Multiple Myeloma(MM)-01

Kyakkyawar Farfaɗowar Majinin Myeloma na Gida tare da CAR-T Therapy Duk da Rashin Bayyanar BCMA

Mace mara lafiya da aka gano tare da mataki na IIIA IgD-λ nau'in myeloma mai yawa a cikin 2018 ya sami magani na farko tare da bortezomib. Bayan zagaye 3, ta sami cikakkiyar gafara (CR). A cikin Oktoba 2018, an yi mata dashen kwayar cutar hematopoietic ta atomatik a matsayin maganin ƙarfafawa, sannan ta hanyar kulawa da lenalidomide. A watan Afrilun 2020, cutar ta sake dawowa, kuma ta yi ta zagaye na biyu na magani na biyu, wanda ya haifar da rashin inganci. Daga Disamba 2020 zuwa Afrilu 2021, ta sami chemotherapy galibi tare da daratumumab, amma ƙwayar kasusuwa biopsy har yanzu ya nuna 21.763% m monoclonal plasma sel, tare da sarkar haske mai kyauta λ a 1470 mg/L da sarkar haske kyauta na fitsari λ a 5330 mg/L. A wannan lokacin, ta ƙare manyan ma'auni da sabbin jiyya da ake samu a cikin gida, gami da jujjuyawar kwayar halitta ta atomatik, tare da shiga gwajin asibiti na CAR-T shine mafi kyawun zaɓi.

Likitocin gida ne suka gabatar da ita ga Asibitin Ludaopei a ranar 10 ga Mayu, 2021, tare da fatan yin rajista a gwajin asibiti don maganin BCMA CAR-T a cikin myeloma da yawa (MM). Bayan shigarta, ta kasance cikin rauni mai rauni tare da raɗaɗi na gabaɗaya da yawan zazzaɓi. Cikakken jarrabawa ya tabbatar da "myeloma da yawa, nau'in sarkar haske, ISS mataki III, R-ISS mataki III, mSMART babban haɗari."

Scan PET-CT ya bayyana ƙara yawan aiki na rayuwa a cikin ɗigon nama mai laushi a cikin ramukan kasusuwan kasusuwan mata da tibias, wanda ke nuni da shigar ƙari. Biopsy na kasusuwa na kasusuwa ya nuna 60.13% m kwayoyin plasma monoclonal ba tare da bayyanar BCMA ba.

Asibitin Ludaopei ya sanar da majiyyaci da danginta game da ingancin jiyya na yanzu don BCMA-negative multiple myeloma, wanda ko da yake yana iya yin tasiri bisa ga wasu wallafe-wallafe, ba shi da takamaiman bayanai. Bayan an yi la'akari da kyau, mai haƙuri da danginta sun zaɓi ci gaba da tsarin kulawa.

Bayan sharadi gwargwado tare da tsarin FC, an shigar da ƙwayoyin BCMA CAR-T a ranar 1 ga Yuni, 2021, a Asibitin Ludaopei. Mai haƙuri ya ci gaba da zazzaɓi bayan jiko, wanda a hankali aka sarrafa shi tare da maganin rigakafi mai ƙarfi da alamun tallafi. Kwanaki goma sha huɗu bayan jiko, ƙwayar kasusuwa na kasusuwa ya nuna babu sauran ƙwayoyin plasma marasa kyau na monoclonal. Kwanaki talatin da ɗaya bayan jiko, ƙwayar kasusuwa ya kasance mara kyau. Maganin rigakafi ba ya da kyau, sarkar haske mai kyauta λ yana cikin kewayon al'ada, kuma furotin M ba shi da kyau, yana nuna cikakkiyar gafarar cutar.

A halin yanzu, fiye da watanni 8 bayan samun jiko na kwayar halitta na BCMA CAR-T, mai haƙuri ya kasance cikin cikakkiyar gafara tare da farfadowa mai kyau da kuma gamsuwa da sakamakon magani.