Ciwon sankarar lymphoblastic mai tsanani (T-ALL)-04

Majinyacin namiji ne ɗan shekara 15, an gano yana da cutar sankarar lymphoblastic mai tsanani ta T-cell (T-ALL tare da STIL-TAL1 positivity, wata kwayar halitta mai ƙarancin hasashen cuta) a ƙarshen Disamba 2020, kuma an yi masa magani a wani asibiti na gida tare da zagayowar chemotherapy da yawa akai-akai don samun cikakkiyar waraka. An yi dashen ƙwayoyin halitta na hemizygous hematopoietic uba zuwa ɗa a ranar 2 ga Yuni 2021, amma abin takaici an gano komawar ƙashi cikin watanni 3 bayan dashen, kuma zagaye 1 na chemotherapy bai yi tasiri ba. A lokaci guda, ya sami kumburin kunci da zubewar iska, kusurwoyin baki masu karkacewa, da hudawar lumbar sun nuna ci gaban cutar sankarar jijiyoyin tsakiya.

T-ALL tare da STIL-TAL1 tabbatacce, sake dawowa da wuri bayan dashen allogeneic, tare da cutar sankarar jini ta tsakiya, lamari ne mai matuƙar wahala a magance shi a zamanin da ba tare da CAR-T ba. Mahaifin yaron ya yi tambaya game da sashen kula da jini a Asibitin Jirgin Sama na Asibitin Ciwon daji na Tianjin ta hanyar abokansa. Bayan cikakken bayani, sun zo Asibitin Filin Jirgin Sama na Asibitin Ciwon daji na Tianjin, suna neman shiga gwajin asibiti na CAR-T a matsayin ƙoƙari na ƙarshe.

Kwayoyin cutar sankara ta farko da suka lalace a CAR-T sun ƙaru da sauri, wanda hakan ya sanya rayuwarsa cikin haɗari.

A ranar 26 ga Oktoba, 2021, an kwantar da majinyacin a sashen farko na Sashen Kula da Cututtukan Jini. Saboda saurin yaduwar ƙwayoyin cutar kansa, majinyacin ya yi amfani da maganin chemotherapy don rage yawan ciwon daji kuma ya sami maganin chemotherapy a cikin jiki. Ruwan cerebrospinal bai nuna wata cuta da ta rage ba. Bayan daidaitawa, an tattara ƙwayoyin lymphocytes na mahaifinsa don haɓaka ƙwayoyin CAR-T. A ranar 19 ga Nuwamba, an saka ƙwayoyin CAR-T na CD7 masu bayarwa a cikin majinyacin.

Kwanaki bayan allurar, kafin faɗaɗa ƙwayoyin CAR-T, ƙwayoyin ƙari suka sake yaɗuwa cikin sauri, tare da yawan fashewa a cikin jinin gefe, wanda ke nuna gazawar maganin CAR-T na farko.

A wannan lokacin, Asibitin Filin Jirgin Sama na Asibitin Daji na Tianjin yana gudanar da gwajin asibiti na CAR-T (CD7 UCAR-T) don cutar sankarar T-lymphoblastic mai tsanani. Iyayen sun nuna matukar gaggawa, suna masu cewa za su nemi ko da kashi 1% na damar ɗansu. Ƙungiyar likitocin ta tattauna da iyalan kuma ta yanke shawarar shigar da majinyacin cikin gwajin asibiti na CD7 UCAR-T.

Cikakkiyar gafara bayan CD7 UCAR-T Yanzu watanni 2 bayan dashen.

A ranar 2 ga Disamba, majiyyacin ya sami allurar ƙwayoyin CD7 U-CART tare da maganin rage nauyin ƙari da kuma kulawa mai tallafi. Bayan allurar, ya fuskanci zazzabi mai tsanani da gajiya mai tsawo. Tare da tallafin hana kamuwa da cuta da kuma ruwa, alamunsa na rayuwa sun daidaita kuma yanayin jikinsa ya daidaita.

Kimantawar ruwan ƙashi da na cerebrospinal a ranakun 18 da 28 bayan CAR-T ta tabbatar da warkewa gaba ɗaya tare da rashin lafiyar MRD. Yanayin yaron ya inganta sosai, kuzarinsa ya dawo, sha'awarsa ta dawo, kuma mahaifiyarsa—wadda a da take cikin damuwa—ta sake samun bege.

A halin yanzu, majinyacin ya yi wa wani likitan haploid na biyu tiyatar HSCT a Asibitin Filin Jirgin Sama na Asibitin Cancer na Tianjin kuma yana cikin cikakkiyar sassaucin watanni 2 bayan dasawa.