Multiple Myeloma ine Extramedullary Plasmacytoma

Izvi ndizvo zvakaitika kumurwere wechirume ane makore makumi manomwe nematatu ekuberekwa akaonekwa aine multiple myeloma, zvichikonzerwa nekuvapo kwe extramedullary plasmacytoma. Munguva yese yekurapwa neDara-VRD (Daratumumab, Bortezomib, Lenalidomide, Dexamethasone), extramedullary plasmacytoma yakaramba iripo, zvichikonzera kurwadziwa kukuru uye kusagadzikana kumurwere.

Tichifunga nezvehunhu hwechirwere ichi uye kusagamuchira kwachinoita mishonga yechivanhu, murwere akanyoreswa mukuyedzwa kwekiriniki kweBCMA CAR-T cell therapy. Mushure mekuita matanho ekugadzirira anodiwa, anosanganisira lymphodepletion, murwere akapihwa BCMA CAR-T cells.

Zvinoshamisa kuti, mukati memazuva gumi mushure mekuisirwa mushonga uyu, murwere akaonekwa kuti ane chirwere che cytokine release syndrome (CRS) chedanho rechipiri, zvichiratidza kuti immune system yakashanda nesimba. Pamusoro pezvo, pakanga paine CRS yakakura panzvimbo ye extramedullary plasmacytoma.

Chinotoshamisa ndechekuti munguva pfupi iyi, gomarara rekunze kwemudumbu raive risingarapike, iro raive risingarapike nemishonga yakawanda yekurapa, mishonga inotarirwa, uye ma antibodies e monoclonal, rakanyangarika zvachose. Murwere akasvika pakureruka zvakakwana, zvichiratidza kubudirira kwekurapwa.

Mukati mekurapwa kwese, timu yezvekurapa yainyatsotarisa murwere kuti aone kana paine zviratidzo zvekusagadzikana uye yakamupa rubatsiro rwakakwana. Izvi zvaisanganisira kugadzirisa zviratidzo zveCRS uye kugadzirisa mamwe matambudziko ane chekuita nekurapwa.

Sezvo kurapwa kwacho kwaifambira mberi, chikwata chevanachiremba chakaramba chichinyatsoongorora maitiro emurwere kuBCMA CAR-T cell therapy. Kuongororwa nguva dzose kwakaitwa kuti kuongororwe kushanda kwekurapa uye kugadzirisa chero migumisiro yakaipa iri kubuda nekukurumidza.

Mushure mekurerukirwa kukuru kwemurwere, hupenyu hwake hwakavandudzika zvikuru, nekurerutswa kwemarwadzo nekusagadzikana kwakabatana ne extramedullary plasmacytoma. Nekudzora kwechirwere ichi, murwere akakwanisa kutangazve mabasa ake ezuva nezuva uye kunakidzwa nehupenyu hwakanaka.

Uyezve, tichiziva kukosha kwekurapwa kwenguva refu, timu yedu yezvekurapa yakaramba ichibatanidzwa murwendo rwemurwere mushure mekurapwa. Nguva dzose pairongwa nguva nenguva yekurapwa kuti vaongorore mamiriro emurwere, vaongorore kugara kwenguva refu kwekurapwa, uye vagadzirise chero mukana wekudzoka kana migumisiro yakaipa.

Pamusoro pekutevera kurapwa, sangano redu rakapa rubatsiro rwakakwana kuti ribatsire murwere kugadzirisa hupenyu hwake mushure mekurapwa. Izvi zvaisanganisira kuwana mazano, zvirongwa zvekurapwa, uye zvekushandisa pakudzidzisa murwere nemhuri yake kuti vararame hupenyu hwakanaka uye varambe vaine mararamiro ane hutano.

Kubudirira kwenyaya iyi hakungoratidzi chete kushanda kweBCMA CAR-T cell therapy mukurapa refractory multiple myeloma asiwo kunoratidza kukosha kwekutarisira kwakagadzirirwa munhu uye kwemarudzi akasiyana-siyana mukurapa kenza yakaoma yeropa. Kuzvipira kwedu kupa rutsigiro rusingaperi uye kutarisirwa kwekutevera kunoratidza kuzvipira kwedu kuona kuti varwere vedu vanowana mhedzisiro yakanaka kupfuura chikamu chekurapa.

Mwedzi mitatu usati wapihwa mushonga weinfusion