Systemic lupus erythematosus (SLE)-05

Mai C mukadzi ane makore makumi matatu nemaviri ekuberekwa ane nhoroondo yekuonekwa aine chirwere chesystemic lupus erythematosus (SLE) makore maviri apfuura. Zviratidzo zvake zvikuru zvaisanganisira nephritis yakanyanya, arthritis, uye mapundu. Pasinei nekurapwa kwakawanda kwekudzivirira muviri (kusanganisira glucocorticoids, hydroxychloroquine, uye rituximab), chirwere chake chakaramba chisina kudzoreka.

Mamiriro Ekurapwa Pamberi Pekurapwa:

Zviratidzo: Kurwadziwa kwakanyanya kwemajoini nekuzvimba, mapundu asingaperi, kuneta kukuru, uye kuputika kweropa kunoramba kuchiitika.

Zvakawanikwa muLaboratory:

# SLEDAI-2K mamakisi: 16

# Mazinga eDNA anti-stranded double-stranded DNA antibodies muropa: Akakwira kupfuura mwero wakajairika

# Wedzera mazinga eC3 neC4: Pasi pehuwandu hwakajairwa

Maitiro Ekurapa:

1. Kusarudzwa kweMurwere: Zvichienderana nekusashanda kwemishonga yechivanhu uye kuoma kwechirwere chavo, Ms. C vakanyoreswa mukuyedzwa kwekiriniki kweCAR-T cell therapy.

2. Kugadzirira: Vasati vagamuchira CAR-T cell infusion, Ms. C vakanyoreswa chemotherapy kuti vabvise ma lymphocytes aripo uye vagadzirire kuunzwa kweCAR-T cells.

3. Kugadzirira Masero:

# Masero eT akabviswa muropa raMs. C.

# Masero aya eT akagadziriswa majini murabhoritari kuti abudise chimeric antigen receptors (CAR) inotarisa maantigen eCD19 neBCMA.

4. Kuiswa Masero: Mushure mekuwedzerwa uye kuyedzwa kwemhando, masero eCAR-T akagadzirwa akadzorerwa mumuviri waMs. C.

5. Kuongororwa kwevarwere vari muchipatara: Mai C vakatariswa muchipatara kwemazuva makumi maviri nemashanu mushure mekupinzwa mushonga kuti vaone kana paine migumisiro yakaipa uye kuti vaone kushanda kwayo.

Mhedzisiro yeKurapwa:

1. Mhinduro Yenguva Pfupi:

# Kuvandudzwa kweZviratidzo: Mukati memavhiki matatu mushure mekupinzwa mushonga, Mai C vakanzwa kudzikira kukuru kwemarwadzo emapfupa nekuzvimba, uye mapundu avo akapera zvishoma nezvishoma.

# Zvakawanikwa muLaboratory: Mazuva maviri mushure mekuiswa ropa, masero eB muropa raMs. C akabviswa zvachose, zvichiratidza kuti masero eCAR-T ainyatsonanga.

2. Kuongorora Kwepakati Penguva (mwedzi mitatu):

Nhamba ye # SLEDAI-2K: Yaderedzwa kusvika pa2, zvichiratidza kurerukirwa kukuru kwechirwere.

# Basa reItsvo: Kuderera kukuru kweproteinuria, nephritis ichidzorwa.

# Zviratidzo zveImmunological: Kudzikira kwehuwandu hwema antibodies eDNA ane tambo mbiri, uye huwandu hweC3 neC4 hwadzoka pahunhu hwakajairika.

3. Migumisiro Yenguva Refu (mwedzi gumi nemiviri):

# Kuregererwa Kunogara Kwenguva refu: Ms. C vakaramba vasina mishonga kwegore rimwe vasina zviratidzo zvekudzokera shure kweSLE.

# Kuchengetedzwa: Kunze kwechirwere chemild cytokine release syndrome (CRS), Mai C havana kusangana nemigumisiro yakaipa. Masoja avo ekudzivirira muviri akadzoka zvishoma nezvishoma mushure mekurapwa, uye masero eB akadzokazve haana kuratidza hutachiona.

Kazhinji, chirwere chaMs. C chakaratidza kuvandudzika kukuru uye kugadzikana kwakaramba kuripo mushure mekurapwa neCAR-T cell, zvichiratidza mukana wekurapa uku kune SLE yakaoma uye isingarapiki.

Mushumo wekuyedzwa kwesero reCART: