Systemic lupus erythematosus (SLE)-05

Mai C mudzimai ane makore makumi matatu nemaviri ekuberekwa ane nhoroondo yekubatwa nechirwere chinonzi systemic lupus erythematosus (SLE) makore maviri apfuura. Zviratidzo zvake zvekutanga zvinosanganisira nephritis yakaoma, arthritis, uye mapundu. Kunyangwe akagamuchira akawanda immunosuppressive therapies (kusanganisira glucocorticoids, hydroxychloroquine, uye rituximab), mamiriro ake akaramba asingadzoreki.

Pre-treatment Condition:

 Zviratidzo: Kurwadza kwemajoini kwakanyanya uye kuzvimba, mapundu anoramba aripo, kuneta kwakanyanya, uye nephritis flare inodzokororwa.

 Murabhoritari Zvakawanikwa:

# SLEDAI-2K zvibodzwa: 16

# Serum anti-double-stranded DNA antibody mazinga: Yakasimudzwa pamusoro peyakajairwa renji

# Kuzadzisa C3 uye C4 mazinga: Pazasi akajairwa renji

Kurapa Maitiro:

1.Kusarudzwa Kwemurwere: Zvichipa kusashanda kwemishonga yemagariro uye kuoma kwehutano hwake, Ms. C akanyoreswa muchirongwa chekliniki cheCAR-T cell therapy.

2.Kugadzirira: Asati agamuchira CAR-T cell infusion, Ms. C akawana chemotherapy conditioning kuti apedze lymphocytes iripo uye kugadzirira kuiswa kweCAR-T masero.

3.Kugadzirira Sero:

# T masero aive akaparadzaniswa neropa raMai C.

# Aya maT masero akagadzirwa genetically engineered mulabhu kuratidza chimeric antigen receptors (CAR) yakanangana neCD19 uye BCMA maantigen.

4.Cell Infusion: Mushure mekuwedzera uye kuongororwa kwehutano, masero eCAR-T akagadzirwa akaiswazve mumuviri waMs. C.

5.Inpatient Monitoring: Ms. C aiongororwa muchipatara kwemazuva makumi maviri nemashanu mushure mekuvhara-infusion kuti aone zvinogona kuitika uye kuongorora kushanda.

Kurapa Kunobuda:

1.Mhinduro yenguva pfupi:

# Kuvandudzwa kweChiratidzo: Mumavhiki matatu mushure mekuisirwa, Ms. C vakaona kuderera kukuru kwemarwadzo emajoini uye kuzvimba, uye mapundu ake akadzikira zvishoma nezvishoma.

# Marabhoritari Mhedzisiro: Mazuva maviri mushure mekuiswa, masero eB muropa raMs C akabviswa zvachose, zvichiratidza kutariswa kunoshanda nemaseru eCAR-T.

2.Mid-term Evaluation (mwedzi mitatu):

# SLEDAI-2K mamakisi: Yakaderedzwa kusvika pa2, ichiratidza kuregererwa kwechirwere.

# Renal Basa: Kudzikira kwakakosha muproteinuria, ine nephritis iri pasi pekutonga.

# Immunological Markers: Kudzikira kwemazinga e-anti-double-stranded DNA antibodies, uye anoenderana neC3 neC4 mazinga akadzokera kune zvakajairika.

3.Nguva Yakareba Mibairo (12 mwedzi):

# Sustained Remission: Ms. C vakachengeta kuregererwa kusina zvinodhaka kwegore rimwe pasina zviratidzo zveSLE kudzoka zvakare.

# Chengetedzo: Kunze kweiyo mild cytokine release syndrome (CRS), Ms. C havana kuona chero mhedzisiro yakaoma. immune system yake zvishoma nezvishoma yakapora mushure mekurapwa, uye kubudazve B masero haana kuratidza pathogenicity.

Pakazara, chimiro cheMs. C chakaratidza kuvandudzwa kunoshamisa uye kuregererwa kwakasimba kunotevera CAR-T cell therapy, zvichiratidza kugona kwekurapa uku kweSLE yakaoma uye inoramba.

CART cell test report: