Chirwere cheAcute Lymphoblastic Leukemia (T-ALL)-04

Murwere uyu aive murume ane makore gumi nemashanu ekuberekwa, akaonekwa aine T-cell acute lymphoblastic leukaemia (T-ALL ane STIL-TAL1 positivity, gene risingafadzi reprognostic) pakupera kwaZvita 2020, uye akarapwa muchipatara chemuno nekurapwa kakawanda kwechemotherapy kuti awane zororo rakazara. Kuisirwa masero eropa kubva kuna baba kuenda kumwanakomana kwakaitwa musi wa2 Chikumi 2021, asi zvinosuwisa kuti mapfupa emapfupa akadzoka zvakare mushure memwedzi mitatu mushure mekuisirwa, uye chemotherapy imwe chete haina kushanda. Panguva imwe chete, akatanga matama akatumbuka uye mhepo inobuda, makona akakombama emuromo, uye lumbar puncture yakaratidza kukura kwe central nervous system leukaemia.

T-ALL ine STIL-TAL1 positivity, kudzoka kwechirwere mushure mekuisirwa allogeneic, pamwe chete ne central nervous system leukaemia, inyaya yakaoma kurapa munguva isina CAR-T. Baba vemwana vakabvunza nezve hematology department kuTianjin Cancer Hospital Airport Hospital kuburikidza neshamwari dzavo. Mushure mekutaurirana zvakadzama, vakauya kuTianjin Cancer Hospital Airport Hospital, vachitsvaga kunyoresa muongororo yeCAR-T senzira yekupedzisira.

Masero ekutanga egomarara eCAR-T akakundikana kukura nekukurumidza, zvichiisa hupenyu hwake panjodzi.

Musi wa26 Gumiguru 2021, murwere akapinda muwadhi yekutanga yeDhipatimendi reHematology. Nekuda kwekuwanda kwemasero egomarara nekukurumidza, murwere akapihwa chemotherapy yekuderedza mutoro wegomarara uye akapihwa chemotherapy yemukati memusana. Mvura yemuuropi yakaratidza kuti hapana chirwere chakasara. Mushure mekugadzikana, ma lymphocytes ababa vake akaunganidzwa kuti agadziriswe masero eCAR-T. Musi wa19 Mbudzi, masero eCD7 CAR-T akaiswa mumurwere.

Mazuva mashoma mushure mekuisirwa mushonga uyu, masero eCAR-T asati akura, masero ebundu akakurumidza kuwedzera zvakare, nekuputika kwakawanda kwakaonekwa muropa rekunze, zvichiratidza kukundikana kwekurapa kwekutanga kweCAR-T.

Panguva iyi, Tianjin Cancer Hospital Airport Hospital yaive ichiongorora chirwere che CAR-T (CD7 UCAR-T) che acute T-lymphoblastic leukaemia. Vabereki vakaratidza kukurumidza, vachiti vaizotsvaga mukana we1% wemwana wavo. Chikwata chevanachiremba chakakurukura nemhuri yacho ndokusarudza kunyoresa murwere muongororo yeCD7 UCAR-T.

Kurerukirwa kwakakwana mushure meCD7 UCAR-T Iye zvino mwedzi miviri mushure mekuisirwa.

Musi wa2 Zvita, murwere akapihwa CD7 U-CART cell infusion pamwe chete nekurapwa kwekuderedza bundu uye rubatsiro rwekutsigira. Mushure mekupihwa mushonga uyu, akanzwa fivha yakareba uye kuneta. Nerutsigiro rwekudzivirira hutachiona uye hydration, zviratidzo zvake zvehupenyu zvakagadzikana uye tembiricha yemuviri yakabva yaita seyakajairika.

Kuongororwa kwemapfupa nemapfupa emusana pazuva rechi18 nerechi28 mushure meCAR-T kwakaratidza kugadzikana kwakakwana kweMRD nekushaya simba. Mamiriro emwana akavandudzika zvakanyanya simba rake rakadzoka, kuda kudya kwadzoka, uye amai vake—vaimbova nepfungwa dzakaora mwoyo—vakawanazve tariro.

Parizvino, murwere akaongororwa kechipiri chirwere cheHaploidentical HSCT kuTianjin Cancer Hospital Airport Hospital uye achiri kupora zvachose kwemwedzi miviri mushure mekuisirwa mwana.