Junaid----Acute B-lymphocytic Leukemia (B-ALL)

Ulingo lwezonyango lwe-CAR-T ibhulorho umongo wethambo uqhaqho-fakelo lwe-refractory B-ALL isifo sesigulana esisimahla kwiSibhedlele saseLu Daopei.

Kwiminyaka emihlanu eyadlulayo, uJunaid wayengumfundi kwiYunivesithi yezoNyango yasePakistan, ezele yiminqweno yokuba ngugqirha. Kodwa ngoMeyi 2014, kwafunyaniswa ukuba une-acute B-lymphocytic leukemia kwaye kwafuneka aziyeke izifundo zakhe.

Wanyangwa ekuhlaleni iminyaka engaphezu kwemibini. NgoJanuwari 2018, waphinda waphuhlisa intlungu yethambo kwakhona kwaye uvavanyo lwamathambo lubonisa ukuba ubuyele kwakhona. Emva kwekhosi yesibini yonyango lwechemotherapy kwisibhedlele sasekuhlaleni, akazange akwazi ukufikelela kuxolelo yaye eso sifo saye saqhubeka. Ngophando lwe-intanethi kunye neengcebiso zezinye izigulane, bagqiba ekubeni beze kwiSibhedlele sase-Lu Daopei kulingo lwezonyango lwe-CART olukwinqanaba eliphezulu kunye ne-BMT.

Ngomhla wama-26 kaMatshi 2018, uJunaid kunye nosapho lwakhe beza eTshayina kwaye bamkelwa kwisebe le-hematology jikelele kwisibhedlele saseLu Daopei. UGqr Peggy Lu kunye noGqr Junfang Yang benze uphononongo olubanzi lukaJunaid. Iingxelo zabonisa ukuba umthwalo wokuqhushumba umongo wawuphezulu ukuya kuma-69% kwaye wayenosulelo lomngundo emiphungeni. Emva kokunyangwa ngenyameko, isigulane sasikwimeko ezinzile. Ngomhla wama-24 ku-Epreli 2018, uJunaid waphinda wagalelwa ngeeseli ezimbini ze-CD19 & CD22 CAR-T. Emva kweeveki ezimbini, inani leeseli zomongo wethambo laliyi-0. Uncumo lwabuyela kwintsapho kaJunaid. UJunaid wayeza kungena kwi-BMT ukuze angabinazifo.

Ngomhla wama-25 kuJuni ka-2018, uGqr Yue Lu, umlawuli wesebe le-BMT, kunye neqela lezonyango likaGqr Fang Xu baqhubela uJunaid iBMT yabantakwabo. Umnikeli kaJunaid ngumntakwabo omncinci. nge-6 kaJulayi, i-donor peripheral stem cell yafakwa kwakhona kwi-Junaid, emva kweentsuku ezili-17 uqhaqho lofakelo lweseli emhlophe yegazi lugqityiwe kwaye waphuma kwiwadi yokuphuma kwe-laminar. Emva kweentsuku ezingama-24, uhlobo lomongo wakhe wethambo luhambelana ngokupheleleyo nohlobo lomongo wethambo lomnikeli. Ukuphononongwa kwengxelo yentsalela yomongo akulunganga, akukho zingxaki zakwangoko zinxulumene nokutshintshwa. Ngomhla we-6 ka-Agasti 2018, uJunaid wakhutshwa esibhedlele waza waqala ukulandelela izigulane.

Umbutho wegazi waseTshayina yinkxaso eqinileyo yesigulana iJunaid luhlobo lwegazi olune-RH engalunganga, luhlobo lwegazi olunqabileyo. Wamkela "umanyano lwegazi olunqabileyo lweLang Fang" ukunikela ngegazi simahla kangangezihlandlo ezininzi ngexesha lokulaliswa kwakhe esibhedlele. Akuzange kubonakale ngathi kukunqongophala kwegazi kuye, uJunaid kunye nosapho lwakhe bayalixabisa kakhulu iziko lamazwe ngamazwe ngokwenza zonke ezi zinto kuJunaid. Kwangaxeshanye, abasebenzi beziko lezizwe ngezizwe bapheleka uJunaid nentsapho yakhe ukususela ekufikeni kwabo ukuza kuthi ga ngoku, babanika inkxaso yobomi yaye bayinceda intsapho yoyise umqobo wolwimi.

I-CAR-T yolingo lwezonyango iibhulorho ze-BMT ukwenza omnye ummangaliso. Isebe le-BMT leSibhedlele iLu Daopei lelinye lamaziko asebenzayo e-BMT kumazwe ngamazwe. U-Junaid ungowesibini obuyele umva kwaye uyisigulana esibukhali se-B-lymphocytic leukemia esivela ePakistan ukufumana unyango lwe-BMT ye-CAR-T Bridge. Ukukhutshwa okuyimpumelelo kukaJunaid esibhedlele kwakhona kuphawula ukuvunywa kwamazwe ngamazwe kobuchwepheshe obuphezulu besibhedlele sethu sokufakelwa kwebhulorho ye-CAR-T.