Akamaro k'imirongo ya poroteyine ya Oligoclonal nyuma yo kuvurwa na BCMA CAR-T ku barwayi benshi ba Myeloma
Gusobanukirwa imigozi ya poroteyine ya Oligoclonal mu buvuzi bwa CAR-T
Muri Myeloma nyinshi (MM), kuba hariho uduce duto twa poroteyine (APB) tudasanzwe, kandi tuzwi nka oligoclonal protein bands, byagaragaye nyuma yo gutera uturemangingo tw’amaraso. Ariko, inshuro zikunze gukoreshwa mu gutera uturemangingo twa CAR-T mu buryo bwa BCMA ntizisobanutse neza. Kugira ngo iki kibazo gikemuke, abashakashatsi bo mu bitaro bya kabiri bifitanye isano bya Kaminuza ya Xi'an Jiaotong bakoze ubushakashatsi bwo gusuzuma ingaruka za APB, ubwoko butandukanye bw’uturemangingo, n’akamaro k’ubuhanuzi ku barwayi ba MM bavuwe LCAR-B38M nk'igice cy'igerageza rya Phase 1 LEGEND-2. Ibyavuye mu bushakashatsi biherutse gusohoka muriHemaSphere, iyobowe na Porofeseri He Aili, Wang Fangxia, na Bai Ju.
Ibyavumbuwe by'ingenzi
Ubushakashatsi bwasuzumye abarwayi 47, aho 23 (48.9%) bagaragaje APB nyuma yo kuvurwa na CAR-T. Ubwoko bwakunze kugaragara cyane ni IgG (91.3%). Igihe cyo hagati cyo gutangira kwa APB cyari amezi 3.6 nyuma yo guterwa CAR-T, naho igihe cyo hagati cyari amezi 5.8. Icy'ingenzi ni uko APB yagaragaye byajyanaga no kongera uburyo bwo kuvurwa, kubaho igihe kirekire nta guhindagurika (PFS), no kunoza ubuzima muri rusange (OS).
Ibindi bitekerezo byari bikubiyemo:
- Ingaruka nziza ku buvuzi: Abarwayi bafite APB bagaragaje ko bakira neza ubuvuzi bwa LCAR-B38M kandi barushaho koroherwa.
- Uburyo bwo kongera gukira kw'ubudahangarwa bw'umubiri: Abarwayi ba APB bagaragaje igipimo cyo gukira cyane kwa immunoglobulins na lymphocytes nyuma y'amezi 3 na 6 nyuma yo kuvurwa, bigaragaza ko ubudahangarwa bw'umubiri buhagaze neza ndetse n'ubwiyongere bw'ubudahangarwa bw'umubiri nyuma yaho.
- Ibipimo by'iteganyagihe: Isesengura rya Multivariate ryagaragaje ko uburyo bwo kuvura CAR-T bukora neza, umubare wa platelets, APB iboneka, n'urugero rwa β2-microglobulin ari ibintu byigenga bigaragaza ko PFS ari yo ikoreshwa. Kuri OS, uburyo CAR-T ikora neza n'umubare wa platelets byari ibintu byigenga.
Igishimishije ni uko ubushakashatsi nta tandukaniro rigaragara bwagaragaje mu miterere y’uturemangingo twa T cyangwa NK hagati y’amatsinda ya APB n’andi atari aya APB, bigaragaza ko agaciro ka APB gashobora guturuka ahanini ku kongera gukira kw’uturemangingo no ku gukira kw’umubiri aho kuba uburyo bw’ubudahangarwa bw’uturemangingo.
Umwanzuro n'ibisobanuro
Ubushakashatsi bugaragaza ko kuba hariho APB nyuma yo kuvurwa na BCMA CAR-T bifitanye isano no koroherwa cyane no kugira ingaruka nziza ku barwayi ba MM basubiye mu buzima bwabo cyangwa barwaye MM. Byongeye kandi, ibyavuye mu bushakashatsi bigaragaza ko APB ishobora kuba ikimenyetso cy’uko ubudahangarwa bw’umubiri bushobora kugaruka neza nyuma yo kuvurwa, bikingura inzira z’ubushakashatsi bw’inyongera mu kunoza ubuvuzi bwa CAR-T no gusobanukirwa imiterere y’ubudahangarwa bw’umubiri.
Uko uburyo bwo kuvura bwa CAR-T bushingiye kuri BCMA bukomeza gutera imbere, ubumenyi nk'ubwo ni ingenzi cyane mu kunoza uburyo bwo kuvura no kunoza umusaruro ku barwayi ba MM ku isi yose.