I-Myeloma eNinzi ene-Extramedullary Plasmacytoma

Le yimeko yesigulana esineminyaka engama-73 ubudala esifunyaniswe sine-multiple myeloma, esiyinkimbinkimbi kukubakho kwe-extramedullary plasmacytoma. Kuyo yonke inkqubo yonyango ngeDara-VRD (Daratumumab, Bortezomib, Lenalidomide, Dexamethasone), i-extramedullary plasmacytoma yaqhubeka, ibangela iintlungu ezinkulu kunye nokungonwabi kwisigulana.

Xa kujongwa indlela esi sifo esihlasela ngayo kunye nokungabikho kwempendulo kunyango oluqhelekileyo, isigulana sabhaliswa kuvavanyo lweklinikhi lonyango lweeseli ze-BCMA CAR-T. Emva kokuthatha amanyathelo okulungiselela ayimfuneko, kuquka ukususwa kwe-lymphocyte, isigulana safumana utyando lweeseli ze-BCMA CAR-T.

Okumangalisayo kukuba, kwiintsuku ezili-10 emva kokufakwa, isigulane safumana impendulo ye-cytokine release syndrome (CRS) yenqanaba lesibini, nto leyo ebonisa ukusebenza okuqinileyo komzimba. Ukongeza, kwakukho i-CRS ebonakalayo kwindawo ye-extramedullary plasmacytoma.

Okumangalisa ngakumbi kukuba ngeli xesha lifutshane, isilonda esingaphandle kwe-medullary esasinganyangeki kunyango ngaphambili, esasibonakalise ukuba asinyangeki kwiindlela ezininzi ze-chemotherapy, ii-agents ezijoliswe kuzo, kunye nee-antibodies ze-monoclonal, sanyamalala ngokupheleleyo. Isigulana safumana ukuphumla okupheleleyo, nto leyo eyaphawula impumelelo yonyango.

Kuyo yonke inkqubo yonyango, iqela lezonyango lalijonga ngokusondeleyo isigulana ukuze libone naziphi na iimpawu zeziphumo ezibi kwaye labonelela ngonyango olupheleleyo oluxhasayo. Oku kuquka ukulawula iimpawu ze-CRS kunye nokujongana nazo naziphi na ezinye iingxaki ezinxulumene nonyango.

Njengoko unyango luqhubeka, iqela lezonyango laqhubeka nokujonga ngokusondeleyo indlela isigulane esisabela ngayo kunyango lweeseli ze-BCMA CAR-T. Uvavanyo oluqhelekileyo lwenziwe ukuze kuvavanywe ukusebenza kakuhle konyango kunye nokujongana nazo naziphi na iziphumo ebezingalindelekanga ezivelayo ngokukhawuleza.

Emva kokuphumelela okumangalisayo kokuxolelwa ngokupheleleyo, umgangatho wobomi besigulana uphucuke kakhulu, ngokukhululeka kwiintlungu kunye nokungonwabi okunxulunyaniswa ne-extramedullary plasmacytoma. Njengoko isifo silawulwa, isigulana sakwazi ukuqhubeka nemisebenzi yemihla ngemihla kwaye sonwabele impilo-ntle engcono iyonke.

Ngaphezu koko, siqonda ukubaluleka kokhathalelo oluhlala ixesha elide, iqela lethu lezonyango laqhubeka libandakanyeka ngokukhutheleyo kuhambo lwesigulana emva konyango. Kwacwangciswa amaxesha okulandela rhoqo ukuze kujongwe imeko yesigulana, kuvavanywe ukuqina kwempendulo yonyango, kwaye kujongwane nayo nayiphi na imiphumo enokubakho yokubuyela umva okanye ukuqala kade kwesifo.

Ukongeza ekulandeleni unyango, iziko lethu libonelele ngeenkonzo ezipheleleyo zokuxhasa isigulana ukuba silungelelane nobomi emva konyango. Oku kuquka ukufikelela kwiinkonzo zokunika iingcebiso, iinkqubo zokubuyisela kwimeko yesiqhelo, kunye nezixhobo zemfundo ukunceda isigulana kunye nosapho lwaso bakwazi ukusinda baze baphile ubomi obusempilweni.

Isiphumo esiphumeleleyo sale meko asibonisi nje kuphela ukusebenza kakuhle konyango lweeseli ze-BCMA CAR-T ekunyangeni i-refractory multiple myeloma kodwa sikwagxininisa ukubaluleka kokhathalelo lomntu ngamnye nolwezifundo ezahlukeneyo ekulawuleni izigulana ezintsonkothileyo ze-hematologic. Ukuzibophelela kwethu ekuboneleleni ngenkxaso eqhubekayo kunye nokhathalelo olulandelayo kubonisa ukuzinikela kwethu ekuqinisekiseni iziphumo ezilungileyo kwizigulana zethu ngaphaya kwesigaba sonyango.

Ngaphambi kunye neenyanga ezi-3 emva kokufakwa