Multiple Myeloma(MM)-01

Kudzoreredza Kwakanaka Kwemudzimba Multiple Myeloma Murwere ane CAR-T Therapy Pasinei nekushaikwa kweBCMA Kuratidzira.

Murwere wechikadzi akaonekwa aine nhanho IIIA IgD-λ mhando yakawanda myeloma muna 2018 akawana kurapwa kwekutanga kunyanya nebortezomib. Mushure me3 kutenderera, akawana kuregererwa kwakakwana (CR). Muna Gumiguru 2018, akaita autologous hematopoietic stem cell transplantation sekubatanidza kurapa, ichiteverwa nekugadzirisa kurapa nenalidomide. Muna Kubvumbi 2020, chirwere chakatanga zvakare, uye akarapwa kanomwe kechipiri kurapwa, zvichipa kusashanda zvakanaka. Kubva Zvita 2020 kusvika Kubvumbi 2021, akawana chemotherapy kunyanya ne daratumumab, asi bone marrow biopsy ichiri kuratidza 21.763% yakashata monoclonal plasma masero, aine serum yemahara light chain pa1470 mg/L uye weti isina chiedza cheni λ pa5330 mg/L. Panguva ino, akange apedza kurapa kwakakura uye kutsva kunowanikwa mudzimba, kusanganisira kuita autologous stem cell transplantation, nekupinda muCAR-T muyedzo wekiriniki iriyo yakanyanya kusarudzika sarudzo.

Vachitaurwa nevarapi veko, vakaendesa kuchipatara cheLudaopei muna Chivabvu 10, 2021, vachitarisira kunyoresa muyedzo yavo yekiriniki yeBCMA CAR-T kurapwa mune akawanda myeloma (MM). Pakubvumirwa, akanga asina simba nemarwadzo akazara uye fivha yaidzokororwa. Ongororo dzakadzama dzakasimbisa "multiple myeloma, λ light chain type, ISS stage III, R-ISS stage III, mSMART high-risk group."

PET-CT scan yakaratidza kuwedzera kwemetabolism muhutano hwakapfava mukati memapfupa emapfupa emakumbo emadzimai maviri uye tibias, zvichiratidza kubatanidzwa kwebundu. Bone marrow biopsy yakaratidza 60.13% yakaipa monoclonal plasma masero asina kutaura kweBCMA.

Chipatara cheLudaopei chakazivisa murwere nemhuri yake nezvekushanda kwekurapa kwazvino kweBCMA-negative multiple myeloma, iyo kunyangwe ichigona kushanda maererano nemamwe mabhuku, haina data chaiyo. Mushure mekunyatsofungisisa, murwere nemhuri yake vakasarudza kuenderera mberi nehurongwa hwekurapwa.

Kutevera preconditioning neFC regimen, maseru eBCMA CAR-T akaiswa musi waChikumi 1, 2021, kuLudaopei Hospital. Murwere akatanga fever post-infusion, iyo yakadzorwa zvishoma nezvishoma nehutsinye hwekurwisa hutachiona uye zviratidzo zvinotsigira kurapwa. Mazuva gumi nemana mushure mekunyudzwa, bone marrow biopsy yakaratidza kusasara kwakashata monoclonal plasma masero. Mazuva makumi matatu nerimwe mushure mekuiswa, bone marrow biopsy yakaramba isina kunaka. Serum immunofixation yakanga isina kunaka, serum yemahara light chain λ yaive mukati meyakajairika, uye serum M protein yaive isina kunaka, ichiratidza kuregererwa kwakakwana kwechirwere.

Parizvino, mwedzi inopfuura 8 mushure mekugamuchira BCMA CAR-T cell infusion, murwere anoramba ari mukuregererwa kwakakwana nekugadzirisa kwakanaka uye kugutsikana kukuru nemugumisiro wekurapa.