ʻO ka lymphoma B-cell nui e hoʻolaha ʻia (DLBCL) -04

ʻO ka Pane Mua Kupanaha a Mr. Monger: Lawe mai ka Dual CD19/CD20 CAR-T Therapy i ka Manaʻolana Hou no ka DLBCL Relapsed

Ka Moʻolelo o ka Mea Maʻi 

ʻO Rodney Charles Monger, he kanaka 68 makahiki mai nā ʻāina ʻē, ua ʻike ʻia he diffuse large B-cell lymphoma (DLBCL) ʻekolu mau makahiki ma mua. Ua ʻimi ʻo ia i ka mālama kiʻekiʻe ma ka Halemai Kanesa ʻo Tianjin i ʻAukake 2025. Ua hōʻoia kahi biopsy cervical lymph node i ka invasive B-cell lymphoma o ke kikowaena germinal. Ua maikaʻi loa ka Immunohistochemistry no CD20, CD19, a me CD10, me ka hōʻike kiʻekiʻe o Bcl-6, Bcl-2 (70%+), a me c-MYC (60%+). Ua hōʻike ka hoʻāʻo genetic i ka hoʻonohonoho hou ʻana o BCL2 e FISH a me nā mutations ma EZH2, KMT2D, TNFRSF14, NRAS, a me TPMT genes—nā māka e kūlike me kahi ʻano hoʻouka kaua a kiʻekiʻe ka pilikia.

Huakaʻi Lapaʻau Ma mua 

I ʻAukake 2025, ua loaʻa iā Mr. Monger ka pola i hui pū ʻia me kahi mea hoʻopaʻa BTK a me lenalidomide. A laila ua hana ʻia ʻo ia i ka chemotherapy lymphodepletion FC (fludarabine + cyclophosphamide). ʻOiai kēia mau hoʻoikaika ʻana, ua mau ka paʻakikī o kona maʻi, e koi ana i ka hui lapaʻau e paipai i ka lāʻau lapaʻau cell CD19/CD20 CAR-T ʻo Bioocus.

Ma ka lā 8 o Kepakemapa, 2025, ua loaʻa iā Mr. Monger ka hoʻokomo ʻia ʻana o nā pūnaewele autologous CD19/CD20 CAR-T. ʻO ka mea kupaianaha, ua ʻike ʻo ia ʻaʻohe cytokine release syndrome (CRS)a me ʻaʻohe maʻi neurotoxicity e pili ana i nā cell effector immune (ICANS)—he papa hana maʻalahi ma hope o ka hoʻokomo ʻana i hiki ai iā ia ke noho paʻa a me ka manaʻolana mai ka lā mua.

Hoʻonui ʻia ke kelepona CAR-T: Wikiwiki a PaʻaUa hōʻike ka nānā ʻana i ke koko peripheral i ka hoʻonui kupaianaha ʻana o nā cell CAR-T, e hōʻoia ana i ka engraftment maikaʻi loa a me ka hoʻonui ʻana:

• D4 ma hope o ka hoʻokomo ʻana(Kepakemapa 12): ʻO nā pūnaewele CAR19+ he 0.50% o nā pūnaewele CD3+ T (waiwai piha 6.04 × 10⁷/L); nā pūnaewele CAR20+ 0.41% (4.96 × 10⁷/L).
• D7(Kepakemapa 15): Ua piʻi aʻe ʻo CAR19+ i 1.68% (1.40 × 10⁷/L); CAR20+ i 1.63% (1.36 × 10⁷/L).
• D10(Kepakemapa 18): Ua hōʻea ʻo CAR19+ 43%o nā pūnaewele CD3+ T (waiwai piha 3.13 × 10⁸/L); ua hōʻea ʻo CAR20+ 32.74%(waiwai piha 3.26 × 10⁸/L).

Ua hōʻike hou aku ka cytometry kahe i ka hoʻolaha kaulike ma waena o nā ʻāpana CD4+ a me CD8+, me ka hōʻike ʻana o CAR pālua ikaika. Ua hōʻike nā pihi nānā ʻana i kahi pae hoʻonui exponential maopopo, e hōʻike ana ua hoʻolaha maikaʻi ka hoʻolālā CD19/CD20 pālua i ka hoʻomau a me ka hoʻolaha ʻana o CAR-T i vivo.

Ke Kūlana o Kēia Manawa a me ka Mālama Kākoʻo 

Ma ka nānā hou loa ʻana (D10), ke hoʻomau nei ʻo Mr. Monger i ka hana maikaʻi ma ke ʻano lapaʻau. Aia ʻo ia ma kahi papa hana lāʻau waha i hoʻopilikino ʻia e pili ana i ka acyclovir, ka hui sulfamethoxazole, orelabrutinib, lenalidomide, a me nā mea kākoʻo, me ka nānā mau ʻana i nā helu koko, ka hana o ke akepaʻa a me nā puʻupaʻa, a me nā māka mumū e like me ka hoʻolālā hoʻokuʻu.

Ua hāʻawi aku ka hui Bioocus i ke kākoʻo piha a i kau ʻia ma ke kikowaena o ka mea maʻi ma nā wahi a pau: kahi noho ʻoluʻolu, nā meaʻai momona, ke kōkua halihali, a me ke aʻoaʻo noʻonoʻo no Mr. Monger a me kona ʻohana. Ua kōkua kēia ʻano hana holoʻokoʻa iā ia e kālele piha i ka hoʻōla ʻana.

He Leka o ka Manaʻolana 

Hōʻike ka hihia o Mr. Monger i ka hiki ke hoʻololi i ka lāʻau lapaʻau Bioocus dual CD19/CD20 CAR-T no nā poʻe maʻi me ka DLBCL relapsed/refractory. ʻO ka hoʻonui wikiwiki a ikaika o nā cell CAR-T me ka ʻole o nā ʻawaʻawa koʻikoʻi e hōʻike ana i ka ʻaoʻao palekana maikaʻi o ka huahana a me ka hana anti-tumor ikaika—ʻoiai i kahi maʻi ʻelemakule me nā hiʻohiʻona molekala kiʻekiʻe.

Haʻaheo mākou e kākoʻo i nā poʻe maʻi e like me Mr. Monger ma kā lākou huakaʻi hoʻi i ke olakino. Hoʻoikaika nā moʻolelo e like me kāna i kā mākou kūpaʻa i ka hāʻawi ʻana i nā lāʻau lapaʻau cell hou a hoʻololi ola me ka mālama pilikino.

Ua hōʻike ʻia kēia hihia me ka ʻae ʻana o ka mea maʻi. Hiki ke ʻokoʻa nā hopena; Pili nā hopena CAR-T i ka biology maʻi pilikino a me nā kumu lapaʻau. No ka ʻike hou aku a i ʻole e ʻimi i nā koho lapaʻau, e ʻoluʻolu e kipa i kā mākou ʻaoʻao CAR-T Therapy for Non-Hodgkin Lymphoma.