Na Re Haufi le Pheko ea Lefuemia e sa Foleng ea Lymphocytic?

Litaba

• Immunotherapy e tlisa liphokotso tse telele
• Kalafo ea T-cell ea CAR
• Lithethefatsi tse ncha tse reretsoeng
• Ho kenyelletsa sele ea stem
• Tsa Tsau-tsau

Lefuemia e sa foleng ea lymphocytic (CLL)

Lefuemia e sa foleng ea lymphocytic (CLL) ke mofetše oa sesole sa 'mele. Ke mofuta oa se seng oa Hodgkin lymphoma o qalang tšoaetsong ea 'mele-e loantšang lisele tse tšoeu tsa mali, tse bitsoang lisele tsa B. Kankere ena e hlahisa lisele tse tšoeu tse ngata tse tšoeu tsa mali mongoaneng oa mali le maling a ke keng a loantša tšoaetso.

Hobane CLL ke mofetše o hōlang butle, batho ba bang ba ke ke ba hloka ho qala kalafo ka lilemo tse ngata. Ho batho bao kankere ea bona e namang, kalafo e ka ba thusa ho fihlela nako e telele ha ho sena sesupo sa mofetše 'meleng ea bona. Hona ho bitswa tshwarelo. Ho fihlela joale, ha ho na setlhare kapa kalafo e ngoe e atlehileng ho folisa CLL.

Phephetso e 'ngoe ke hore hangata palo e fokolang ea lisele tsa mofetše e sala' meleng kamora kalafo. Sena se bitsoa lefu le fokolang la masalla (MRD). Kalafo e ka folisang CLL e tla tlameha ho hlakola lisele tsohle tsa mofetše le ho thibela mofetše hore o se hlole o khutla kapa o khutlela hape.

Metsoako e mecha ea chemotherapy le immunotherapy e se e thusitse batho ba nang le CLL ho phela halelele ka ho tšoareloa. Tšepo ke hore e 'ngoe kapa tse' maloa tsa litlhare tse ncha tse nts'etsopele li ka fana ka pheko eo bafuputsi le batho ba nang le CLL ba neng ba tšepile ho e fumana.

Immunotherapy e tlisa liphokotso tse telele

Pele ho lilemo tse 'maloa tse fetileng, batho ba nang le CLL ba ne ba sena likhetho tsa kalafo ntle le chemotherapy. Joale, liphekolo tse ncha tse kang immunotherapy le kalafo e reretsoeng li ile tsa qala ho fetola pono le ho holisa haholo linako tsa ho pholoha bakeng sa batho ba nang le mofetše ona.

Immunotherapy ke kalafo e thusang sesole sa hau sa 'mele ho fumana le ho bolaea lisele tsa mofetše. Bafuputsi ba ntse ba leka liteko tse ncha tsa chemotherapy le immunotherapy tse sebetsang hantle ho feta kalafo feela.

Tse ling tsa likarolo tsena - joalo ka FCR - li thusa batho ho phela ba se na mafu nako e telele ho feta neng kapa neng. FCR ke motsoako oa chemotherapy drug fludarabine (Fludara) le cyclophosphamide (Cytoxan), hammoho le monoclonal antibody rituximab (Rituxan).

Ho fihla hajoale, ho bonahala e sebetsa hantle ho feta ho batho ba bacha, ba phetseng hantle ba nang le phetoho liphatseng tsa lefutso tsa IGHV. Ho batho ba 300 ba nang le CLL le phetoho ea liphatsa tsa lefutso, ba fetang halofo ba ile ba phela lilemo tse 13 ba se na mafu ho FCR.

Kalafo ea T-cell ea CAR

Kalafo ea C-T-cell ke mofuta o khethehileng oa kalafo ea 'mele ea ho itšireletsa mafung e sebelisang lisele tsa hau tsa' mele tse fetotsoeng ho itoants'etsa mofetše.

Ntlha ea pele, lisele tsa 'mele tse bitsoang T cell li bokelloa maling a hao. Lisele tsena tsa T li fetotsoe ka liphatsa tsa lefutso ka laborateng ho hlahisa chimeric antigen receptors (CARs) - li-receptor tse ikhethang tse tlamang liprotheine tse kaholimo ho lisele tsa mofetše.

Ha lisele tsa T tse fetotsoeng li khutlisetsoa 'meleng oa hau, li batla le ho senya lisele tsa mofetše.

Hona joale, kalafo ea C-T-cell e amoheloa bakeng sa mefuta e meng e 'maloa ea e seng Hodgkin lymphoma, empa eseng bakeng sa CLL. Kalafo ena e ntse e ithutoa ho bona hore na e ka hlahisa ntlafatso e telele kapa ea folisa CLL.

Lithethefatsi tse ncha tse reretsoeng

Lithethefatsi tse lebisitsoeng joalo ka idelalisib (Zydelig), ibrutinib (Imbruvica), le venetoclax (Venclexta) li latela lintho tse thusang lisele tsa mofetše ho hola le ho phela. Le ha litlhare tsena li sa khone ho phekola lefu lena, li kanna tsa thusa batho ho phela nako e telele haholo tšoarelong.

Ho kenyelletsa sele ea stem

Allogenic stem cell transplanting hajoale ke eona feela kalafo e fanang ka monyetla oa ho folisa CLL. Ka kalafo ena, o fumana tekanyetso e phahameng haholo ea chemotherapy ho bolaea lisele tse ngata tsa mofetše kamoo ho ka khonehang.

Chemo e boetse e senya lisele tse phetseng hantle tse etsang mali mokong oa masapo. Kamora moo, o kenya lisele tsa bakoang tse tsoang ho mofani ea phetseng hantle ho tlatsa lisele tse senyehileng.

Bothata ba ho fetisetsa lisele tsa stem ke hore li kotsi. Lisele tsa bafani li ka hlasela lisele tsa hau tse phetseng hantle. Ena ke boemo bo tebileng bo bitsoang lefu la ho hlomathisa khahlanong le ho amohela.

Ho kenyelletsa hape ho eketsa menyetla ea ho tšoaetsoa. Hape, ha e sebetse ho bohle ba nang le CLL. Ho kenya li-cell cell ho ntlafatsa ho phela nako e telele ntle le mafu ho batho ba ka etsang liperesente tse 40 ba li fumanang.

Tsa Tsau-tsau

Ho tloha hajoale, ha ho na kalafo e ka folisang CLL. Ntho e haufi ka ho fetisisa eo re lokelang ho e phekola ke ho kenya seleng ea stem, e kotsi ebile e thusa feela batho ba bang ho phela nako e telele.

Litlhare tse ncha ntlafatsong li ka fetola bokamoso ba batho ba nang le CLL. Li-immunotherapies le lithethefatsi tse ling tse ncha li se li ntse li eketsa bophelo. Haufinyane, metsoako e mecha ea lithethefatsi e ka thusa batho ho phela halelele.

Tšepo ke hore ka letsatsi le leng, kalafo e tla sebetsa hantle hoo batho ba tla tseba ho emisa ho noa meriana ea bona mme ba phele bophelo bo felletseng bo se nang mofets'e. Ha seo se etsahala, qetellong bafuputsi ba tla tseba ho bolela hore ba folisitse CLL.