Ukwelashwa kwe-CD19 CAR-T kweSibhedlela iLu Daopei okune-Dose Ephansi Kubonisa Imiphumela Ethembisayo Ezigulini ze-B-ALL
Esifundweni esisha esenziwe eLu Daopei Hospital, abacwaningi babike intuthuko ebalulekile ekwelapheni i-refractory noma i-relapse B acute lymphoblastic leukemia (B-ALL) esebenzisa i-CAR-T cell therapy eqondiswa yi-CD19 ngesilinganiso esiphansi. Ucwaningo, oluhilele iziguli ezingu-51, lwembule ukuthi le ndlela entsha ayigcinanga nje ngokuthola amazinga aphezulu okukhululwa okuphelele (CR) kodwa futhi igcine iphrofayili yokuphepha enhle.
Ithimba locwaningo, eliholwa nguDkt. C. Tong ovela eMnyangweni weHematology kanye noDkt. AH Chang ovela eClinical Translational Research Center eTongji University School of Medicine, lihlole imiphumela yokunikeza umthamo ophansi wamaseli e-CAR-T—cishe i-1 × 10^5/kg—uma kuqhathaniswa nemithamo ephezulu evamile. Le ndlela ihlose ukulinganisela ukusebenza kahle kokwelapha nokunciphisa imiphumela emibi kakhulu, ikakhulukazi i-cytokine release syndrome (CRS).
Imiphumela yocwaningo yayimangalisa. Phakathi kweziguli ezingu-42 ze-B-ALL ezingazange zikwazi ukwelapha isifo sikashukela/ezaphinde zathola isifo sikashukela, ezingu-36 zathola isifo sikashukela noma i-CR ngokululama kwesibalo esingaphelele (i-CRi), kuyilapho zonke iziguli eziyisishiyagalolunye ezine-minimum residue disease (MRD) zafinyelela ku-MRD negativity. Ngaphezu kwalokho, iziguli eziningi zathola isifo sikashukela esincane kuya kwesiphakathi kuphela, kanti amacala amakhulu aphathwa ngempumelelo ngamasu okungenelela kwasekuqaleni.
UDkt. Tong ugcizelele ukubaluleka kwalolu cwaningo, ethi, "Imiphumela ikhombisa ukuthi ukwelashwa ngamaseli e-CD19 CAR-T ngomthamo ophansi, okulandelwa ukufakelwa kwamaseli e-hematopoietic stem (allo-HCT), kunikeza inketho yokwelapha ephumelela kakhulu ezigulini ezinezinye izindlela ezilinganiselwe. Lokhu kwelashwa akugcini nje ngokunikeza amazinga aphezulu okusabela kodwa futhi kunciphisa kakhulu ingozi yemiphumela emibi kakhulu."
Impumelelo yalolu cwaningo igcizelela amandla okwelashwa kwamaseli e-CAR-T okwenzelwe wena ekwelapheni izifo eziyinkimbinkimbi zegazi. Isibhedlela iLu Daopei, esidumile ngomsebenzi waso wokuqala kwezamangqamuzana. Ukwelashwa nge-immunotherapy, iyaqhubeka nokuhola ekuhlinzekeni ukwelashwa okuphambili kweziguli ezinezimo zegazi eziyinselele.
Njengoba ucwaningo luqhubeka, ithimba locwaningo linethemba lokuthi lizoqhubeka nokuthuthukisa umthamo kanye nezinqubo zokuthuthukisa imiphumela yesiguli. Okutholakele kulolu cwaningo kushicilelwe ephephabhukwini. I-Leukemia futhi kunikeze umbono wethemba ngeziguli ze-B-ALL emhlabeni jikelele.