Mr. D----Tautoko o Kanata: Lymphoma Pūtau-B Nui e horapa ana (DLBCL) me te whakarerekētanga TP53

I whai mana mātou, hei whare hauora, ki te rongoā i tētahi tūroro ko Mr. D tōna ingoa, nō Kanata ia. I kitea tōna mate pukupuku Diffuse Large B-cell Lymphoma (DLBCL) me te whakarerekētanga TP53, he āhuatanga i uaua ai ngā tikanga rongoā tuku iho.

I tīmata a Tā D i tana haerenga ki te whawhai ki tēnei mate nui me te hihiri me te whakapau kaha e āhua ana i roto i tōna tuakiri. I te tīmatanga, i tukuna ia ki te rongoā tuatahi R-CHOP, he tikanga maimoatanga paerewa mō te DLBCL. Ahakoa ngā tumanakohanga tuatahi, i kore i angitu ngā nganatanga i muri mai me ngā rongoā tuarua pērā i te R-DHAP me te GEMOX-BTKi, ā, i waiho tōna āhua kia uaua, he mea pouri ki a Tā D me tana tīma hauora.

I te mōhio ki te tere o te āhuatanga me te hiahia mō ngā otinga auaha, i whakatau mātou kia whakaurua a Mr. D ki te mahere whakaora CD19-CAR-T. Mā tēnei huarahi hou ki te rongoā mate pukupuku ka whakamahia te mana o te pūnaha ārai mate o te tinana ki te aro atu me te whakangaro i ngā pūtau mate pukupuku, ka tukuna he hihi o te tumanako mō ngā tūroro pērā i a Mr. D kua pau katoa ngā huarahi rongoā tuku iho.

He tino mīharo ngā hua. Kotahi marama noa iho i muri i te werohanga o ngā pūtau CD19-CAR-T, ka tutuki i a Mr. D te murunga katoa, he mahi i ahua kore e taea i ngā wiki noa iho i mua. Heoi, kāore i kore he wero mō tēnei haerenga ki te murunga. I pāngia a Mr. D e te mate tuku cytokine taumata-waenga (CRS) me te mate neurotoxicity e pā ana ki ngā pūtau ārai mate taumata-1 (ICANS) i te wā e rongoatia ana. He waimarie, i tere te wawao a tā mātou tīma hauora mataara, me te whakahaere pai i ēnei raruraru me te tocilizumab, adalimumab, me te rongoā homoni, me te whakarite i te haumaru me te whakamarie o Mr. D puta noa i te tukanga.

Ko te whai huatanga o te rongoā pūtau CAR-T i roto i te keehi a Mr. D he tohu tumanako mō ngā tūroro DLBCL uaua puta noa i te ao, e whakaatu ana i te kaha whakarerekētanga o tēnei tikanga maimoatanga hou. Heoi anō, e whakaatu ana te haerenga a Mr. D i te tūranga nui o te mahi tahi maha-mātauranga me te manaaki aroha i roto i te pakanga ki te mate pukupuku.

I a ia e whakaaroaro ana ki ōna wheako, i whakapuaki a Mr. D i tōna mihi nui ki te tautoko me te tohungatanga pumau o tana tīma hauora. "Kāore he rite o te taumata o te manaaki me te whakapau kaha i riro mai i ahau i roto i taku maimoatanga," tana kī. "Ehara i te mea i rongoatia noa e rātou taku mate, engari i manaaki hoki rātou i aku matea hinengaro me aku matea kai, me te whakarite kia tautokona ahau i ia taahiraa o te huarahi."

He tohu te kōrero a Mr. D i te manawanui o te wairua tangata me ngā whanaketanga whakamiharo kua puta i te ao oncology. I a mātou e pana tonu ana i ngā rohe o te auahatanga hauora, e mau tonu ana tā mātou whakapau kaha ki te whakarato i te manaaki whaiaro, aroha ki ia tūroro e whakawhirinaki mai ana ki a mātou ki te tiaki i ō rātou hauora me te oranga.

I te tīmatanga o te mate, kotahi te rā i mua atu, kotahi te marama i muri i te werohanga.