Icyo Azacitidine ari cyo: Ibyo ikoreshwa, urugero rwo kuyifata, ingaruka zayo n'ibindi

Azacitidine ni umuti uvura kanseri ufasha kuvura kanseri zimwe na zimwe zifata amaraso ukora ku rwego rw'imiterere ya za gene kugira ngo wongere usubizeho imikorere isanzwe y'uturemangingo. Ni icyo abaganga bita "hypomethylating agent," bivuze ko ifasha kongera gukoresha za gene uturemangingo twa kanseri twahagaritse gukoresha, bigatuma umubiri wawe urwanya indwara neza.

Uyu muti wazaniye icyizere abarwayi benshi bafite kanseri zifata amaraso mbere bari bafite uburyo buke bwo kuvurwa. Nubwo bisaba gukurikiranwa neza kandi bikagira ingaruka zazo, azacitidine yafashije kongera ubuzima no guteza imbere imibereho y'ibihumbi by'abantu ku isi hose.

Azacitidine ni iki?

Azacitidine ni verisiyo ya gihanga y'igice cy'ibanze gisanzwe cya DNA cyitwa cytidine. Ikora igihe yinjijwe muri DNA na RNA yawe, hanyuma igahagarika enzyme yitwa DNA methyltransferase uturemangingo twa kanseri dukoresha kugira ngo ducecekeshe za gene z'ingenzi.

Bitekereze nk'urufunguzo rwa molekile rufungura za gene umubiri wawe ukeneye kurwanya kanseri. Iyo uturemangingo twa kanseri twiyongera, akenshi "bihagarika" za gene zari gusanzwe zihagarika imikurire yazo cyangwa zigatuma uturemangingo dupfa. Azacitidine ifasha kongera gukoresha izi gene zirengera, igaha umubiri wawe ubudahangarwa amahirwe meza yo kumenya no kurwanya uturemangingo twa kanseri.

Uyu muti ubarirwa mu cyiciro cyitwa antimetabolites, bivuze ko ivanga n'imikorere y'uturemangingo twa kanseri no gukorwa kwa DNA. Bitandukanye n'imiti ya chemotherapy igira uburozi ku turemangingo twa kanseri, azacitidine ikora mu buryo butaziguye bwo kongera gukoresha uturemangingo twa kanseri.

Azacitidine ikoreshwa mu kuvura iki?

Azacitidine ikoreshwa cyane cyane mu kuvura myelodysplastic syndromes (MDS), itsinda rya kanseri zifata amaraso aho umushongi wawe w'amagufa udakora neza uturemangingo tw'amaraso twiza. Yemerejwe kandi gukoreshwa mu kuvura ubwoko bumwe na bumwe bwa acute myeloid leukemia (AML) ku barwayi batemerewe gukoresha chemotherapy ikomeye.

Muganga wawe ashobora kugusaba gukoresha azacitidine niba ufite ubwoko bwa MDS burimo anemia idakira, anemia idakira hamwe na ringed sideroblasts, cyangwa anemia idakira hamwe na blasts nyinshi. Ibi bibazo bituma umushongi wawe ukora uturemangingo tw'amaraso tudasanzwe tudakora neza, bigatuma anemia, kwiyongera kw'ibibazo by'indwara, n'ibibazo by'amaraso.

Uyu muti rimwe na rimwe ukoreshwa kuri chronic myelomonocytic leukemia (CMML), ubundi bwoko bwa kanseri y'amaraso igira ingaruka ku turemangingo twera tw'amaraso. Mu bihe bimwe na bimwe, abaganga bashobora kubitekerezaho kuri izindi kanseri z'amaraso iyo imiti isanzwe idakwiriye cyangwa itagize icyo ikora.

Gake cyane, azacitidine ishobora gukoreshwa hanze y'icyapa kuri tumwe mu dukenyeri dukomeye iyo izindi miti yananiwe, nubwo ibi bisaba kwitonderwa n'ikipe yawe ya oncology.

Azacitidine ikora ite?

Azacitidine ikora ihungabanya DNA methylation, uburyo uturemangingo twa kanseri dukoresha kugirango ducecekeshe imirasire isanzwe yirinda gukura kwa tumor. Iyo wakiriye urukingo, umuti ugenda mu maraso yawe ukagera muri DNA y'uturemangingo twihuta, harimo uturemangingo twa kanseri.

Iyo imbere muri DNA, azacitidine ifata kandi igatuma enzyme DNA methyltransferase igabanuka, uturemangingo twa kanseri twishingikiriza kugirango dukomeze imirasire ya tumor suppressor izimye. Ibi bituma imirasire y'ingenzi nka p16 na p15 yongera gukora, bifasha gusubiza isanzwe kugenzura umuzunguruko w'uturemangingo no gutera urupfu rw'uturemangingo twa kanseri.

Uyu muti kandi ugira ingaruka kuri RNA, uhungabanya umusaruro wa poroteyine mu turemangingo twa kanseri. Iki gikorwa cyombi kuri DNA na RNA gituma azacitidine ikora neza cyane kurwanya kanseri z'amaraso zamaze kwanga izindi miti.

Azacitidine ifatwa nk'umuti wa kanseri ukomeye. Ntabwo ari nk'imiti ikomeye ya chemotherapy, ariko irakomeye kuruta imiti ya hormone cyangwa imiti yagenewe. Abantu benshi barayihanganira neza kuruta chemotherapy ya gakondo mugihe bagihura n'ibisubizo bifatika.

Nkwiriye Gufata Ate Azacitidine?

Azacitidine itangwa nk'urushinge munsi y'uruhu rwawe (subcutaneous) cyangwa mu urukururuku (intravenous), akenshi bikorerwa mu biro bya muganga cyangwa ikigo cyita ku barwayi ba kanseri. Ntushobora gufata uyu muti unywa mu kanwa, kuko ugomba gutangwa n'abakozi b'ubuzima babihuguriwe.

Gahunda isanzwe irimo guhabwa inshinge iminsi irindwi ikurikirana, igakurikirwa n'ikiruhuko cy'ibyumweru bitatu. Iyi gahunda y'iminsi 28 irasubirwamo, nubwo muganga wawe ashobora guhindura igihe bitewe n'uko umubiri wawe witwara n'imibare y'amaraso yawe.

Mbere yo gutera urushinge rwose, ikipe yawe y'ubuzima izagenzura imibare y'amaraso yawe n'ubuzima bwawe muri rusange. Ntabwo ukeneye kwiyiriza mbere yo kuvurwa, ariko kurya ifunguro rito mbere bishobora gufasha kwirinda isesemi. Kunywa amazi menshi mu minsi yo kuvurwa bifasha impyiko zawe gutunganya imiti neza.

Aho batera urushinge rwawe ruzahindurwa kugirango birinde kurakara, akenshi bahinduranya hagati y'ibibero byawe, inda, n'amaboko yawe yo hejuru. Uru rushinge ubwarwo rufata iminota mike, nubwo ushobora gukenera kuguma kugirango ukurikiranwe, cyane cyane mugihe uvurwa bwa mbere.

Nkwiriye Gufata Azacitidine Igihe Kingana Gite?

Abantu benshi barwara bakomeza gufata azacitidine nibura mu byiciro bine kugeza kuri bitandatu (nka amezi 4-6) mbere yuko abaganga bashobora gusuzuma neza niba ikora. Abantu benshi bitwara neza ku muti bakomeza kuvurwa igihe kirekire, rimwe na rimwe imyaka myinshi, igihe cyose babyihanganira neza kandi bigenzura kanseri yabo.

Muganga wawe azagenzura imibare y'amaraso yawe n'ubuzima bwawe muri rusange buri byumweru bike kugirango amenye niba umuti ufasha. Abantu bamwe babona impinduka mumashuri make ya mbere, mugihe abandi bashobora gukenera igihe kirekire kugirango bagaragaze inyungu. Intego ni ukubona uburyo bukwiye bwo kugenzura kanseri yawe no gukomeza ubuzima bwawe bwiza.

Niba ubona ibimenyetso bikomeye byo ku ruhande cyangwa kanseri yawe ikomeje kwiyongera nubwo uvurwa, muganga wawe ashobora guhindura urugero rw'umuti, guhindura gahunda, cyangwa guhindurira ku wundi muti. Umwanzuro wo gukomeza cyangwa guhagarika azacitidine biterwa n'uburyo umubiri wawe ubyakira n'uburyo urimo gucunga ibimenyetso byose byo ku ruhande.

Bitandukanye n'ubundi buvuzi bwa kanseri butangwa mu gihe gito gihamye, azacitidine akenshi ikomeza gutangwa igihe cyose itanga inyungu itateje ibimenyetso bitakwemerwa byo ku ruhande. Itsinda ryawe rishinzwe kuvura kanseri rizakorana nawe kugirango rimenye uburyo bwiza bwo guhangana n'ikibazo cyawe.

Ni Ibihe Bimenyetso Bigaragara Byo Ku Ruhande Byatewe na Azacitidine?

Azacitidine ishobora gutera ibimenyetso byo ku ruhande kuko igira ingaruka ku turemangingo twa kanseri ndetse no ku turemangingo duke tw'umubiri muzima twihuta. Ibimenyetso byinshi byo ku ruhande birashobora gucungwa neza hakoreshejwe uburyo bwo gukurikirana neza no gutanga ubufasha, kandi abarwayi benshi basanga bashobora kugira ubuzima bwiza mu gihe bakira ubuvuzi.

Ibimenyetso byo ku ruhande ushobora guhura nabyo cyane harimo umunaniro, isesemi, n'ibimenyetso byo ku ruhu aho umuti utererwa nko gutukura cyangwa kubyimba. Ibi bikunda kugaragara mu minsi mike ya mbere ya buri cyiciro kandi akenshi bigenda bikemuka uko umubiri wawe wimenyereza umuti.

Dore ibimenyetso byo ku ruhande ushobora guhura nabyo cyane, byateguwe kuva ku byinshi kugeza ku bike:

• Umunaniro n'intege nke, bigira ingaruka ku bagera kuri 80% b'abarwayi
• Isesemi no kuruka, akenshi byoroheje kugeza ku birenze urugero
• Ibimenyetso byo ku ruhu aho umuti utererwa nko gutukura, kubyimba, cyangwa gukomeretsa
• Umubare muto w'amaraso (anemiya, umubare muto w'uturemangingo twera tw'amaraso, umubare muto wa plasima)
• Impiswi cyangwa guhagarara k'amara
• Igabanyuka ry'irari ryo kurya
• Urubore, cyane cyane mu byiciro bya mbere
• Urubavu cyangwa kubabara mu ngingo
• Urugero cyangwa kubabara umutwe
• Kugufiwa umwuka

Itsinda ry'ubuvuzi ryawe rizagukurikiranira hafi ibi byose, kandi rishobora gutanga imiti cyangwa ingamba zo kugufasha kubicunga. Abantu benshi barasanga ingaruka ziterwa n'imiti zigaragara cyane mu byiciro bya mbere, kandi akenshi zikagenda zicungwa neza uko igihe kigenda.

Ingaruka zikomeye ariko zitagaragara cyane zisaba ubufasha bwihutirwa bw'abaganga. Ibi birimo ibimenyetso byo kwandura bikomeye (umuriro mwinshi, guhinda umushyitsi, umunaniro ukabije), kuva amaraso cyangwa gukomeretsa bidasanzwe, isesemi ikabije ikubuza kunywa amazi, cyangwa guhumeka bigoye.

Gake, abarwayi bamwe bashobora guhura n'ibibazo bikomeye nk'umwuka mubi, ibibazo bikomeye byo ku ruhu, cyangwa ibibazo by'impyiko. Muganga wawe azaganira kuri ibi bishoboka nawe, akagusobanurira ibimenyetso byo kwitondera hagati y'imiti.

Ninde utagomba gufata Azacitidine?

Azacitidine ntabwo ikwiriye kuri buri wese, kandi muganga wawe azasuzuma neza niba ari umutekano kuri wowe bitewe n'ubuzima bwawe muri rusange n'amateka yawe y'ubuvuzi. Uyu muti usaba umubiri wawe kugira ububiko buhagije bwo guhangana n'ingaruka zawo ku mikorere y'uturemangingo tw'amaraso.

Ntugomba guhabwa azacitidine niba ufite allergie kuri yo cyangwa mannitol (ikintu gikoreshwa mu nshinge). Muganga wawe azitonda cyane niba ufite indwara ikomeye y'umwijima, kuko ibi bishobora kugira ingaruka ku buryo umubiri wawe ukoresha uyu muti.

Ibyiciro bimwe na bimwe bisaba kwitonda cyane no gukurikiranwa hafi, nubwo bitagutera guhita uva mu kuvurwa:

• Indwara ikomeye y'impyiko cyangwa kwishingikiriza kuri dialysis
• Udukoko dukora, tutagenzurwa
• Indwara ikomeye y'umutima cyangwa umutima wa vuba
• Umubare muto cyane w'amaraso utagira icyo uhindura n'ubufasha
• Gusama cyangwa konsa
• Kubagwa bikomeye vuba cyangwa gukira ibikomere
• Izindi kanseri zikora zisaba kuvurwa

Muganga wawe azagereranya ibyo bintu n'inyungu zishobora kuzanwa n'imiti. Mu bihe bimwe na bimwe, gukemura ibyo bibazo mbere cyangwa gutanga ubufasha bwiyongera birashobora gutuma azacitidine iba uburyo bwiza.

Niba uteganya gutwita cyangwa kubyara umwana, ganira na muganga wawe mbere yo gutangira kuvurwa. Azacitidine irashobora gukomeretsa abana bakiri bato, kandi abagabo n'abagore bagomba gukoresha uburyo bwo kuboneza urubyaro neza mugihe bavurwa no mumyaka mike nyuma yaho.

Amazina y'Ubwoko bwa Azacitidine

Azacitidine iboneka munsi y'izina ry'ubwoko rya Vidaza, rikaba ari ryo rimenyerewe cyane rya uyu muti. Vidaza iza nk'ifu ivangwa n'amazi atagira mikorobe mbere yo guterwa, kandi iboneka muburyo bwo guterwa munsi y'uruhu no mu maraso.

Ubwoko bushya bwo kunywa bwa Onureg (ibipimo bya azacitidine) buraboneka kandi kubarwayi bamwe na bamwe bujuje ibisabwa byo kuvurwa nyuma yo kuvurwa mbere. Ubu bwoko bw'ibipimo butuma abarwayi bamwe bakomeza kuvurwa murugo aho kuza kwa muganga guterwa inshinge.

Ubwoko busanzwe bwa azacitidine iterwa nayo iraboneka, ishobora kuba ihendutse mugihe itanga inyungu zimwe zo kuvura. Ubwishingizi bwawe n'ubuvuzi bushobora kugira uruhare muriki gicuruzwa cyangwa ubwoko busanzwe wakira.

Tutitaye kubwoko wakira, ibikoresho bikora n'ubushobozi birakomeza kuba kimwe. Itsinda ryawe ry'ubuvuzi rizagufasha kubona uburyo bukwiye bwo kuvurwa kwawe.

Uburyo bwo gusimbuza Azacitidine

Imiti itandukanye irashobora kuvura kanseri zimwe z'amaraso, nubwo guhitamo biterwa n'uburwayi bwawe bwihariye, ubuzima muri rusange, n'imiti wakoresheje mbere. Muganga wawe azatekereza izi nzira niba azacitidine itakwiriye cyangwa ihagaritse gukora kuri wowe.

Decitabine (Dacogen) ni ikindi kinyabutabuzi gihindura imikorere y'uturemangingo dukora kimwe na azacitidine. Abantu bamwe batitabira umuti umwe bashobora kungukirwa n'undi, nubwo basangiye ingaruka nyinshi ndetse n'uburyo bakora.

Izindi nzira zo kuvura muganga wawe ashobora gutekereza zirimo:

• Venetoclax, akenshi ivanze na azacitidine ku bwoko runaka bwa AML
• Lenalidomide (Revlimid) ku bwoko bwihariye bwa MDS
• Imiti ikomeye ya chemotherapy ku barwayi bakiri bato kandi bafite ubuzima bwiza
• Ubufasha bwo kuvurwa n'iterwa ry'amaraso n'ibintu bikura
• Igeragezwa ry'imiti mishya ikoreshwa mu bushakashatsi
• Guterwa umushongi w'amagufa ku barwayi bemerewe

Uburyo bwiza buterwa n'ibintu nk'imyaka yawe, ubuzima muri rusange, ibimenyetso bya genetike mu turemangingo twa kanseri yawe, n'ibyo ukunda. Itsinda ryawe ryita ku buvuzi bw'indwara z'umubiri rizaganira kuri izi nzira nawe niba azacitidine atari wo muti ukwiriye cyangwa uhagaritse gukora.

Abantu bamwe bashobora guhabwa imiti ivanze irimo azacitidine hamwe n'indi miti, rimwe na rimwe bishobora kugira akamaro kurusha umuti umwe gusa.

Ese Azacitidine iruta Decitabine?

Azacitidine na decitabine ni ibinyabutabuzi bihindura imikorere y'uturemangingo dukora kimwe, ariko bafite itandukaniro rishobora gutuma umwe akwira kurusha undi. Nta numwe uruta undi byemejwe – guhitamo biterwa n'uko ubuzima bwawe bumeze n'uko umubiri wawe witwara.

Azacitidine itangwa mu nshinge iminsi irindwi ikurikirana buri gihembwe, mugihe decitabine akenshi itangwa mu maraso iminsi itatu kugeza kuri itanu. Abantu bamwe bakunda gahunda ya azacitidine kuko inshinge ziterwa munsi y'uruhu zishobora gutangwa vuba mu gihe umuntu ari hanze y'ibitaro.

Ubushakashatsi bwerekana ko azacitidine ishobora kuba ifite akamaro gato ku bwoko bumwe bwa MDS, cyane cyane indwara ifite ibyago byinshi. Ariko, decitabine ishobora gukundwa ku barwayi bagorwa no guterwa inshinge cyangwa bakunda kuyihabwa mu maraso.

Imiterere y'ingaruka ziterwa n'imiti yombi irasa, nubwo abarwayi bamwe babyihanganira kurusha abandi. Muganga wawe azatekereza ku bwoko bwa kanseri ufite, imiti wabanje gufata, n'ibyo ukunda ku giti cyawe mugihe ahitamo hagati yayo.

Ibikunze Kubazwa Kuri Azacitidine

Ese Azacitidine irakwiriye abarwayi bafite indwara y'impyiko?

Azacitidine irashobora gukoreshwa ku barwayi bafite indwara y'impyiko yoroheje cyangwa yo hagati, ariko bisaba gukurikiranwa neza kandi birashoboka ko imiti igomba guhindurwa. Muganga wawe azagenzura imikorere y'impyiko zawe buri gihe akoresheje ibizamini by'amaraso kandi ashobora kugabanya urugero rw'umuti niba impyiko zawe zitagikora neza.

Niba ufite indwara ikomeye y'impyiko cyangwa uri kuri diyarese, muganga wawe azatekereza neza inyungu n'ibibazo. Uyu muti ushobora gukurwaho na diyarese, bityo igihe cyo gufata imiti gishobora gukenera guhuzwa n'igihe cya diyarese yawe.

Nkwiriye gukora iki niba nifashishije azacitidine nyinshi bitunguranye?

Kubera ko azacitidine itangwa n'abakora mu buvuzi ahantu hagenzurwa, gufata umuti mwinshi bitunguranye ntibibaho cyane. Ariko, niba ucyeka ko wakiriye umuti mwinshi cyangwa urimo guhura n'ingaruka zikomeye, vugana n'ikipe yawe y'ubuvuzi ako kanya cyangwa ujye mu cyumba cy'ubutabazi cyegereye.

Ibimenyetso byo gushobora gufata umuti mwinshi birimo isesemi ikabije no kuruka, umunaniro ukabije, umuriro, kuva amaraso bidasanzwe, cyangwa guhumeka bigoranye. Nta muti wihariye wa azacitidine, bityo kuvura bishingiye ku gucunga ibimenyetso no gushyigikira umubiri wawe mu gukira.

Nkwiriye gukora iki niba nciweho urugero rwa azacitidine?

Niba wareretswe guterwa urushinge rwa azacitidine, vugana n'ikipe yawe y'ubuzima ako kanya kugira ngo musubize gahunda. Ntugerageze kwishyura imiti wibagiwe gufata wongera imiti – ibyo bishobora guteza akaga kandi ntibizateza imbere imiti yawe.

Muganga wawe ashobora guhindura gahunda yawe y'imiti cyangwa agahindura uruziga rwawe bitewe n'imiti wibagiwe gufata. Kuguma ku murongo ni ingenzi kugira ngo imiti igire akamaro, bityo gerageza kwitabira gahunda zose zagenwe kandi umenyeshe mbere niba hari ibibazo byo gutegura gahunda.

Nshobora Kureka Gufata Azacitidine Ryari?

Ugomba kureka gufata azacitidine gusa uyobowe na muganga wawe. Bitandukanye n'imiti imwe ifatwa mu gihe giteganijwe, azacitidine akenshi ikomeza gufatwa igihe cyose ifasha kugenzura kanseri yawe kandi uyihanganira neza.

Muganga wawe azajya asuzuma buri gihe niba umuti ukiri ingirakamaro binyuze mu igeragezwa ry'amaraso, kubaga umushubuzi w'amagufa, no gukurikirana ibimenyetso byawe. Niba kanseri yawe ikomeje cyangwa ingaruka zikaba zidakumirwa, muganga wawe azaganira ku miti yindi cyangwa ubufasha.

Nshobora Gukingirwa Ngihe Ndafata Azacitidine?

Ugomba kwirinda inkingo zifite ubuzima mugihe ufata azacitidine kuko umuti ushobora kunaniza ubudahangarwa bwawe. Ibi bikubiyemo inkingo nk'urukingo rw'ibicurane (spray yo mu mazuru), MMR, na varicella (inkombo) inkingo.

Ariko, inkingo zitagira ubuzima nk'urukingo rw'ibicurane, urukingo rwa pneumoniya, n'inkingo za COVID-19 muri rusange ni nziza kandi zirashimwa. Muganga wawe azakugira inama ku nkingo ugomba guhabwa n'igihe cyo kuzihabwa kugira ngo urindwe neza mugihe ugabanya ibyago.