Myeloma yambiri yokhala ndi Extramedullary Plasmacytoma

Izi ndi zomwe zinachitika kwa wodwala wamwamuna wazaka 73 yemwe adapezeka ndi matenda a multiple myeloma, omwe amavutitsidwa ndi kupezeka kwa extramedullary plasmacytoma. Pa nthawi yonse ya chithandizo ndi Dara-VRD (Daratumumab, Bortezomib, Lenalidomide, Dexamethasone), extramedullary plasmacytoma inapitirira, zomwe zinapangitsa wodwalayo kupweteka kwambiri komanso kusasangalala.

Poganizira za kuopsa kwa matendawa komanso kusayankha bwino mankhwala ochiritsira, wodwalayo adalembetsedwa mu mayeso azachipatala a chithandizo cha maselo a BCMA CAR-T. Atachita zokonzekera zofunika, kuphatikizapo lymphodepletion, wodwalayo adalandira chithandizo cha maselo a BCMA CAR-T.

Chodabwitsa n'chakuti, mkati mwa masiku 10 kuchokera pamene wodwalayo anapatsidwa mankhwala, wodwalayo anamva kuti ali ndi vuto lachiwiri la cytokine release syndrome (CRS), zomwe zinasonyeza kuti chitetezo cha mthupi chinali cholimba. Kuphatikiza apo, panali CRS yodziwika bwino pamalo omwe panali extramedullary plasmacytoma.

Chodabwitsa kwambiri n'chakuti mkati mwa nthawi yochepayi, chilonda cha extramedullary chomwe chinali chosachiritsika ndi mankhwala, chomwe chinali chitatsimikizika kuti sichinachiritsidwe ndi mitundu ingapo ya mankhwala a chemotherapy, mankhwala ofunikira, ndi ma antibodies a monoclonal, chinatha kwathunthu. Wodwalayo anachira kwathunthu, zomwe zinasonyeza kuti chithandizocho chinapambana.

Pa nthawi yonse yolandira chithandizo, gulu lachipatala linkayang'anitsitsa wodwalayo kuti aone ngati pali zizindikiro zilizonse zomwe zingachitike ndipo linapereka chithandizo chokwanira. Izi zinaphatikizapo kuthana ndi zizindikiro za CRS ndi kuthana ndi mavuto ena aliwonse okhudzana ndi chithandizo.

Pamene chithandizocho chinkapitirira, gulu lachipatala linapitiriza kuyang'anira mosamala momwe wodwalayo akumvera pa chithandizo cha maselo a BCMA CAR-T. Kuwunika nthawi zonse kunachitika kuti awone momwe chithandizocho chikugwirira ntchito komanso kuthana ndi zotsatirapo zilizonse zomwe zingachitike mwachangu.

Pambuyo pa kuchira kwathunthu kwa wodwalayo, moyo wake unasintha kwambiri, ndipo ululu ndi kusasangalala komwe kumayambitsidwa ndi extramedullary plasmacytoma kunachepa. Matendawa atathetsedwa, wodwalayo anatha kuyambiranso ntchito zake za tsiku ndi tsiku ndikusangalala ndi thanzi labwino.

Komanso, pozindikira kufunika kwa chisamaliro cha nthawi yayitali, gulu lathu lachipatala linapitirizabe kutenga nawo mbali paulendo wa wodwalayo pambuyo pa chithandizo. Maulendo obwerezabwereza obwerezabwereza adakonzedwa kuti ayang'anire momwe wodwalayo alili, kuwunika kulimba kwa yankho la chithandizo, komanso kuthana ndi vuto lililonse lomwe lingabwerenso kapena zotsatirapo zake zomwe zingachitike mochedwa.

Kuwonjezera pa kutsatira chithandizo chamankhwala, bungwe lathu linapereka chithandizo chokwanira chothandiza wodwalayo kuti azolowere moyo wake atalandira chithandizo. Izi zinaphatikizapo kupeza uphungu, mapulogalamu okonzanso thanzi, ndi zinthu zophunzitsira kuti zithandize wodwalayo ndi banja lake kuti apulumuke komanso kukhala ndi moyo wathanzi.

Zotsatira zabwino za nkhaniyi sizikuwonetsa kokha kuti chithandizo cha maselo a BCMA CAR-T chimagwira ntchito bwino pochiza matenda a myeloma ambiri omwe sagwira ntchito komanso zikuwonetsa kufunika kwa chisamaliro chapadera komanso chamitundu yosiyanasiyana pochiza khansa yovuta ya m'magazi. Kudzipereka kwathu popereka chithandizo chosalekeza ndi chisamaliro chotsatira kukuwonetsa kudzipereka kwathu kuonetsetsa kuti odwala athu akupeza zotsatira zabwino kwambiri kupitirira gawo la chithandizo.

Miyezi itatu isanafike komanso itatha kulowetsedwa