I-Junaid----I-Acute B-lymphocytic Leukemia (B-ALL)

Ukufakelwa umnkantsha wethambo wesivivinyo se-CAR-T kwenza isifo se-B-ALL esingalapheki esigulini e-BIOOCUS Medical Group singabi naso.

Eminyakeni emihlanu edlule, uJunaid wayengumfundi ePakistan Medical University, egcwele izifiso zokuba udokotela. Kodwa ngoMeyi 2014, kwatholakala ukuthi unesifo se-B-lymphocytic leukaemia esibi futhi kwadingeka ayeke izifundo zakhe.

Welashwa endaweni isikhathi esingaphezu kweminyaka emibili. NgoJanuwari 2018, waphinde waba nobuhlungu emathanjeni omzimba futhi ukuhlolwa komnkantsha kwabonisa ukuthi usebuyele esimweni sakhe. Ngemva kwenkambo yesibili yokwelashwa ngamakhemikhali esibhedlela sendawo, akakwazanga ukuthola ukuphulukiswa futhi lesi sifo sase siqhubekele phambili. Ngokuseshwa kwe-inthanethi kanye nezincomo zezinye iziguli, banquma ukuza esikhungweni sethu se-CGT ukuze bathole isivivinyo sezokwelapha se-CART kanye ne-BMT.

Ngomhlaka-26 Mashi 2018, uJunaid nomndeni wakhe bafika eShayina futhi bangeniswa emnyangweni we-hematology jikelele. UDkt. wenza ukuhlolwa okuphelele kukaJunaid. Imibiko ibonise ukuthi umthwalo wokuqhuma komnkantsha wawuphezulu ngamaphesenti angu-69 futhi wayenezifo zesikhunta zamaphaphu. Ngemva kokwelashwa ngokucophelela, isiguli sasisesimweni esizinzile. Ngomhlaka-24 Ephreli 2018, uJunaid waphinde wafakwa amaseli amabili e-CD19 kanye ne-CD22 CAR-T. Ngemva kwamasonto amabili, inani lamaseli okuqhuma komnkantsha lalingu-0. Ukumamatheka kwabuyela emndenini kaJunaid. UJunaid wayezobhekana ne-BMT ukuze angabi nazifo.

Ngomhlaka-25 Juni 2018, uDkt. woMnyango we-BMT wenza i-BMT yomfowabo kaJunaid. Umnikeli kaJunaid ngumfowabo omncane. ngomhlaka-6 Julayi, iseli le-peripheral peripheral lomnikeli lafakwa kuJunaid, ngemuva kwezinsuku ezingu-17 ukufakelwa kwamangqamuzana amhlophe egazi kwaqedwa futhi wasuka ewadini lokugeleza kwe-laminar. Ngemuva kwezinsuku ezingu-24, uhlobo lwakhe lomnkantsha lufana ngokuphelele nohlobo lomnkantsha lomnikeli. Ukubuyekezwa kombiko osele womnkantsha wethambo akukuhle, akukho zinkinga zokuqala ezihlobene nokufakelwa. Ngomhlaka-6 Agasti 2018, uJunaid wakhishwa esibhedlela waqala ukulandelwa kweziguli zangaphandle.

Inhlangano yegazi yaseShayina iyisisekeli esiqinile sesiguli. UJunaid une-RH negative blood type, okuwuhlobo lwegazi olungavamile. Wamukela ukunikela ngegazi mahhala "uLang Fang rare blood type alliance" izikhathi eziningi ngesikhathi elaliswe esibhedlela. Kuye akubonakali sengathi kukhona ukushoda kwegazi, uJunaid nomndeni wakhe bayakwazisa kakhulu isikhungo samazwe ngamazwe ngokwenza konke lokhu kuJunaid. Phakathi naleso sikhathi, abasebenzi besikhungo samazwe ngamazwe baphelekezele uJunaid nomndeni wakhe kusukela befika kuze kube manje, babanikeza konke ukwesekwa kokuphila futhi basiza umndeni ukuba unqobe isithiyo solimi.

Isivivinyo sezokwelapha se-CAR-T sixhumanisa i-BMT ukuze senze esinye isimangaliso. UJunaid ungowesibili one-B-lymphocytic leukaemia ebukhali futhi engaphikisi futhi evela ePakistan ukuthola ukwelashwa kwe-CAR-T Bridge BMT. Ukuphuma kukaJunaid ngempumelelo esibhedlela futhi kuphawula ukuqashelwa emhlabeni wonke kobuchwepheshe obuthuthukisiwe besibhedlela sethu bokufakelwa kwebhuloho le-CAR-T.