Leukemia ikabije ya Lymphoblastic (T-ALL)-04

Uyu murwayi yari umugabo w'imyaka 15, yasanze afite T-cell acute lymphoblastic leukaemia (T-ALL ifite STIL-TAL1 positivity, gene mbi yo guhanura) mu mpera z'Ukuboza 2020, kandi yavuriwe mu bitaro byo muri ako gace akoresheje uburyo bwinshi bwa chemotherapy kugira ngo agire ubumuga bwuzuye. Kwandikirwa uturemangingo tw’amaraso twa se ku mwana kwakozwe ku ya 2 Kamena 2021, ariko ikibabaje ni uko umwongo wo mu igufwa wongeye kugaragara mu mezi 3 nyuma yo guterwa, kandi ukwezi kumwe kwa chemotherapy ntacyo kwatanze. Muri icyo gihe, yagize ibibazo byo kubyimba amatama no kuva umwuka, impande zo mu kanwa zigoramye, no gupfuka kw'umugongo bigaragaza ko yarwaye kanseri y'imitsi yo mu mutwe.

T-ALL ifite STIL-TAL1 positivity, gusubira inyuma hakiri kare nyuma yo guterwa allogeneic, hamwe na leukemia yo mu bwonko, ni ikibazo kigoye cyane kuvura muri iki gihe nta CAR-T. Se w'umwana yabajije ishami ry'ubuvuzi bw'amaraso mu bitaro bya Tianjin Cancer Hospital binyuze ku nshuti ze. Nyuma yo kuvugana birambuye, baje mu bitaro bya Tianjin Cancer Hospital Airport, bashaka kwiyandikisha mu igerageza rya CAR-T nk'igikorwa cya nyuma.

Uturemangingo twa mbere twa CAR-T twananiwe kwiyongera vuba, bishyira ubuzima bwe mu kaga.

Ku ya 26 Ukwakira 2021, umurwayi yakiriwe mu cyumba cya mbere cy’ishami ry’ubuvuzi bw’amaraso. Kubera ko uturemangingo tw’ibibyimba twiyongeraga cyane, umurwayi yakorewe imiti igabanya umuvuduko w’ibibyimba kandi ahabwa imiti ivura indwara yo mu bwonko. Amazi yo mu bwonko nta ndwara yasigaye yagaragaje. Nyuma yo gutuza, lymphocytes za se zakusanyijwe kugira ngo zikoreshwe mu gupima uturemangingo twa CAR-T. Ku ya 19 Ugushyingo, uturemangingo twa CD7 CAR-T twatanzwe twashyizwe mu murwayi.

Nyuma y'iminsi mike batanze iyi miti, mbere yuko uturemangingo twa CAR-T twaguka, uturemangingo twa kanseri twongeye kwiyongera vuba, amaraso menshi agaragara mu maraso yo mu mpande, bigaragaza ko uburyo bwa mbere bwo kuvura CAR-T bwananiwe.

Muri iki gihe, ibitaro by’ikibuga cy’indege bya Tianjin Cancer Hospital byari birimo gukora igerageza rya CAR-T (CD7 UCAR-T) ku ndwara ya kanseri y’amaraso ya T-lymphoblastic ikabije. Ababyeyi bagaragaje ko byihutirwa cyane, bavuga ko bazakurikirana amahirwe angana na 1% ku mwana wabo. Itsinda ry’abaganga ryaganiriye n’umuryango maze rifata icyemezo cyo kwinjiza umurwayi mu igerageza rya CD7 UCAR-T.

Gukira burundu nyuma yo guterwa CD7 UCAR-T Ubu amezi 2 nyuma yo guterwa.

Ku itariki ya 2 Ukuboza, umurwayi yahawe CD7 U-CART cell infusion hamwe n'ubuvuzi bwo kugabanya umuvuduko w'ikibyimba ndetse n'ubuvuzi bumufasha. Nyuma yo guterwa, yagize umuriro mwinshi igihe kirekire ndetse anananirwa. Akoresheje uburyo bwo kurwanya indwara no kuvura amazi, ibimenyetso by'ubuzima bwe byarahagaze neza ndetse n'ubushyuhe bw'umubiri bugabanuka.

Isuzuma ry’umusemburo w’amagufwa n’amazi yo mu bwonko ku munsi wa 18 na 28 nyuma ya CAR-T ryemeje ko umwana akize burundu ubwonko bwe bwa MRD. Indwara y’umwana yarushijeho kumera neza, imbaraga ze zaragarutse, ubushake bwo kurya buragaruka, na nyina—wari warababaye cyane—yongeye kugira icyizere.

Kuri ubu, umurwayi yakozweho ikizamini cya kabiri cya HSCT mu bitaro bya Tianjin Cancer Hospital Airport Hospital kandi aracyafite ubumuga bw'amezi 2 nyuma yo guterwa inshinge.