Rituxan, Gazyva, ndi Anti-CD20 Cancer Therapy
Rituxan ndi mitsempha yopangidwa ndi majini-mtundu wothandizira munthu. Amagwiritsidwa ntchito pochita zinthu zingapo kuphatikizapo omwe si a Hodgkin lymphoma.
Momwe Ikugwirira Ntchito
Podziwa momwe masewera athu amatetezera mthupi ndiyeno kuchotsa mabakiteriya ndi mavairasi kumalo athu, asayansi amaganiza kuti zingatheke kutsanzira njira zomwe zingayambitse maselo a kansa.
Chitetezo chathu cha mthupi chimatha kuzindikira zizindikiro pamwamba pa mabakiteriya ndi mavairasi omwe amasonyeza kuti sali m'thupi.
Tikadziwidwa ndi tizilombo toyambitsa matenda timapanga tizilombo toyambitsa matenda kuti tigwirizane ndi zizindikirozi, kuti chitetezo chathu chonse chituluke. Zapezeka kuti maselo ena omwe si a Hodgkin amachititsa kuti azilekanitsa. Cholembachi chimatchedwa CD20 antigen ndipo chiri pamwamba pa maselo ena oteteza thupi lathu otchedwa B-lymphocytes, kapena maselo a B. Awa ndiwo maselo omwe amakhala khansa mwa mitundu ina ya osakhala Hodgkin lymphoma ndi chronic lymphocytic khansa ya m'magazi.
Chinthu chotsatira chinali kupeza mankhwala omwe angakhale ngati ma antibodies omwe apanga matupi a thupi omwe angazindikire malo apamwamba, koma pa maselo a khansa. Rituxan (rituximab) ndi "anti-antibody" yomwe imapezeka kuti imamatire ku CD20 antigen pa maselo aang'ono a Pre-B omwe ali ndi khansa komanso ma B-lymphocytes okhwima. Nthawi ina Rituxan imamangiriza ku CD20 pa maselo a khansa, mwinamwake pali njira zingapo zomwe maselo a khansa amawonongedwa.
Asayansi amagawira magulu a antibodies m'magulu osiyanasiyana, malingana ndi momwe amachitira ndi ntchito zawo, ndipo Rituxan imagawidwa ngati immunoglobulin G, kapena IgG. Rituxan imatchedwa antioclonal antibody - mtundu wa immunotherapy umene umagwiritsa ntchito ma antibodies kuti apange khansara.
Ntchito
Rituxan imagwiritsidwa ntchito kwa matenda a khansa ndi omwe alibe khansa.
Kodi izi zingatheke bwanji? Zonsezi zimakhudzana ndi maselo oyera omwe amadziwika kuti B-maselo kapena B-lymphocytes, omwe ali mbali ya chitetezo cha mthupi. Maselo a B-maselo omwe amachititsa khansa ku mitundu yosiyanasiyana ya ma lymphomas-amathandizanso kuti chitukuko cha nyamakazi ndi matenda ena opweteka. Angagwiritsidwe ntchito pa khansa komanso matenda osagwirizana ndi khansa.
Khansa:
- Anthu omwe ali ndi mafupa ena omwe si a Hodgkin kuphatikizapo follicular lymphoma (FL) ndi ma B-cell lymphoma (DLBCL) omwe amawonekera kwambiri.
- Anthu omwe ali ndi matenda odwala matenda a m'magazi (CLL) omwe ali ndi CD20.
Osati Matenda a Khansa:
- Anthu ena ali ndi nyamakazi ya nyamakazi.
- Anthu ena omwe ali ndi matenda omwe amapezeka m'magazi monga granulomatosis ndi polyangiitis (GPA) (Granulomatosis ya Wegener) komanso polyangiitis (MPA).
- Akuphunzira m'mayesero a kachipatala kuti athe kugwiritsidwa ntchito mu multiple sclerosis ndi systemic lupus erythematosus.
Kuwongolera B-maselo mu Non-Hodgkin Lymphoma ndi Chronic Lymphocytic Leukemia
Kuwonjezeredwa kwa Rituxan ku malo athu ochizira mankhwala kuti athetse NHL kwasintha kwambiri. Zisanayambe kumayambiriro kwa zaka za zana lino, chiŵerengero cha imfa kuchokera ku lymphoma chinali kuwonjezeka. Kuchokera nthawi imeneyo zakhala zikuchepa, mwina chifukwa cha kupulumuka kwa Rituxan.
Mafupa ena omwe Rituxan amachititsa kusiyana ndi awa.
Follicular lymphoma - Follicular lymphoma ndiyo mtundu wamba wa mankhwala osokoneza bongo - kutanthauza kukula kwa NHL, yomwe nthawi zambiri imawoneka m'magulu am'thupi. Monga mtundu wopitirira pang'onopang'ono wa NHL, FL sizimafuna nthawi yomweyo chithandizo. Ngati dokotala akuganiza kugwiritsa ntchito Rituxan kwa FL, imagwiritsidwa ntchito m'njira ziwiri:
- Chithandizo choyambirira : kuti mukhululukidwe
Rituxan imagwiritsidwa ntchito kuphatikiza ndi chemotherapy. Ngati mankhwala amachititsa kukhululukidwa kotheratu kapena kwathunthu, Rituxan ingagwiritsidwe ntchito monga mankhwala ochiritsira. - Thandizo lokonza : kukhalabe mukukhululukidwa
Cholinga cha chithandizo chokonzekera ndi kuthandiza kuti matendawa asakhululukidwe kwa nthawi yaitali. Rituxan imagwiritsidwa ntchito yokha, popanda chemotherapy, panthawi yachipatala.
Kuphwanya lalikulu B-cell lymphoma (DLBCL) - Kufalikira kwakukulu B-cell lymphoma kumapanga ma oposa 30 peresenti ya ma ARV omwe angoyamba kumene kupezeka. Rituxan imatengedwa ngati gawo limodzi la mankhwala oyamba pamene akugwiritsidwa ntchito ndi mankhwala a chemotherapy monga CHOP. Kafukufuku wamkulu atatu adasonyeza kuti sikuti kungowonjezera Rituxan kuchepetsa matenda obwereranso kapena kupititsa patsogolo, kungapangitsenso kuti apulumuke. Choncho, rituxan imaperekedwa ndi mankhwala omwe amatha kupanga mankhwala a chemotherapy ndipo akhoza kupitilira kwa nthawi yopitirira mankhwala a chemotherapy. Kwa omwe adachiritsidwa kale ndi chemotherapy okha ndipo tsopano ayambiranso kapena apitabe patsogolo, Rituxan ikhoza kuperekedwa monga mankhwala ochizira. (Salvage mankhwala amatanthauza chithandizo chimene chimachepetsa zizindikiro ndi / kapena chimapitiriza kukhala ndi moyo, koma sichichiza matenda.)
Momwe Rituxan Inaperekedwa
Rituxan imaperekedwa ngati kulowetsedwa m'mitsempha yanu. Rituximab imaperekedwa kwa maola angapo. Kulowetsedwa kumayambira pang'onopang'ono, ndipo ngati wodwalayo sakuwonetsa mankhwala ake, mlingo wa kulowetsedwa ukuwonjezeka ora lililonse mpaka kulowetsedwa kwatha.
Rituxan imaperekedwa mlungu uliwonse kwa masabata 4 mpaka 8 pamene ikugwiritsidwa ntchito yokha. Mukaperekedwanso ndi chemotherapy, nthawi zambiri amaperekedwa pa tsiku loyamba la mankhwala a chemotherapy pafupipafupi 6 mpaka 8.
Zotsatirapo ndi Rituxan:
- Zotsatira zoyipa za Rituxan zimagwirizana ndi kulowetsedwa m'maganizo . Ambiri mwa odwala ali ndi njira yowonjezera, makamaka pa nthawi yoyamba kulowetsedwa. Zizindikiro zofala kwambiri ndizoziwopsa ndi zozizira, ndi odwala ena akumva zowawa kapena zamutu. Izi zimayendetsedwa mosavuta ndi ogwira ntchito ophunzitsidwa ndipo sizikhala zovuta.
- Rituxan ingachititse kugwa m'magazi, monga chemotherapy. Izi nthawi zina zingayambitse kutentha thupi ndipo zingafunike kukula kwa jekeseni.
- Ochepa odwala angakhale ndi chifuwa chachikulu ndi minofu pambuyo pa Rituxan. Mavuto aakulu a mapapu ndi osowa kwambiri.
Gazyva
Mosiyana ndi Rituxan, Gazyva ndi anti-humanist monoclonal anti-gayyva. Gazyva monga mankhwala atsopano omwe amachititsa "tag" yomweyo monga Rituxan, yomwe ndi CD20 antigen. Rituxan ndi Gazyva zimagwiritsa ntchito CD20 antigen yomwe ilipo pamwamba pa maselo ena, kuphatikizapo maselo oyera a m'magazi omwe amadziwika kuti B-lymphocytes, kapena maselo a B.
Monga Rituxan, Gazyva ndi anti-monoclonal antibody. Ndikutanthauza kuti ndi mtundu wapadera wa anti-antibody wopangidwa ndi asayansi ndipo amapangidwa ndi opanga. Chogwiritsidwa ntchito chomaliza chimapachikidwa m'thumba ngati madzi ndipo amaperekedwa kudzera mwa kulowetsedwa.
Malinga ndi zomwe omasulira mankhwala amamasulira, Gazyva akuganiza kuti ali ndi mphamvu yowonjezereka yopangitsa selo yeniyeni kufa-yomwe imapangitsa ntchito yayikulu yowononga chitetezo cha thupi kuti chiteteze B-maselo.
Zotsatira:
Fleury, I., Chevret, S., Pfreundschuh, M. et al. Ritiximab ndi chiopsezo cha mankhwala oyamba achiwiri omwe ali odwala omwe si a Hodgkin lymphoma. Annals of Oncology . 2015 Dec 17. (Epub patsogolo pa kusindikiza).
National Cancer Institute. Kugwiritsira ntchito chitetezo cha Immune m'kulimbana ndi khansa: Kutulukira kwa Rituximab. Kusinthidwa 03/07/14.