Sebtembar 2022: The treatment of various tumours has been transformed by cell-based immunotherapy, often known as Daaweynta unugyada CAR-T. Si loola dagaallamo noocyada gaarka ah ee leukemia iyo lymphoma, daaweyntu waxay shaqaaleysiisaa unugyada T-ga ee hidde ahaan. In kasta oo ay awood u leedahay in ay daweyso kansarka shakhsiyaad gaar ah oo si kale uga gudbi lahaa cudurka, waxay sidoo kale xambaarsan tahay khatarta tiro waxyeellooyin ah, kuwaas oo qaarkood ay noqon karaan kuwo dilaa ah oo carqaladeeya shaqada maskaxda.
Sida laga soo xigtay daraasad dhowaan ka soo baxday Iskuulka Caafimaadka ee Jaamacadda Washington ee St. Louis, baaritaanka dhiigga degdega ah wuxuu ka caawin karaa dhakhaatiirta inay go'aamiyaan bukaannada ay u badan tahay inay la kulmaan saameynaha neurotoxic maalmaha iyo toddobaadyada soo socda Daaweynta unugyada CAR-T. Cilmi-baadhayaashu waxay ogaadeen in heerarka borotiinka ee loo yaqaanno silsiladda iftiinka neurofilament (NfL) ay ku badan yihiin shakhsiyaadka u sii socda inay yeeshaan dhibaatooyinka neurotoxic ka dib markii ay daraasad ku sameeyeen muunadaha dhiigga ee bukaannada ka hor, inta lagu jiro, iyo ka dib daaweynta unugyada CAR-T. Kahor inta aan daawaynta xitaa bilaabmin, waxaa jira tiro badan oo borotiinka ah, heerarkaasina waxay joogaan heerar sare inta lagu jiro daawaynta iyo ilaa hal bil kadib.
Daraasadda, oo lagu sii daayay Sebtembar 1 ee joornaalka JAMA Oncology, ayaa laga yaabaa inay ka caawiso xirfadlayaasha caafimaadka inay saadaaliyaan waxyeellooyinkan halista ah waxayna u suurtagelisaa inay bilaabaan maamulida daawooyinka kuwaas oo yareyn kara cawaaqibka neurotoxic goor hore ee daaweynta bukaanka. Intaa waxaa dheer, waxay bixisaa madal hore ee daaweynta unugyada CAR-T ka hortagga waxyeelada ama cilmi-baarista dhimista khatarta.
Qoraaga hormuudka ah Omar H. Butt, MD, PhD, oo ah macalin caafimaad oo arka bukaanada jooga Xarunta Kansarka Siteman ee Isbitaalka Barnes-Jewish iyo Iskuulka Caafimaadka ee Jaamacadda Washington, ayaa yiri, “Daraasaddeennu waxay soo jeedinaysaa in bukaannada qaarkood ee qaata daaweynta unugyada CAR-T Dhaawac aan hore loo ogaan oo soo gaadhay neerfayaasha ayaa ku jira gundhigga, ka hor inta aynaan bilaabin u diyaarinta daawayntan. "Ma garanayno hidda-wadaha dhaawacan, laakiin waxay u muuqataa inay u saadaalisay shakhsiyaadka inay qabaan dhibaatooyin neurotoxic ah. Waxaan ka hortagi karnaa ama yareyn karnaa darnaanta cawaaqibyadan haddii aan ogaanno cidda khatarta ugu jirta.
Barootiinka NfL, oo ah tilmaame ballaadhan oo ah dhaawaca neerfaha, ayaa loo isticmaalay in lagu cabbiro ama la socdo darnaanta tiro xaalado neerfaha ah, oo ay ku jiraan cudurka Alzheimers iyo sclerosis badan.
Sida laga soo xigtay qoraaga sare iyo Daniel J. Brennan Professor of Neurology Beau M. Ances, MD, PhD, "cabbirrada NfL ee dhiigga waxaa loo isticmaalaa qalab si loo qiimeeyo waxtarka daaweynta cusub ee mustaqbalka ee sclerosis badan." "Waxaan dooneynaa inaan sameyno cilmi-baaris dheeraad ah si aan u go'aamino waxa sababa dhaawaca neerfaha ee bukaannada kansarka. Sababtoo ah Jaamacadda Washington waxay leedahay qaar ka mid ah khubarada ugu fiican ee daaweynta unugyada CAR-T iyo aqoonta heerka ugu sarreeya ee cudurrada neerfayaasha, iskaashigan aan caadiga ahayn ayaa la suurtageliyay. Waxay bixisaa fursad cajiib ah oo lagu buuxinayo daldaloolada iyo isu keenida xirfado kala duwan si loo helo xal niyad jab leh iyo faa'iido dadka.
30 individuals underwent treatment at Cleveland’s Siteman Cancer Center and Case Comprehensive Cancer Center, both of which are affiliated with Case Western Reserve University.
Bukaan-socodka aan la kulmin wax saameyn ah oo neurotoxic ah ayaa laga yaabaa in laga sooco kuwa sidaas sameeyay iyadoo lagu saleynayo heerarka asaasiga ah ee NfL. Si loo eego in muunadda weyni ay awood u siinayso inay aqoonsadaan bukaanada halista ugu jira kuwa fudud, dhexdhexaad ah, ama dhibaatooyin daran, cilmi-baarayaashu waxay doonayaan inay sii wadaan baaritaanka xogta bukaanno badan.
Dhibaatooyinku waxay aad ugu kala duwanaan karaan madax-xanuun, qalal, istaroog, iyo bararka maskaxda ilaa dhibaatooyinka xoogga saarista, arrimaha xusuusta, jaahwareerka, akhriska oo ku adkaata, iyo madax-xanuun. Daawooyinka steroid-ka ah ee la qaato iyo marmarka qaarkood daaweynta wax-ka-beddelka difaaca ee ujeeddadoodu tahay in la yareeyo bararka ayaa ah siyaabaha ugu muhiimsan ee dhakhaatiirtu u daaweeyaan dhibaatooyinkan. Maadaama daawayntan laga yaabo, wax laga xumaado, inay waxyeeleeyaan saamaynta ka hortagga kansarka ee unugyada CAR-T, dhakhaatiirtu waxay doorbidi lahaayeen inay iska ilaaliyaan isticmaalkooda mar kasta oo ay suurtogal tahay, sidaas awgeed aad bay waxtar u leedahay in la ogaado cidda khatarta ugu jirta waxyeellooyinka ugu waxyeellada badan.
Halxiraalaha kale ayaa ah in xitaa sida bukaanada qaar ay leeyihiin saameynaha neurotoxic ka dibna ay ka soo kabtaan, heerarka NfL ee kor loo qaaday ayaa horeyba u jiray oo badiyaa joogto ah. Tani waxay tusinaysaa in iyadoo heerarka NfL aysan qasab ahayn inay matalaan waxa dhacaya si ay u keenaan dhibaatooyinka bukaanka, waxay muujinayaan inay wax khaldan yihiin.
Marka la eego habka jirrada dhabta ah, "waxaan kaliya aragnaa meesha ugu sareysa ee barafka, taasina waa meesha qaar badan oo ka mid ah baaritaanadayada mustaqbalka ay ku socdaan," Butt ayaa sidaas yidhi. "Waxaan isku dayeynaa inaan si cad u fahanno waxa markii hore keenay hagaajintan. Kadibna, xitaa marka astaamuhu hoos u dhacaan, heerarkan sare ee NfL ayaa wali jira.
We have a study ongoing at Siteman to see if, in fact, these patients continue to have subtle symptoms in terms of cognitive changes or deficits that persist long term,” added co-senior author Armin Ghobadi, MD, an associate professor of medicine and clinical director of the Center for Gene and Cellular immunotherapy at Washington University School of Medicine and Siteman Cancer Center.
