Iterambere mu kuvura abantu bakuru B-ALL mu buryo bwa mbere: Isuzuma ryimbitse ryavuye muri The Lancet Haematology

Mu isuzuma ry’ingenzi ryasohotse muri Indwara y'amaraso ya Lancetimpuguke zasobanuye intambwe iherutse guterwa mu kuvura kanseri y’amaraso ya B-cell Acute Lymphoblastic Leukemia (B-ALL) ku rwego rwa mbere, zishimangira akamaro ko kuvura umuntu ku giti cye no guhuza uburyo bushya bwo kuvura indwara. Mu myaka icumi ishize, kuvura B-ALL y’abantu bashya bavuwe byateye intambwe ikomeye bitewe no gusobanukirwa neza imiterere y’indwara, iterambere ry’uburyo bwo gupima indwara ntoya (MRD), no gushyiramo uburyo bwo kuvura abana (PIR) kugira ngo habeho umusaruro mwiza.

Isuzuma rishimangira ko nubwo abarwayi bakuru ba B-ALL bakomeje guhura n'ibibazo byo kunanirwa kuvurwa no kwiyongera kw'impfu ugereranije n'abana, ingamba nyinshi z'ingenzi zirimo kunoza uburyo bwo kuvura. Ku barwayi bakiri bato, gukoresha uburyo bwo kuvura bwahumetswe n'abana byagaragaye ko ari ingirakamaro kurusha uburyo busanzwe bwo kuvura abantu bakuru, aho igipimo cyo kubaho igihe kirekire kigera kuri 78%. Nubwo inyungu z'ubu buryo bwo kuvura zigabanuka uko imyaka igenda ishira, ubu buryo buracyatanga impinduka zikomeye, cyane cyane iyo buhujwe n'uburyo bugezweho bwo kuvura nka tyrosine kinase inhibitors (TKI) kuri Philadelphia chromosome-positive (Ph+) B-ALL.

Byongeye kandi, gushyira imiti ivura indwara nka anti-CD20 monoclonal antibodies (urugero, Belantamab Mafodotin na Inotuzumab Ozogamicin) mu buryo bwa mbere bwo kuvura byagaragaje ko bizafasha mu kugabanya uburozi buterwa na chemotherapy no kongera umubare w’abakira indwara. Ubushakashatsi bwagaragaje ko iyi miti, iyo ikoreshejwe hamwe na chemotherapy isanzwe, yongera cyane umubare w’abakira indwara, cyane cyane mu bwoko bwa B-ALL bufite ibyago byinshi byo kurwara.

Ku barwayi bakuze (barengeje imyaka 60), havutse igihe gishya cyo kuvura hakoreshejwe imiti igabanya ubukana bw'indwara z'umubiri. Ubu buryo bugamije kugabanya umutwaro wa chimiotherapie, butanga uburyo bwizewe kandi bworoshye kwihanganira iri tsinda ry'abantu bafite intege nke. Ubushakashatsi ku buvuzi burimo gusuzuma uburyo bwiza bwo guhuza ubu buryo bwo kuvura, harimo no gukoresha uburyo bwo kuvura bwa CAR-T cells n'imiti igenewe, kugira ngo harusheho kunozwa umusaruro.

Isuzuma ryasoje rivuga ko nubwo hari intambwe nini yatewe mu kunoza uburyo bwo kuvura bwa mbere B-ALL ku bantu bakuru, ubushakashatsi bukomeje gukorwa n'igeragezwa ry'ubuvuzi ni ingenzi cyane mu gukemura ibibazo biri mu buvuzi, cyane cyane ku barwayi bafite ibyago byinshi n'abageze mu za bukuru. Gahunda z'ubuvuzi zishingiye ku bushakashatsi bw'uturemangingo n'uturemangingo, ndetse no gukomeza guteza imbere uburyo bwo kuvura ubudahangarwa bw'umubiri, bitanga icyizere cy'umusaruro mwiza kurushaho mu gihe kizaza.

Iri sesengura ryimbitse ry’ubuvuzi bwa B-ALL rigaragaza umwanya w’ingenzi mu rugamba rwo kurwanya iyi kanseri y’amaraso igoye, rizana icyizere gishya ku barwayi bo ku isi yose.