Kuongorora kweZvamwe Zvokurapa Options
Chirwere choga chekurapa chekutanga myelofibrosis (PMF) is stem cell transplant , zvisinei, kurapwa uku kwakakurudzirwa kuvarwere vepamusoro-uye pakati-mukati-kati chete. Kunyange muboka iri, zera uye mamwe marapirwo ehutano zvinogona kuwedzera njodzi dzinobatanidza nekugadziriswa zvakanyanya zvichiita kuti zvive zvishoma kudarika pfungwa yekurapa. Uyezve, havasi vanhu vose vane ngozi yepamusoro-uye pakati-kati-kati vachave nekodzero yakakwana yekufambisa muchengeti (inofananidzwa nehanzvadzi kana akafananidza mupiki asingabatsiri).
Zvinokurudzirwa kuti vanhu vane mungozi yakanyanya PMF vanotambira kurapa inotarisirwa kuderedza zviratidzo zvinosangana nehosha.
Zvichida chiremba wako akarayira kuti kuisa kwemavara hakusi nzira yakanakisisa iwe, kana kuti hapana mupi akakodzera anogona kuonekwa, kana iwe hauna kubvumira imwe nzira yekutanga yekurapa kwe PMF. Zvinonzwisisika, mubvunzo wako unotevera ungave-ndeupi mamwe maitiro ekurapa aripo? Nenzira yakanaka, kune dzakawanda zvidzidzo zvinoenderera mberi zvichiedza kuwana mamwe maitiro ekurapwa. Tichaongorora mamwe emishonga iyi muchidimbu.
JAK2 Inhibitors
Ruxolitinib , JAK2 inhibitor, ndiyo yaiva yekutanga kupiwa chirwere chinonzi PMF. Kuchinja kwemukati muJAK2 geni kwakabatanidzwa nekukudziridza kweMDC.
Ruxolitinib chirongwa chakakodzera kune vanhu vane mamiriro aya akachinja-chinja avo vasingakwanisi kutora stem cell transplantation. Nenzira yakanaka, yakawanikwa ichibatsira kunyange kuvanhu vasina JAK2 mutations.
Kune hutsva hunotsvakurudza hunotarisa kuve nemishonga yakafanana (dzimwe JAK2 inhibitors) inogona kushandiswa mukurapa kweMDC uye pamwe nekubatanidza ruxolitinib nemimwe mishonga.
Momelotinib mumwewo JAK2 inhibitor ari kudzidziswa kurapwa kweMDC. Zvidzidzo zvepakutanga zvakaratidza kuti 45 muzana yevanhu vakagamuchira momelotinib vakange vane kuderedzwa kwepleen size.
Inenge hafu yevanhu vaidzidza yaive nekuvandudza muhutano hwavo uye vanopfuura 50 muzana vakakwanisa kumira kuwedzerwa ropa. Thrombocytopenia (low platelet count) inogona kukura uye inokwanisa kugadzirisa kubudirira. Momelotinib ichafananidzwa neRuxolitinib muchikamu chechitatu chekuongorora kuti inoshanda sei mukurapa kweMDC.
Immunomodulatory Zvinodhaka
Pomalidomide is immunomodulatory drug (mishonga inoshandura masimba epachiviri). Inobatana ne thalidomide uye lenalidomide. Kazhinji, mishonga iyi inopiwa ne prednisone (steroid mishonga).
Thalidomide uye lenalidomide vatove vadzidza sevanosarudza kurapa muPMF. Kunyange zvazvo vose vari vaviri vachiratidza kubatsirwa, kushandiswa kwavo kunowanzowanikwa nemigumisiro. Pomalidomide yakagadzirwa sechinhu chiduku chine tsvina. Vamwe varwere vanovandudzwa mune chirwere chekushaya ropa asi hapana chiitiko chakaonekwa mukukura kwepleen. Zvichipa izvi zvisingabatsiri, kune zvidzidzo zvinoenderera mberi zvichirangidza kubatanidza polmalidomide nedzimwe nhengo dzakadai seRuxolitinib yekurapa PMF.
Epigenetic Zvinodhaka
Epigenetic zvinodhaka mishonga inobatsira kutaura kwemajini mamwe pane kuchinja muviri. Rimwe boka remishonga iyi inonzi hypomethylating agents, iyo inosanganisira azacitidine uye decitabine.
Iyi mishonga inoshandiswa kurapa myelodysplastic syndrome . Zvidzidzo zvinotarisa basa rezacitidine uye decitabine zviri mukutanga mapeji. Imwe mimwe mishonga ndeye histone deacetlyase (HDAC) inhibitors sezvinonzi givinostat uye panobinostat.
Everolimus
Everolimus mishonga inorondedzerwa seMTOR kinase inhibitor uye immunosuppressant. Ndiyo FDA (Zvokudya uye Drug Administration) yakagamuchirwa kurapwa kwezvikwereti zvakawanda (mazamu, renal cell carcinoma, tumorousocrine tumor, etc.) uye kudzivirira kukanganiswa kwechimiro kune vanhu vakagamuchira chimiro chekugadzirwa kwechiropa (chiropa kana zveputsvo). Everolimus inotorwa nemuromo.
Zvidzidzo zvepakutanga zvinoratidza kuti zvinogona kuderedza zviratidzo, spleen size, anemia, platelet count uye white white cell count.
Imetelstat
Imetelstat yakadzidzwa mune dzimwe kenza uye myelofibrosis. Mune zvidzidzo zvekutanga, zvakakonzera kuregererwa (zviratidzo zvekufa uye zviratidzo zveMDC) kune vamwe vanhu vane PMF pakati pekunge-kati kana kuti vane ngozi.
Kana iwe usingaiti mutsara unotangira mutsara, kunyora muchirwere chekuchipatara kunogona kukupa kusvika kune zvinyorwa zvitsva. Parizvino, kune mishonga inopfuura makumi maviri emakiriniki anoongorora nzira dzokurapa dzevanhu vane myelofibrosis. Iwe unogona kukurukura nechisarudzo ichi nechiremba wako.
> Sources:
> Cervantes F. Ndoita sei myelofibrosis yekutanga. Ropa. 2014; 124: 2635-2642.
> Geyer HL uye Mesa RA. Kurapa kwemyeloproliferative neoplasms: nguva ipi, iyo inyanzvi, uye sei? Ropa. 2014; 124: 3529-3537.