Uphononongo lweMulti-Center lubonisa ukubikezela okuhle kwezigulana zeHematologic Malignancy ezifakelwa i-MMUD Allogeneic Stem Cell Transplant nge-ATG
Uphononongo olujonga emva oluqhutywa eTshayina oluneziko ezininzi lubonise iziphumo ezithembisayo zokufakelwa kweeseli ze-hematopoietic stem cell (i-allo-HSCT) ezingasebenzi kakuhle kwizigulane ezine-hematologic malignancies. Ukufakelwa kweBone Marrow, olu phononongo luhlola ukusebenza kakuhle kokudibanisa i-MMUD allo-HSCT kunye ne-antithymocyte globulin (ATG) ukuthintela isifo se-graft-versus-host (GVHD). Le ndlela ibonakalise ukuba inika iziphumo eziqinileyo zeklinikhi, nangona kukho ukungangqinelani phakathi kwe-human leukocyte antigen (HLA) phakathi komnikeli kunye nommkeli.
Olu phononongo lubhalise izigulana ezingama-211 ezineminyaka eli-14 nangaphezulu, zonke zifunyaniswe zine-hematologic malignancies kwaye zikhululekile ngokupheleleyo ngaphambi kokuba zifakelwe ezinye izigulana. Izigulana zahlulwe zangamaqela amabini ngokusekelwe kwinani le-HLA mismatch: Iqela A elinomahluko omnye we-allele kunye neQela B elinomahluko amabini nangaphezulu. Zonke izigulana zifumene iiseli zegazi ezingaphandle kunye nonyango lokulungisa umzimba ngenkqubo yokucoca umongo, kunye nothintelo lwe-GVHD olubandakanya i-ATG.
Iziphumo eziphambili ziquka izinga eliphezulu lokufakelwa kwe-cumulative eggplant ye-96.2% kwi-neutrophils kunye ne-93.4% kwi-platelets kwiintsuku zokuqala ezingama-28. Olu phononongo lukwabonise ukuba kukho inani eliphantsi kakhulu le-GVHD ebukhali kakhulu, apho i-III-IV grade GVHD isenzeka kwi-12.3% yamatyala, kunye ne-GVHD engapheliyo ephakathi ukuya kwenzima ifikelela kwi-21% emva kweminyaka emithathu. Izinga lokusinda lilonke leminyaka emithathu (OS) yayiyi-63.1%, kunye nezinga lokusinda elingenasifo (DFS) elingama-54.5%.
Ezi ziphumo zikwabonise ukuba inani lokungafani kwe-HLA alizange lichaphazele kakhulu amazinga okusinda, ukwanda kwe-GVHD, okanye ukuvuselelwa kwentsholongwane. Ukongeza, ukusetyenziswa kweedosi eziphantsi ze-ATG (≤6 mg/kg) kuphucule amazinga okufakelwa kwamayeza kwaye kubonelela ngeenzuzo zonyango ngaphandle kokuchaphazela amazinga okusinda okanye ukuphinda ubuye, okubonelela ngokhetho lonyango olungabizi kakhulu.
Olu phando lolona phando lukhulu lweziko ezininzi eTshayina kwi-MMUD allo-HSCT kwaye lugxininisa amandla ale ndlela yokufakelwa izigulana ezinomhlaza we-hematologic onobungozi obukhulu. Lubonelela ngolwazi oluxabisekileyo malunga nokuphucula iziphumo zesigulana kunye nokuphucula iindlela zokufakelwa izitho, nto leyo eyenza ukuba ibe negalelo elibalulekileyo kwicandelo legazi. Unyango lomhlaza.