Wodwala waku Australia Wapeza Chiyankho Chodabwitsa Kwambiri Poyambirira ndi Chithandizo cha BIOOCUS Medical Group cha Dual CD19/CD20 CAR-T cha DLBCL Yobwerera M'mbuyo
Rodney Charles Monger, mwamuna wazaka 68 wochokera ku Australia, adapezeka ndi matenda a diffuse large B-Cell Lymphoma (DLBCL) zaka zitatu zapitazo. Pofuna chithandizo chapamwamba, adapita ku BIOOCUS Medical Group mu Ogasiti 2025. Kufufuza kwa lymph node ya chiberekero kunatsimikizira kuti B-cell lymphoma yochokera pakati pa germinal inapezeka. Immunohistochemistry inali ndi zotsatira zabwino kwambiri pa CD20, CD19, ndi CD10, ndipo Bcl-6, Bcl-2 (70%+), ndi c-MYC (60%+). Kuyesa majini kunawonetsa kukonzanso kwa BCL2 ndi FISH ndi kusintha kwa majini mu majini a EZH2, KMT2D, TNFRSF14, NRAS, ndi TPMT—zizindikiro zomveka bwino za mbiri yaukali komanso yoopsa kwambiri.
Pambuyo polandira pola pamodzi ndi mankhwala oletsa BTK ndi lenalidomide, kenako ndi mankhwala a FC lymphodepletion chemotherapy, matenda a Mr. Monger adapitilizabe kukhala osachiritsika. Gulu la BIOOCUS Medical Group linalimbikitsa chithandizo chawo chatsopano cha maselo a CD19/CD20 CAR-T chowunikira kawiri.
Pa Seputembala 8, 2025, a Monger adalandira chithandizo cha autologous CD19/CD20 CAR-T cells. Chodabwitsa n'chakuti sanakumanepo ndi cytokine release syndrome (CRS) komanso immunoeffector cell-associated neurotoxicity syndrome (ICANS), zomwe zinapangitsa kuti ayambe kuyenda bwino pambuyo pa chithandizo chomwe chinamuthandiza kukhala wolimba komanso wosangalala kuyambira tsiku loyamba.
Kuwunika magazi m'mbali mwa thupi kunasonyeza kukula kwa maselo a CAR-T kodabwitsa, kutsimikizira kulowetsedwa bwino ndi kufalikira. Pa tsiku lachinayi pambuyo pa kulowetsedwa, maselo a CAR19+ anali 0.50% ya maselo a CD3+ T (mtengo wake wonse ndi 6.04 × 10⁷/L) ndi maselo a CAR20+ anali 0.41% (4.96 × 10⁷/L). Pofika tsiku la 7, CAR19+ inakwera kufika pa 1.68% (1.40 × 10⁷/L) ndi CAR20+ kufika pa 1.63% (1.36 × 10⁷/L). Pa tsiku la 10, CAR19+ inafika pa 31.43% ya maselo a CD3+ T (mtengo wake wonse ndi 3.13 × 10⁸/L) ndipo CAR20+ inafika pa 32.74% (mtengo wake wonse ndi 3.26 × 10⁸/L). Kuyeza kwa kayendedwe ka magazi m'thupi (flow cytometry) kunawonetsanso kufalikira kwa maselo a CD4+ ndi CD8+ okhala ndi mphamvu ziwiri za CAR, zomwe zikusonyeza kuthekera kwa chithandizochi kulimbikitsa kupirira kwamphamvu komanso kuchulukana kwa maselo m'thupi.
Pa nthawi yotsatira (tsiku la 10), a Monger akupitilizabe kuchita bwino pachipatala. Akumwa mankhwala opangidwa mwapadera kuphatikizapo acyclovir, compound sulfamethoxazole, orelabrutinib, lenalidomide, ndi mankhwala othandizira, ndikuwunika pafupipafupi kuchuluka kwa magazi, ntchito ya chiwindi ndi impso, komanso zizindikiro za kutupa.
Gulu la BIOOCUS Medical Group linapereka chithandizo chokwanira komanso choganizira odwala, kuphatikizapo malo ogona abwino, chakudya chopatsa thanzi, thandizo la mayendedwe, komanso uphungu wamaganizo kwa a Monger ndi banja lawo. Njira yonseyi inamuthandiza kuti aganizire kwambiri za kuchira.
Nkhani ya a Monger ikuwonetsa kuthekera kosintha kwa chithandizo cha BIOOCUS Medical Group cha CD19/CD20 CAR-T kwa odwala omwe ali ndi DLBCL yobwerera m'mbuyo/yosagwira ntchito. Kukula mwachangu komanso kwamphamvu kwa maselo a CAR-T opanda poizoni wambiri kukuwonetsa chitetezo chabwino cha mankhwalawa komanso mphamvu yolimbana ndi chotupa - ngakhale kwa wodwala wachikulire yemwe ali ndi mawonekedwe oopsa a mamolekyulu.