Multiple Myeloma(MM)-01

Kupora Kwakanaka Kwemurwere weMultiple Myeloma weDzimba ane CAR-T Therapy Pasinei Nekushaya Kubuda KweBCMA

Murwere wechikadzi akaonekwa aine chirwere che stage IIIA IgD-λ type multiple myeloma muna 2018 akapihwa mushonga wekutanga ne bortezomib. Mushure me cycles nhatu, akawana relieve yakakwana (CR). Muna Gumiguru 2018, akaisirwa autologous hematopoietic stem cell transplantation se consolidation therapy, ndokuzoteverwa ne maintainance therapy ne lenalidomide. Muna Kubvumbi 2020, chirwere ichi chakadzoka, uye akaisirwa second-line cycles nomwe, zvikaita kuti asashande zvakanaka. Kubva muna Zvita 2020 kusvika Kubvumbi 2021, akapihwa chemotherapy ne daratumumab, asi bone marrow biopsy yakaratidza 21.763% malignant monoclonal plasma cells, ne serum free light chain λ pa1470 mg/L uye urine free light chain λ pa5330 mg/L. Panguva iyi, akanga apedza kurapwa kukuru uye kutsva kuripo munyika, kusanganisira kuisirwa autologous stem cell transplantation, nekupinda mu CAR-T clinical trial ndiyo sarudzo yakanakisisa yasara.

Akaendeswa kuchipatara cheLudaopei musi wa10 Chivabvu, 2021, achitarisira kunyoresa mukuyedzwa kwavo kweBCMA CAR-T therapy ye multiple myeloma (MM). Paakapinda muchipatara, akanga asina simba nekurwadziwa kwakajairika uye fivha inoramba ichidzoka. Ongororo dzakakwana dzakaratidza "multiple myeloma, λ light chain type, ISS stage III, R-ISS stage III, mSMART high-risk group."

Kuongororwa kwePET-CT kwakaratidza kuwedzera kwekushanda kwemasero emuviri mumasero akapfava mukati memapfupa emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba emumakomba, zvichiratidza kupindira kwegomarara. Kuongororwa kwemapfupa emumakomba kwakaratidza 60.13% yemasero eplasma emumakomba asina BCMA.

Nzvimbo yedu yeCGT yakazivisa murwere nemhuri yake nezvekushanda kwemishonga iripo yeBCMA-negative multiple myeloma, iyo kunyange zvazvo ingave inoshanda zvichienderana nemamwe mabhuku, haina ruzivo rwakakwana. Mushure mekunyatsofungisisa, murwere nemhuri yake vakasarudza kuenderera mberi nehurongwa hwekurapa.

Mushure mekugadziriswa kwemishonga yeFC, masero eBCMA CAR-T akaiswa musi wa1 Chikumi, 2021, kuLudaopei Hospital. Murwere akatanga fivha mushure mekuiswa mushonga, izvo zvakadzorwa zvishoma nezvishoma nekurapwa zvine simba zvinorwisa hutachiona uye zvinotsigira zviratidzo. Mazuva gumi nemana mushure mekuiswa mushonga, bone marrow biopsy haina kuratidza masero eplasma emonoclonal akasara. Mazuva makumi matatu nerimwe mushure mekuiswa mushonga, bone marrow biopsy yakaramba isina. Serum immunofixation yaive isina kunaka, serum free light chain λ yaive mukati menguva yakajairika, uye serum M protein yaive isina kunaka, zvichiratidza kuti chirwere chacho chapera zvachose.

Parizvino, mushure memwedzi inopfuura misere mushure mekugamuchira BCMA CAR-T cell infusion, murwere anoramba ari murunyararo rwakazara nekupora kwakanaka uye kugutsikana kukuru nemhedzisiro yekurapwa.