Ho hasanya lymphoma e kholo ea B-cell (DLBCL)-04

Karabelo e Hlollang ea Pele ea Monghali Monger: Kalafo ea Dual CD19/CD20 CAR-T e Tlisa Tšepo e Ncha bakeng sa DLBCL e Khutlileng Bocha

Semelo sa Mokuli 

Rodney Charles Monger, monna ea lilemo li 68 ea tsoang mose ho maoatle, o ile a fumanoa a e-na le lymphoma e kholo ea B-cell (DLBCL) e hasaneng lilemo tse tharo tse fetileng. O ile a batla tlhokomelo e tsoetseng pele Sepetleleng sa Kankere sa Tianjin ka Phato 2025. Tlhahlobo ea lymph node ea molomo oa popelo e tiisitse hore lymphoma ea B-cell e hlaselang e simolohile bohareng ba germinal. Immunohistochemistry e ne e le ntle haholo bakeng sa CD20, CD19, le CD10, ka tlhahiso e phahameng ea Bcl-6, Bcl-2 (70%+), le c-MYC (60%+). Liteko tsa liphatsa tsa lefutso li senotse ho hlophisoa bocha ha BCL2 ke FISH le liphetoho liphatsa tsa lefutso tsa EZH2, KMT2D, TNFRSF14, NRAS, le TPMT—matšoao a lumellanang le boemo bo mabifi le bo kotsi haholo.

Leeto la Pele la Kalafo 

Ka Phato 2025, Monghadi Monger o ile a fumana pola e kopantsoeng le BTK inhibitor le lenalidomide. Eaba o fuoa chemotherapy ea FC (fludarabine + cyclophosphamide) lymphodepletion. Ho sa tsotellehe boiteko bona, lefu la hae le ile la lula le sa sebetse hantle, e leng se ileng sa etsa hore sehlopha sa bongaka se khothaletse phekolo ea lisele tsa CD19/CD20 CAR-T tse nang le li-dual-targeting.

Ka la 8 Loetse 2025, Monghadi Monger o ile a fumana pheko ya disele tsa CD19/CD20 CAR-T tsa autologous. Ho makatsang ke hore o ile a ba le phihlelo ya ha ho na cytokine release syndrome (CRS)le lefu la neurotoxicity le amanang le lisele tse se nang immune effect (ICANS)—ketso e boreleli ka mora ho kenngwa e ileng ya mo dumella ho dula a tsitsitse mme a na le tshepo ho tloha letsatsing la pele.

Katoloso ea Lisele tsa CAR-T: E Potlakile ebile e MatlaTlhokomelo ea mali ka thoko e tlalehile katoloso e tsotehang ea lisele tsa CAR-T, e tiisang ho kenngoa le ho ata ho babatsehang:

• D4 kamora ho kenngoa(Loetse 12): Lisele tsa CAR19+ e ne e le 0.50% ea lisele tsa CD3+ T (boleng bo felletseng ke 6.04 × 10⁷/L); Lisele tsa CAR20+ 0.41% (4.96 × 10⁷/L).
• D7(Loetse 15): CAR19+ e nyolohetse ho 1.68% (1.40 × 10⁷/L); CAR20+ ho isa ho 1.63% (1.36 × 10⁷/L).
• D10(Loetse 18): CAR19+ e fihlile 43%ea lisele tsa CD3+ T (boleng bo felletseng 3.13 × 10⁸/L); CAR20+ e fihlile 32.74%(boleng bo felletseng 3.26 × 10⁸/L).

Tšebetso ea potoloho ea mali e boetse e bontšitse kabo e leka-lekaneng ho pholletsa le li-subset tsa CD4+ le CD8+, ka tlhahiso e matla ea CAR e habeli. Li-curve tsa tlhokomelo e matla li bontšitse mohato o hlakileng oa katoloso ea exponential, tse bontšang hore moralo oa CD19/CD20 e habeli o khothalelitse ka katleho ho phehella le ho ata ha CAR-T ka har'a 'mele.

Boemo ba Hona Joale le Tlhokomelo e Tšehetsang 

Phuputsong ea morao-rao (D10), Monghali Monger o ntse a tsoela pele ho sebetsa hantle ka bongaka. O sebelisa meriana e nooang e etselitsoeng motho ka mong e kenyeletsang acyclovir, sulfamethoxazole e kopantsoeng, orelabrutinib, lenalidomide, le meriana e tšehetsang, ka ho beha leihlo khafetsa lipalo tsa mali, tšebetso ea sebete le liphio, le matšoao a ho ruruha ho latela moralo oa ho ntša mali.

Sehlopha sa Bioocus se fane ka tšehetso e felletseng, e shebaneng le bakuli ho pholletsa le: bolulo bo mabothobotho, lijo tse nang le phepo, thuso ea lipalangoang le likeletso tsa kelello bakeng sa Monghali Monger le ba lelapa la hae. Mokhoa ona o akaretsang o mo thusitse ho tsepamisa maikutlo ka botlalo ho foleng.

Molaetsa oa Tšepo 

Nyeoe ea Monghali Monger e bontša bokhoni ba phetoho ba phekolo ea Bioocus dual CD19/CD20 CAR-T bakeng sa bakuli ba nang le DLBCL e khutlelang morao/e sa sebetseng hantle. Katoloso e potlakileng le e matla ea lisele tsa CAR-T ntle le chefo e matla e totobatsa boemo bo botle ba polokeho ea sehlahisoa le ts'ebetso e matla ea ho loantša hlahala - esita le ho mokuli ea hōlileng ea nang le litšobotsi tse kotsi tsa limolek'hule.

Re motlotlo ho tšehetsa bakuli ba kang Monghali Monger leetong la bona la ho khutlela bophelong bo botle. Lipale tse kang tsa hae li tiisa boitlamo ba rona ba ho fana ka mekhoa e mecha ea phekolo ea lisele e fetolang bophelo ka tlhokomelo ea motho ka mong.

Nyeoe ena e tlalehiloe ka tumello ea mokuli. Liphetho li ka fapana; Liphetho tsa CAR-T li itšetlehile ka baeloji ea lefu ka bomong le lintlha tsa kliniki. Bakeng sa tlhaiso-leseling e batsi kapa ho hlahloba mekhoa ea kalafo, ka kopo etela leqephe la rona la CAR-T Therapy for Non-Hodgkin Lymphoma.