M cutar sankarar bargo ta Lymphoblastic (T-ALL) -04

Ciwon sankarar mahaifa mai tsanani na lymphoblastic tare da farkon koma bayan dasawa da kuma hadewar tsarin jijiya na tsakiya

Majinyacin dan shekara 15 ne, wanda aka gano yana dauke da cutar sankarar lymphoblastic na T-cell (T-ALL tare da STIL-TAL1 positivity, matalauta prognostic gene) a karshen Disamba 2020, kuma an yi masa magani a wani asibiti na gida tare da yawa. hawan keke na yau da kullun chemotherapy don cimma cikakkiyar gafara. an gudanar da dashen kwayar halittar hemizygous na haematopoietic na uba-da-da a ranar 2 ga Yuni 2021, amma abin takaici an gano komadar kasusuwa a cikin watanni 3 bayan dashen, kuma zagaye 1 na chemotherapy bai yi tasiri ba. Daya sake zagayowar chemotherapy bai yi tasiri ba, kuma a lokaci guda, ya sami kunci mai kumbura da zubar iska, kusurwoyin bakin baki, da huda lumbar yana nuna ci gaban tsarin jijiya na tsakiya.

T-ALL tare da STIL-TAL1 positivity, dawowa da wuri bayan dasawa na allogeneic, haɗe tare da cutar sankarar bargo ta tsakiya, lamari ne mai wuyar gaske don bi da shi a zamanin ba tare da CAR-T ba. Mahaifin yaron ya yi tambaya game da Darakta Zhang Qian na asibitin Ludoupe ta hanyar abokansa, kuma bayan cikakken sadarwa, sun zo asibitin Yanda Ludoupe, suna son yin gwagwarmaya don ceton rayukansu ta hanyar shiga cikin gwajin asibiti na CAR-T.

CAR-T na farko ya gaza, ƙwayoyin ƙari sun ninka da sauri, kuma rayuwarsa na cikin haɗari.

A ranar 26 ga Oktoba, 2021, an shigar da majiyyaci a sashen farko na Sashen Nazarin Jini. Saboda saurin yawaitar ƙwayoyin ƙwayar cuta, za a iya yi wa majiyyacin magani da chemotherapy kawai don rage nauyin ƙwayar ƙwayar cuta, da kuma allurar ƙwayar ƙwayar ƙwayar cuta ta lumbar da magungunan chemotherapeutic. Ruwan cerebrospinal ya kasance mara kyau. Bayan yanayin mai haƙuri ya daidaita, an tattara ƙwayoyin lymphocytes na mahaifinsa don al'adun cell CAR-T, kuma a ranar 19 ga Nuwamba, CD7 CAR-T masu ba da gudummawa sun shiga cikin mai haƙuri.

Bayan 'yan kwanaki bayan jiko, kafin haɓakar ƙwayoyin CAR-T, ƙwayoyin tumor marasa lafiya sun sake karuwa da sauri, kuma ana iya ganin adadi mai yawa na kwayoyin halitta a cikin jini na gefe, don haka CAR-T na farko ya kasa.

Ya faru ne cewa asibitinmu yana gudanar da gwajin asibiti na duniya CAR-T (CD7 UCAR-T) don cutar sankarar bargo mai tsanani ta T-lymphoblastic a wannan mataki. Iyayen sun damu sosai kuma sun ce suna son gwada yaran su ko da akwai damar kashi 1%. Darakta Zhang Qin ya sake tattaunawa da dangi kuma ya yanke shawarar shigar da yaran su cikin gwajin asibiti na CD7 UCAR-T.

# Cikakken gafara bayan shiga cikin CD7 UCAR-T gwajin asibiti, yanzu watanni 2 bayan dasawa.

A ranar 2 Disamba, an shigar da mai haƙuri tare da ƙwayoyin CD7 U-CART, waɗanda aka yi amfani da su don rage ƙwayar ƙwayar cuta yayin da ke ba da magani mai goyan bayan alamun aiki. A ranar 2 Disamba, an shigar da ƙwayoyin CD7 U-CART a cikin majiyyaci. Bayan jiko, majiyyacin yana da zazzabi mai zafi na kwanaki da yawa kuma yana cikin rashin ƙarfi. Mahimman alamun majiyyaci sun daidaita sannu a hankali kuma zafin jiki ya daidaita a hankali bayan an yi wa mara lafiya magani tare da maganin hana kamuwa da cuta da rehydration na tallafin ma'aikatan lafiya.

Kashi da lumbar huda a kan 18th da 28th days bayan CD7 UCAR-T jiko ya nuna cikakken gafara tare da MRD mara kyau. Hankalin yaron ya kara gyaruwa, sha'awarsa ta dawo kuma ya sake samun kuzari, mahaifiyarsa da ke hawaye a kullum, ta ga murmushin da ba a daɗe ba.

A halin yanzu, majiyyacin ya sami HSCT na biyu mai dacewa da hemi a asibitinmu na tsawon watanni 2, kuma cutar tana cikin cikakkiyar gafara.