Mavuto Okhudza Kuchiza Matenda Oyambitsa Bowa Omwe Amafalikira M'magazi mwa Odwala Matenda a M'magazi: Chidziwitso Chochokera ku ASH 2024
Pa Msonkhano Wapachaka wa 66 wa American Society of Hematology (ASH) mu 2024, Pulofesa Sun Yuqian wochokera ku Peking University People's Hospital adapereka kafukufuku wofunikira pa matenda oyamba ndi fungus (bIFD) mwa odwala omwe akulandira chithandizo cha allogeneic hematopoietic hematopoietic stem cell transplantation (allo-HSCT) ku China. Kafukufukuyu, wochitidwa m'zipatala 12, adasindikizidwa mu magazini yovomerezeka ya Matenda Opatsirana Bungwe la America,Matenda Opatsirana Opatsirana (CID).
Kafukufukuyu, wodziwika kuti kafukufuku wa CAESAR 2.0, adayang'ana kwambiri anthu 2,015 omwe adalandira mankhwala a HSCT kuyambira Januware mpaka Disembala 2021. Adavumbulutsa kuti 76.08% ya odwala adalandira mankhwala ophera tizilombo toyambitsa matenda, makamaka voriconazole (44.37%) ndi posaconazole (31.71%). Ngakhale kuti mankhwala ophera tizilombo toyambitsa matendawa amagwiritsidwa ntchito kwambiri, kafukufukuyu adapeza kuti kuchuluka kwa matenda a fungus (IFD) pachaka ndi 6.3%, ndipo chiwerengero chachikulu cha imfa chimafika pa 48.28%. Candida, Aspergillus, ndi bowa wina adadziwika kuti ndi omwe amachititsa matendawa.
Pulofesa Sun adalankhulanso za mavuto azachipatala okhudzana ndi kuzindikira ndi kuchiza bIFD mwa odwala khansa ya m'magazi. Kupambana kwa IFD kumachitika panthawi yopewera matenda oyambitsidwa ndi bowa, zomwe zimapangitsa kuti matendawo azivuta komanso kuti chithandizo chikhale chovuta. Chifukwa chosowa tanthauzo lokhazikika, kuchuluka kwa matenda a bIFD kumasiyana kwambiri, kuyambira 1% mpaka 42%. Kusiyana kumeneku kumapangitsa kuti zikhale zovuta kukhazikitsa njira zodziwira matenda komanso njira zochiritsira.
Chimodzi mwa zovuta zazikulu zomwe Pulofesa Sun adawonetsa ndi zovuta za zinthu zoopsa zomwe zimayambitsa matenda a bIFD, zomwe zimaphatikizapo neutropenia yayitali, kugwiritsa ntchito ma steroid, komanso kugwiritsa ntchito maantibayotiki ambiri nthawi yayitali. Kuphatikiza apo, mankhwala ophera bowa omwe amagwiritsidwa ntchito popewa matenda sangakhudze nthawi zonse mitundu yonse ya tizilombo toyambitsa matenda, ndipo mitundu yatsopano ya bowa imatha kupewa kupezeka chifukwa cha kuchepa kwa chidwi mu mayeso ozindikira matenda monga mayeso a PCR ndi GM.
Pulofesa Sun adagogomezera kufunika kochiza matenda oyamba ndi bowa, makamaka kwa odwala omwe ali pachiwopsezo chachikulu omwe akuwonetsa zizindikiro za matenda. Adalangiza kuti chithandizo cha mankhwala oyamba ndi bowa chiyenera kuyambitsidwa nthawi yomweyo kwa odwala omwe akudwala kwambiri omwe akuganiziridwa kuti ali ndi bIFD, ngakhale zotsatira za labotale zisanapezeke. Adalangizanso kugwiritsa ntchito mankhwala oyambitsa bowa omwe amasiyana ndi njira yodzitetezera kuti athandize kwambiri chithandizocho.
Zomwe zapezeka mu kafukufuku wa CAESAR 2.0 zikugogomezera kufunika kwa njira zabwino zowongolera chiopsezo cha IFD mwa odwala omwe ali ndi HSCT komanso kufunikira kofunikira kopeza matenda msanga ndi kulowererapo. Monga momwe Pulofesa Sun adanenera, ngakhale kuti mankhwala ophera ma fungi omwe alipo akupitilizabe kugwira ntchito yofunika kwambiri, kupanga njira zatsopano zochizira matenda ndi zida zodziwira matenda ndikofunikira kwambiri pakukweza zotsatira za odwala. Mankhwala atsopano, monga Chithandizo cha Immunotherapy ndi mankhwala atsopano ophera bowa, angapereke chiyembekezo chatsopano kwa odwala omwe akulimbana ndi matenda owopsa awa.
Kafukufuku wodabwitsa uyu pa bIFD akuwonetsa mavuto omwe madokotala akukumana nawo pakuwongolera matenda a bowa mwa odwala omwe ali ndi khansa ya m'magazi ndipo akuwonetsa kufunikira kwakukulu kopitiliza patsogolo njira zopewera komanso zochizira.