Kupararira kweB-cell lymphoma (DLBCL)-03

MunaKurume 2021, VaWang (zita rekunyepedzera) vakangoerekana vanzwa kurwadziwa mudumbu repazasi kurudyi, pakutanga vachifunga kuti kwaive kusagadzikana mudumbu, uye havana kutsvaga rubatsiro rwechiremba nekukurumidza. Mumwedzi miviri yakatevera, vakaramba vachiona zviratidzo zvekurwadziwa mudumbu repazasi kurudyi, zvikaita kuti vatsvage rubatsiro rwechiremba kuchipatara chemuno. CT scan yakaratidza kusarongeka muura uye kukura kwema lymph nodes epa retroperitoneal.

Vanachiremba vakakurudzira colonoscopy uye biopsy kuti vaongororwe zvakanyanya, izvo zvakasimbisa "diffuse large B-cell lymphoma," bundu rinowanzozivikanwa se lymphoma. PET-CT yakaratidzawo kuti maronda emuviri wake akapararira mumuviri wake wese, ane hukuru hwe 4.3 * 4.1 * 4.5cm.

Nerutsigiro rwemhuri yavo, VaWang vakaitwa R-CHOP chemotherapy kanomwe. PET-CT yakatevera mushure mechemotherapy yakaratidza kuti yapera zvishoma.

Zvisinei, kurapwa kwakatevera kwakakonzera matambudziko makuru kuna VaWang, akadai sekuvharika kwemudumbu, kubooka, uye peritonitis inorwadza. Vanachiremba vematumbu pamwe chete navanachiremba vaimubatsira vakabatsirana pakuvhiya, vachibvisa ura hwemukati nekuburitsa mvura mumuviri, pamwe chete nekubatsira nezviratidzo, vachibata zviratidzo zvemudumbu zvinobudirira.

Kuongororwa kwakazotevera kwePET-CT kwakaratidza kuwedzera kwemaronda egomarara nehukuru hwaro. Kuti vabvise zviri nani masero egomarara, vanachiremba vakagadzirisa chirongwa chakasimba chekurapa kenza uye vakakurudzira kuti vaisire masero eropa.

VaWang vakasangana nematambudziko akawanda mumuviri nemupfungwa sezvo mamiriro avo airamba achiwedzera kuipa. Kupinda kwebundu kwakaonekwa munzvimbo dzakawanda, uye zvipembenene zvitsva zve multifocal nodular hypermetabolic loses zvakawedzera zvakanyanya nzvimbo yekenza. Nekuda kwebundu mumuviri wavo wese, VaWang vakatambura nekurwadziwa kusingaperi kwemuviri, zvichiita kuti zvivaomere kurara pasi nekurara nekuda kwekurwadziwa.

Vapererwa nezano, VaWang vakadzidza nezve CAR-T therapy, mushonga mutsva weCAR-T cell immunotherapy wakagadzirirwa varwere vane relapse or refractory B-cell lymphoma.

Vasati vatanga kurapwa neCAR-T, kuongororwa kwelymph node munharaunda yegumbo rekurudyi kwakaratidza kuti CD19 neCD20 zvine hutano, zvichipa zvinangwa chaizvo zvekurapa CAR-T cell. Purofesa Yu akaronga kuongororwa kwakazara kwemuviri, zvichikonzera kugadzirwa kwechirongwa chekurapa CAR-T chaVaWang.

Musi wa25 Chikunguru, 2022, VaWang vakapinzwa CD19/20 CAR-T cell infusion kuchipatara, uye maitiro acho akafamba zvakanaka. Kunyatso tarisa uye kutarisirwa kwakasimba kwakadzora mhedzisiro yakaipa mushure mekupinzwa pasina matambudziko anotyisidzira hupenyu.

Mumwedzi isingasviki mitatu, pakasvika Gumiguru 10, 2022, PET-CT scan yakazotevera yakaratidza kuti chirwere chake chakanga chapera, uye ongororo yacho yakaratidza kuvandudzika kukuru muhutano hwake.

Pakuongororwa kwakazotevera, VaWang vaigara vachiongororwa CT, MRI, kana PET-CT, zvese zvichiratidza kuti vakasununguka zvachose. Pari zvino, hutano hwavo huchiri hwakanaka, huchipfuura nguva yekusunungurwa zvachose kwemwedzi inopfuura gumi nemana.