Ni iki Axicabtagene Ciloleucel: Ibikoresho, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Axicabtagene ciloleucel ni uburyo bushya bwo kuvura kanseri bukoresha uturemangingo twawe twikingira kugira ngo turwanye kanseri zimwe na zimwe zifata amaraso. Ubu buryo bushya bwo kuvura, buzwi kandi nka CAR-T cell therapy, bufata uturemangingo twikingira mu mubiri wawe, tukabuhindura mu laboratori kugira ngo bumenye neza kandi bigabe ku turemangingo twa kanseri, hanyuma tukongera tukagusubiza binyuze mu gutera imitsi ya IV.

Ubu buvuzi bwihariye bugize intambwe ikomeye mu kwita ku barwayi ba kanseri, butanga icyizere ku barwayi bafite ubwoko bwihariye bwa lymphoma na leukemia batitabiriye ubundi buvuzi. Nubwo iyi nzira igoye kandi isaba ibigo by'ubuvuzi byihariye, yagaragaje intsinzi ishimishije mu gufasha abarwayi kugera ku gukira iyo ubundi buryo bwashiriye.

Axicabtagene Ciloleucel ni iki?

Axicabtagene ciloleucel ni ubwoko bwo kuvura bwo kurwanya kanseri buzwi nka CAR-T cell therapy buhindura urwego rwawe rwikingira umubiri rukaba imbaraga zikomeye zo kurwanya kanseri. Ubu buvuzi bukubiyemo gukusanya uturemangingo twa T (ubwoko bw'uturemangingo twera tw'amaraso) mu maraso yawe, tukabahindura mu buryo bwa genetike muri laboratori yihariye, hanyuma tukongera tukabatera mu mubiri wawe.

Bitekereze nk'uko uha urwego rwawe rwikingira umubiri imbaraga zihariye. Uturemangingo twa T twahinduwe dufite icyuma cyihariye cyitwa chimeric antigen receptor (CAR) kibafasha kumenya no kwifatanya na poroteyine yitwa CD19 iboneka ku turemangingo tumwe na tumwe twa kanseri. Iyo utwo turemangingo twongerewe imbaraga dusubiye mu mubiri wawe, turashobora kwiyongera no gutangiza igitero gikomeye kurwanya kanseri.

Ubu buvuzi bukorerwa umuntu ku giti cye, bigatuma buba uburyo bwihariye bwo kuvura kanseri. Inzira yose, kuva mu gukusanya uturemangingo kugeza ku gutera imitsi, mubisanzwe bifata ibyumweru byinshi kandi bisaba kuvurirwa mu bigo by'ubuvuzi byihariye bifite ubuhanga muri CAR-T cell therapy.

Axicabtagene Ciloleucel ikoreshwa mu kuvura iki?

Axicabtagene ciloleucel yemejwe by'umwihariko kuvura ubwoko runaka bwa kanseri z'amaraso zagarutse nyuma yo kuvurwa cyangwa zititabiriye imiti isanzwe. Indwara nyamukuru ivura zirimo diffuse large B-cell lymphoma, primary mediastinal large B-cell lymphoma, na high-grade B-cell lymphoma.

Ubu buvuzi bukoreshwa kandi ku barwayi bakuru bafite relapsed cyangwa refractory follicular lymphoma bagerageje nibura ubundi buvuzi bubiri bwo mu mubiri. Byongeye kandi, bushobora kuvura ubwoko runaka bwa kanseri ya acute lymphoblastic leukemia mu rubyiruko n'abana iyo ubundi buvuzi butagize icyo butanga cyangwa kanseri yagarutse.

Muganga wawe akenshi azagusaba ubu buvuzi iyo imiti isanzwe ya chemotherapy, radiyo, cyangwa ubundi buvuzi bwihariye butagize icyo butanga. Bifatwa nk'uburyo bwo kuvura abarwayi bafite ubuzima bwiza buhagije bwo kunyura muri ubu buryo bukomeye kandi bujuje ibisabwa by'ubuvuzi.

Axicabtagene Ciloleucel ikora ite?

Axicabtagene ciloleucel ikora ihindura urwego rw'ubwirinzi bwawe rukaba imashini ikora neza kurwanya kanseri. Ubu buryo butangira iyo abaganga bakusanyije uturemangingo twawe twa T binyuze mu buryo bwiswe leukapheresis, busa no gutanga amaraso ariko bifata igihe kirekire kuko bitandukanya uturemangingo twihariye mu maraso yawe.

Muri laboratori, abahanga bahindura genetike izi ngirangingo za T bongeramo reseptori idasanzwe ikora nka sisitemu ya GPS yo gushaka uturemangingo twa kanseri. Iyi reseptori, yitwa CAR, yateguwe kugira ngo imenye kandi ifate proteyine ya CD19 yicaye ku gice cyo hejuru cy'uturemangingo runaka twa kanseri. Iyo zimaze guhindurwa, izi ngirangingo zirakura kandi zigahindurwa nyinshi muri laboratori mu byumweru byinshi.

Iyo uture twa T twongerewe imbaraga twiteguye, dusubizwa mu maraso yawe dukoresheje urushinge rwa IV. Utu ture tw'umubiri twongerewe imbaraga noneho tuzenguruka mu mubiri wawe wose, dushakisha no kurimbura uture twa kanseri twerekana poroteyine ya CD19. Uture twahinduwe kandi dushobora kwiyongera imbere mu mubiri wawe, bigatuma habaho uburyo bwo kurwanya kanseri burambye.

Ibi bifatwa nk'ubuvuzi bukomeye kandi bugamije, kuko bugaba ibitero byihariye ku ture twa kanseri mugihe rusanzwe rurekerana n'uture tw'umubiri twiza. Ariko, imbaraga z'ubwo buryo bwo kurwanya indwara zisaba gukurikiranwa no gucungwa neza n'amakipe y'abaganga b'inzobere.

Nkwiriye Gufata Nte Axicabtagene Ciloleucel?

Axicabtagene ciloleucel si ikintu ufata mu rugo nk'umuti usanzwe. Ahubwo, uzayihabwa nk'urushinge rumwe rwa intravenous mu kigo cy'ubuvuzi cyihariye cyemerewe gutanga ubuvuzi bwa CAR-T cell.

Mbere yo guhabwa urushinge, uzanyura mu buryo bwo kwitegura busanzwe bukubiyemo imiti ya kanseri kugirango umubiri wawe witegurwe uture twa T twahinduwe. Ubu buvuzi bwo kwitegura busanzwe bubaho iminsi mike mbere y'itariki yawe yagenwe yo guterwa urushinge. Uzaba ukeneye kuguma hafi y'ikigo cy'ubuvuzi byibuze mu byumweru bine nyuma yo guhabwa ubuvuzi kugirango ukurikirane hafi.

Uburyo nyabwo bwo guterwa urushinge burihuta, akenshi bifata iminota 30 kugeza ku isaha. Ariko, uzakurikiranwa hafi mbere, mugihe, na nyuma y'inzira. Ikipe yawe y'abaganga izareba ibyabaho ako kanya kandi irebe niba urimo gusubiza neza ku buvuzi.

Ntabwo uzaba ukeneye gufata imiti yihariye hamwe n'ibiryo cyangwa kwirinda ibinyobwa bimwe na bimwe, kuko ibi bitangwa mu maraso yawe n'abakozi b'ubuzima. Ikipe yawe y'ubuvuzi izatanga amabwiriza yihariye yerekeye icyo witegura n'imyiteguro yose ukeneye gukora.

Nkwiriye Gufata Axicabtagene Ciloleucel Igihe Kingana Gite?

Axicabtagene ciloleucel itangwa nk'urushinge rumwe, rimwe rukora, bityo ntuyifata buri gihe nk'izindi miti. Iyo uturemangingo twa T twahinduwe dutewe mu mubiri wawe, bigenewe gukomeza gukora no kwiyongera ku giti cyabyo kugira ngo birwanye kanseri.

Ingaruka z'ubu buvuzi zirashobora kumara amezi cyangwa imyaka, kuko uturemangingo twa T twongerewe imbaraga dushobora gukomeza kubaho mu mubiri wawe no gutanga ubugenzuzi burambye bwa kanseri. Abarwayi bamwe bamaze imyaka myinshi baruhutse kanseri nyuma yo guhabwa ubuvuzi bumwe gusa, nubwo ibisubizo ku muntu ku giti cye bitandukanye.

Nubwo utazabona doze zindi z'ubuvuzi ubwabwo, uzakenera gahunda zisanzwe zo kugukurikiranira hafi kugira ngo ukurikirane uko witwara kandi urebe niba hari izindi ngaruka zatewe n'ubuvuzi. Itsinda ryawe ry'abaganga rizakurikirana iterambere ryawe binyuze mu bipimo by'amaraso, ibizamini by'amashusho, n'ibizamini by'umubiri mu mezi n'imyaka iri imbere.

Niba kanseri igarutse cyangwa ntiyitware neza ku buvuzi bwa mbere, muganga wawe ashobora kuganira ku zindi nzira z'ubuvuzi. Mu bihe bimwe na bimwe, abarwayi bashobora kwemererwa ubuvuzi bwongereweho bwa CAR-T cyangwa ubundi buvuzi bushya, ariko ibi biterwa n'imimerere y'umuntu ku giti cye n'ibintu by'ubuvuzi.

Ni izihe ngaruka ziterwa na Axicabtagene Ciloleucel?

Axicabtagene ciloleucel ishobora gutera ingaruka zikomeye kuko itera igisubizo gikomeye cyane cy'umubiri. Ingaruka zisanzwe kandi zishobora kuba zikomeye ni syndrome yo kurekura cytokine n'ibibazo by'imitsi, niyo mpamvu uzakenera gukurikiranwa hafi mu kigo cy'ubuvuzi cyihariye.

Kumenya izi ngaruka zishobora guterwa birashobora kugufasha kumenya icyo witegura n'igihe cyo gushaka ubufasha bw'ubuvuzi bwihuse. Itsinda ryawe ry'ubuzima rizakurikirana hafi kandi rifite imiti ihari yo gukemura izi ngaruka zirambye ziragabanuka.

Ingaruka zikunze kugaragara zirimo:

• Icyitera cya cytokine, gitera umuriro, guhinda umushyitsi, kugorwa no guhumeka, no kugabanuka k'umuvuduko w'amaraso
• Ingaruka zo mu bwonko nk'urujijo, kugorwa kuvuga, gufatwa n'ibihungabanyo, cyangwa impinduka mu bwenge
• Umubare muto w'uturemangingo tw'amaraso twera, bikongera ibyago byo kwandura indwara
• Umubare muto w'uturemangingo tw'amaraso dutukura, bituma gukomereka cyangwa kuva amaraso byoroha
• Kunanirwa no gucika intege
• Isesemi no kugabanuka k'ipfa ry'ibiryo
• Umutwe no kuribwa kw'imitsi

Ingaruka zikomeye ariko zitagaragara cyane zirimo kwandura indwara zikomeye, ibibazo by'umutima, no kugabanuka kw'uturemangingo tw'amaraso igihe kirekire. Abantu bamwe barwara indwara ya tumor lysis syndrome, aho uturemangingo twa kanseri dusenyuka vuba na vuba maze tugasohora ibintu bishobora kugira ingaruka ku mikorere y'impyiko.

Ingaruka zirambye ziracyigwa, ariko abantu bamwe bashobora kugira urwego ruto rw'uturemangingo tumwe na tumwe tw'umubiri dukingira, bishobora kugira ingaruka ku bushobozi bwabo bwo kurwanya indwara. Itsinda ryawe ry'abaganga rizakurikirana imikorere y'umubiri wawe wikingira kandi rishobora kugusaba imiti yo gukumira nka immunoglobulin replacement therapy niba bibaye ngombwa.

Ingaruka zo mu bwonko zidakunze kubaho ariko zikomeye zirimo kubyimba kw'ubwonko, gufatwa n'ibihungabanyo, cyangwa impinduka mu miterere y'ubwenge bishobora gusaba ubuvuzi bukomeye. Izi ngaruka nizo zituma ibigo bivura bifite uburyo bwihariye n'amakipe afite ubunararibonye bwo gukemura ibibazo vuba kandi neza.

Ninde utagomba gufata Axicabtagene Ciloleucel?

Axicabtagene ciloleucel ntabwo ikwiriye kuri buri wese, kandi itsinda ryawe ry'abaganga rizagenzura neza niba uri umukandida mwiza kuri ubu buvuzi. Abantu banduye indwara zikomeye zitavurwa cyangwa bafite ibibazo bikomeye by'umutima, ibihaha, cyangwa umwijima ntibashobora kwemererwa ubu buvuzi.

Ntabwo ushobora kuba umukandida niba ufite indwara ikora yo hagati mu mutwe, indwara zimwe na zimwe ziterwa n'umubiri wikingira, cyangwa niba ufata imiti ikumira umubiri wawe wikingira. Abagore batwite cyangwa bonka ntibagomba guhabwa ubu buvuzi, kuko byangiza umwana ukiri mu nda.

Ubuzima bwawe muri rusange bugira uruhare runini mu kumenya niba wemerewe. Abantu bafite intege nke cyane cyangwa bafite indwara nyinshi zikomeye ntibashobora kwihanganira gukurikiranwa cyane n'ingaruka zishobora kubaho. Muganga wawe azasuzuma uko ubuzima bwawe buhagaze n'ubuzima bwawe muri rusange kugira ngo uvuzwe.

Imyaka y'amavuko yonyine ntigomba kuba imbogamizi, ariko abantu bakuze bashobora guhura n'ibibazo byinshi kandi bagomba gusuzumwa neza. Itsinda ryawe ry'abaganga rizasuzuma uko ubuzima bwawe buhagaze, harimo n'imiterere ya kanseri yawe, imiti wahawe mbere, n'ibintu by'ubuzima bwawe bwite mugihe cyo kumenya niba ubu buvuzi bukugirira akamaro.

Izina ry'urugero rya Axicabtagene Ciloleucel

Axicabtagene ciloleucel igurishwa ku izina ry'urugero rya Yescarta. Iri zina ry'urugero rikoreshwa n'abaganga n'abanditsi b'ubuvuzi mugihe bavuga kuri ubu buvuzi bwihariye bwa CAR-T cell.

Yescarta ikorwa na Kite Pharma, ikaba ari igice cya Gilead Sciences. Uyu muti uboneka gusa binyuze mu bigo byihariye byavuzweho ko bishobora gutanga imiti ya CAR-T cell neza kandi neza.

Mugihe uvugana n'ikipe yawe y'ubuzima kubijyanye n'uburyo bwo kuvurwa, bashobora kubivuga bakoresheje izina iryo ariryo ryose. Yescarta na axicabtagene ciloleucel byombi bivuga ku buvuzi bumwe bwihariye bwa kanseri bukoresha imitsi yawe y'umubiri yahinduwe kugirango irwanye kanseri.

Uburyo bwo gusimbuza Axicabtagene Ciloleucel

Ubwoko butandukanye bw'imiti ya CAR-T cell buraboneka nk'uburyo bwo gusimbuza axicabtagene ciloleucel, bitewe n'ubwoko bwa kanseri yawe n'ubuzima bwawe. Tisagenlecleucel (Kymriah) ni ubundi buryo bwa CAR-T cell bugamije kanseri ya CD19-positive kandi bushobora kuba uburyo bwo gufasha abarwayi bamwe.

Lisocabtagene maraleucel (Breyanzi) ni uburyo bushya bwo kuvura bwa CAR-T cell bwemerejwe kandi kubera kanseri zimwe na zimwe, kandi bushobora kuzitwa hashingiwe ku miterere yawe bwite. Ubu buryo bwose bufite uburyo butandukanye bwo gukora kandi bushobora kugira ingaruka zitandukanye.

Usibye uburyo bwo kuvura bwa CAR-T cell, izindi nzira zo kuvura zirimo imiti gakondo ya chemotherapy, imiti igamije, cyangwa ibizamini byo mu bitaro byiga ku buryo bushya. Kwimura uturemangingo tw'umubiri bishobora kuzitwa ku barwayi bamwe, nubwo ibi biterwa n'ibintu byinshi birimo imyaka yawe, ubuzima muri rusange, n'imiterere ya kanseri.

Umuvuzi wawe w'indwara z'umubiri azaganira ku buryo bukwiye cyane imiterere yawe bwite, yitegereza ibintu nk'ubwoko bwa kanseri yawe, ubuvuzi bwakozwe mbere, ubuzima muri rusange, n'ibyo ukunda. Icyemezo gikunze gufata urugero rwo gushyira mu gaciro inyungu zishoboka n'ibibazo n'ingaruka ziterwa.

Ese Axicabtagene Ciloleucel iruta Tisagenlecleucel?

Byombi axicabtagene ciloleucel na tisagenlecleucel ni uburyo bwiza bwo kuvura bwa CAR-T cell bugamije kanseri ya CD19-positive, ariko bifite itandukaniro rito mu gukora no gukoreshwa kwemerejwe. Kugereranya mu buryo butaziguye biragoye kuko byigiwe mu matsinda y'abarwayi batandukanye no mu bizamini byo mu bitaro.

Axicabtagene ciloleucel yemerejwe kubera kanseri zimwe na zimwe kandi yerekanye urwego rwo gusubiza rwo hejuru mu bizamini byo mu bitaro. Tisagenlecleucel yemerejwe kubera kanseri zimwe na zimwe n'ubwoko bumwe bwa leukemia, bituma igira urwego rwagutse rwo gukoreshwa kwemerejwe. Guhitamo hagati yabyo bikunze guterwa n'ubwoko bwa kanseri yawe bwite n'ibintu by'ubuvuzi bwite.

Uburyo bwo gukora buratandukanye gato, bishobora kugira ingaruka ku buryo ubuvuzi bwawe bushobora gutegurwa no gutangwa vuba. Ubuvuzi bwombi bufite ubwoko bumwe bw'ingaruka, harimo syndrome yo kurekura cytokine n'ingaruka za neurologique, nubwo kenshi n'uburemere bishobora gutandukana hagati y'abantu.

Itsinda ryawe ry’abaganga rizagusaba uburyo bukwiye cyane bushingiye ku cyemezo cyawe cyihariye, imiti wakoresheje mbere, ubuzima bwawe muri rusange, n'uko buri buvuzi buboneka mu kigo cyawe kivura. Byombi bigaragaza iterambere rikomeye mu kuvura kanseri kandi byafashije abarwayi benshi kugera ku gukira.

Ibibazo Bikunze Kubazwa Kuri Axicabtagene Ciloleucel

Ese Axicabtagene Ciloleucel irakwiriye ku bantu barwaye indwara z'umutima?

Axicabtagene ciloleucel isaba isuzuma ryitondewe ku bantu barwaye indwara z'umutima kuko ubu buvuzi bushobora gutera ingaruka ku mutima. Uburwayi bwo kurekura cytokine rimwe na rimwe bubaho bushobora kugira ingaruka ku mikorere y'umutima, gutera umuvuduko muke w'amaraso, umuvuduko w'umutima wihuse, cyangwa izindi ngorane z'umutima.

Umuvuzi w'umutima wawe n'umuganga w'indwara ya kanseri bazakorana kugira ngo basuzume niba indwara yawe y'umutima ihagaze neza ku buryo yakira ubu buvuzi. Bazatekereza ibintu nk'imikorere y'umutima wawe, imiti ukoresha ubu, n'ubuzima bwawe bw'imitsi y'umutima muri rusange. Abarwayi bamwe bafite indwara z'umutima zigenzurwa neza barashobora kuba bakwiriye hamwe no gukurikiranwa neza no kwitabwaho.

Niba wakira ubu buvuzi ufite indwara y'umutima, uzakenera gukurikiranwa cyane kw'umutima mugihe cyo gutera no nyuma y'urushinge. Itsinda ryawe ry'abaganga rizagira gahunda zo gucunga ingorane z'imitsi y'umutima zishobora kuvuka mugihe cyo kuvurwa.

Nkwiriye gukora iki niba mbonye ku buryo butunganye Axicabtagene Ciloleucel nyinshi cyane?

Gukoresha doze nyinshi ya axicabtagene ciloleucel birashoboka cyane kuko itegurwa byihariye kuri buri murwayi kandi itangwa n'abantu b'inzobere mu by'ubuvuzi mu kigo cy'ibitaro kigenzurwa. Urutonde rurabarwa neza hashingiwe ku gipimo cy'umubiri wawe n'imibare y'uturemangingo, kandi urushinge rukurikiranwa hafi n'abakozi b'ubuzima babihuguriwe.

Niba hariho ikosa ryo gutanga imiti, ibimenyetso bishobora kuba bisa n'ingaruka zisanzwe ariko bikaba bikomeye cyane. Ibi bishobora kuba birimo indwara ikomeye yo kurekura cytokine, ingaruka zikomeye zo mu bwonko, cyangwa kugabanuka cyane kw'imibare y'amaraso.

Kubera ko wakira ubu buvuzi mu kigo cy'ubuvuzi cyihariye gifite gukurikiranwa buri gihe, ibibazo byose byahita bimenyekana kandi bigafatwa n'ikipe yawe y'abaganga. Bafite uburyo n'imiti ihari yo gucunga ibibazo bikomeye no gutanga ubufasha nk'uko bikwiye.

Nkwiriye gukora iki niba nciwe urugero rwa Axicabtagene Ciloleucel?

Gucikwa urugero rwa axicabtagene ciloleucel ntibisanzwe kuba ikibazo kuko bitangwa nk'urugero rumwe, rimwe gusa mu bitaro. Ubu buvuzi butegurwa neza, kandi uzakirwa mu kigo cy'ubuvuzi cyane cyane kubera iki gikorwa.

Niba hari impamvu urugero rwawe ruteganyijwe rugomba gusubikwa kubera uburwayi, indwara, cyangwa izindi mpamvu z'ubuvuzi, ikipe yawe y'ubuzima izongera kuruteganya igihe uzaba umeze neza mu buvuzi. Igihe kiroroshye igihe gusa utugingo twawe twateguwe tugihumeka, nubwo hariho imipaka y'igihe utugingo twahinduwe dushobora kubikwa.

Ikipe yawe y'ubuvuzi izavugana nawe ku bijyanye n'impinduka zose z'igihe kandi izemeza ko wakira ubuvuzi bwawe mu gihe gikwiye cyane ku buzima bwawe n'umutekano wawe. Bazanakurikirana uko umeze mugihe utegereje urugero rwasubitswe.

Nshobora guhagarika ryari gufata Axicabtagene Ciloleucel?

Ntabwo ukeneye guhagarika gufata axicabtagene ciloleucel kuko bitangwa nk'urugero rumwe, ntabwo ari nk'umuti ukomeza. Igihe utugingo twahinduwe twa T twinjijwe mu mubiri wawe, bakomeza gukora ku giti cyabo kurwanya utugingo twa kanseri.

Ingaruka z'ubuvuzi zirashobora kumara amezi cyangwa imyaka, kuko uturemangingo twa T twongerewe imbaraga dushobora gukomeza no kwiyongera mu mubiri wawe. Ntabwo uzakeneye gufata imiti ya buri munsi ijyanye n'uturemangingo twa CAR-T ubwabo, nubwo ushobora gukenera indi miti ifasha cyangwa ubuvuzi.

Ubuvuzi bwawe bukurikira buzagamije gukurikirana uko witwara ku buvuzi no gucunga izindi ngaruka zikomeje. Itsinda ryawe ry'abaganga rizakurikirana iterambere ryawe binyuze mu biganiro bisanzwe, ibizamini by'amaraso, n'ubushakashatsi bwo gushushanya kugirango barebe neza niba ubuvuzi bukora neza no kureba niba hari ibibazo byateyeho.

Nshobora Kugenda Nyuma yo Kwakira Axicabtagene Ciloleucel?

Urugendo rurabujijwe byibuze mu byumweru bine nyuma yo kwakira axicabtagene ciloleucel kuko ugomba kuguma hafi y'ikigo cy'ubuvuzi kugirango ukurikirane hafi. Iki gihe ni ingenzi mu kureba ingaruka zikomeye nk'indwara yo kurekura cytokine cyangwa ibibazo by'imitsi bikenera ubufasha bwihuse bw'ubuvuzi.

Nyuma y'igihe cyo gukurikirana, ubushobozi bwawe bwo kugenda buzaterwa n'ukuntu wivugurura n'isuzuma ry'abaganga bawe ku buzima bwawe. Uzaba ukeneye kuba ufite ubuzima bwiza bw'ubuzima hamwe n'imibare myiza y'amaraso kandi nta bibazo bikomeje mbere yo kwemererwa kugenda.

Igihe uzagenda nyuma, ni ngombwa gutwara amakuru yerekeye ubuvuzi bwawe kandi ukagira uburyo bwo kubona ubuvuzi bumenya ubuvuzi bwa CAR-T cell. Itsinda ryawe ry'abaganga rishobora kuguha ishusho y'ubuvuzi n'amakuru yo guhamagara mu gihe cyihutirwa yo gusangira n'abatanga ubuvuzi niba bibaye ngombwa mugihe ugenda.