Hōʻike ka Haʻawina Multi-Center i ka Prognosis Maikaʻi no nā Maʻi Hematoma Malignancy e Hana ʻia ana e ka MMUD Allogeneic Stem Cell Transplant me ATG
Ua hōʻike ʻia kahi noiʻi retrospective multi-center i mālama ʻia ma Kina i nā hopena hoʻohiki o ka mismatched related donor (MMUD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) no nā poʻe maʻi me nā maʻi hematologic malignancies. Paʻi ʻia ma Ka Hoʻoili ʻana o ka Iwi Moa, ke nānā nei kēia haʻawina i ka pono o ka hoʻohui ʻana iā MMUD allo-HSCT me ka antithymocyte globulin (ATG) no ka pale ʻana i ka maʻi graft-versus-host (GVHD). Ua hōʻike ʻia kēia ʻano hana e hāʻawi i nā hopena lapaʻau ikaika, ʻoiai me nā mismatches i ka human leukocyte antigen (HLA) compatibility ma waena o ka mea hāʻawi a me ka mea loaʻa.
Ua kākau inoa ke aʻo ʻana i 211 mau maʻi i piha i ka makahiki 14 a ʻoi paha, ua ʻike ʻia lākou a pau me nā maʻi hematologic a ua hoʻomaha piha ʻia ma mua o ka hoʻoili ʻana. Ua māhele ʻia nā maʻi i ʻelua mau pūʻulu ma muli o ka helu o nā HLA mismatches: Hui A me hoʻokahi allele mismatch a me Hui B me ʻelua a ʻoi aku paha nā mismatches. Ua loaʻa i nā maʻi a pau nā cell kumu koko peripheral a me ka mālama ʻana me kahi regimen hoʻomaʻemaʻe iwi, me ka pale ʻana iā GVHD e pili ana iā ATG.
ʻO nā hopena koʻikoʻi e komo pū ana me ka nui o ka hoʻopili ʻana o 96.2% no nā neutrophils a me 93.4% no nā platelets i loko o nā lā 28 mua. Ua hōʻike pū ka noiʻi i kahi hanana haʻahaʻa o ka GVHD koʻikoʻi koʻikoʻi, me ka III-IV grade GVHD e kū nei ma 12.3% o nā hihia, a me ka GVHD maʻi waena a koʻikoʻi e hiki ana i ka 21% ma hope o ʻekolu makahiki. ʻO ka helu ola holoʻokoʻa (OS) ʻekolu makahiki he 63.1%, me ka helu ola ʻole maʻi (DFS) he 54.5%.
Ua hōʻike pū nā ʻike ʻaʻole i hoʻopilikia nui ka nui o nā mismatches HLA i nā helu ola, ka hanana GVHD, a i ʻole ka hoʻāla hou ʻana o ka viral. Eia kekahi, ʻo ka hoʻohana ʻana i nā dosis haʻahaʻa o ATG (≤6 mg/kg) i hoʻomaikaʻi i nā helu engraftment a hāʻawi i nā pono lapaʻau me ka ʻole o ka hoʻopilikia ʻana i nā helu ola a i ʻole ka relapse, e hāʻawi ana i kahi koho lapaʻau kūpono.
ʻO kēia noiʻi ka noiʻi nui loa ma Kina ma MMUD allo-HSCT a hōʻike i ka hiki o kēia ʻano hoʻoili no nā poʻe maʻi me nā maʻi ʻaʻai hematologic kiʻekiʻe. Hāʻawi ia i nā ʻike waiwai nui i ka hoʻomaikaʻi ʻana i nā hopena o ka mea maʻi a me ka hoʻomaʻemaʻe ʻana i nā protocols transplant, e lilo ia i mea kōkua nui i ke kahua o ke koko. Ka Lapaʻau ʻana i ka Maʻi ʻAʻai.