Kubudirira Muzvidzidzo | Chikwata Chekurapa chaLu Daopei Chaburitsa Chidzidzo Chekiriniki Chinoshamisa muBritish Journal of Haematology

Mukubudirira kukuru kweChikwata Chekurapa cheLu Daopei, bepa rekutanga rekutsvagisa kwekiriniki rine musoro unoti "Chidzidzo chekuchengetedza uye kushanda zvakanaka kwe allogeneic haematopoietic stem cell transplantation yevarwere veT-cell acute lymphoblastic leukaemia/lymphoblastic lymphoma vasina simba uye vakadzokazve vakarerukirwa mushure me autologous CD7 chimeric antigen receptor T-cell therapy" rakabudiswa mumagazini inozivikanwa Chinyorwa cheBritish cheHematology (IF=5.1). Chidzidzo ichi, chakanyorwa naDr. Cao Xingyu pamwe naProf. Lu Peihua semunyori anoenderana nacho, chinotarisa pakukwanisa kwekubatanidza allo-HSCT kune varwere vane R/R T-ALL neT-LBL vakawana relieve yakakwana (CR) mushure mekurapa kweCD7 CAR-T.

Kutsvaga Kwakatangira:

Maronda eT-cell, akadai seT-ALL neT-LBL, anozivikanwa nekurwisa kwawo uye kuramba kurapwa kwakanyanya. Kune varwere vane T-ALL/LBL (R/R T-ALL/T-LBL) isingashande kana kuti vakadzokera kuchipatara, mishonga yechivanhu haina kubudirira zvakanyanya uye fungidziro dzisina kunaka. Zvisinei, kurapwa neCD7 CAR-T kwave kubuda senzira yekubudirira, zvichiratidza tarisiro huru mukurapa zvirwere izvi zvakaoma kurapa, kunyangwe zvichiri mumatanho ekutanga ekuyedza kwekiriniki. Kana zvikateverwa nekubatanidzwa ne allo-HSCT, varwere vanowana CR neCD7 CAR-T therapy vanopiwa mukana chaiwo wekurerukirwa kwenguva refu.

Maitiro Ekudzidza:

Chidzidzo ichi chekare chakaongorora varwere veR/R T-ALL neT-LBL vakapihwa NS7 CAR-T therapy, ndokuzoteverwa ne allo-HSCT combination pakati paMbudzi 2020 naNdira 2023 kuLu Daopei Hospital. Chidzidzo ichi chakaongorora zvinhu zvakasiyana-siyana, kusanganisira zera remurwere, nhamba yekopi yeCAR-T cell copy isati yaiswa, uye nzira dzakasiyana dzekutora CAR-T dosing, kuti vaongorore kukanganisa kwavo pamigumisiro yekuisirwa. Mhedzisiro yacho yakaenzaniswa neyevarwere 124 vakawana CR kuburikidza nechemotherapy ichiteverwa ne allo-HSCT.

Zvakawanikwa Zvikuru:

Chidzidzo ichi chaisanganisira varwere 34 veR/R T-ALL/T-LBL vakawana CR mushure mekurapwa neNS7 CAR-T uye vakazoitwa allo-HSCT. Nguva yepakati pakati pekurapwa neCAR-T nekuisa chitunha yaive mazuva 57.5. Zvinonyanya kukosha kuti 47.1% yevarwere vaive nechirwere chekutanga chekusagona kurapwa, nepo 52.9% vaive nechirwere chekudzokera shure. Mushure meCAR-T infusion, cytokine release syndrome (CRS) yakaitika muvarwere 33, uye 94.1% vaive neGrade 1-2 CRS. Nerombo rakanaka, hapana varwere vaive ne immune effector cell-associated neurotoxicity syndrome (ICANS).

Pamazuva makumi maviri nemasere mushure meCAR-T, varwere makumi matatu nerimwe vakawana MRD-negative CR, nepo varwere vatatu vaine MRD-positive CR. Chidzidzo ichi chakawanawo kuti varwere vane ≤20% bone marrow blasts vasati vaisirwa mushonga vaive nehuwandu hwe 0% hwekudzokera kuchirwere mushure memwedzi gumi nemisere mushure mekuisirwa mushonga. Kana tichienzanisa nevarwere vane chemotherapy-based CR, huwandu hwemakore maviri ekurarama (OS) hwaive hwakafanana: 61.9% yeboka reCD7 CAR-T vs. 67.6% yeboka rechemotherapy. Pamusoro pezvo, huwandu hwemakore maviri ekurarama pasina leukemia (LFS) hwaive hwakafanana (62.3% vs. 62.0%).

Zvakakosha kuziva kuti varwere vane makore ≤14 vakagamuchira kurapwa kweCD7 CAR-T vaive ne87.5% OS uye LFS yemakore maviri. Zvakabuda zvinoratidza kuti kurapwa kweCD7 CAR-T kunoteverwa ne allo-HSCT kunogona kupa imwe nzira yakachengeteka uye inoshanda kune varwere veR/R T-ALL/T-LBL vasingakodzeri kurapwa kwechinyakare.

Mhedziso:

Chidzidzo ichi chinogumisa kuti kusanganiswa kweCD7 CAR-T therapy inoteverwa ne allo-HSCT kunopa nzira yekurapa inovimbisa uye inoshanda kune varwere vane R/R T-ALL/T-LBL. Mhedzisiro yacho yakafanana neiya yakawanikwa ne chemotherapy ne allo-HSCT, pasina kuwedzera kwekufa kwevanhu vasingadzokeri shure, zvichipa sarudzo inokosha yekurapa kune varwere vane sarudzo shoma dzekurapa. Zvakawanikwa muchidzidzo ichi zvinopa tariro yekuregererwa kwenguva refu uye kurarama, kunyanya kune varwere vane njodzi huru vanopinda mukubatanidzwa ne allo-HSCT nenguva.

Mhedzisiro uye Maonero Eramangwana:

Kuburitswa kwetsvagurudzo iyi itsva mu Chinyorwa cheBritish cheHematologychiratidzo chekuzvipira uye hunyanzvi hweChikwata Chekurapa cheLu Daopei. Kubudirira uku kunoratidza zviri kuitwa nechipatara mukusimudzira kurapwa kwezvirwere zveropa uye mipiro yavo yakakosha kunharaunda yezvekurapa yepasi rose. Zvinoratidza kugona kwekurapa kweCD7 CAR-T senzira inoshanda kune varwere vane R/R T-ALL/T-LBL uye zvinoratidza kuzvipira kwechikwata kusundira miganhu yekurapa kweropa. Kurapa Kenza.