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

Isivivinyo somtholampilo se-CAR-T ibhuloho lokufakelwa kwethambo lomnkantsha kwenza isifo sesiguli esingu-B-ALL singatholakali esibhedlela saseLu Daopei.

Eminyakeni emihlanu edlule, uJunaid wayengumfundi ePakistan Medical University, egcwele izifiso zokuba udokotela. Kodwa ngoMeyi 2014, kwatholakala ukuthi une-acute B-lymphocytic leukemia futhi kwadingeka ayeke izifundo zakhe.

Welashelwa endaweni iminyaka engaphezu kwemibili. NgoJanuwari 2018, waphinde waba nobuhlungu be-systemic bamathambo futhi ukuhlolwa komnkantsha kwabonisa ukuthi usebuyele emuva. Ngemva kwesifundo sesibili sokwelashwa ngamakhemikhali esibhedlela sendawo, akakwazanga ukukhululeka futhi isifo sase sithuthukile. Ngokusesha nge-inthanethi kanye nokuncoma kwezinye iziguli, banquma ukuza esibhedlela i-Lu Daopei ukuze bathole ukuhlolwa komtholampilo kwe-CART kanye ne-BMT.

Ngomhla zingama-26 kuNdasa wezi-2018, uJunaid nomndeni wakhe beza eChina futhi bangeniswa emnyangweni we-hematology ojwayelekile weSibhedlela iLu Daopei. UDkt Peggy Lu kanye noDkt Junfang Yang benze ukuhlola okuphelele kukaJunaid. Imibiko iveze ukuthi umthamo wokuqhuma komnkantsha wawungaphezulu kuka-69% futhi wayenezifo zefungal yamaphaphu. Ngemva kokwelashwa ngokucophelela, isiguli sasisesimweni esizinzile. Ngomhla zingama-24 kuMbasa 2018, u-Junaid waphinde wafakwa namaseli amabili e-CD19 & CD22 CAR-T. Ngemva kwamasonto amabili, isibalo sokuqhuma komnkantsha kwaba ngu-0. Ukumamatheka kwabuyela emndenini kaJunaid. UJunaid wayezongena kwi-BMT ukuze angabi nezifo.

Ngomhla zingama-25 kuNhlangulana wezi-2018, uDkt Yue Lu, umqondisi womnyango we-BMT, kanye nethimba lezokwelapha likaDkt Fang Xu benza i-BMT yabafowabo nodadewabo uJunaid. Umnikezeli kaJunaid umfowabo omncane. ngomhla ka-6 Julayi, i-peripheral stem cell yabuyiselwa ku-Junaid, ngemva kwezinsuku eziyi-17 ukufakelwa kwamangqamuzana amhlophe egazi kwaqedwa futhi waphuma ewodini lokugeleza kwe-laminar. Ngemva kwezinsuku ezingu-24, uhlobo lomnkantsha wakhe luhambisana ngokuphelele nohlobo lomnkantsha walowo onikelayo. Ukubuyekezwa kombiko wensalela yomnkantsha akulungile, azikho izinkinga zangaphambi kwesikhathi ezihlobene nokufakelwa. Ngomhla ziyisi-6 Agasti 2018, u-Junaid wakhishwa esibhedlela futhi waqala ukulandelela iziguli zangaphandle.

Inhlangano yegazi yamaShayina iwukusekela okuqinile kwesiguli i-Junaid iwuhlobo lwegazi olune-RH, okuwuhlobo lwegazi olungavamile. Wamukela "i-Lang Fang ezingavamile igazi lomfelandawonye" ukunikela ngegazi mahhala izikhathi eziningi ngesikhathi elala esibhedlela. Akubonakali njengokushoda kokumpontshelwa igazi kuye, uJunaid nomndeni wakhe babonga kakhulu isikhungo samazwe ngamazwe ngokwenza konke lokhu kuJunaid. Phakathi naleso sikhathi, abasebenzi besikhungo samazwe ngamazwe baphelezela uJunaid nomndeni wakhe lapho befika kuze kube manje, babanikeza konke ukuphila kwabo futhi basiza lo mkhaya ukuba unqobe umgoqo wolimi.

Isivivinyo somtholampilo se-CAR-T sihlanganisa i-BMT ukuze sidale esinye isimangaliso. Umnyango we-BMT we-Lu Daopei Hospital ungesinye sezikhungo ezisebenza kakhulu ze-BMT emhlabeni jikelele. U-Junaid uyisiguli sesibili esibuye sabuyela emuva futhi esine-refractory acute B-lymphocytic leukemia esivela ePakistan ukuthola ukwelashwa kwe-CAR-T Bridge BMT. Ukukhishwa ngempumelelo kukaJunaid esibhedlela kuphinda kuphawula ukuqashelwa emhlabeni wonke kobuchwepheshe obuthuthukisiwe besibhedlela sethu sokufakelwa kabusha kwebhuloho le-CAR-T.