Gutandukanya lymphoma nini ya B-selile (DLBCL) -04

Bwana Li, ufite imyaka 64 (izina ry'irihimbano), bamusanganye indwara ya lymphoma nini ya B-selile (DLBCL) mu myaka ine ishize, ikaba yari yarateje imbere uruhara, imbavu, ibihaha, na pleura, ishyirwa mu cyiciro cya IV . Nyuma yumurongo wa mbere immunochemotherapie, ubuzima bwe bwakomeje kumara imyaka irenga itatu. Icyakora, muri Werurwe umwaka ushize, indwara ye yongeye kugaruka, irimo lymph node nyinshi ya retroperitoneal. Nubwo imiti ya kabiri ya salvage ya chimiotherapie, yageze gusa ku gukira igice kandi yangirika vuba, bikenera kuvurwa neza kugirango agenzure iterambere.

Mu guhangana n’iki kibazo kitoroshye, itsinda ry’impuguke mu bitaro bya Lu Daopei ryasuzumye cyane ikibazo cya Bwana Li maze ritumiza inama y’itsinda ry’abantu benshi (MDT) kugira ngo basabe kuvura CAR-T. Ubuvuzi bwa CAR-T, nkuburyo bwa nyuma bwo gukingira ikibyimba, butanga ibyiza byingenzi nko kwibasira cyane no kwihanganira ingaruka nziza kubarwayi barwaye lymphoma yongeye kwisubiraho.

Muri Mutarama 2023, Bwana Li yabazwe CAR-T mu ishami rya Lymphoma. Mbere yo kuvurwa, yabazwe na biopsy ya lymph node iburyo, yemeje CD19 na CD20, itanga intego zisobanutse zo kuvura selile CAR-T. Bayobowe na Porofeseri Li, itsinda ry’abaganga ryateguye gahunda yo kuvura yihariye.

Ku ya 25 Nyakanga 2023, Bwana Li yarangije gahunda yo kwinjiza CD19 / 20 CAR-T, zigenda neza zikurikiranwa neza n'itsinda ry'abaganga. Nubwo yahuye na syndrome ya cytokine, cytopenia, hamwe nubwandu bwanduye nyuma yo gushiramo, ubuvuzi bukomeye bufasha gukemura ibibazo bibi mugihe cyo kuvura.

Amezi atandatu nyuma yo gushyira mu bikorwa imiti ivura CAR-T, Bwana Li yerekanye ko nta bisebe bikomeye bigaragara mu mubiri we, agera ku gisubizo cyuzuye cya metabolike (CMR), cyazanye ibyiringiro bishya ku buzima bwe. Itsinda ry'abaganga ryongeyeho ibikomere bisigaye bya retroperitoneal hamwe na radiotherapi kugira ngo indwara zisubire inyuma kandi zihamye igihe kirekire.

Binyuze muri ubu buryo bwo gukingira indwara ya CAR-T, bwana Li ntabwo yateye imbere cyane mubuzima bwe ahubwo yanagaruye ikizere nubuzima mubuzima. Urubanza rwe rutanga ibyiringiro bishya nicyerekezo kubarwayi ba lymphoma kandi byerekana ubushobozi ningirakamaro byubuvuzi bwa CAR-T mu kuvura lymphoma yangiritse.

Ubuvuzi bwa CAR-T, nk'ubuvuzi bushya bwa kanseri, burahindura inzira z'ubuzima bw'abarwayi bafite lymphoma yoroheje. Bitewe n'ubwitonzi bw'itsinda ry'impuguke mu ishami rya Lymphoma, abarwayi benshi nka Bwana Li barashobora kwitega ko hazabaho iterambere ryinshi mu mibereho no mu mibereho. Urebye imbere, iterambere rindi hamwe nogukoresha uburyo bwo kuvura selile CAR-T bitanga ibyiringiro byinshi nibishoboka mukuvura kanseri.