I-Myeloma Eningi ene-Extramedullary Plasmacytoma

Lesi yisimo sesiguli sesilisa esineminyaka engu-73 ubudala esitholakale sine-multiple myeloma, esiyinkimbinkimbi ngokuba khona kwe-extramedullary plasmacytoma. Kuyo yonke inkambo yokwelashwa nge-Dara-VRD (Daratumumab, Bortezomib, Lenalidomide, Dexamethasone), i-extramedullary plasmacytoma yaqhubeka, yabangela ubuhlungu obukhulu kanye nokungakhululeki esigulini.

Uma sibheka isimo esibi salesi sifo kanye nokuntuleka kwempendulo ekwelashweni okuvamile, isiguli sabhaliswa ocwaningweni lwezokwelapha lwe-BCMA CAR-T cell therapy. Ngemva kokuthatha izinyathelo zokulungiselela ezidingekayo, okuhlanganisa nokususwa kwe-lymphocyte, isiguli sathola ukufakwa kwamaseli e-BCMA CAR-T.

Okuphawulekayo ukuthi zingakapheli izinsuku eziyi-10 ngemva kokufakwa, isiguli sathola impendulo ye-cytokine release syndrome (CRS) yezinga lesibili, okubonisa ukusebenza okuqinile kwamasosha omzimba. Ngaphezu kwalokho, kwakukhona i-CRS ebalulekile endaweni lapho i-extramedullary plasmacytoma yayikhona.

Okumangaza nakakhulu ukuthi phakathi nalesi sikhathi esifushane, isilonda sangaphandle kwe-medullary esasingamelani nokwelashwa ngaphambili, esasibonakalise ukuthi singamelani nemithi eminingi ye-chemotherapy, ama-agent aqondiwe, kanye nama-antibodies e-monoclonal, sanyamalala ngokuphelele. Isiguli sathola ukuphulukiswa okuphelele, okwaphawula impumelelo yokwelashwa.

Kuyo yonke inqubo yokwelashwa, ithimba lezokwelapha laliqapha isiguli ngokucophelela ukuthola noma yiziphi izimpawu zokusabela okubi futhi lanikeza ukunakekelwa okuphelele okusekelayo. Lokhu kwakuhlanganisa ukuphatha izimpawu ze-CRS kanye nokubhekana nanoma yiziphi ezinye izinkinga ezihlobene nokwelashwa.

Njengoba ukwelashwa kuqhubeka, ithimba lezokwelapha laqhubeka nokuqapha eduze impendulo yesiguli ekwelashweni kwamaseli e-BCMA CAR-T. Kwenziwa ukuhlolwa okuvamile ukuze kuhlolwe ukusebenza kahle kokwelashwa kanye nokubhekana nanoma yimiphi imiphumela emibi evelayo ngokushesha.

Ngemva kokuthola ukuphulukiswa okuphelele okuphawulekayo, ikhwalithi yokuphila kwesiguli yathuthuka kakhulu, ngokukhululeka kobuhlungu nokungakhululeki okuhlobene ne-extramedullary plasmacytoma. Njengoba lesi sifo silawulwa, isiguli sakwazi ukuqhubeka nemisebenzi yansuku zonke futhi sajabulela inhlalakahle engcono iyonke.

Ngaphezu kwalokho, siqaphela ukubaluleka kokunakekelwa kokulandelela kwesikhathi eside, ithimba lethu lezokwelapha laqhubeka lihilelekile ohambweni lwesiguli ngemuva kokwelashwa. Kwahlelwa ama-aphoyintimenti okulandelela njalo ukuze kuqashwe isimo sesiguli, kuhlolwe ukuqina kwempendulo yokwelashwa, futhi kulungiswe noma yikuphi ukubuyela emuva okungenzeka noma imiphumela emibi eqala sekwephuzile.

Ngaphezu kokulandelwa kwezokwelapha, isikhungo sethu sinikeze izinsizakalo eziphelele zokusekela ukusiza isiguli ukuthi sijwayele impilo yangemva kokwelashwa. Lokhu kuhlanganisa ukufinyelela izinsizakalo zokwelulekwa, izinhlelo zokuvuselela, kanye nezinsiza zemfundo ukusiza isiguli nomndeni waso ukuthi baphile impilo enempilo futhi balondoloze indlela yokuphila enempilo.

Umphumela ophumelelayo waleli cala awubonisi nje kuphela ukusebenza kahle kokwelashwa kwamaseli e-BCMA CAR-T ekwelapheni i-multiple myeloma engaphikisi kodwa futhi ugcizelela ukubaluleka kokunakekelwa komuntu siqu nokwemikhakha eminingi ekuphatheni umdlavuza oyinkimbinkimbi we-hematologic. Ukuzibophezela kwethu ekuhlinzekeni ukwesekwa okuqhubekayo nokunakekelwa kokulandelela kukhombisa ukuzinikela kwethu ekuqinisekiseni imiphumela engcono kakhulu ezigulini zethu ngale kwesigaba sokwelashwa.

Ngaphambi kanye nezinyanga ezi-3 ngemuva kokumnika