Kū kokoke paha mākou i kahi hoʻōla no ka Lymphocytic Leukemia Chronic?

Anter

• Lawe mai ʻo Immunotherapy i nā kala lōʻihi
• CAR T-cell therapy
• Nā lāʻau i hoʻomāka ʻia hou
• Ke kuʻi ʻōnaʻi ʻōnaeho
• Lawe aku

Leukemia lymphocytic mau (CLL)

ʻO ka leukemia lymphocytic mau (CLL) kahi maʻi ʻaʻai o ka ʻōnaehana pale. ʻO kahi ʻano o ka lymphoma non-Hodgkin e hoʻomaka i ka maʻi o ke kino e hakakā ana i nā hunaola keokeo, i kapa ʻia he B cells. Hoʻokumu kēia kanesa i nā kehena koko keʻokeʻo maʻamau i ka iwi iwi a me ke koko i hiki ʻole ke kūʻē i ka maʻi.

No ka mea he maʻi maʻi lohi ka ulu ʻana o CLL, ʻaʻole pono kekahi poʻe e hoʻomaka i ka mālama ʻana no nā makahiki he nui. I ka poʻe i pālahalaha ka maʻi ʻaʻai, hiki i nā mālama iā lākou ke hoʻokō i nā wā lōʻihi ke ʻaʻohe hōʻailona o ka maʻi ʻaʻai i loko o ko lākou kino. Kapa ʻia kēia he kala kala. I kēia manawa, ʻaʻole hiki i kahi lāʻau a i ʻole nā ​​lāʻau ʻē aʻe ke hōʻola iā CLL.

ʻO kahi pahuhopu kahi hapa liʻiliʻi o nā hunaola maʻi ʻaʻai e noho pinepine i ke kino ma hope o ka mālama ʻana. Kapa ʻia kēia he minimal residual disease (MRD). ʻO kahi lapaʻau e hiki ke hoʻōla iā CLL e holoi i nā keena maʻi ʻaʻai a pale i ka maʻi ʻaʻa mai ka hoʻi ʻana a hoʻi hou ʻana paha.

Ua kōkua nā hui hou o ka chemotherapy a me ka immunotherapy i ka poʻe me CLL e ola lōʻihi i ke kala. ʻO ka manaʻolana ʻo kekahi a ʻoi paha o nā lāʻau hou i ka hoʻomohala ʻana e hāʻawi ai i ka lāʻau lapaʻau a ka poʻe noiʻi a me ka poʻe me CLL e manaʻo nei e hoʻokō.

Lawe mai ʻo Immunotherapy i nā kala lōʻihi

Ma mua o kekahi mau makahiki i hala aku nei, ʻaʻohe koho o nā poʻe me CLL ma mua o ka chemotherapy. A laila, ua hoʻomaka nā lapaʻau hou e like me ka maʻi pale maʻi a me ka hoʻomōhala hoʻomāka e hoʻololi i ka kuanaʻike a hoʻolōʻihi i nā manawa ola no ka poʻe me kēia maʻi ʻaʻai.

He lāʻau lapaʻau ka Immunotherapy e kōkua ai i ka pale pale o kou kino e loaʻa a pepehi i nā hunaola maʻi ʻaʻai. Ke hoʻokolohua nei nā kānaka noiʻi me nā hui hou ʻana o ka chemotherapy a me ka immunotherapy e ʻoi aku ka maikaʻi ma mua o ka mālama ʻana wale nō.

ʻO kekahi o kēia mau hui pū - e like me FCR - ke kōkua nei i ka poʻe e noho manuahi ʻole no ka mea ʻoi aku ka lōʻihi ma mua. ʻO FCR kahi hui pū me nā lāʻau chemotherapy fludarabine (Fludara) a me cyclophosphamide (Cytoxan), a me ka monoclonal antibody rituximab (Rituxan).

I kēia manawa, he mea ʻoi aku ka maikaʻi o ka hana i ka wā ʻōpio, ʻoi aku ka olakino i loaʻa ka hoʻololi i kā lākou IGHV. Ma loko o 300 mau kānaka me CLL a me ka hoʻololi ʻana o ka moʻokūʻauhau, ʻoi aku i ka hapalua i ola no 13 mau makahiki me ka maʻi ʻole ma FCR.

CAR T-cell therapy

ʻO CAR T-cell therapy kahi ʻano kūikawā o ka pale pale pale e hoʻohana ai i kāu iho i hoʻoponopono ʻia e pale aku ai i ka maʻi ʻaʻai.

ʻO ka mea mua, ʻohiʻohi ʻia nā hunaola i kapa ʻia nā hunaola T mai kou koko. Hoʻololi genetically kēlā mau hunaola T i loko o kahi keʻena e hana i nā chimeric antigen receptors (CARs) - nā mea loaʻa kūikawā i hoʻopaʻa ʻia i nā protein i ka ʻili o nā hunaola maʻi ʻaʻai.

Ke hoʻihoʻi ʻia nā pūnaewele T i hoʻololi ʻia i kou kino, ʻimi lākou a luku i nā hunaola maʻi ʻaʻai.

I kēia manawa, ʻāpono ʻia ʻo CAR T-cell therapy no kekahi ʻano ʻē aʻe o ka lymphoma non-Hodgkin, akā ʻaʻole no CLL. Ke aʻo ʻia nei kēia ʻano lāʻau e ʻike inā hiki ke hana i nā kala lōʻihi a i ʻole kahi lāʻau no CLL.

Nā lāʻau i hoʻomāka ʻia hou

ʻO nā lāʻau i māka ʻia e like me idelalisib (Zydelig), ibrutinib (Imbruvica), a me venetoclax (Venclexta) e hele ma hope o nā mea kōkua i nā hunaola maʻi ʻea e ulu a ola. ʻOiai ʻaʻole hiki i kēia mau lāʻau ke hoʻōla i ka maʻi, kōkua paha lākou i ka poʻe e ola lōʻihi i ke kala.

Ke kuʻi ʻōnaʻi ʻōnaeho

ʻO ka Allogenic stem cell transplantation i kēia manawa wale nō ka lapaʻau e hāʻawi i ka hiki ke hoʻōla ʻia no CLL. Me kēia lapaʻau, loaʻa iā ʻoe nā lāʻau kiʻekiʻe loa o ka chemotherapy e pepehi i nā hunaola maʻi ʻaʻa e hiki.

Hoʻopau pū nō hoʻi ʻo Chemo i nā hunaola hoʻōla koko maikaʻi i loko o kou iwi iwi. Ma hope, loaʻa iā ʻoe kahi transplant o nā hunaola kūmole mai kahi mea hāʻawi olakino e hoʻopiha hou i nā hunaola i luku ʻia.

ʻO ka pilikia me nā transplants cell stem mea hopohopo lākou. Hiki i nā hunaola hāʻawi ke hoʻouka i kāu mau hunaola olakino. He kūlana koʻikoʻi kēia i kapa ʻia ʻo ka maʻi graft-versus-host.

ʻO ka loaʻa ʻana o kahi transplant pū kekahi e hoʻonui ai i kāu makaʻu o ka maʻi. Eia kekahi, ʻaʻole holo pono ia no nā mea āpau me CLL. Hoʻomaikaʻi nā transplants cell i nā ola lōʻihi ʻole me ke ola ʻole ma kahi o 40 pākēneka o ka poʻe i loaʻa iā lākou.

Lawe aku

E like me kēia manawa, ʻaʻohe lapaʻau hiki ke hoʻōla iā CLL. ʻO ka mea kokoke loa iā mākou e hoʻōla ai kahi transplant cell stem, kahi mea makaʻu a kōkua wale i kekahi poʻe e ola lōʻihi.

Hiki i nā mālama hou ʻana i ka hoʻomohala ke hoʻololi i ka wā e hiki mai ana no ka poʻe me CLL. Ke hoʻonui nei nā Immunotherapies a me nā lāʻau hou ʻē aʻe i ke ola. I ka wā e hiki mai ana, hiki i nā hui hou ʻana o nā lāʻau ke kōkua i ka poʻe e ola lōʻihi.

ʻO ka lana o ka manaʻo i kekahi lā, e lilo ka hopena i mea maikaʻi e hiki ai i nā kānaka ke hooki i ka lawe ʻana i kā lākou lāʻau a ola i ke ola ʻaʻohe maʻi ʻaʻai. Ke kū kēlā, e hiki nō i nā kānaka noiʻi ke ʻōlelo aʻe ua hoʻōla lākou iā CLL.