Ngā Reiti Ora Whakapai Ake me ngā Tikanga Bu/Cy+Melphalan me Bu/Cy+Thiotepa i roto i te Whakatō Pūtau Take Haploidentical mō te Leukemia Megakaryoblastic Koretake (AMKL)

I te Hui-ā-Tau 66 o te American Society of Hematology (ASH) i tū ki San Diego mai i te 7-10 o Hakihea, 2024, i whakaatu a Tākuta Zhi-Jie Wei, te Kaiwhakahaere o te Tari Hematology i te Hōhipera o Lu Daopei, i ngā rangahau hou mō te maimoatanga o te Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Ko te taitara o te rangahau a tana tīma, "Ngā Putanga Whakapai ake me te Bu/Cy+Melphalan me te Bu/Cy+Thiotepa Regimens i roto i te Haploidentical Hematopoietic Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia," i whakaatuhia ki te Abstract 3492, ā, he tohu tēnei i tētahi whanaketanga nui i roto i te maimoatanga AMKL.

Ko te Non-DS-AMKL, he momo onge, he kaha hoki o te mate toto toto, he iti noa te ōrau o ngā mate toto toto toto myeloid acute (AML) mō ngā tamariki me ngā pakeke. Ahakoa he pai ake te matapae o te DS-AMKL, he kino te matapae o Non-DS-AMKL me te reiti oranga whānui (OS) e toru tau te iti iho i te 40%. Ko te whakawhitinga pūtau take hematopoietic haploidentical (haplo HCT) anake te maimoatanga whakaora e wātea ana mō ēnei tūroro i tēnei wā.

I arotahi te rangahau ki te whakamahinga o ngā tikanga rongoā Bu/Cy kua whakarerekētia me te Melphalan (MEL) me te Thiotepa (TT) rānei hei whakapai ake i ngā reiti oranga me te whakaiti i ngā raruraru i roto i ngā tūroro e whakawhitihia ana ki te pūtau take haploidentical. He pai ngā hua, e whakaatu ana i te whakapainga nui o te oranga whānui (OS) i waenga i ngā tūroro murunga katoa (CR). Ko te OS mō ngā tūroro CR he 68.2%, ki te 16.7% mō ngā tūroro kāore i eke ki te CR (PR/NR), e whakaatu ana i te tūranga nui o te whakatutuki i te CR ki te whakapai ake i ngā putanga oranga.

I whakaurua ki te rangahau he 59 ngā tūroro tamariki ehara i te DS-AMKL, ā, ko te pakeke toharite he 2 tau. I muri i te maimoatanga, i angitu te whakawhitinga o ngā tūroro katoa, me te wā toharite he 13 ngā rā mō te whakawhitinga o ngā neutrophil me te 9 ngā rā mō te whakawhitinga o ngā platelet. He mea nui, ko ngā tikanga Bu/Cy+MEL me Bu/Cy+TT i hua ake ai he 100% te auau OS mō ngā tūroro i roto i te rōpū Bu/Cy+TT, ahakoa kāore he rerekētanga nui i roto i te OS i waenga i ngā rōpū Bu/Cy me Bu/Cy+MEL.

Mō ngā raruraru, i whakaatuhia e ngā tikanga whakarerekētanga he whakahekengate pikinga o te auau o te mate urutā-whakaeke-whakaeke-whakaeke-whakamataku o te Tau III-IV (aGVHD) me te mate e pā ana ki te whakawhitinga (TRM), e whakaatu ana i te haumaru o ngā tikanga hou. He iti ake te auau o te aGVHD kino i roto i te rōpū Bu/Cy+TT, me te whakahekenga o te GVHD whakapeka me te mau tonu ki te whakaritea ki te tikanga Bu/Cy tuku iho.

I whakanui a Tākuta Wei i te kaha o ēnei tikanga rongoā kua whakarerekētia ki te whakapai ake i ngā putanga o ngā tūroro ehara i te DS-AMKL, inā koa ko te hunga e whiwhi ana i te murunga katoa. Ka whakaratohia e te rangahau he māramatanga nui ki te arotau i ngā tikanga maimoatanga mō te AMKL, ā, ka whakatakoto i te huarahi mō ētahi atu tūhuratanga haumanu. Ahakoa kāore i te tino whai hua ngā hua mō ngā tūroro murunga wāhanga me ngā tūroro kāore i te murunga, ka tukuna e te huarahi he tumanako mō ngā rautaki maimoatanga pai ake ā muri ake nei.

Mā te rangahau tonu me te kohikohi raraunga, e whai ana te tīma Hōhipera o Lu Daopei ki te whakapai ake i ēnei tikanga maimoatanga hei whakarato otinga pumau mō ngā tūroro ehara i te DS-AMKL, ā, ka taea pea te whakarerekē i te āhua o te maimoatanga mō tēnei momo leukemia uaua.