Te lymphoma pūtau-B nui horapa (DLBCL)-03

I te marama o Poutū-te-rangi 2021, ka pāngia a Mr. Wang (ingoa huna) e te mamae o te puku matau o raro, i te tuatahi i pohehetia he mamae o te puku, ā, kāore i tere te rapu awhina hauora. I roto i ngā marama e rua i muri mai, i pāngia tonutia ia e te mamae o te puku matau o raro, ā, ka akiaki ia ki te rapu awhina hauora i tētahi hōhipera o te rohe. I kitea i roto i te matawai CT ngā āhuatanga rerekē o te koroni me te nui haere o ngā kōpū lymph retroperitoneal.

I tūtohu ngā tākuta kia whakamahia he colonoscopy me te biopsy hei tātaritanga atu, ā, i whakaūtia te "lymphoma pūtau-B nui horapa," he pukupuku kino e mōhiotia whānuitia ana ko te lymphoma. I whakaūtia anō e te PET-CT te horapa o ngā whara nodular hypermetabolic puta noa i tōna tinana, ko te mea nui rawa atu he 4.3*4.1*4.5cm te rahi.

Nā te tautoko a tōna whānau, i whai wāhi a Mr. Wang ki ngā huringa e whā o te rongoā rongoā R-CHOP. I kitea i te PET-CT whai muri i te rongoā rongoā he ngāwari noa iho te whakaora.

Heoi, i puta mai ngā raruraru kino mō Mr. Wang i muri mai, pērā i te aukati i te puku, te poka, me te peritonitis whakapeka. I mahi tahi ngā taote puku me ngā tākuta e haere ana ki te whakatakoto i tētahi mahere pokanga, i mahi i te tango i te koroni me te tango i te wai, me te tiaki tautoko i ngā tohumate, me te whakahaere pai i ana tohumate puku.

I kitea i muri mai i te matawai PET-CT te pikinga o ngā whara me te rahi o te pukupuku. Hei whakakore pai ake i ngā pūtau pukupuku, i whakatikatikahia e ngā tākuta te tikanga chemotherapy kaha ake, ā, i tūtohutia te whakawhitinga pūtau take hematopoietic.

I raro i ngā raruraru maha, i pāngia a Wang e te mamae nui o te tinana me te hinengaro i te kino haere o tōna āhua. I kitea te urunga mai o te pukupuku ki ngā wāhi maha, me ngā whara hou o te nodular hypermetabolic e whakanui ana i te rohe mate pukupuku. Nā te nui o ngā pukupuku puta noa i tōna tinana, i pāngia a Wang e te mamae pūnaha mau tonu, ā, he uaua ki a ia te takoto papatahi me te moe nā te mamae.

I roto i te pouri, ka ako a Mr. Wang mō te rongoā CAR-T, he rongoā ārai mate pūtau CAR-T hou i hangaia mō ngā tūroro he lymphoma pūtau-B kua hoki mai, he uaua rānei ki te ora.

I mua i te whai i te rongoā CAR-T, i whakaatuhia he pai te CD19 me te CD20 i te tirotiro i ngā kōpū lymph i te rohe o te ngaungau matau, ā, i whakaratohia he whāinga tika mō te rongoā pūtau CAR-T. I whakarite a Ahorangi Yu i tētahi whakamātautau tinana whānui, ā, i arahina atu ki te whakawhanaketanga o tētahi mahere rongoā CAR-T takitahi mō Mr. Wang.

I te 25 o Hūrae, 2022, i whiwhi a Mr. Wang i te werohanga pūtau CD19/20 CAR-T i te hōhipera, ā, i pai te haere o te tukanga. Nā te aroturukitanga tata me te tiaki tautoko pakari i whakahaere i ngā urupare kino i muri i te werohanga, me te kore he raruraru morearea.

I roto i ngā marama e toru, tae noa ki te 10 o Oketopa, 2022, i whakaūtia e te matawai PET-CT kua murua katoatia tōna mate, me te aromatawai whānui e whakaatu ana i te whakapainga nui o tōna hauora.

I ngā tirotirohanga i muri mai, i tirotirohia a Mr. Wang e te CT, MRI, PET-CT rānei, ā, i whakaūtia ai tōna āhua kua marino katoa. I tēnei wā, kei te pai tonu tōna hauora, neke atu i te 14 marama te roa o te wā marino katoa.