I-Acute Lymphoblastic Leukemia (T-ALL)-04

Isigulana sasiyindoda eneminyaka eli-15 ubudala, efunyenwe ine-T-cell acute lymphoblastic leukaemia (T-ALL ene-STIL-TAL1 positivity, i-gene embi yokuxela kwangaphambili) ekupheleni kukaDisemba ka-2020, kwaye yanyangwa kwisibhedlele sasekuhlaleni ngemijikelo emininzi ye-chemotherapy eqhelekileyo ukuze kufezekiswe ukukhululeka ngokupheleleyo. Ukufakelwa kwe-hemizygous haematopoietic stem cell ukusuka kuyise ukuya kunyana kwenziwa ngomhla wesi-2 kuJuni ka-2021, kodwa ngelishwa ukuphinda kwamathambo kwafunyanwa kwiinyanga ezi-3 emva kokufakelwa, kwaye umjikelo omnye we-chemotherapy awuzange usebenze. Kwangaxeshanye, wavelisa izidlele ezivuvukileyo kunye nokuvuza komoya, iikona ezigobileyo zomlomo, kunye nokubhobozwa kwe-lumbar kwabonisa uphuhliso lwe-central nervous system leukaemia.

I-T-ALL ene-STIL-TAL1 positivity, ukuphinda ubuye kwangethuba emva kokufakelwa i-allogeneic, kunye ne-central nervous system leukaemia, yimeko enzima kakhulu ukunyanga ngeli xesha ngaphandle kwe-CAR-T. Utata womntwana ubuze ngesebe le-hematology kwiSibhedlele seSibhedlele seSibhedlele seSibhedlele saseTianjin Cancer ngabahlobo bakhe. Emva konxibelelwano oluneenkcukacha, beza kwiSibhedlele seSibhedlele seSibhedlele seSibhedlele saseTianjin Cancer, befuna ukubhalisa kuvavanyo lweklinikhi lwe-CAR-T njengomzamo wokugqibela.

Iiseli zeTumor zokuqala zeCAR-T ezingasebenziyo zanda ngokukhawuleza, zibeka ubomi bakhe esichengeni.

Ngomhla wama-26 kweyeDwarha ngo-2021, isigulana sangeniswa kwigumbi lokuqala leSebe leHematology. Ngenxa yokwanda ngokukhawuleza kweeseli zethumba, isigulana senziwa i-chemotherapy ukunciphisa umthwalo wethumba saza safumana i-chemotherapy yangaphakathi. Ulwelo lwe-cerebrospinal aluzange lubonise sifo sishiyekileyo. Emva kokuzinza, ii-lymphocytes zikayise zaqokelelwa ukuze kukhuliswe iiseli ze-CAR-T. Ngomhla we-19 kweyeNkanga, iiseli ze-CD7 CAR-T ezinikelayo zafakwa kwisigulana.

Iintsuku emva kokufakwa, ngaphambi kokwandiswa kweeseli ze-CAR-T, iiseli zethumba zanda ngokukhawuleza kwakhona, kwabakho ukuqhuma okuninzi egazini elingaphandle, nto leyo eyaphawula ukungaphumeleli konyango lokuqala lwe-CAR-T.

Ngeli xesha, iSibhedlele saseTianjin Cancer Hospital Airport besiqhuba uvavanyo lweklinikhi lwe-universal CAR-T (CD7 UCAR-T) lwe-acute T-lymphoblastic leukaemia. Abazali bavakalise ungxamiseko olukhulu, besithi baza kulandela ithuba eliyi-1% kumntwana wabo. Iqela lezonyango lixoxe nosapho laza lagqiba ekubeni libhalise isigulana kuvavanyo lweklinikhi lwe-CD7 UCAR-T.

Ukukhululwa ngokupheleleyo emva kwe-CD7 UCAR-T Now emva kweenyanga ezi-2 emva kokufakelwa.

Ngomhla wesi-2 kuDisemba, isigulana safumana i-CD7 U-CART cell infusion kunye nonyango lokunciphisa umthwalo wethumba kunye nonyango oluxhasayo. Emva kokumnika i-infusion, waba nomkhuhlane ophakamileyo ixesha elide kunye nokudinwa. Ngokuxhaswa ngokulwa nosulelo kunye nokufuma, iimpawu zakhe ezibalulekileyo zazinza kwaye ubushushu bomzimba babuyela esiqhelweni.

Uvavanyo lwe-bone marrow kunye ne-cerebrospinal fluid kwiintsuku ze-18 kunye ne-28 emva kwe-CAR-T luqinisekisile ukuchacha ngokupheleleyo ngenxa ye-MRD negativity. Imeko yomntwana yaphucuka kakhulu amandla akhe abuya, ukutya kwabuyela kwimeko yesiqhelo, kwaye umama wakhe—owayekhathazekile ngaphambili—wafumana ithemba kwakhona.

Okwangoku, isigulana sikhe safumana utyando lwesibini lwe-haploidentical HSCT kwiSibhedlele saseTianjin Cancer Hospital Airport kwaye sihlala sikhululekile ngokupheleleyo emva kweenyanga ezimbini emva kokufakelwa isibeleko.