Kala firdhi lymfoma B-cell weyn (DLBCL) -03

Bishii Maarso 2021, Mr. Wang (magaca beenta ah) ayaa si lama filaan ah u dareemay xanuunka caloosha hoose ee saxda ah, markii hore lagu qalday raaxo la'aanta caloosha iyo mindhicirka, mana uusan raadsan daryeel caafimaad isla markiiba. Labadii bilood ee soo socota, wuxuu si isdaba joog ah ula kulmay calaamadaha xanuunka caloosha hoose ee midig, taasoo ku kaliftay inuu la tashado caafimaad cosbitaal maxalli ah. Baadhitaanka CT-ga ayaa daaha ka qaaday cillado aan caadi ahayn oo ku jira xiidanka iyo qanjidhada retroperitoneal oo weyn.

Dhakhaatiirtu waxay ku taliyeen colonoscopy iyo biopsy si loo helo baadhitaan dheeraad ah, kaas oo xaqiijiyay "la faafiyo lymphoma weyn ee B-cell," oo ah buro halis ah oo loo yaqaan lymphoma. PET-CT waxay sii xaqiijisay nabarrada hypermetabolic nodular ee baahsan ee jidhkiisa oo dhan, oo cabbirka ugu weyni yahay 4.3*4.1*4.5cm.

Isagoo taageero ka helaya qoyskiisa, Mr. Wang waxa uu maray afar wareeg oo R-CHOP chemotherapy. Dabagal PET-CT kemotherabi ka dib ayaa muujisay cafis qayb ah.

Si kastaba ha ahaatee, daawaynta xigtay waxay u horseeday dhibaatooyin daran Mr. Wang, sida xannibaadda mindhicirka, dalool, iyo peritonitis ba'an. Dhakhaatiirta caloosha iyo mindhicirka iyo dhakhaatiirta ka qaybgalaya waxay iska kaashadeen qorshe qalliin, iyagoo fulinaya iska-soocidda mindhicirka iyo dheecaanka, oo ay weheliyaan daryeel taageero calaamad ah, si wax ku ool ah u maareynaya calamihiisa caloosha.

Baadhitaan dambe oo PET-CT ayaa daaha ka qaaday kor u kaca nabarada buro iyo cabbirkooda. Si loo cirib tiro unugyada burooyinka, takhaatiirtu waxay hagaajiyeen habka kiimoterabiga ee la xoojiyay waxayna ku taliyeen in unugyada tarma ee hematopoietic lagu tallaalo.

Isagoo ku jira dib-u-dhacyo isdaba joog ah, Mr. Wang waxa uu la kulmay dhibaato jidheed iyo mid shucuureed oo aad u wayn markii xaaladiisu ka sii darayso. Galitaanka burada ayaa lagu arkay meelo badan, iyada oo ay dhawaan soo baxeen nabarro hypermetabolic nodular nodular ah oo dhawaan soo baxay oo si weyn u weyneynaya aagga kansarka. Burooyin ka soo baxay jidhkiisa oo dhan awgeed, Mr. Wang waxa ka soo gaadhay xanuun habdhis ah, taas oo ku adkaysay in uu si siman u jiifsado oo uu seexdo xanuunka dartii.

Isagoo quus ah, Mr. Wang wuxuu wax ka bartay daawaynta CAR-T, oo ah sheeko cusub oo ah CAR-T immunotherapy si gaar ah loogu talagalay bukaanada qaba dib u laabashada ama dib u celinta unugyada B-cell lymphoma.

Kahor inta aan la marin daawaynta CAR-T, dheecaanka qanjidhada qanjidhada ee gobolka inguinal saxda ah ayaa muujiyay CD19 iyo CD20 togan, taasoo bixisa bartilmaameedyo sax ah oo loogu talagalay daaweynta unugyada CAR-T. Professor Yu waxa uu abaabulay baadhitaan jidheed oo faahfaahsan oo faahfaahsan, taasoo keentay horumarinta qorshe daawaynta CAR-T ee shakhsi ahaaneed ee Mr. Wang.

Julaay 25, 2022, Mr. Wang waxa uu cusbitaalka ka helay faleebo unug CD19/20 CAR-T, iyada oo hawshu si habsami leh u socotay. Kormeer dhow iyo daryeel adag oo taageero ah ayaa la xakameeyey falcelinta xun ee faleebada ka dib iyada oo aan lahayn dhibaatooyin nafta halis gelinaya.

In ka yar saddex bilood, markay ahayd Oktoobar 10, 2022, baaritaan PET-CT oo daba socday ayaa xaqiijiyay cafis dhammaystiran, iyadoo qiimeynta guud ay muujineysaa horumar la taaban karo oo xaaladdiisa caafimaad.

Intii lagu guda jiray dabagalka xiga, Mr. Wang wuxuu si joogto ah u maray CT, MRI, ama PET-CT scans, dhamaantood waxay xaqiijinayaan xaaladiisa cafiska oo dhamaystiran. Ilaa hadda, caafimaadkiisu aad ayuu u wanaagsan yahay, isaga oo dhaafay muddada cafiska oo dhammaystiran in ka badan 14 bilood.