Te Myeloma Maha (MM)-01

He pai te whakaoranga o tētahi tūroro myeloma maha o te kāinga me te rongoā CAR-T ahakoa te korenga o te whakaaturanga BCMA

I te tau 2018, i whiwhi tētahi tūroro wahine i tāpaetia he mate myeloma maha momo IgD-λ wāhanga IIIA i te maimoatanga tuatahi, ko te bortezomib te nuinga. I muri i ngā huringa e 3, ka tutuki i a ia te murunga katoa (CR). I te marama o Oketopa 2018, i tukuna ia ki te whakawhitinga pūtau take hematopoietic autologous hei rongoā whakakotahi, ā, i muri mai ko te rongoā pupuri me te lenalidomide. I te marama o Āperira 2020, ka hoki anō te mate, ā, e 7 ngā huringa o te maimoatanga tuarua i tukuna i a ia, ā, kāore i tino whai hua. Mai i Hakihea 2020 ki Āperira 2021, i tukuna ia ki te chemotherapy me te daratumumab te nuinga, engari i whakaatuhia tonutia e te koiora wheua wheua he 21.763% ngā pūtau plasma monoclonal kino, me te mekameka mārama kore toto λ i te 1470 mg/L me te mekameka mārama kore mimi λ i te 5330 mg/L. I tēnei wā, kua pau katoa i a ia ngā maimoatanga paerewa me ngā maimoatanga hou e wātea ana i te kāinga, tae atu ki te whakawhitinga pūtau take autologous, me te whakaurunga ki te whakamātautau haumanu CAR-T te kōwhiringa pai rawa atu e toe ana.

I tukuna ia e ngā tākuta o te rohe, ā, i tae atu ia ki te Hōhipera o Ludaopei i te 10 o Mei, 2021, me te tumanako ka uru atu ia ki tā rātou whakamātautau haumanu mō te rongoā BCMA CAR-T mō te myeloma maha (MM). I tōna whakaurunga, i roto ia i te āhua ngoikore me te mamae whānui me te kirika hoki. I whakaūhia e ngā whakamātautau whānui "myeloma maha, momo mekameka māmā λ, taumata III ISS, taumata III R-ISS, rōpū mōrearea nui mSMART."

I whakaatuhia e te matawai PET-CT te pikinga o te ngohe pākia o te kiko ngohengohe i roto i ngā kōhao hinu wheua o ngā femur me ngā tibia e rua, he tohu tēnei mō te whai wāhi mai o te pukupuku. I whakaatuhia e te koiora hinu wheua he 60.13% ngā pūtau plasma monoclonal kino, kāore he whakaaturanga o te BCMA.

I whakamōhiotia e tā mātou pokapū CGT te tūroro me tōna whānau mō te whai huatanga o ngā maimoatanga o nāianei mō te myeloma maha BCMA-negative, ahakoa he whai hua pea e ai ki ētahi tuhinga, kāore i te rawaka ngā raraunga tuturu. Whai muri i te whakaaroaro tupato, i whiriwhiria e te tūroro me tōna whānau te haere tonu me te mahere maimoatanga.

Whai muri i te whakatikatika i mua me te tikanga FC, i werohia ngā pūtau BCMA CAR-T i te 1 o Hune, 2021, i te Hōhipera o Ludaopei. I pāngia te tūroro e te kirika i muri i te werohanga, ā, i whakahaeretia mārire mā te maimoatanga kaha ārai-mate me te tautoko tohumate. Tekau mā whā ngā rā i muri i te werohanga, kāore i kitea he pūtau plasma monoclonal kino e toe ana i roto i te koiora wheua wheua. Toru tekau mā tahi ngā rā i muri i te werohanga, kāore i kitea he pai te koiora wheua wheua wheua. Kāore i kitea he pai te whakapūmautanga o te toto, kei roto i te awhe noa te mekameka mārama kore toto λ, ā, kāore i kitea he pai te pūmua M toto, e tohu ana i te murunga katoa o te mate.

I tēnei wā, neke atu i te 8 marama i muri i te werohanga pūtau BCMA CAR-T, kei te tino māhorahora te tūroro, ā, he pai te whakaoranga me te tino makona ki ngā hua o te maimoatanga.