Kupararira kweB-cell lymphoma yakakura (DLBCL)-04

Mhinduro Yakanaka YaVaMonger Yekutanga: Kurapa KweCD19/CD20 CAR-T Kunounza Tariro Itsva yeDLBCL Yakadzoka Muupenyu

Nhoroondo yeMurwere 

Rodney Charles Monger, murume ane makore 68 ekuberekwa anobva kunze kwenyika, akaonekwa aine chirwere che diffuse large B-cell lymphoma (DLBCL) makore matatu apfuura. Akatsvaga rubatsiro rwepamusoro kuTianjin Cancer Hospital muna Nyamavhuvhu 2025. Kuongororwa kwe cervical lymph node biopsy kwakaratidza kuti B-cell lymphoma inopararira inobva pakati pe germinal center. Immunohistochemistry yaive yakanaka kwazvo kune CD20, CD19, uye CD10, ine Bcl-6, Bcl-2 (70%+), uye c-MYC (60%+). Kuongororwa kwemajini kwakaratidza kuti BCL2 yakagadziriswazve neFISH uye mutations mumajini eEZH2, KMT2D, TNFRSF14, NRAS, uye TPMT—zviratidzo zvinoenderana nehuwandu hwehutachiona, hune njodzi huru.

Rwendo Rwekurapwa Pamberi 

Muna Nyamavhuvhu 2025, VaMonger vakapihwa mushonga we pola pamwe chete nemushonga weBTK inhibitor nelenalidomide. Vakazopihwa mushonga weFC (fludarabine + cyclophosphamide) lymphodepletion chemotherapy. Pasinei nekuedza uku, chirwere chavo chakaramba chisingashande, zvikaita kuti chikwata chekurapa chikurudzire Bioocus dual-targeting CD19/CD20 CAR-T cell therapy.

Musi wa8 Gunyana, 2025, VaMonger vakapinzwa muropa remasero eCD19/CD20 CAR-T. Zvinoshamisa kuti vakaona kuti hapana cytokine release syndrome (CRS)uye chirwere chepfungwa chinokonzerwa nemasero (ICANS) chisina immune effector cell-associated neurotoxicity syndrome (ICANS)—nzira yakanaka mushure mekunwa mvura yakamubvumira kuramba akasimba uye aine tariro kubva pazuva rekutanga.

Kuwedzera Kwemasero eCAR-T: Kunokurumidza uye KwakasimbaKuongororwa kweropa kunoratidza kuwedzera kunoshamisa kwemasero eCAR-T, zvichiratidza kukura kwakanaka uye kuwanda kwemasero aya:

• D4 mushure mekunyudzwa(Gunyana 12): Masero eCAR19+ aive 0.50% yemasero eCD3+ T (kukosha kwakakwana 6.04 × 10⁷/L); Masero eCAR20+ 0.41% (4.96 × 10⁷/L).
• D7(Gunyana 15): CAR19+ yakakwira kusvika pa1.68% (1.40 × 10⁷/L); CAR20+ kusvika pa1.63% (1.36 × 10⁷/L).
• D10(Gunyana 18): CAR19+ yasvika 43%yemasero eCD3+ T (kukosha kwakakwana) 3.13 × 10⁸/L); CAR20+ yasvika 32.74%(kukosha kwakakwana 3.26 × 10⁸/L).

Flow cytometry yakaratidzawo kupararira kwakaringana pakati peCD4+ neCD8+ subsets, nekutaura kwakasimba kweCAR mbiri. Dynamic monitoring curves yakaratidza danho rakajeka rekuwedzera, zvichiratidza kuti dhizaini yeCD19/CD20 mbiri yakasimudzira CAR-T kuramba ichienderera mberi uye kuwanda mumuviri.

Chimiro Chazvino uye Kutarisirwa Kwekutsigira 

Pakuongororwa kwazvino (D10), VaMonger vachiri kushanda zvakanaka mukurapa. Vari kutora mishonga yemuromo yakagadzirwa nemaoko inosanganisira acyclovir, compound sulfamethoxazole, orelabrutinib, lenalidomide, uye mishonga inotsigira, vachitarisa huwandu hweropa, mashandiro echiropa neitsvo nguva nenguva, uye zviratidzo zvekuzvimba zvichienderana nehurongwa hwekubuda kweropa.

Chikwata cheBioocus chakapa rutsigiro rwakakwana, rwakanangana nemurwere panguva yese: pekugara pakanaka, chikafu chinovaka muviri, rubatsiro rwekufambisa, uye mazano epfungwa kuna VaMonger nemhuri yavo. Maitiro aya akazara akamubatsira kuti anyatsotarisa pakupora.

Shoko Retariro 

Nyaya yaVaMonger inoratidza kugona kweBioocus dual CD19/CD20 CAR-T therapy kune varwere vane DLBCL yakadzoka/isina simba. Kukura nekukurumidza uye kwakasimba kwemasero eCAR-T asina chepfu zvakanyanya kunoratidza kuchengetedzeka kwechigadzirwa ichi uye kushanda kwakasimba kwekudzivirira bundu - kunyangwe kumurwere mukuru ane zvinhu zvine njodzi huru.

Tinodada nekutsigira varwere vakaita saVaMonger parwendo rwavo rwekudzokera kuhutano. Nyaya dzakadai sedzake dzinosimbisa kuzvipira kwedu kupa mishonga mitsva, inochinja hupenyu hwemasero nerubatsiro rwemunhu oga.

Nyaya iyi inoshumwa nemvumo yemurwere. Mhedzisiro inogona kusiyana; Mhedzisiro yeCAR-T inoenderana nehupenyu hwechirwere chemunhu uye zvinhu zvinoonekwa pakiriniki. Kuti uwane rumwe ruzivo kana kuti uongorore nzira dzekurapa, ndapota shanyira peji redu reCAR-T Therapy for Non-Hodgkin Lymphoma.