FLT3 Mutation a me Acute Myeloid Leukemia: Nānā, Prevalence, a me ka mālama ʻana

Anter

• He aha ka hoʻololi o FLT3?
• Pehea e pili ai ka FLT3 iā AML?
• He aha nā hōʻailona?
• Ke hoʻāʻo nei no ka hoʻololi o FLT3
• Hoʻomaʻo no ka hoʻololi FLT3
• Lawe aku

He aha ka hoʻololi o FLT3?

Māhele ʻia ka maʻi myeloid leukemia (AML) i mau subtypes e pili ana i ka nānā ʻana o nā hunaola maʻi ʻaʻai, a he aha nā ʻano a lākou e loli ai. ʻOi aku ka hakakā o kekahi ʻano o ka AML ma mua o nā mea ʻē aʻe a pono i nā mālama ʻokoʻa.

ʻO FLT3 kahi loli, a i ʻole mutation, i nā huna leukemia. Ma waena o nā poʻe me AML loaʻa kēia hoʻololi.

ʻO nā code gen FLT3 no kahi protein i kapa ʻia ʻo FLT3 e kōkua i ka ulu ʻana o nā hunaola keokeo. Hoʻoikaika kahi hoʻololi i kēia gen i ka ulu ʻana o nā keʻa leukemia ʻē aʻe he nui.

Loaʻa i ka poʻe me ka mutation FLT3 kahi ʻano huhū loa o ka leukemia e hoʻi hou ana paha ma hope o ka mālama ʻia ʻana.

I ka wā ma mua, ʻaʻole maikaʻi loa nā hoʻoponopono AML e kūʻē i nā maʻi ʻaʻai me ka mutation FLT3. Akā ʻo nā lāʻau hou e kuhikuhi pono ana i kēia hoʻololi e hoʻomaikaʻi i ka nānā o ka poʻe me kēia ʻano AML.

Pehea e pili ai ka FLT3 iā AML?

Kōkua ka ʻohana FLT3 i ka mālama ʻana i ke ola ʻana o ka pūnaewele. ʻO ka hoʻololi ʻana o ka gen i kumu e ulu pinepine ʻole ai nā aʻa koko ʻole.

A ʻo kahi hopena, ʻoi aku ka nui o ka hewa o ka poʻe me ka mutation FLT3 o AML. E hoʻi hou paha kā lākou maʻi, a i ʻole hoʻi hou i hope, ma hope o ka lapaʻau ʻana. He haʻahaʻa ola ko lākou ma mua o ka poʻe me ka ʻole o ka loli.

He aha nā hōʻailona?

Nā ʻōuli o ka AML:

• paopao maʻalahi a hoʻokahe koko paha
• ihu ihu
• gums kahe
• luhi
• nāwaliwali
• fiva
• lilo kaumaha maopopo ʻole
• ʻeha poʻo
• ʻili mae

Ke hoʻāʻo nei no ka hoʻololi o FLT3

Paipai ka College of American Pathologists a me ka American Society of Hematology i kēlā me kēia mea i ʻike ʻia me ka AML e hoʻāʻo no ka mutation gene FLT3.

E hoʻāʻo kāu kauka iā ʻoe ma kekahi o nā ala ʻelua:

• Hōʻike koko: Lawe ʻia ke koko mai kahi aa i kou lima a hoʻouna ʻia i kahi keʻena hana.
• ʻIno o ka iwi iwi: Hoʻokomo ʻia kahi nila i kou iwi. Lawe ka nila i kahi liʻiliʻi o ka iwi iwi wai.

Hoʻomaʻo ʻia ke koko a i ʻole ka iwi momona o ka iwi e ʻike inā loaʻa iā ʻoe ka mutation FLT3 i kāu mau leukemia. E hōʻike ana kēia hōʻike inā he moho maikaʻi ʻoe no nā lāʻau i kuhikuhi pono i kēia ʻano AML.

Hoʻomaʻo no ka hoʻololi FLT3

A hiki i kēia manawa, ua mālama nui ʻia ka poʻe me ka mutation FLT3 me ka chemotherapy, ʻaʻole maikaʻi loa ma ka hoʻomaikaʻi ʻana i nā helu ola. ʻO kahi hui hou o nā lāʻau i kapa ʻia ʻo FLT3 mea kāohi e hoʻomaikaʻi nei i ka nānā o ka poʻe me ka hoʻololi.

ʻO Midostaurin (Rydapt) ka lāʻau mua i ʻae ʻia no FLT3, a ʻo ka lāʻau hou i ʻae ʻia e mālama iā AML i 40 mau makahiki. Hāʻawi nā kauka iā Rydapt me nā lāʻau chemotherapy e like me cytarabine a me daunorubicin.

Lawe ʻoe iā Rydapt ma ka waha ʻelua mau manawa i ka lā. Hana ia ma ke kāpae ʻana iā FLT3 a me nā protein ʻē aʻe ma nā leukemia e kōkua iā lākou e ulu.

Ua nānā ʻia kahi noiʻi o 717 poʻe me ka gen FLT3 i paʻi ʻia ma The New England Journal of Medicine i nā hopena o ka mālama ʻana me kēia lāʻau hou. Ua ʻike nā kānaka noiʻi i ka hoʻohui ʻana iā Rydapt i ka chemotherapy hoʻolōʻihi ʻia ke ola ke hoʻohālikelike ʻia me kahi hana ʻole (placebo) a me chemotherapy.

ʻO ka helu ola ʻehā mau makahiki he 51 pākēneka ma waena o ka poʻe i lawe iā Rydapt, i hoʻohālikelike ʻia ma kahi o 44 wale nō pākēneka i ka hui placebo. ʻO ka lōʻihi awelika o ke ola ma mua o ʻeono mau makahiki i ka hui lapaʻau, ma mua o ʻelua mau makahiki i ka hui placebo.

Hiki iā Rydapt ke hana i nā hopena ʻē aʻe e like me:

• fiva a me nā keʻokeʻo haʻahaʻa keʻokeʻo haʻahaʻa (febrile neutropenia)
• nausea
• ka luaʻi
• ʻeha a ʻulaʻula paha i ka waha
• ʻeha poʻo
• ʻehaʻeha a ʻeha iwi paha
• ʻōpala
• ihu ihu
• kiʻekiʻe pae kō kō

E nānā ana kāu kauka iā ʻoe no nā hopena inā ʻoe ma kēia lāʻau, a hāʻawi iā ʻoe i nā mālama e kōkua i ka mālama ʻana iā lākou.

Aia nō kekahi mau mea kāohi ʻo FLT3 ʻē aʻe i nā hoʻokolohua hoʻokolohua e ʻike inā holo pono lākou. Pākuʻi ʻia kēia mau mea:

• crenolanib
• gilteritinib
• quizartinib

Ke aʻo pū nei nā kānaka noiʻi inā he transplant cell stem ma hope o ka mālama ʻana me kahi mea kāohi iā FLT3 e hōʻemi paha i ka manawa o ka maʻi ʻaʻai e hoʻi mai ai. Ke nānā nei lākou inā paha ʻoi aku ka maikaʻi o nā hui like ʻole o nā lāʻau i ka poʻe me kēia hoʻololi.

Lawe aku

Loaʻa ka hoʻololi ʻana o FLT3 inā loaʻa iā ʻoe ka AML i ke ʻano o ka hopena ʻilihuna. I kēia manawa, ke kōkua nei nā lāʻau e like me Rydapt e hoʻomaikaʻi i ka nānā. ʻO nā lāʻau hou a me nā hui pū ʻana o nā lāʻau e hoʻolōʻihi i ke ola i nā makahiki e hiki mai ana.

Inā ʻike ʻia ʻoe me AML, e hoʻāʻo kāu kauka i kou maʻi ʻaʻai no FLT3 a me nā hoʻololi hoʻololi ʻē aʻe. ʻO ka ʻike e like me ka hiki e pili ana i kāu tumo e kōkua i kāu kauka e ʻike i ka lāʻau maikaʻi loa nāu.