I-Multiple Myeloma(MM)-01

Ukubuyela esimeni esihle kwesigulana sasekhaya esine-multiple myeloma esine-CAR-T Therapy nangona singenazo iimpawu ze-BCMA

Isigulana esibhinqileyo esafunyaniswa sine-stage IIIA IgD-λ type multiple myeloma ngo-2018 safumana unyango lokuqala ikakhulu nge-bortezomib. Emva kwemijikelo emi-3, safumana i-complement remission (CR). Ngo-Okthobha ka-2018, senza i-autologous hematopoietic stem cell transplantation njengonyango lokuqinisa, kwalandela unyango lokugcina nge-lenalidomide. Ngo-Epreli ka-2020, esi sifo saphinda sabuya, kwaye senza imijikelo esi-7 yonyango lwesibini, nto leyo eyabangela ukuba singasebenzi kakuhle. Ukususela ngoDisemba ka-2020 ukuya ku-Epreli ka-2021, wafumana i-chemotherapy ikakhulu nge-daratumumab, kodwa i-bone marrow biopsy yabonisa ii-21.763% zeeseli ze-plasma ze-malignant monoclonal, ezine-serum free light chain λ kwi-1470 mg/L kunye ne-urine free light chain λ kwi-5330 mg/L. Ngeli xesha, wayesele egqibe unyango oluqhelekileyo nolutsha olufumanekayo ekhaya, kubandakanya nokufakelwa i-autologous stem cell transplantation, kunye nokungena kwi-CAR-T clinical trial yeyona ndlela iseleyo.

Ethunyelwe ngoogqirha basekuhlaleni, wafika kwiSibhedlele saseLudaopei ngoMeyi 10, 2021, enethemba lokubhalisa kuvavanyo lwabo lwezonyango lwe-BCMA CAR-T therapy kwi-multiple myeloma (MM). Emva kokungeniswa, wayekwimeko ebuthathaka enentlungu eqhelekileyo kunye nomkhuhlane ophindaphindiweyo. Uvavanyo olupheleleyo luqinisekisile "i-multiple myeloma, uhlobo lwe-λ light chain, i-ISS stage III, i-R-ISS stage III, i-mSMART high-risk group."

I-PET-CT scan ibonise ukwanda komsebenzi we-metabolic kwi-soft tissue density ngaphakathi kwe-bone marrow cavities ye-bilateral femurs kunye ne-tibias, nto leyo ebonisa ukubandakanyeka kwe-tumor. I-Bone marrow biopsy ibonise ii-60.13% zeeseli ze-plasma ze-monoclonal ezinobungozi ezingenayo i-BCMA.

Iziko lethu le-CGT lazise isigulana kunye nosapho lwaso malunga nokusebenza kakuhle konyango lwangoku lwe-BCMA-negative multiple myeloma, nangona lunokusebenza ngokutsho kwezinye iincwadi, kodwa alunazo iinkcukacha ezicacileyo. Emva kokucingisisa kakuhle, isigulana kunye nosapho lwaso bakhetha ukuqhubeka nesicwangciso sonyango.

Emva kokulungiswa kwangaphambili nge-FC regimen, iiseli ze-BCMA CAR-T zafakwa ngomhla woku-1 kweyeSilimela, ngo-2021, kwiSibhedlele saseLudaopei. Isigulana safumana umkhuhlane emva kokufakwa, owalawulwa kancinci kancinci ngonyango olunamandla lokulwa nosulelo kunye nonyango oluxhasayo. Emva kweentsuku ezilishumi elinesine emva kokufakwa, i-bone marrow biopsy ayizange ibonise iiseli ze-plasma ze-monoclonal eziseleyo. Emva kweentsuku ezingamashumi amathathu ananye emva kokufakwa, i-bone marrow biopsy yahlala ingenayo. I-Serum immunofixation yayingenayo, i-serum free light chain λ yayikwinqanaba eliqhelekileyo, kwaye i-serum M protein yayingenayo, nto leyo ebonisa ukukhululeka ngokupheleleyo kwesi sifo.

Okwangoku, emva kweenyanga ezingaphezu kwesi-8 emva kokufumana i-BCMA CAR-T cell infusion, isigulane sihlala siphilile ngokupheleleyo kwaye sichacha kakuhle kwaye sanelisekile kakhulu yimiphumo yonyango.