Intuthuko Ekwelashweni Komugqa Wokuqala Kwabantu Abadala Abane-B-ALL: Isibuyekezo Esiphelele Esivela Ku-Lancet Haematology
Esibuyekezweni esibalulekile esanyatheliswa ku- I-Lancet Haematology, ochwepheshe bachaze kabanzi ngentuthuko yakamuva ekwelashweni kokuqala kwe-B-cell Acute Lymphoblastic Leukemia (B-ALL) yabantu abadala, begcizelela ukubaluleka kwamasu okwelapha aqondene nomuntu ngamunye kanye nokuhlanganiswa kwezindlela zokwelapha ezintsha. Eminyakeni eyishumi edlule, ukwelashwa kwe-B-ALL yabantu abadala esanda kutholakala kuye kwenza intuthuko enkulu ngenxa yokuqonda okujulile ngebhayoloji yesifo, ukuthuthukiswa kwezindlela zokulinganisa izifo ezincane ezisele (MRD), kanye nokufakwa kwezindlela eziphefumulelwe izingane (PIR) ukuze kube nemiphumela engcono.
Ukubuyekezwa kugcizelela ukuthi nakuba iziguli ze-B-ALL zabantu abadala ziqhubeka nokubhekana nezinselele zokwehluleka kokwelashwa kanye namazinga aphezulu okufa uma kuqhathaniswa nezingane, amasu amaningana abalulekile athuthukisa ukubikezela. Ezigulini ezisencane, ukusetshenziswa kwezindlela zokwelapha eziphefumulelwe yizingane kuye kwabonakala kusebenza kakhulu kunezindlela zokwelapha zabantu abadala zendabuko, kanti amazinga okusinda isikhathi eside afinyelela ku-78%. Nakuba inzuzo yalezi zindlela zokwelapha yehla ngokuguga, le ndlela isanikeza ukuthuthuka okukhulu, ikakhulukazi uma ihlanganiswa nezindlela zokwelapha zesimanje eziqondiwe njenge-tyrosine kinase inhibitors (TKI) ye-Philadelphia chromosome-positive (Ph+) B-ALL.
Ngaphezu kwalokho, ukufakwa kwezindlela zokwelapha izifo ezifana nama-anti-CD20 monoclonal antibodies (isib. i-Belantamab Mafodotin kanye ne-Inotuzumab Ozogamicin) kumaphrothokholi okwelashwa okuqala kubonise ithemba ekunciphiseni ubuthi obuhlobene ne-chemotherapy kanye nokuthuthukisa amazinga okuphendula. Izifundo zibonise ukuthi lawa ma-ejenti, uma esetshenziswa kanye ne-chemotherapy evamile, andisa kakhulu amazinga okukhululwa, ikakhulukazi kuma-subtypes e-B-ALL anobungozi obukhulu.
Kubantu asebekhulile (abangaphezu kweminyaka engama-60), kuvele inkathi entsha yokwelashwa ngokusetshenziswa kwemithi yokwelapha ephansi ehlanganiswe nemithi yokwelapha amasosha omzimba. Lezi zindlela zihlose ukunciphisa umthwalo we-chemotherapy, zinikeza inketho ephephile nebekezelelekayo kuleli qembu elisengozini. Izifundo zemitholampilo zihlola ngenkuthalo ukuhlanganiswa okuhle kwalezi zindlela zokwelapha, okuhlanganisa ukusetshenziswa kwemithi yokwelapha yamaseli e-CAR-T kanye nama-agent aqondiwe, ukuze kuthuthukiswe imiphumela.
Ukubuyekezwa kuphetha ngokuthi yize kwenziwe intuthuko enkulu ekwenzeni ngcono ukwelashwa kokuqala kwabantu abadala i-B-ALL, ucwaningo oluqhubekayo kanye nezivivinyo zemitholampilo kubalulekile ekubhekaneni nezikhala ekwelashweni, ikakhulukazi ezigulini ezisengozini enkulu kanye nezikhulile. Izinhlelo zokwelapha ezenzelwe wena ezisekelwe ekuhlolweni kwezakhi zofuzo kanye nama-molecule, kanye nokuthuthukiswa okuqhubekayo kwezindlela zokwelapha ngezifo, kunikeza ithemba lemiphumela engcono nakakhulu esikhathini esizayo.
Lokhu kuhlaziywa okuphelele kokwelashwa kwe-B-ALL kuphawula isikhathi esibalulekile empini eqhubekayo yokulwa nalo mdlavuza we-hematologic onzima, okuletha ithemba elisha ezigulini emhlabeni jikelele.