I-Rituxan, Gazyva, ne-anti-CD20 Cancer Therapy
I-Rituxan iyinambuzane ephilayo enegciwane-i-anti-antibody. It isetshenziswa ukuphatha izimo eziningana kuhlanganise non-Hodgkin lymphoma.
Indlela Esebenza ngayo
Ukwazi ukuthi amasosha ethu omzimba angabhekisela kanjani futhi aqede amabhaktheriya namagciwane endaweni yethu, ososayensi babecabanga ukuthi kungenzeka ukulingisa leyo ndlela yokuhlasela amangqamuzana omdlavuza.
Amasosha omzimba wethu akwazi ukubona amamaki ebusweni bama-bacterium kanye nama-virus abonisa ukuthi abangekho emzimbeni.
Uma sibhekene nalezi zinambuzane, senza izinhlamvu zokuzivikela ukuze zihlanganise nalezi zimpawu zomhlaba, ukuvumela wonke amasosha omzimba wethu awazi ukuhlasela. Kutholakale ukuthi amanye amangqamuzana angewona ama-Hodgkin lymphoma anezimpawu ezingabeka eceleni. Lo maki ubizwa ngokuthi i-CD20 antigen futhi ingaphezulu kwamaseli ethu omzimba omzimba aziwa njenge-B-lymphocyte, noma amaseli B. Lawa angamaseli abe nomdlavuza kwezinye izinhlobo ze-non-Hodgkin lymphoma kanye negazi elingelapheki i-lymphocytic leukemia.
Isinyathelo esilandelayo kwakuwukuthola isidakamizwa esingenza njengama-antibodies ama-anti-antibodies omzimba womzimba ayokwazi ukubona amanothi angaphezulu, kodwa emasenini omdlavuza. I-Rituxan (rituximab) yiyona "i-antibody yokufakelwa" etholakala ukunamathela ku-anti-CD20 kuma-cell ase-pre-B omdlavuza kanye nama-B-lymphocytes avuthiwe. Uma i-Rituxan ibophezela ku-CD20 emangqamuzaneni omdlavuza, cishe kukhona izindlela ezimbalwa lapho amangqamuzana omdlavuza abhujiswa khona.
Ososayensi bahlukanisa ama-antibodies emaqenjini ahlukene, ngokusekelwe kwesakhiwo sabo kanye nomsebenzi wabo, kanti i-Rituxan ihlukaniswe njenge-immunoglobulin G, noma i-IgG. I-Rituxan ihlukaniswa njenge -antibody (monoclonal antibody) - uhlobo lwe-immunotherapy olusebenzisa ama-antibodies "awenziwe ngabantu" ukuhlasela umdlavuza.
Ukusetshenziswa
I-Rituxan isetshenziselwa izifo zomdlavuza noma ezingenayo umdlavuza.
Kwenzeka kanjani lokhu? Konke kuhlobene namaseli amhlophe egazi aziwa ngokuthi ama-B-cells noma ama-l-amphocyte, ayingxenye yesistimu yomzimba. Ama-B-amangqamuzana-amangqamuzana afanayo abe nomdlavuza ezinhlobonhlobo ze-lymphomas-angadlala indima ekuthuthukiseni isifo samathambo nesifo esithile sokuvuvukala. Kungasetshenziselwa ukwelashwa kanye nezifo ezingenayo umdlavuza.
Amanqamu:
- Abantu abanezinhlobo ezithile ze-lymphoma ezingekho ze-Hodgkin ezihlanganisa i-follicular lymphoma (FL) nokusabalalisa i-B-cell lymphoma enkulu (i-DLBCL).
- Abantu abane-leukemia engalapheki i-lymphocytic (CLL) ene-CD20 enhle.
Izifo ezingenayo i-Cancerous:
- Abanye abantu abane-arthritis ye-rheumatoid.
- Abanye abantu abanezifo ezingavamile zezikhumba zegazi ezifana ne-granulomatosis ne-polyangiitis (GPA) (i-Wegener's Granulomatosis) ne-polyangiitis encane (i-MPA).
- Ifundiswa ekuvivinyweni kwemitholampilo ukuze kusetshenziswe ukusetshenziswa kwe-multiple sclerosis kanye ne-systemic lupus erythematosus.
Ukubheja ama-B-cell ku-Non-Hodgkin Lymphoma ne-Chronic Lymphocytic Leukemia
Ukwengezwa kweRituxan ekwenzeni kabusha izidakamizwa ukuphatha iNHL kwenze umehluko omkhulu. Ngaphambi kokusungulwa kwalo ekuqaleni kwekhulu leminyaka, isilinganiso sokufa esivela ku-lymphoma sasikhula kancane. Kusukela ngaleso sikhathi kuye kwehla, cishe ngenxa yokusinda okuvela ku-Rituxan.
Ezinye ze-lymphomas lapho iRituxan yenza umehluko kufaka okulandelayo.
I-follicular lymphoma - I-lymphoma ye-follicular uhlobo oluvame kakhulu lwe- indolent - okusho ukuthi i-NHL ekhula kancane, evame ukuvela kuma-lymph nodes kuwo wonke umzimba. Njengoba uhlobo olukhula kancane lwe-NHL, i-FL ayisoze idinga ukwelashwa ngokushesha. Uma udokotela wakho enquma ukusebenzisa i-Rituxan ye-FL, isetshenziswe ngezindlela ezimbili ezihlukene:
- Ukwelashwa kokuqala : ukuze uthole ukuxolelwa
I-Rituxan isetshenziselwa ukuhlanganiswa ne-chemotherapy. Uma ukwelashwa kuholela ekuxoxweni okuyingxenye noma okuphelele, i-Rituxan ingasetshenziswa njengokwelashwa kwesondlo. - Ukwelashwa kwesondlo : ukuhlala ekulalelweni
Umgomo wezokwelapha zokwelapha ukusiza ukugcina lesi sifo singenasikhathi eside. I-Rituxan isetshenziselwa yedwa, ngaphandle kwe-chemotherapy, ngenkathi ukwelashwa kwesondlo.
Ukusakaza i-B-cell lymphoma enkulu (i-DLBCL) - Ukusabalalisa i-B-cell lymphoma enkulu kwenza amaphesenti angaphezu kuka-30 amacala amasha asanda kutholakala e-NHL. I-Rituxan ibhekwa njengengxenye ejwayelekile yokwelapha kokuqala lapho isetshenziselwa ukuhlanganiswa kwe-chemotherapy njenge-CHOP. Ucwaningo olukhulu oluthathu luye lwabonisa ukuthi akugcini kuphela ukungeza ukubambezeleka kwe-Rituxan isifo noma ukuqhubeka, kungase kubangele nokusinda okuthuthukile. Ngakho-ke i-Rituxan inikezwa ngomjikelezo ngamunye we-chemotherapy futhi ingase iqhutshwe isikhathi esingaphelelanga kwemigodi ye-chemotherapy. Kulabo abaye baphathwa ngaphambilini nge-chemotherapy kuphela futhi manje sebebuyile noma baqhubekela phambili, i-Rituxan ingenziwa njengokwelashwa kwe-salvage. (Ukwelashwa kwe-Salvage kubhekisela ekwelapheni okunciphisa izimpawu kanye / noma kwandisa ukusinda, kodwa ayikwazi ukuphilisa lesi sifo.)
Indlela Rituxan Yanikezwa ngayo
I-Rituxan iphathwa njenge-infusion emithanjeni yakho. I-Rituximab inikezwa phezu kwamahora ambalwa. Ukumnika ukuqala kancane kancane, futhi uma isiguli singabonakali noma yikuphi ukuphendula emthini, izinga lokumnika likhuphuka njalo kuhora kuze kube sekupheleni.
I-Rituxan ilawulwa njalo ngesonto lamasonto amane kuya kwangu-8 uma ilawulwa yedwa. Uma kulawulwa nge-chemotherapy, ngokuvamile kunikezwa ngosuku lokuqala lomjikelezo ngamunye we-chemotherapy ngayinye yemijikelezo ka-6 kuya kwangu-8.
Imiphumela emibi nge-Rituxan:
- Imiphumela emibi ye-Rituxan ihlobene nokukhipha ukuphendula kwe-allergenic . Iningi leziguli linomthelela othile, ngakho-ke phakathi nokukhipha kuqala. Izimpawu ezivame kakhulu yi-fever and chills, kanti ezinye iziguli zizwa zihlaziye noma zinezinwele. Lezi zilawulwa kalula ngabasebenzi abaqeqeshwe futhi azivamile ukukhathazeka.
- I-Rituxan ingabangela ukuwa kwezibalo zegazi, njenge-chemotherapy. Lokhu kungase kubangele ukuthi kube nomkhuhlane futhi kungadinga izijovo zokukhula zokulawula.
- Inombolo encane yeziguli ingaba nokukhwehlela nokukhishwa kwamanzi ngemuva kweRituxan. Izinkinga ezinkulu zamaphaphu zivame kakhulu.
Gazyva
Ngokuphambene neRituxan, i-Gazyva iyinhlangano ephikisayo ye-monoclonal i-monoclonal.Gazyva njengesidakamizwa esisha esibheka "ithegi" efanayo njenge-Rituxan, okuyi-CD20 antigen. I-Rituxan neGazyva zombili zikhomba i-CD20 antigen ekhona emangqamuzaneni athile, kuhlanganise namaseli amhlophe egazi aziwa ngokuthi ama-B-lymphocyte, noma amaseli B.
NjengaRituxan, i-Gazyva i-antibody monoclonal. Okusho ukuthi, uhlobo olukhethekile lwe-antibody olwenziwa ngabaososayensi futhi olwenziwe abakhiqizi. Umkhiqizo wokugcina uphonswa esikhwameni njengoketshezi futhi unikezwe ngokumnika okufakwe ngaphakathi.
Ngokusho kokukhululwa komshini kwabakhiqizi bezidakamizwa, uGazyva kucatshangwa ukuthi unamandla okwandisa ukubulala isilwane ngokuqondile-ekwenzeni umsebenzi omkhulu ekuqasheni isimiso somzimba samasosha omzimba ukuhlasela ama-B-cell.
Imithombo:
Fleury, I., Chevret, S., Pfreundschuh, M. et al. I-Ritiximab kanye nobungozi bokuhlukumeza okuyisisekelo sesibili ezigulini ezine-non-Hodgkin lymphoma: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta. Amanothi we-Oncology . 2015 Dec 17. (Epub ngaphambi kokuphrinta).
I-National Cancer Institute. Ukusebenzisa uhlelo lwe-Immune System ekulwa nomdlavuza: Ukutholakala kweRituximab. Kubuyekezwe 03/07/14.