Mayi Siti ---- Kufalitsa Lymphoma Yaikulu ya B-cell (DLBCL)

Mayi Siti, mayi wa ku Indonesia wazaka 58, anapezeka ndi matenda a follicular lymphoma omwe sankagwiritsidwa ntchito ndi mankhwala omwe pambuyo pake anasanduka lymphoma ya B-cell lymphoma (DLBCL). Ngakhale kuti analandira chithandizo cha mzere wachinayi, chotupa chake chinapitiriza kukula, kupanga chipolopolo chachikulu chokhala ndi zotsatira zopsinjika. Mwatsoka, mavuto adayamba pamene adataya magazi muubongo atalandira chithandizo cholimbitsa thupi, zomwe zinapangitsa kuti vuto lake likhale lovuta kwambiri.

Popeza matenda ake anali oopsa komanso njira zochepa zochiritsira zomwe zinalipo, Mayi Siti adalembetsedwa mu mayeso azachipatala a chithandizo cha maselo a CD19+22 CAR-T potsatira njira zofunika zochiritsira asanayambe. Komabe, kuwunika koyambirira pa Tsiku la 7 kunawonetsa kukula kochepa kwa maselo a CAR-T, zomwe zikusonyeza kusowa kwa mphamvu yochiritsira. Kuwunika kotsatira pa Tsiku la 14 ndi Tsiku la 21 kunawonetsa kusintha pang'onopang'ono, koma chithandizocho sichinakwaniritse mphamvu yomwe chinkafunidwa.

Paulendo wake wonse wolandira chithandizo, kulimba mtima ndi kutsimikiza mtima kwa Mayi Siti kunawala kwambiri. Ngakhale anakumana ndi zopinga zambiri, adakumana ndi vuto lililonse molimba mtima komanso mwachiyembekezo. Pamene mayeso azachipatala anali kupita patsogolo, gulu lachipatala linayang'anitsitsa momwe Mayi Siti amayankhira chithandizocho. Anasintha njira yochiritsira momwe amachirira ngati pakufunika, kuonetsetsa kuti alandira chithandizo chabwino kwambiri chogwirizana ndi zosowa zake. Ngakhale kuti panali zopinga zoyamba, kusintha pang'onopang'ono kwa kukula kwa maselo a CAR-T kunapereka chiyembekezo chabwino.

Pa Tsiku la 28, pamene Mayi Siti adakumana ndi vuto lalikulu la chitetezo chamthupi, gulu lachipatala linayamba kuchitapo kanthu mwachangu, kuthana ndi vuto la kutulutsidwa kwa cytokine ndikupereka chithandizo chofunikira. Ukadaulo wawo komanso kulowererapo mwachangu kunathandiza kwambiri pakulimbitsa thanzi lake ndikutsegula njira yopitira patsogolo.

Pofika pa Tsiku la 35, kupambana kwakukulu kwa chikhululukiro cha matenda kunali umboni wa kulimba mtima kwa Mayi Siti komanso khama la gulu lachipatala. Ulendo wake sunangowonetsa kuthekera kwa chithandizo cha maselo a CAR-T komanso unagogomezera kufunika kwa kupirira ndi chisamaliro chaumwini pothana ndi mavuto ovuta azachipatala.

Mayi Siti anayamikira chisamaliro chachifundo chomwe adalandira, akugogomezera momwe thandizo la gulu lachipatala linathandizira paulendo wake wochira. "Ndikuyamikira kwambiri kudzipereka ndi luso la gulu langa lachipatala," adatero. "Chithandizo chawo chosalekeza chinandipatsa mphamvu panthawi yovuta kwambiri, ndipo nthawi zonse ndikuthokoza kudzipereka kwawo ku thanzi langa."

Nkhani ya Mayi Siti ndi chitsanzo cholimbikitsa cha kulimba mtima ndi chiyembekezo pamene akukumana ndi mavuto. Zotsatira zake zabwino zikuwonetsa kuthekera kosintha kwa njira zatsopano zochiritsira komanso gawo lofunika kwambiri la mankhwala opangidwa payekhapayekha pakukweza zotsatira za odwala.