Ukusasaza i-lymphoma enkulu ye-B-cell (DLBCL)-04

Impendulo Emangalisayo KaMnu. Monger Yasekuqaleni: Unyango Lwe-CAR-T Oluphindwe Kabini Lwe-CD19/CD20 Luzisa Ithemba Elitsha Kwi-DLBCL Ebuyela Umva

Imvelaphi yesigulane 

URodney Charles Monger, indoda eneminyaka engama-68 ubudala evela phesheya, wafunyaniswa ukuba une-diffuse large B-cell lymphoma (DLBCL) kwiminyaka emithathu eyadlulayo. Wafuna unyango oluphambili kwiSibhedlele soMhlaza saseTianjin ngo-Agasti 2025. I-cervical lymph node biopsy yaqinisekisa ukuba kukho i-invasive B-cell lymphoma evela kwiziko le-germinal. I-Immunohistochemistry yayine-CD20, CD19, kunye ne-CD10, kunye nokubonakaliswa okuphezulu kwe-Bcl-6, Bcl-2 (70%+), kunye ne-c-MYC (60%+). Uvavanyo lwe-genetic lubonise ukulungelelaniswa kwe-BCL2 yi-FISH kunye nokuguqulwa kwe-EZH2, KMT2D, TNFRSF14, NRAS, kunye ne-TPMT genes—iimpawu ezihambelana neprofayili enobundlongondlongo, enomngcipheko ophezulu.

Uhambo Lonyango Lwangaphambili 

Ngo-Agasti 2025, uMnu. Monger wafumana i-pola edityaniswe ne-BTK inhibitor kunye ne-lenalidomide. Emva koko wenziwa i-FC (fludarabine + cyclophosphamide) lymphodepletion chemotherapy. Nangona le mizamo yayinzima, isifo sakhe saqhubeka singanyangeki, nto leyo eyabangela ukuba iqela lezonyango licebise unyango lweeseli ze-CD19/CD20 CAR-T zeBioocus ezimbini.

Ngomhla wesi-8 kuSeptemba, ngo-2025, uMnu. Monger wafumana utyando lweeseli ze-CD19/CD20 CAR-T ezizii-autologous. Okumangalisayo kukuba, wafumana amava angaqhelekanga. akukho cytokine release syndrome (CRS)kwaye i-immunotoxicity syndrome (i-ICANS) engenazo iziphumo zomzimba ezichaphazela iiseli—indlela egudileyo emva kokufakwa emzimbeni eyamvumela ukuba ahlale ezinzile kwaye enethemba ukususela ngomhla wokuqala.

Ulwandiso lweeSeli zeCAR-T: Lukhawuleza kwaye LuqinileUkuhlolwa kwegazi elijikeleze igazi kubonise ukwanda okumangalisayo kweeseli ze-CAR-T, okuqinisekisa ukufakelwa kunye nokwanda okugqwesileyo:

• D4 emva kokufakwa(Septemba 12): Iiseli ze-CAR19+ zaziyi-0.50% yeeseli ze-CD3+ T (ixabiso elipheleleyo yi-6.04 × 10⁷/L); iiseli ze-CAR20+ ziyi-0.41% (4.96 × 10⁷/L).
• D7(Septemba 15): I-CAR19+ inyuke yaya kwi-1.68% (1.40 × 10⁷/L); I-CAR20+ yaya kwi-1.63% (1.36 × 10⁷/L).
• D10(Septemba 18): I-CAR19+ ifikelelekile 43%iiseli ze-CD3+ T (ixabiso elipheleleyo 3.13 × 10⁸/L); i-CAR20+ ifikelelwe 32.74%(ixabiso elipheleleyo 3.26 × 10⁸/L).

I-Flow cytometry ibonise ngakumbi ukusasazwa okulinganayo kwii-CD4+ kunye nee-CD8+, kunye nokubonakaliswa okunamandla kwe-CAR kabini. Ii-Dynamic monitoring curves zibonise isigaba esicacileyo sokwandiswa kwe-exponential, ezibonisa ukuba uyilo lwe-CD19/CD20 ezimbini lukhuthaze ngempumelelo ukuqhubeka kwe-CAR-T kunye nokwanda kwayo emzimbeni.

Imeko yangoku kunye noNcedo oluxhasayo 

Kwingxelo yamva nje (D10), uMnu. Monger uyaqhubeka nokusebenza kakuhle ngokwezonyango. Usebenzisa amayeza omlomo alungiselelwe wena aquka i-acyclovir, i-compound sulfamethoxazole, i-orelabrutinib, i-lenalidomide, kunye neearhente ezixhasayo, kunye nokujonga rhoqo inani legazi, ukusebenza kwesibindi kunye nezintso, kunye neempawu zokuvuvukala ngokwesicwangciso sokukhupha.

Iqela leBioocus libonelele ngenkxaso epheleleyo, egxile kwizigulane kulo lonke ixesha: indawo yokuhlala ekhululekileyo, ukutya okunesondlo, uncedo lokuhamba, kunye neengcebiso zengqondo kuMnu. Monger kunye nosapho lwakhe. Le ndlela ipheleleyo yamnceda ukuba agxile ngokupheleleyo ekuchacheni.

Isigidimi Sethemba 

Ityala likaMnu. Monger libonisa amandla okuguqula iBioocus dual CD19/CD20 CAR-T therapy kwizigulana ezine-DLBCL ephinde yabuyela kwisimo sayo/engasasebenziyo. Ukwanda ngokukhawuleza nangokuqinileyo kweeseli zeCAR-T ngaphandle kwetyhefu eqatha kugxininisa iprofayili yokhuseleko olufanelekileyo lwemveliso kunye nomsebenzi onamandla wokulwa nethumba—nangona kwisigulana esikhulileyo esineempawu zeemolekyuli ezinobungozi obukhulu.

Siyazingca ngokuxhasa izigulane ezifana noMnu. Monger kuhambo lwazo lokubuyela empilweni. Amabali afana nelakhe aqinisa ukuzinikela kwethu ekunikezeni unyango lweeseli olutsha nolutshintsha ubomi ngononophelo lomntu ngamnye.

Eli tyala lixelwa ngemvume yesigulana. Iziphumo zinokwahluka; Iziphumo ze-CAR-T zixhomekeke kwibhayoloji yesifo ngasinye kunye nezinto zonyango. Ukuze ufumane ulwazi oluthe kratya okanye ukuphonononga iindlela zonyango, nceda undwendwele iphepha lethu le-CAR-T Therapy for Non-Hodgkin Lymphoma.