Shawn [Ifaniso ayibonelelwanga]----Acute B-lymphocytic Leukemia (B-ALL)

Ulingo olugqwesileyo lwe-CAR-T lwezonyango lusindisa isigulana saseHong Kong B-ZONKE.

UShawn, yindoda eneminyaka engama-29 ubudala yaseHong Kong. Ngo-Matshi 2017, uneempawu zefiva, ukukhathala kunye nebala. Wafunyaniswa ukuba une-acute B-lymphocytic leukemia kwiSibhedlele sasePrince of Wales kwaye wafumana unyango lwechemotherapy. NgoAprili waya kuxolelo olupheleleyo ngechemotherapy kunye neradiotherapy. Kwaye akukho nto ingaqhelekanga ifunyenweyo kwingxelo yolungelelwaniso lwe-CSF.

Nangona kunjalo, kude kube yi-19 ku-Epreli 2018, i-morphology yomongo wakhe wamathambo ibonise i-10% ye-gonorrhoea yokuqala kunye nolutsha. Oogqirha baseHong Kong bacinga ukuba ichemotherapy inzima ukumenza ukuba axolelwe ngokupheleleyo, yiCAR-T kuphela enethuba elikhulu lokuyenza. Emva kweengcebiso zoogqirha kunye nokuthelekisa izinga lempumelelo kunye nomzamo, u-Shawn weza kwiSibhedlele sase-Lu Daopei e-China ukuba athathe inxaxheba kulingo lwezonyango lwe-CAR-T ngomhla wama-23 ku-Epreli 2018.

Uvavanyo lwe-biopsy yomongo wokungeniswa lubonise ukuba wayengekho kuxolelo ngokupheleleyo kwaye i-CD19, i-CD20 ine-positive. Emva kokubonisana ngezinto ezininzi, iingcali zethu zegazi zicebisa ukuba athathe inxaxheba kulingo lwezonyango lwe-CD19+CD20 CAR-T phambi kokuba afakele umongo wethambo. Kwiimeko zethu ezingama-300 ze-CAR-T, izinga loxolelo olupheleleyo lijikeleze i-90%.

Ngomhla wama-25 ku-Epreli, iiseli ze-T zikaShawn zaqokelelwa zaza zathunyelwa kwilebhu ye-GMP CAR-T kubunjineli bemfuza. Emva kokuguqulwa kofuzo, i-T-cells yaguqulwa yaba "i-chimeric antigen receptor (CAR) T-cells". Ii-CARs ziiproteni ezinceda ii-T-cell zibone i-antigen kwiiseli zethumba ekujoliswe kuzo. Emva kokuba iiseli ze-CAR T zikhuliswe kwisixa esaneleyo sonyango, iiseli ze-CAR T zifakwe kuzo ukuphelisa iiseli zethumba.

UShawn ufumene ikhosi ye-1 ye-chemotherapy ngomhla we-6 kaMeyi, eziziintsuku ezi-5 ngaphambi kokungena kweseli ye-CAR-T. NgoMeyi. Ngomhla we-11 kuMeyi, ukufakwa kweeseli ze-CD19 ze-CAR-T zanikwa njenge-cellular immunotherapy. Emva kweeveki ze-4 zokunakekelwa kwenkxaso kunye nokulawulwa kwempembelelo yecala, akukho ziphoso ezifunyenweyo kwingxelo yokulungelelanisa ye-CSF, i-cytometry yokuhamba, i-bone marrow cell morphology, uvavanyo lwe-DNA kunye nengxelo ye-CAR-T ibonise ukuba ufumene ukuxolelwa okupheleleyo.

Ukuxolelwa ngokupheleleyo yeyona ndlela ilungileyo yokuba abuyele eHong Kong ukuze athabathe inyathelo elilandelayo—uqhaqho-fakelo lwegazi nomongo wethambo.