ʻO ka Myeloma lehulehu me ka Extramedullary Plasmacytoma

ʻO kēia ka hihia o kahi maʻi kāne 73 makahiki i ʻike ʻia me ka myeloma multiple, i hoʻopilikia ʻia e ke alo o ka plasmacytoma extramedullary. Ma loko o ke kaʻina hana o ka mālama ʻana me Dara-VRD (Daratumumab, Bortezomib, Lenalidomide, Dexamethasone), ua hoʻomau ka plasmacytoma extramedullary, e hōʻeha nui ana i ka mea maʻi.

Ma muli o ke ʻano ikaika o ka maʻi a me ka nele o ka pane ʻana i nā lāʻau lapaʻau maʻamau, ua kākau inoa ʻia ka mea maʻi i loko o kahi hoʻokolohua lapaʻau no ka lāʻau lapaʻau BCMA CAR-T cell. Ma hope o ka hana ʻana i nā ʻanuʻu hoʻomākaukau e pono ai, me ka lymphodepletion, ua loaʻa i ka mea maʻi ka hoʻokomo ʻia ʻana o nā cell BCMA CAR-T.

ʻO ka mea kupanaha, i loko o 10 mau lā ma hope o ka hoʻokomo ʻana, ua ʻike ka mea maʻi i kahi pane cytokine release syndrome (CRS) kekelē ʻelua, e hōʻike ana i kahi hoʻoulu ikaika o ka pale ʻana. Eia kekahi, aia kahi CRS kūloko koʻikoʻi ma kahi o ka plasmacytoma extramedullary.

ʻO ka mea kupanaha loa, i loko o kēia manawa pōkole, ua nalowale loa ka ʻeha extramedullary i kūʻē i ka lāʻau lapaʻau ma mua, ka mea i hōʻoia i kūʻē i nā laina chemotherapy he nui, nā mea i kuhikuhi ʻia, a me nā antibodies monoclonal. Ua loaʻa i ka mea maʻi ke kala piha ʻana, e hōʻailona ana i ka holomua o ka lāʻau.

Ma loko o ke kaʻina hana lapaʻau, ua nānā pono ke kime lapaʻau i ka mea maʻi no kekahi mau hōʻailona o nā hopena maikaʻi ʻole a hāʻawi i ka mālama kākoʻo piha. Ua komo pū kēia me ka mālama ʻana i nā hōʻailona CRS a me ka hoʻoponopono ʻana i nā pilikia ʻē aʻe e pili ana i ka lāʻau.

I ka holomua ʻana o ka lāʻau lapaʻau, ua hoʻomau ka hui lapaʻau i ka nānā pono ʻana i ka pane a ka mea maʻi i ka lāʻau lapaʻau BCMA CAR-T cell. Ua hana ʻia nā loiloi maʻamau e loiloi i ka pono o ka lāʻau lapaʻau a e hoʻoponopono koke i nā hopena ʻaoʻao e kū mai ana.

Ma hope o ka hoʻokō kupaianaha o ke kala piha ʻana, ua hoʻomaikaʻi nui ʻia ke ʻano o ke ola o ka mea maʻi, me ka hōʻoluʻolu ʻana i ka ʻeha a me ka ʻoluʻolu ʻole e pili ana i ka plasmacytoma extramedullary. Me ka maʻi ma lalo o ke kaohi, ua hiki i ka mea maʻi ke hoʻi hou i nā hana o kēlā me kēia lā a hauʻoli i kahi olakino maikaʻi aʻe.

Eia kekahi, me ka ʻike ʻana i ke koʻikoʻi o ka mālama ʻana i ka wā lōʻihi, ua hoʻomau kā mākou hui lapaʻau i ka hana ikaika i ka huakaʻi ma hope o ka mālama ʻana o ka mea maʻi. Ua hoʻonohonoho ʻia nā manawa hahai maʻamau e nānā i ke kūlana o ka mea maʻi, e loiloi i ka lōʻihi o ka pane ʻana i ka lāʻau lapaʻau, a e hoʻoponopono i kekahi hopena hou a i ʻole nā ​​​​hopena ʻaoʻao lohi.

Ma waho aʻe o ka nānā ʻana i ke olakino, ua hāʻawi kā mākou ʻoihana i nā lawelawe kākoʻo piha e kōkua i ka mea maʻi i ka hoʻomaʻamaʻa ʻana i ke ola ma hope o ka mālama ʻana. Ua komo pū kēia me ke komo ʻana i nā lawelawe aʻoaʻo, nā papahana hoʻoponopono hou, a me nā kumuwaiwai hoʻonaʻauao e kōkua i ka mea maʻi a me ko lākou ʻohana e hoʻokele i ke ola a mālama i kahi nohona olakino.

ʻAʻole wale ka hopena holomua o kēia hihia e hōʻike ana i ka pono o ka lāʻau lapaʻau BCMA CAR-T cell i ka mālama ʻana i ka myeloma multiple refractory akā hōʻike pū kekahi i ke koʻikoʻi o ka mālama pilikino a me ka multidisciplinary i ka hoʻokele ʻana i nā maʻi hematologic paʻakikī. ʻO kā mākou kūpaʻa i ka hāʻawi ʻana i ke kākoʻo mau a me ka mālama hahai ʻana e hōʻike ana i ko mākou hoʻolaʻa ʻana i ka hōʻoia ʻana i nā hopena maikaʻi loa no kā mākou mau maʻi ma mua o ka wā lapaʻau.

Ma mua a me 3 mau mahina ma hope o ka hoʻokomo ʻana