Ingantaccen Yawan Rayuwa Tare da Tsarin Bu/Cy+Melphalan da Bu/Cy+Thiotepa a cikin Dashen Kwayoyin Haploidentical don Ciwon Mara Mai Sauƙi na Megakaryoblastic Leukemia (AMKL)

A taron shekara-shekara na 66 na Ƙungiyar Nazarin Jini ta Amurka (ASH) da aka gudanar a San Diego daga 7-10 ga Disamba, 2024, Dr. Zhi-Jie Wei, Daraktan Sashen Nazarin Jini a Asibitin Lu Daopei, ya gabatar da wani bincike mai zurfi kan maganin Ciwon Mara da Ba a Sauke Ba (Non-Down Syndrome Acute Megakaryoblastic Leukemia) (Non-DS-AMKL). Binciken ƙungiyarsa, mai taken "Ingantattun Sakamako tare da Bu/Cy+Melphalan da Bu/Cy+Thiotepa Regimens a cikin Haploidentical Hematopoietic Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia," an nuna shi a cikin Abstract 3492 kuma yana nuna babban ci gaba a cikin maganin AMKL.

Ba DS-AMKL ba, wani nau'in cutar sankarar bargo mai saurin yaduwa, yana da ƙaramin kaso na waɗanda ke fama da cutar sankarar bargo mai saurin yaɗuwa (AML) ta yara da manya. Duk da cewa DS-AMKL sau da yawa yana da kyakkyawan hasashen cutar, ba a samun hasashen cutar ba sosai, tare da ƙarancin tsawon shekaru uku na rayuwa (OS) na ƙasa da 40%. Dashen ƙwayoyin halittar jini na Haploidentical (haplo HCT) a halin yanzu shine kawai maganin warkarwa da ake da shi ga waɗannan marasa lafiya.

Binciken ya mayar da hankali kan amfani da tsarin da aka gyara na Bu/Cy tare da Melphalan (MEL) ko Thiotepa (TT) don inganta yawan rayuwa da rage matsaloli ga marasa lafiya da ake yi wa dashen ƙwayoyin halitta na haploid. Sakamakon ya kasance mai kyau, yana nuna babban ci gaba a cikin rayuwa gaba ɗaya (OS) tsakanin marasa lafiya da ke da cikakkiyar gafara (CR). Tsarin aiki na OS ga marasa lafiya na CR ya kasance 68.2%, idan aka kwatanta da 16.7% ga marasa lafiya waɗanda ba su sami CR (PR/NR) ba, yana nuna muhimmiyar rawar da cimma CR ke takawa wajen inganta sakamakon rayuwa.

Binciken ya haɗa da marasa lafiya 59 da ba su da DS-AMKL waɗanda matsakaicin shekarunsu ya kai shekaru 2. Bayan magani, duk marasa lafiya sun sami nasarar yin aikin gyaran fuska, tare da matsakaicin lokaci na kwanaki 13 don yin aikin gyaran fuska na neutrophil da kuma kwanaki 9 don yin aikin gyaran fuska na platelet. Abin lura shi ne, tsarin Bu/Cy+MEL da Bu/Cy+TT ya haifar da kashi 100% na yawan OS ga marasa lafiya a cikin rukunin Bu/Cy+TT, kodayake babu wani babban bambanci a cikin OS tsakanin ƙungiyoyin Bu/Cy da Bu/Cy+MEL.

Dangane da matsalolin da aka fuskanta, tsarin da aka gyara ya nuna raguwarsakamako a cikin yawan kamuwa da cututtukan dashen-dashen-masu fama da cutar Grade III-IV (aGVHD) da kuma mace-macen da suka shafi dashen-dashen (TRM), wanda hakan ya ƙara tabbatar da amincin sabbin ka'idoji. Yawan kamuwa da cutar aGVHD mai tsanani ya yi ƙasa sosai a cikin ƙungiyar Bu/Cy+TT, tare da raguwar GVHD mai tsanani da na yau da kullun idan aka kwatanta da tsarin Bu/Cy na gargajiya.

Dr. Wei ya jaddada yuwuwar waɗannan tsarin da aka gyara wajen inganta sakamakon marasa lafiya marasa DS-AMKL, musamman a waɗanda suka sami cikakkiyar gafara. Binciken ya ba da bayanai masu mahimmanci game da inganta ka'idojin magani ga AMKL kuma ya kafa matakin ci gaba da bincike a asibiti. Duk da cewa sakamakon ga marasa lafiya da suka sami sassaucin ra'ayi da waɗanda ba su sami gafara ba bai yi kyau ba, hanyar tana ba da bege ga ingantattun dabarun magani a nan gaba.

Tare da ci gaba da bincike da tattara bayanai, ƙungiyar Asibitin Lu Daopei tana da niyyar inganta waɗannan hanyoyin don samar da mafita mai ɗorewa ga marasa lafiya marasa DS-AMKL, wanda hakan na iya canza yanayin magani ga wannan nau'in cutar sankarar bargo mai ƙalubale.