Systemic lupus erythematosus (SLE)-05

Ms. C yog ib tug poj niam hnub nyoog 32 xyoo uas muaj keeb kwm raug kuaj pom tias muaj kab mob lupus erythematosus (SLE) ob xyoos dhau los. Nws cov tsos mob tseem ceeb suav nrog mob nephritis, mob caj dab, thiab pob khaus. Txawm hais tias tau txais ntau yam tshuaj tiv thaiv kab mob (xws li glucocorticoids, hydroxychloroquine, thiab rituximab), nws tus mob tseem tswj tsis tau.

Kev kho mob ua ntej:

 Cov tsos mob: Mob pob qij txha thiab o, ua pob ua pob ua xyua, qaug zog, thiab rov tshwm sim nephritis flares.

 Laboratory Nrhiav tau:

# SLEDAI-2K qhab nias: 16

# Serum anti-ob-stranded DNA antibody qib: Nce saum toj ib txwm muaj

# Ua kom tiav C3 thiab C4 qib: Hauv qab li qub

Kev Kho Mob:

1. Kev Xaiv Tus Neeg Mob: Muab qhov tsis zoo ntawm cov kev kho mob ib txwm muaj thiab qhov hnyav ntawm nws tus mob, Ms. C tau cuv npe hauv kev sim tshuaj rau CAR-T cell therapy.

2.Kev Npaj: Ua ntej tau txais CAR-T cell infusion, Ms. C tau txais cov txheej txheem tshuaj kho mob kom tshem tawm cov lymphocytes uas twb muaj lawm thiab npaj rau kev qhia txog CAR-T hlwb.

3.Cell Kev Npaj:

# T cells raug cais tawm ntawm Ms. C cov ntshav.

# Cov T hlwb no tau tsim cov noob caj noob ces nyob rau hauv lub chaw kuaj mob los qhia txog chimeric antigen receptors (CAR) tsom rau CD19 thiab BCMA antigens.

4.Cell Infusion: Tom qab kev nthuav dav thiab kev ntsuam xyuas zoo, cov tshuab hluav taws xob CAR-T tau rov ua rau hauv Ms. C lub cev.

5.Inpatient Monitoring: Ms. C tau saib xyuas hauv tsev kho mob li 25 hnub tom qab txhaj tshuaj los soj ntsuam cov kev mob tshwm sim thiab ntsuas kev ua tau zoo.

Cov txiaj ntsig kev kho mob:

1. Cov lus teb luv luv:

# Kev Txhim Kho Cov tsos mob: Tsis pub dhau peb lub lis piam tom qab txhaj tshuaj, Ms. C tau ntsib kev txo qis hauv kev sib koom tes thiab o, thiab nws cov pob khaus maj mam ploj mus.

# Cov txiaj ntsig ntawm kev soj ntsuam: Ob hnub tom qab kev txhaj tshuaj, B hlwb hauv Ms. C cov ntshav tau raug tshem tawm tag nrho, qhia tau tias muaj txiaj ntsig zoo los ntawm CAR-T hlwb.

2. Kev Ntsuas Lub Sijhawm Nruab Nrab (3 lub hlis):

# SLEDAI-2K qhab nia: Txo rau 2, qhia txog kev tshem tawm cov kab mob ntau heev.

# Lub raum Ua Haujlwm: Kev txo qis hauv proteinuria, nrog rau nephritis tswj tau.

# Immunological Markers: Txo qib ntawm cov tshuaj tiv thaiv DNA ob npaug, thiab ntxiv C3 thiab C4 qib rov qab mus rau qhov qub.

3.Long-term Outcomes (12 lub hlis):

# Kev Tso Cai Tsis Txaus Siab: Ms. C khaws cia tsis pub siv tshuaj rau ib xyoos uas tsis muaj qhov tshwm sim ntawm SLE rov qab los.

# Kev Nyab Xeeb: Ib sab ntawm me me cytokine release syndrome (CRS), Ms. C tsis muaj kev phiv loj heev. Nws lub cev tiv thaiv kab mob maj mam rov qab kho tom qab, thiab rov tshwm sim B hlwb tsis pom muaj kab mob.

Zuag qhia tag nrho, Ms. C tus mob tau pom tias muaj kev txhim kho zoo tshaj plaws thiab kev tso tawm kom ruaj khov tom qab CAR-T cell therapy, ua kom pom lub peev xwm ntawm qhov kev kho mob no rau qhov hnyav thiab refractory SLE.

CART cell test report: