Amanani Okusinda Athuthukisiwe Nge-Bu/Cy+Melphalan kanye ne-Bu/Cy+Thiotepa Regimens ku-Haploidentical Stem Cell Transplantation ye-Non-Down Syndrome Acute Megakaryoblastic Leukemia (AMKL)
Emhlanganweni Waminyaka Yonke Wama-66 we-American Society of Hematology (ASH) owawuseSan Diego kusukela mhla ziyi-7 kuya kweziyi-10 kuZibandlela 2024, uDkt. Zhi-Jie Wei, uMqondisi woMnyango We-Hematology eSibhedlela iLu Daopei, wethule ucwaningo oluqavile ngokwelashwa kwe-Non-Down Syndrome Acute Megakaryoblastic Leukemia (Non-DS-AMKL). Ucwaningo lwethimba lakhe, olunesihloko esithi “Imiphumela Ethuthukisiwe nge-Bu/Cy+Melphalan kanye ne-Bu/Cy+Thiotepa Regimens in Haploidentical Hematopoietic Stem Cell Transplantation for Non-Down Syndrome Acute Megakaryoblastic Leukemia,” luvezwe ku-Abstract 3492 futhi luphawula intuthuko enkulu ekwelashweni kwe-AMKL.
I-Non-DS-AMKL, uhlobo olungavamile nolunamandla lwe-leukemia, ibangela iphesenti elincane lamacala e-acute myeloid leukemia (AML) ezinganeni nakubantu abadala. Ngenkathi i-DS-AMKL ivame ukuba ne-prognosis engcono, i-Non-DS-AMKL ine-prognosis embi enesilinganiso sokusinda seminyaka emithathu (OS) esingaphansi kwama-40%. Ukufakelwa kwe-Haploidentical hematopoietic stem cell (haplo HCT) okwamanje kuyindlela yokwelapha kuphela etholakalayo yalezi ziguli.
Ucwaningo lugxile ekusetshenzisweni kwezindlela zokwelashwa ezisekelwe ku-Bu/Cy eziguquliwe kanye ne-Melphalan (MEL) noma i-Thiotepa (TT) ukuthuthukisa amazinga okusinda nokunciphisa izinkinga ezigulini ezifakelwa i-haploidentical stem cell. Imiphumela yayithembisa, ikhombisa ukuthuthuka okukhulu ekusindeni okuphelele (OS) phakathi kweziguli ezithola ukukhululwa okuphelele (CR). I-OS yeziguli ze-CR yayingu-68.2%, uma kuqhathaniswa no-16.7% weziguli ezingazange zifinyelele i-CR (PR/NR), okugqamisa indima ebalulekile yokufeza i-CR ekuthuthukiseni imiphumela yokusinda.
Lolu cwaningo luhlanganise iziguli zezingane ezingama-59 ezingezona i-DS-AMKL ezineminyaka ephakathi kwemi-2. Ngemva kokwelashwa, zonke iziguli zaphumelela ekufakweni kwe-neutrophil, isikhathi esimaphakathi sezinsuku eziyi-13 sokufakelwa kwe-neutrophil kanye nezinsuku eziyi-9 zokufakelwa kwe-platelet. Okuphawulekayo ukuthi izindlela ze-Bu/Cy+MEL kanye ne-Bu/Cy+TT ziholele esilinganisweni se-OS esingu-100% ezigulini eqenjini le-Bu/Cy+TT, yize kwakungekho mehluko omkhulu ku-OS phakathi kwamaqembu e-Bu/Cy kanye ne-Bu/Cy+MEL.
Ngokuphathelene nezinkinga, izindlela zokwelashwa eziguquliwe zibonise ukunciphisaukwehla kwesifo se-Grade III-IV acute graft-versus-host (aGVHD) kanye nokufa okuhlobene nokufakelwa (TRM), okugcizelela kakhulu ukuphepha kwezinqubo ezintsha. Ukwanda kwe-aGVHD enzima kwakuphansi kakhulu eqenjini le-Bu/Cy+TT, kanye nokwehla kwe-GVHD ebukhali nengamahlalakhona uma kuqhathaniswa nohlelo lwendabuko lwe-Bu/Cy.
UDkt. Wei ugcizelele amandla alezi zindlela zokwelashwa eziguquliwe ekuthuthukiseni imiphumela yeziguli ezingezona i-DS-AMKL, ikakhulukazi kulabo abathola ukuxolelwa okuphelele. Ucwaningo luhlinzeka ngemininingwane ebalulekile yokwenza ngcono izindlela zokwelapha ze-AMKL futhi lubeka isisekelo sokuhlolwa okwengeziwe kwezokwelapha. Nakuba imiphumela yeziguli ezixolelwe ngokwengxenye kanye neziguli ezingaxolelwanga yayingathembisi kangako, le ndlela inikeza ithemba ngamasu angcono okwelapha esikhathini esizayo.
Ngocwaningo oluqhubekayo kanye nokuqoqwa kwedatha, ithimba leSibhedlela iLu Daopei lihlose ukuthuthukisa lezi zindlela zokwelapha ukuze linikeze izixazululo ezihlala njalo ezigulini ezingezona i-DS-AMKL, okungenzeka kushintshe indlela yokwelapha yalolu hlobo lwe-leukemia oluyinselele.