Abaphandi bathi ukufakelwa kwe-stem cell, ngakumbi kumalungu entsapho enye, kuguqule unyango lwe-leukemia, isifo esithwaxa abantu baseMerika abamalunga nesiqingatha sesigidi. Kwaye nangona unyango luyimpumelelo kwabaninzi, isiqingatha sabo bangena kwinkqubo bafumana uhlobo oluthile lwe-graft-versus-host disease (GvHD). Oku kwenzeka xa iiseli ezisanda kufakwa kwi-immune immune system ziqonda ukuba umzimba wazo "njengowasemzini" zize zijolise kuwo ukuba ziwuhlase, kanye njengokuba benokwenza intsholongwane ehlaselayo.
Iimeko ezininzi ze-GvHD ziyanyangeka, kodwa kuqikelelwa ukuba enye kwali-10 inokubeka ubomi esichengeni. Ngenxa yesi sizathu, abaphandi bathi, amachiza akhusela umzimba asetyenziselwa ukukhusela i-GvHD ngeeseli ezinikezelweyo, kwaye izigulane, ezininzi ezinganxulumananga, zihambelana nanini na xa kunokwenzeka nabaxhasi kwangaphambili ukuze baqinisekise ukuba amajoni abo omzimba ayafana kangangoko kunokwenzeka.
Ikhokelwa ngabaphandi kwi-NYU Langone Health kunye ne-Laura kunye ne-Isaac Perlmutter Cancer Centre, uphando olutsha kunye oluqhubekayo lubonise ukuba i-regimen entsha ye-immune-suppressing drug, i-cyclophosphamide, i-abatacept, kunye ne-tacrolimus, ijongene bhetele nengxaki ye-GvHD kubantu abaphathwayo. umhlaza wegazi.
"Iziphumo zethu zokuqala zibonisa ukuba ukusebenzisa i-abatacept ngokudibanisa namanye amachiza akhusela umzimba kukhuselekile kwaye kuyindlela efanelekileyo yokukhusela i-GvHD emva kokutshintshwa kwe-stem cell for blood cancers," utsho umphandi okhokelayo kunye ne-hematologist uSamer Al-Homsi, MD, MBA. “Iimpawu zeGvHD ezine-abatacept bezincinci kwaye bezinyangeka kakhulu. Akukho nanye ebeka ubomi esichengeni, utshilo u-Al-Homsi, unjingalwazi wezonyango kwiSebe lezoNyango kwi-NYU Grossman School of Medicine kunye ne-Perlmutter Cancer Centre.
U-Al-Homsi, osebenza njengomlawuli wenkqubo yokufakelwa kwegazi kunye nomongo kwi-NYU Langone kunye ne-Perlmutter Cancer Centre, ubonisa iziphumo zeqela kwi-intanethi ngo-Dec. 13 kwintlanganiso yonyaka ye-American Society of Hematology e-Atlanta.
Uphando lubonise ukuba phakathi kwezigulana zokuqala ezingama-23 ezinomhlaza wegazi ondlongondlongo zinikwe irejimeni yeyeza emva kokutshintshwa kwisithuba seenyanga ezintathu, ezine kuphela zabonisa iimpawu zokuqala ze-GvHD, eziquka irhashalala yolusu, isicaphucaphu, ukugabha, kunye norhudo. Ezinye ezimbini zavela emva kweeveki, ubukhulu becala irhashalala. Bonke baye baphathwa ngempumelelo ngamanye amayeza kwiimpawu zabo. Akukho namnye oye waba neempawu eziqatha ngakumbi, kuquka ukonakala kwesibindi okanye ubunzima bokuphefumla. Noko ke, omnye umguli, ofakelo lwaso lungazange luphumelele, sabulawa sisifo se<em>leukemia esasihlala sihleli. Abanye (amadoda angama-22 kunye nabasetyhini, okanye iipesenti ezingama-95) bahlala bengenamhlaza ngaphezu kweenyanga ezintlanu emva kokutshintshwa, kunye neeseli ezinikezelweyo ezibonisa iimpawu zokuvelisa iiseli zegazi ezintsha, ezinempilo, kunye nomhlaza.
Kanye kunye nokunyusa ukhetho lwabaxhasi kuzo zonke izigulane, iziphumo zophononongo zinamandla okujongana nokungafani kobuhlanga kwi-stem cell transplantation. Ukunikezelwa kobume be-donor pool ukuza kuthi ga ngoku, abaMnyama, ama-Asiya aseMelika, kunye ne-Hispanics bangaphantsi kwesinye kwisithathu njengoko kunokwenzeka njengama-Caucasians ukufumana i-stem cell donor ehambelana ngokupheleleyo, eshiya amalungu entsapho njengomthombo othembekileyo womnikeli. Abanye be-12,000 baseMelika zidweliswe ngoku kwaye balinde kwirejista yenkqubo yomongo wesizwe, amanqaku e-Al-Homsi.
Uphononongo lwangoku lubandakanya ukutshintshwa kweeseli ze-stem ezivela kubaxhasi abasondeleyo (isiqingatha esihambelanayo) kunye nezigulane, kubandakanywa nabazali, abantwana, kunye nabantakwabo, kodwa ukuveliswa kwemfuzo kwakungafani, kunye nokudibanisa ichiza kwandisa amathuba okuba nempumelelo yokutshintshwa.
Irejimeni entsha ithatha indawo yechiza elisetyenziswa ngokwesintu i-mycophenolate mofetil nge-abatacept. U-Al-Homsi uthi i-abatacept "ijoliswe ngakumbi" kune-mycophenolate mofetil kwaye ikhusela iiseli ze-T ze-immune ukuba "zisebenze," inyathelo elifunekayo ngaphambi kokuba ezi ziseli zokuzivikela zihlasele ezinye iiseli. I-Abatacept sele ivunyiwe ngokubanzi ukunyanga ezinye izifo ze-immune, ezifana nesifo samathambo, kwaye ivavanywe ngempumelelo ekukhuseleni i-GvHD ngokuhambelana ngokusondeleyo, abaxhasi abangabalulekanga. Ukuza kuthi ga ngoku, abanikeli abafaniswe ngokupheleleyo babonise iziphumo ezingcono ekuthinteleni isifo sokuxhunyelelwa ngokuchasene nomkhosi kunesiqingatha sosapho oluhambelana nesiqingatha, okanye oko kubizwa ngokuba yi-haploidentical, abanikeli.
Kwakhona, njengenxalenye yonyango oluhlaziyiweyo, abaphandi banciphisa ixesha lonyango lwe-tacrolimus kwiinyanga ezintathu, ukusuka kwifestile yonyango yokuqala kwiinyanga ezintandathu ukuya kwezilithoba. Oku bekungenxa yeziphumo ebezingalindelekanga ezinobungozi zechiza kwizintso.
