugqirha wakho unokumisela idosi ephezulu. Baya kubona ukuba iiseli zomhlaza ziphendula kwakhona kunyango. Ugqirha wakho unokumisela iyeza elahlukileyo ongenalo ukumelana nalo.

Ngaba kukho izithintelo kwindlela yokutya endimele ndiyilandele ngelixa ndithatha iGleevec?

Akukho zithintelo kwindlela yokutya esemthethweni ekufuneka uyilandele ngelixa uthatha iGleevec. Nangona kunjalo, kuya kufuneka ukunqabe ukutya iidiliya kunye nokusela ijusi yeziqhamo. I-Grapefruit iqulethe ikhemikhali enokuthintela umzimba wakho ekuchumeni (ekwaphuleni) iGleevec. Oku kunokukhokelela kumanqanaba aphezulu eziyobisi egazini lakho. Amanqanaba eGleevec aphezulu kunesiqhelo anyusa umngcipheko weziphumo ebezingalindelekanga ezimandundu.

Ukongeza, ugqirha wakho unokukunika iingcebiso ngokubanzi malunga nokutya kwakho ukunceda ukunciphisa iziphumo ebezingalindelekanga ezithile. Umzekelo, iGleevec ibangela isicaphucaphu nokugabha kubantu abaninzi. Ukukunceda ukukhusela oku, ugqirha wakho unokucebisa ukuba uphephe ukutya okunokwenza isicaphucaphu sibe mandundu. Oku kubandakanya ukutya okunzima, okunamafutha, okanye okunamafutha, kunye nokutya okuqholiweyo okanye okuneasidi. Imizekelo isoso ebomvu, ukutya okuqhotsiweyo, kunye nezinto ezininzi ezikhawulezayo zokutya.

Okokugqibela, ukuba uthatha i-Gleevec yomhlaza wamathumbu, ezinje ngamathumba e-stromal (GIST) zesisu, ugqirha wakho unokucebisa ngezithintelo ezithile zokutya. Injongo kukuthintela iingxaki esiswini okanye emathunjini akho. Thetha nogqirha wakho malunga nokutya okulungele wena.

Ngaba ndiza kuba neempawu zokurhoxa xa ndiyeka ukusebenzisa iGleevec?

Unga. Abanye abantu baneempawu zokurhoxa emva kokuphelisa unyango lwabo lwe-Gleevec. Kwisifundo esinye seklinikhi esincinci, i-30% yabantu babenezihlunu okanye iintlungu zethambo emva kokumisa iGleevec. Intlungu yayihlala isemagxeni, esinqeni, emilenzeni nasezingalweni. Olu phawu lokurhoxa lwenzeke kwiveki enye ukuya kwezintandathu zokumisa unyango.

Phantse isiqingatha sabantu baphatha iintlungu zabo ngokuphelisa iintlungu. Esinye isiqingatha sasifuna amayeza kagqirha. Uninzi lwabantu ababenezi mpawu zokurhoxa, iintlungu zemisipha kunye nethambo zahamba kwisithuba seenyanga ezintathu ukuya kunyaka okanye nangaphezulu.

Ngaba kuya kufuneka ndisebenzise ezinye iziyobisi kwi-Gleevec kunyango?

Kuxhomekeka ekubeni umhlaza wakho uqhubele phambili kangakanani. Kwinqanaba eliphambili lomhlaza okanye umhlaza osasazeke waya kwingqondo okanye emqolo, ugqirha wakho unokongeza i-chemotherapy kunyango lwakho lwe-Gleevec. Ukongeza, abantwana abanePhiladelphia-positive (Ph +) acute lymphocytic leukemia (BONKE) banokufumana iGleevec kunye nekhemotherapy.

Kwiintlobo ezithile zomhlaza, ugqirha wakho unokumisela i-steroid. Kwaye unokufuna ukusebenzisa amayeza ukulawula iziphumo ebezingalindelekanga, ezinje ngokuphelisa iintlungu kwintlungu yemisipha.

Ukuphelelwa lixesha kweGleevec, ukugcinwa kunye nokulahlwa

Xa ufumana iGleevec ekhemesti, usokhemesti uya kongeza umhla wokuphelelwa kwileyibhile esebhotileni. Lo mhla uqhelekile ukuba ube ngunyaka omnye ukusukela kumhla wokuhambisa kwabo amayeza.

Umhla wokuphelelwa unceda ekuqinisekiseni ukusebenza kwamayeza ngeli xesha. Isimo sangoku soLawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) kukuphepha ukusebenzisa amayeza aphelelwe lixesha. Ukuba awusebenzisanga iyeza elidlulileyo, thetha nopharmist. Banokukuxelela ukuba usenokwazi na ukuyisebenzisa.

Ukugcina

Ukuhlala ixesha elingakanani iyeza lihlala lilungile kunokuxhomekeka kwizinto ezininzi, kubandakanya ukuba uligcina phi kwaye phi na iyeza.

Gcina iipilisi zakho zeGleevec kubushushu begumbi kwisitya esitywinwe ngokuqinileyo. Qiniseka ukuba ubakhusela kumswakama.

Ukulahla

Ukuba akusafuneki uthathe i-Gleevec kwaye unamayeza ashiyekileyo, kubalulekile ukulahla ngokukhuselekileyo.

Oku kunceda ukuthintela abanye, kubandakanya abantwana kunye nezilwanyana zasekhaya, ekubeni bathathe iyeza ngengozi. Kuyanceda ukugcina ichiza lingonzakalisi okusingqongileyo.

Iwebhusayithi ye-FDA ibonelela ngeengcebiso ezininzi eziluncedo ngokulahla amayeza. Unokucela ikhemesti yakho ukuba ikwazi ukuba ulahla njani na amayeza akho.

Ulwazi lobungcali lweGleevec

Olu lwazi lulandelayo lubonelelwe ngoochwephesha kunye nabanye abaqeqeshi bezempilo.

Iimpawu

I-Gleevec (imatinib) ivunyiwe yi-FDA ukunyanga oku kulandelayo:

  • Abantu abadala kunye nabantwana abane-Philadelphia-positive (Ph +) engapheliyo ye-myeloid leukemia (CML) kwisigaba esingapheliyo
  • Abantu abadala abane-Ph + CML kuso nasiphi na isigaba, kulandela ukusilela kunyango lwe-interferon-alpha
  • Abantu abadala abane-Ph + accy leukemia (ALL)
  • abantwana abane-Ph + BONKE abasandula ukufunyanwa ngokudibanisa ne-chemotherapy
  • Abantu abadala abane-myelodysplastic / isifo se-myeloproliferative esidibene neplatelet-derived ukukhula factor factor rearrangements
  • Abantu abadala abane-mastocytosis enobundlobongela ngaphandle kwe-D816V c-Kit mutation okanye imeko ye-c-Kit yokutshintsha
  • Abantu abadala abane-hypereosinophilic syndrome kunye / okanye i-leosemia engapheliyo ye-eosinophilic ne-FIP1L1-PDGFRcy fusion kinase, engalunganga kwi-FIP1L1-PDGFRcy fusion kinase, okanye imeko engaziwayo.
  • Abantu abadala abane-unresectable, recurrent, okanye metastatic dermatofibrosarcoma protuberans (DFSP)
  • Abantu abadala abane-Kit engabonakaliyo okanye ye-metastatic malignant Kit + yamathumbu esisu e-stromal tumors (GIST)
  • Unyango oluncedisayo kubantu abadala abane-Kit + GIST kulandela ukugqitywa ngokupheleleyo

Indlela yokusebenza

I-Gleevec inqanda i-BCR-ABL tyrosine kinase, eyi-tyrosine kinase engaqhelekanga efumaneka kwi-Ph + CML. Ukuthintela i-BCR-ABL tyrosine kinase kuthintela ukwanda kweselfowuni kwaye kubangele i-apoptosis kwimigca yeseli ye-BCR-ABL nakwimigca yeseli eneleukemic. I-Gleevec ikwathintela i-tyrosine kinases yokukhula okuphume kwiplatelet (PDGF) kunye ne-stem cell factor (SCF) kunye ne-c-Kit, ethintela ukwanda kunye ne-apoptosis kwiiseli ze-GIST.

I-Pharmacokinetics kunye ne-metabolism

Kuthetha ukuba ukungafumaneki ngokupheleleyo yi-98% emva kolawulo lomlomo. Phantse i-95% yedosi ibotshelelwe kwiiproteni zeplasma (ubukhulu becala i-albhamuin kunye ne-α1-acid glycoprotein).

I-Metabolism yenzeka ikakhulu nge-CYP3A4 kwi-metabolite esebenzayo, kunye ne-metabolism encinci eyenzeka nge-CYP1A2, CYP2D6, CYP2C9, kunye ne-CYP2C19. Eyona nto ihamba phambili ekusebenzeni kwemetabolite yenziwe yi-CYP3A4. Phantse i-68% iyasuswa kwilindle, nge-13% kumchamo. Ukupheliswa kwesiqingatha sobomi beziyobisi ezingatshintshanga ziiyure ezili-18 kunye nokupheliswa kwesiqingatha sobomi be-metabolite esebenzayo ziiyure ezingama-40.

Ukungqinelana

Akukho zingqinisiso zichanekileyo kusetyenziso lweGleevec.

Ukugcinwa kunye nokuphathwa

Amacwecwe eGleevec kufuneka agcinwe kubushushu begumbi (77 ° F / 25 ° C) kwisitya esitywinwe ngokuqinileyo. Khusela iipilisi kumanzi.

Amacwecwe eGleevec athathwa ngokuba ayingozi, ngokwemigangatho yoKhuseleko eMsebenzini kunye noLawulo lwezeMpilo (OSHA). Amacwecwe akufuneki atyunyuzwe. Gwema ukuchukumisa iipilisi. Ukuba ulusu okanye inwebu yencindi inxibelelana namacwecwe acoliweyo, hlamba indawo echaphazelekayo ngokwesikhokelo se-OSHA.

Iphepha elichazayo ukuba awusenanto oyifunayo: Iindaba zezoNyango namhlanje zenze zonke iinzame zokuqinisekisa ukuba zonke iinkcukacha zichanekile, zibanzi kwaye zihlaziyiwe. Nangona kunjalo, eli nqaku akufuneki lisetyenziswe endaweni yolwazi kunye nobuchule bengcali yezempilo enelayisensi. Kuya kufuneka usoloko uqhagamshelana nogqirha wakho okanye nolunye uqeqesho kwezonyango ngaphambi kokuba uthathe nawaphi na amayeza. Ulwazi lweziyobisi oluqulethwe apha luyakwazi ukutshintsha kwaye alujoliswanga ekusetyenzisweni konke okunokwenzeka, imikhombandlela, izilumkiso, izilumkiso, ukuhlangana kweziyobisi, ukungahambelani komzimba, okanye iziphumo ezibi. Ukungabikho kwezilumkiso okanye olunye ulwazi ngesiyobisi esinikiweyo akubonisi ukuba indibaniselwano yeziyobisi ikhuselekile, iyasebenza, okanye ifanelekile kuzo zonke izigulana okanye konke ukusetyenziswa okuthile.

Iimpapasho Zethu

Ityala lokuphambili malunga nesini sakho ngomhla wokuqala
Indlela Yokuphila

Ityala lokuphambili malunga nesini sakho ngomhla wokuqala

Kwakungokuphela komhla wokuqala. Ukuza kuthi ga ngoku, izinto bezihamba kakuhle. ithintele kwiimbali zokuthandana, aqini eki a ubudlelwane bethu obuhambelanayo (bobabini bodwa), axoxa ngobubi bethu, i...
INzululwazi ithi Eli lelona xesha lifanelekileyo leMarathon yaBasetyhini
Indlela Yokuphila

INzululwazi ithi Eli lelona xesha lifanelekileyo leMarathon yaBasetyhini

Ukukhawuleza kwendoda eyakha yaqhuba umdyarho: 2:02:57, ivalwe nguKenya uDenni Kimetto. Kwaba etyhini, nguPaula Radcliffe, obaleke ama-26.2 kwi-2:15:25. Ngeli hwa, akukho mfazi uya kuba nakho ukuvala ...