Kuparadzira hombe B-cell lymphoma(DLBCL) -03

Muna Kurume 2021, VaWang (zita remanyepo) vakangoerekana vanzwa kurwadza kwepazasi peguvhu chaiko, vakatanga vakanganisa nekusagadzikana kwemudumbu, uye havana kutsvaga kurapwa nekukurumidza. Mumwedzi miviri yakatevera, akadzokorora kuona zviratidzo zvekurwadziwa kwezasi kweguvhu kwekurudyi, zvichiita kuti atsvake kurapwa kuchipatara cheko. A CT scan yakaratidza kusagadzikana mucolon uye yakawedzera retroperitoneal lymph nodes.

Vanachiremba vakakurudzira colonoscopy uye biopsy kuti iwedzere kuongororwa, izvo zvakasimbisa "kuparadzira hombe B-cell lymphoma," bundu rakashata rinozivikanwa se lymphoma. PET-CT yakawedzera kusimbisa kupararira nodular hypermetabolic maronda mumuviri wake wose, nekuyera kukuru 4.3 * 4.1 * 4.5cm.

Nerutsigiro rwemhuri yake, VaWang vakaita mitsetse ina yeR-CHOP chemotherapy. Kutevera PET-CT mushure mechemotherapy kwakaratidza kuregererwa kwechikamu.

Zvisinei, kurapwa kwakatevera kwakatungamirira kumatambudziko akanyanya kuna VaWang, zvakadai sekuvharika kwematumbo, kuboora, uye acute peritonitis. Vanachiremba vepamuviri uye vanachiremba vanoenda vakabatana pachirongwa chekuvhiya, vachiita colon resection uye drainage, pamwe chete nezviratidzo zvinotsigira zviratidzo, kunyatsogadzirisa zviratidzo zvake zvedumbu.

Yakazotevera PET-CT scan yakaratidza kuwedzera bundu maronda uye saizi. Kuti vapedze masero ebundu zvirinani, vanachiremba vakagadzirisa iyo yakawedzera chemotherapy regimen uye vakakurudzira hematopoietic stem cell transplantation.

Vachisangana nezvipingamupinyi zvakatevedzana, VaWang vakatambura zvikuru mumuviri nomupfungwa sezvo mamiriro avo ezvinhu aiwedzera kuipa. Kupinda kwebundu kwakaonekwa munzvimbo dzakawanda, ichangobva kugadzirwa multifocal nodular hypermetabolic maronda akawedzera zvakanyanya nzvimbo yegomarara. Pamusana pemamota mumuviri wake wose, VaWang vakatambura nemarwadzo asingagumi, zvichiita kuti zvive zvakaoma kuti arare pasi uye kurara nekuda kwemarwadzo.

Mukuora mwoyo, VaWang vakadzidza nezveCAR-T therapy, bhuku rinonzi CAR-T cell immunotherapy rakagadzirirwa chaizvo varwere vane kudzokazve kana kuti refractory B-cell lymphoma.

Asati arapwa neCAR-T, lymph node biopsy munzvimbo yerudyi yeinguinal yakaratidza CD19 neCD20 positivity, ichipa zvinangwa chaizvo zveCAR-T cell kurapwa. Purofesa Yu akaronga kuongororwa kwakadzama kwemuviri, zvichitungamira mukugadzirwa kwega yega chirongwa cheCAR-T chekurapa kwaVaWang.

Musi waChikunguru 25, 2022, VaWang vakagamuchira CD19/20 CAR-T cell infusion muchipatara, maitiro akafamba zvakanaka. Kunyatsotarisisa uye kunyatsotsigira kutsigira kwakadzora maitiro akashata mushure mekuwedzera pasina matambudziko anotyisidzira hupenyu.

Mumwedzi isingasviki mitatu, pakasvika Gumiguru 10, 2022, imwe PET-CT scan yakasimbisa kuregererwa kwakakwana, nekuongororwa kwese kunoratidza kuvandudzwa kukuru kwehutano hwake.

Munguva yekutevera kunotevera, Mr. Wang aigara achiita CT, MRI, kana PET-CT scans, zvose zvichisimbisa chimiro chake chekuregererwa kwakakwana. Kubva pari zvino, hutano hwake hunoramba hwakanaka, kupfuura nguva yekuregererwa yakakwana yemwedzi inopfuura 14.