Chithandizo cha Lu Daopei cha CD19 CAR-T Chochepa Chikuwonetsa Zotsatira Zabwino mwa Odwala a B-ALL
Mu kafukufuku wodziwika bwino womwe unachitikira ku Lu Daopei Hospital, ofufuza anena za kupita patsogolo kwakukulu pa chithandizo cha matenda a B acute lymphoblastic leukemia (B-ALL) omwe abwereranso m'thupi pogwiritsa ntchito mankhwala ochepa a CAR-T cell therapy omwe amatsogoleredwa ndi CD19. Kafukufukuyu, womwe unakhudza odwala 51, adawonetsa kuti njira yatsopanoyi sinangopangitsa kuti pakhale kuchuluka kwa ma CR (CR) komanso inasunga chitetezo chabwino.
Gulu lofufuzali, lotsogozedwa ndi Dr. C. Tong wochokera ku Dipatimenti ya Hematology ndi Dr. AH Chang wochokera ku Clinical Translational Research Center ku Tongji University School of Medicine, linafufuza zotsatira za kupereka mlingo wochepa wa maselo a CAR-T—pafupifupi 1 × 10^5/kg—poyerekeza ndi mlingo wamba wapamwamba. Njirayi cholinga chake chinali kulinganiza mphamvu ya chithandizo ndi kuchepetsa zotsatirapo zoyipa, makamaka cytokine release syndrome (CRS).
Zotsatira za kafukufukuyu zinali zokopa. Mwa odwala 42 omwe anali ndi B-ALL omwe sanachiritsidwe/anabwereranso m'mbuyo, 36 adapeza CR kapena CR ndi kuchira kosakwanira kwa chiwerengero (CRi), pomwe odwala onse asanu ndi anayi omwe anali ndi matenda ochepa otsalira (MRD) adafika pa MRD negativity. Kuphatikiza apo, odwala ambiri adakumana ndi CRS yocheperako mpaka yapakatikati, ndipo milandu yayikulu idathandizidwa bwino kudzera munjira zoyambira.
Dr. Tong adagogomezera kufunika kwa kafukufukuyu, ponena kuti, "Zotsatira zake zikusonyeza kuti chithandizo cha maselo a CD19 CAR-T chotsika mtengo, chotsatiridwa ndi kulowetsedwa kwa maselo oyambira a hematopoietic hematopoietic (allo-HCT), chimapereka chithandizo chothandiza kwambiri kwa odwala omwe ali ndi njira zina zochepa. Chithandizochi sichimangopereka kuchuluka kwa mayankho komanso chimachepetsa kwambiri chiopsezo cha zotsatirapo zoyipa kwambiri."
Kupambana kwa kafukufukuyu kukuwonetsa kuthekera kwa njira zochiritsira maselo a CAR-T zomwe zakonzedwa bwino pochiza matenda ovuta a magazi. Chipatala cha Lu Daopei, chodziwika bwino chifukwa cha ntchito yake yoyambirira mu maselo a m'magazi. Chithandizo cha Immunotherapy, ikupitirizabe kutsogolera popereka chithandizo chamakono kwa odwala omwe ali ndi matenda ovuta a magazi.
Pamene kafukufukuyu akupita patsogolo, gulu lofufuza likukhulupirira kuti lipitiliza kusintha mlingo ndi njira zoyendetsera kuti liwonjezere zotsatira za odwala. Zomwe zapezeka mu kafukufukuyu zasindikizidwa mu magaziniyi. Khansa ya m'magazi ndipo amapereka chiyembekezo chabwino kwa odwala a B-ALL padziko lonse lapansi.