He aha ʻo Gemtuzumab: Nā hoʻohana, ka nui o ka lāʻau, nā hopena ʻaoʻao a me nā mea hou aku

ʻO Gemtuzumab he lāʻau lapaʻau maʻi maʻi i hoʻohui i kahi antibody me kahi lāʻau chemotherapy e mālama ai i kekahi mau ʻano o ka acute myeloid leukemia (AML). Hana kēia lapaʻau kūikawā e like me ka missile alakaʻi, e ʻimi ana i nā cell maʻi maʻi kikoʻī me ka waiho ʻana i nā cell olakino he nui wale nō.

Inā ua kau ʻia ʻo gemtuzumab iā ʻoe a i ʻole kekahi āu e mālama ai, e manaʻo paha ʻoe e piha ana i nā nīnau. He mea maʻamau a maopopo loa kēlā. Hōʻike kēia lāʻau lapaʻau i ka manaʻolana no ka nui o ka poʻe e kū nei i ka AML, a ʻo ka hoʻomaopopo ʻana i ke ʻano o kāna hana hiki ke kōkua iā ʻoe e ʻoi aku ka hilinaʻi i kāu huakaʻi lapaʻau.

He aha ʻo Gemtuzumab?

ʻO Gemtuzumab he antibody-drug conjugate, ʻo ia hoʻi, ʻelua mau lapaʻau ikaika i hui pū ʻia i hoʻokahi. Hana ka ʻāpana antibody e like me ka mea hana homing e ʻimi ana i nā cell maʻi maʻi me kahi protein kikoʻī i kapa ʻia ʻo CD33 ma ko lākou ʻili. Ke paʻa ia i kēia mau cell, hāʻawi ia i kahi lāʻau chemotherapy ikaika i loko o lākou.

E noʻonoʻo iā ia he ʻōnaehana hāʻawi i manaʻo ʻia e hiki ke hoʻokaʻawale ma waena o nā cell maʻi maʻi a me nā cell olakino. Kōkua kēia ʻano hana pololei i ka hōʻemi ʻana i ka pōʻino i nā ʻiʻo maʻamau i ka wā e kālele ana i ka lapaʻau ma kahi e pono ai. Hele ka lāʻau lapaʻau ma ka inoa brand Mylotarg a no ka papa o nā lāʻau i kapa ʻia he monoclonal antibodies.

Hoʻolālā kūikawā ʻia kēia lapaʻau no ka acute myeloid leukemia, kahi ʻano maʻi maʻi koko e pili ana i nā cell koko keʻokeʻo. Loaʻa ka protein CD33 ma ka hapa nui o nā cell AML, e hana ana iā gemtuzumab i koho kūpono no ka nui o nā maʻi me kēia maʻi.

No ke aha e hoʻohana ʻia ai ʻo Gemtuzumab?

Hoʻohana nui ʻia ʻo Gemtuzumab e mālama i ka acute myeloid leukemia i nā pākeke a me nā keiki ma luna o 2 mau makahiki. E ʻōlelo maʻamau kāu kauka i kēia lāʻau lapaʻau ke hōʻike maikaʻi kāu mau cell maʻi maʻi no ka protein CD33, e hana ana ma kahi o 90% o nā hihia AML.

Hoʻohana pinepine ʻia ka lāʻau lapaʻau me nā lāʻau chemotherapy ʻē aʻe e like me daunorubicin a me cytarabine no ka AML i hōʻike ʻia. Ua hōʻike kēia hui ʻana i nā hopena maikaʻi aʻe ma mua o ka hoʻohana ʻana i ka chemotherapy wale nō. E hoʻoholo kāu hui mālama ola i ka hoʻolālā lapaʻau maikaʻi loa e pili ana i kou kūlana kikoʻī, makahiki, a me ke olakino holoʻokoʻa.

I kekahi mau hihia, hiki ke hoʻohana ʻia ka gemtuzumab ma ke ʻano he lapaʻau hoʻokahi no nā maʻi i hiki ʻole ke ʻae i ka chemotherapy ikaika. Hiki ke pili kēia i nā mākua kahiko a i ʻole ka poʻe me nā maʻi olakino ʻē aʻe e hoʻoweliweli ai ka chemotherapy maʻamau.

Pehea e hana ai ʻo Gemtuzumab?

Hana ʻo Gemtuzumab ma o kahi kaʻina hana ʻelua ʻanuʻu i hoʻopaʻa ʻia i nā cella maʻi me ka pololei nui. ʻO ka mea mua, ʻike ka ʻāpana antibody a hoʻopaʻa i nā protein CD33 ma ka ʻili o nā cella AML. He mea like kēia me ke kī e ʻimi nei i kāna laka kikoʻī.

Ke hoʻopili ʻia, huki ka cella maʻi i ka mole gemtuzumab holoʻokoʻa i loko ma o ke kaʻina hana i kapa ʻia ʻo ka internalization. I loko o ka cella, hoʻokuʻu ʻia ka ʻāpana chemotherapy (i kapa ʻia ʻo calicheamicin) a hoʻomaka e luku i ka cella maʻi mai loko mai. ʻO kēia ala i hoʻopaʻa ʻia, ʻo ia hoʻi, ua hāʻawi pololei ʻia ka lāʻau chemotherapy ikaika i kahi e pono ai.

Ua manaʻo ʻia he lāʻau lapaʻau maʻi ikaika. ʻOiai ua lawa ka ikaika e pepehi pono i nā cella maʻi, kōkua ka ʻōnaehana hāʻawi i hoʻopaʻa ʻia e hōʻemi i nā hopena ʻaoʻao ākea āu e ʻike ai me ka chemotherapy kuʻuna. Eia naʻe, he lapaʻau koʻikoʻi nō ia e koi ana i ka nānā pono ʻana e kāu hui lapaʻau.

Pehea e lawe ai au i ka Gemtuzumab?

Hāʻawi ʻia ʻo Gemtuzumab ma ke ʻano he intravenous infusion pololei i loko o kou kahe koko ma o ka vein. ʻAʻole hiki iā ʻoe ke lawe i kēia lāʻau lapaʻau ma ka waha, a pono e lawelawe ʻia i loko o kahi haukapila a i ʻole ke kikowaena lapaʻau maʻi kūikawā e nā poʻe loea mālama ola i hoʻomaʻamaʻa ʻia.

Ma mua o kēlā me kēia hoʻokomo ʻana, e hāʻawi kāu hui lapaʻau iā ʻoe i nā lāʻau lapaʻau e kōkua i ka pale ʻana i nā hopena maʻi. ʻO kēia mau mea e komo pū ana me nā antihistamines e like me ka diphenhydramine a me ka acetaminophen e hōʻemi i ke kuni a me ka ʻoluʻolu ʻole. ʻAʻole pono ʻoe e pale i ka meaʻai ma mua o ka mālama ʻana, akā he mea nui ka noho ʻana i ka wai maikaʻi ma ka inu ʻana i ka wai nui.

ʻO ka hoʻokomo ʻana iho ma kahi o 2 mau hola, a e nānā pono ʻia ʻoe i ka wā a ma hope o ka mālama ʻana. E nānā kāu hui mālama ola kino i nā hōʻailona o nā hopena maʻi a i ʻole nā hopena ʻē aʻe. E hoʻolālā e hoʻolilo i ka hapa nui o ka lā ma ke kikowaena lapaʻau, no ka mea, pono pinepine ka manawa nānā hou.

Hiki iā ʻoe ke ʻoluʻolu i ka lawe ʻana i kahi puke, papa, a i ʻole ke loaʻa ʻana o kahi hoaaloha a i ʻole lālā o ka ʻohana e noho pū me ʻoe i ka wā o ka mālama ʻana. Nui ka poʻe i ʻike i ke kaʻina hana hoʻokomo ʻana i ka liʻiliʻi o ke koʻikoʻi ke loaʻa iā lākou kekahi mea e mālama ai i ko lākou manaʻo.

Pehea ka lōʻihi e lawe ai au i ka Gemtuzumab?

Aia ka lōʻihi o ka mālama ʻana i ka gemtuzumab i kāu hoʻolālā lapaʻau kikoʻī a me ka maikaʻi o kou pane ʻana i ka lāʻau lapaʻau. Loaʻa ka hapa nui o nā maʻi i ka gemtuzumab ma ke ʻano he ʻāpana o ka therapy induction, kahi e pili ana i 1-2 pōʻai i hāʻawi ʻia ma luna o kekahi mau pule.

Inā loaʻa iā ʻoe ka therapy hui pū me nā lāʻau chemotherapy ʻē aʻe, hiki iā ʻoe ke kiʻi i ka gemtuzumab i nā lā 1, 4, a me 7 o kāu pōʻai lapaʻau mua. No nā maʻi e loaʻa ana i ka gemtuzumab wale nō, ʻokoʻa ka papa manawa, e pili ana i nā lāʻau i hoʻokaʻawale ʻia e ka liʻiliʻi o 2 mau pule.

E nānā mau kāu kauka i kāu helu koko a me ka pane holoʻokoʻa e hoʻoholo ai inā pono nā lāʻau hou. Loaʻa paha i kekahi poʻe maʻi ka gemtuzumab i ka wā o ka therapy consolidation, e hele mai ana ma hope o ka pae lapaʻau mua. ʻAʻole i ʻoi aku ka nui o nā lāʻau i ka 3-4 mau lapaʻau.

He mea nui e hoʻopau i ka papa piha o ka lapaʻau e like me ke kauoha ʻia, ʻoiai inā hoʻomaka ʻoe e ʻoi aku ka maikaʻi. ʻO ka hoʻōki ʻana i ka wā mua e ʻae i nā cell cancer e ulu hou a paʻakikī ke mālama.

He aha nā hopena ʻaoʻao o Gemtuzumab?

E like me nā lāʻau lapaʻau maʻi 'aʻai a pau, hiki i ka gemtuzumab ke hana i nā hopena ʻē aʻe, ʻoiai ʻaʻole nā mea a pau e ʻike iā lākou a pau. ʻO ka hoʻomaopopo ʻana i ka mea e manaʻo ai hiki ke kōkua iā ʻoe e hoʻomākaukau a ʻike i ka manawa e hoʻokaʻaʻike aku ai i kāu hui mālama ola.

ʻO nā hopena ʻē aʻe maʻamau āu e ʻike ai, ʻo ia ka luhi, ke kuni, ka nausea, a me ka helu haʻahaʻa o nā cell koko. Hoʻomohala pinepine ʻia kēia mau hopena i nā lā mua ma hope o ka mālama ʻana a hoʻomaikaʻi pinepine i ka wā e hoʻoponopono ai kou kino.

Eia nā hopena ʻē aʻe i hōʻike pinepine ʻia, i hoʻonohonoho ʻia mai ka mea maʻamau a hiki i ka mea maʻamau:

• Luhi a me ka nāwaliwali e hiki ke mau no kekahi mau lā
• Ke kuni a me nā anu, ʻoi loa i loko o 24 mau hola o ka mālama ʻana
• Nausea a me ka luaʻi ʻana, hiki ke mālama ʻia me nā lāʻau lapaʻau
• Helu haʻahaʻa o ke keʻokeʻo koko, e hoʻonui ana i ka pilikia o ka maʻi
• Helu platelet haʻahaʻa, e alakaʻi ana i ka ʻeha maʻalahi a i ʻole ke kahe ʻana
• Poʻo a me ka noʻonoʻo
• Nā ʻeha waha a i ʻole ka huhū ʻana o ka ʻāʻī
• Pākuʻi ʻili a i ʻole ka ʻū

Hiki ke mālama ʻia kēia mau hopena ʻē aʻe me ka mālama kākoʻo a me nā lāʻau lapaʻau hiki i kāu kauka ke kuhikuhi. ʻIke ka hapa nui o nā kānaka e hoʻomaikaʻi ana kēia mau hopena i loko o hoʻokahi a ʻelua pule ma hope o kēlā me kēia mālama ʻana.

Aia kekahi mau hopena ʻē aʻe akā koʻikoʻi e pono ai ka lāʻau lapaʻau koke. ʻOiai ʻaʻole i loaʻa kēia mau mea i ka hapa nui o nā maʻi, he mea nui e ʻike iā lākou i hiki iā ʻoe ke ʻimi koke i ke kōkua inā pono.

ʻO nā hopena ʻē aʻe akā koʻikoʻi, ʻo ia:

• Nā pilikia ate koʻikoʻi, me kahi maʻi i kapa ʻia ʻo ka maʻi veno-occlusive
• Nā hopena maʻi maʻi koʻikoʻi i ka wā o ka hoʻokomo ʻana
• Nā maʻi koʻikoʻi ma muli o ka helu haʻahaʻa loa o ke keʻokeʻo koko
• Nā pilikia kahe koko koʻikoʻi mai nā helu platelet haʻahaʻa loa
• Nā pilikia o ka puʻuwai a i ʻole ka pōʻino o ka ʻiʻo o ka puʻuwai
• Nā pilikia māmā koʻikoʻi a i ʻole ka pilikia o ka hanu

E nānā pono kāu hui mālama ola iā ʻoe no kēia mau hopena koʻikoʻi ma o nā hoʻokolohua koko maʻamau a me nā hoʻokolohua kino. Inā ʻike ʻoe i ka pilikia nui o ka hanu ʻana, ka ʻeha o ka umauma, ka melemele ʻana o kou ʻili a i ʻole nā maka, a i ʻole nā hōʻailona o ka maʻi koʻikoʻi, e kelepona koke i kāu kauka.

ʻO wai ka mea pono ʻole e lawe iā Gemtuzumab?

ʻAʻole kūpono ʻo Gemtuzumab no nā mea a pau, a e loiloi pono kāu kauka inā ʻo ia ke koho kūpono no kou kūlana. Pono paha nā poʻe me kekahi mau maʻi olakino a i ʻole nā kūlana i nā lāʻau lapaʻau ʻē aʻe.

ʻAʻole pono ʻoe e loaʻa iā gemtuzumab inā loaʻa iā ʻoe kahi hopena maʻi koʻikoʻi i ka lāʻau a i ʻole kekahi o kāna mau mea. Eia kekahi, inā ʻaʻole loaʻa i kāu mau maʻi maʻi ka protein CD33, ʻaʻole pono kēia lapaʻau iā ʻoe.

E ʻōlelo paha kāu kauka iā ʻoe e kūʻē iā gemtuzumab inā loaʻa iā ʻoe:

• Maʻi ate koʻikoʻi a i ʻole ka mōʻaukala o nā pilikia ate
• Nā maʻi ikaika, ʻaʻole i mālama ʻia
• Nā helu koko haʻahaʻa loa ʻaʻole e hoʻomaikaʻi me ka mālama kākoʻo
• Nā pilikia puʻuwai koʻikoʻi a i ʻole ka puʻuwai i ka wā i hala
• Hāpai a i ʻole nā hoʻolālā e hāpai

Pono ka mālama kūikawā no nā mākua kahiko, no ka mea, ʻoi aku ka maʻalahi o lākou i nā hopena ʻaoʻao. E kaupaona kāu kauka i nā pōmaikaʻi kūpono e kūʻē i nā pilikia e pili ana i kou olakino holoʻokoʻa a me nā maʻi olakino ʻē aʻe.

ʻO ka inoa inoa o Gemtuzumab

Kūʻai ʻia ʻo Gemtuzumab ma lalo o ka inoa inoa Mylotarg. ʻO kēia wale nō ka inoa inoa i loaʻa no kēia lāʻau lapaʻau ma ʻAmelika Hui Pū ʻIa a me ka hapa nui o nā ʻāina ʻē aʻe.

Ua ʻae mua ʻia ʻo Mylotarg e ka FDA i ka makahiki 2000, ua wehe ʻia mai ka mākeke i ka makahiki 2010 ma muli o nā hopohopo palekana, a laila ua ʻae hou ʻia i ka makahiki 2017 me nā ʻōlelo aʻoaʻo dosage hou. Ua manaʻo ʻia ka formulation o kēia manawa he palekana a ʻoi aku ka maikaʻi ma mua o ka mana mua.

I ka wā e loaʻa ai iā ʻoe kāu lapaʻau, e hōʻailona ʻia ka hue lāʻau lapaʻau ʻo Mylotarg. ʻAʻohe mana generic o gemtuzumab i loaʻa i kēia manawa, no ka mea, he lāʻau lapaʻau kūikawā loa kēia e koi ana i nā hana hana paʻakikī.

Nā Koho ʻē aʻe o Gemtuzumab

Inā ʻaʻole kūpono ʻo gemtuzumab no kou kūlana, aia kekahi mau lapaʻau ʻē aʻe no ka leukemia myeloid acute. E kōkua kāu kauka e hoʻoholo i ke koho maikaʻi loa e pili ana i kāu ʻano AML, makahiki, a me ke olakino holoʻokoʻa.

ʻO nā hui chemotherapy maʻamau e like me

Akā, e hilinaʻi ana ka "maikaʻi" i kou kūlana pilikino. ʻOiai paha e hāʻawi ana ke ala hui pū i ka mana maikaʻi aʻe i ka maʻi 'aʻai, hele pū mai nō hoʻi me nā hopena ʻaoʻao hou a koi aku i ka nānā ʻana i ka nui. E kōkua kāu kauka iā ʻoe e loiloi i kēia mau mea e pili ana i kou makahiki, ke olakino, a me nā pahuhopu lapaʻau.

No kekahi poʻe maʻi, ʻo nā mākua ʻelemakule a i ʻole ka poʻe me nā maʻi olakino ʻē aʻe, ʻoi aku ka maikaʻi o nā lapaʻau mālie ʻoiai paha ʻaʻole lākou e kūʻē i ka maʻi 'aʻai. ʻO ka lapaʻau maikaʻi loa ka mea e hāʻawi iā ʻoe i ke kaulike maikaʻi o ka pono a me ka maikaʻi o ke ola.

Nā Nīnau i Nīnau Pinepine ʻia e pili ana iā Gemtuzumab

He palekana anei ʻo Gemtuzumab no ka poʻe me ka maʻi ate?

Hiki ke pilikia loa ʻo Gemtuzumab no ka poʻe me nā pilikia ate. Hiki i ka lāʻau lapaʻau ke hana i kahi maʻi koʻikoʻi i kapa ʻia ʻo ka maʻi veno-occlusive hepatic, e ālai ana i ke kahe koko i loko o ke ake a hiki ke hoʻoweliweli i ke ola.

Inā he mau pilikia ate maʻalahi kāu, hiki i kāu kauka ke noʻonoʻo iā gemtuzumab akā e nānā pono iā ʻoe me nā hoʻokolohua koko pinepine. Eia naʻe, inā he maʻi ate waena a koʻikoʻi paha kāu, e ʻōlelo paha kāu kauka i nā lapaʻau ʻē aʻe e hōʻemi ana i ka pilikia i kou ate.

Ma mua o ka hoʻomaka ʻana i ka lapaʻau, e loiloi pono kāu hui mālama ola i kāu hana ate ma o nā hoʻokolohua koko a me nā haʻawina kiʻi. Kōkua kēia iā lākou e hoʻoholo inā palekana ʻo gemtuzumab iā ʻoe a hoʻokumu i nā ana kumu no ka nānā ʻana i ka wā o ka lapaʻau.

He aha kaʻu e hana ai inā loaʻa iaʻu ka nui o Gemtuzumab?

ʻAʻole paha e loaʻa ka overdose o gemtuzumab no ka mea e lawelawe ʻia e nā poʻe loea mālama ola i aʻo ʻia i nā wahi i mālama ʻia. Eia naʻe, inā manaʻo ʻoe ua hana ʻia kahi hewa a i ʻole e ʻike i nā hōʻailona koʻikoʻi i ka wā a i ʻole ma hope o ka lapaʻau, e hoʻomaopopo koke i kāu hui lapaʻau.

ʻO nā hōʻailona o ka overdose e komo pū ana me ka nausea nui, ka luaʻi ʻana, ka luhi nui, a i ʻole nā ​​hōʻailona ʻē aʻe i ʻoi aku ka ʻino ma mua o ka mea i manaʻo ʻia. E nānā pono kāu hui mālama ola iā ʻoe a hāʻawi i ke kākoʻo e mālama i nā pilikia.

ʻAʻohe antidote kikoʻī no ka gemtuzumab, no laila e kālele ana ka mālama ʻana i ka mālama ʻana i nā hōʻailona a me ke kākoʻo ʻana i ke ola o kou kino. Hiki i kēia ke komo i nā lāʻau lapaʻau e kāohi i ka nausea, nā wai IV e pale ai i ka dehydration, a me ka nānā pono ʻana i kāu helu koko.

He aha kaʻu e hana ai inā e hala wau i kahi mahele o Gemtuzumab?

No ka mea, hāʻawi ʻia ka gemtuzumab i loko o kahi haukapila a i ʻole ke kikowaena lapaʻau e like me ka papa manawa kikoʻī, ʻaʻole ia he mea e hana ʻia ana ka hala ʻana i kahi mahele. Hoʻolālā pono kāu hui mālama ola i kēlā me kēia kau lapaʻau ma ke ʻano he ʻāpana o kāu protocol lapaʻau holoʻokoʻa.

Inā pono ʻoe e hoʻopaneʻe i kahi mahele i hoʻonohonoho ʻia ma muli o ka maʻi, nā helu koko haʻahaʻa, a i ʻole nā ​​pilikia olakino ʻē aʻe, e hoʻoholo kāu kauka i ke ala maikaʻi loa. I kekahi manawa hiki ke hoʻopaneʻe ʻia ka lapaʻau ʻana i kekahi mau lā a i ʻole mau pule a hiki i ka mākaukau ʻana o kou kino e mālama i ka lāʻau lapaʻau me ka palekana.

Mai hoʻāʻo e hoʻoponopono i kahi mahele i hala ma ka pāpālua ʻana i ka mea e hiki mai ana. E hoʻoponopono kāu kauka i kāu papa manawa lapaʻau e like me ka mea e pono ai me ka mālama ʻana i ka palekana a me ka pono o kāu therapy. ʻO ke kamaʻilio ʻana me kāu hui mālama ola ke kī i ka mālama ʻana i nā loli hoʻonohonoho.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana iā Gemtuzumab?

ʻAʻole ʻoe e

I kekahi mau hihia, hiki ke hoʻōki mua ʻia ka lapaʻau inā loaʻa iā ʻoe nā hopena ʻaoʻao koʻikoʻi a i ʻole inā ʻaʻole e pane kāu maʻi maʻi e like me ka mea i manaʻo ʻia. E kau mau kāu hui mālama ola i kou palekana a me kou olakino i ka wā e hana ai i kēia mau hoʻoholo.

Hiki iaʻu ke hāpai i ka wā e lawe ana i ka Gemtuzumab?

Hiki i ka Gemtuzumab ke hōʻeha nui i kahi pēpē i hānau ʻole ʻia, no laila pono e pale ʻia ka hāpai ʻana i ka wā o ka lapaʻau a no kekahi mau mahina ma hope. Pono nā kāne a me nā wahine e hoʻohana i ka contraception pono i ka wā e loaʻa ai kēia lāʻau.

Inā he wahine ʻoe o ka makahiki hānau keiki, e koi paha kāu kauka i kahi hoʻokolohua hāpai ma mua o ka hoʻomaka ʻana i ka lapaʻau. Pono ʻoe e hoʻomau i ka hoʻohana ʻana i ka mana hānau hilinaʻi no ka liʻiliʻi o 7 mau mahina ma hope o kāu mahele hope loa o ka gemtuzumab.

Pono nā kāne e hoʻohana i ka contraception i ka wā o ka lapaʻau a no ka liʻiliʻi o 4 mau mahina ma hope o kā lākou mahele hope loa, no ka mea, hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka sperm a hiki ke hōʻeha i kahi pēpē e ulu ana. Inā ʻoe e hoʻolālā nei e loaʻa nā keiki i ka wā e hiki mai ana, e kūkākūkā i nā koho mālama momona me kāu kauka ma mua o ka hoʻomaka ʻana i ka lapaʻau.