Muchidimbu
Mukudzokororazve uye kunokanganisa AML ine hurombo hwemakore mashanu ekupona kwe5% chete, kiriniki yekudzidza ichifananidza kurapwa kwakanangwa ne salvage cytotoxic chemotherapy yakaratidza kurapwa kwakanangwa kunoenderana ne genomic uye mamorekuru profiling inogona kuve nemhedzisiro zvirinani ine yakaderera frequency yezviitiko zvakashata, kana ichienzaniswa nekemotherapy.
Acute Myeloid Leukemia (AML) ari kenza yeropa nemasero emapfupa uye inonyanya kubata vanhu vakuru. AML inoratidzirwa nekusadzora uye kukura kwakanyanya kweropa risati rakura rinogadzira myeloblast masero mumwongo wepfupa anomanikidza kunze kweakajairwa masero eropa. Chinangwa che AML kurapwa ndechekubvisa ese abnormal leukemia masero uye kuita kuti murwere aregererwe. Nekudaro, muzviitiko zvakawanda, kana maseru ese eleukemia asina kupedzwa nekurapa, chirwere chinogona kudzoka mushure mekuva mukuregererwa kweimwe nguva. Mune vamwe varwere, iyo leukemia inopesana neyakajairwa yekurapa chemotherapy kurapwa uye inoonekwa serefractory.
Chikafu chekudya Mushure meKenza Kuongorora!
Hapana kanzura mbiri dzakafanana. Enda pamusoro peyakajairwa nhungamiro yemunhu wese uye utore sarudzo dzakagadzirirwa nezve chikafu uye zvinowedzerwa uine chivimbo.
Ndezvipi zvirinani - Targeted Therapy kana Chemotherapy?
Muzviitiko zvekudzokazve kana kuramba AML, genomic profiling yebundu inopa ruzivo rwakawanda muhunhu hwemamorekuru huri pasi pebundu. kenza izvo zvinozokwanisa kurapwa nemishonga inonangwa yakawanda. Imwe yehutachiona husina kunaka hunowanikwa mu30% yevarwere veAML ndeyeFMS-like tyrosine kinase 3 (FLT3) receptor, kana iripo, mutyairi wechirwere uye chikonzero chekudzivisa chemotherapy.Papaemmanuil Et al, New Engl. J Med., 2016). Kune maviri akakosha marudzi eFLT2 genomic abnormalities ayo akawanikwa muAML genomes: kudzokororwa kwetandem yeFLT3 geni (ITD) kana shanduko mune tyrosine kinase domain yeFLT3 gene (TKD). Ose maberrations anokonzeresa kumisikidza kweiyo FLT3 receptor siginicha nzira iyo inotyaira isingadzoreke kukura kweiyo leukemia uye inoita kuti ive inopesana neyakajairika ekuchengetedza chemotherapy sarudzo. Bhokisi rekushandisa remishonga yakanangwa ine kusarudzika kwakasarudzika, potency uye chiitiko chekiriniki, izvo zvakagamuchirwa kana mukuvandudza kweFLT3 mutated AML ndeaya:
- Midostaurin, mishonga yakanangwa yakawanda, inogamuchirwa pamwe neyakajairwa 7 + 3 (cytarabine + daunorubicin) chemotherapy yevarwere vachangobva kuongororwa vane AML neFLT3 mutation. Asi kune varwere vakadzokazve kana kusagadzikana AML, midostaurin haina kuratidza kugara kwechigarire kubatsirwa seyechete mumiriri. (Dombo RM et al, Nyowani Engl. J Med., 2017; Fisher T, nevamwe, J Clin Oncol., 2010)
- Sorafenib, imwe yakawanda-kinase inotarisa zvinodhaka, yakaratidza kiriniki chiitiko mune varwere vane FLT3-mutated AML. (Borthakur G, et al, Haematologica, 2011)
- Quizartinib, kirasi nyowani yakanangwa neFLT3 inhibitor yakaratidza chimwe chiitiko chemumwe-mumiririri mune vakadzokazve uye vanopokana nevarwere neFLT3-ITD asi mhinduro yaive pfupi kurarama nekuda kwekusatarisira shanduko yeFLT3 TKD inogona kumuka panguva yekurapa. (Cortes JE nevamwe, Lancet Oncol., 2019)
- Gilteritinib nderimwe kirasi nyowani yemushonga mukuvandudzwa kwekiriniki, iyo inosarudzira shanduko dzeITD uye TKD. Muchikamu 1-2 kiriniki yekudzidza, 41% yevarwere vakadzokazve uye vanokanganisa AML vakaregererwa zvakakwana. (Perl AE, et al, Lancet Oncol., 2017)
Chikamu chechitatu chakarongedzwa chemakiriniki kuyedzwa ichifananidza kukanganisa kweiyo yakanangwa kurapwa Gilteritinib vs.savage chemotherapy mu3 yakadzokazve uye inokanganisa varwere ve AML (Trial No. NCT371). Pakati pevane 02421939 vakadzokazve uye vanopesana nevarwere ve AML, 371 vakangoerekana vaendeswa kuboka reGilteritinib uye 247 kune salvage chemotherapy boka. Chiyero chekudzokazve uye kusagadzikana mumapoka ese aive angangoita 124:60. Iyo salvage chemotherapy sarudzo dzaigona kunge dzakanyanya masimba ekurapa: Mitoxantrone, Etoposide, Cytarabine (MEC), kana Fludarabine, Cytarabine, Granulocyte koloni-inosimudzira chinhu uye Idarubicin (FLAG-IDA); kana sarudzo dzakadzika dzekurapa: yakaderera-dosi Cytarabine, kana Azacitidine. Mhedzisiro yakaburitswa mhedzisiro yeiyedzo yakaratidza kuti yakanangwa boka rekurapa naGilteritinib yaive nehupenyu hwese hwemwedzi 40 kana ichienzaniswa nemwedzi 9.3 neboka rechechi chemotherapy. Pakanga paine 5.6% yevarwere vakawana kuregererwa kwakakwana nehuremu kana hwakazara hematologic kupora muboka reGilteritinib, nepo chete 34% mune chemotherapy boka. Zvakare, zviitiko zvakakomba zvakashata zvegiredhi 15.3 kana yepamusoro zvakawanikwa zvichiitika zvishoma kazhinji muboka rakanangwa pamusoro pekemotherapy boka (Perl AE, et al, Nyowani Engl. J Med., 2019).
Iyi data iripamusoro inotsigira kuti mune iyi yakaoma kurapa AML yakadzokororwa uye isingabvumirwe ine fungidziro yakashata uye makore mashanu ekupona kwe5% chete, kurapwa kwakanangidzirwa kunoenderana negenomic uye mamorekuru profiling inogona kuve nemhedzisiro zvirinani nekudzikira kwakawanda kwezviitiko zvakashata, kana zvichienzaniswa nekuenderera chemotherapy kurapwa.
Chikafu chipi chaunodya uye chinowedzera iwe kutora chisarudzo chaunoita. Sarudzo yako inofanirwa kusanganisira kutarisisa kwecancer genes shanduko, iyo kenza, kurapwa kuri kuenderera uye zvinowedzerana, chero mairigeji, ruzivo rwemararamiro, huremu, kukwirira uye maitiro.
Kurongeka kwehutano kwekenza kubva kuAddon hakubvi pakutsvaga kweinternet. Iyo inoshandura sarudzo kuitirwa iwe zvichibva pane samorekuru sainzi inoitwa nemasayendisiti edu uye mainjiniya esoftware. Zvisinei kuti une hanya here nekunzwisisa iyo yepasi biochemical molecular pathways kana kwete - yekuronga kudya kwemukenza kunzwisiswa kunodiwa.
Tanga IZVOZVO nekuronga kwako kudya kunovaka muviri nekupindura mibvunzo pazita rekenza, majini masayendisiti, kurapwa kuri kuenderera uye zvinowedzerana, chero kurwara, tsika, mararamiro, boka rezera uye murume kana murume.
Hunhu Hwakakosheswa Nekamwe Kenza!
Gomarara rinoshanduka nekufamba kwenguva. Gadzirisa uye gadzirisa chikafu chako zvichibva pachiratidzo chegomarara, marapirwo, mararamiro, zvaunofarira zvekudya, allergies uye zvimwe zvinhu.
Varwere veCancer kazhinji vanofanirwa kubata zvakasiyana chemotherapy mhedzisiro izvo zvinokanganisa kwavo hupenyu hwehupenyu uye kutarisa kune dzimwe nzira dzokurapa kenza. Kutora iyo kudya kwakakwana uye zvekuwedzera zvinoenderana nesainzi (kudzivisa kufungidzira uye kusarudzika kusarudzwa) ndiyo yakanyanya kunaka mushonga we kenza uye kurapa kwakabatana nemhedzisiro.