Unyango lwe-CD19 CAR-T oluphantsi lweSibhedlele iLu Daopei lubonisa iziphumo ezithembisayo kwizigulana ze-B-ALL
Kwisifundo esibalulekileyo esenziwa kwiSibhedlele iLu Daopei, abaphandi baxele ngenkqubela phambili ebalulekileyo kunyango lwe-refractory okanye i-relapse B acute lymphoblastic leukemia (B-ALL) kusetyenziswa unyango lwe-CAR-T cell olulawulwa yi-CD19 oluphantsi. Olu phononongo, olubandakanya izigulane ezingama-51, lutyhile ukuba le ndlela intsha ayiphumelelanga nje kuphela ekufumaneni amazinga aphezulu okukhululwa ngokupheleleyo (CR) kodwa ikwagcina iprofayili yokhuseleko efanelekileyo.
Iqela lophando, elikhokelwa nguGqr. C. Tong ovela kwiSebe leHematology kunye noGqr. AH Chang ovela kwiZiko loPhando lweKlinikhi kwiSikolo sezonyango seYunivesithi yaseTongji, baphande ngemiphumo yokunika idosi ephantsi yeeseli zeCAR-T—malunga ne-1 × 10^5/kg—xa kuthelekiswa needosi eziphezulu eziqhelekileyo. Le ndlela ijolise ekulinganiseni ukusebenza kakuhle konyango kunye nokunciphisa iziphumo ebezingalindelekanga ezibi, ngakumbi i-cytokine release syndrome (CRS).
Iziphumo zolu phando bezinomtsalane. Phakathi kwezigulane ezingama-42 ze-B-ALL ezingazange zikwazi ukuphinda zifumane unyango/ezaphinda zifumane unyango, ezingama-36 zifumene unyango lwe-CR okanye lwe-CR olungenakulinganiswa (i-CRi), ngelixa zonke izigulane ezilithoba ezine-minimum residue disease (MRD) zifikelele kwi-MRD negativity. Ngaphezu koko, uninzi lwezigulane lufumene unyango lwe-CRS oluncinci ukuya koluphakathi, kwaye amatyala anzima alawulwa ngempumelelo ngamaqhinga okungenelela kwangethuba.
UGqr. Tong ugxininise ukubaluleka kolu phononongo, esithi, "Iziphumo zibonisa ukuba unyango lweeseli ze-CD19 CAR-T olusebenzisa idosi ephantsi, olulandelwa kukufakelwa kweeseli ze-hematopoietic stem (allo-HCT), lubonelela ngonyango olusebenzayo kakhulu kwizigulana ezinezinye iindlela ezinqongopheleyo. Olu nyango aluniki nje kuphela amazinga aphezulu okusabela kodwa lukwanciphisa kakhulu umngcipheko weziphumo ezimbi kakhulu."
Impumelelo yolu phononongo igxininisa amandla onyango lweeseli ze-CAR-T ezenzelwe wena ekunyangeni izigulo ezintsonkothileyo zegazi. Isibhedlele iLu Daopei, esidume ngomsebenzi waso wokuqala kwi-cellular stomatitis. Unyango lwe-immunotherapy, iyaqhubeka nokukhokela ekuboneleleni ngonyango oluphambili kwizigulana ezineengxaki zegazi ezinzima.
Njengoko uphando luqhubeka, iqela lophando linethemba lokuphucula ngakumbi umthamo kunye neendlela zokusebenzisa ukuze kuphuculwe iziphumo zezigulane. Iziphumo zolu phononongo zipapashwe kwijenali I-Leukemia kwaye inika ithemba kubantu abane-B-ALL kwihlabathi liphela.