I-Acute Lymphoblastic Leukemia (T-ALL)-04

Isiguli sasiyindoda eneminyaka engu-15 ubudala, satholakala sinesifo se-T-cell acute lymphoblastic leukaemia (i-T-ALL ene-STIL-TAL1 positivity, i-gene embi yokubikezela) ekupheleni kukaDisemba 2020, futhi selashwa esibhedlela sendawo ngemijikelezo eminingi ye-chemotherapy ejwayelekile ukuze kutholakale ukuphulukiswa okuphelele. Ukufakelwa kwe-hemizygous haematopoietic stem cell kusuka kuyise kuya endodaneni kwenziwa ngomhlaka-2 Juni 2021, kodwa ngeshwa ukuphinda kwe-bone marrow kwatholakala ezinyangeni ezi-3 ngemuva kokufakelwa, kanti umjikelezo owodwa we-chemotherapy awuzange uphumelele. Ngesikhathi esifanayo, waba nezihlathi ezivuvukele kanye nokuvuza komoya, amakhona agwegwile omlomo, kanye nokubhoboza kwe-lumbar kwasikisela ukuthuthukiswa kwe-central nervous system leukaemia.

I-T-ALL ene-STIL-TAL1 positivity, ukuphinda iqale kabusha ngemva kokufakelwa i-allogeneic, kuhlanganiswe ne-central nervous system leukemia, kuyicala elinzima kakhulu ukwelapha kule nkathi ngaphandle kwe-CAR-T. Uyise wengane wabuza ngomnyango we-hematology e-Tianjin Cancer Hospital Airport Hospital ngabangani bakhe. Ngemva kokuxhumana okuningiliziwe, beza e-Tianjin Cancer Hospital Airport Hospital, befuna ukubhalisa esivivinyweni sezokwelapha se-CAR-T njengomzamo wokugcina.

Amaseli okuqala e-CAR-T ahlulekile ukukhiqiza i-Tumor anda ngokushesha, ebeka impilo yakhe engozini.

Ngomhlaka-26 Okthoba 2021, isiguli sangeniswa ewadini yokuqala yoMnyango Wezokwelapha Ngegazi. Ngenxa yokwanda okusheshayo kwamaseli esimila, isiguli senziwe i-chemotherapy ukuze kuncishiswe umthwalo wesimila futhi sathola i-chemotherapy yangaphakathi kwe-thecal. Uketshezi lwe-cerebrospinal aluzange lubonise isifo esisele. Ngemva kokuzinza, ama-lymphocyte kayise aqoqwa ukuze kukhuliswe amaseli e-CAR-T. Ngomhlaka-19 Novemba, amaseli e-CD7 CAR-T anikelwayo afakwa esigulini.

Ezinsukwini ngemva kokufakwa, ngaphambi kokwanda kwamaseli e-CAR-T, amaseli esimila aphinde anda ngokushesha, kwabonakala ukuqhuma okuningi egazini elingaphandle, okubonisa ukwehluleka kokwelashwa kokuqala kwe-CAR-T.

Ngalesi sikhathi, iSibhedlela Sezindiza saseTianjin Cancer Hospital sasenza isivivinyo sezokwelapha se-universal CAR-T (CD7 UCAR-T) se-acute T-lymphoblastic leukaemia. Abazali bazwakalise ukuphuthuma okukhulu, bathi bazofuna ngisho nethuba elingu-1% lengane yabo. Ithimba lezokwelapha lixoxisane nomndeni futhi lanquma ukubhalisa isiguli esivivinyweni sezokwelapha se-CD7 UCAR-T.

Ukukhululwa okuphelele ngemva kwe-CD7 UCAR-T Now izinyanga ezimbili ngemuva kokufakelwa.

Ngomhlaka-2 Disemba, isiguli sathola ukufakwa kweseli le-CD7 U-CART kanye nokwelashwa kokunciphisa umthwalo wesimila kanye nokunakekelwa okusekelayo. Ngemva kokumpontshelwa, sabhekana nomkhuhlane ophakeme isikhathi eside kanye nokudinwa. Ngokusekelwa kokulwa nokutheleleka kanye nomswakama, izimpawu zakhe zokuphila zaqina futhi izinga lokushisa lomzimba labuyela esimweni salo esijwayelekile.

Ukuhlolwa komnkantsha wamathambo kanye noketshezi lomgogodla ezinsukwini ezingu-18 no-28 ngemuva kwe-CAR-T kuqinisekisile ukuphulukiswa okuphelele ngenxa yokungabi nandaba kwe-MRD. Isimo sengane sathuthuka kakhulu amandla ayo abuya, isifiso sokudla sabuya, kanti unina—owayekhathazekile ngaphambili—waphinde waba nethemba.

Njengamanje, isiguli sesike sahlolwa okwesibili kwe-haploidentical HSCT eTianjin Cancer Hospital Airport Hospital futhi sisalokhu sikhululekile ngokuphelele ezinyangeni ezimbili ngemuva kokufakelwa.