Chii chinonzi Azacitidine: Zvinoshandiswa, Madosi, Mativi eMuviri uye Zvimwe

Azacitidine mushonga wekenza unobatsira kurapa mamwe marudzi ekenza yeropa nekushanda pamwero we genetic kuti idzorere basa retsika retsika. Ndizvo zvinodaidzwa nachiremba kuti "hypomethylating agent," izvo zvinoreva kuti inobatsira kudzima majini ayo maseru ekenza akanyararisa, achibvumira muviri wako kurwisa chirwere ichi zvakanyanya.

Mushonga uyu wakaunza tariro kuvatengi vazhinji vane kenza yeropa avo vakambove vaine sarudzo shoma dzekurapa. Kunyange zvazvo ichida kutarisa zvakanyanya uye ichiuya nemigumisiro yemativi, azacitidine yakabatsira kuwedzera uye kuvandudza hupenyu hwezviuru zvevanhu pasi rose.

Chii chinonzi Azacitidine?

Azacitidine ishanduro yekugadzirwa yechivakwa chechisikigo cheDNA chinonzi cytidine. Inoshanda nekupinzwa muDNA yako neRNA, wobva wadzivisa enzyme inonzi DNA methyltransferase iyo maseru ekenza anoshandisa kunyaradza majini akakosha.

Funga nezvayo sekiyi yemamorekuru inovhura majini anodiwa nemuviri wako kurwisa kenza. Kana maseru ekenza akawanda, anowanzo "kudzima" majini ayo anowanzo kumisa kukura kwavo kana kukonzera rufu rweseru. Azacitidine inobatsira kudzima aya majini ekudzivirira, ichipa immune system yako mukana uri nani wekuziva nekurwisa maseru ekenza.

Mushonga uyu ndewechikamu chinonzi antimetabolites, izvo zvinoreva kuti inokanganisa metabolism yeseru rekenza uye kugadzirwa kweDNA. Kusiyana nemishonga yekemotherapu iyo inouraya maseru ekenza zvakananga, azacitidine inoshanda zvinyoro nyoro nekugadzirisa maitiro anoita maseru ekenza.

Chii chinonzi Azacitidine chinoshandiswa?

Azacitidine inonyanya kushandiswa kurapa myelodysplastic syndromes (MDS), boka rekenza yeropa uko uropi hwako hahugadziri maseru eropa ane hutano zvakanaka. Inobvumirwawo kune mamwe marudzi eacute myeloid leukemia (AML) muvarwere vasiri vakwikwidzi vekemotherapu yakanyanya.

Chiremba wako angakurudzira azacitidine kana uine mhando dzeMDS dzinosanganisira refractory anemia, refractory anemia ine ringed sideroblasts, kana refractory anemia ine excess blasts. Zvinhu izvi zvinoita kuti mupfupa wako ugadzire masero eropa asina kujairika asingashande zvakanaka, zvichikonzera anemia, kuwedzera njodzi yekutapukirwa, uye matambudziko ekubuda ropa.

Mushonga uyu dzimwe nguva unoshandiswa kune chronic myelomonocytic leukemia (CMML), imwe gomarara reropa rinokanganisa masero machena eropa. Mune dzimwe nguva, vanachiremba vanogona kuifunga kune mamwe magomarara eropa apo kurapwa kwakajairika hakuna kukodzera kana kusashanda.

Kazhinji, azacitidine inogona kushandiswa kunze kwechinyorwa chetumors dzakasiyana dzakasimba kana dzimwe nzira dzekurapa dzakundikana, kunyangwe izvi zvichida kufunga zvakanyanya nechikwata chako cheoncology.

Azacitidine Inoshanda Sei?

Azacitidine inoshanda nekukanganisa DNA methylation, maitiro anoshandiswa nemasero egomarara kunyaradza majini ayo anowanzo kudzivirira kukura kwetumor. Paunogamuchira jekiseni, mushonga unofamba nemuropa rako uye unobatwa muDNA yemasero anokurumidza kukamukana, kusanganisira masero egomarara.

Kana uri mukati meDNA, azacitidine inoteya uye inopera enzyme DNA methyltransferase, iyo masero egomarara anovimba nayo kuti arambe achidzima majini ekudzivirira tumor. Izvi zvinobvumira majini akakosha se p16 uye p15 kuti avepo zvakare, achibatsira kudzorera kutonga kwakajairika kwemasero uye kutanga kufa kwemasero egomarara.

Mushonga uyu unokanganisawo RNA, uchikanganisa kugadzirwa kweprotein mumaseru egomarara. Chiito ichi kaviri paDNA neRNA chinoita kuti azacitidine ive inonyanya kushanda pamagomarara eropa ayo ave achidzivirira kune dzimwe nzira dzekurapa.

Azacitidine inoonekwa semushonga wegomarara une simba. Haina kusimba semaitiro echemotherapy yakakwirira-dose, asi ine simba kupfuura hormone therapies kana targeted therapies. Vazhinji varwere vanoishivirira zvirinani kupfuura chemotherapy yechinyakare vachiri kuona mhedzisiro inoreva.

Ndingatora Sei Azacitidine?

Azacitidine inopiwa sejojo pasi peganda rako (subcutaneous) kana mutsinga (intravenous), kazhinji muhofisi yechiremba kana nzvimbo yekurapa kenza yevasingabatwi. Hauzotorwe mushonga uyu nemuromo, sezvo uchida kupihwa nevashandi vehutano vakadzidziswa.

Chirongwa chakajairika chinosanganisira kuwana majojo kwemazuva manomwe akateedzana, achiteverwa nenguva yekuzorora yeanenge mavhiki matatu. Iyi cycle yemazuva makumi maviri nemasere inozodzokororwa, kunyangwe chiremba wako achigona kugadzirisa nguva zvichienderana nekuti muviri wako unopindura sei uye kuverenga kweropa rako.

Pamberi pejojo rega rega, timu yako yehutano ichatarisa kuverenga kweropa rako uye hutano hwako hwese. Haufaniri kutsanya usati wapiwa mushonga, asi kudya chikafu chakareruka pamberi pezvo kunogona kubatsira kudzivirira kusvotwa. Kunwa mvura yakawanda mumazuva ako ekurapa kunobatsira itsvo dzako kugadzirisa mushonga zvakanyanya.

Nzvimbo dzako dzekujojera dzichashandurwa kudzivirira kutsamwa, kazhinji dzichichinjana pakati pemakumbo ako, dumbu, uye maoko ako epamusoro. Jojo pacharo rinotora maminitsi mashoma, kunyangwe iwe uchigona kuda kugara uchitariswa, kunyanya panguva yekurapa kwako kwekutanga.

Ndingatora Azacitidine Kwenguva Yakareba Sei?

Vazhinji varwere vanoenderera mberi vachitora azacitidine kwemavhiki mana kusvika matanhatu (anenge 4-6 mwedzi) vasati vachiremba vagona kuongorora zvizere kana ichishanda. Vanhu vazhinji vanopindura zvakanaka kumushonga vanoenderera mberi nekurapa kwenguva refu, dzimwe nguva kwemakore, chero bedzi vachigona kuutora zvakanaka uye uchidzora kenza yavo.

Chiremba wako achatarisa kuverenga kweropa rako uye hutano hwako hwese mumasvondo mashoma kuti aone kana mushonga uchibatsira. Vamwe varwere vanoona kuvandudzwa mukati memavhiki mashoma ekutanga, nepo vamwe vachigona kuda nguva yakareba kuti varatidze mabhenefiti. Chinangwa ndechekuwana chiyero chakakodzera pakati pekudzora kenza yako nekuchengetedza hupenyu hwako.

Kana ukawana matambudziko makuru kana kenza yako ikawedzera kunyangwe uchirapwa, chiremba wako anogona kuchinja mushonga wako, kuchinja nguva yekurapa, kana kuchinjira kumushonga wakasiyana. Sarudzo yekuramba kana kumisa azacitidine inoenderana nemhinduro yako pachako uye kuti uri kubata sei matambudziko ese.

Kusiyana nemamwe marapirwo ekenza anopiwa kwenguva yakatarwa, azacitidine inowanzoenderera chero bedzi ichipa rubatsiro pasina kukonzera matambudziko asingagamuchirwe. Chikwata chako cheoncology chichashanda newe kuti chizive nzira yakanakisa yemamiriro ako chaiwo.

Ndezvipi Zvipingamupinyi zveAzacitidine?

Azacitidine inogona kukonzera matambudziko nekuti inokanganisa ese maseru ekenza uye mamwe maseru ane hutano anokurumidza kukamuka. Matambudziko mazhinji anogona kubatwa nekutarisa kwakakodzera uye kutarisirwa kunotsigira, uye varwere vazhinji vanowana kuti vanogona kuchengetedza hupenyu hwakanaka vachigamuchira kurapwa.

Matambudziko akajairika aunogona kusangana nawo anosanganisira kuneta, kusvotwa, uye maitiro ekudzivirira jekiseni senge kutsvuka kana kuzvimba. Izvi zvinowanzoitika mukati memazuva mashoma ekutanga edenderedzwa rega rega uye kazhinji anovandudza muviri wako paunojaira mushonga.

Heano matambudziko aunonyanya kusangana nawo, akarongwa kubva kune akajairika kusvika kune asingawanzoitiki:

• Kuneta uye kusava nesimba, kunokanganisa vanenge 80% yevarwere
• Kusvotwa nekutsvuka, kazhinji zvinyoro kusvika pakati nepakati
• Maitiro ekudzivirira jekiseni senge kutsvuka, kuzvimba, kana kupwanya
• Kuverenga ropa kwakaderera (anemia, maseru machena eropa akaderera, maplatelet akaderera)
• Dhayareya kana kuvharika
• Kuderera kwechido
• Fivha, kunyanya panguva yedenderedzwa rekutanga
• Kurwadziwa kwemhasuru kana majoini
• Dizziness kana kurwadziwa nemusoro
• Kufema kwemhepo

Vashandi venyu vezvehutano vachakutarisa zvakanyanya kuti vaone mhedzisiro iyi uye vanogona kukupa mishonga kana nzira dzekukubatsira kuzvigadzirisa. Vanhu vazhinji vanowana kuti mhedzisiro yacho inooneka zvakanyanya mumakore mashoma ekutanga uye inowanzoita kuti ive nyore kubata nekufamba kwenguva.

Mhedzisiro yakakomba asi isingawanzoitiki inoda kutariswa kwekurapa nekukurumidza. Izvi zvinosanganisira zviratidzo zveutachiona hwakakomba (fivha yakanyanya, kutonhora, kuneta kwakanyanya), kubuda ropa kusingaite kana kupwanya, kusvotwa kwakanyanya kunokutadzisa kuchengeta mvura pasi, kana kuoma kufema.

Kazhinji, vamwe varwere vanogona kusangana nematambudziko akakomba se pneumonia, maitiro akakomba eganda, kana matambudziko eitsvo. Chiremba wako achakurukura izvi newe uye achatsanangura zviratidzo zvekuchenjerera zvekutarisa pakati pekurapa.

Ndiani Asingafaniri Kutora Azacitidine?

Azacitidine haina kukodzera munhu wese, uye chiremba wako achanyatsoongorora kana zvakachengeteka kwauri zvichibva pahutano hwako hwese uye nhoroondo yekurapa. Mushonga unoda kuti muviri wako uve nekuchengetedza kwakakwana kuti ubate mhedzisiro yawo pakugadzirwa kwemasero eropa.

Haufanire kugamuchira azacitidine kana uine allergic kwairi kana mannitol (chikamu chinoshandiswa mujekiseni). Chiremba wako achavawo akanyatso chenjerera kana uine chirwere chakakomba chechiropa, sezvo izvi zvinogona kukanganisa maitiro emuviri wako ekugadzirisa mushonga.

Mamiriro akati wandei anoda kungwarira kwakanyanya uye kutariswa pedyo, kunyangwe asingakubvise iwe kubva mukurapa:

• Chirwere chakakomba cheitsvo kana kuvimba ne dialysis
• Zvirwere zvinoshanda, zvisingadzorwe
• Chirwere chemoyo chakakomba kana kurwisa kwemoyo kwemazuva ano
• Kuverenga ropa kwakaderera zvikuru kusingavandudzike nekuchengetedza
• Kuzvitakura kana kuyamwisa
• Kuvhiyiwa kukuru kwemazuva ano kana kupora maronda
• Mamwe akashanda kenza anoda kurapwa

Chiremba wako achayerera zvinhu izvi pamwe chete nemabhenefiti anogona kuwanikwa kubva mukurapa. Mune dzimwe nguva, kugadzirisa nyaya idzi kutanga kana kupa rubatsiro rutsigiro runogona kuita kuti azacitidine ive sarudzo inoshanda.

Kana uri kuronga kuva nepamuviri kana kuva nemwana, taura izvi nachiremba wako usati watanga kurapwa. Azacitidine inogona kukuvadza vana vari kukura, uye varume nevakadzi vanofanira kushandisa nzira dzekudzivirira pamuviri dzinoshanda panguva yekurapwa uye kwemwedzi yakati wandei mushure meizvozvo.

Mazita eBrand eAzacitidine

Azacitidine inowanikwa pasi pezita rebrand rekuti Vidaza, iro ndiro fomu rinonyanya kunyorerwa remushonga uyu. Vidaza inouya seupfu hunosanganiswa nemvura yakachena isati yabaiwa, uye inowanikwa mune ese ari maviri subcutaneous uye intravenous formulations.

Imwe fomu itsva yemuromo inonzi Onureg (azacitidine mahwendefa) inowanikwawo kune vamwe varwere vanokodzera kurapwa kwekuchengetedza mushure mekurapwa kwekutanga. Iyi fomu remahwendefa rinobvumira vamwe varwere kuti vaenderere mberi nekurapwa kumba panzvimbo yekuuya kukiriniki kuzobaiwa.

Mhando dzakajairika dzeazacitidine inobaiwa dziripo zvakare, izvo zvinogona kuve zvakachipa uku vachipa mabhenefiti akafanana ekurapa. Inishuwarenzi yako uye pharmacy zvinogona kukanganisa kuti ndeipi chaiyo brand kana generic vhezheni yaunogamuchira.

Zvisinei nekuti ndeipi brand yaunogamuchira, iyo inoshanda ingredient uye kushanda zvinoramba zvakafanana. Chikwata chako chehutano chichaita shuwa kuti unogamuchira fomu rakakodzera rekurapa kwako.

Zvimwe Zvingashandiswa Panzvimbo peAzacitidine

Mishonga yakati wandei inogona kurapa cancer yeropa yakafanana, kunyangwe sarudzo ichienderana nekuongororwa kwako, hutano hwese, uye kurapwa kwakapfuura. Chiremba wako achafunga nezvezvimwe zvinhu izvi kana azacitidine isina kukodzera kana ikamira kushanda kwauri.

Decitabine (Dacogen) imumwe mushonga unoderedza methylation unoshanda zvakafanana neazacitidine. Vamwe varwere vasingapinduri kune mumwe vangabatsirwa nemumwe, kunyangwe vaine matambudziko akawanda akafanana nemaitiro ekushanda.

Dzimwe nzira dzekurapa chiremba wako angangofunga dzinosanganisira:

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• Venetoclax, inowanzo shandiswa pamwe chete neazacitidine kune mamwe marudzi eAML
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• Lenalidomide (Revlimid) kune akasiyana MDS subtypes
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• Intensive chemotherapy regimens yevakuru vadiki, varwere vane hutano hwakanaka
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• Kuchengetwa kunotsigira nekuwedzerwa kweropa uye kukura kwezvinhu
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• Miedzo yekiriniki ichiongorora kurapwa kutsva kwejekerere
\n
• Bone marrow transplant yevanorwara vanokodzera
\n

Imwe nzira yakanakisa inoenderana nezvinhu zvakaita sezera rako, hutano hwese, genetic markers mumasero ako ekenza, uye zvaunofarira. Chikwata chako cheoncology chichakurukura izvi zvingasarudzwa newe kana azacitidine isiri sarudzo chaiyo kana ikamira kushanda.

Vamwe varwere vanogona kugamuchira kurapwa kwakabatanidzwa kunosanganisira azacitidine pamwe chete nemimwe mishonga, iyo dzimwe nguva inogona kushanda zvakanyanya pane chero mushonga mumwe chete.

Ko Azacitidine Ari Nani Kudarika Decitabine?

Ose ari maviri azacitidine uye decitabine zvinoderedza methylation zvinoshanda zvakafanana, asi vane misiyano inogona kuita kuti mumwe akukodzere iwe kupfuura mumwe. Hapana imwe yakanyatso

Tsvakurudzo inoratidza kuti azacitidine inogona kushanda zvishoma zvakanyanya kune mamwe marudzi eMDS, kunyanya chirwere chine njodzi yakakwirira. Zvisinei, decitabine inogona kufarirwa kune varwere vane matambudziko nekuita kwenzvimbo yekujekisheni kana vachida kutarisirwa nemutsinga.

Maitiro emigumisiro akafanana pakati pemishonga miviri, kunyangwe vamwe varwere vachishivirira imwe zviri nani pane imwe. Chiremba wako achafunga nezve rudzi rwekenza yako, kurapwa kwakapfuura, uye zvaunofarira pachako pakusarudza pakati pavo.

Mibvunzo Inowanzo Bvunzwa Nezve Azacitidine

Azacitidine Yakachengeteka Kune Varwere vane Chirwere cheItsvo Here?

Azacitidine inogona kushandiswa kune varwere vane chirwere cheitsvo chinyoro kusvika pakati nepakati, asi inoda kunyatso tariswa uye pamwe kugadzirisa muyero. Chiremba wako achatarisa kushanda kweitsvo dzako nguva dzose kuburikidza nemiedzo yeropa uye anogona kuderedza muyero wako kana itsvo dzako dzisingashande zvakanaka sezvavanofanira kuita.

Kana uine chirwere cheitsvo chakakomba kana uri pa dialysis, chiremba wako achayerera zvakanakira nenjodzi zvakanyanya. Mushonga unogona kubviswa ne dialysis, saka nguva yekurapa inogona kuda kurongwa nechirongwa chako che dialysis.

Ndoitei Kana Ndikashandisa Azacitidine Yakawandisa Netsaona?

Sezvo azacitidine ichipiwa nevashandi vehutano munzvimbo dzakadzorwa, overdose netsaona haisi kazhinji. Zvisinei, kana uchifungidzira kuti wakagamuchira mishonga yakawandisa kana uri kusangana nemigumisiro yakakomba, taura nechikwata chako chehutano nekukasira kana kuenda kukamuri rekukurumidzira riri pedyo.

Zviratidzo zvekuwandisa zvinogona kusanganisira kusvotwa kwakanyanya nekutukwa, kuneta kwakanyanya, fivha, kubuda ropa kusinganzwisisike, kana kuoma kufema. Hapana mushonga chaiwo weazacitidine, saka kurapwa kunotarisa pakugadzirisa zviratidzo uye kutsigira kupora kwemuviri wako.

Ndoitei Kana Ndikakanganwa Dose yeAzacitidine?

Kana ukasapinda jekiseni rakarongwa reazacitidine, taura nechikwata chako chekuchengetwa kwehutano nekukasira kuti urongezve. Usaedze kutsiva mishonga yakapotswa nekutora mishonga yakawanda - izvi zvinogona kuva nenjodzi uye hazvizovandudzi mhedzisiro yako yekurapa.

Chiremba wako anogona kugadzirisa chirongwa chako chekurapa kana kuchinja kutenderera kwako zvichienderana nekuti wakapotsa madosi mangani. Kuenderana kwakakosha pakuita kuti zvishande, saka edza kuchengeta zvese zvako zvakarongehwa zvekugadzwa uye taura chero kusawirirana kwekuronga pamberi.

Ndingamira Rini Kutora Azacitidine?

Unofanira kungomira azacitidine pasi pekutungamirirwa nachiremba wako. Kusiyana nemimwe mishonga inotorwa kwenguva yakatarwa, azacitidine inowanzoenderera mberi chero ichibatsira kudzora kenza yako uye uchiiita zvakanaka.

Chiremba wako achagara achiongorora kana mushonga uchiri kubatsira kuburikidza nemiedzo yeropa, biopsy yemuzongoza, uye kuongorora zviratidzo zvako. Kana kenza yako ikafambira mberi kana mativi emhedzisiro akava asingadzoreki, chiremba wako achakurukura dzimwe nzira dzekurapa kana sarudzo dzekutsigira.

Ndingagamuchira Majekiseni Ndiri Kutora Azacitidine?

Unofanira kudzivisa majekiseni mhenyu uchitora azacitidine nekuti mushonga unogona kuderedza immune system yako. Izvi zvinosanganisira majekiseni senge jekiseni remuromo mhenyu (nasal spray), MMR, uye varicella (chickenpox) majekiseni.

Zvisinei, majekiseni asina basa senge jekiseni reflu, jekiseni renyumonia, uye majekiseni eCOVID-19 anowanzo chengeteka uye anokurudzirwa. Chiremba wako achakupa zano pamajekiseni aunofanira kugamuchira uye kuti ungawana riini kuti uwane dziviriro yakanakisisa uchideredza njodzi.