Iterambere mu gushyira mu byiciro ibyago bya T-ALL: Ishyirwa mu byiciro rishingiye kuri NGS rigaragaza amatsinda mato afite ibyago byinshi

Mu bushakashatsi bwasohotse mu Amaraso, abashakashatsi bakoresheje uburyo bwo gukurikirana indwara bwa “next-generation sequencing” (NGS) kugira ngo bongere uburyo bwo gushyira mu byiciro ibyago byo kwandura kanseri y’amaraso ya T-cell acute lymphoblastic leukemia (T-ALL). Ubu buryo bwo gushyira mu byiciro butanga uburyo bunoze bwo guhanura ibisubizo by’abarwayi no kumenya amatsinda mato afite ibyago byinshi, bishobora gutuma habaho uburyo bwo kuvura bwihariye.

Ubu bushakashatsi, bwari bugizwe n’abarwayi 198 bakuze ba T-ALL bo mu igerageza rya GRAALL-2003/2005 n’abarwayi 242 ba T-ALL bo mu igerageza rya FRALLE2000T, bwakoresheje uburyo bwo gusuzuma ingirabuzimafatizo 72 zifitanye isano na kanseri. Mu byavumbuwe, impinduka za NOTCH1 ni zo zikunze kugaragara cyane mu bantu bakuru, ziboneka muri 77% by’abarwaye, hagakurikiraho impinduka za CDKN2A (66%) na PHF6 (50%). Ubu bushakashatsi burambuye bwa genetiki bwafashije abashakashatsi gushyira abarwayi mu byiciro by’abafite ibyago byinshi n’abafite ibyago bike, bikagira ingaruka zikomeye ku mibereho yabo.

Hashyizweho uburyo bushya bwo gushyira mu byiciro bushingiye kuri NGS, bwagaragaje ubushobozi bwo guhanura indwara mu buryo bworoshye, kubaho muri rusange, no kubaho nta ndwara ugereranije n’uburyo bwakoreshejwe mbere. Ubushakashatsi bwagaragaje ko abarwayi bafite ibyago bike ari bo bafite impinduka zihariye (urugero, NOTCH1/FBXW7, PHF6, EP300) badafite izindi mpinduka zikomeye (urugero, impinduka mu nzira ya PI3K, TP53, na IDH1/2). Aba barwayi bari bafite igipimo cyo gusubiramo indwara mu myaka 5 (CIR) cya 21%, mu gihe abari mu cyiciro cy’abafite ibyago byinshi bahuye na CIR iri hejuru cyane ya 47%.

Byongeye kandi, guhuza ibyavuye muri NGS n'ibintu by'ubuvuzi nk'umubare w'uturemangingo tw'amaraso (WBC) n'urugero ruto rw'indwara zisigara (MRD) byatumye habaho icyitegererezo cyiza cy'ibyago cyashyize abarwayi mu matsinda atatu: abagera ku ngaruka nini, abagera ku ngaruka nto, n'abagera ku ngaruka nke. Ubu buryo bwagaragaje ko bufite akamaro kanini mu gutandukanya abarwayi bashobora kungukirwa n'ubuvuzi bukomeye, cyane cyane abafite imiterere y'uturemangingo ifite ibyago byinshi.

Ibyavuye mu bushakashatsi bigaragaza ubushobozi bwa NGS bwo kunoza ubuhanuzi bw’uko indwara izabaho no kunoza gahunda yo kuvura abarwayi ba T-ALL bakuru n’abana. Mu guhuza ubumenyi bushingiye ku ngirabuzimafatizo n’amakuru y’ubuvuzi, abaganga bashobora kumenya neza abarwayi bashobora kungukirwa n’ubuvuzi bushya, nka PI3K inhibitors na selective IDH1 / IDH2 inhibitors.

Mu gihe ubushakashatsi butegura inzira yo gufata ingamba zo kuvura ku giti cyazo, nabwoo itera ibibazo by'ingenzi ku bijyanye n'uko iri tsinda rikoreshwa mu moko atandukanye no mu buryo bugezweho bwo kuvura. Nubwo ibyiciro bishingiye kuri NGS bifite icyizere, hakenewe ubushakashatsi bw'inyongera kugira ngo hemezwe ko rikora neza mu baturage batandukanye no kunoza uburyo bwo kuvura indwara zikomeye, nk'abafite uburwayi bwa T-ALL budashobora kugaragara.