Igipimo cyo kubaho cyarushijeho kuba cyiza hamwe na Bu/Cy+Melphalan na Bu/Cy+Thiotepa Regimens mu gutera uturemangingo twa Haploidentical Stem Selplantation ku ndwara ya Non-Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)

Mu nama ngarukamwaka ya 66 y’Umuryango w’Abanyamerika w’Ubuvuzi bw’Amaraso (ASH) yabereye i San Diego kuva ku ya 7 kugeza ku ya 10 Ukuboza 2024, Dr. Zhi-Jie Wei, Umuyobozi w’Ishami ry’Ubuvuzi bw’Amaraso mu Bitaro bya Lu Daopei, yatanze ubushakashatsi bw’ingenzi ku kuvura indwara ya Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Ubushakashatsi bw’ikipe ye, bwitwa “Impamvu nziza hamwe na Bu/Cy+Melphalan na Bu/Cy+Thiotepa Regimens mu Gutera Uturemangingo tw’Amaraso mu Bitaro bya Haploidentical Hematopoietic Stem Cell Transplantation kuri Non-Down Syndrome Acute Megakaryoblastic Leukemia,” bwashyizwe ahagaragara mu Incamake ya 3492 kandi bugaragaza iterambere rikomeye mu kuvura AMKL.

Non-DS-AMKL, ubwoko budasanzwe kandi bukabije bwa leukemia, bugira uruhare runini mu ndwara za leukemia y’abana n’abantu bakuru (AML). Nubwo DS-AMKL ikunze kugira imiterere myiza, Non-DS-AMKL ifite imiterere mibi aho igipimo cy’ubuzima bw’imyaka itatu (OS) kiri munsi ya 40%. Gutera uturemangingo tw’amaraso mu maraso (haploidentical hematopoietic stem cells) ni bwo buryo bwonyine bwo kuvura buhari kuri aba barwayi.

Ubushakashatsi bwibanze ku ikoreshwa ry’uburyo bwahinduwe bushingiye kuri Bu/Cy bukoreshwa hamwe na Melphalan (MEL) cyangwa Thiotepa (TT) kugira ngo hongerwe uburyo bwo kubaho no kugabanya ingorane ku barwayi baterwa uturemangingo tw’umubiri twa haploidentical. Ibisubizo byari byiza, bigaragaza iterambere rikomeye mu kubaho muri rusange (OS) mu barwayi barembye burundu (CR). OS ku barwayi ba CR yari 68.2%, ugereranyije na 16.7% ku barwayi batageze kuri CR (PR / NR), bigaragaza uruhare runini rwo kugera kuri CR mu kunoza umusaruro w’ubuzima.

Ubushakashatsi bwakorewe ku barwayi 59 badafite DS-AMKL bafite imyaka ibarirwa muri za 2. Nyuma yo kuvurwa, abarwayi bose babashije guterwa neza, aho igihe cyo guterwa cy’iminsi 13 cya neutrophil n’iminsi 9 cyatejwe. Ikigaragara ni uko gahunda ya Bu/Cy+MEL na Bu/Cy+TT yatumye habaho igipimo cya OS 100% ku barwayi bo mu itsinda rya Bu/Cy+TT, nubwo nta tandukaniro rigaragara mu buryo bwa OS hagati y’amatsinda ya Bu/Cy na Bu/Cy+MEL.

Ku bijyanye n'ingorane, gahunda zavuguruwe zagaragaje ko hari uburyo bwo kugabanyaku ikwirakwizwa ry’indwara yo mu cyiciro cya gatatu kugeza icya kane (aGVHD) n’impfu zikomoka ku gutwikirwa (TRM), bishimangira umutekano w’amabwiriza mashya. Ikwirakwizwa ry’indwara ikomeye ya aGVHD ryari rike cyane mu itsinda rya Bu/Cy+TT, aho GVHD ikabije n’iya karande byagabanutse ugereranije n’uburyo busanzwe bwa Bu/Cy.

Dr. Wei yashimangiye ko izi gahunda zahinduwe zishobora kunoza umusaruro w’abarwayi batari DS-AMKL, cyane cyane abagera ku buremere bwuzuye. Ubu bushakashatsi butanga ubumenyi bw’ingirakamaro ku kunoza uburyo bwo kuvura AMKL kandi bugashyiraho inzira yo gukomeza ubushakashatsi ku buvuzi. Nubwo ibisubizo by’abarwayi barembye igice kimwe n’abarembye bitari byiza cyane, ubu buryo butanga icyizere cy’ingamba nziza zo kuvura mu gihe kizaza.

Hamwe n’ubushakashatsi bukomeje no gukusanya amakuru, itsinda ry’ibitaro bya Lu Daopei rigamije kunoza ubu buryo bwo kuvura kugira ngo ritange ibisubizo birambye ku barwayi batari abarwayi ba DS-AMKL, bishobora guhindura imiterere y’ubuvuzi bw’iyi ndwara ikomeye ya kanseri y’amaraso.