Ọtụtụ Myeloma (MM) -02

Onye ọrịa Ịtali na-achọ ọgwụgwọ ma gwọọ ya nke ọtụtụ Myeloma na CAR-T Therapy

Cinty, nwanyị dị afọ 66, a chọpụtara na ọ nwere lambda light chain multiple myeloma, ISS stage I, na Italy na October 2018. Mgbe ọ natachara 4 cycles nke VTD regimen chemotherapy, ọ malitere mgbaji n'akụkụ atọ nke clavicle na. neuropathy peripheral. N'ịchọ ọgwụgwọ dị irè karị, a na-ebugharị mkpụrụ ndụ abụọ nke autologous na Mee 2019 na Nọvemba 2019, na-enweta mgbaghara zuru oke, ma debe ya na lenalidomide ọnụ.

Agbanyeghị, n'August 2020, nyocha PET/CT na-esochi kpughere mbibi ọkpụkpụ ọhụrụ yana mmụba ngwa ngwa na ụdọ ọkụ na-enweghị ọbara. Ọkpụkpụ ụmị ọkpụkpụ na-egosi ọganihu ọrịa, na nyocha FISH gosipụtara ihe ọhụrụ cytogenetic abnormality: t (11;14). Mgbe okirikiri anọ nke usoro ọgwụgwọ DVD bido na Septemba 2020, a chịkwaghị ọrịa ya wee na-aga n'ihu. N'agbanyeghị na ọ na-atụgharị gaa na cycles 3 nke usoro PCd, mgbu ọkpụkpụ ya nọgidere na-enwe na edema n'akụkụ ala nke akụkụ abụọ na-akawanye njọ. N'ịbụ onye ike gwụla ọtụtụ ọgwụgwọ dị irè nke mba ụwa matara ma megharịa mkpụrụ ndụ sel abụọ nke autologous, ọ malitere iguzogide ọtụtụ ọgwụ.

Mgbe ọ matara banyere ịdị irè nke nnwale ụlọ ọgwụ CAR-T na ụlọ ọgwụ Ludaopei site na ozi ịntanetị, ọ tinyere akwụkwọ maka visa wee bịarute China na Machị 2021. Mgbe otu ọnwa nke iche, a nabatara ya n'ụlọ ọgwụ Yanda Ludaopei na Eprel 22 2021. N'ịgbaso usoro nyocha na nyocha ọrịa, ọ natara ntinye nke mkpụrụ ndụ BCMA CAR-T mgbe FC chemotherapy preconditioning na May nke otu afọ ahụ. Mgbe infusion gasịrị, ihe ịrịba ama ya dị mkpa kwụsiri ike, ọ nweghịkwa mmetụta ọ bụla dị na ya ma e wezụga ahụ ọkụ dị ala. Ọkpụkpụ azụ ụkwụ ya dị n'akụkụ ya ji nwayọọ nwayọọ dalata, obi dịkwa ya ụtọ ịhụ ka ahụike ya niile na-akawanye mma.

Otu ọnwa mgbe ntinye nke CAR-T gasịrị, nyocha nke Cinty gosiri: 24-hour urine protein quantification na 50 mg / day, nke dị ntakịrị belata site na ọkwa nnabata; Agbụ ọkụ na-enweghị ọbara ọbara: FLC-κ na 4.58 mg/L yana FLC-λ na 0.61 mg/L; na nyocha ụmị ọkpụkpụ egosighi mkpụrụ ndụ plasma dị ịrịba ama. Achọpụtara ya n'ụlọ ọgwụ ka ọ nọ na remission zuru oke (CR).

Ka ọ dị ugbu a, ọnwa asatọ ka ọ lọghachitere n'Ịtali, mgbu azụ Cinty na edema n'akụkụ akụkụ ụkwụ ya apụọla kpamkpam, ahụ ike ya dịkwa ya mma. Site na ọtụtụ puku kilomita site na Cinty gosipụtara obi ekele ya n'ebe otu ahụ nọ na ụlọ ọgwụ Yanda Ludaopei na onye isi Zhang Xian.

Okwu ikpe abụọ a sitere na ụlọ ọgwụ Ludaopei gosipụtara na ọbụlagodi ndị ọrịa nwere obere okwu BCMA ma ọ bụ enweghị okwu na otutu myeloma nwere ike nweta ezigbo nrụpụta site na ọgwụgwọ cell BCMA CAR-T. Nke a na-anọchite anya ọganihu na ọgwụgwọ CAR-T maka otutu myeloma, na-ebute olileanya ọhụrụ nye ndị ọrịa nwere nsogbu mkpụrụ ndụ plasma dị elu na otutu myeloma.