Mitengo Yopulumuka Yowonjezereka ndi Bu/Cy+Melphalan ndi Bu/Cy+Thiotepa Regimens mu Haploidentical Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)

Pa Msonkhano Wapachaka wa 66 wa American Society of Hematology (ASH) womwe unachitikira ku San Diego kuyambira pa 7-10 Disembala, 2024, Dr. Zhi-Jie Wei, Mtsogoleri wa Dipatimenti ya Hematology ku Lu Daopei Hospital, adapereka kafukufuku wofunikira pa chithandizo cha Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Kafukufuku wa gulu lake, wotchedwa "Zotsatira Zabwino Kwambiri ndi Bu/Cy+Melphalan ndi Bu/Cy+Thiotepa Regimens mu Haploidentical Hematopoietic Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia," adawonetsedwa mu Abstract 3492 ndipo akuwonetsa kupita patsogolo kwakukulu pa chithandizo cha AMKL.

Non-DS-AMKL, mtundu wa khansa ya m'magazi yomwe siidziwika bwino komanso yowopsa, imayambitsa chiwerengero chochepa cha milandu ya khansa ya m'magazi ya ana ndi akuluakulu (AML). Ngakhale kuti DS-AMKL nthawi zambiri imakhala ndi zizindikiro zabwino, Non-DS-AMKL imakhala ndi zizindikiro zoyipa zokhala ndi chiŵerengero cha moyo wonse wa zaka zitatu (OS) chosakwana 40%. Kusamutsa maselo oyambira a magazi (haploidentical hematopoietic stem cell transplantation) (haplo HCT) ndiye chithandizo chokhacho chomwe chimapezeka kwa odwalawa.

Kafukufukuyu adayang'ana kwambiri pakugwiritsa ntchito njira zosinthira za Bu/Cy mogwirizana ndi Melphalan (MEL) kapena Thiotepa (TT) kuti apititse patsogolo kuchuluka kwa kupulumuka ndikuchepetsa mavuto mwa odwala omwe akupatsidwa chithandizo cha haploidentical stem cell. Zotsatira zake zinali zabwino, zomwe zikuwonetsa kusintha kwakukulu mu kupulumuka konse (OS) pakati pa odwala omwe ali ndi chikhululukiro chokwanira (CR). OS ya odwala a CR inali 68.2%, poyerekeza ndi 16.7% ya odwala omwe sanakwaniritse CR (PR/NR), zomwe zikuwonetsa udindo wofunikira pakukwaniritsa CR pakukweza zotsatira za kupulumuka.

Kafukufukuyu adaphatikizapo odwala 59 omwe si a DS-AMKL omwe ali ndi zaka zapakati pa 2. Pambuyo pa chithandizo, odwala onse adakwanitsa kuyika bwino, ndi nthawi yapakati ya masiku 13 yoyika neutrophil ndi masiku 9 yoyika ma platelet. Chodziwika bwino ndi chakuti, njira za Bu/Cy+MEL ndi Bu/Cy+TT zidapangitsa kuti odwala omwe ali mgulu la Bu/Cy+TT akhale ndi chiwopsezo cha 100% cha OS, ngakhale kuti panalibe kusiyana kwakukulu pakati pa magulu a Bu/Cy ndi Bu/Cy+MEL.

Ponena za zovuta, njira zosinthidwazo zawonetsa kuchepetsaKuchuluka kwa matenda opatsirana pogwiritsa ntchito graft-versus-host (aGVHD) ndi imfa zokhudzana ndi transplantation (TRM), zomwe zikugogomezera chitetezo cha njira zatsopanozi. Kuchuluka kwa matenda opatsirana pogwiritsa ntchito graft-versus-host kunali kotsika kwambiri mu gulu la Bu/Cy+TT, ndipo GVHD yoopsa komanso yosatha inachepa poyerekeza ndi njira yachikhalidwe ya Bu/Cy.

Dr. Wei adagogomezera kuthekera kwa njira zosinthidwazi pakukweza zotsatira za odwala omwe si a DS-AMKL, makamaka omwe akupeza chikhululukiro chathunthu. Kafukufukuyu akupereka chidziwitso chofunikira pakukonza njira zochiritsira za AMKL ndikukhazikitsa njira yopitira patsogolo yofufuza zachipatala. Ngakhale zotsatira za odwala omwe akupeza chikhululukiro chapang'ono ndi omwe sanalandire chikhululukiro sizinali zabwino kwenikweni, njira iyi imapereka chiyembekezo cha njira zabwino zochiritsira mtsogolo.

Ndi kafukufuku wopitilira komanso kusonkhanitsa deta, gulu la Chipatala cha Lu Daopei likufuna kukonza njira izi kuti lipereke mayankho okhalitsa kwa odwala omwe si a DS-AMKL, zomwe zitha kusintha momwe chithandizochi chimathandizira mtundu wovutawu wa khansa ya m'magazi.