IiMyeloma ezininzi (MM)-02

Isigulana saseTaliyane Sifuna Unyango kwaye Sinyangekile kwiMyeloma emininzi ngoNyango lweCAR-T

UCinty, umfazi oneminyaka engama-66 ubudala, wafunyaniswa ukuba une-lambda light chain multiple myeloma, isigaba se-ISS I, e-Italy ngo-Oktobha 2018. Emva kokufumana imijikelezo ye-4 ye-VTD regimen chemotherapy, waphuhliswa ukuphuka kwinqanaba lesithathu le-clavicle kunye. i-peripheral neuropathy. Ukufuna unyango olusebenzayo ngakumbi, uye wafumana i-autologous stem cell transplants ngoMeyi ka-2019 nangoNovemba ka-2019, wafumana uxolelo olupheleleyo, kwaye wagcinwa kwi-lenalidomide yomlomo.

Nangona kunjalo, ngo-Agasti ka-2020, ukulandelwa kwe-PET / CT scan kwatyhila ukutshatyalaliswa kwamathambo amatsha kunye nokwanda ngokukhawuleza kwe-serum yamakhonkco okukhanya. I-Bone marrow biopsy ibonise ukuqhubela phambili kwesifo, kwaye uvavanyo lwe-FISH lubonise ukungaqhelekanga kwe-cytogenetic entsha: t (11; 14). Emva kwemijikelo emi-4 ye-DVD yerejimeni yechemotherapy eqala ngoSeptemba ka-2020, isifo sakhe sasingalawuleki kwaye siqhubela phambili. Ngaphandle kokutshintshela kwimijikelezo ye-3 yerejimeni ye-PCd, intlungu yakhe yamathambo iqhubekile kwaye i-edema ye-bilateral ephantsi ye-edema iyancipha. Emva kokuba egqibile unyango olusebenzayo olwamkelwa kumazwe ngamazwe kwaye wenziwa uqhaqho-fakelo lwe-autologous stem cell, uye waqalisa ukuxhathisa kumachiza amaninzi.

Emva kokufunda malunga nokusebenza okubalulekileyo kovavanyo lwezonyango lwe-CAR-T kwiSibhedlele saseLudaopei ngolwazi lwe-intanethi, wafaka isicelo se-visa waza wafika e-China ngo-Matshi 2021. Emva kwenyanga yokuvalelwa yedwa, wangeniswa kwisibhedlele saseYanda Ludaopei ngo-Epreli 22. 2021. Ukulandela uthotho lweemviwo kunye novavanyo lwezifo, wafumana ukufakelwa kweeseli ze-BCMA CAR-T emva kwe-FC chemotherapy preconditioning ngoMeyi waloo nyaka. Emva kokutofa, iimpawu zakhe ezibalulekileyo zazizinzile, kwaye akazange abe neziphumo ebezingalindelekanga zibalulekileyo ngaphandle komkhuhlane womgangatho ophantsi. I-edema yelungu lamacala amabini asezantsi yathotha ngokuthe ngcembe, kwaye wavuya ukubona impilo yakhe iyonke iphucuka.

Inyanga enye emva kokunyuswa kwe-CAR-T, iziphumo zovavanyo zikaCinty zibonise: ubungakanani beprotheyini ye-urine ye-24 yeyure kwi-50 mg / ngosuku, iyancipha kakhulu kumanqanaba okungeniswa; i-serum yamahhala amatyathanga okukhanya: i-FLC-κ kwi-4.58 mg / L kunye ne-FLC-λ kwi-0.61 mg / L; kunye novavanyo lomongo wethambo alubonisi iiseli zeplasma ezibalulekileyo. Waye wavavanywa ngokwezonyango ukuba uxolelwe ngokupheleleyo (CR).

Sithetha nje, kwiinyanga ezisibhozo ebuyele e-Italiya, iintlungu zikaCinty zomqolo kunye nokudumba kwelungu elingaphantsi kwamacala amabini ziye zanyamalala ngokupheleleyo, yaye usempilweni entle. Ukusuka kumawaka eekhilomitha kude, uCinty wavakalisa umbulelo ongazenzisiyo kwiqela lesibhedlele saseYanda Ludaopei kunye noMlawuli uZhang Xian.

Ezi meko zimbini zeklinikhi ezisuka kwiSibhedlele saseLudaopei zibonisa ukuba nezigulane ezine-BCMA ephantsi okanye ezingenayo inkcazo kwi-myeloma eninzi zinokufezekisa ukusebenza kakuhle ngonyango lweseli ye-BCMA CAR-T. Oku kubonisa impumelelo kwi-CAR-T yonyango lwe-myeloma emininzi, izisa ithemba elitsha kwizigulane ezineengxaki eziphambili ze-plasma kunye ne-myeloma eninzi.