Multi Myeloma (MM) -02

Umurwayi wabataliyani arashaka kwivuza kandi akira indwara ya Myeloma myinshi hamwe nubuvuzi bwa CAR-T

Cinty, umukecuru w'imyaka 66, bamusanganye urunigi rwa lambda urumuri rwinshi rwa myeloma, icyiciro cya ISS icyiciro cya mbere, mu Butaliyani mu Kwakira 2018. Amaze kubona inzinguzingo 4 za chimiotherapie ya VTD, yaje kuvunika mu gice cya gatatu cya clavicle kandi peripheri neuropathie. Mu gushaka uburyo bunoze bwo kuvurwa, yatewe inshuro ebyiri zo mu bwoko bwa autologique stem selile muri Gicurasi 2019 na Ugushyingo 2019, ageza ku gukira burundu, kandi akomezwa kuri lenalidomide yo mu kanwa.

Ariko, muri Kanama 2020, ubushakashatsi bwakorewe PET / CT bwerekanye ko kwangirika kw'amagufwa no kwiyongera byihuse kw'iminyururu itagira umucyo. Amagufwa ya biopsy yamagufa yerekanaga iterambere ryindwara, naho kwipimisha AMAFI byerekanaga ibintu bidasanzwe bya cytogenetike: t (11; 14). Nyuma yinzinguzingo 4 za DVD regimen chimiotherapie guhera muri Nzeri 2020, indwara ye ntiyagenzuwe kandi iratera imbere kurushaho. Nubwo yahinduye inzinguzingo 3 za gahunda ya PCd, ububabare bwamagufwa ye bwarakomeje kandi ibihimba byo hepfo byombi byiyongera. Amaze kunaniza imiti myinshi yemewe ku rwego mpuzamahanga kandi yatewe inshuro ebyiri zo mu bwoko bwa autologique stem selile, yatangije kurwanya ibiyobyabwenge byinshi.

Amaze kumenya akamaro gakomeye k'igeragezwa ry’amavuriro CAR-T mu bitaro bya Ludaopei abinyujije ku rubuga rwa interineti, yasabye viza agera mu Bushinwa muri Werurwe 2021. Nyuma y'ukwezi kumwe, yashyizwe mu bitaro bya Yanda Ludaopei ku ya 22 Mata, 2021. Nyuma y’ibizamini hamwe n’isuzuma ry’indwara, yakiriye ingirabuzimafatizo za BCMA CAR-T nyuma ya chimiotherapie ya FC ibanziriza Gicurasi muri uwo mwaka. Nyuma yo gushiramo, ibimenyetso bye byingenzi byari bihamye, kandi nta ngaruka mbi yigeze agira usibye umuriro wo hasi. Buhoro buhoro, ibibyimba byo hepfo byombi byaragabanutse, kandi yishimiye kubona ubuzima bwe bumeze neza muri rusange.

Ukwezi kumwe nyuma yo kwanduza CAR-T, ibisubizo by'ibizamini bya Cinty byerekanye: ingano ya poroteyine y'inkari y'amasaha 24 kuri 50 mg / ku munsi, byagabanutse cyane bivuye ku rwego rwo kwinjira; serumu yubusa urumuri: FLC-κ kuri 4.58 mg / L na FLC-λ kuri 0,61 mg / L; isuzuma ryamagufwa yerekana ko nta selile ikomeye ya plasma. Yasuzumiwe mubuvuzi ko ari muburyo bwuzuye (CR).

Kugeza ubu, amezi umunani nyuma yo gusubira mu Butaliyani, ububabare bw'umugongo bwa Cinty hamwe no kuribwa mu maguru byombi byacitse burundu, kandi afite ubuzima bwiza. Kuva ku bilometero ibihumbi, Cinty yashimiye byimazeyo iyi kipe mu bitaro bya Yanda Ludaopei ndetse n'umuyobozi Zhang Xian.

Izi ndwara zombi zivuye mu bitaro bya Ludaopei zerekana ko n'abarwayi bafite imvugo ya BCMA nkeya cyangwa idafite muri myeloma myinshi bashobora kugera ku mikorere myiza hamwe na BCMA CAR-T ivura selile. Ibi byerekana intambwe mu kuvura CAR-T kuvura myeloma myinshi, bizana ibyiringiro bishya kubarwayi bafite plasma selile yateye imbere na myeloma myinshi.