Kufalitsa Large B-cell lymphoma (DLBCL)-04

Bambo Li, azaka 64 (dzina losavomerezeka), adapezeka ndi matenda a lymphoma ya B-cell (DLBCL) zaka zinayi zapitazo, yomwe idapita patsogolo mpaka kufika pamlingo womaliza wa ndulu, nthiti, mapapo, ndi pleura, zomwe zimagawidwa ngati gawo lachinayi. Pambuyo pa chithandizo choyamba cha immunochemotherapy, matenda ake adakhalabe abwino kwa zaka zoposa zitatu. Komabe, mu Marichi chaka chatha, matenda ake adabwereranso, kuphatikizapo ma lymph nodes ambiri a retroperitoneal. Ngakhale kuti adalandira mankhwala a chemotherapy a mzere wachiwiri, adapeza mpumulo pang'ono ndipo adachepa mofulumira, zomwe zidapangitsa kuti pakhale chithandizo chothandiza kwambiri kuti azitha kupititsa patsogolo matendawa.

Pokumana ndi vuto lalikulu ili, gulu la akatswiri ku BIOOCUS Medical Group linawunikanso nkhani ya a Li kwambiri ndipo linayitanitsa msonkhano wa gulu la akatswiri osiyanasiyana (MDT) kuti lipereke chithandizo cha maselo a CAR-T. Chithandizo cha maselo a CAR-T, monga njira yatsopano yochiritsira matenda a chotupa, chimapereka zabwino zazikulu monga kuyang'anira mwamphamvu komanso kugwira ntchito bwino kwa odwala omwe ali ndi lymphoma yobwereranso m'mbuyo komanso yosagwirizana ndi matendawa.

Mu Januwale 2023, a Li adapatsidwa chithandizo cha maselo a CAR-T ku Dipatimenti ya Lymphoma. Asanalandire chithandizo, adapatsidwa biopsy ya ma lymph nodes akumanja a inguinal, zomwe zidatsimikizira kuti CD19 ndi CD20 zili bwino, zomwe zidapereka zolinga zomveka bwino za chithandizo cha maselo a CAR-T. Motsogozedwa ndi Pulofesa Li, gulu lachipatala lidapanga dongosolo lothandizira payekha.

Pa Julayi 25, 2023, a Li adamaliza njira yoperekera maselo a CD19/20 CAR-T, zomwe zidachitika bwino motsogozedwa ndi gulu lachipatala. Ngakhale kuti anali ndi vuto la kutulutsidwa kwa cytokine, cytopenia, komanso matenda opatsirana pambuyo popatsidwa mankhwala, chisamaliro cholimba chothandizira chinathandiza kuthetsa mavuto omwe analipo panthawi ya chithandizo.

Patatha miyezi isanu ndi umodzi atagwiritsa ntchito chithandizo cha maselo a CAR-T, a Li sanawonetse zilonda zazikulu m'thupi lawo lonse, zomwe zinapangitsa kuti thupi lawo lizigwira ntchito bwino (CMR), zomwe zinabweretsa chiyembekezo chatsopano pa thanzi lawo. Gulu lachipatala linawonjezeranso chithandizo cha radiotherapy kuti matenda abwerere mwakale komanso kuti akhale olimba kwa nthawi yayitali.

Kudzera mu chithandizo cha chitetezo cha mthupi cha maselo a CAR-T, a Li sanangopeza kusintha kwakukulu pa thanzi lawo komanso anabwezeretsa chidaliro ndi mphamvu m'moyo wawo. Nkhani yawo imapereka chiyembekezo chatsopano ndi malangizo kwa odwala matenda a lymphoma ndipo ikuwonetsa kuthekera ndi kugwira ntchito kwa chithandizo cha maselo a CAR-T pochiza matenda a lymphoma omwe sagwira ntchito.

Chithandizo cha maselo a CAR-T, monga njira yatsopano yochizira khansa, chikusintha moyo wa odwala omwe ali ndi refractory lymphoma. Motsogozedwa mosamala ndi gulu la akatswiri ku Dipatimenti ya Lymphoma, odwala ambiri ngati a Li angayembekezere kusintha kwakukulu pa moyo wawo komanso ubwino wa moyo wawo. Poyang'ana mtsogolo, kupita patsogolo ndi kugwiritsa ntchito chithandizo cha maselo a CAR-T kukulonjeza mwayi waukulu komanso mwayi wopeza chithandizo cha khansa.