Iinqwelo zokuPhando ngeCarcer Blood
Unyaka ngamnye i-American Society of Hematology (ASH) ibambe inkomfa ebonisa uphando olutsha malunga namachiza kunye nolunye unyango. Amachiza axoxwa ngazo kule ntla nganiso kuzo zonke izigaba ezahlukeneyo zophuhliso lweeklinikhi. Ngamanye amazwi, ezinye zazo ziyeza unyango, zizama kwaye zinyani, sele zivunyiwe kwaye zisetyenziswe, kwaye ezinye ziphanda uphando ngemithi, nto ithetha ukuba asazi okuningi ngabo.
Thatha i-rituximab, umzekelo. Ngo-2016, i-Rituximab yayicingwa ngokuba "yiminyaka emidala" eye yasetyenziselwa iminyaka ukuphatha ezininzi iintlobo ezahlukeneyo ze-non-Hodgkin lymphoma. Ama-Older, amayeza amaninzi angasenokwenza amagagasi kwelinye leenkomfa, umzekelo, xa kusetyenziswe ukusetyenziswa olutsha.
Ezinye iziyobisi ezixutyushwa kwi-ASH zikwinqanaba lokuqala lokuphuhliswa-oko kukuthi, ukufunyanwa kwabelwana kubaluleke kakhulu. Ngokuqhelekileyo, ezi zifundo zichazwe "izifundo-zecandelo." Isigaba sibhekisela kwizilingo zonyango ezivavanya iyeza elitsha okanye unyango kwiqela elincinci labantu-okokuqala ngethuba lokubona ukuba lisebenza, ukufumana i-dosage ekhuselekile. uluhlu, kwaye ukuchonga imiphumo emibi. Izilingo zeSigaba zifana nembewu: ungagcina ufumana isityalo okanye isiqhamo onokubonga ukuba ungabonakalisa kwi-fair state, kodwa unokufumana ukuhluleka ukuhluma okanye isityalo esingathethi siqhamo.
Uphando ngeDLBCL
Ukusasaza i-B cell cell lymphoma, okanye i-DLBCL, i-lymphoma ekhula ngokukhawuleza.
Luhlobo oluqhelekileyo lwe-lymphoma kubantu abadala, kwaye luvela kwi-B-lymphocytes-white white cells ezikhokelela kwimveliso yokhuselo lomzimba kwi-immune system. Abantu abahlukeneyo baneentlobo ezahlukeneyo ze-DLBCL kunye nabaphandi baphanda iindlela ezintsha zokufumana izigulane nge-DLBCL .
Rituximab Plus CHOP okanye i-DA-EPOCH-Rituximab
Isifundo sesigaba se-III sasinezigulane ezingama-524 ezibhaliswe (262 kwinqanaba leyonyango ngalinye) phakathi kukaMeyi 2005 no-Meyi 2013. Olu pho nonongo lufanisa unyango lwe-R-CHOP kunye ne-DA-EPOCH-R unyango, unyango olungakumbi lwe-chemotherapy, olunethemba lokusasaza izigulane ezine- stage II okanye ngaphezulu kweDLBCL.
Abathathi-nxaxheba babeneminyaka engama-18 ubudala kunye ne-HIV. Okwangoku, ngokubanzi, i-DA-EPOCH-R yayidibaniswe nobutyhefu kunye nemiphumo emibi, kwaye kwakungekho umahluko phakathi kwamaqela ngokweengcebiso zonyango ezifundwayo. Sekunjalo, abaphandi bajonga ukujonga malunga namacandelwana athile abantu abane-DLBCL kwaye ingaba bangaxhamli kunye ne-DA-EPOCH-R iya kuboniswa ngamagqabana. Uhlaziyo luqhubeka.
Obinutuzumab Plus CHOP okanye iRituximab Plus CHOP
Oku kwakukhona esinye isigaba sokufunda III kunye nabathathi-1,418 abathathi-nxaxheba bavavanya ukuphumelela nokukhuseleko kwe- obinutuzumab vs. rituximab kunye ne-CHOP kwizigulane ezine-DLBCL. Abathathi-nxaxheba babeneminyaka eli-18 ubudala okanye ngaphezulu kwaye bengaphatywanga i-DLBCL. Ngokubanzi, kwakungabikho mmahluko ophawulwe phakathi kwamaqela amabini ngokwemivuzo yokusinda, kunye nezinye iziganeko ezimbi zichazwe kwizigulane kwi-obinutuzumab-CHOP kuneqela le-CHOP. Ngokubanzi, amazinga okufa aphezulu kwaye ahoxiswa kunyango oluqhelekileyo kwi-obinutuzumab -CHOP ingalo.
Nangona kunjalo, abaphandi baceba ukujonga iinqununu kunye ne-DLBCL ukuzama nokufumana nayiphi na inzuzo okanye ingozi engabonakali kwiqela lonke.
I-Lenalidomide kwizigulane ezine-DLBCL ebuyisiwe
Abantu abangenakufanelekela ukutsalwa komnatha wethambo okanye bahlaselwa emva kokupheka komnyoba banokuphila okunciphisa ukunyanga, ngoko elinye iqela lokuphanda likhangele ekusebenziseni imishanguzo yokwandisa ukusinda kwezi zi gulane.
Bafumene ukuba i-agent ye-lenalidomide ngumviwa ofanelekileyo kuba isilwanyana esisemlonyeni, esisebenzayo malunga ne-DLBCL enokuthi ithathe iminyaka emalunga neprofayili eyamkelekileyo.
Uhlolisiso lubonise ukuba izigulane ezithe zineentlobo ezahlukeneyo ze-DLBCL zixhamle kwi-lenalidomide yonyango yolondolozo kunye nokuphila okuphuculweyo. Ulwaphulo lokulondolozwa lubhekisela kunyango lomhlaza ngemichiza, ngokuqhelekileyo emva kokujikeleza kokuqala.
Uphando kwi-Follicular Lymphoma
I-lymphoma yesigxina iyona hlobo eqhelekileyo ye-indolent-oko kukuthi, ukukhula kancinci-lymphoma. Nangona i-obinutuzumab ingazange ibonakale inika izibonelelo ezibonakalayo nakwi-DLBCL ekhankanywe ngasentla, kwakungekho yimeko ye-obinutuzumab kwi-lymphoma yesalulo.
I-Obinutuzumab-Based Based Treatment Iqhubela phambili Ukusinda Okungapheliyo Kwizigulane Ngexesha Elidlulileyo I-Lymphoma YeFolli
Uvavanyo lweGALLIUM lwaluyinto yokuhlola isigaba samazwe angama-3 ukuthelekisa ukusebenza nokukhuseleko kwe-rituximab okanye i-obinutuzumab kunye ne-chemotherapy elandelwa ulondolozo njengonyango lokuqala lolawulo lwe-non-Hodgkin lymphoma.
Kwizigulane ezine-lymphoma ezingaphelelwanga ngaphambili, i-obinutuzumab-based based chemmetic regimen kunye neprogram yokugcinwa kwabangela ukuphuculwa kwintsholongwane ekwenzeni impilo ngaphandle kwesi sifo siphumelele-ukunciphisa ama-34 kwiphepha lokunyuka kwenyango ngokuphathelele kwi-rituximab-based treatment. I-Obinutuzumab yayinexesha eliphakamileyo lezinye iziganeko ezimbi ezinjengeempendulo ezihambelana nokunyuswa kwegazi, ukubalwa kwegazi okuphantsi kunye nokusuleleka. Abaphengululi baphelisa i-regimen inkxaso ye-data yenkxaso ye-obinutuzumab ibe ngumgangatho omtsha wokunyamekela kwizigulane ezingaphatanga zingaphathwa nge-lymphoma ye-follicular.
Uphando ngeHodgkin Lymphoma
Kukho iintlobo ezintlanu ezinkulu zeHodgkin lymphoma (HL) ukuba umntu unokuthi ufumaneke. I-Classical Hodgkin lymphoma lixesha elide elisetyenziselwa ukuchaza iqela leendidi ezine eziqhelekileyo ezidibanisa ngaphezulu kwama-95 ekhulwini kuwo onke amacala e-HL kumazwe athuthukile.
Ukukhuselwa kwe-Immune Checkpoint ye-Classical Hodgkin Lymphoma
I-Classical Hodgkin lymphoma ibonakala ibe neenguqu zofuzo eza kwenza ukuba ibe negalelo elitsha lamachiza ebizwa ngokuba ngama-inhibitors , okusekelwe kwizifundo zangaphambili. Ngoko, iqela lophando e-ASH libheke kwiigulane ezingama-210 ziphathwe ngenxa yesifo esichaphazelekayo okanye ibuyele kwakhona i-HL ukubona indlela i-inhibitor ye-check in pembrolizumab eya kwenza ngayo.
Amanye amangqamuzana omhlaza avelisa inani elikhulu le-PD-L1, kwaye le nto iyabasiza ukuba babalekele ukuhlaselwa ngumzimba. I-Pembrolizumab inokukunceda ukumisa loo nto. I-PD-1 i-blockade ne-pembrolizumab isebenza kumaqela ezigulane nge-classic HL eyayiphilile kakhulu ngezinye iindlela zokwelapha. I-Pembrolizumab yayinezinga eliphezulu lokuphendula nangona isifo esingaxhatshazwa kwi-chemotherapy. Iziphumo ezongezelelweyo, kubandakanywa ukuba impendulo yangexesha elide ilindeleke njani kwintlanganiso.
Uphando nge-leukemia
Unyango Oluxhasayo lwabaguli abane-AML - Eltrombopag
Kwizigulane ezithatha i-chemotherapy enamandla kwi- acute leememiagenic (AML) , ngamanye amaxesha izibalo zeplatelet zihlala ziphantsi emva kwe-chemotherapy, kwaye oku kungakhokelela kwimingcipheko yokunyuka kwegazi, isidingo segazi ezininzi, kunye nezigulana ziyakwazi ukuhlakulela iimpawu zamagciwane kwiiplatelets, apho bonke bakhonza ukunqanda inkqubela.
Ngowe-2016 iqela labika ngokusebenzisa i-eltrombopag, iyeza elikhuthaza umzimba ukuba wenze amaplatele angaphezulu, kubantu abadala asebekhulile i-AML.
Iziphumo zazingekuqala-oku kwakuyinqanaba lokuhlola isicatshulwa-isigaba-kodwa kubonakala ngathi baphumelele ngokufumana abantu ukuba bafumane ngokukhawuleza bevela kwi-chemo ukuze bangafune ukuba baphelelwe igazi. Kukho ukukhathazeka ukuba i-agent efana ne-eltrombopag inokukhawulezisa ukuqhubela phambili kwe-leukemia, ngaphezu kweenzuzo ezinokuncedisa iiplatelets, nangona kunjalo, ukufikelela kule sifundo akukho ubungqina bokuba loo mngcipheko uyinyani.
Ukubuyiselwa kwakhona okanye ukukhenkcezwa kwe-Lymphoblastic Leukemia (YONKE)
Ayikho irejimenti eqhelekileyo yokubuyiselwa yonke i-ALL. I-Inotuzumab ozogamicin yi-FDA ekhethiweyo yokuphululela unyango kwizigulane eziphindaphindiweyo okanye ezikrakra ze-lymphoblastic leukemia (ZONKE). Kwisilingo esisodwa sekliniki, i-inotuzumab ozogamicin yavelisa uphuculo oluphambili kwi-chemotherapy ejwayelekile kwizigulane ezine-ALL refractory to, okanye ezingaphenduliyo, ezinye iindlela zokwelapha.
I-Inotuzumab ozogamicin yintsebenziswano yophando olwenziwe ngophuloli olwenziwe ngumntu olwa ne-antibody oluxhomekeke kwi-arhente engakwazi ukubulala amangqamuzana omhlaza. Xa isichengisi sibophezela kumthi obizwa ngokuba ngu-CD22 kumaseli omhlaza, uyangena ngaphakathi kwiseli apho ibangela ukuba i-DNA iphule, ekhokelela ekufeni kweseli.
Oko Uphando Lithetha Kuwe
Ngoxa iinkomfa zivame ukulungiswa ukuba zinike iinkonzo zonyango ngophando lwangoku, ulwazi luhlala lunomdla kulabo bafumene imimiselo, kunye nabathandekayo babo. Xa u tyelela ugqirha wakho ubuza malunga nento entsha esentsimini-kuba nolwazi kunokukunceda uzive ungakumbi ekulawuleni impilo yakho.
> Imithombo:
> 469 IsiGaba sesi-III IsiGaba seR-CHOP Versus DA-EPOCH-R kunye nohlalutyo lweMeleki ye-Unreated Diffuse Large B-Cell Lymphoma: CALGB / Alliance 50303
> 474 Ulondolozo lweLenalidomide ngokuphawulekayo luphuculisa ukuKhuselwa koMzimba kwizigulane ezithintekayo ngokusasazeka kwe-B-Cell Lymphoma (rDLBCL) Abangabonekanga kwi-Autologous Stem Transplantation (iSSCT): Iziphumo zokugqibela zeSigaba sesi-2 seMatricentre.
> 470 I-Obinutuzumab okanye i-Rituximab Plus I-CHOP kwizigulane ezineziganeko zangaphambili ezingabonakaliyo ezahlukileyo kwi-B-Cell Lymphoma: Iziphumo zokugqibela ezivela kwi-Label-Open, IsiGaba se-Randomized Phase 3 (GOYA)
> 1107 I-Pembrolizumab Kwi-Relapsed / Refractory I-Classical Hodgkin Lymphoma: IsiPhelo sePrayimari sokuPhathwa kweSigaba sesi-2 Keynote-087 Isifundo
> 447 Isondo esisodwa, Isigaba II Isifundo se-Eltrombopag ukuPhucula iPlatlet Count Recovery in Patients of Older's Lyeloid Leukemic
> 6 I-Obinutuzumab-Based Based Incuction and Maintenance Exlongs Ukuqhubeka Kwangaphunyezwa Kwamahhala (PFS) kwizigulane ezinePilly Lymphoma yangaphambili engabonakaliyo: Iziphumo eziPrayimari zeSigaba esiPhezulu esiPhakathi kweGALIUM