Kab mob qog ntshav Lymphoblastic loj heev (T-ALL)-04

Tus neeg mob yog ib tug txiv neej hnub nyoog 15 xyoo, kuaj pom tias muaj T-cell acute lymphoblastic leukaemia (T-ALL nrog STIL-TAL1 positivity, ib qho noob caj noob ces tsis zoo) thaum kawg ntawm lub Kaum Ob Hlis 2020, thiab tau kho mob hauv tsev kho mob hauv zos nrog ntau lub voj voog ntawm chemotherapy tsis tu ncua kom ua tiav kev zam txim tag nrho. Ib qho kev hloov pauv ntawm leej txiv rau tus tub hemizygous haematopoietic stem cell tau ua rau hnub tim 2 Lub Rau Hli 2021, tab sis hmoov tsis zoo qhov kev rov qab los ntawm cov pob txha tau pom hauv 3 lub hlis tom qab kev hloov pauv, thiab 1 lub voj voog ntawm chemotherapy tsis ua haujlwm. Tib lub sijhawm, nws tau tsim cov puab tsaig bulging thiab cov pa tawm, cov ces kaum ntawm lub qhov ncauj nkhaus, thiab qhov lumbar puncture qhia txog kev loj hlob ntawm cov kab mob hauv lub paj hlwb hauv nruab nrab.

T-ALL nrog STIL-TAL1 zoo, rov qab mob sai tom qab hloov pauv allogeneic, ua ke nrog cov kab mob leukaemia hauv lub paj hlwb, yog ib qho teeb meem nyuaj heev rau kev kho mob hauv lub sijhawm tsis muaj CAR-T. Tus txiv ntawm tus menyuam tau nug txog chav kho mob ntshav ntawm Tianjin Cancer Hospital Airport Hospital los ntawm nws cov phooj ywg. Tom qab sib txuas lus ntxaws ntxaws, lawv tau tuaj rau Tianjin Cancer Hospital Airport Hospital, nrhiav kev koom nrog CAR-T kev sim tshuaj ua qhov kev sim kawg.

Cov qe ntshav qog thawj zaug uas tsis ua haujlwm ntawm CAR-T tau nthuav dav sai heev, ua rau nws txoj sia muaj kev phom sij.

Thaum Lub Kaum Hli 26, 2021, tus neeg mob tau raug xa mus rau chav kho mob thawj zaug ntawm Chav Saib Xyuas Hematology. Vim yog qhov kev loj hlob sai ntawm cov hlwb qog, tus neeg mob tau txais kev kho mob chemotherapy kom txo qhov mob qog thiab tau txais kev kho mob intrathecal chemotherapy. Cov kua dej cerebrospinal tsis pom muaj kab mob seem. Tom qab kev ruaj khov, nws txiv cov lymphocytes tau sau rau CAR-T cell kab lis kev cai. Thaum Lub Kaum Ib Hlis 19, tus neeg pub dawb CD7 CAR-T cell tau txhaj rau hauv tus neeg mob.

Ob peb hnub tom qab txhaj tshuaj, ua ntej CAR-T cell nthuav dav, cov qog nqaij hlav tau nthuav dav sai dua, nrog rau kev tawg ntau hauv cov ntshav peripheral, uas yog qhov ua tsis tau zoo ntawm thawj CAR-T kev kho mob.

Lub sijhawm no, Tsev Kho Mob Cancer Tianjin Lub Tsev Kho Mob Tshav Dav Hlau tab tom ua kev sim tshuaj CAR-T (CD7 UCAR-T) rau kev mob qog ntshav T-lymphoblastic mob hnyav. Cov niam txiv tau hais tias lawv xav tau kev kho mob sai sai, hais tias lawv yuav nrhiav kev kho mob txawm tias muaj 1% rau lawv tus menyuam. Pab pawg kho mob tau tham nrog tsev neeg thiab txiav txim siab sau npe tus neeg mob rau hauv kev sim tshuaj CD7 UCAR-T.

Kev zam txim tag nrho tom qab CD7 UCAR-T Tam sim no 2 lub hlis tom qab hloov pauv.

Thaum Lub Kaum Ob Hlis 2, tus neeg mob tau txais CD7 U-CART cell infusion ua ke nrog kev kho mob txo qhov mob qog noj ntshav thiab kev saib xyuas txhawb nqa. Tom qab infusion, nws tau kub taub hau ntev thiab qaug zog. Nrog kev tiv thaiv kab mob thiab kev txhawb nqa dej, nws cov cim tseem ceeb tau ruaj khov thiab lub cev kub tau zoo li qub.

Kev ntsuam xyuas cov pob txha thiab cov kua hauv lub hlwb ntawm hnub 18 thiab 28 tom qab CAR-T tau lees paub tias nws zoo tag nrho thiab tsis muaj MRD. Tus menyuam tus mob tau zoo dua qub, nws lub zog rov qab los, nws txoj kev xav noj mov rov qab los, thiab nws niam—uas yav tas los nyuaj siab—tau rov qab muaj kev cia siab.

Tam sim no, tus neeg mob tau ua qhov thib ob haploidentical HSCT ntawm Tianjin Cancer Hospital Airport Hospital thiab tseem zoo li qub tom qab 2 lub hlis tom qab hloov hlwb.