Ucwaningo Lwezikhungo Eziningi Lubonisa Ukubikezela Okuhle Kweziguli Ezinesifo Sofuba Esibangelwa Ukugula Kwegazi Ezifakelwa I-MMUD Allogeneic Stem Cell nge-ATG
Ucwaningo olubheka emuva olunezikhungo eziningi olwenziwe eShayina luveze imiphumela ethembisayo yokufakelwa kwe-allogeneic hematopoietic stem cell transplantation (allo-HSCT) ezigulini ezine-hematologic malignancies. Ukufakelwa Komnkantsha Wamathambo, lolu cwaningo luhlola ukusebenza kahle kokuhlanganisa i-MMUD allo-HSCT ne-antithymocyte globulin (ATG) ukuvimbela isifo se-graft-versus-host (GVHD). Le ndlela ibonise ukuthi iletha imiphumela emihle yezokwelapha, ngisho nokungalingani ekuvumelaneni kwe-human leukocyte antigen (HLA) phakathi komnikeli kanye nomamukeli.
Ucwaningo lubhalise iziguli ezingu-211 ezineminyaka engu-14 noma ngaphezulu, zonke ezitholakale zine-hematologic malignancies futhi zathola ukuphulukiswa okuphelele ngaphambi kokufakelwa. Iziguli zahlukaniswa ngamaqembu amabili ngokusekelwe enanini lokungalingani kwe-HLA: Iqembu A elinokungalingani kwe-allele eyodwa kanye neqembu B elinokungalingani okubili noma ngaphezulu. Zonke iziguli zathola amaseli egazi angaphandle kanye nokwelashwa kokulungisa isimo ngohlelo lokuhlanza umongo, kanye nokuvimbela i-GVHD okubandakanya i-ATG.
Imiphumela ebalulekile ifaka phakathi izinga eliphezulu lokufakelwa kwama-neutrophils kanye nama-platelet angu-93.4% ezinsukwini zokuqala ezingu-28. Ucwaningo luphinde lwabonisa izinga eliphansi kakhulu le-GVHD ebukhali, lapho i-GVHD yebanga le-III-IV ivela ku-12.3% wamacala, kanye ne-GVHD engamahlalakhona ephakathi kuya kwenzima ifinyelela ku-21% ngemva kweminyaka emithathu. Izinga lokusinda (OS) leminyaka emithathu lalingu-63.1%, kanye nezinga lokusinda elingenasifo (DFS) elingu-54.5%.
Okutholakele kuphinde kwabonisa ukuthi inani lokungafani kwe-HLA alizange lithinte kakhulu amazinga okusinda, ukwanda kwe-GVHD, noma ukuvuselelwa kwegciwane. Ngaphezu kwalokho, ukusetshenziswa kwemithamo ephansi ye-ATG (≤6 mg/kg) kuthuthukise amazinga okufakelwa futhi kwanikeza izinzuzo zezokwelapha ngaphandle kokuthinta amazinga okusinda noma okubuyela emuva, okunikeza inketho yokwelapha engabizi kakhulu.
Lolu cwaningo luwucwaningo olukhulu kunawo wonke oluqhutshwa ezindaweni eziningi eShayina nge-MMUD allo-HSCT futhi lugcizelela amandla ale ndlela yokufakelwa izitho ezigulini ezinomdlavuza we-hematologic oyingozi kakhulu. Lunikeza ukuqonda okubalulekile ekuthuthukiseni imiphumela yeziguli kanye nokulungisa izindlela zokufakelwa izitho, okwenza kube negalelo elibalulekile emkhakheni wegazi. Ukwelashwa Komdlavuza.