Ongororo yeMulti-Center Inoratidza Kufungidzira Kwakanaka Kwevarwere VeHematologic Malignancy Vari Kuiswa MuMMUD Allogeneic Stem Cell Transplant neATG
Ongororo yekuongorora yakaitwa muChina yakaratidza mhedzisiro yakanaka ye mismatched relatively related donor (MMUD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) kune varwere vane chirwere cheropa. Yakaburitswa muChina muna 2016. Kudyarwa kweBone Morrow, chidzidzo ichi chinoongorora kushanda kwekubatanidza MMUD allo-HSCT ne antithymocyte globulin (ATG) kudzivirira chirwere che graft-versus-host (GVHD). Nzira iyi yakaratidza kuti inopa mhedzisiro yakasimba yekiriniki, kunyangwe paine kusawirirana mukubatana kwe human leukocyte antigen (HLA) pakati pemupi nemugamuchiri.
Chidzidzo ichi chakanyoresa varwere 211 vane makore 14 zvichikwira, vese vakaonekwa vaine chirwere cheropa uye vakapora zvachose vasati vaisirwa mushonga wekubvisa chirwere. Varwere vakakamurwa kuita mapoka maviri zvichienderana nehuwandu hwekusawirirana kweHLA: Boka A rine allele imwe chete isina kufanana uye Boka B rine kusawirirana kaviri kana kupfuura. Varwere vese vakapihwa masero eropa anowanikwa panze uye kurapwa kwekugadzirisa chirwere nehurongwa hwekuchenesa marora, pamwe chete nekudzivirira GVHD kunosanganisira ATG.
Mhedzisiro huru inosanganisira mwero wepamusoro we96.2% yema neutrophils uye 93.4% yemaplatelet mukati memazuva makumi maviri nemasere ekutanga. Chidzidzo ichi chakaratidzawo kuwanda kwehuwandu hweGVHD yakakomba, neGVHD yegiredhi rechitatu-rechina (III-IV) ichiitika mu12.3% yezviitiko, uye GVHD yenguva refu kusvika yakanyanya kusvika pa21% mushure memakore matatu. Mwero wekurarama kwemakore matatu (OS) waive 63.1%, nemwero wekurarama usina chirwere (DFS) we54.5%.
Zvakawanikwa zvakaratidzawo kuti huwandu hwekusawirirana kweHLA hauna kukanganisa zvakanyanya mwero wekurarama, kuwanda kweGVHD, kana kudzoserwa kwehutachiona. Pamusoro pezvo, kushandiswa kweATG yakaderera (≤6 mg/kg) kwakavandudza mwero wekubatanidzwa kwemasero uye kwakapa mabhenefiti ekurapa pasina kukanganisa mwero wekurarama kana kudzokera kuchirwere, zvichipa sarudzo yekurapa inodhura zvishoma.
Tsvagiridzo iyi ndiyo ongororo yakakura kwazvo yakaitwa muChina pamusoro peMMUD allo-HSCT uye inoratidza mukana weiyi nzira yekuisa nhengo dzemuviri kune varwere vane kenza yeropa ine njodzi huru. Inopa ruzivo rwakakosha mukuvandudza mhedzisiro yemurwere uye kugadzirisa maitiro ekuisira nhengo dzemuviri, zvichiita kuti ive mupiro wakakosha munharaunda yeropa. Kurapa Kenza.