Kuvandudzwa Kwemari Yekurarama neBu/Cy+Melphalan uye Bu/Cy+Thiotepa Regimens muHaploidentical Stem Cell Transplantation yeNon-Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)
PaMusangano weGore negore wechi66 weAmerican Society of Hematology (ASH) wakaitirwa muSan Diego kubva musi wa7-10 Zvita, 2024, Dr. Zhi-Jie Wei, Mutungamiriri weDhipatimendi reHematology kuLu Daopei Hospital, vakapa tsvakiridzo inoshamisa pamusoro pekurapa Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Chidzidzo chechikwata chake, chine musoro unoti “Improved Outcomes with Bu/Cy+Melphalan and Bu/Cy+Thiotepa Regimens in Haploidentical Hematopoietic Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia,” chakabudiswa muAbstract 3492 uye chinoratidza kufambira mberi kukuru mukurapa kweAMKL.
Non-DS-AMKL, rudzi rweleukemia rusingawanzoitiki uye rwakasimba, runopa huwandu hushoma hwezvirwere zvevana nevakuru vane chirwere cheAcute myeloid leukemia (AML). Kunyange hazvo DS-AMKL ichiwanzova nechirwere chiri nani, Non-DS-AMKL ine chirwere chisina kunaka chine huwandu hwemakore matatu ekurarama (OS) huri pasi pe40%. Haploidentical hematopoietic stem cell transplantation (haplo HCT) ndiyo chete nzira yekurapa iripo yevarwere ava.
Chidzidzo ichi chakanyanya kutarisa pakushandiswa kwemishonga yakagadziriswa yeBu/Cy pamwe chete neMelphalan (MEL) kana Thiotepa (TT) yekuvandudza mwero wekurarama uye kuderedza matambudziko muvarwere vari kuisirwa haploidentical stem cell. Mhedzisiro yacho yaivimbisa, ichiratidza kuvandudzika kukuru mukurarama kwese (OS) pakati pevarwere vane remission yakakwana (CR). OS yevarwere vane CR yaive 68.2%, zvichienzaniswa ne16.7% yevarwere vasina kuwana CR (PR/NR), zvichiratidza basa rakakosha rekuwana CR mukuvandudza mhedzisiro yekurarama.
Chidzidzo ichi chaisanganisira varwere vevana 59 vasiri veDS-AMKL vane makore maviri epakati. Mushure mekurapwa, varwere vese vakabudirira kuisirwa mushonga, neavhareji yenguva yemazuva gumi nematatu yekuisirwa mushonga we neutrophil uye mazuva mapfumbamwe ekuisirwa mushonga weplatelet. Zvinonyanya kukosha kuti, maitiro eBu/Cy+MEL neBu/Cy+TT akaita kuti pave ne100% OS rate yevarwere vari muboka reBu/Cy+TT, kunyangwe pasina musiyano mukuru muOS pakati pemapoka eBu/Cy neBu/Cy+MEL.
Panyaya yezvinetso, nzira dzakagadziriswa dzakaratidza kudzikiswaKuongororwa kwechirwere cheGrade III-IV che acute graft-versus-host disease (aGVHD) uye kufa kwe transplant-related (TRM), zvichiratidza kuchengetedzeka kwemaitiro matsva. Kuwanda kwe aGVHD yakanyanya kwakaderera zvakanyanya muboka reBu/Cy+TT, nekudzikira kweGVHD inorwadza neyechigarire zvichienzaniswa neBu/Cy regimen yechinyakare.
Dr. Wei vakasimbisa kugona kwemishonga iyi yakagadziriswa mukuvandudza mhedzisiro yevarwere vasiri veDS-AMKL, kunyanya kune avo vanowana kuregererwa kwakakwana. Chidzidzo ichi chinopa ruzivo rwakakosha mukuvandudza nzira dzekurapa dzeAMKL uye chinoisa danho rekutsvaga kwakawanda kwekiriniki. Kunyange hazvo mhedzisiro yevarwere vanoregererwa zvishoma uye vasina kuregererwa yakanga isina tariro yakawanda, nzira iyi inopa tariro yenzira dziri nani dzekurapa mune ramangwana.
Nekuenderera mberi nekutsvaga nekuunganidza data, timu yeLu Daopei Hospital ine chinangwa chekuvandudza nzira idzi dzekurapa kuti dzipe mhinduro dzinogara kwenguva refu kune varwere vasiri DS-AMKL, zvichigona kushandura mamiriro ekurapwa kwerudzi urwu rweleukemia.