Myeloma nyinshi (MM) -01

Gukira neza k'umurwayi wa Myeloma nyinshi wo mu rugo ufite CAR-T nubwo nta bushobozi bwo kugaragaza BCMA afite

Umurwayi w’umugore wasanze afite myeloma nyinshi yo mu bwoko bwa IIIA IgD-λ mu 2018 yahawe ubuvuzi bwa mbere cyane cyane na bortezomib. Nyuma y’ingendo 3, yakize burundu (CR). Mu Kwakira 2018, yatewe uturemangingo tw’amaraso mu maraso nk’ubuvuzi bwo gukomeretsa, hakurikiraho ubuvuzi bwo kubungabunga hakoreshejwe lenalidomide. Muri Mata 2020, iyi ndwara yongeye kugaruka, maze avurwa inshuro 7 mu ngendo 7, bituma adakora neza. Kuva mu Kuboza 2020 kugeza muri Mata 2021, yahawe imiti ivura kanseri cyane cyane na daratumumab, ariko biopsy y’umusemburo w’amagufwa yagaragaje ko uturemangingo tw’amaraso twa monoclonal tugize 21.763% ari tugize amaraso, dufite urukurikirane rw’urumuri rw’amaraso rudafite λ kuri 1470 mg/L n’urukurikirane rw’urumuri rw’inkari rudafite λ kuri 5330 mg/L. Icyo gihe, yari amaze kuvura indwara zisanzwe kandi nshya zari zihari mu gihugu, harimo no guterwa uturemangingo tw’amaraso tudafite imiterere, aho kwinjira mu igerageza rya CAR-T ari bwo buryo bwiza busigaye.

Yashyikirijwe abaganga bo mu gace, ku ya 10 Gicurasi 2021, yizeye kwiyandikisha mu igerageza ryabo ryo kuvura indwara ya BCMA CAR-T muri myeloma nyinshi (MM). Ubwo yakirwaga, yari afite intege nke kubera ububabare rusange n'umuriro usubiramo. Isuzuma ryuzuye ryemeje ko "mu ndwara nyinshi za myeloma, ubwoko bwa λ light chain, ISS stage III, R-ISS stage III, mSMART high risk group."

Isuzuma rya PET-CT ryagaragaje ko imikorere y’imikorere y’umubiri mu mubiri woroshye mu mwobo w’amagufwa y’inyuma y’inyuma n’inyuma y’inyuma, bigaragaza ko hari ikibyimba cyagize. Isuzuma ry’umusokoro w’amagufwa ryagaragaje ko 60.13% by’uturemangingo tw’amaraso twa monoclonal plasma tudafite BCMA.

Ikigo cyacu cya CGT cyamenyesheje umurwayi n'umuryango we akamaro k'ubuvuzi busanzwe bwo kuvura myeloma nyinshi ya BCMA-negative, nubwo bushobora kugira akamaro nk'uko bimwe mu bitabo bibigaragaza, ariko nta makuru afatika ahagije bugaragaza. Nyuma yo kubisuzuma neza, umurwayi n'umuryango we bahisemo gukomeza gahunda yo kuvura.

Nyuma yo kuvura indwara mbere yo gukoresha uburyo bwa FC, uturemangingo twa BCMA CAR-T twashyizwemo ku ya 1 Kamena 2021, mu bitaro bya Ludaopei. Umurwayi yagize umuriro nyuma yo guterwa, wagiye ugenzurwa buhoro buhoro hakoreshejwe uburyo burwanya indwara zandura kandi butanga ibimenyetso. Nyuma y'iminsi 14 yo guterwa, hagaragaye ko nta turemangingo twa plasma twa monoclonal tugize kanseri twasigaye. Nyuma y'iminsi 31 yo guterwa, hagaragaye ko habayeho uburwayi bwa serum. Ubushobozi bwo gufata serum bwari bubi, serum free light chain λ yari iri mu rugero rusanzwe, naho serum M yari mbi, bigaragaza ko indwara irangiye burundu.

Kuri ubu, nyuma y'amezi arenga 8 ahawe selile za BCMA CAR-T, umurwayi akomeje koroherwa neza kandi akize neza kandi anyuzwe cyane n'umusaruro w'ubuvuzi.