Ukuguqulwa kwe-FLT3 kanye ne-Acute Myeloid Leukemia: Ukucatshangelwa, Ukudlanga, kanye nokwelashwa

-Delile

• Kuyini ukuguqulwa kwe-FLT3?
• I-FLT3 iyithinta kanjani i-AML?
• Ziyini izimpawu?
• Ukuhlolelwa ushintsho lwe-FLT3
• Ukwelashwa kokuguquguquka kwe-FLT3
• Ukudla okudlela endlini

Kuyini ukuguqulwa kwe-FLT3?

I-acute myeloid leukemia (AML) ihlukaniswe ngama-subtypes ngokuya ngokuthi amangqamuzana omdlavuza abukeka kanjani, nokuthi anaziphi izinguquko zofuzo. Ezinye izinhlobo ze-AML zinolaka kakhulu kunezinye futhi zidinga ukwelashwa okuhlukile.

I-FLT3 ingukushintsha kwezakhi zofuzo, noma ukuguquka, kumaseli we-leukemia. Phakathi kwabantu abane-AML banalokhu kuguquka.

Amakhodi wezakhi zofuzo ze-FLT3 zeprotheni ebizwa nge-FLT3 esiza amangqamuzana amhlophe egazi ukuba akhule. Ukuguquka kwesakhi sofuzo kukhuthaza ukukhula kwamaseli amaningi we-leukemia angajwayelekile.

Abantu abane-FLT3 mutation banendlela enobudlova kakhulu ye-leukemia okungenzeka ukuthi ibuye ngemuva kokuphathwa kwayo.

Esikhathini esedlule, ukwelashwa kwe-AML bekungasebenzi kahle uma kuqhathaniswa nomdlavuza ngokuguqulwa kwe-FLT3. Kepha imishanguzo emisha ehlose ngqo lokhu kuguquka ithuthukisa umbono wabantu abanale nhlobo engezansi ye-AML.

I-FLT3 iyithinta kanjani i-AML?

Uhlobo lwe-FLT3 lusiza ukulawula ukusinda nokuzala kwamaseli. Ukuguqulwa kwezakhi zofuzo kubangela ukuthi amangqamuzana egazi angavuthiwe ande ngokungalawuleki.

Ngenxa yalokhu, abantu abanokuguquguquka kwe-FLT3 banefomu elibi kakhulu le-AML. Isifo sabo kungenzeka ukuthi sibuye, noma sibuyele emuva, ngemuva kokwelapha. Futhi banesilinganiso esiphansi sokusinda kunabantu abangenawo ushintsho.

Ziyini izimpawu?

Izimpawu ze-AML zifaka:

• ukulinyazwa okulula noma ukopha
• ukuphuma kwamakhala
• izinsini ezophayo
• ukukhathala
• ubuthakathaka
• imfiva
• ukuncipha kwesisindo okungaqondakali
• ikhanda
• isikhumba esiphaphathekile

Ukuhlolelwa ushintsho lwe-FLT3

I-College of American Pathologists kanye neAmerican Society of Hematology bancoma ukuthi wonke umuntu okutholakala ukuthi une-AML ahlolwe ukushintsha kofuzo lwe-FLT3.

Udokotela wakho uzokuhlola ngezindlela ezimbili:

• Ukuhlolwa kwegazi: Igazi lithathwa emthanjeni engalweni yakho bese lithunyelwa ebhodini.
• Isifiso somnkantsha we-Bone: Kufakwa inaliti ethanjeni lakho. Inaliti isusa inani elincane lomnkantsha wethambo oketshezi.

Isampula legazi noma lomnkantsha liyahlolwa ukuze kutholakale ukuthi unakho yini ukuguquka kwe-FLT3 kumaseli akho e-leukemia. Lokhu kuhlolwa kuzokhombisa ukuthi ingabe uyilandelwa elifanele lezidakamizwa eliqonde ngqo lolu hlobo lwe-AML.

Ukwelashwa kokuguquguquka kwe-FLT3

Kuze kube muva nje, abantu abanokuguquguquka kwe-FLT3 babephathwa kakhulu ngamakhemikhali, okwakungasebenzi kakhulu ekuthuthukiseni amazinga okusinda. Iqembu elisha lemithi elibizwa nge-FLT3 inhibitors lithuthukisa umbono wabantu abanezinguquko.

IMidostaurin (Rydapt) kwakuyisidakamizwa sokuqala esivunyelwe i-FLT3, kanti umuthi wokuqala omusha ovunyelwe ukwelapha i-AML eminyakeni engama-40. Odokotela banikeza iRydapt kanye nemithi yokwelapha ngamakhemikhali efana ne-cytarabine ne-daunorubicin.

Uthatha iRydapt ngomlomo kabili ngosuku. Isebenza ngokuvimba i-FLT3 namanye amaprotheni kumaseli we-leukemia abasiza ukuba bakhule.

Ucwaningo lwabantu abangu-717 abanegciwane le-FLT3 olushicilelwe kwiThe New England Journal of Medicine lubheke imiphumela yokwelashwa ngalo muthi omusha. Abaphenyi bathole ukuthi ukufaka iRydapt ekhemotherapy ukusinda isikhathi eside uma kuqhathaniswa nokwelashwa okungasebenzi (i-placebo) kanye ne-chemotherapy.

Izinga lokusinda leminyaka emine lalingamaphesenti angama-51 kubantu abathathe iRydapt, uma kuqhathaniswa namaphesenti angaphezu kwangu-44 kuphela eqenjini le-placebo. Isilinganiso sobude bokusinda besingaphezu kweminyaka eyisithupha eqenjini lokwelashwa, kuqhathaniswa neminyaka engaphezu kwemibili kuphela eqenjini le-placebo.

I-Rydapt ingadala imiphumela emibi efana nale:

• umkhuhlane namaseli egazi amhlophe aphansi (febrile neutropenia)
• isicanucanu
• ukuhlanza
• izilonda noma ububomvu emlonyeni
• ikhanda
• ubuhlungu bemisipha noma bethambo
• imihuzuko
• ukuphuma kwamakhala
• amazinga aphezulu kashukela egazini

Udokotela wakho uzokuqapha ngemiphumela engemihle ngenkathi ukulesi sidakamizwa, futhi akunikeze nokwelashwa okusiza ukuyilawula.

Amanye ama-inhibitors we-FLT3 ambalwa asesezivivinyweni zokwelashwa ukubona ukuthi ayasebenza yini. Lokhu kufaka phakathi:

• crenolanib
• umagasine
• quizartinib

Abaphenyi bafunda nokuthi ngabe ukufakelwa kwe-stem cell ngemuva kokwelashwa nge-FLT3 inhibitor kungawehlisa yini amathuba okuthi umdlavuza ubuye. Babheka nokuthi ngabe inhlanganisela ehlukene yezidakamizwa ingasebenza ngempumelelo kubantu abakule nguquko.

Ukudla okudlela endlini

Ukuba nokuguquguquka kwe-FLT3 uma une-AML bekujwayele ukusho ukuba nomphumela ompofu. Manje, izidakamizwa ezinjengeRydapt zisiza ukuthuthukisa umbono. Izidakamizwa ezintsha kanye nokuhlanganiswa kwemithi kunganweba ukusinda kakhulu eminyakeni ezayo.

Uma kutholakala ukuthi une-AML, udokotela wakho uzohlola umdlavuza wakho we-FLT3 nokunye ukuguqulwa kofuzo. Ukwazi okuningi ngangokunokwenzeka ngesimila sakho kuzosiza udokotela wakho akuthole ukwelashwa okuphumelela kakhulu.