Isu Tiri Pedyo Nemushonga Wechirwere cheLymphocytic Leukemia?

Zvemukati

• Immunotherapy inounza kuregererwa kwenguva refu
• MOTO T-cell kurapa
• Mishonga mitsva yakanangwa
• Stem cell kuisirwa
• Tora woenda nazvo

Chirwere lymphocytic leukemia (CLL)

Chronic lymphocytic leukemia (CLL) ikenza yemasoja emuviri. Iyo mhando yeiyo isiri Hodgkin lymphoma iyo inotangira muhutachiona hwemuviri-kurwisa masero eropa machena, anonzi B masero. Gomarara iri rinogadzira akawanda masero machena eropa mumongo wepfupa neropa risingakwanise kurwisa hutachiona.

Nekuti CLL ikenza inononoka kukura, vamwe vanhu havazodi kutanga kurapwa kwemakore mazhinji. Mune vanhu vane gomarara rinopararira, kurapwa kunogona kuvabatsira kuti vabudirire kwenguva yakareba kana pasina chiratidzo chekenza mumuviri wavo. Uku ndiko kunonzi kuregererwa. Parizvino, hapana mushonga kana mumwe mushonga wakwanisa kuporesa CLL.

Rimwe dambudziko nderekuti mashoma maseru ekenza anowanzo gara mumuviri mushure mekurapwa. Izvi zvinonzi zvishoma zvasara chirwere (MRD). Mushonga unogona kurapa CLL uchafanirwa kupukuta ese maseru ekenza uye kudzivirira iyo cancer kuti isazombodzoka kana kudzoka zvakare.

Mutsva musanganiswa wechemotherapy uye immunotherapy zvakatobatsira vanhu vane CLL kurarama kwenguva refu mukuregererwa. Iyo tariro ndeyekuti imwe kana yakawanda yemishonga mitsva mukuvandudza inogona kupa mushonga uyo vatsvagiri nevanhu vane CLL vanga vachitarisira kuwana.

Immunotherapy inounza kuregererwa kwenguva refu

Makore mashoma apfuura, vanhu vane CLL vaive vasina nzira dzekurapa kupfuura chemotherapy. Zvino, mishonga mitsva senge immunotherapy uye yakanangwa kurapa yakatanga kuchinja maonero uye nekuwedzera zvinoshamisa nguva dzekupona dzevanhu vane gomarara iri.

Immunotherapy mushonga unobatsira immune system yemuviri wako kuwana uye kuuraya cancer maseru. Vatsvagiri vanga vachiedza musanganiswa mutsva wechemotherapy uye immunotherapy inoshanda zvirinani pane kungaitwa kurapwa chete.

Mimwe yemasanganiswa aya - senge FCR - iri kubatsira vanhu kurarama vasina chirwere kwenguva yakareba kupfuura nakare kose. FCR mubatanidzwa wechemotherapy zvinodhaka fludarabine (Fludara) uye cyclophosphamide (Cytoxan), pamwe ne monoclonal antibody rituximab (Rituxan).

Parizvino, zvinoita kunge zvinonyanya kushanda mune vechidiki, vane hutano vanhu vane shanduko mune yavo IGHV geni. Mune vanhu mazana matatu vane CLL uye negene mutation, vanopfuura hafu vakapona kwemakore gumi nematatu vasina chirwere paFCR.

MOTO T-cell kurapa

CAR T-cell kurapa imhando yakasarudzika yekurwisa immune iyo inoshandisa yako wega akachinjika maseru ekudzivirira kurwisa gomarara.

Kutanga, masero ekudzivirira anonzi maT seli anounganidzwa kubva muropa rako. Iwo masero eT anoshandurwa nemageneti murabhorari kuti agadzire chimeric antigen receptors (maCAR) - akakosha anogamuchira anosunga mapuroteni ari pamusoro pecancer maseru.

Kana iwo akagadziridzwa T maseru akaiswa kumashure mumuviri wako, ivo vanotsvaga nekuparadza cancer maseru.

Parizvino, CAR T-cell kurapa inogamuchirwa kune mamwe mashoma marudzi asiri eHodgkin lymphoma, asi kwete yeCLL. Kurapwa uku kuri kuongororwa kuti uone kana kuchigona kuburitsa kuregererwa kwenguva refu kana kunyangwe mushonga weCLL.

Mishonga mitsva yakanangwa

Zvinotarisirwa zvinodhaka senge idelalisib (Zydelig), ibrutinib (Imbruvica), uye venetoclax (Venclexta) inoteedzera zvinhu zvinobatsira maseru ekenza kukura uye kurarama. Kunyangwe kana mishonga iyi isingakwanise kurapa chirwere ichi, inogona kubatsira vanhu kurarama kwenguva yakareba mukuregererwa.

Stem cell kuisirwa

Allogenic stem cell kuisirwa parizvino ndiyo chete kurapwa kunopa mukana wekurapa kweCLL. Nekurapa uku, iwe unowana yakanyanya dosi yechemotherapy yekuuraya akawanda maseru ekenza sezvinobvira.

Chemo zvakare inoparadza maseru ane hutano-anogadzira maseru mumapfupa ako. Mushure meizvozvo, iwe unowana kuisirwa masisitimu maseru kubva kune anopa hutano kuti azadze masero akaparadzwa.

Dambudziko nekudzikiswa kwemasero emadzinde ane njodzi. Masero evanopa anogona kurwisa maseru ako ane hutano. Ichi chiitiko chakakomba chinonzi chinomiririra-maringe nehutachiona chirwere.

Kuva nekutapudza kunowedzerawo njodzi yekutapukirwa. Zvakare, hazvishande kune wese munhu ane CLL. Stem cell transplants inovandudza kwenguva refu-isina chirwere kupona mune ingangoita makumi mana muzana yevanhu vanoiwana.

Tora woenda nazvo

Kubva ikozvino, hapana kurapwa kunogona kuporesa CLL. Chinhu chepedyo chatinofanira kurapwa mushonga wesitemusi, uyo une njodzi uye unongobatsira vamwe vanhu kurarama kwenguva yakareba.

Mishonga mitsva mukuvandudza inogona kuchinja ramangwana revanhu vane CLL. Immunotherapies uye mimwe mishonga mitsva iri kutowedzera kupona. Munguva pfupi iri kutevera, mubatanidzwa mutsva wemishonga unogona kubatsira vanhu kurarama kwenguva yakareba.

Tariro ndeyekuti rimwe zuva, kurapwa kuchashanda zvakanyanya zvekuti vanhu vanozokwanisa kurega kutora mishonga yavo uye kurarama hupenyu huzere, husina gomarara. Kana izvo zvikaitika, vaongorori vanozopedzisira vakwanisa kutaura kuti vakaporeswa CLL.