Indwara ya Lymphoblastique ikaze (T-BYOSE) -04

Cellular acute lymphoblastique leukemia hamwe na kare nyuma yo guhindurwa hanyuma igahuzwa na sisitemu yo hagati yo hagati ya leukemia

Uyu murwayi yari umusore wimyaka 15, bamusanganye indwara ya T-selile acute lymphoblastique leukemia (T-ALL hamwe na positif ya STIL-TAL1, gene mbi ya prognostic) mu mpera zUkuboza 2020, maze avurirwa mu bitaro byaho afite benshi inzinguzingo ya chimiotherapie isanzwe kugirango igere kubisubizo byuzuye. Se-umuhungu-hemizygous haematopoietic stem selile transplantation yakozwe ku ya 2 kamena 2021, ariko ikibabaje nuko igufwa ryongeye kugaragara ryagaragaye mumezi 3 nyuma yo guterwa, kandi 1 cycle ya chimiotherapie ntacyo byagize. Inzinguzingo imwe ya chimiotherapie ntiyagize icyo igeraho, kandi muri icyo gihe, yateje imisaya iturika kandi isohoka mu kirere, impande zigoramye zo mu kanwa, kandi gucumita mu mugongo byerekana ko indwara ya leukemiya yo hagati ikura.

T-BYOSE hamwe na STIL-TAL1 positivité, gusubira hakiri kare nyuma yo guhindurwa kwa allogeneic, hamwe na sisitemu yo hagati ya nervice sisitemu yo mu maraso, ni ikibazo kitoroshye cyo kuvura mugihe kidafite CAR-T. Se w'uyu mwana yabajije ibijyanye n'Umuyobozi Zhang Qian wo mu bitaro bya Ludoupe abinyujije ku nshuti ze, maze nyuma yo gushyikirana birambuye, baza mu bitaro bya Yanda Ludoupe, bashaka kurwanira ubuzima bwabo biyandikisha mu rubanza rwa CAR-T.

CAR-T yambere yananiwe, selile yibibyimba yagwiriye vuba cyane, kandi ubuzima bwe bwari mukaga.

Ku ya 26 Ukwakira 2021, umurwayi yinjiye mu cyumba cya mbere cy’ishami rishinzwe kuvura indwara. Bitewe no kugwira kwinshi kwingirangingo yibibyimba, umurwayi yashoboraga kuvurwa gusa na chimiotherapie kugirango agabanye umutwaro wikibyimba, hamwe no gutera inshinge zo mumitsi yatewe imiti ya chimiotherapeutique. Amazi yo mu bwonko yari mabi. Nyuma y’uko umurwayi ameze neza, lymphocytes za se zegeranijwe kugira ngo umuco w’akagari ka CAR-T, maze ku ya 19 Ugushyingo, abaterankunga CD7 CAR-T binjira mu murwayi.

Iminsi mike nyuma yo gushiramo, mbere yo kwaguka kwingirangingo za CAR-T, ingirabuzimafatizo yibibyimba yumurwayi yongeye kwiyongera vuba, kandi umubare munini wuturemangingo twa progenitor washoboraga kugaragara mumaraso ya peripheri, bityo CAR-T ya mbere irananirana.

Byarabaye kuburyo ibitaro byacu byakoraga igeragezwa rya CAR-T (CD7 UCAR-T) kuri leukemia ikaze ya T-lymphoblastique. Ababyeyi bahangayitse cyane bavuga ko bashaka kugerageza umwana wabo kabone niyo haba hari amahirwe 1%. Umuyobozi Zhang Qin yongeye kuganira n’umuryango maze ahitamo kwandikisha umwana wabo mu igeragezwa ry’amavuriro CD7 UCAR-T.

# Kurangiza burundu nyuma yo kwiyandikisha muri CD7 UCAR-T ivuriro, ubu amezi 2 nyuma yo guterwa

Ku ya 2 Ukuboza, umurwayi yashyizwemo selile CD7 U-CART, zikoreshwa mu kugabanya umutwaro w'ikibyimba mu gihe zitanga imiti ifasha ibimenyetso. Ku ya 2 Ukuboza, selile CD7 U-CART yinjijwe mu murwayi. Nyuma yo gushiramo, umurwayi yagize umuriro mwinshi iminsi myinshi kandi yari afite umutima mubi. Ibimenyetso byingenzi byumurwayi byagiye bihinduka buhoro buhoro kandi ubushyuhe bwumubiri bwagiye buhoro buhoro nyuma yumurwayi amaze kuvurwa hakoreshejwe imiti igabanya ubukana na rehydrasiyo hamwe nubuvuzi.

Gutobora amagufwa no mu gihimba ku munsi wa 18 na 28 nyuma ya CD7 UCAR-T yinjije yerekanaga ko yakiriye neza hamwe na MRD mbi. Imitekerereze y'umwana yarushagaho kuba mwiza, irari ryaragaruwe kandi arongera arakora, kandi nyina wari urira buri munsi, amaherezo yabonye inseko itari imaze igihe kinini itagaragara.

Kugeza ubu, umurwayi amaze amezi 2 akorerwa HSCT ya kabiri ihuje na hemi mu bitaro byacu, kandi indwara iracyakira neza.