Myeloma Mai Yawa (MM)-01

Kyakkyawan murmurewa na Marasa Lafiyar Myeloma da yawa a Gida tare da Maganin CAR-T Duk da Rashin Bayyanar BCMA

Wata majiyyaciya mace da aka gano tana da cutar myeloma mai nau'in IgD-λ a shekarar 2018 ta sami maganin farko musamman da bortezomib. Bayan zagaye 3, ta sami cikakkiyar sassauci (CR). A watan Oktoba na 2018, ta yi dashen ƙwayoyin halittar jini na autologous a matsayin maganin haɗin gwiwa, sannan aka yi mata magani mai kyau da lenalidomide. A watan Afrilun 2020, cutar ta sake dawowa, kuma ta yi zagaye 7 na magani na layi na biyu, wanda ya haifar da rashin inganci. Daga Disamba 2020 zuwa Afrilun 2021, ta sami chemotherapy galibi tare da daratumumab, amma biopsy na ƙashi har yanzu ya nuna kashi 21.763% na ƙwayoyin plasma na monoclonal masu cutarwa, tare da sarkar haske mara jini λ a 1470 mg/L da sarkar haske mara fitsari λ a 5330 mg/L. A wannan lokacin, ta gaji manyan jiyya na yau da kullun da ake samu a cikin gida, gami da yin dashen ƙwayoyin halittar jini na autologous, tare da shiga gwajin asibiti na CAR-T shine mafi kyawun zaɓi.

Likitoci na gida sun tura ta zuwa Asibitin Ludaopei a ranar 10 ga Mayu, 2021, tana fatan yin rijista a gwajin asibiti don maganin BCMA CAR-T a cikin myeloma mai yawa (MM). Bayan an kwantar da ita, tana cikin rauni tare da ciwo mai yawa da zazzabi mai maimaitawa. Cikakkun gwaje-gwaje sun tabbatar da "myeloma da yawa, nau'in sarkar haske λ, matakin ISS na III, matakin R-ISS na III, ƙungiyar mSMART mai haɗari."

Binciken PET-CT ya nuna ƙaruwar aikin metabolism a cikin yawan nama mai laushi a cikin ramukan ƙashi na ƙashi na femurs da tibias, wanda ke nuna alamun kamuwa da ƙari. Binciken ƙwayoyin cuta na ƙashi ya nuna kashi 60.13% na ƙwayoyin plasma na monoclonal masu cutarwa ba tare da bayyanar BCMA ba.

Cibiyarmu ta CGT ta sanar da majiyyaciyar da iyalinta game da ingancin magungunan da ake amfani da su a yanzu don maganin myeloma mai yawa na BCMA, wanda kodayake yana iya yin tasiri a cewar wasu wallafe-wallafe, ba shi da cikakken bayani. Bayan an yi la'akari da kyau, majiyyaciyar da iyalinta suka zaɓi ci gaba da tsarin maganin.

Bayan an yi amfani da tsarin FC kafin a yi amfani da shi, an saka ƙwayoyin BCMA CAR-T a ranar 1 ga Yuni, 2021, a Asibitin Ludaopei. Majinyacin ya kamu da zazzabi bayan an yi masa allurar, wanda aka sarrafa shi a hankali ta hanyar maganin hana kamuwa da cuta da kuma maganin da ke taimakawa wajen nuna alamun cutar. Kwanaki goma sha huɗu bayan an yi masa allurar, an nuna babu sauran ƙwayoyin plasma na monoclonal masu cutarwa. Kwanaki talatin da ɗaya bayan an yi masa allurar, an ci gaba da yin allurar biopsy na bargo. An yi wa allurar immunofixing na jini ba tare da wani magani ba, λ yana cikin matsakaicin da aka saba, kuma furotin na M na jini ba shi da wani magani, wanda ke nuna cewa an warke cutar gaba ɗaya.

A halin yanzu, sama da watanni 8 bayan shan maganin BCMA CAR-T, majinyacin yana cikin cikakkiyar sassauci tare da murmurewa mai kyau da gamsuwa sosai da sakamakon maganin.