Nkk. Siti ---- Ukusabalalisa i-Large B-cell Lymphoma (DLBCL)

UNkk. Siti, owesifazane wase-Indonesia oneminyaka engu-58 ubudala, watholakala ene-follicular lymphoma engazweli emithini eyaphenduka kamuva yaba yi-diffuse large B-cell lymphoma (DLBCL). Naphezu kokwelashwa komugqa wesine, isimila sakhe saqhubeka nokukhula kwaso, sakha inqwaba enkulu enemiphumela yokucindezela. Ngeshwa, izinkinga zavela lapho eba nokopha ebuchosheni ngemuva kokwelashwa nge-bridging, okwenza isimo sakhe saba nzima nakakhulu.

Ngenxa yobunzima besifo sakhe kanye nezinketho zokwelapha ezilinganiselwe ezitholakalayo, uNkk. Siti wabhaliswa esivivinyweni somtholampilo sokwelashwa kwamaseli e-CD19+22 CAR-T ngemuva kwezinqubo ezidingekayo zangaphambi kokwelashwa. Kodwa-ke, ukuhlolwa kokuqala ngosuku lwe-7 kwembule ukwanda okuncane kwamaseli e-CAR-T, okubonisa ukuntuleka kokusebenza kahle kokwelapha. Ukuhlolwa okulandelayo ngosuku lwe-14 kanye nosuku lwama-21 kubonise ukuthuthuka okuqhubekayo, kodwa ukwelashwa kwehluleka ukufeza ukusebenza kahle okufiswayo.

Kuwo wonke uhambo lwakhe lokwelashwa, ukuqina nokuzimisela kukaNkk. Siti kwakhanya kakhulu. Naphezu kokubhekana nezingqinamba eziningi, wabhekana nenselele ngayinye ngesibindi esingaguquki kanye nethemba. Njengoba isivivinyo sezokwelapha siqhubeka, ithimba lezokwelapha laliqaphelisise indlela uNkk. Siti asabela ngayo ekwelashweni. Balungisa indlela yokwelapha njengoba kudingeka, baqinisekisa ukuthi uthola ukunakekelwa okungcono kakhulu okufanela izidingo zakhe zomuntu ngamunye. Naphezu kokuphazamiseka kokuqala, ukuthuthuka kancane kancane ekukhulisweni kwamaseli e-CAR-T kwanikeza ukukhanya kwethemba lomphumela omuhle.

Ngosuku lwama-28, lapho uNkk. Siti eba nokusabela okukhulu komzimba, ithimba lezokwelapha laqala ukusebenza, laphatha ngokushesha i-cytokine release syndrome futhi lanikeza ukunakekelwa okusekelayo okudingekayo. Ubuchwepheshe babo kanye nokungenelela okusheshayo kwaba usizo ekuqiniseni isimo sakhe kanye nokuvula indlela yentuthuko eyengeziwe.

Ngosuku lwama-35, impumelelo emangalisayo yokuxolelwa yayiyisibonakaliso sokuqina kukaNkk. Siti kanye nemizamo ehlangene yethimba lezokwelapha. Uhambo lwakhe aluzange lugcizelele kuphela amandla okwelashwa ngamaseli e-CAR-T kodwa futhi lwagcizelela ukubaluleka kokubekezela nokunakekelwa komuntu siqu ekubhekaneni nezimo zezokwelapha eziyinkimbinkimbi.

UNkk. Siti uzwakalise ukubonga kwakhe ngokunakekelwa ngesihawu akutholile, egcizelela umthelela wokusekelwa yithimba lezokwelapha ohambweni lwakhe lokululama. "Ngibonga kakhulu ngokuzinikela kanye nolwazi lwethimba lami lezokwelapha," ephawula. "Ukusekela kwabo okungantengantengi kwanginika amandla ngezikhathi ezinzima, futhi ngihlala ngibonga ngokuzibophezela kwabo enhlalakahleni yami."

Icala likaNkk. Siti lisebenza njengesibonelo esikhuthazayo sokuzinza nethemba lapho ubhekene nobunzima. Umphumela wakhe ophumelelayo ugcizelela amandla okuguqula ezindlela zokwelapha ezintsha kanye nendima ebalulekile yemithi eyenzelwe wena uqobo ekuthuthukiseni imiphumela yeziguli.