Transplantasyon ve H\u00fccresel Tedaviler Derne\u011fince \u00fc\u00e7\u00fcnc\u00fcs\u00fc yap\u0131lan Transplantasyon ve H\u00fccresel Tedaviler Kongresi, Kuzey K\u0131br\u0131s T\u00fcrk Cumhuriyeti’nde (KKTC) bir otelde d\u00fczenlendi.<\/p>\n
Derne\u011fin Kurucu Ba\u015fkan\u0131 ve D\u00fcnya Aferez Birli\u011fi Ba\u015fkan\u0131 Prof. Dr. Fevzi Altunta\u015f, 26 Eyl\u00fcl’de ba\u015flayan ve bug\u00fcn tamamlanan kongreye ili\u015fkin d\u00fczenlenen bas\u0131n toplant\u0131s\u0131nda, kongreye \u00fc\u00e7 k\u0131tadan yakla\u015f\u0131k 400 akademisyenin kat\u0131ld\u0131\u011f\u0131n\u0131, transplantasyon, h\u00fccresel tedaviler ve klinik \u00e7al\u0131\u015fmalara y\u00f6nelik d\u00fcnyadaki bilimsel geli\u015fmelerin kongrede detayl\u0131 olarak tart\u0131\u015f\u0131ld\u0131\u011f\u0131n\u0131 anlatt\u0131.<\/p>\n
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Akut lenfoblastik l\u00f6semi, lenfoma, multiple myeloma gibi hematolojik kanserlerin tedavisinde “\u00e7\u0131\u011f\u0131r a\u00e7an” bir y\u00f6ntem olarak tan\u0131mlanan CAR-T h\u00fccre tedavisinin de kongrede \u00fcretimden uygulama a\u015famas\u0131na kadar t\u00fcm y\u00f6nleriyle de\u011ferlendirildi\u011fini belirten Altunta\u015f, Transplantasyon ve H\u00fccresel Tedavi Merkezlerinin “m\u00fckemmeliyet merkezi” olmas\u0131 i\u00e7in neler yap\u0131labilece\u011fine ili\u015fkin de bilgi payla\u015f\u0131m\u0131nda bulunuldu\u011funu kaydetti.<\/p>\n
“T\u00fcrkiye, k\u00f6k h\u00fccre naklinde d\u00fcnyan\u0131n say\u0131l\u0131 \u00fclkelerinden biri”<\/h3>\n
Prof. Dr. Altunta\u015f, k\u00f6k h\u00fccre nakli bekleyen hastalara en uygun ba\u011f\u0131\u015f\u00e7\u0131n\u0131n bulunabilmesi amac\u0131yla Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 ve T\u00fcrk K\u0131z\u0131lay i\u015fbirli\u011finde y\u00fcr\u00fct\u00fclen T\u00fcrkiye K\u00f6k H\u00fccre Koordinasyon Merkezi (T\u00dcRK\u00d6K) projesinin \u00f6nemine i\u015faret ederek, \u015fu bilgileri payla\u015ft\u0131:<\/p>\n
“T\u00fcrkiye, k\u00f6k h\u00fccre naklinde d\u00fcnyan\u0131n g\u0131ptayla bakt\u0131\u011f\u0131, yurt d\u0131\u015f\u0131ndan da hastalar\u0131n tercih etti\u011fi \u00e7ok iyi bir noktada. K\u00f6k h\u00fccre nakil merkezlerimiz, hem bilimsel ara\u015ft\u0131rmalar\u0131 hem uygulamalar\u0131yla uluslararas\u0131 kabul g\u00f6ren, bir\u00e7ok \u00fclkeden ki\u015filerin e\u011fitim ald\u0131\u011f\u0131 merkezler. T\u00fcrkiye, k\u00f6k h\u00fccre naklinde d\u00fcnyan\u0131n say\u0131l\u0131 \u00fclkelerinden biri. Ancak h\u00fccresel tedaviler noktas\u0131nda geli\u015fmeye ihtiya\u00e7 bulunuyor. CAR-T h\u00fccresi, t\u00fcm\u00f6r a\u015f\u0131lar\u0131, imm\u00fcnoterapi gibi alanlarda trendi yakalamam\u0131z, ge\u00e7 kalmamam\u0131z laz\u0131m. Transplantasyonda yakalad\u0131\u011f\u0131m\u0131z ba\u015far\u0131y\u0131 burada da yakalaman\u0131n, \u00fclkemize bu konuda de\u011fer katman\u0131n gayreti i\u00e7erisindeyiz.”<\/p>\n
“Y\u0131ll\u0131k nakil say\u0131s\u0131 5 bini a\u015ft\u0131”<\/h3>\n
Kongre Ba\u015fkan\u0131, Malatya \u0130n\u00f6n\u00fc \u00dcniversitesi T\u0131p Fak\u00fcltesi Hematoloji Bilim Dal\u0131 \u00d6\u011fretim \u00dcyesi ve K\u00f6k H\u00fccre Nakli Merkezi Direkt\u00f6r\u00fc Prof. Dr. Mehmet Ali Erkurt, T\u00fcrkiye’nin kemik ili\u011fi nakillerinde bat\u0131 standartlar\u0131n\u0131 yakalad\u0131\u011f\u0131n\u0131 vurgulad\u0131.<\/p>\n
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Erkurt, T\u00dcRK\u00d6K’\u00fcn hastalar i\u00e7in umut oldu\u011funun alt\u0131n\u0131 \u00e7izerek, “\u00dclkemizde k\u00f6k h\u00fccre nakil merkezi say\u0131s\u0131 100’\u00fc, y\u0131ll\u0131k nakil say\u0131s\u0131 ise 5 bini a\u015fm\u0131\u015ft\u0131r. Akraba d\u0131\u015f\u0131 nakillerin art\u0131k y\u00fczde 95’i kendi bankam\u0131zdan olmaktad\u0131r. Otolog ve allojenik nakiller i\u00e7in bekleme s\u0131ras\u0131 kalmam\u0131\u015ft\u0131r. Haploidentik dedi\u011fimiz HLA doku grubu uyumsuz nakillerde ba\u015far\u0131 oranlar\u0131 bat\u0131 toplumlar\u0131na benzerdir. Kemik ili\u011fi nakillerinin y\u00fczde 10’u yurtd\u0131\u015f\u0131ndan gelen hastalara yap\u0131lmaktad\u0131r.” diye konu\u015ftu.<\/p>\n
K\u00f6k h\u00fccre olmadan kemik ili\u011fi nakli yap\u0131lamayaca\u011f\u0131na, dolay\u0131s\u0131yla k\u00f6k h\u00fccre ba\u011f\u0131\u015flar\u0131n\u0131n b\u00fcy\u00fck \u00f6nem ta\u015f\u0131d\u0131\u011f\u0131na dikkati \u00e7eken Erkurt, “Herhangi bir sa\u011fl\u0131k sorunu olmayan 18-50 ya\u015f aras\u0131 herkes kemik ili\u011fi ba\u011f\u0131\u015f\u00e7\u0131s\u0131 olabilir. K\u00f6k h\u00fccre ba\u011f\u0131\u015f\u00e7\u0131s\u0131 olmak i\u00e7in korkmaya gerek yok, bunun ba\u011f\u0131\u015f\u00e7\u0131ya hi\u00e7bir zarar\u0131 yok. Gelin g\u00f6n\u00fcll\u00fc olal\u0131m, bir hayat kurtaral\u0131m. Ba\u011f\u0131\u015fta bulunmak isteyenler en yak\u0131n K\u0131z\u0131lay G\u00f6n\u00fcll\u00fc Verici Merkezi’ne ba\u015fvurarak, hem bilgilendirme alabilir hem de ba\u011f\u0131\u015f i\u00e7in aday olabilirler.” ifadelerini kulland\u0131.<\/p>\n
“CAR-T, \u00f6zellikle diren\u00e7 geli\u015fen durumlarda \u00f6nemli bir tedavi se\u00e7ene\u011fi”<\/h3>\n
Tekirda\u011f Nam\u0131k Kemal \u00dcniversitesi Hematoloji Bilim Dal\u0131 Ba\u015fkan\u0131 Prof. Dr. Burhan Turgut da T\u00fcrkiye’de klinik \u00e7al\u0131\u015fmalar\u0131 s\u00fcren CAR-T h\u00fccre tedavisine ili\u015fkin bilgileri payla\u015ft\u0131.<\/p>\n
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CAR-T’nin, ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin bir h\u00fccresinin gen transferi yoluyla de\u011fi\u015ftirilmesiyle elde edilen “kansere kar\u015f\u0131 silahland\u0131r\u0131lm\u0131\u015f bir h\u00fccre” olarak tan\u0131mlanabilece\u011fini belirten Turgut, \u015funlar\u0131 kaydetti:<\/p>\n
“Bu \u015fekilde bir ba\u011f\u0131\u015f\u0131kl\u0131k sistemi h\u00fccresini kanser tedavisinde kullanm\u0131\u015f oluyoruz. CAR-T, \u00f6zellikle son 3-5 y\u0131lda geli\u015fen ve \u015fu an h\u00fccresel tedaviler i\u00e7erisinde en etkili y\u00f6ntem olarak g\u00fcndemde olan bir tedavi \u015fekli. Bu tedavi \u015fu anda lenfoma, l\u00f6semi, akut lenfoblastik l\u00f6semi, multiple myeloma gibi hematolojik kanserlerde, \u00f6zellikle diren\u00e7 geli\u015fen, standart tedavilerin etkisiz kald\u0131\u011f\u0131 durumlarda \u00f6nemli bir tedavi se\u00e7ene\u011fi haline gelmi\u015f durumda. D\u00fcnyada \u00f6zellikle ABD’de 30 binden fazla hastaya uyguland\u0131, Avrupa’da belli \u00fclkelerde ve \u00c7in’de de yayg\u0131nla\u015fm\u0131\u015f, standart tedavi haline gelmi\u015f durumda.<\/p>\n
\u00dclkemizde ise bu alanda y\u00fcr\u00fcyen preklinik ve baz\u0131 faz \u00e7al\u0131\u015fmalar\u0131 yap\u0131l\u0131yor. Bu \u00e7al\u0131\u015fmalar yoluyla tedaviye ula\u015fabilen hastalar oldu. Ancak hen\u00fcz standart tedavi olarak \u00fclkemizde ruhsatlanm\u0131\u015f bir CAR-T h\u00fccre \u00fcr\u00fcn\u00fc yok. \u00d6n\u00fcm\u00fczdeki y\u0131llarda bu konuda belli bir noktaya gelebilece\u011fimizi \u00f6ng\u00f6r\u00fcyoruz.”<\/p>\n
Prof. Dr. Turgut, CAR-T h\u00fccre tedavisinde hastal\u0131\u011fa, hastaya g\u00f6re de\u011fi\u015fen oranlarda ba\u015far\u0131 elde edildi\u011finin alt\u0131n\u0131 \u00e7izerek, “Mesela akut lenfoblastik l\u00f6semide, lenfomalarda olduk\u00e7a y\u00fcksek oranlarda tedavi ba\u015far\u0131s\u0131 elde ediliyor, pek \u00e7ok hastan\u0131n hayat\u0131 kurtar\u0131labiliyor.” dedi.<\/p>\n
Turgut, CAR-T h\u00fccre tedavisinin k\u00f6k h\u00fccre naklinin alternatifi de\u011fil tamamlay\u0131c\u0131s\u0131 gibi g\u00f6r\u00fclmesi gerekti\u011finin, nakil sonras\u0131 hastal\u0131\u011f\u0131 n\u00fckseden ki\u015filerde kurtar\u0131c\u0131 bir tedavi olabilece\u011finin ve \u015fu an ilk basamak bir tedavi olmad\u0131\u011f\u0131n\u0131n alt\u0131n\u0131 \u00e7izdi.<\/p>\n
“Hematolojik kanserlerin \u00f6nemli bir grubunda tedavi se\u00e7ene\u011fi olacak”<\/h3>\n
Daha sonra bas\u0131n mensuplar\u0131n\u0131n CAR-T h\u00fccre tedavisi ile ilgili sorular\u0131n\u0131 yan\u0131tlayan Prof. Dr. Fevzi Altunta\u015f, \u015fu an d\u00fcnya genelinde bu tedaviyle ilgili 1000’in \u00fczerinde klinik \u00e7al\u0131\u015fman\u0131n y\u00fcr\u00fct\u00fcld\u00fc\u011f\u00fcn\u00fc aktard\u0131.<\/p>\n
Tedavinin d\u00fcnyada on binlerce hastaya uyguland\u0131\u011f\u0131na ve bunun tedaviyle ilgili \u00f6nemli bir veri birikimini de sa\u011flad\u0131\u011f\u0131na dikkati \u00e7eken Altunta\u015f, \u015f\u00f6yle devam etti:<\/p>\n
“Bu veri birikimiyle \u00f6n\u00fcm\u00fczdeki s\u00fcre\u00e7te CAR-T h\u00fccre tedavilerinin \u00f6zellikle hematolojik kanser hastalar\u0131n\u0131n \u00f6nemli bir grubunda bir tedavi se\u00e7ene\u011fi olaca\u011f\u0131n\u0131 s\u00f6yleyebiliriz. Burada alt\u0131n\u0131 \u00e7izmemiz gerekiyor, bu bir tedavi se\u00e7ene\u011fi. CAR-T h\u00fccre tedavisi \u00e7\u0131\u011f\u0131r a\u00e7an bir teknoloji, bu teknolojiyi kullanmak, yayg\u0131nla\u015ft\u0131rmak laz\u0131m. Ancak ‘her derde deva’ olarak g\u00f6r\u00fclmemeli, se\u00e7ilmi\u015f hasta gruplar\u0131nda hastal\u0131\u011f\u0131 \u00f6nemli oranda kontrol alt\u0131na alabilmekte. CAR-T son derece pahal\u0131 da bir tedavi, bunun yayg\u0131nla\u015fmas\u0131 i\u00e7in teknolojinin geli\u015fmesi laz\u0131m, zamana da ihtiya\u00e7 var. Hangi hastalar\u0131n fayda g\u00f6rece\u011finin de tespit edilip, standardize edilmesi gerekiyor. Merkezlerin bu konuda deneyimlerinin artmas\u0131 \u00e7ok \u00f6nemli. T\u00fcm bunlar\u0131n zamanla ilerleyece\u011fine, teknolojinin geli\u015fmesiyle tedavi maliyetinin de azalaca\u011f\u0131na inan\u0131yorum.”<\/p>\n
Altunta\u015f, T\u00fcrkiye’de de klinik ara\u015ft\u0131rmalar\u0131 s\u00fcren bu tedavinin ilerleyen d\u00f6nemde \u00fcretimin de devreye al\u0131nmas\u0131yla yayg\u0131nla\u015fmas\u0131, daha \u00e7ok hastaya ula\u015fmas\u0131 temennisinde bulundu.<\/p>\n