Lupus erythematosus (SLE) -05

Ms. C mace ce ’yar shekara 32 da tarihin an gano ta da cutar lupus erythematosus (SLE) shekaru biyu da suka wuce. Alamominta na farko sun haɗa da nephritis mai tsanani, arthritis, da rashes. Duk da karbar magungunan rigakafi da yawa (ciki har da glucocorticoids, hydroxychloroquine, da rituximab), yanayinta ya kasance ba a kula da shi ba.

Yanayin Magani:

Alamomin: Ciwon haɗin gwiwa mai tsanani da kumburi, rashes na dindindin, gajiya mai mahimmanci, da kuma kumburin nephritis.

 Abubuwan da aka gano na dakin gwaje-gwaje:

Sakamakon # SLEDAI-2K: 16

# Serum anti-biyu-stranded DNA matakan antibody: An ɗaukaka sama da kewayon al'ada

# Haɓaka matakan C3 da C4: ƙasa da kewayon al'ada

Tsarin Jiyya:

1. Zaɓin Haƙuri: Ganin rashin tasiri na maganin gargajiya da kuma tsananin yanayinta, Ms. C ta shiga cikin gwaji na asibiti don maganin CAR-T.

2.Tsarin: Kafin karɓar jiko na CAR-T, Ms. C ta yi amfani da ma'auni na chemotherapy na yau da kullum don rage ƙwayoyin lymphocytes na yanzu da kuma shirya don gabatarwar ƙwayoyin CAR-T.

3.Tsarin Kwayoyin:

An ware # ƙwayoyin T daga jinin Ms. C.

# Waɗannan ƙwayoyin T an ƙirƙira su ta asali a cikin dakin gwaje-gwaje don bayyana masu karɓar antigen na chimeric (CAR) da ke niyya CD19 da antigens BCMA.

4.Cell Jiko: Bayan fadadawa da gwajin inganci, an sake shigar da ƙwayoyin CAR-T na injiniya a cikin jikin Ms. C.

5.Inpatient Kulawa: An kula da Ms. C a asibiti don kwanaki 25 bayan jiko don lura da yiwuwar illa da kuma tantance inganci.

Sakamakon Jiyya:

1. Martani na gajeren lokaci:

# Inganta Alamun: A cikin makonni uku bayan jiko, Ms. C ta sami raguwa sosai a cikin ciwon haɗin gwiwa da kumburi, kuma a hankali raƙumanta suna shuɗewa.

# Sakamakon Laboratory: Kwana biyu bayan jiko, ƙwayoyin B a cikin jinin Ms. C an kawar da su gaba ɗaya, yana nuna tasiri mai tasiri ta ƙwayoyin CAR-T.

2.Tattalin Arziki (watanni 3):

Maki # SLEDAI-2K: Rage zuwa 2, yana nuna babban gafarar cuta.

# Ayyukan Renal: Mahimman raguwa a cikin proteinuria, tare da nephritis a ƙarƙashin kulawa.

# Alamar rigakafi: Rage matakan anti-biyu-stranded DNA antibodies, da kuma daidaita matakan C3 da C4 sun dawo daidai.

3. Sakamako na Dogon lokaci (watanni 12):

# Cigaba Mai Dorewa: Ms. C ta kiyaye gafarar miyagun ƙwayoyi na tsawon shekara guda ba tare da alamun sake dawowa SLE ba.

# Tsaro: Baya ga ciwon sakin cytokine mai laushi (CRS), Ms. C ba ta fuskanci wani mummunan illa ba. Tsarin garkuwar jikin ta a hankali ya dawo bayan jiyya, kuma ƙwayoyin B da suka sake fitowa ba su nuna cutar ba.

Gabaɗaya, yanayin Ms. C ya nuna ci gaba mai ban mamaki da ɗorewa mai ɗorewa bayan jiyya na ƙwayar cuta ta CAR-T, yana nuna yuwuwar wannan jiyya ga SLE mai tsanani da rashin ƙarfi.

Rahoton gwajin cell CART: