Na-agbasa nnukwu lymphoma B-cell (DLBCL) -03

Na Machị 2021, Maazị Wang (pseudonym) nwere mmetụta mgbu n'ime ala nke ọma na mberede, na mbụ ezighi ezi maka ahụ erughị ala afọ, ma ọ chọghị nlekọta ahụike ozugbo. N'ime ọnwa abụọ sochirinụ, ọ na-enweta ihe mgbaàmà nke mgbu afọ ala aka nri ugboro ugboro, nke mere ka ọ chọọ nlekọta ahụike n'ụlọ ọgwụ dị n'ógbè ahụ. Nnyocha CT kpughere ihe na-adịghị mma na eriri afọ na ụbara lymph nodes retroperitoneal.

Ndị dọkịta na-atụ aro colonoscopy na biopsy maka nyocha ọzọ, nke kwadoro "na-agbasa nnukwu lymphoma B-cell," ụbụrụ ọjọọ nke a na-akpọkarị lymphoma. PET-CT kwuputara na ọnya hypermetabolic nodular zuru ebe niile n'ahụ ya, nke kachasị nha 4.3 * 4.1 * 4.5cm.

Site n'enyemaka nke ezinụlọ ya, Maazị Wang nwetara usoro ọgwụgwọ chemotherapy R-CHOP anọ. PET-CT na-esochi mgbe chemotherapy gasịrị gosipụtara mgbaghara akụkụ.

Otú ọ dị, ọgwụgwọ ndị sochirinụ butere nsogbu siri ike nye Maazị Wang, dị ka mgbochi intestinal, perforation, na nnukwu peritonitis. Ndị dọkịta na-awa ahụ na-ahụ maka eriri afọ na ndị dọkịta na-aga na-arụkọ ọrụ ọnụ na atụmatụ ịwa ahụ, na-eme nhazi nke eriri afọ na drainage, n'akụkụ nlekọta nkwado mgbaàmà, na-achịkwa mgbaàmà ya nke ọma.

Nnyocha PET-CT nke sochirinụ kpughere ọnya etuto ahụ na oke nha. Iji kpochapụ mkpụrụ ndụ tumo nke ọma, ndị dọkịta meziri usoro ọgwụgwọ chemotherapy siri ike ma tụọ aro ka a na-atụgharị mkpụrụ ndụ hematopoietic stem.

N'ịbụ ndị nwere ọtụtụ ihe ndọghachi azụ, Maazị Wang nwetara nnukwu nhụjuanya anụ ahụ na nke mmetụta uche ka ọnọdụ ya na-akawanye njọ. A na-ahụ ntinye ntinye tumor n'ọtụtụ ebe, yana ọnya hypermetabolic multifocal nodular hypermetabolic emepụtara ọhụrụ na-eme ka mpaghara ọrịa kansa dịkwuo ukwuu. N'ihi etuto ahụ dị n'ahụ ya niile, Maazị Wang nwere mgbu na-adịghị ala ala nke na-eme ka ọ na-esiri ya ike ịgha ụgha na ihi ụra n'ihi mgbu.

N'ime obi nkoropụ, Maazị Wang mụtara gbasara ọgwụgwọ CAR-T, akwụkwọ ọhụrụ CAR-T cell immunotherapy emebere maka ndị ọrịa nwere nlọghachi azụ ma ọ bụ refractory B-cell lymphoma.

Tupu ịmalite ọgwụgwọ CAR-T, biopsy node lymph na mpaghara inguinal aka nri gosiri CD19 na CD20 positivity, na-enye ebumnuche ziri ezi maka ọgwụgwọ cell CAR-T. Prọfesọ Yu haziri nyocha zuru oke nke anụ ahụ, na-eduga na mmepe nke atụmatụ ọgwụgwọ CAR-T nke onwe maka Mr. Wang.

Na Julaị 25, 2022, Maazị Wang nwetara infusion cell CD19/20 CAR-T n'ụlọ ọgwụ, ebe usoro ahụ na-aga nke ọma. Nleba anya dị nso na nlekọta nkwado siri ike na-achịkwa mmeghachi omume ọjọọ mgbe infusion na-enweghị nsogbu ndị na-eyi ndụ egwu.

N'ihe na-erughị ọnwa atọ, ka ọ na-erule Ọktoba 10, 2022, nyocha PET-CT na-esochi gosipụtara mgbaghara zuru oke, yana nyocha n'ozuzu ya na-egosi mmụba dị ukwuu na ọkwa ahụike ya.

N'oge nlebanya na-esote, Maazị Wang na-enyocha CT, MRI, ma ọ bụ PET-CT mgbe niile, ihe niile na-akwado ọkwa mgbapụta ya zuru oke. Ka ọ dị ugbu a, ahụike ya ka dị mma, karịa oge mgbaghara zuru oke karịa ọnwa 14.