Ngā Wero i te Whakaora i te Mate Harore Whakaekenga Hou i roto i ngā Tūroro Mate Pukupuku Toto: Ngā Tirohanga mai i te ASH 2024

I te Hui-ā-Tau 66 o te American Society of Hematology (ASH) i te tau 2024, i whakaatu a Ahorangi Sun Yuqian o te Peking University People's Hospital i tētahi rangahau nui mō te mate harore urutomo (bIFD) i roto i ngā tūroro e whiwhi ana i te whakawhitinga pūtau take hematopoietic allogeneic (allo-HSCT) i Haina. I whakaputaina te rangahau, i whakahaerehia puta noa i ngā hōhipera 12, ki te puka mana o te Ngā Mate Pirau Te Rōpū o Amerika,Ngā Mate Pāwera Hauora (CID).

Ko te rangahau, e mōhiotia ana ko te rangahau CAESAR 2.0, i arotahi ki te 2,015 ngā pakeke i whiwhi i te allo-HSCT mai i Hanuere ki Tīhema 2021. I whakaatuhia e 76.08% o ngā tūroro i whiwhi i te ārai harore, ko te nuinga ko te voriconazole (44.37%) me te posaconazole (31.71%). Ahakoa te whānui o te whakamahinga o ēnei rongoā harore, i kitea e te rangahau he 6.3% te maha o ngā mate harore whakaeke (IFD) i ia tau, me te nui o te mate e pā ana ki te 48.28%. Ko Candida, Aspergillus, me ētahi atu harore i tautuhia ko ngā mate matua e kawe ana i ngā mate.

I aro atu anō a Ahorangi Sun ki ngā wero haumanu e pā ana ki te tātaritanga me te rongoā i te bIFD i roto i ngā tūroro mate pukupuku toto. Ka puta te IFD angitu i te wā o te ārai harore, ka uaua ai te tātaritanga me te rongoā. Nā te korenga o tētahi whakamāramatanga paerewa, he rerekē rawa ngā reiti tūponotanga o te bIFD, mai i te 1% ki te 42%. Nā tēnei rerekētanga ka uaua ki te whakatū i ngā paearu tātaritanga me ngā tikanga maimoatanga ōrite.

Ko tētahi o ngā wero nui i whakamāramahia e Ahorangi Sun ko te uaua o ngā āhuatanga mōrearea mō te bIFD, tae atu ki te neutropenia roa, te whakamahinga o ngā steroids, me te whakamahinga roa o ngā paturopi maha. Hei tāpiri, ko ngā rongoā harore e whakamahia ana hei ārai, kāore pea e kapi i te whānuitanga katoa o ngā mate pukupuku pea, ā, ko ngā momo harore hou ka karo pea i te kitea nā te iti o te aro ki ngā whakamātautau tātaritanga pērā i te PCR me ngā whakamātautau GM.

I whakanui a Ahorangi Sun i te hiranga o te maimoatanga harore wawe, inā koa mō ngā tūroro mōrearea nui e whakaatu ana i ngā tohu o te mate. I tūtohu ia kia tīmata tonu te maimoatanga harore whakamātautau mō ngā tūroro tino mate e whakapaetia ana he bIFD, ahakoa i mua i te putanga mai o ngā hua taiwhanga. I tohutohu anō hoki ia kia whakamahia ngā rongoā harore he rerekē i te tikanga ārai mate hei whakanui ake i te whai huatanga o te maimoatanga.

Ko ngā kitenga o te rangahau CAESAR 2.0 e whakaatu ana i te hiahia mō ngā rautaki whakapai ake hei whakahaere i te mōrearea IFD i roto i ngā tūroro allo-HSCT me te hiahia nui mō te tautuhi wawe me te wawaotanga. E ai ki te whakatau a Ahorangi Sun, ahakoa kei te whai wāhi nui tonu ngā kaihoko harore o nāianei, he mea nui te whakawhanake i ngā rongoā hou me ngā taputapu tautuhi hei whakapai ake i ngā putanga o te tūroro. Ko ngā maimoatanga hou, pērā i Te rongoā ārai mate me ngā rongoā harore hou, tera pea ka whakarato i te tumanako hou mō ngā tūroro e whawhai ana ki ēnei mate morearea.

E whakaatu ana tēnei rangahau hou mō te bIFD i ngā wero tonu e pā ana ki ngā tākuta ki te whakahaere i ngā mate harore i roto i ngā tūroro mate toto, me te tohu hoki i te hiahia nui mō ngā whanaketanga tonu i roto i ngā rautaki ārai me te maimoatanga.