Kev Txhim Kho Cov Nqi Sia Nyob Nrog Bu/Cy+Melphalan thiab Bu/Cy+Thiotepa Regimens Hauv Haploidentical Stem Cell Transplantation Rau Cov Neeg Mob Tsis Yog Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)

Nyob rau ntawm Lub Rooj Sib Tham Txhua Xyoo 66th ntawm American Society of Hematology (ASH) uas tau muaj nyob rau hauv San Diego txij lub Kaum Ob Hlis 7-10, 2024, Dr. Zhi-Jie Wei, Tus Thawj Coj ntawm Lub Tsev Kho Mob Hematology ntawm Lu Daopei, tau nthuav tawm kev tshawb fawb tshiab txog kev kho mob Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Nws pab neeg txoj kev tshawb fawb, hu ua "Cov Txiaj Ntsig Zoo Dua nrog Bu/Cy+Melphalan thiab Bu/Cy+Thiotepa Regimens hauv Haploidentical Hematopoietic Stem Cell Transplantation rau Non-Down Syndrome Acute Megakaryoblastic Leukemia," tau tshwm sim hauv Abstract 3492 thiab cim qhov kev nce qib tseem ceeb hauv kev kho mob AMKL.

Non-DS-AMKL, yog ib hom mob leukemia uas tsis tshua muaj thiab hnyav, yog ib feem pua ​​me me ntawm cov menyuam yaus thiab cov neeg laus uas muaj mob acute myeloid leukemia (AML). Txawm hais tias DS-AMKL feem ntau muaj kev kwv yees zoo dua, Non-DS-AMKL muaj kev kwv yees tsis zoo nrog rau peb xyoos ntawm kev ciaj sia (OS) tsawg dua 40%. Haploidentical hematopoietic stem cell transplantation (haplo HCT) tam sim no yog tib txoj kev kho mob uas muaj rau cov neeg mob no.

Txoj kev tshawb fawb no tau tsom mus rau kev siv cov kev kho mob Bu/Cy uas tau hloov kho ua ke nrog Melphalan (MEL) lossis Thiotepa (TT) los txhim kho cov neeg mob uas muaj sia nyob thiab txo cov teeb meem hauv kev hloov pauv hlwb haploidentical. Cov txiaj ntsig tau cog lus tias yuav zoo, qhia txog kev txhim kho tseem ceeb hauv kev ciaj sia tag nrho (OS) ntawm cov neeg mob uas tau zam txim tag nrho (CR). OS rau cov neeg mob CR yog 68.2%, piv rau 16.7% rau cov neeg mob uas tsis tau ua tiav CR (PR/NR), qhia txog lub luag haujlwm tseem ceeb ntawm kev ua tiav CR hauv kev txhim kho cov txiaj ntsig kev ciaj sia.

Txoj kev tshawb fawb no suav nrog 59 tus neeg mob menyuam yaus uas tsis yog DS-AMKL uas muaj hnub nyoog nruab nrab ntawm 2 xyoos. Tom qab kev kho mob, txhua tus neeg mob tau ua tiav kev cog qoob loo, nrog rau lub sijhawm nruab nrab ntawm 13 hnub rau kev cog qoob loo neutrophil thiab 9 hnub rau kev cog qoob loo platelet. Qhov tseem ceeb, cov txheej txheem Bu/Cy+MEL thiab Bu/Cy+TT tau ua rau muaj 100% OS rau cov neeg mob hauv pawg Bu/Cy+TT, txawm hais tias tsis muaj qhov sib txawv tseem ceeb hauv OS ntawm pawg Bu/Cy thiab Bu/Cy+MEL.

Hais txog cov teeb meem, cov kev kho mob hloov kho tau qhia txog kev txo qiskev cuam tshuam hauv qhov tshwm sim ntawm Qib III-IV mob hnyav graft-versus-host (aGVHD) thiab kev tuag ntsig txog kev hloov pauv (TRM), ntxiv qhov kev nyab xeeb ntawm cov txheej txheem tshiab. Qhov tshwm sim ntawm aGVHD hnyav tau qis dua hauv pawg Bu/Cy+TT, nrog rau kev txo qis hauv ob qho tib si mob hnyav thiab mob GVHD ntev piv rau cov kev kho mob Bu/Cy ib txwm muaj.

Dr. Wei tau hais txog lub peev xwm ntawm cov kev kho mob hloov kho no hauv kev txhim kho cov txiaj ntsig ntawm cov neeg mob uas tsis yog DS-AMKL, tshwj xeeb tshaj yog rau cov neeg uas tau txais kev zam txim tag nrho. Kev tshawb fawb no muab cov kev nkag siab tseem ceeb rau kev ua kom zoo dua cov txheej txheem kho mob rau AMKL thiab teeb tsa theem rau kev tshawb nrhiav ntxiv. Txawm hais tias cov txiaj ntsig rau cov neeg mob uas tau zam txim ib nrab thiab cov neeg mob uas tsis tau zam txim tsis muaj kev cia siab, txoj hauv kev no muab kev cia siab rau cov tswv yim kho mob zoo dua yav tom ntej.

Nrog kev tshawb fawb thiab kev sau cov ntaub ntawv txuas ntxiv mus, pab pawg neeg hauv tsev kho mob Lu Daopei lub hom phiaj yog los txhim kho cov kev kho mob no kom muab cov kev daws teeb meem ntev rau cov neeg mob uas tsis yog DS-AMKL, uas yuav hloov pauv qhov kev kho mob rau hom kab mob leukemia nyuaj no.