Ukusasaza i-large B-cell lymphoma (DLBCL)-03

NgoMatshi 2021, uMnu. Wang (igama elingelolakhe) ngequbuliso weva iintlungu zesisu esisezantsi ngasekunene, ekuqaleni ephazanyiswe kukungakhululeki kwesisu, kwaye akazange afune unyango ngokukhawuleza. Kwiinyanga ezimbini ezalandelayo, wafumana iimpawu zentlungu yesisu esisezantsi ngasekunene ngokuphindaphindiweyo, nto leyo eyambangela ukuba afune uncedo lwezonyango kwisibhedlele sasekuhlaleni. I-CT scan yabonisa ukungaqheleki kwikholoni kunye nokwanda kwee-lymph nodes ezingasemva kwesisu.

Oogqirha bacebisa i-colonoscopy kunye ne-biopsy ukuze kufunyanwe isifo esingaphezulu, nto leyo eqinisekisile ukuba "i-diffuse large B-cell lymphoma," isifo esibulalayo esaziwa ngokuba yi-lymphoma. I-PET-CT iqinisekisile ukuba izilonda ezixhaphakileyo ze-nodular hypermetabolic emzimbeni wakhe, ezona zinkulu zinomlinganiselo we-4.3 * 4.1 * 4.5cm.

Ngenkxaso yosapho lwakhe, uMnu. Wang wenziwa imijikelo emine ye-R-CHOP chemotherapy. Uvavanyo olulandelayo lwe-PET-CT emva kwe-chemotherapy lwabonisa ukuba i-relapse engaphelelanga.

Nangona kunjalo, unyango olulandelayo lwakhokelela kwiingxaki ezinzima kuMnu. Wang, ezinje ngokuvaleka kwamathumbu, ukugqobhoka, kunye ne-acute peritonitis. Oogqirha botyando kunye noogqirha ababemncedisa basebenzisana kwisicwangciso sotyando, benza ukususwa kwamathumbu amakhulu kunye nokuphuma kwamanzi, kunye nonyango oluxhasayo oluneempawu, belawula ngempumelelo iimpawu zakhe zesisu.

I-PET-CT scan eyalandelayo yabonisa ukwanda kwezilonda zethumba kunye nobukhulu bazo. Ukuze kupheliswe ngcono iiseli zethumba, oogqirha balungisa inkqubo ye-chemotherapy eqinisiweyo baza bacebisa ukufakelwa kweeseli ze-hematopoietic stem.

Ejongene neengxaki ezininzi, uMnu. Wang wafumana ubunzima obukhulu emzimbeni nangokweemvakalelo njengoko imeko yakhe yayisiba mandundu. Ukungena kwethumba kwabonwa kwiindawo ezininzi, kunye nezilonda ezisandul’ ukuveliswa ze-multifocal nodular hypermetabolic ezikhulisa kakhulu indawo yomhlaza. Ngenxa yeethumba emzimbeni wakhe wonke, uMnu. Wang wayenentlungu engapheliyo yomzimba, nto leyo eyenza kwaba nzima ukuba alale tyaba aze alale ngenxa yentlungu.

Ephelelwe lithemba, uMnu. Wang wafunda ngonyango lwe-CAR-T, unyango olutsha lwe-CAR-T cell immunotherapy oluyilelwe ngokukodwa izigulana ezine-B-cell lymphoma ephinde yabuyela kwisimo sayo okanye engenakuchatshazelwa.

Ngaphambi kokuba afumane unyango lwe-CAR-T, i-lymph node biopsy kwindawo yasekunene ye-inguinal yabonisa ukuba ne-CD19 kunye ne-CD20 positivity, nto leyo enika iinjongo ezichanekileyo zonyango lweeseli ze-CAR-T. UNjingalwazi uYu waququzelela uvavanyo olupheleleyo lomzimba, olukhokelela ekuphuhlisweni kwesicwangciso sonyango lwe-CAR-T somntu ngamnye kuMnu. Wang.

Ngomhla wama-25 kuJulayi, ngo-2022, uMnu. Wang wafumana i-CD19/20 CAR-T cell infusion esibhedlele, inkqubo ihamba kakuhle. Ukubekwa esweni ngokusondeleyo kunye nonyango oluqinileyo oluxhasayo lulawula iimpendulo ezingalunganga emva kokufakwa ngaphandle kweengxaki ezisongela ubomi.

Kwisithuba esingaphantsi kweenyanga ezintathu, nge-10 ka-Okthobha 2022, i-PET-CT scan elandelayo yaqinisekisa ukuba uphilile ngokupheleleyo, kwaye uvavanyo lulonke lubonisa ukuphucuka okukhulu kwimeko yakhe yempilo.

Ngexesha lokulandela emva koko, uMnu. Wang wayesoloko esenziwa ii-CT, i-MRI, okanye ii-PET-CT scans, zonke eziqinisekisa imeko yakhe yokuxolelwa ngokupheleleyo. Okwangoku, impilo yakhe isalungile, idlula ixesha lokuxolelwa ngokupheleleyo elingaphezulu kweenyanga ezili-14.