Ka Holomua Hoʻonaʻauao | Ua Paʻi ka Hui Lapaʻau ʻo Lu Daopei i kahi Haʻawina Lapaʻau Hou ma ka British Journal of Haematology
Ma kahi hoʻokō koʻikoʻi no ka Lu Daopei Medical Team, he pepa noiʻi lapaʻau mua i kapa ʻia "He haʻawina palekana a me ka pono o ka hoʻoili ʻana o nā cell stem haematopoietic allogeneic no nā maʻi maʻi leukemia lymphoblastic acute T-cell refractory a me relapsed T-cell acute/lymphoblastic lymphoma i loaʻa ke kala piha ma hope o ka autologous CD7 chimeric antigen receptor T-cell therapy" ua paʻi ʻia ma ka puke kaulana Ka Nūpepa Pelekane o ka Hematology (IF=5.1). ʻO ke aʻo ʻana, i kākau ʻia e Kauka Cao Xingyu me Polopeka Lu Peihua ma ke ʻano he mea kākau pili, e kālele ana i ka hiki ke hoʻohiki i ka hoʻopili ʻana i ka allo-HSCT no nā maʻi R/R T-ALL a me T-LBL i loaʻa ka hoʻomaha piha (CR) ma hope o ka lāʻau lapaʻau autologous CD7 CAR-T.
Ka Moolelo Noiʻi:
ʻIke ʻia nā maʻi ʻino T-cell, e like me T-ALL a me T-LBL, no ko lākou ʻano huhū a me ke kūʻē kiʻekiʻe i ka lāʻau lapaʻau. No nā poʻe maʻi me ka T-ALL/LBL paʻakikī a i ʻole ka relapsed (R/R T-ALL/T-LBL), hāʻawi nā lāʻau lapaʻau kuʻuna i ka holomua palena a me nā prognoses maikaʻi ʻole. Eia nō naʻe, ua puka mai ka lāʻau lapaʻau CD7 CAR-T ma ke ʻano he holomua hiki, e hōʻike ana i ka hoʻohiki koʻikoʻi i ka mālama ʻana i kēia mau kūlana paʻakikī e mālama, ʻoiai aia nō i nā pae mua o nā hoʻokolohua lapaʻau. Ke ukali ʻia e ka hoʻohui ʻana me allo-HSCT, hāʻawi ʻia nā poʻe maʻi i hoʻokō i ka CR me ka lāʻau lapaʻau CD7 CAR-T i kahi manawa maoli i ke kala ʻana no ka manawa lōʻihi.
Ke ʻano hana aʻo:
Ua kālailai kēia haʻawina hoʻihoʻi i nā maʻi R/R T-ALL a me T-LBL i loaʻa i ka lāʻau lapaʻau NS7 CAR-T, a ukali ʻia e ka hoʻohui ʻana o allo-HSCT ma waena o Nowemapa 2020 a me Ianuali 2023 ma ka Halemai ʻo Lu Daopei. Ua nānā ke aʻo ʻana i nā kumu like ʻole, me ka makahiki o ka mea maʻi, ka helu kope o nā cell CAR-T ma mua o ke kāpili ʻana, a me nā ʻano hana dosing CAR-T like ʻole, e loiloi i ko lākou hopena i nā hopena o ke kāpili ʻana. Ua hoʻohālikelike ʻia nā hopena me nā mea o 124 mau maʻi i loaʻa iā CR ma o ka chemotherapy a ukali ʻia e allo-HSCT.
Nā ʻIke Koʻikoʻi:
Ua komo pū ka noiʻi me 34 mau maʻi R/R T-ALL/T-LBL i loaʻa iā lākou ka CR ma hope o ka lāʻau lapaʻau NS7 CAR-T a ma hope iho ua hana ʻia ka allo-HSCT. ʻO ka manawa waena ma waena o ka lāʻau lapaʻau CAR-T a me ka hoʻoili ʻana he 57.5 mau lā. ʻIke ʻia, 47.1% o nā maʻi i loaʻa i ka maʻi paʻakikī mua, ʻoiai 52.9% i loaʻa ka maʻi hou. Ma hope o ka hoʻokomo ʻana o CAR-T, ua loaʻa ka cytokine release syndrome (CRS) i 33 mau maʻi, me 94.1% e ʻike ana i ka Grade 1-2 CRS. ʻO ka mea pōmaikaʻi, ʻaʻohe maʻi i loaʻa i ka immune effector cell-associated neurotoxicity syndrome (ICANS).
I 28 mau lā ma hope o ke CAR-T, ua loaʻa i nā maʻi he 31 ka CR MRD-negative, ʻoiai he 3 mau maʻi i loaʻa iā MRD-positive CR. Ua ʻike pū ka noiʻi he 0% ka nui o ka hoʻihoʻi ʻana o nā maʻi me ≤20% o nā pahū iwi ma mua o ke kāpili ʻana i ka iwi ma 18 mau mahina ma hope o ke kāpili ʻana. I ka hoʻohālikelike ʻia me nā maʻi CR e pili ana i ka chemotherapy, ua like nā helu ola holoʻokoʻa (OS) 2 makahiki: 61.9% no ka hui CD7 CAR-T vs. 67.6% no ka hui chemotherapy. Eia kekahi, ua aneane like nā helu ola leukemia-free (LFS) 2 makahiki (62.3% vs. 62.0%).
ʻO ka mea nui, ʻo nā maʻi i piha i ka 14 mau makahiki i loaʻa i ka lāʻau lapaʻau CD7 CAR-T he 87.5% OS a me LFS 2 makahiki maikaʻi loa. Hōʻike nā hopena e hiki i ka lāʻau lapaʻau CD7 CAR-T i ukali ʻia e ka allo-HSCT ke hāʻawi i kahi koho palekana a maikaʻi hoʻi no nā maʻi R/R T-ALL/T-LBL i kūpono ʻole no nā lāʻau lapaʻau kuʻuna.
Hopena:
Ua hoʻoholo ka haʻawina ʻo ka hui pū ʻana o ka lāʻau lapaʻau CD7 CAR-T i ukali ʻia e ka allo-HSCT e hāʻawi i kahi ala lapaʻau hoʻohiki a maikaʻi hoʻi no nā maʻi R/R T-ALL/T-LBL. Ua like nā hopena me nā mea i loaʻa me ka chemotherapy a me ka allo-HSCT, me ka ʻole o ka piʻi ʻana o ka make ʻole-relapse, e hāʻawi ana i kahi koho lapaʻau waiwai nui no nā maʻi me nā koho therapeutic palena. Hāʻawi nā ʻike o ka haʻawina i ka manaʻolana no ke kala ʻana a me ke ola lōʻihi, ʻoi aku hoʻi i nā maʻi kiʻekiʻe e hana ana i ka hoʻohui kūpono me ka allo-HSCT.
Hopena a me ka Nānā i ka Wā E Hiki Mai Ana:
ʻO ka hoʻolaha ʻia ʻana o kēia noiʻi kupaianaha ma Ka Nūpepa Pelekane o ka Hematologyhe hōʻike ia i ka hoʻolaʻa a me ka ʻike loea o ka Lu Daopei Medical Team. Hōʻike kēia hoʻokō i nā hana e hoʻomau nei o ka haukapila i ka hoʻolaha ʻana i ka mālama ʻana i nā maʻi koko a me kā lākou mau hāʻawi koʻikoʻi i ke kaiāulu lapaʻau honua. Hōʻike ia i ka hiki o ka lāʻau lapaʻau CD7 CAR-T ma ke ʻano he koho kūpono no nā poʻe maʻi me R/R T-ALL/T-LBL a hōʻike i ka hoʻokō ʻana o ka hui i ka hoʻokuke ʻana i nā palena o ka hematological Ka Lapaʻau ʻana i ka Maʻi ʻAʻai.