Lupus erythematosus (SLE) -05

Ms. C waa 32 jir dumar ah oo leh taariikh laga helay cudurka lupus erythematosus (SLE) laba sano ka hor. Calaamadaheeda aasaasiga ah waxaa ka mid ah nephritis daran, arthritis, iyo finan. In kasta oo la helay daawayn badan oo difaaca jirka ah (ay ku jiraan glucocorticoids, hydroxychloroquine, iyo rituximab), xaaladeeda ayaa weli ah mid aan la xakameynin.

Xaaladda daawaynta ka hor:

 Calaamadaha: Xanuun iyo barar daran oo kalagoysyo ah, finan joogto ah, daal badan, iyo hurgunka nephritis oo soo noqnoqda.

Natiijooyinka Shaybaarka:

Dhibcaha # SLEDAI-2K: 16

# Serum anti-double-stranded DNA heerarka antibody: Sare u kacday heerka caadiga ah

# Buuxi heerarka C3 iyo C4: Ka hooseeya heerka caadiga ah

Habka daawaynta:

1.Xulashada Bukaan-socodka: Marka la eego waxtarla'aanta daaweynta dhaqameed iyo darnaanta xaaladdeeda, Ms. C waxaa lagu qoray tijaabo caafimaad oo loogu talagalay daaweynta unugyada CAR-T.

2. Diyaarinta: Ka hor inta aan la helin faleebo unug CAR-T ah, Ms. C waxa ay mareen qaboojinta kiimoterabiga caadiga ah si ay u baabi'iso lymphocytes ee hadda jira iyo u diyaargarowga hordhaca unugyada CAR-T.

3. Diyaarinta unugga:

Unugyada T waxay ka go'doomiyeen dhiigga Marwo C.

Unugyadan T-da waxa lagu farsameeyay hidde ahaan shaybaadhka si ay u muujiyaan reseptors-ka antigen-ka (CAR) ee lagu beegsanayo CD19 iyo BCMA antigens.

4.Cell Faleebo: Kadib ballaarinta iyo tijaabinta tayada, unugyada CAR-T ee la farsameeyay ayaa dib loo galiyay jirka Ms. C.

5. Kormeerka Bukaan-jiifka: Ms. C waxaa lagu kormeeray cusbitaalka 25 maalmood ka dib faleebo si loo eego waxyeelada suurtagalka ah loona qiimeeyo waxtarka.

Natiijooyinka daawaynta:

1.Jawaab waqti gaaban:

# Hagaajinta Calaamadaha: Saddex toddobaad gudahood faleebada ka dib, Ms. C waxay la kulantay hoos u dhac weyn oo ku yimaadda xanuunka wadajirka ah iyo bararka, finankeeduna si tartiib tartiib ah ayey u libdheen.

# Natiijooyinka Shaybaadhka: Laba maalmood ka dib faleebada, unugyada B ee dhiiga Ms. C ayaa gabi ahaanba la dabar gooyay, taasoo muujinaysa bartilmaameedka waxtarka leh ee unugyada CAR-T.

2. Qiimaynta Dhex-dhexaadka ah (3 bilood):

Dhibcaha # SLEDAI-2K: Waa loo dhimay 2, taasoo muujinaysa cafis la taaban karo oo cudur ah.

# Shaqada kelyaha: Hoos u dhac weyn oo ku yimid borotiinka, iyadoo la xakameynayo nephritis.

Calaamadaha Immunological: Heerarka unugyada difaaca DNA-da-laba-xaran ee hoos u dhacay, iyo dhammaystirka heerarka C3 iyo C4 ayaa caadi ku soo noqday.

3. Natiijooyinka muddada-dheer (12 bilood):

# Cafis Joogta ah: Marwo C waxa ay sii daysay cafis bilaa daroogo ah muddo hal sano ah iyada oo aan lahayn calaamado ah soo noqoshada SLE.

# Badbaadada: Marka laga reebo cilladda sii-deynta cytokine fudud (CRS), Ms. C ma aysan la kulmin waxyeellooyin daran. Nidaamkeeda difaaca ayaa si tartiib tartiib ah u soo kabtay daawaynta ka dib, iyo unugyada B ee dib u soo baxay ma muujin cudur-sidaha.

Guud ahaan, xaaladda Ms. C waxay muujisay horumar la yaab leh iyo cafis joogto ah ka dib daawaynta unugyada CAR-T, taasoo muujinaysa awoodda daawayntan ee SLE daran oo aan leexleexad lahayn.

Warbixinta baaritaanka unugga CART: