Amanqanaba okusinda aphuculweyo nge-Bu/Cy+Melphalan kunye ne-Bu/Cy+Thiotepa Regimens kwi-Haploidentical Stem Cell Transplantation ye-Non-Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)

KwiNtlanganiso yoNyaka yama-66 ye-American Society of Hematology (ASH) ebibanjelwe eSan Diego ukususela nge-7-10 kaDisemba, ngo-2024, uGqr. Zhi-Jie Wei, uMlawuli weSebe leHematology kwiSibhedlele saseLu Daopei, ubonise uphando oluphambili malunga nonyango lwe-Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Uphononongo lweqela lakhe, olunesihloko esithi “Iziphumo eziPhuculweyo nge-Bu/Cy+Melphalan kunye ne-Bu/Cy+Thiotepa Regimens kwi-Haploidentical Hematopoietic Stem Cell Transplantation ye-Non-Down Syndrome Acute Megakaryoblastic Leukemia,” luboniswe kwi-Abstract 3492 kwaye lubonisa inkqubela phambili ebalulekileyo kunyango lwe-AMKL.

I-Non-DS-AMKL, uhlobo olungaqhelekanga nolunobundlongondlongo lwe-leukemia, ibangela ipesenti encinci yamatyala e-acute myeloid leukemia (AML) yabantwana kunye neyabantu abadala. Nangona i-DS-AMKL idla ngokuba ne-prognosis engcono, i-Non-DS-AMKL ine-prognosis embi kunye ne-OS-year-year survival rate (OS) engaphantsi kwama-40%. Ukufakelwa kweeseli ze-hematopoietic stem (haplo HCT) okwangoku lolona nyango kuphela olufumanekayo kwezi zigulana.

Olu phononongo lugxile ekusebenziseni iindlela zokulungisa ezisekelwe kwi-Bu/Cy eziguquliweyo kunye ne-Melphalan (MEL) okanye i-Thiotepa (TT) ukuphucula amazinga okusinda kunye nokunciphisa iingxaki kwizigulana ezifakelwa i-haploidentical stem cell transplantation. Iziphumo bezithembisa, zibonisa ukuphucuka okukhulu kwi-overall survival (OS) phakathi kwezigulana ezipheleleyo (CR). I-OS yezigulana ze-CR yayiyi-68.2%, xa kuthelekiswa ne-16.7% kwizigulana ezingakhange zifumane i-CR (PR/NR), nto leyo egxininisa indima ebalulekileyo yokufezekisa i-CR ekuphuculeni iziphumo zokusinda.

Olu phononongo luquke izigulana ezingama-59 zezingane ezingezizo ii-DS-AMKL ezineminyaka ephakathi kwemi-2 ubudala. Emva konyango, zonke izigulana ziphumelele ekufakweni kwe-neutrophil, ixesha eliphakathi leentsuku ezili-13 zokufakwa kwe-neutrophil kunye neentsuku ezili-9 zokufakwa kwe-platelet. Okuphawulekayo kukuba, iindlela ze-Bu/Cy+MEL kunye ne-Bu/Cy+TT zibangele izinga le-OS eliyi-100% kwizigulana ezikwiqela le-Bu/Cy+TT, nangona bekungekho mahluko abalulekileyo kwi-OS phakathi kwamaqela e-Bu/Cy kunye ne-Bu/Cy+MEL.

Ngokuphathelele iingxaki, iindlela ezilungisiweyo zibonise ukunciphisaukwenziwa kwesifo se-Grade III-IV acute graft-versus-host disease (aGVHD) kunye nokufa okunxulumene nokufakelwa (TRM), nto leyo egxininisa ngakumbi ukhuseleko lweenkqubo ezintsha. Ukwenzeka kwe-aGVHD enzima bekuphantsi kakhulu kwiqela le-Bu/Cy+TT, kunye nokuncipha kwe-GVHD ebukhali nengapheliyo xa kuthelekiswa nenkqubo yendabuko ye-Bu/Cy.

UGqr. Wei ugxininise amandla ezi ndlela zilungisiweyo ekuphuculeni iziphumo zezigulane ezingezizo i-DS-AMKL, ingakumbi kwabo bafumana ukukhululwa ngokupheleleyo. Olu phononongo lubonelela ngengqiqo ebalulekileyo malunga nokuphucula iindlela zonyango ze-AMKL kwaye lubeka isiseko sophando oluthe kratya lwezonyango. Nangona iziphumo zezigulane ezikhululwayo ngokungaphelelanga kunye nezingazange zikhutshwe zingathembisi kangako, le ndlela inika ithemba leendlela zonyango ezingcono kwixesha elizayo.

Ngophando oluqhubekayo kunye nokuqokelelwa kwedatha, iqela leSibhedlele saseLu Daopei lijolise ekuphuculeni ezi ndlela zonyango ukuze libonelele ngezisombululo ezihlala ixesha elide kwizigulane ezingezizo i-DS-AMKL, nto leyo enokutshintsha indlela yonyango olu hlobo lwe-leukemia olunzima ngayo.