I-Acute Lymphoblastic Leukemia (T-ALL)-07

Intombazane yaseMiao ithola ukuphulukiswa okuphelele ngemva kokwelashwa nge-CAR-T ngemuva kokubuyela emuva kokufakelwa.

U-Amei, umfundi we-postgraduate waseHunan waseMiao, wayeshicilele amaphepha amabili e-SCI. Ngo-Ephreli 2, 2020, wangeniswa esibhedlela sesifundazwe ngenxa yomkhuhlane ophindaphindayo. Ukuhlolwa komnkantsha kwathola ukuthi une-acute lymphoblastic leukemia (T-ALL). Ngemva kwezifundo eziningi ze-chemotherapy esibhedlela sangaphandle, umnkantsha wakhe wahlala usesimweni esingcono. NgoNovemba 2, 2020, wafakelwa i-allogeneic hematopoietic stem cell esibhedlela sethu (umfowabo nodadewabo, i-HLA 7/10 match). Ngemva kokufakelwa, amangqamuzana afakwa ngempumelelo, futhi ukuhlolwa komnkantsha okulandelayo kwabonisa ukuphulukiswa okuqhubekayo.

Ngomhlaka-16 Juni 2021 (izinyanga ezingu-7 ngemuva kokufakelwa), ukuhlolwa okuvamile kwembula ukubuyela emuva kwe-leukemia yakhe. Ukwelashwa ngamakhemikhali okwalandela kwehlulekile ukulawula lesi sifo, futhi waba nokutheleleka kwe-pneumonia kanye ne-herpes virus, kanye nezilonda zomlomo ezibuhlungu ezenza kwaba nzima ukugwinya. Wangeniswa ewadini lesibili lomnyango we-hematology futhi wabhaliswa esivivinyweni somtholampilo se-CD7 CAR-T.

Ithimba lezokwelapha linikeze ukwelashwa okusebenzayo kokulwa nokutheleleka, ukuqeda ubuhlungu, kanye nokumpontshelwa igazi nama-platelet amaningi. Ngenxa yomthwalo omkhulu wesimila (ukuqhuma okungu-80% emnkantsheni wamathambo kanye nokuqhuma okungu-97% egazini elingaphandle), kwakungenakwenzeka ukuqoqa amangqamuzana akhe. Ama-lymphocyte egazi angaphandle avela kumnikeli (umfowabo) aqoqwa futhi athunyelwa enkampanini ye-biotech yokukhulisa amangqamuzana e-CAR-T.

Ngomhlaka-10 Agasti 2021, amaseli e-CD7 CAR-T athathwe ngabanikeli aphinde afakwa. Ngemva kokufakwa kabusha, amaseli e-CAR-T anda afinyelela ku-54.64% egazini elingaphandle, enomkhuhlane kuphela futhi engenayo i-significant cytokine release syndrome (CRS) noma isifo se-graft-versus-host (GVHD). Ukuhlolwa komnkantsha ngosuku lwe-16 ngemuva kokufakwa kabusha kwabonisa ukuphulukiswa okuphelele, ngamaseli e-CAR-T angu-54.13% emnkantsha. Ngosuku lwama-36, umnkantsha waqhubeka nokubonisa ukuphulukiswa okuqhubekayo. Njengamanje, isimo sakhe sengqondo, ubuthongo, kanye nesifiso sokudla kuhle, futhi uyalulama kahle.