Unyaka ngamnye, ukuqhubela phambili kwezo zonyango kunye ne teknoloji kubangela iindlela ezintsha kunye neendlela ezinokubangela ukwelapha i-leukemia kunye ne-lymphoma kwaye uncede unakekele abo sele benayo okanye okwangoku bafumana unyango. Kwezinye iimeko, ukunyuka okunjalo ngokwenene kukuphucula ukusetyenziswa kwamandla okwangoku, ngelixa ezinye zimelela zakutshanje kwi-smart tech nakwezinye iindlela ezizenzekelayo.
Ezi zilandelayo zine intuthuko eqhutywayo kwi-leukemia kunye nokunakekelwa kwe-lymphoma ephuma kwiindlela ezahlukeneyo zophando ngo-2017.
1. I-Rituximab Injectable
I-Rituximab , i-anti-monoglonal anti-laboratory eyenzelwe i-laboratory, iye yaba yinye yezona zinto zonyango zonyango ezithile ze-non-Hodgkin lymphomas. I-Lymphomas inokuthi iqokelelwe ngokusemthethweni kwiintlobo ezimbini, iHodgkin kunye non-Hodgkin, okanye i-NHL.
I-Rituximab ibonise ukusetyenziswa kweentetho ezithile zeendlela ezimbini eziqhelekileyo zeNHL :
- I-lymphoma yesigxina
- Ukusasaza i-B-cell NHL enkulu (DLBCL)
I-Rituximab nayo ibonise ukuba isebenzisa kwezinye iintetho zezifo ezilandelayo:
- I-lymphocytic leukemia engapheliyo
- Irheumatoid arthritis
- Wegener granulomatosis
- Microscopic polyangiitis
- I-immune thrombocytopenic purpura (ITP)
- Pemphigus vulgaris
Umlingani oTethered
Ngazo zonke ezo zisebenzisi ezahlukeneyo, kwaye kunye ne-rituximab enjalo ngonyango obalaseleyo kwi-NHL, abenzi beziyobisi baye banamehlo kwi-rituximab ukuze babone ukuba ingaguqulelwa kwi-intravenous (IV) yonyango enye enokunikwa njengesibheno.
Ukuba uke waba isigulane esidinga imithi ye-IV, ngoko uyazi isibheno sokuguqula le nkunkuma into enokuthi inikwe ikhutshulwa.
Xa i- rituximab inikwe i-intravenously, uqhotyoshelwe kwisikhwama kwi-pole ye-IV, kwaye i-poll kumavili kunye nesigxobo sayo sokuguqula sibe "iqabane lakho" elilandelayo kwiiyure ezimbalwa okanye ngaphezulu.
Ngokuqhelekileyo oku kunokuthetha ukuba, ukuba ufuna ukuya kwindlu yokuhlambela, kufuneka uqhube 'umlingane' wakho kunye nawe. Ngamanye amaxesha, kunokukhawuleza ukukhala kunye ne-alamu izandi zivela kumashini we-IV xa uzama ukufunda, ubukele iTV okanye uqokelele iingcamango zakho. Kwiigulane ezinxulumene neengcingo zegazi, iiyure ezininzi zolu hlobo lusekho kwimisebenzi, ngoko nantoni na enceda ukunciphisa lo mthwalo uyanamkelwa.
Isisombululo esitsha
Ukuqulunqwa kwe-injection entsha kuyimxube ye-rituximab kunye ne-substance ebizwa ngokuba yi-hyaluronidase, enceda ukuhambisa amayeza phantsi kwekhumba. Ukuvunyelwa kwe-US kulindeleke ngehlobo 2017, kwaye sele sele ivunyiwe eYurophu. Xa kunikezelwa phantsi kwesikhumba, inokulawulwa kwimizuzu emi-5 ukuya kweyesi-7, xa kuthelekiswa neyure nesiqingatha okanye ngaphezulu kwi-rituximab engaphakathi. Ucwaningo oluninzi luye lwabonisa ukuba ukuqulunqwa okusha kwe-rituximab ekhutshwe phantsi kwesikhumba kukhuselekile kwaye kusebenza kunye ne-rituximab engena-intravenous, ekhokelela kumanqanaba afanayo nesilwanyana egazini. I-injected version ivunyiwe kwi-European Union ukususela ngo-2014. Ukuba i-FDA iyavuma, i-IV rituximab iya kuqhubeka ifumaneka kwizigulane zaseMerika.
2. I-Computer Algorithm ye-Acute Myeloid Leukemia
Ngaba bekungeke kube kuhle ukuba oogqirha bakwazi ukuchonga ngubani na ongaphinda abuyele emva kokunyanga kwaye ngubani oya kuxolelwa?
Ewe, abaphandi abaxhasiwe yiNational Cancer Institute, kunye neminye imibutho emininzi, basebenzela ukwenza loo nto, usebenzisa iikhomputha.
I-Lyeloid Leukemia
I-lemonem ye-leememia e-Acute (i-AML) enomdla luhlobo lomdlavuza wegazi apho amangqamuzana egazi amhlophe angavamile ngokukhawuleza emnzini wethambo aze aphazamise ukuveliswa kweeseli eziqhelekileyo zegazi. Kukho ezine iindidi eziphambili ze-leukemia-ezimbini ezibalulekileyo, okanye i-leukemia ekhula ngokukhawuleza, kunye ne-2 engapheliyo, okanye ikhula ngokukhawuleza. I-AML yinto eqhelekileyo kakhulu , okanye i-leukemia ekhula ngokukhawuleza kubantu abadala. I-AML yi-leyemia yesibini echaphazelekayo kubantwana, kwaye i-leukemia, ngokubanzi, ngumhlaza wesifo sobuntwaneni.
Ukuxilongwa kweData
Ukwenza ukuxilongwa kwe-AML kudinga ukwazi iziphumo zeemvavanyo ezithile zebhoratri, ngaphezu kweempawu neempawu zesifo esingaba khona. Oku kuquka into ebizwa ngokuthi yi-cytometry yokuhamba, indlela yokubala nokuhlenga iincinci ezincinci kumanzi; Kule meko, iiseli ze-leukemia kunye namanqaku abo, iiprotheyini kunye neeprotheni-complex complexes as detectible as part of the cells. Ukuhlalutya idatha kwi-cytometry yokuhamba kungadla ixesha.
Ngena: Iikhomputha ze-Smarter
Abaphandi be-Purdue University kunye neRoswell Park Cancer Institute baye basebenza kwi-computer-learning algorithm engayinceda ngaphambili, kwaye bakholelwa ukuba inokukhipha ulwazi kwi data engcono kunabantu.
Ukufunda ngomatshini kubhekisela kwi-computer yesayensi ye-computer ejongene neekhomputhaza ezikwazi ukwandisa kwimisebenzi ethile eyenziweyo okanye ihlalutya ngokusebenzisa "amava," ngaphandle kokucwangciswa ngokucacileyo ukwenza njalo. Iqela libike ukuba likwazi ukusebenzisa i-cytometry yedatha yokuhamba ukuchaza isiphumo sesigulane phakathi kwama-90 ne-100 ekhulwini.
3. Ukuqhaqhafaza ukukhangela ukujonga kwakhona
Isiqingatha sazo zonke izigulane ezine-Hodgkin lymphoma kunye ne-B-cell lymphoma enkulu (uhlobo oluqhelekileyo lwe-non-Hodgkin lymphoma) luya kuphinda luyeke kwaye lufuna unyango olongezelelweyo. Ngenxa yokuba i-statistic, zihlandlo zingaphi izigulane ezinjalo kufuneka zihlolwe ukuqinisekisa ukuba umhlaza awubuyanga?
Kutheni ungahlawuli? Ukhuselekile Kakhulu Kunesixolo, kulungile?
Ukuba i-imaging yokujonga ngokuqhelekileyo iyakwazi ukuhlaziya ngokukhawuleza, xa kungekho zibonakaliso, kwaye ukuba oku kuphucula ukuhlala kweso sigulane, kuya kuba yinto entle, kodwa kukho imibuzo engaphenduliyo kule ndawo.
Ekubeni, kubonakala ngathi kuya kuba yinto efanelekileyo kubantu abaye baphathwa ngezi zifo ukuba bafumane izicwangciso eziqhelekileyo, ukuqinisekisa ukuba umhlaza awubuyanga. Oku kuyinyaniso kwinqanaba, kodwa ngaphesheya kwe-equation, imirhumo ehambayo evela kwimiba enomngcipheko inokubeka umngcipheko wokukhuthaza ukulimala okwesibini. Awuyi kufuna abantu abasemngciphekweni ophantsi kakhulu wokuphindaphinda, osifo sabo sele siphunywe ngonyango olusebenzayo, ukuba baxhomekeke kwiingcingo ezingenasidingo eziphindaphindiweyo, bebhenxise kwi-radiation, befuna ukuphindaphinda okungenakuze kwenzeke. Olunye uqikelelo kukuba iimeko ezibuxoki zenzeka. Ngokweziphumo zangoku, iqhekeza elinentsingiselo yezigulane kufuneka lijongane nemiphumo emibi yokukhangela, evelisa ukuxhalabisa okongezelelweyo kunye neendlela zonyango.
Abaphandi abavela kwiYunivesithi yase-Emory naseMayo Clinic basandula ukupapasha iziphumo ezivela kwisifundo abaye baqhuba ukuhlola ezinye ze mibuzo. Bavavanya indima yokujonga-ngqondweni ekubuyiseni kwakhona kwakhona kunye nokuphononongwa kwempembelelo yayo ekusindeni kwezigulane ezibuyele kwiHodgkin lymphoma okanye i- DLBCL engekho iHodgkin lymphoma. Ngokuqhelekileyo, bafumanisa ukuba iindlela ezikhoyo zengcamango azibonakali ziphinde zibuyele ngaphambi kweempawu zeempawu zekliniki okanye ziphuculise ukusinda.
Ukuchonga izifo eziphezulu
Oko kwathiwa, akubona bonke abantu abakwiiqela ezihlolwe kulolu cwaningo babesengozini efanayo yokuphindaphinda. Ngoko, oko kuphakamisa umbuzo, yiziphi iigulane zezigulane eziphakamileyo ngokwaneleyo ukuba ziphinde ziphinde zifumane iingenelo zokusasaza ngokuqhelekileyo eziza kubangela ingozi? Abaphandi baqaphele ukuba izifundo ezifunekayo ezizayo zifunekayo ukuze zichonge ukuba ukutshekisha okuqhelekileyo ukuphinda kuphinda kuphinde kukuboneleleke xa ukhetha izigulane ezifanelekileyo zokuskena, oko kuthiwa "ngabantu abakhethiweyo."
Okwangoku, eli qela labaphandi linomuvo onengqiqo kwizigulane ezine-DLBCL kunye nezixhobo ezinobungozi obuphezulu-kuquka i-International Prognostic Index (IPI) ye-3 ukuya kwe-5-ukujonga iingcamango ngamnye emva kokuxubusha ingozi kunye neenzuzo kunye nokwazi ukuba ukufumanisa okokuqala ukuphindaphinda akuzange kubonakaliswe ngokuqinisekileyo ukuphucula ukusinda.
4. I-Nano-CAR-T unyango
Kwizigulane ezineengcingo zegazi kunye nabathandekayo babo, kukho into enomdla malunga ne-CAR-T yonyango lonyango. Ukuphumelela okutsha okubandakanya i-CAR-T yonyango lonyango luvakala rhoqo, kubonakala ngathi yonke imihla.
Mayelana neeklasi ze-CAR-T
I-T-seli zihlobo lwesitrato se-immune esinazo zonke emzimbeni wethu. Ziyaziwa ngokuthe ngqo njenge-T-lymphocyte, uhlobo lweseli legazi elimhlophe. Iifom ze-T zinemiphumeli kwiindawo zazo, ezibizwa ngokuba yi-T-cell receptors, okanye i-TCR. Ezi TCR zibophelela kuma-antigen kuma-invaders angaphandle okanye kwezinye iiseli ezisongelayo, njengemaseli omhlaza, ukunceda umzimba uphakamise iimpendulo zomzimba, ukulwa nesongelo.
Xa iiselithi ze-T zisetyenziselwa unyango lomhlaza wesifo se-CAR-T, okokuqala ziqokelelwa kwigazi lomguli. Emva koko, kwi-laboratory, i-T-cell iguqulwa ukuvelisa i-receptors ekhethekileyo phezu komhlaba ebizwa ngokuthi i-chimeric antigen receptors, okanye i-CAR, ezikwazi ukubopha kwiiprotheni ezithile zomhlaba zamaseli athile omhlaza. Ezi T-cell kunye ne-CARs zingakhokelela ekubhubhiseni kwintsholongwane, emva kokuba ziphinde zibuyele kwisigulane.
I-Nanotechnology idibana neCAR-T Iiseli
Esinye seziganeko ezihambayo ezihambayo kule nyikiloni kukuba iiseli zesigulane kufuneka zivunwe, zakhiwe ngaphandle komzimba, kwaye ziphinde zenziwe emva kokuba zikhona iinani ezaneleyo zokwenza umsebenzi. Ngaba bekungeke kube yinto efanelekileyo ukuba loo nyathelo yobunjineli ingenziwa kwiiyena zakho ngokukhawuleza, mhlawumbi ngezixhobo zobunjineli ezincinci? Leyo ngcamango emva kokusetyenziswa kwe-nanotechnology kule sicelo. I-Nanotechnology apha ibhekisela ekusebenziseni amashishini amancinci ukubonelela ngenzuzo ngaphakathi komzimba.
Abaphengululi kwiCentral Cancer Centre bavakalisa ukuba i-nanoparticle-programmed immune cells iyakucima okanye iphose ukuphuhliswa kwe-leukemia kwimokelo yabo yebhoratri yesifo. Uphando "lobungqina bomgaqo" lubaluleke kakhulu, kwaye iziphumo zipapashwe kwi "Nature Nanotechnology." UDkt. Matthias Stephan, umphandi kule nkqutyana, wacatshulwe esithi "I-teknoloji yethu yowokuqala ukuba siyazi ngokukhawuleza inkqubo yokuqonda i-tumor-cells in T cells ngaphandle kokukhipha kwi-laboratory manipulation."
> Imithombo:
> Genentech. Ikomidi elicebisa i-FDA likhuthaza ngokuvunyelweneyo imvume yohlobo lwe-Genentech oluphantsi kwamathambo egazi.
> Stanford Medicine. I-algorithm yekhompyutheni iqikelela isiphumo segciwane le-leukemia.
> Cohen JB, Behera M, Thompson A, et al. Ukuphonononga ukujonga i-imaging ye-B-cell lymphoma kunye neHodgkin lymphoma. Igazi. 2017; 129: 561-564.