I-lymphoma enkulu ye-B-cell (DLBCL)-03 isakazeka

NgoMashi 2021, uMnu. Wang (igama elingamanga) ngokuzumayo wezwa ubuhlungu besisu esingezansi kwesokudla, ekuqaleni waphambaniswa nobuhlungu besisu, futhi akazange afune usizo lwezokwelapha ngokushesha. Ezinyangeni ezimbili ezalandela, wabhekana nezimpawu zobuhlungu besisu esingezansi kwesokudla ngokuphindaphindiwe, okwamenza wafuna usizo lwezokwelapha esibhedlela sendawo. I-CT scan yembula ukukhubazeka kumathumbu amakhulu kanye nokwanda kwama-lymph node e-retroperitoneal.

Odokotela batusa i-colonoscopy kanye ne-biopsy ukuze kutholakale okunye ukuxilongwa, okuqinisekisa ukuthi "i-diffuse large B-cell lymphoma," isimila esibi esaziwa kakhulu ngokuthi i-lymphoma. I-PET-CT iphinde yaqinisekisa ukuthi izilonda ezisakazekile ze-nodular hypermetabolic emzimbeni wakhe wonke, ezinkulu kunazo zonke ezilinganiselwa ku-4.3*4.1*4.5cm.

Ngokusekelwa ngumndeni wakhe, uMnu. Wang wenziwa imijikelezo emine ye-R-CHOP chemotherapy. I-PET-CT elandelwayo ngemuva kwe-chemotherapy yabonisa ukuphulukiswa okuyingxenye.

Kodwa-ke, ukwelashwa okulandelayo kwaholela ezinkingeni ezinkulu kuMnu. Wang, njengokuvaleka kwamathumbu, ukubhoboka, kanye ne-peritonitis ebukhali. Odokotela abahlinzayo bamathumbu kanye nodokotela ababemsiza babambisana ohlelweni lokuhlinzwa, benza ukususwa kwamathumbu amakhulu kanye nokuphuma kwamanzi, kanye nokunakekelwa okusekelayo okunezimpawu, belawula ngempumelelo izimpawu zakhe zesisu.

Ukuhlolwa kwe-PET-CT okulandelayo kwembule ukwanda kwezilonda zesimila kanye nosayizi. Ukuze kuqedwe kangcono amaseli esimila, odokotela balungisa uhlelo oluqinisiwe lwe-chemotherapy futhi batusa ukufakelwa kwamaseli e-hematopoietic stem.

Ebhekene nochungechunge lwezinkinga, uMnu. Wang wabhekana nokuhlupheka okukhulu ngokomzimba nangokomzwelo njengoba isimo sakhe sasiba sibi kakhulu. Ukungena kwesimila kwabonakala ezindaweni eziningi, kanye nezilonda ezintsha ze-multifocal nodular hypermetabolic ezandisa kakhulu indawo yomdlavuza. Ngenxa yezimila emzimbeni wakhe wonke, uMnu. Wang wahlushwa ubuhlungu obungapheli bomzimba, okwenza kwaba nzima ngaye ukulala phansi nokulala ngenxa yobuhlungu.

Ephelelwe yithemba, uMnu. Wang wafunda ngokwelashwa kwe-CAR-T, i-CAR-T cell immunotherapy entsha eyenzelwe ngqo iziguli ezine-B-cell lymphoma ephinde yabuyela esimweni sayo noma engaphikisi.

Ngaphambi kokwelashwa nge-CAR-T, i-lymph node biopsy esifundeni se-inguinal kwesokudla yabonisa ukuthi i-CD19 kanye ne-CD20 ziphilile, okunikeza izinhloso eziqondile zokwelashwa kwamaseli e-CAR-T. UProfesa Yu wahlela ukuhlolwa okuningiliziwe ngokomzimba, okwaholela ekuthuthukisweni kohlelo lokwelashwa lwe-CAR-T oluqondene noMnu. Wang.

Ngomhlaka-25 kuJulayi 2022, uMnu. Wang wathola ukufakwa kweseli le-CD19/20 CAR-T esibhedlela, inqubo ihamba kahle. Ukuqapha okuseduze kanye nokunakekelwa okuqinile kokusekela kulawula ukusabela okubi ngemva kokufakwa ngaphandle kwezinkinga ezisongela ukuphila.

Esikhathini esingaphansi kwezinyanga ezintathu, ngomhlaka-10 Okthoba 2022, ukuhlolwa kwe-PET-CT okulandelayo kwaqinisekisa ukuphumula okuphelele, kanti ukuhlolwa okuphelele kwabonisa ukuthuthuka okukhulu esimweni sakhe sempilo.

Ngesikhathi sokulandelela okulandelayo, uMnu. Wang wayevame ukwenza i-CT, i-MRI, noma i-PET-CT scan, konke okuqinisekisa isimo sakhe sokululama ngokuphelele. Njengamanje, impilo yakhe isalokhu iyinhle, idlula isikhathi sokululama okuphelele sezinyanga ezingaphezu kwe-14.