Gutandukanya lymphoma nini ya B-selile (DLBCL) -03

Muri Werurwe 2021, bwana Wang (izina ry'irihimbano) yahise yumva ububabare bwo mu nda bwo hepfo, yabanje kwibeshya ko atigeze agira ikibazo cyo mu gifu, ntiyihutira kwivuza. Mu mezi abiri yakurikiyeho, yagiye agaragaza ibimenyetso byerekana ububabare bwo mu nda bwo hepfo, bituma asaba ubuvuzi kwa muganga mu bitaro byaho. Isuzuma rya CT ryagaragaje ibintu bidasanzwe muri colon no kwagura retroperitoneal lymph node.

Abaganga basabye colonoskopi na biopsy kugira ngo barusheho kwisuzumisha, bemeza ko "ikwirakwiza lymphoma nini ya B," ikibyimba kibi gikunze kwitwa lymphoma. PET-CT yemeje kandi ko indwara ya hypermetabolike ya nodular ikabije mu mubiri we, ikaba ifite ubunini bwa 4.3 * 4.1 * 4.5cm.

Abifashijwemo n’umuryango we, Bwana Wang yakorewe inshuro enye za chimiotherapie R-CHOP. Gukurikirana PET-CT nyuma ya chimiotherapie yerekanye gukira igice.

Icyakora, ubuvuzi bwakurikiyeho bwateje ibibazo bikomeye Bwana Wang, nko guhagarika amara, gutobora, na peritonite ikaze. Abaganga ba Gastrointestinal hamwe n'abaganga bitabiriye bafatanije gahunda yo kubaga, bakora kanseri yo mu nda no kuvoma, hamwe no kuvura ibimenyetso bifatika, gucunga neza ibimenyetso bya gastrointestinal.

Isuzuma ryakurikiyeho PET-CT ryerekanye ibibyimba byiyongereye hamwe nubunini. Kugira ngo kurandura burundu selile yibibyimba, abaganga bahinduye uburyo bwa chimiotherapie bwongerewe imbaraga kandi basaba ko haterwa transplant hematopoietic stem selile.

Bwana Wang yahuye n'ibibazo byinshi, Bwana Wang yagize ububabare bukabije bw'umubiri n'amarangamutima uko ubuzima bwe bwifashe nabi. Kwinjira kwa Tumor byagaragaye ahantu henshi, hamwe nudukoko twinshi twitwa nodular hypermetabolic ibikomere byaguye cyane kanseri. Kubera ibibyimba mu mubiri we, Bwana Wang yagize uburwayi bwa sisitemu idakira, bimugora kuryama neza no gusinzira kubera ububabare.

Mu kwiheba, Bwana Wang yamenye ibijyanye no kuvura CAR-T, igitabo cyitwa immunotherapie CAR-T cyagenewe abarwayi bafite lymphoma B-selile yongeye kwisubiraho.

Mbere yo kwivuza CAR-T, lymph node biopsy mukarere ka inguinal iburyo yerekanaga CD19 na CD20, bitanga intego zifatika zo kuvura selile CAR-T. Porofeseri Yu yateguye isuzuma rirambuye ku mubiri, biganisha ku gutegura gahunda yo kuvura CAR-T yihariye ya Bwana Wang.

Ku ya 25 Nyakanga 2022, Bwana Wang yakiriye ibitaro bya CD19 / 20 CAR-T mu bitaro, inzira igenda neza. Gukurikiranira hafi no kwita kubufasha bukomeye byagenzuye ingaruka mbi nyuma yo gushiramo nta ngaruka zangiza ubuzima.

Mu gihe kitarenze amezi atatu, bitarenze ku ya 10 Ukwakira 2022, ubushakashatsi bwakozwe na PET-CT bwemeje ko bwakuweho burundu, isuzuma rusange ryerekana ko ubuzima bwe bwifashe neza.

Mu gihe cyakurikiranwe, Bwana Wang yahoraga asuzumwa CT, MRI, cyangwa PET-CT, byose byemeza ko afite uburenganzira bwo gusezererwa burundu. Kugeza ubu, ubuzima bwe bukomeje kuba bwiza, burenze igihe cyo gukuraho amezi arenga 14.