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Unyango lweGene olutsha lubonelela ngeThemba elitsha kwiSickle Cell kunye nezigulana zeThalassemia

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I-Acute Lymphoblastic Leukemia(T-ALL)-06

Umonde: Xiaohong

Isini: Indoda

Ubudala: iminyaka emi-2 ubudala

Ubuzwe: IsiTshayina

UxilongoI-Acute Lymphoblastic Leukemia (T-ALL)

    Qhagamshelana nathi

    Isigulana esineminyaka emi-2 ubudala esine-T-ALL sifumana uxolelo emva konyango lwe-CAR-T kulandela imijikelo elishumi ye-chemotherapy.


    U-Xiaohong oneminyaka emibini ubudala waseZhejiang wafunyaniswa ukuba une-leukemia kwihlobo elidlulileyo. Emva konyaka wonyango, i-flow cytometry yafumanisa ukuphinda ibuyele, ikhokelela intsapho ukuba ifune unyango lwe-CAR-T kwisibhedlele saseLu Daopei.


    Nge-9 ka-Agasti 2020, uXiaohong wangeniswa kwisibhedlele sabantwana sasekhaya ngenxa "yomkhuhlane weentsuku ezintathu." Umongo wethambo uviwo lwe-MICM lufunyaniswe ukuba i-acute lymphoblastic leukemia (T-ALL). Emva kwekhosi enye ye-chemotherapy, i-bone marrow morphology yabonisa ukuxolelwa okupheleleyo, kunye ne-cytometry yokuhamba yafumanisa ukuba akukho ziseli ezinobungozi. Ichemotherapy ebanzi eyalandelayo kwiikhosi ezili-11 zagcina uxolelo olupheleleyo lomongo wethambo.


    Nge-3 kaSeptemba ka-2021, ulandelelwano lokuhlatywa komongo wamathambo lubonise uxolelo olupheleleyo kwi-morphology, kodwa ukuhamba kwe-cytometry kuveze i-1.85% yeeseli ezingekavuthwa. Ukufuna unyango olongezelelweyo, u-Xiaohong wangeniswa kwiSibhedlele saseYanda Lu Daopei ngoSeptemba 24. Emva kokungeniswa, i-bone marrow morphology yayisesekuxolweni ngokupheleleyo, kodwa i-immunophenotyping ibonise i-0.10% ye-lymphocytes enobungozi e-T lymphocytes.


    Ngokuqwalasela iminyaka emncinci ka-Xiaohong kunye nokuzingisa kwesi sifo ngaphandle kwemijikelo elishumi ye-chemotherapy enzima, iqela lezonyango kwiwadi yesibini yesebe le-hematology lagqiba ekubeni u-Xiaohong angabhalisa kulingo lwezonyango lwe-CD7 CAR-T.


    NgoSeptemba 30, 2021, iiseli zegazi ezijikelezayo zaqokelelwa kwinkcubeko yeeseli ze-CAR-T. Nge-10 ka-Okthobha, u-Xiaohong wafumana i-FC yerejimeni yechemotherapy. Ngomhla we-13 ka-Oktobha, i-bone marrow puncture ibonise ngaphantsi kwe-5% ukuqhuma kwi-morphology, kwaye i-cytometry yokugeleza ibonise i-0.37% ye-cell malignant immature T. Ngomhla we-15 ku-Okthobha, iiseli ze-CD7 CAR-T zaphinda zafakwa.


    Ngomhla we-3 kaJanuwari (ientsuku ze-20 emva kokubuyiselwa kwakhona), ukuhlatywa komnkantsha wamathambo kubonisa ukuxolelwa okupheleleyo kwi-morphology, ngaphandle kweeseli ezinobungozi ezinobungozi ezifunyenwe yi-cytometry yokuhamba. Imeko ka-Xiaohong sele izinzile, kwaye uye watshintshelwa kwisebe lokufakelwa ukuze alungiselele ukufakelwa kwe-allogeneic hematopoietic stem cell.


    UXiaohong wayengaphantsi konyaka omnye ubudala xa wayegula kwaye wanyamezela isithuba esingangonyaka sonyango lweziyobisi. Uqhagamshelo oluyimpumelelo kuqhaqho emva konyango lwe-CD7 CAR-T lubonelele ngesixhobo esinamandla ukoyisa ngokupheleleyo isifo.

    4mm3

    Ukususela ngoJulayi 2015, isibhedlele saseLu Daopei siqalise ulingo lwezonyango lwe-CAR AT yonyango lweseli kwizifo zegazi. Njengenye yeeyunithi zokuqala zokuqalisa unyango lweseli ye-CAR-T e-China, izigulane ze-1342 ziye zangena kulingo ukuza kuthi ga ngoku, kwaye idatha yeklinikhi ibonisa ukusebenza kakuhle kunye nokhuseleko olulawulekayo. I-CD7 yi-40 kDa glycoprotein eyeye-immunoglobulin superfamily, kwaye i-CD7 eqhelekileyo ibonakaliswa ikakhulu kwiiseli ze-T kunye neeseli ze-NK kunye nakumanqanaba okuqala okuhlula iiseli ze-T, B kunye ne-myeloid, kwaye inokusebenza njenge-costimulatory receptor ukusebenzisana phakathi kwe-T kunye ne-B lymphocytes ngexesha lophuhliso lwe-lymphocyte. I-CD7 yi-marker ezinzileyo kumphezulu we-T cell kwaye ikwavavanywa ngoku njengenoveli ekujoliswe kuyo ngonyango lweeseli ze-CAR T kwi-hematological malignancies. Kungekudala, kwiwadi yesibini yeSebe le-Hematology yeSibhedlele saseLudaopei, izigulane ze-4 ezineemeko ezinzima ziye zafumana iziphumo ezicacileyo emva konyango lwe-CD7 CAR-T.

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