Kufambira Mberi Mukurapa Kwemutsetse Wekutanga Kwevanhu Vakuru B-ALL: Ongororo Yakakwana kubva kuThe Lancet Haematology
Muongororo itsva yakaburitswa mu Kurapwa kweLancet Hematology, nyanzvi dzakatsanangura kufambira mberi kwazvino mukurapa kwekutanga kweB-cell Acute Lymphoblastic Leukemia (B-ALL) yevakuru, vachisimbisa kukosha kwenzira dzekurapa dzakagadzirwa nemunhu uye kubatanidzwa kwemishonga mitsva yekudzivirira muviri. Mumakore gumi apfuura, kurapwa kweB-ALL yevakuru vachangobva kuongororwa kwakabudirira zvikuru nekuda kwekunzwisisa kwakadzama kwehupenyu hwechirwere, kukura kwenzira dzekuongorora chirwere cheminimum residual (MRD), uye kuiswa kwemishonga inofemerwa nevana (PIR) kuti pave nemigumisiro iri nani.
Ongororo iyi inoratidza kuti kunyange zvazvo varwere vakuru veB-ALL vachiramba vachisangana nematambudziko ekutadza kurapwa uye huwandu hwerufu hwakakwira zvichienzaniswa nevana, nzira dzinoverengeka dzakakosha dziri kuvandudza fungidziro yerapi. Kune varwere vadiki, kushandiswa kwemishonga inotungamirwa nevana kwaratidza kushanda zvakanyanya kupfuura mishonga yechivanhu yevakuru, nehuwandu hwekurarama kwenguva refu hunosvika pa78%. Kunyangwe kubatsira kwekurapa uku kuchiderera nekukura, nzira iyi ichiri kupa kuvandudzwa kwakakosha, kunyanya kana ikasanganiswa nemishonga yemazuva ano yakaita setyrosine kinase inhibitors (TKI) yePhiladelphia chromosome-positive (Ph+) B-ALL.
Pamusoro pezvo, kuiswa kwemishonga yekudzivirira muviri yakadai se anti-CD20 monoclonal antibodies (semuenzaniso, Belantamab Mafodotin na Inotuzumab Ozogamicin) muzvirongwa zvekurapa zvekutanga kwakaratidza tarisiro mukuderedza chepfu inokonzerwa nechemotherapy uye kuwedzera mwero wekupindura. Zvidzidzo zvakaratidza kuti mishonga iyi, kana ikashandiswa pamwe chete nechemotherapy yakajairika, inowedzera zvakanyanya mwero wekurerukirwa, kunyanya mumhando dzeB-ALL dzine njodzi huru.
Kune varwere vakwegura (vanopfuura makore makumi matanhatu), nguva itsva yekurapwa yabuda nekushandiswa kwemishonga ine simba shoma pamwe chete ne immunotherapy. Nzira idzi dzinovavarira kuderedza mutoro we chemotherapy, zvichipa sarudzo yakachengeteka uye inoshivirira kune boka iri risingakwanise kurapwa. Zvidzidzo zvekiriniki zviri kutsvaga kubatanidzwa kwakakodzera kwemishonga iyi, kusanganisira kushandiswa kweCAR-T cell therapy uye mishonga yakanangwa, kuti zviwedzere kuvandudza mhedzisiro.
Ongororo iyi inogumisa kuti kunyange hazvo paine kufambira mberi kukuru kwakaitwa mukugadzirisa kurapwa kwekutanga kweB-ALL yevakuru, kutsvagurudza kuri kuenderera mberi uye kuyedzwa kwekiriniki kwakakosha kugadzirisa mipata mukurapa, kunyanya kune varwere vane njodzi huru uye vakwegura. Zvirongwa zvekurapa zvakagadzirwa zvinoenderana nekuongorora majini nemasero, pamwe nekuenderera mberi kwekuvandudzwa kwemishonga yekudzivirira muviri, zvinopa tariro yemhedzisiro iri nani mune ramangwana.
Ongororo iyi yakazara yekurapwa kweB-ALL inoratidza nguva inokosha mukurwisa gomarara iri reropa, zvichiunza tariro itsva kuvarwere pasi rose.