Ukwelashwa kwe-CAR T-Cell (i-chimeric antigen receptor) kwenziwa kakhulu ezinhlotsheni ezithile zomdlavuza wegazi. Luhlobo lwendlela ethuthukisa amandla omzimba womuntu siqu ukulwa namaseli omdlavuza. Iguqula amaseli e-T akhona emzimbeni ukuze abone futhi alimaze kangcono amaseli omdlavuza. Lokhu kwenziwa kakhulu ezinhlotsheni ezithile zomdlavuza wegazi njenge-leukemia, i-multiple myeloma, i-lymphoma, njll. Ngathi, iziguli ezivela emhlabeni wonke zingathola lokhu kwelashwa eNdiya, eThailand, eDubai nakwamanye amazwe amaningi ngodokotela abangochwepheshe abahlinzeka ngezikhungo zokunakekelwa kwempilo eziqondene nomuntu siqu neziphephile.

Ubani Odinga Ukwelashwa Nge-CAR T-Cell?

Ukwelashwa nge-CAR T-Cell kuyindlela eyenziwa kakhulu kwezinye izinhlobo zomdlavuza wegazi. Le nqubo ingasetshenziswa kokubili ezinganeni nakubantu abadala. Uma ingane noma umuntu omdala enesifo somdlavuza wegazi esilandelayo, angase ayisebenzisele ukwelashwa nge-CAR T Cell ngemva kokuthola iseluleko kudokotela.

I-leukemia ye-acute lymphoblastic yamaseli e-B
I-Follicular Lymphoma
I-myeloma eminingi
Sabalalisa I-B Cell Lymphoma Enkulu
I-leukemia engapheli ye-lymphocytic
UMantle Cell Lymphoma

Izinhlobo ze-CAR T-Cell Therapy

Kunezinhlobo eziningi zokwelapha nge-CAR T-Cell ezitholakala kakhulu ukuthi zihlose izinhlobo ezahlukene zama-antigen ahlala ebusweni bamaseli omdlavuza, njenge:

I-Tisagenlecleucel: Lokhu kwelashwa kwenziwa ikakhulukazi ekwelapheni i-acute B cell lymphoblastic leukemia yabantu abadala, i-large B cell lymphoma kanye ne-follicular lymphoma.
I-Axicabtagene Ciloleucel: Ukwelashwa nge-immunotherapy okugxile kakhulu ku-antigen ku-large B-cell lymphoma kanye ne-follicular lymphoma.
I-Brexucabtagene Autoleucel: Olunye uhlobo lwalolu hlobo lokwelapha, olwenziwa ikakhulukazi ukuqondisa i-antigen ku-mantle cell lymphoma kanye ne-adult B-cell acute lymphoblastic leukemia.
I-Lisocabtagne Maraleucel: Lokhu kwelashwa kusetshenziselwa ukuhlasela i-antigen ye-CD19 ku-large B-cell lymphoma, i-chronic lymphocytic leukemia, i-follicular lymphoma kanye ne-mantle cell lymphoma.
Idecabtagene Vicleucel: Ngokuvamile igxila ku-antigen yokuvuthwa kwamaseli e-B ku-myeloma eminingi.
I-Ciltacabtagene Autoleucel: Lokhu kwelashwa kwenziwa ukuze kuhloswe ukuvuthwa kwamaseli e-B ku-myeloma eminingi.
I-Obecabtagene Autoleucel: Lokhu kwelashwa kusetshenziswa ku-B cell acute lymphoblastic leukemia yabantu abadala ukuze kuhlaselwe i-antigen ye-CD19.

Ukuphikisana kokwelashwa kwe-CAR T-Cell

Kubhekwa njengokukhetha okungcono ukwelapha izinhlobo ezithile zomdlavuza wegazi kodwa akusizi wonke umuntu. Uma isiguli sinezimo ezilandelayo, singase singakulungeli lokhu kwelashwa:

Uma umuntu etheleleke nge-HIV, i-hepatitis, njll.
Uma umuntu enezifo ezizimele njenge-rheumatoid arthritis, i-lupus, njll.
Amazinga aphezulu esifo sikashukela, isifo senhliziyo, njll.
Isigaba sokuncelisa sowesifazane.
Izimila eziqinile.
Iziguli ezike zadlula kulolu hlobo lokwelashwa kanye.
Ubudala bungaba yisici esibalulekile ikakhulukazi kubantu abadala.
Izici Zengqondo.

Indlela Yokulungiselela Ukwelashwa Kwe-CAR T-Cell

Nazi ezinye zezinyathelo ezibalulekile umuntu angazicabangela ngenkathi ezilungiselela lokhu kwelashwa okungase kunikeze imiphumela emihle kakhulu:

Ukubonisana: Ekuqaleni, odokotela bahlola umlando wezokwelapha kanye nesimo sempilo yesiguli.
Ukuhlolwa Komzimba Nokuhlolwa Kwezithombe: Odokotela benza izivivinyo ezithile ezihlanganisa ukuskena kwe-CT ne-MRI, kanye nokuhlolwa kwegazi.
Ukuhlolwa Kwangaphambi Kokwelashwa: Ochwepheshe bezempilo bahlola ukuthi inhliziyo, amaphaphu nezinso zisebenza kahle noma cha.
Imithi yokugoma: Iziguli zinikezwa imijovo ethile yokugoma ezisiza ekuvikeleni ezifweni.
Ingxoxo mayelana nemithi: Kulokhu iziguli zitshela ochwepheshe bazo bezempilo ngemithi eziyithathayo njengamanje.
Ukwesekwa Kwengqondo: Ukusekelwa komndeni, abangane noma ukunakekelwa kwezempilo kubalulekile kumuntu ngesikhathi sokwelashwa okumsiza ukuthi aphathe imizwa yakhe ngesikhathi sokwelashwa.
Ushintsho Lwendlela Yokuphila: Umuntu kufanele alandele ukudla okulinganiselayo, aphuze amanzi amaningi futhi agweme ukujima okunzima. Lokhu kusiza ekuzilungiseleleni ngaphambi kokwelashwa.

I-CAR T Cell Therapy: Isinyathelo Ngesinyathelo Inqubo

Nansi incazelo yenqubo, njengokuthi:

Ukuqoqwa Kwama-T-Cells: Ekuqaleni, odokotela baqoqa igazi lesiguli bese behlukanisa amaseli e-T kulo. Le nqubo ibizwa ngokuthi i-leukapheresis.
Ukuguqulwa kwelebhu: Ngemva kokuqoqwa kwama-T cell, odokotela bawathumela emalabhorethri ukuze kuguqulwe ama-CAR. Lokhu kusiza ama-T-cell ukuthi abone amaseli omdlavuza futhi awalimaze ngempumelelo.
Ukwandiswa kwama-T-Cells e-CAR: Uma ukuguqulwa sekuqediwe, ochwepheshe bayawakhulisa futhi bawakhulise la maseli elabhorethri. Lokhu kwenziwa ukuze inani lama-T-cell lande okuvame ukuthatha izinsuku ezimbalwa.
Ukulungiselela Ukufakwa Kwama-T-Cells e-CAR: Kulesi sigaba, odokotela banciphisa inani lamaseli omzimba ukuze bakhe isikhala sokufaka amaseli e-CAR T ngosizo lwe-chemotherapy. Ngemva kwalokhu, bayawafaka egazini lesiguli.

Izinzuzo ze-CAR T-Cell Therapy

Ezinye zezinzuzo zalolu hlobo lokwelapha zinikezwe ngezansi:

Lokhu kwelashwa kugxile kakhulu ekulimazeni amangqamuzana omdlavuza.
Kuthuthukisa ikhwalithi yokuphila.
Amathuba okuzalwa kabusha kwamaseli omdlavuza mancane.
Amanani aphezulu okusinda.
Imiphumela emibi evela kulokhu kwelashwa incane.
Lokhu kwelashwa kwenziwa ngokwendlela yesiguli.

Izingozi Nezinkinga: Ukwelashwa Nge-CAR T-Cell

Ezinye zezingozi nezinkinga ezingase zenzeke ngemva kokwelashwa nge-CAR T-Cell:

I-Cytokine Release Syndrome
I-Immune Effector Cell Associated Neurotoxicity Syndrome
Coma
Ubuhlungu Bekhanda Obukhulu
Ukubalwa Kwegazi Eliphansi
Izifo ezifana ne-fungus, i-viral, njll.
Ukungezwani komzimba
Izinguquko Emsebenzini Wokuzivikela Emzimbeni

Izindleko ze-CAR T-Cell Therapy e-India

Izindleko zokwelapha nge-CAR T-Cell eNdiya ngokuvamile zisukela ku-INR 30,00,000 kuya ku-50,00,000. Zingahluka kuye ngendawo, isibhedlela, odokotela, izinga lobunzima besiguli, njll. Izindleko zalokhu kwelashwa eNdiya cishe ziyingxenye yeshumi uma kuqhathaniswa namanye amazwe asentshonalanga.