He Mieloma Nui (MM)-02

Ua ʻimi ka maʻi Italia i ka lapaʻau ʻana a ua hoʻōla ʻia i ka Myeloma he nui me ka lāʻau lapaʻau CAR-T

Ua ʻike ʻia ʻo Cinty, he wahine he 66 makahiki, me ka lambda light chain multiple myeloma, ISS stage I, ma Italia i ʻOkakopa 2018. Ma hope o ka loaʻa ʻana o 4 mau manawa o ka VTD regimen chemotherapy, ua hoʻomohala ʻo ia i kahi haki ma ka ʻaoʻao ʻekolu o ka clavicle a. neuropathy āpau. No ka ʻimi ʻana i ka lāʻau lapaʻau ʻoi aku ka maikaʻi, ua hana ʻo ia i ʻelua autologous stem cell transplants i Mei 2019 a me Nowemapa 2019, e loaʻa ana i ke kala piha, a mālama ʻia ma ka lenalidomide waha.

Eia nō naʻe, i ʻAukake 2020, ua hōʻike ʻia kahi scan PET/CT scan i ka luku iwi hou a me ka piʻi wikiwiki ʻana o nā kaulahao māmā manuahi. Ua hōʻike ʻia ka biopsy o ka iwi iwi i ka piʻi ʻana o ka maʻi, a ua hōʻike ʻia ka hoʻāʻo ʻana o FISH i kahi ʻano ʻino cytogenetic hou: t(11;14). Ma hope o 4 mau manawa o ka DVD regimen chemotherapy e hoʻomaka ana i Kepakemapa 2020, ʻaʻole i kāohi ʻia kona maʻi a holomua hou. Me ka hoʻololi ʻana i 3 mau pōʻai o ka PCd regimen, ua hoʻomau ʻia ka ʻeha o kona iwi a ua ʻoi aku ka nui o ka edema o nā lālā lalo. Ma hope o ka pau ʻana o nā lāʻau lapaʻau maikaʻi i ʻike ʻia ma ke ao holoʻokoʻa a ua hana ʻia ʻelua autologous stem cell transplants, ua hoʻomohala ʻo ia i ke kūʻē ʻana i nā lāʻau lapaʻau he nui.

I kona aʻo ʻana e pili ana i ka maikaʻi nui o ka hoʻokolohua lapaʻau CAR-T ma ka Halemai Ludaopei ma o ka ʻike pūnaewele, ua noi ʻo ia i visa a hōʻea i Kina i Malaki 2021. Ma hope o hoʻokahi mahina o ka quarantine, ua hoʻokomo ʻia ʻo ia i ka Halemai ʻo Yanda Ludaopei ma ʻApelila 22, 2021. Ma hope o kekahi mau hoʻokolohua a me nā loiloi maʻi, ua loaʻa iā ia kahi infusion o BCMA CAR-T cell ma hope o FC chemotherapy preconditioning i Mei o ia makahiki. Ma hope o ka hoʻokomo ʻana, ua kūpaʻa kona mau hōʻailona koʻikoʻi, a ʻaʻohe ona hopena ʻaoʻao koʻikoʻi koe wale nō ke kuni haʻahaʻa. Ua emi iki ka edema o kona mau lālā lalo, a ua hauʻoli ʻo ia i ka ʻike ʻana i ka hoʻomaikaʻi ʻana o kona olakino holoʻokoʻa.

Hoʻokahi mahina ma hope o ka hoʻokomo ʻana o CAR-T, ua hōʻike ʻia nā hopena hoʻāʻo a Cinty: 24-hour urine protein quantification ma 50 mg / lā, hoʻemi nui ʻia mai nā pae komo; nā kaulahao māmā serum free: FLC-κ ma 4.58 mg/L a me FLC-λ ma 0.61 mg/L; a ʻaʻole i hōʻike ʻia ka loiloi ʻana o ka iwi iwi ʻaʻohe mea koʻikoʻi. Ua loiloi ʻia ʻo ia ma ke ʻano he kala piha (CR).

I kēia manawa, ʻewalu mau mahina ma hope o ka hoʻi ʻana i Italia, ua nalo loa ka ʻeha hope o Cinty a me ka edema o nā lālā haʻahaʻa bilateral, a ua maikaʻi kona olakino. Mai nā kaukani mile ka mamao, ua hōʻike ʻo Cinty i kona mahalo nui i ka hui ma ka Halemai ʻo Yanda Ludaopei a me ka Luna Hoʻokele ʻo Zhang Xian.

ʻO kēia mau maʻi maʻi ʻelua mai ka Halemai Ludaopei e hōʻike ana ʻo nā mea maʻi me ka haʻahaʻa a i ʻole ka hōʻike BCMA i loko o ka myeloma lehulehu hiki ke loaʻa ka hopena maikaʻi me ka BCMA CAR-T cell therapy. Hōʻike kēia i kahi holomua i ka mālama ʻana i ka CAR-T no ka myeloma lehulehu, e lawe mai ana i ka manaʻolana hou i nā poʻe maʻi me nā maʻi maʻi plasma kiʻekiʻe a me ka myeloma lehulehu.