I-Diffuse large B-cell lymphoma (DLBCL)-04

Impendulo Emangalisayo KaMnu. Monger Yasekuqaleni: Ukwelashwa Okubili Kwe-CD19/CD20 CAR-T Kuletha Ithemba Elisha Le-DLBCL Ebuye Ibuyele Emuva

Isizinda Sesiguli 

URodney Charles Monger, indoda eneminyaka engu-68 ubudala evela phesheya kwezilwandle, watholakala ene-diffuse large B-cell lymphoma (DLBCL) eminyakeni emithathu edlule. Wafuna ukunakekelwa okuthuthukisiwe eSibhedlela Somdlavuza saseTianjin ngo-Agasti 2025. I-biopsy ye-cervical lymphoma yaqinisekisa ukuthi i-invasive B-cell lymphoma evela esikhungweni se-germinal center. I-Immunohistochemistry yayine-CD20, CD19, kanye ne-CD10, enokubonakaliswa okuphezulu kwe-Bcl-6, Bcl-2 (70%+), kanye ne-c-MYC (60%+). Ukuhlolwa kwezakhi zofuzo kwembule ukuhlelwa kabusha kwe-BCL2 yi-FISH kanye nokuguqulwa kwezakhi zofuzo ku-EZH2, KMT2D, TNFRSF14, NRAS, kanye ne-TPMT—izimpawu ezihambisana nephrofayili enolaka neyingozi enkulu.

Uhambo Lokwelashwa Ngaphambili 

Ngo-Agasti 2025, uMnu. Monger wathola i-pola ehlanganiswe ne-BTK inhibitor kanye ne-lenalidomide. Wabe esethola i-FC (fludarabine + cyclophosphamide) lymphodepletion chemotherapy. Naphezu kwale mizamo, isifo sakhe saqhubeka singaguquki, okwenza ithimba lezokwelapha lancoma ukwelashwa kwamaseli e-CD19/CD20 CAR-T okuqondiswe kabili yi-Bioocus.

NgoSepthemba 8, 2025, uMnu. Monger wathola ukufakwa kwamaseli e-CD19/CD20 CAR-T e-autologous. Okuphawulekayo ukuthi wabhekana nobunzima bokubhekana nokucindezeleka. i-non cytokine release syndrome (CRS)futhi i-non immune effect cell-associated neurotoxicity syndrome (ICANS)—inkambo ebushelelezi ngemuva kokumnika eyamvumela ukuthi ahlale eqinile futhi enethemba kusukela ngosuku lokuqala.

Ukwandiswa Kweseli le-CAR-T: Kuyashesha Futhi KuqinileUkuqapha igazi elingaphandle kubonise ukwanda okumangalisayo kwamaseli e-CAR-T, okuqinisekisa ukuxhunyelelwa kanye nokwanda okuhle kakhulu:

• D4 ngemva kokufakwa(Septhemba 12): Amaseli e-CAR19+ ayengu-0.50% wamaseli e-CD3+ T (inani eliphelele lingu-6.04 × 10⁷/L); amaseli e-CAR20+ angu-0.41% (4.96 × 10⁷/L).
• D7(Septhemba 15): I-CAR19+ ikhuphuke yafika ku-1.68% (1.40 × 10⁷/L); I-CAR20+ yafika ku-1.63% (1.36 × 10⁷/L).
• D10(Septhemba 18): I-CAR19+ ifinyelelwe 43%amaseli e-CD3+ T (inani eliphelele 3.13 × 10⁸/L); kufinyelelwe ku-CAR20+ 32.74%(inani eliphelele 3.26 × 10⁸/L).

I-Flow cytometry ibonise ukusatshalaliswa okulinganiselayo kuzo zonke izinhlobo ze-CD4+ kanye ne-CD8+, ngokubonakaliswa okuqinile kwe-CAR ekabili. Ama-Dynamic monitoring curves abonise isigaba sokukhula esicacile, okubonisa ukuthi ukwakheka kwe-CD19/CD20 ekabili kukhuthaze ngempumelelo ukuphikelela kwe-CAR-T kanye nokwanda kwayo emzimbeni.

Isimo Samanje Nokunakekelwa Okusekelayo 

Ekulandeleni kwakamuva (D10), uMnu. Monger uyaqhubeka nokwenza kahle ngokwezokwelapha. Usebenzisa umuthi ophuzwayo oklanyelwe wena ohlanganisa i-acyclovir, i-compound sulfamethoxazole, i-orelabrutinib, i-lenalidomide, kanye nemithi esekelayo, ngokuqapha njalo inani legazi, ukusebenza kwesibindi nezinso, kanye nezimpawu zokuvuvukala njengoba kuchazwe ohlelweni lokukhipha.

Ithimba le-Bioocus linikeze ukwesekwa okuphelele, okugxile esigulini kulo lonke: indawo yokuhlala ekhululekile, ukudla okunomsoco, usizo lokuhamba, kanye nokwelulekwa kwengqondo kuMnu. Monger nomndeni wakhe. Le ndlela ehlanganisa konke yamsiza ukuba agxile ngokuphelele ekululameni.

Isigijimi Sethemba 

Icala likaMnu. Monger libonisa amandla okuguqula e-Bioocus dual CD19/CD20 CAR-T therapy ezigulini ezine-DLBCL ephinde yabuya/engasasebenzi. Ukwanda okusheshayo nokuqinile kwamaseli e-CAR-T ngaphandle kobuthi obukhulu kugqamisa iphrofayili yokuphepha enhle yomkhiqizo kanye nomsebenzi onamandla wokulwa nomdlavuza—ngisho nasesigulini esikhulile esinezici zama-molecule eziyingozi kakhulu.

Siyaziqhenya ngokusekela iziguli ezinjengoMnu. Monger ohambweni lwazo lokubuyela empilweni. Izindaba ezifana nezakhe ziqinisa ukuzibophezela kwethu ekuletheni izindlela zokwelapha zamaseli ezintsha nezishintsha impilo ngokunakekelwa komuntu siqu.

Leli cala libikwa ngemvume yesiguli. Imiphumela ingahluka; Imiphumela ye-CAR-T incike kubhayoloji yesifo ngasinye kanye nezici zezokwelapha. Ukuze uthole ulwazi olwengeziwe noma ukuhlola izinketho zokwelapha, sicela uvakashele ikhasi lethu le-CAR-T Therapy for Non-Hodgkin Lymphoma.