Ukwelashwa kwe-CAR T-Cell

Okubalulwe ngezansi eminye yemiphumela emibi yokwelashwa kwe-CAR T-Cell.

1. I-Cytokine release syndrome (CRS): Umthelela oseceleni ovame kakhulu futhi okungenzeka ubaluleke kakhulu wokwelashwa kwe-CAR T-cell i-cytokine release syndrome (CRS). Izimpawu ezinjengomkhuhlane, okuhlanganisa imfiva, ukukhathala, ikhanda elibuhlungu, nobuhlungu bemisipha, zibangelwa ukukhiqizwa kwama-T cell ashintshiwe ama-cytokines. Ezimweni ezimbi kakhulu, i-CRS ingase ibangele izinga lokushisa eliphezulu, i-hypotension, ukwehluleka kwezitho, ngisho nemiphumela engase ibulale. 
2. Ubuthi Bezinzwa: Ezinye iziguli zingase zibe nemiphumela engemihle yemizwa, engase ihluke kakhulu kusukela kuzimpawu ezingathí sina njengokudideka okuncane kanye nokudideka kuye kwezibucayi kakhulu njengokuquleka, ukudangala, kanye ne-encephalopathy. Ngemuva kokujova i-CAR T-cell, ubuthi bezinzwa buvame ukwenzeka phakathi nesonto lokuqala. 
3. I-Cytopenias: Ukwelashwa kwe-CAR T-cell kungabangela ukubala okuphansi kwamangqamuzana egazi, njenge-anemia (isibalo esiphansi samangqamuzana egazi abomvu), i-neutropenia (isibalo esiphansi samangqamuzana egazi amhlophe), kanye ne-thrombocytopenia (isibalo esiphansi seplatelet). Ukutheleleka, ukopha, nokukhathala kuphakathi kwezingozi ezingabhebhethekiswa yilezi cytopenias. 
4. Amagciwane: Ukucindezela kwe-CAR T-cell therapy kwamangqamuzana omzimba anempilo kwandisa ingozi yokutheleleka ngamagciwane, igciwane, kanye nesikhunta. Ukuze kuvinjwe izifo, iziguli kungase kudingeke ukuthi zibhekwe ngeso elibukhali futhi zinikezwe imithi yokuzivikela.
5. I-Tumor Lysis Syndrome (TLS): Ngemva kokwelashwa kwe-CAR T-cell, kwezinye izimo kuyenzeka ukuthi amanani amakhulu wokuqukethwe kweseli akhishelwe egazini ngenxa yokubulawa ngokushesha kwamaseli esimila. Lokhu kungase kubangele ukuphazamiseka kwezinqubo ze-metabolic, okufana namazinga e-potassium eningi, i-uric acid, ne-phosphate, okungase kulimaze izinso futhi kubangele nezinye izinkinga. 
6. I-Hypogammaglobulinemia: Ukwelashwa kwe-CAR T-cell kunamandla okunciphisa ukwakheka kwe-antibody, okungase kubangele i-hypogammaglobulinemia. Lokhu kungase kwenze izifo eziphindelelayo zibe nokwenzeka kakhulu futhi kubize ukuqhubeka kwemithi yokubuyisela amasosha omzimba. 
7. Ubuthi Bomzimba: I-CAR T-cell therapy inamandla okulimaza izitho eziningi, okuhlanganisa inhliziyo, amaphaphu, isibindi, nezinso. Lokhu kungase kuholele ekuhlolweni kokusebenza okungavamile kwezinso, izinkinga zokuphefumula, izinkinga zenhliziyo, nokuhlolwa kokusebenza okungavamile kwesibindi.
8. I-Hemophagocytic lymphohistiocytosis (HLH): Isifo esingandile kodwa esibulalayo esibizwa ngokuthi i-hemophagocytic lymphohistiocytosis (HLH) singakhula ngenxa yokwelashwa kwe-CAR T-cell. Kuhilela ukusebenza ngokweqile kwamangqamuzana omzimba omzimba, okubangela ukulimala okukhulu kwezitho nokuvuvukala.
9. I-Hypotension kanye nokugcinwa koketshezi: Njengomphumela wama-cytokines akhishwa amaseli e-CAR T, ezinye iziguli zingase zibe nomfutho wegazi ophansi (hypotension) nokugcinwa koketshezi. Ukubhekana nalezi zimpawu, kungase kudingeke izinyathelo ezisekelayo ezihlanganisa uketshezi olufakwa emthanjeni nezidakamizwa.
10. Izifo Zesibili: Imibiko yezifo zesibili ezibulalayo ezivela ngemva kokwelashwa kwe-CAR T-cell ikhona, kungakhathaliseki ukuthi inqabile. Njengamanje ucwaningo luyenziwa mayelana namathuba ezifo zesibili kanye nezingozi zesikhathi eside.

Kubalulekile ukukhumbula ukuthi akusona sonke isiguli esizoba nale miphumela engemihle, nokuthi izinga lomuntu ngamunye lokuzwela lizohluka. Ukuze kuncishiswe futhi kuncishiswe le miphumela emibi engaba khona, ithimba lezokwelapha lihlolisisa iziguli ngaphambi, phakathi, nangemuva kokwelashwa kwe-CAR T-cell.