Njalo ngonyaka, ukuthuthuka kokubili kwezokwelapha kanye nobuchwepheshe kuholela ezindleleni ezintsha nezithakazelisayo zokwelapha i-leukemia ne-lymphoma nokusiza labo abanakho kakade noma okwamanje banakekelwa. Kwezinye izimo, intuthuko enjalo empeleni ingcono kakhulu kumasu wamanje, kanti amanye amelela okwakamuva ku-smart tech nakweminye imikhuba engezansi.
Okulandelayo ukuthuthukiswa okune kuhlolwe ekunakekelweni kwegazi kanye ne-lymphoma ezivela ezihlotsheni ezahlukene zocwaningo ngo-2017.
1. Injectable Rituximab
I-Rituximab , i-anti-monoclonal anti-laboratory eyenzelwe i-laboratory, iye yaba yinye yezingqikithi zokwelapha kwezinye izifo ezingekho ze-Hodgkin. I-Lymphomas ingahle ihlanganiswe ngokuyinhloko ibe yizigaba ezimbili, i- Hodgkin non-Hodgkin, noma i-NHL.
I-Rituximab ibonise ukuthi isebenzisa izintshumayelo ezithile zezinhlobo ezimbili ezijwayelekile kakhulu ze-NHL :
- I-lymphoma yezintambo
- Isakaza i-B-cell enkulu ye-NHL (DLBCL)
I-Rituximab nayo ibonise ukuthi isebenzisa emibonisweni ethile yezifo ezilandelayo:
- I-lymphocytic leukemia engapheliyo
- I-rheumatoid arthritis
- I-wegener granulomatosis
- Polyangiitis microscopic
- I-immune thrombocytopenic purpura (i-ITP)
- Pemphigus vulgaris
Umlingani weTethered
Ngayo yonke le ndlela esebenzayo, futhi nge-rituximab njengokwelapha okuvelele ku-NHL, abenzi bezidakamizwa baye babheka amehlo abo ku-rituximab ukuze babone ukuthi ingabe ingaguqulwa yini emithanjeni (IV) yokwelapha eya engayinikwa njengesibhamu.
Uma ngabe uke waba isiguli esidinga imithi ye-IV, uyazi isikhalazo sokuguqula lesi sidakamizwa into enganikezwa njengesibhamu.
Uma i- rituximab inikezwa ngaphakathi, unamathele esikhwameni se-IV, futhi i-poll ezinamasondo enezikhwama zayo ezibalekayo iba "umlingani wakho obambelelekile" amahora ambalwa alandelayo noma ngaphezulu.
Ngokuvamile lokhu kungasho ukuthi, uma udinga ukuya endlini yokugezela, udinga ukushayela 'umlingani' wakho kanye nawe. Ngezinye izikhathi, kungaba khona ukukhala okucasulayo futhi i-alamu izwakala ivela emshinini we-IV uma uzama ukufunda, bukela i-TV noma nje uqoqe imicabango yakho. Kulezi ziguli ezibhekene ne-khansa yegazi, amahora amaningi e-tethering okunjalo kungenzeka esevele esebenza, ngakho-ke noma yini esiza ukunciphisa lo mthwalo uvame ukwamukelwa.
Isixazululo Esisha
Ukwakhiwa okusha okuyijova kuyinhlanganisela ye-rituximab ne-substance ebizwa nge-hyaluronidase, esiza ukuletha imithi ngaphansi kwesikhumba. Ukuvunyelwa kwe-US kulindeleke ukuthi kube ngohlobo 2017, futhi sekuvele kuvunyelwe eYurophu. Uma kunikezwa ngaphansi kwesikhumba, kungenziwa ngaphansi kwemizuzu engu-5 ukuya kwangu-7, kuqhathaniswa nehora kanye nengxenye noma ngaphezulu kwe-rituximab engaphakathi. Ucwaningo oluthile luye lwabonisa ukuthi ukwakhiwa okusha kwe-rituximab okukhishwa ngaphansi kwesikhumba kuphephile futhi kusebenza kanye ne-rituximab engenayo, okuholela emazingeni afanayo omuthi egazini. I-injected version ivunyelwe e-European Union kusukela ngo-2014. Uma i-FDA ivuma, i-IV rituximab izoqhubeka itholakale iziguli zaseMelika.
2. I-Computer Algorithm ye-Acute Myeloid Leukemia
Ngeke yini kube kuhle uma odokotela bekwazi ukuthola ukuthi ngubani ozobuyela emuva ngemuva kokwelashwa futhi ngubani ongangena ekuxoxweni?
Abacwaningi abaxhasiwe yiNational Cancer Institute, kanye nezinye izinhlangano eziningana, basebenzela ukwenza kanjalo, besebenzisa amakhompiyutha.
I-Acute Myeloid Leukemia
I-myeloid leukemia (i-AML) enamandla kakhulu uhlobo lomdlavuza wegazi lapho amangqamuzana egazi amhlophe angavamile akhuphuka ngokushesha emnothweni wethambo futhi aphazamise ukukhiqizwa kwamaseli avamile egazi. Kunezinhlobo ezine eziyinhloko ze-leukemia-ama-leucemia amabili acula, noma akhula ngokushesha, nama-2 angapheli, noma akhula kancane kancane. I-AML yi- acute ejwayelekile kakhulu , noma i-leukemia ekhula ngokushesha kubantu abadala. I-AML yi-leukemia yesibili evame kakhulu ezinganeni, futhi i-leukemia, ngokuvamile, iyimdlavuza evamile kakhulu ebuntwaneni.
Ukutholakala kwedatha
Ukwenza ukuxilongwa kwe-AML kudinga ukwazi imiphumela yezivivinyo ezithile zelabhuthrikhi, ngaphezu kwezibonakaliso nezimpawu zesifo esingase sibe khona. Lokhu ngokuvamile kuhilela okuthile okuthiwa i-cytometry yokugeleza, indlela yokubala nokuhlunga izinhlayiyana ezincane eketsheni; Kulesi simo, amaseli we-leukemia namakaki awo, amaprotheni nama-protein-complexes ayatholakala njengengxenye yamaseli. Ukuhlaziya idatha kusuka ku-cytometry yokugeleza kungadla isikhathi.
Faka: Ama-computer ahlakaniphile
Abacwaningi abavela e-Purdue University naseRoswell Park Cancer Institute bebelokhu besebenza kumshini wokufunda umshini wokufunda umshini ongasiza kulokhu, futhi bakholelwa ukuthi ungakhipha ulwazi oluvela kudatha kangcono kunabantu.
Ukufunda komshini kubhekisela egatsheni le-computer yesayensi ephethe ama-computer akwazi ukwanda emisebenzini ethile ehleliwe noma ehlaziya "isipiliyoni," ngaphandle kokuhlelwa ngokucacile ukwenza kanjalo. Ithimba libike ukuthi likwazi ukusebenzisa idatha ye-cytometry yokugeleza ukubikezela umphumela wesiguli kanye nokulingana okuphakathi kuka-90 no-100.
3. Ukukhipha Isisindo Ukubheka Ukubuyela emuva
Ingxenye yazo zonke iziguli ezine-Hodgkin lymphoma futhi ehlukanisa i-B-cell lymphoma enkulu (uhlobo oluvame kakhulu lwe-non-Hodgkin lymphoma) liyophinde liphinde lidinga ukwelashwa okwengeziwe. Njengoba kunikezwe ukuthi izibalo, iziguli ezinjalo kufanele zithwetshwe kangaki ukuze kuqinisekiswe ukuthi umdlavuza awubuyanga?
Kungani Ungabhalwanga? Kuphephile Kakhulu Kunesihawu, Ngakwesokudla?
Uma i-imaging yokuhlola ijwayelekile ingathola ukuthi ibuyela emuva ekuqaleni, uma kungekho izimpawu, futhi uma lokhu kuthuthukisa ukusinda kweziguli ezinjalo, lokho kungaba into enhle, kodwa kunemibuzo eminingi engaphenduliwe kule ndawo.
Ngaphezulu, kubonakala sengathi kungaba umqondo omuhle kubantu abaye baphathwa ngalezi zifo ukuthola izikhathi ezijwayelekile, ukuqinisekisa ukuthi umdlavuza awubuyisanga. Lokhu kuyiqiniso, kodwa ngakolunye uhlangothi lwe-equation, imisebe ehambisana nalezi zingqinamba ibeka ingozi yokukhuthaza ukulimala kwesibili. Ngeke uthande abantu abasengozini enkulu kakhulu yokuphindaphinda, abanesifo esiphelelwe yisikhathi ngophilisi olusebenzayo, ukuba bahlolwe ngezikhathi ezingadingekile, bawabeke emisebeni, bafune ukubuyela emuva okungenakwenzeka. Okunye okucatshangelwayo ukuthi kwenzeke amanga amanga. Ngokwezifundo zamuva, ingxenye encane yeziguli kufanele ibhekane nemiphumela yokuskena yamanga, eyenza ukhathazeka okwengeziwe nokungenelela kwezokwelapha.
Abacwaningi abavela e-Emory University naseMayo Clinic basanda kushicilela imiphumela evela ocwaningweni ababenzile ukuhlola eminye yale mibuzo. Bahlaziya indima yokucubungula-ukucabanga ekubuyiseni ukutholakala futhi kubuyekezwe umthelela wayo ekusindeni iziguli ezibuyiselwe ngeHodgkin lymphoma noma i- DLBCL engeyona i-Hodgkin lymphoma. Ngokuvamile, bathole ukuthi izindlela zamanje zokubona izithombe aziboni ukuthi eziningi zibuyela emuva ngaphambi kwezibonakaliso nezimpawu zomtholampilo noma zithuthukise ukusinda.
Ukuthola Izifo Eziphakeme Eziphezulu
Lokho kusho ukuthi akuwona wonke umuntu emaqenjini ahlolwe kulolu cwaningo abesengozini efanayo yokubuyela emuva. Ngakho-ke, lokho kuphakamisa umbuzo, yiziphi amaqembu eziguli eziphakeme ngokwanele engozini yokuphindaphinda lezo zinzuzo zokuskena kokuhlola okungajwayelekile zingaphezu kwezingozi? Abaphenyi bathi ukuhlolwa okuzayo okuzayo kuyadingeka ukuze kunqume ukuthi ukuskena okujwayelekile okuphindaphinda kungase kube nezinzuzo uma ukhetha iziguli ezifanele ukuskena, okuthiwa "izizwe ezikhethiwe kakhulu."
Okwamanje, leli qembu labacwaningi lazizwa linengqondo ezigulini ezine-DLBCL kanye nezici eziphezulu zokubeka ingozi-kuhlanganise ne-International Prognostic Index (IPI) ka-3 ukuya ku-5-ukucubungula izikweletu ngesinye isinye isikhathi ngemuva kokuxoxa ngezingozi nezinzuzo nokwazi ukutholakala kokuqala kokuphindaphindiwe akuzange kuboniswe ngokucacile ukuze kuthuthukiswe ukusinda.
4. Ukwelashwa kwe-Nano-CAR-T
Kuziguli ezinegazi lomdlavuza wegazi kanye nabathandekayo babo, kukhona injabulo enkulu mayelana nokwelashwa kwe-CAR-T cell. Ukuphumelela okusha okubandakanya ukwelashwa kwe-CAR-T cell kubikwa kaningi, kubonakala nsuku zonke.
Mayelana namaseli e-CAR-T
T-amangqamuzana uhlobo lwamasosha omzimba esinawo wonke emzimbeni wethu. Ziyaziwa ngokuqondile ngokuthi i-T-lymphocyte, uhlobo lwe-white cell cell. Amaseli e-T anemitholampilo ezindaweni zawo, okuthiwa yi-T-cell receptors, noma ama-TCR. Lezi zi-TCR zibopha ama-antigen kuma-invaders angaphandle noma amanye amaseli asongela, njengamaseli omdlavuza, esiza umzimba ukuba uphakamise impendulo yomzimba, ukulwa nosongo.
Uma amaseli ase-T esetshenziselwa ukwelapha umdlavuza we-CAR-T, aqala ukuqoqwa egazini lakhe. Khona-ke, esibhedlela, ama-T-amangqamuzana aguqulwa ukuze akhiqize ama-receptors akhethekile ebusweni bawo okuthiwa i-chimeric antigen receptors, noma ama-CAR, akwazi ukubopha amaprotheni angaphansi kwamangqamuzana athile omdlavuza. Lawa maseli ase-T anama-CAR awo angaholela ekubhujisweni kwamangqamuzana omdlavuza, uma ephinde abuyele esibhedlela.
I-nanotechnology ihambelana namaseli e-CAR-T
Enye yezingxenye ezihamba phambili ezihambayo kulolu cwaningo kwaba yilokho amaseli wesiguli adinga ukuvunwa, ahlanganiswe ngaphandle komzimba, bese esetjentiswa uma kukhona izinombolo ezanele zokwenza umsebenzi. Ngeke yini kube mnandi uma leso sinyathelo sobunjiniyela singenziwa ngamaseli akho ngokushesha, mhlawumbe ngamathuluzi wobunjiniyela amancane? Lona ngumqondo wokusetshenziswa kwe-nanotechnology kulolu hlelo lokusebenza. I-nanotechnology lapha ibhekisela ekusetshenzisweni kwemishini encane ukuletha izinzuzo ngaphakathi komzimba.
Abacwaningi esikhungweni somdlavuza weFred Hutchinson basanda kubonisa ukuthi amangqamuzana omzimba omzimba ahleliwe angahlanza noma anciphise ukuthuthukiswa kwe-leukemia emfanekisweni wabo we-laboratory wesifo. Ucwaningo lwe-"proof-of-principle" luyisinyathelo esibalulekile sokuqala, futhi okutholakele kwanyatheliswa "ku-Nature Nanotechnology." UDkt Matthias Stephan, umphenyi kuleli qembu, ucashunwe ethi "Ubuchwepheshe bethu yilokuqala ukuthi siyazi ukuthi siphuthuma ukuhlela amandla okugaya amathumba emaT cell ngaphandle kokukhipha ekusebenziseni i-laboratory."
> Imithombo:
> Genentech. Ikomidi elicebisa i-FDA lincoma ngokuvumelana nokugunyazwa kwe-Genentech's rituximab engaphansi kwegazi ezithile zegazi.
> Stanford Medicine. I-algorithm yekhompyutha ibikezela imiphumela yeziguli ze-leukemia.
> Cohen JB, Behera M, Thompson A, et al. Ukuhlolisisa i-imaging ye-surveillance ye-B-cell lymphoma enkulu ne-Hodgkin lymphoma. Igazi. 2017; 129: 561-564.