Bambo A -----Diffuse Large B-cell Lymphoma (DLBCL)

Bambo A, ochokera ku India, munthu wamphamvu wazaka 66, anayamba ulendo wawo wachipatala mu Epulo 2018. Pambuyo pofufuza minofu ya mkono wake wakumanzere, komanso kujambulidwa kwa PET-CT thupi lonse, anapeza matenda a Diffuse Large B-Cell Lymphoma (DLBCL). Izi zinasonyeza kuyamba kwa chithandizo chokhwima chomwe cholinga chake chinali kuthana ndi matendawa.

Poyamba, a A adasintha kukhala magawo asanu ndi limodzi a R-EPOCH chemotherapy regimen, kenako adasintha kukhala magawo atatu a R-GDP regimen, kenako ndi magawo ena awiri ofanana. Regimen yolimba ya chemotherapy iyi idayamba kuyambira Epulo 2018 mpaka Okutobala 2019, nthawi yomwe imadziwika ndi kupirira komanso kulimba mtima pokumana ndi mavuto.

Ngakhale kuti chithandizocho chinali chovuta, vuto linabuka panthawi yowunikanso PET-CT mu Okutobala 2019, zomwe zinavumbula kusakhazikika kwa kagayidwe kachakudya m'dera la calcaneus lamanja ndi mbali yakumanja ya femur. Mosataya mtima, a A, omwe anali ndi chidziwitso cha kudziwika kwa BIOOCUS Medical Group ngati malo otsogola padziko lonse lapansi a CAR-T, adafunafuna ukatswiri wake.

Novembala 2019 inali nthawi yofunika kwambiri pamene a A anayamba chithandizo chatsopano motsogozedwa ndi gulu lathu lachipatala. Kufufuza kwathunthu kunawonetsa kuti panalibe CD19 yokwanira komanso CD22 yokwanira, zomwe zikusonyeza kuti pali chotupa chotsalira kwambiri. Potengera zomwe zapezekazi, chisankho chinapangidwa kuti apitirize ndi chithandizo cha maselo a CD19+CD22 CAR-T, njira yatsopano yothanirana ndi khansa yosatha.

Pambuyo pa kumwa mankhwala oletsa kutupa, a A adadwala matenda a 2 Cytokine Release Syndrome (CRS), omwe adayamba kuchira mwachangu pambuyo pake. Pofika mu Januwale 2020, adatulutsidwa m'chipatala, atalimbikitsidwa ndi zotsatira zabwino kuchokera ku PET-CT scan yaposachedwa yomwe idawonetsa kuchepa kwa chotupa komanso kuchepa kwakukulu kwa kagayidwe kachakudya m'thupi.

Ulendo wa a A umapereka chiyembekezo, kugogomezera kuthekera kosintha kwa njira zamakono zachipatala pankhani ya khansa. Pamene akuyamba njira yowunikira odwala omwe akupita kuchipatala kwa nthawi yayitali, cholinga chake chimakhalabe pakusunga mphamvu zatsopano komanso kuteteza kubwereranso kwa matendawa.