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CAR T-Cell daaweynta Israel

 

Nala soo xidhiidh si aad u dhammaysato adeegyada hadalka.

aad u bilowdo

Daaweynta unugyada CAR T waxay noqotay hab cusub oo lagu daweeyo noocyo badan oo kansar ah, Israa'iilna waxay samaysay horumar badan oo dhinacan ah. Xarumaha caafimaadka ee Israa'iil waxay ku jireen cidhifyada daraasadda daaweynta unugyada CAR T iyo horumarinta, iyagoo siinaya bukaannada qaba kansarka dhiigga ee aan ka jawaabin rajo daawaynta kale. Saynis yahanada Israa'iil ayaa gacan ka gaystay abuurista iyo samaynta unugyada CAR T, kuwaas oo hagaajiyay waxtarkooda iyo badbaadadooda. Daaweynta unugga CAR T si guul leh ayaa loogu isticmaalay bukaannada isbitaallada Israel sida Sheba Medical Centre, isbitaalka Tel Aviv, iyo Xarunta Caafimaadka Hadassah. Tani waxay keentay cafis la yaab leh iyo heerar sare oo dhimasho ah. Israa'iil ayaa weli aad muhiim ugu ah horumarka daaweynta unugyada CAR T, kaas oo siinaya bukaannada kansarka adduunka oo dhan rajo cusub.

CAR T-Cell therapy ee Israa'iil - Horumarradii dhawaa

 

Daawaynta unugga CAR T, oo ah nooc cusub oo tallaalka difaaca jirka ah oo si weyn ugu fatahay dhinaca daryeelka kansarka, ayaa ah tusaale wanaagsan. Cisbitaalada caanka ah iyo xarumaha waxbarasho ee Israel ayaa safka hore kaga jiray horumarinta iyo isticmaalka daawayntan cusub, taasoo rajo gelisay dadka qaba noocyada kala duwan ee kansarka. CAR T-Cell daaweynta Israel hadda waxaa laga heli karaa isbitaallo badan.

The Xarunta Caafimaadka Sheba waa mid ka mid ah meelaha ugu wanaagsan Israa'iil ee laga helo daaweynta unugyada CAR T. Waxay dejisay Xarunta Cellular immunotherapy, kaas oo u xilsaaran samaynta iyo bixinta shakhsi ahaaneed Daaweynta unugyada CAR T. Kooxda khubarada Sheba waxay sameeyeen horumar la yaab leh oo ay ku caawinayaan dadka kansarka dhiigga sida leukemia iyo lymphoma. Bukaannada adduunka oo dhan ka kala yimid ee doonaya daawayn heersare ah ayaa u yimaadda sababtoo ah aqoontooda iyo tas-hiilaadkooda casriga ah.

Another important place is the Hadassah Medical Centre in Jerusalem, which has been doing a lot of study into CAR T cell therapy. Their main goal has been to help kids with acute lymphoblastic leukaemia (ALL) that has come back or doesn’t respond to treatment. The success sheekooyin from Hadassah have given hope to families going through hard times, as CAR T cell therapy could be a lifeline for those with few treatment choices.

Sanadihii la soo dhaafay, daaweynta unugyada CAR T waxay horumar badan ka samaysay Israa'iil. Cilmi-baarayaashu waxay raadinayeen habab ay daweyntu u shaqeeyaan si ka wanaagsan oo ay u caawiyaan dad badan. Mid ka mid ah kuwan waa isticmaalka unugyada CAR T oo leh laba bartilmaameed oo kala duwan. Adigoo raacaya dhowr antigens hal mar, habkan ayaa ujeedadiisu tahay in daawaynta laga dhigo mid aad u guulaysata oo la yareeyo khatarta baxsashada antigen-ka, taas oo ah marka unugyada kansarku ay iska ilaaliyaan in ay aqoonsadaan unugyada CAR T.

Sidoo kale, Saynis yahanada Israa’iil ayaa waxa ay daweeyeen habab cusub oo lagu daweyn karo burooyinka adag, kuwaas oo ay ka adkeyd in la daweeyo marka loo eego xanuunada dhiiga qaada ee waayadii hore. Cilmi-baarayaasha xarunta caafimaadka ee Tel Aviv Sourasky ayaa tijaabiyay unugyo CAR T ah oo la bedelay si ay u soo saaraan unugyo dheeri ah oo ka dhigi kara inay ku roonaadaan dilka burooyinka adag. Natiijooyinka hore waxay u muuqdaan kuwo wanaagsan, taas oo dadka siisa rajo ah in daawaynta unugyada CAR T ay noqon karto tallaabo weyn oo hore loo qaado daaweynta burooyinka adag.

Daawaynta unugga CAR T waxay beddeshay habka loo daweeyo kansarka, taasoo siinaysa bukaannada doorashooyin cusub iyo rajo cusub. Israa'iil gudaheeda, cosbitaalada ugu fiican iyo xarumaha waxbarasho waxay sii wadaan inay riixaan xadka daawayntan, iyagoo isku dayaya inay si fiican u shaqeeyaan oo ay caawiyaan dad badan. Sida cilmi-baaristu horay u socoto, daaweynta unugyada CAR T waxay u badan tahay inay noqoto mid aad muhiim ugu ah Israa'iil iyo adduunka oo dhan dagaalka ka dhanka ah kansarka.

Maxay Israa'iil ugu dooratay daaweynta CAR T-cell?

Qiimaha jaban ee CAR T daawaynta unug ee Shiinaha

Qiimaha iyo helitaanka


CAR T-Cell therapy Qiimaha ee Israa'iil aad ayuu uga hooseeyaa kan wadamada sida US, UK, Australia, Japan, Korea iyo Singapore. CAR T-Cell daawaynta gudaha Israa'iil waxa laga yaabaa inay ku kacdo kaliya $75-100,000 USD. Israa'iil waxay haysataa helitaan heer sare ah marka la barbardhigo daaweynta unugyada CAR T. Israa'iil waxay samaysay xarumo iyo isbitaallo lagu daweeyo noocyada kala duwan ee kansarka oo lagu daweeyo unugyada CAR-T. Hay'adahani waxay samaynayeen daaweynta noocan oo kale ah muddo dheer waxayna heleen kaabayaasha iyo qalabka ay u baahan yihiin. Markaad dooranayso meesha laga helayo daawaynta unugyada CAR-T, waa muhiim inaad ka fikirto helitaanka.

Wakhti sugitaan oo gaaban


Marka alaabta CAR T-cell lagu sameeyo gudaha guriga, waxay leeyihiin heerka guusha la mid ah tan CAR-ganacsiyeedka ee uu sameeyo farmashiyaha, iyada oo aan ku dhawaad ​​​​wax khaladaad ah laga helin. Maareynta dhammaan nidaamka goobta waxay ka dhigan tahay in wakhtiga laga bilaabo leukapheresis ilaa maamulka CAR la dhimi karo ilaa 10 maalmood. Tani waxay ka dhigan tahay in bukaanku uusan u baahnayn inuu maro daaweynta isku-dhafka ah, taas oo ku xiran natiijooyin wanaagsan. Marka la soo koobo wakhtiga daawaynta guud waxa ay hoos u dhigtaa 30 maalmood oo kaliya marka loo eego 60-75 maalmood ee wadamada kale.

 

Khibrad caafimaad oo horumarsan oo Israa'iil ah

Khibrad caafimaad oo sareeysa


Israa'iil waxay caan ku tahay daraasaddeeda caafimaad ee heer sare ah iyo fikrado cusub. Wadanku wuxuu sameeyay horumaro muhiim ah oo ku saabsan daaweynta difaaca jirka, oo ay ku jirto daaweynta unugyada CAR-T. Dhakhaatiirta iyo kalkaaliyayaasha Israel ayaa inta badan ah kuwa ugu horreeya ee horumariya oo isticmaala daweyn cusub, iyaga oo hubinaya in bukaannadooda ay helaan daryeelka ugu fiican ee suurtogalka ah.

 

Sidee looga dalbadaa CAR T-Cell therapy gudaha Israa'iil?

U soo dir warbixinnadaada caafimaad info@cancerfax.com ama WhatsApp ku soo dir +1-213 789-56-55 ama wac +91 96 1588 1588. U soo dir warbixinnada soo socda ra'yi iyo qiyaas:

1) Kooban caafimaad

2) Warbixinnada dhiigga ee ugu dambeeyay

3) Biopsy

4) Baaritaanka PET ee ugu dambeeyay

5) Ka-qaadista dhuuxa lafta (Haddii la heli karo)

6) Warbixino iyo baaritaanno kale oo khuseeya

Marka kooxdayadu ay hesho warbixinnadaada caafimaad, waanu falanqeyneynaa waxaana u direynaa isbitaallada fulinaya daaweynta CAR T-cell ee leh nooca kansarka iyo calaamadeeyaha. Waxaan u dirnaa warbixinnada takhasuska ay khuseyso oo aan helno ra'yigiisa. Waxa kale oo aanu cusbitaalka ka helnaa qiyaasta daawaynta dhamaystiran. Tani waxay kaa caawinaysaa inaad qorshayso muddada daawaynta oo dhan. 

Marka aad go'aansato inaad soo booqato daawaynta, waxaan kuu diyaarinaa warqad fiisaha caafimaadka iyo dukumeentiyada kale ee lagama maarmaanka ah ee isbitaalka. Waxa aanu sidoo kale ku caawinay oo ku hagaynay dalbashada fiisaha caafimaadka safaarada Israel. Marka fiisaha la diyaariyo waxaanu kaa caawinaynaa oo ku hagaya u diyaar garowga safarka iyo tigidhada duulimaadka. Waxaan sidoo kale kuu diyaarinay hoteelkaaga iyo guriga martida, haddii loo baahdo gudaha Israa'iil. Marka uu yimaado magaalada daawaynta wakiilkeena ayaa kugu soo dhaweyn doona garoonka diyaaradaha.

Wakiilkayagu wuxuu kuu qabanqaabin doonaa ballan dhakhtar oo wuxuu kuu dhammaystiri doonaa habraacyada diiwaangelinta lagama maarmaanka ah. Waxa uu sidoo kale kaa caawin doonaa gelitaankaaga cisbitaalka iyo caawimada kale ee degaanka ee loo baahan yahay. Ka dib markii daawadu dhammaato waxaanu kuu diyaarin doonaa la-talintaada la-talinta dhakhtarka daawaynta.

Cisbitaalada ugu sarreeya ee CAR T-Cell therapy ee Israa'iil

Isbitaalka Sheba Tel Aviv Israel

Xarunta Caafimaadka Sheba


CAR T-cell therapy, oo lagu sameeyo Cisbitaalka Sheba ee Tel Aviv, Israel, waa tallaabo weyn oo hore loo qaaday oo lagu daweynayo kansarka. Waxay siisaa dadka qaba noocyada kansarka dhiigga qaarkood rajo. Cibraaniga, Sheba Hospital waxaa lagu magacaabaa Tel HaShomer. Waa cisbitaalka ugu weyn Israa'iil iyo hogaamiye aagga daawaynta CAR T-cell.
Cisbitaalka Sheba waxa uu leeyahay qalab iyo teknooloji heer sare ah si ay uga caawiyaan daawaynta CAR T-cell. Cisbitaalku waxa uu leeyahay unugyo gaar ah oo lagu rakibay tignoolajiyada ugu dambeeyay ee samaynta unugyada. Tani waxay hubinaysaa in unugyada T ee CAR-ku-beddelay ee bukaan kasta loo sameeyay si degdeg ah oo ammaan ah. Sidoo kale, kooxda dhakhaatiirta iyo kalkaaliyayaasha ee Cisbitaalka Sheba waxay leeyihiin waayo-aragnimo badan oo ku socodsiinta tijaabooyinka caafimaad iyo barashada daaweynta CAR T-cell, taas oo ka caawisa goobtan inay sii fiicnaato.

RA'YIGA KA hel oo qiyaas
Isbitaalka Sheba Tel Aviv Israel

Xarunta Caafimaadka Tel-Aviv Sourasky


Xarunta caafimaadka ee Tel Aviv Sourasky (Ichilov Hospital) waa meel aad ka heli karto nooc cusub oo daaweyn ah oo loo yaqaan daawaynta unugyada T-cell. Daawayntan cusub, unugyada T-da ee bukaanku waxa ay beddelaan hidde ahaan si ay u gartaan oo ay u weeraraan unugyada kansarka. Jirka bukaanka ayaa markaa ka buuxsamay unugyadan lagu beddelay shaybaar. Halkaas, waxay ka heli karaan oo ku dili karaan unugyada kansarka. Barnaamijka daawaynta baabuurka T-cell ee Xarunta Caafimaadka ee Tel Aviv Sourasky waxaa maamula koox dhakhaatiir ah iyo khubaro difaac-is-ilaaliye oo khibrad badan leh. Bukaanka qaba noocyada kala duwan ee kansarku waxay rajo ka yeelan karaan doorashadan daawaynta ee horumarsan, taasoo siinaysa hab shakhsiyeysan oo wax ku ool ah oo lagula dagaallamo cudurka.

RA'YIGA KA hel oo qiyaas

Xarunta Caafimaadka Hadassah


The Hadassah Medical Centre in Jerusalem is at the heart of a new way to treat cancer called Car T-cell therapy. Car T-cell therapy changes and activates T cells so they can recognise and fight cancer cells. It does this by using the power of the patient’s own immune system. The skilled group of doctors and experts at Hadassah work together to provide this cutting-edge therapy. Hadassah Medical Centre gives people with different kinds of cancer hope and better outcomes with its cutting-edge equipment and dedication to new ideas. Car T-cell therapy at Hadassah is a shining example of progress in the field of oncology. It gives patients choices for personalized and targeted treatment.

RA'YIGA KA hel oo qiyaas

Dhakhaatiirta ugu sareysa ee CAR T-Cell therapy gudaha Israa'iil

Qaado ra'yi labaad oo khabiir ah oo ku saabsan faleebo daawaynta CAR T-Cell ee khubarada daweynta CAR T-Cell ee ugu fiican Israa'iil. 

Dr Arnon Nagler oo ku takhasusay cudurrada dhiigga ee Israa'iil

Dr. Arnon Nagler (MD, MSc)

Daaweynta T-Cell-ka Baabuurka

Profile: Arnon Nagler, waxa uu sanado badan u soo shaqeeyay maamule ka ah Qaybta Dhiig-baxa iyo Beddelka Dhuuxa Lafta iyo Bankiga Dhiigga ee Xarunta Caafimaadka ee Chaim Sheba, iyo Professor Caafimaadka ee Jaamacadda Tel Aviv, Israel.

RA'YIGA KA hel oo qiyaas
Prof_Amos_Toren_Sheba_Hospital

Dr. Amos Toren (MD, PhD)

Daaweynta Dhiig-baxa Carruurta

Profile: Prof. Amos Toren waa Agaasimaha Qaybta Hemato-Oncology ee Carruurta iyo Qaybta BMT, oo shahaado ku leh Caafimaadka Carruurta, Dhiigga Guud iyo Hemato-Oncology ee Carruurta. Waxa uu 2 shuruudood ka soo noqday Madaxa qaybta Hematology ee Dugsiga Caafimaadka ee Sackler ee Jaamacadda Tel-Aviv.

RA'YIGA KA hel oo qiyaas
Dr. Ben Yehuda (MD, PhD)

Dr. Ben Yehuda (MD, PhD)

Daaweynta T-Cell-ka Baabuurka

Profile: Prof. Dina Ben-Yehuda, oo madax ka ah Ururka Caafimaadka ee Hadassah Department of Hematology, ayaa loo magacaabay Hormuudka Kuliyadda Caafimaadka ee Jaamacadda Hadassah-Hebrew - haweeneydii ugu horreysay ee jagadaas qabata. 

RA'YIGA KA hel oo qiyaas

Waa maxay qiimaha daawaynta CAR T-Cell ee Israa'iil?

Qiimaha daawaynta CAR T-Cell ee Israa'iil waxay ka bilaabataa $75,000 USD depending upon the brand of CAR T chosen. For local home grown CAR T therapy cost will be around \$ 80,000 USD whereas for therapies like Kymeriah and Breyanzi cost may go up to \$ 470,000 USD. Car T-cell therapy costs can vary in Israel based on a number of things, such as the medical centre, the type of cancer being treated, and the health of the patient. Car T-cell therapy is a complicated and highly specialized treatment that includes changing genes and giving each patient their own care. Because of this, it is an expensive procedure. In general, the costs of Car T-cell therapy include the process of genetic engineering, hospitalisation, fees for medical staff, and tracking after the treatment. Patients should talk to their healthcare providers and insurance companies to find out what the costs might be and what kinds of financial help or insurance benefits are available.

Waa maxay daaweynta CAR T-cell?

CAR-T-Cell-daaweynta Shiinaha

Chimeric antigen reseptor T-cell therapy, oo inta badan loo yaqaan CAR T-cell therapy, waa immunotherapy-jabin ah oo gebi ahaanba beddelay habka loo daweeyo kansarka. Waxay siisaa bukaanada qaba kansarrada qaarkood rajo oo markii hore loo arki jiray inay yihiin kuwo aan la daweyn karin ama leh dhowr dawo oo daaweyn ah.

Daawadu waxay ka kooban tahay isticmaalka unugyada difaaca jirka ee bukaanka - si gaar ah, unugyada T-iyo shaybaadhka wax ka beddelka iyaga si kor loogu qaado awooddooda si ay u ogaadaan oo ay u burburiyaan unugyada kansarka. Si taas loo sameeyo, unugyada T-da waxa la siiyaa reseptor-ka-kimeric antigen (CAR), kaas oo siinaya awood ay ku beegsadaan borotiinno gaar ah, ama antigens, oogada unugyada kansarka.

Unugyada T ee bukaanka ayaa marka hore laga saaraa, ka dibna si hidde ahaan wax looga beddelo si ay u muujiyaan CAR. Shaybaadhka, unugyadan la beddelay ayaa la badiyo si ay u soo saaraan tiro badan oo ah unugyada CAR T, kuwaas oo dib loogu celiyo dhiigga bukaanka.

Sida ay u shaqeyso CAR T Cell therapy gudaha Shiinaha

Isla marka ay gudaha jidhka ku jiraan, unugyada CAR T waxay helayaan unugyo kansar oo muujiya antigen-ka la rabo, ku dheggan, oo kiciya jawaab celin difaac oo xooggan. Unugyada CAR T ee la hawlgeliyay way bataan oo waxay weerar ku qaadaan unugyada kansarka, iyaga oo dila.

 

Sidee ayuu u shaqeeyaa CAR T-Cell therapy?

Sida CAR T daawaynta unuggu uga shaqeyso Singapore

Marka loo isticmaalo daawaynta cudurrada dhiigga qaarkood sida leukemia ba'an ee lymphoblastic (ALL) iyo noocyada gaarka ah ee lymphoma, daawaynta CAR T-cell waxay muujisay natiijooyin aan caadi ahayn. Waxay soo saartay heerar jawaab celin oo muuqda iyo bukaannada qaarkood, xitaa cafisyo waara.

Daawaynta CAR T-cell, si kastaba ha ahaatee, waa hab daawayn casri ah oo gaar ah oo laga yaabo inay leedahay khataro iyo saamayn xun. Cytokine release syndrome (CRS), falcelin difaaceed baahsan oo ka dhalan karta calaamado hargab oo kale ah iyo, xaaladaha daran, xubnaha oo fashilma, waxaa laga yaabaa inay la kulmaan dadka qaarkood. Waxa kale oo jiray warbixino ku saabsan saamaynta xun ee neerfaha, si kastaba ha ahaatee inta badan waa la daweyn karaa.

Iyadoo ay jiraan dhibaatooyinkaas, daaweynta CAR T-cell waa horumar la taaban karo oo laga gaaray la dagaallanka kansarka waxayna muujineysaa karti weyn mustaqbalka. Daraasadaha hadda jira waxay diiradda saarayaan kor u qaadista waxtarkeeda iyo astaanta badbaadada iyo sidoo kale fidinta isticmaalkeeda noocyada kansarka ee kala duwan. Daaweynta CAR T-cell waxay awood u leedahay inay beddesho wajiga daaweynta kansarka oo ay siiso bukaannada meel kasta oo ay joogaan rajo cusub oo horumar dheeraad ah leh.

Daaweynta noocaan ah waxay ku lug leedahay wax ka beddelka unugyada T-da ee bukaanka, nooca unugyada difaaca, ee shaybaarka si ay u xidhaan una dilaan unugyada kansarka. Tuubbadu waxay dhiigga ka soo qaadaa xididka cududda bukaanka oo gaynaysa aaladda apheresis (aan la muujin), kaas oo soo saara unugyada dhiigga cad, oo ay ku jiraan unugyada T, oo ku soo celisa dhiigga soo hadhay bukaanka.
 
Unugyada T ayaa markaa si hidde ahaan wax looga beddelay shaybaarka si ay ugu jiraan hidda-wadaha loogu talagalay soo-qabeyaal gaar ah oo loo yaqaanno reseptor-ka antigen-ka (CAR). Unugyada CAR T waxay ku bataan shaybaadhka ka hor inta aan la gelin bukaanka tiro badan. Antigen-ka unugyada kansarka waxaa aqoonsan kara unugyada CAR T, ka dibna dila unugyada kansarka.
 

Nidaamka

Habka daawaynta CAR-T, oo qaadata dhowr toddobaad, waxay ku lug leedahay tillaabooyin badan:

Unugyada T waxaa laga soo saaraa dhiiggaaga iyadoo la isticmaalayo tuubo la geliyo xididka cududda. Tani waxay qaadataa dhowr saacadood.

Unugyada T waxaa loo qaadaa xarun ay ku maraan beddelka hidde-sidaha si ay u noqdaan unugyo CAR-T. Laba ilaa saddex toddobaad ayaa ku dhammaanaya tan.

Unugyada CAR-T ayaa dib loogu soo celinayaa dhiiggaaga iyadoo loo marayo dhibic. Tani waxay u baahan tahay dhowr saacadood.

Unugyada CAR-T waxay beegsadaan oo tirtiraan unugyada kansarka ee jirka oo dhan. Ka dib markaad hesho daawaynta CAR-T, si dhow ayaa laguula socon doonaa.

Noocee ah unugyada kansarka ayaa lagu daweyn karaa CAR-T Cell Therapy? 

Kaliya bukaanada qaba unugyada B ee qaangaarka ah ee aan lymphoma Hodgkin ama dhakhtarka carruurta Lymphoblastic lymphoblastic leukemia kuwaas oo mar hore isku dayay laba daawaynta caadiga ah oo aan guulaysan ayaa hadda isticmaali kara alaabta daawaynta ee CAR T-cell kuwaas oo helay ogolaanshaha FDA. Si kastaba ha ahaatee, daaweynta CAR T-cell ayaa hadda lagu tijaabiyay daraasadaha kiliinikada sida daawaynta safka koowaad ama labaad ee lymphoma qaangaarka iyo kansarka carruurta ee lymphoblastic leukemia. Dhawaan, qaar ka mid ah daraasadaha ayaa muujiyay guulo cajiib ah kiisaska burooyinka adag sida glioblastoma, gliomas, kansarka beerka, kansarka sambabada, kansarka GI, kansarka ganaca iyo afka kansarrada.

Si loo soo gabagabeeyo

Tani waxay ka dhigan tahay horumar la taaban karo oo laga sameeyay maaraynta leukemia iyo lymphoma B-cell. Intaa waxa dheer, waxa ay rajo gelinaysaa kuwa hore loo saadaaliyay in noloshooda ay ku jirto lix bilood oo keliya. Hadda oo aanu aqoonsannay hababka wax-iska-caabbinta oo aanu abuurnay farsamooyin badan oo lagula dagaallamo, mustaqbalka waxa uu u muuqdaa mid aad u rajo badan.

Kala xidhiidh bixiyeyaashayada daryeelka caafimaadka ee khibradda sare leh halkan Faa'iidada Kansarka la tashi bilaash ah si loo sameeyo qorshe daryeel oo ku habboon baahiyahaaga daryeelka caafimaadka. Fadlan u soo dir warbixinnadaada caafimaad info@cancerfax.com ama WhatsApp + 1 213 789 56 55.

Waa maxay faa'iidooyinka CAR-T Cell Therapy?

The main benefit is that CAR T-cell therapy only requires a single infusion and often only requires two weeks of inpatient care. Patients with non-Hodgkin qanjiro iyo leukemia-ga carruurta ee hadda la helay, dhanka kale, caadi ahaan waxay u baahan yihiin kiimoterabi ugu yaraan lix bilood ama ka badan.

Faa'iidooyinka daaweynta CAR T-cell, oo runtii ah dawo nool, waxay sii jiri kartaa sanado badan. Haddi iyo marka ay soo noqodku dhacdo, unugyadu wali way awoodi doonaan inay aqoonsadaan oo ay beegsadaan unugyada kansarka sababtoo ah waxay ku noolaan karaan jidhka muddo dheer. 

Inkasta oo macluumaadka uu weli soo korayo, 42% bukaannada lymphoma ee qaangaarka ah ee lagu sameeyay daawaynta CD19 CAR T-cell ayaa weli ku jira cafis 15 bilood ka dib. Lix bilood ka dib, saddex-meelood laba meel bukaannada qaba kansarka leukemia ee ba'an ee carruurta ayaa weli ku jiray cafis. Nasiib darro, bukaannadani waxay lahaayeen burooyin aad u daran kuwaas oo aan si guul leh loo daweyn iyadoo la adeegsanayo heerarka daryeelka dhaqameed.

Bukaanno noocee ah ayaa noqon lahaa kuwa si wanaagsan u qaata daawaynta unugyada CAR-T?

Bukaanada da'doodu u dhaxayso 3 Sano ilaa 70 Sano ayaa lagu tijaabiyay daawaynta CAR T-cell ee noocyada kala duwan ee kansarka dhiiga waxaana la ogaaday in ay aad waxtar u leedahay. Xarumo badan ayaa sheegtey heerarka guusha ee in ka badan 80%. Musharaxa ugu wanagsan ee daawaynta unugyada CAR T-cell wakhtigan waa ilmo yar oo qaba lymfoblastic leukemia ba'an ama qof weyn oo qaba lymphoma B-cell oo daran kaas oo horey u lahaa laba xariiq oo daaweyn aan waxtar lahayn. 

Ka hor dhamaadka 2017, ma jirin heer la aqbalay daryeelka bukaanka kuwaas oo horay u soo maray laba xariiq oo daawaynta ah iyada oo aan la kulmin cafis. Daawaynta kaliya ee FDA-ansixisay ee ilaa hadda la caddeeyey inay faa'iido weyn u leedahay bukaankan waa daawaynta CAR T-cell.

Sidee waxtar u leeyahay daawaynta unug ee CAR-T?

CAR T-cell therapy has been very effective in treating some types of blood cancer, like acute lymphoblastic leukaemia (ALL) and qanjirada unugyada 'Hodgkin'. In clinical trials, the response rates have been very good, and a lot of patients have gone into full remission. In some cases, people who had tried every other medicine had long-lasting remissions or even possible cures.

Mid ka mid ah waxyaabaha ugu wanaagsan ee ku saabsan daaweynta CAR T-cell waa inay beegsato unugyada saxda ah. Qabayaasha CAR ee lagu daray unugyada T waxay heli karaan calaamado gaar ah unugyada kansarka. Tani waxay suurtogal ka dhigaysaa in la bixiyo daawaynta la beegsaday. Habkan la beegsanayo waxa ay wax u dhimaysaa unugyada caafimaadka qaba sida ugu yar ee suurtogalka ah waxana ay hoos u dhigtaa halista waxyeelooyinka ka yimaada daawaynta dhaqameed sida kiimoterabiga.

Laakiin waxaa muhiim ah in maskaxda lagu hayo in daawaynta CAR T-cell ay wali tahay aag cusub oo wali isbedelaysa. Cilmi-baarayaasha iyo takhaatiirta ayaa si adag u shaqeynaya si ay u xalliyaan dhibaatooyinka sida kharashka badan, suurtagalnimada waxyeellooyin halis ah, iyo xaqiiqda ah in ay u shaqeyso oo kaliya noocyada kansarka qaarkood.

Dhammaadkii, daawaynta CAR T-cell waxay muujisay inay tahay hab aad loogu guulaysto in lagu daweeyo noocyada kansarka dhiigga qaarkood. Inkasta oo ay tahay hab rajo leh oo awood leh, daraasado badan iyo tijaabooyin caafimaad ayaa loo baahan yahay si loo hagaajiyo loona helo habab cusub oo loo isticmaalo. Daaweynta CAR T-cell waxay bedeli kartaa sida loo daweeyo kansarka oo wax u roonaan kara dadka adduunka oo dhan haddii ay sii fiicnaanayso.

Ka mid noqoshada & shuruudaha ka saarida

Shuruudaha ka mid noqoshada daaweynta CAR T-cell:

1. Bukaanka qaba CD19 + B-cell Lymphoma (Uguyaraan 2 isku darka hore chemotherapy nidaam)

2. Inaad gaarto 3 ilaa 75 sano

3. Dhibcaha ECOG ≤2

4. Haweenka awoodda dhalmada leh waa in laga qaado shaybaadh uur kaadi ah oo la caddeeyey in aan lahayn daawaynta ka hor. Dhammaan bukaannadu waxay ku heshiiyaan inay isticmaalaan habab la isku halayn karo oo ka hortagga uurka inta lagu jiro muddada tijaabada iyo ilaa la socodka wakhtiga ugu dambeeya.

Shuruudaha ka saarida ee daaweynta CAR T-cell:

1. Dhiig-kar gudaha ah ama miyir-beel

2. Neefsashada oo xumaata

3. Xinjirowga xididdada dhiigga ku faafa

4. Hematosepsis ama Infekshan firfircoon oo aan la xakamayn

5. Sonkorowga oo aan la xakamayn.

CAR T-Cell daawaynta ay ansixisay USFDA

Unugyada B-unugyada leukemia ba'an oo soo noqnoqda ama soo noqnoqda

Heerka jawaabta oo dhammaystiran (CR): >90%

Beegsiga: CD19

Price: $ 475,000

Waqtiga ansixinta: Agoosto 30, 2017

Soo noqoshada ama dib-u-soo-celinta waxay kala firdhisaa lymphoma unugga B-weyn, soo noqoshada ama dib-u-kicinta unugyada follicular

Heerka jawaab celinta dhamaystiran ee lymphoma non-Hodgkin (CR): 51%

Beegsiga: CD19

Price: $ 373,000

Waqtiga ansixinta: 2017 Oktoobar 18

Soo noqoshada ama dib-u-celinta waxay faafisaa lymphoma weyn ee unugyada B

lymphoma unugga mantle Heerka jawaabta oo dhammaystiran (CR): 67%

Beegsiga: CD19

Price: $ 373,000

Waqtiga la ansixiyay: Oktoobar 18, 2017

Soo noqoshada ama dib-u-celinta waxay faafisaa lymphoma weyn ee unugyada B

Heerka jawaabta oo dhammaystiran (CR): 54%

Beegsiga: CD19
Price: $ 410,300

Waqtiga la ansixiyay: Oktoobar 18, 2017

Soo noq-noqotay ama soo noqnoqonaysa Multiple Myeloma 

Heerka jawaabta oo dhammaystiran: 28%

Beegsiga: CD19
Price: $ 419,500
Waxaa la ansixiyay: Oktoobar 18, 2017

Waa maxay waxyeelada daawaynta unug ee CAR-T?

Hoos waxaa ku xusan qaar ka mid ah waxyeelada daawaynta CAR T-cell.

  1. Cytokine release syndrome (CRS): Saamaynta ugu badan ee ugu badan ee suurtogalka ah ee muhiimka ah ee daaweynta CAR T-cell waa cytokine release syndrome (CRS). Calaamadaha hargabka oo kale, oo ay ku jiraan qandho, daal, madax-xanuun, iyo murqo xanuun, waxaa keena wax-soo-saarka cytokines-ka ee T-ga oo la beddelay. Xaalado aad u daran, CRS waxa ay keeni kartaa heerkul sare, dhiig-yaraan, xubin la'aan, iyo xataa cawaaqib halis ah. 
  2. Sunta Neerfaha: Bukaanjiifka qaarkood waxaa laga yaabaa inay yeeshaan saameynaha neerfaha, kuwaas oo u dhexeeya darnaan laga bilaabo calaamado aan halis ahayn sida jahawareer khafiif ah iyo jahawareer ilaa kuwa ka sii daran sida suuxdin, delirium, iyo encephalopathy. Ka dib faleebada CAR T-cell, sunta neerfaha waxay badanaa dhacdaa usbuuca ugu horreeya. 
  3. Cytopenia: Daawaynta CAR T-unuggu waxay keeni kartaa inay hoos u dhigto tirooyinka unugyada dhiigga, sida dhiig-yarida (tirada unugyada dhiigga cas ee hooseeya), neutropenia (tirada unugyada dhiigga cad oo hooseeya), iyo thrombocytopenia (tirada platelet oo hooseeya). Caabuqyada, dhiig-baxa, iyo daalku waxay ka mid yihiin khataraha ay uga sii dari karto cytopenia. 
  4. Caabuqyada: CAR T-cell therapy's xakamaynta unugyada difaaca jirka ee caafimaadka qaba waxay kordhisaa halista caabuqyada bakteeriyada, fayraska, iyo fungal. Si looga hortago infekshannada, bukaanku waxay u baahan karaan in si dhow loola socdo oo la siiyo daawo ka hortag ah.
  5. Tumor Lysis Syndrome (TLS)Ka dib daaweynta CAR T-cell, waxaa suurtagal ah xaaladaha qaarkood in xaddi la taaban karo oo ka kooban unugyada lagu sii daayo dhiigga sababtoo ah dilka degdega ah ee unugyada burooyinka. Tani waxay keeni kartaa cillado dheef-shiid kiimikaad ah, sida potassium-ka xad-dhaafka ah, uric acid, iyo heerarka fosfateet, kuwaas oo dhaawici kara kelyaha oo sababi kara dhibaatooyin kale. 
  6. Hypogammaglobulinemia: Daawaynta CAR T-cell waxay leedahay awood ay ku yarayso isku-darka unugyada difaaca jirka, taas oo keeni karta hypogammaglobulinemia. Tani waxay ka dhigi kartaa infekshannada soo noqnoqda inay u badan tahay waxayna wacdaa in la sii wado daawada beddelka unugyada. 
  7. Sunta Xubinta: Daaweynta CAR T-cell waxay leedahay awood ay ku waxyeeleyso tiro xubno ah, oo ay ku jiraan wadnaha, sambabada, beerka, iyo kelyaha. Tani waxay u horseedi kartaa baaritaanada shaqada kelyaha ee aan caadiga ahayn, arrimaha neefsashada, arrimaha wadnaha, iyo baaritaanka shaqada beerka ee aan caadiga ahayn.
  8. Hemophagocytic lymphohistiocytosis (HLH): Cudur naadir ah laakiin suurtagal ah oo dilaa ah oo loo yaqaan hemophagocytic lymphohistiocytosis (HLH) ayaa ku soo bixi kara natiijada daawaynta CAR T-cell. Waxay ku lug leedahay firfircoonida xad-dhaafka ah ee unugyada difaaca jirka, taas oo keenta dhaawac halis ah xubnaha iyo bararka.
  9. Hypotension iyo Haysashada Dheecaannada: Natiijadu waxay tahay cytokines ay unugyada CAR T sii daayaan, bukaannada qaarkood waxaa laga yaabaa inay yeeshaan cadaadis dhiig oo hooseeya (hypotension) iyo xajinta dareeraha. Si wax looga qabto calaamadahan, tillaabooyin taageero ah oo ay ku jiraan dheecaannada xididka iyo dawooyinka ayaa loo baahan karaa.
  10. Xannaanada Labaad: Warbixinnada malignancies-ka labaad ee soo baxaya ka dib daaweynta CAR T-cell ayaa jira, inkastoo ay naadir yihiin. Cilmi baaris ayaa hadda lagu sameynayaa suurtagalnimada malignant-ka labaad iyo khataraha mustaqbalka fog.

Waxaa muhiim ah in la xasuusnaado in bukaan kastaa aanu yeelanayn dhibaatooyinkan soo raaca, iyo in qof walba heerka dareenkiisu uu kala duwanaan doono. Si loo yareeyo loona yareeyo saamaynta xun ee iman karta, kooxda caafimaadku waxay si dhow u baadhaan bukaanka ka hor, inta lagu jiro, iyo ka dib daawaynta CAR T-cell.

Waqtiga waqtiga

Hoos ka hubi wadarta wakhtiga loo baahan yahay si loo dhamaystiro habka daawaynta CAR T-cell. In kasta oo wakhtiga xaddidan uu aad ugu xidhan yahay fogaanta shaybaadhka ee cusbitaalka diyaariyey CAR-da.

  1. Imtixaan & imtixaan: hal usbuuc
  2. Daawaynta kahor & Ururinta T-Cell: hal usbuuc
  3. Diyaarinta iyo soo celinta T-Cell: laba-saddex toddobaad
  4. Falanqaynta waxtarka 1aad: saddex toddobaad
  5. 2nd Waxtarka falanqaynta: saddex toddobaad.

Wadarta wakhtiga: 10-12 toddobaad

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Cytokine Release Syndrome (CRS) waa falcelin habdhiska difaaca oo inta badan ka dhasha daawaynta qaarkood sida immunotherapy ama daawaynta unugga CAR-T. Waxay ku lug leedahay sii-deynta xad-dhaafka ah ee cytokines, taasoo keenta calaamado u dhexeeya qandho iyo daal ilaa dhibaatooyin nafta halis gelin kara sida dhaawaca xubnaha. Maareyntu waxay u baahan tahay kormeer taxadar leh iyo xeelado faragelineed.

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Dhakhaatiirta caafimaadka ayaa door muhiim ah ka ciyaara guusha daaweynta CAR T-cell iyaga oo hubinaya daryeelka bukaanka ee aan joogtada ahayn inta lagu jiro habka daaweynta. Waxay bixiyaan taageero muhiim ah inta lagu jiro gaadiidka, la socodka calaamadaha muhiimka ah ee bukaanka, iyo maamulida waxqabadyada caafimaadka degdega ah haddii ay dhibaatooyin soo baxaan. Jawaabtooda degdega ah iyo daryeelka khabiirku waxay gacan ka geystaan ​​​​badbaadada guud iyo waxtarka daaweynta, fududeynta kala-guurka fudud ee u dhexeeya goobaha daryeelka caafimaadka iyo hagaajinta natiijooyinka bukaanka ee muuqaalka adag ee daaweynta gacanta ee sare.

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Akhri wax dheeraad ah "
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CAR T-Cell therapy ee Israa'iil waxay ku kacaysaa inta u dhaxaysa 75,000 iyo 90,000 USD, taas oo ku xidhan nooca iyo heerka cudurka iyo cisbitaalka la doortay.

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