Ukuphatha Imiphumela Engemihle Yokwelashwa Kwamaseli e-CAR-T: Ukuqonda Okubalulekile Ocwaningweni Lwakamuva
Ucwaningo lwamuva nje olushicilelwe ku- I-Hematological Oncologyikhanyisa ukuphathwa kobuthi obuhambisana nokwelashwa kwe-T-cell ye-Chimeric Antigen Receptor (CAR), ukwelashwa okusha kwe- I-B-Cell Lymphomas. Nakuba ukwelashwa kwe-CAR-T kubonise impumelelo emangalisayo ekwelapheni i-lymphoma enkulu ye-B-cell ephinde yabuya noma engaphikisi, futhi kuletha izinselele ezinkulu ngenxa yemiphumela emibi emibi kakhulu.
Lolu cwaningo, oluholwa nguDkt. S. Neelapu, lugxile ezintweni ezimbili ezivame kakhulu ezitholakala ngokwelashwa kwe-CAR-T: i-cytokine release syndrome (CRS) kanye ne-immune effector cell-associated neurotoxicity syndrome (ICANS). Lezi zinto eziyingozi zivame ukwenzeka ngokushesha ngemva kokufakwa kwe-CAR-T futhi zidinga ukuphathwa ngokushesha ukuze kuvinjelwe izinkinga ezinkulu. I-CRS ivame ukuveza umkhuhlane, umfutho wegazi ophansi, kanye nobunzima bokuphefumula, kuyilapho i-ICANS ingaholela ekudidekeni, ekuqulekeni, kanye nasezimweni ezimbi kakhulu, e-coma.
Lesi sihloko siqokomisa ukubaluleka kokuhlonza nokubeka amazinga kwasekuqaleni kwalezi zinto ezinobuthi ukuze kulungiswe amasu okwelapha afanele. Siphinde sixoxe ngokusetshenziswa kwezindlela zokwelapha ezifana ne-tocilizumab ye-CRS kanye ne-corticosteroids ye-ICANS, eziye zabonakala zisebenza kahle ekunciphiseni lezi zindlela ezingaba yingozi empilweni.
Ngaphezu kwalokho, umbiko uhlola ubuthi besikhathi eside, okuhlanganisa i-cytopenia ende (ukwehla kwenani lamaseli egazi) kanye nemiphumela eqondile, engaphandle kwe-tumor, edinga ukuqapha nokuphathwa okuqhubekayo. Ucwaningo lugcizelela ukuthi, yize ukwelashwa kwe-CAR-T kunamandla amakhulu, abahlinzeki bezempilo kumele bahlonyiswe ukubhekana nemiphumela yayo engavamile neyingozi.
Ngezivivinyo zemitholampilo eziqhubekayo kanye nokusungula izinto ezintsha, lo mkhakha uyaqhubeka nokuthuthukisa amasu angcono okulawula lobu buthi, okuvumela ukwelashwa kwe-CAR-T ukuthi kusetshenziswe ngokuphephile nangendlela ephumelelayo.