Madamu Siti ---- Diffuse Large B-cell Lymphoma (DLBCL)

Madamu Siti, umugore w’imyaka 58 wo muri Indoneziya, yasanzwemo indwara ya follicular lymphoma idashobora imiti, nyuma iza guhinduka lymphoma nini ya B-cell lymphoma (DLBCL). Nubwo yavuwe ku murongo wa kane, ikibyimba cye cyakomeje gukura, kigira uburemere bunini kandi butera ingaruka mbi. Ikibabaje ni uko ingorane zavutse ubwo yavaga amaraso mu bwonko nyuma yo kuvurwa, birushaho kugorana.

Bitewe n’uko indwara ye yari ikomeye cyane ndetse n’uburyo buke bwo kuyivura, Madamu Siti yiyandikishije mu igerageza rya muganga ku buvuzi bwa CD19+22 CAR-T cells nyuma y’uburyo bwa ngombwa bwo kuyivura mbere yo kuyivura. Ariko, isuzuma rya mbere ryakozwe ku munsi wa 7 ryagaragaje ko uturemangingo twa CAR-T twongerewemo ubushobozi buke, bigaragaza ko nta musaruro wo kuvura ufite. Isuzuma ryakurikiyeho ku munsi wa 14 no ku munsi wa 21 ryagaragaje iterambere ryinshi, ariko ubuvuzi ntibwageze ku musaruro wifuzwaga.

Mu rugendo rwe rwo kuvurwa, kwihangana no kwiyemeza kwa Madamu Siti byaramuritse cyane. Nubwo yahuye n'imbogamizi nyinshi, yahanganye na buri kibazo afite ubutwari n'icyizere kidasubirwaho. Uko igeragezwa rya muganga ryakomeje, itsinda ry'abaganga ryakurikiraniye hafi uburyo Madamu Siti yakiraga ubuvuzi. Bahinduye uburyo bwo kuvura uko byari bikenewe, bemeza ko yabonye ubuvuzi bwiza bujyanye n'ibyo akeneye ku giti cye. Nubwo habayeho ibibazo bya mbere, iterambere ryagiye rirushaho kwiyongera mu kongera uturemangingo twa CAR-T ryatanze icyizere cy'umusaruro mwiza.

Ku munsi wa 28, ubwo Madamu Siti yagiraga ikibazo gikomeye cy’ubudahangarwa bw’umubiri, itsinda ry’abaganga ryatangiye gukora, rihita rikemura ikibazo cyo gusohora cytokine no gutanga ubuvuzi bukenewe. Ubuhanga bwabo n’ubutabazi bwabo byihuse byagize uruhare runini mu gutuma ubuzima bwe buhagarara neza no kumutegurira inzira yo gukomeza gutera imbere.

Ku munsi wa 35, kugera ku rugero rutangaje rwo kugabanya ububabare byari igihamya cy’uko Madamu Siti yashoboye kwihangana ndetse n’imbaraga z’itsinda ry’abaganga. Urugendo rwe ntirwagaragaje gusa ubushobozi bwo kuvura CAR-T cell therapy, ahubwo rwanagaragaje akamaro ko kwihangana no kwita ku giti cye mu guhangana n’ibibazo bigoye by’ubuvuzi.

Madamu Siti yashimiye cyane ubuvuzi bw’impuhwe yahawe, ashimangira ingaruka z’inkunga y’itsinda ry’abaganga mu rugendo rwe rwo gukira. Yagize ati: “Ndashimira cyane ubwitange n’ubuhanga bw’itsinda ryanjye ry’abaganga.” “Inkunga yabo idacogora yampaye imbaraga mu bihe bikomeye, kandi iteka ryose ndashimira ubwitange bwabo mu mibereho yanjye.”

Urubanza rwa Madamu Siti ni urugero rwiza rwo kwihangana no kugira icyizere mu gihe cy’ibibazo. Ibyavuye mu bushakashatsi bwe bigaragaza ubushobozi bwo guhindura ubuvuzi bushya ndetse n’uruhare rw’ubuvuzi bwihariye mu kunoza umusaruro w’abarwayi.