I-Myeloma eminingi(MM)-02

Isiguli Sase-Italy Sifuna Ukwelashwa Futhi Selashwa I-Myeloma Eningi Ngokwelashwa Kwe-CAR-T

U-Cinty, owesifazane oneminyaka engu-66 ubudala, kwatholakala ukuthi une-lambda light chain multiple myeloma, isigaba se-ISS I, e-Italy ngo-Okthoba 2018. Ngemva kokuthola imijikelezo engu-4 ye-VTD yokwelashwa ngamakhemikhali, waba nokuphuka kwengxenye yesithathu engemuva ye-clavicle futhi. I-peripheral neuropathy. Efuna ukwelashwa okuphumelelayo, wafakwa ama-autologous stem cell ngoMeyi 2019 nangoNovemba 2019, wathola ukuxolelwa okuphelele, futhi wagcinwa ku-lenalidomide yomlomo.

Kodwa-ke, ngo-Agasti 2020, ukuskena okulandelwayo kwe-PET/CT kwembula ukucekelwa phansi kwamathambo okusha kanye nokwanda okusheshayo kwamaketanga okukhanya angenayo i-serum. I-biopsy yomnkantsha yabonisa ukuqhubeka kwesifo, futhi ukuhlolwa kwe-FISH kwabonisa ukungavamile okusha kwe-cytogenetic: t(11;14). Ngemuva kwemijikelezo emi-4 ye-DVD yerejimeni yokwelashwa ngamakhemikhali eqala ngoSepthemba 2020, isifo sakhe sasingalawuleki futhi siqhubekela phambili. Naphezu kokushintshela emijikelezweni ye-3 yerejimeni ye-PCd, ubuhlungu bethambo lakhe baqhubeka futhi i-edema yemilenze engaphansi kwamazwe amabili yaba yimbi kakhulu. Ngemva kokuqeda izindlela zokwelapha eziningi ezisebenza ngempumelelo ezaziwa emhlabeni wonke futhi waphinde wafakelwa izingxenye ezimbili ze-autologous stem cell, waqala ukumelana nemithi eminingi.

Lapho ezwa ngokusebenza okuphawulekayo kokuhlolwa komtholampilo kwe-CAR-T esibhedlela saseLudaopei ngolwazi oluku-inthanethi, wafaka isicelo se-visa futhi wafika eChina ngoMashi 2021. Ngemva kwenyanga evalelwe yedwa, wangeniswa esibhedlela sase-Yanda Ludaopei ngo-Ephreli 22. 2021. Ngemva kochungechunge lwezivivinyo nokuhlolwa kwezifo, wathola ukufakwa kwamaseli e-BCMA CAR-T ngemva kwe-FC chemotherapy preconditioning ngoMeyi wawo lowo nyaka. Ngemva kokumpontshelwa, izimpawu zakhe ezibalulekile zazizinzile, futhi akazange abe nemiphumela engemihle ephawulekayo ngaphandle komkhuhlane wezinga eliphansi. I-edema yakhe engaphansi kwezinhlangothi zombili yadamba kancane kancane, futhi wajabula ukubona impilo yakhe yonke iba ngcono.

Inyanga eyodwa ngemva kokufakwa kwe-CAR-T, imiphumela yokuhlolwa kukaCinty yabonisa: ukulinganisa kwamaprotheni omchamo wamahora angu-24 ku-50 mg/ngosuku, kwehle kakhulu emazingeni okungeniswa; amaketanga okukhanya e-serum mahhala: i-FLC-κ ku-4.58 mg/L ne-FLC-λ ku-0.61 mg/L; nokuhlolwa komnkantsha akubonisi amaseli e-plasma abalulekile. Wahlolwa ngokomtholampilo ukuthi usexolelwe ngokuphelele (CR).

Njengamanje, ngemva kwezinyanga eziyisishiyagalombili ebuyele e-Italy, ubuhlungu bukaCinty emhlane kanye ne-edema esithweni esingaphansi kwamazwe amabili sekunyamalele ngokuphelele, futhi unempilo enhle. Kusukela ezinkulungwaneni zamamayela kude, u-Cinty uzwakalise ukubonga kwakhe okuqotho ethimbeni lase-Yanda Ludaopei Hospital kanye noMqondisi u-Zhang Xian.

Lezi zimo ezimbili zomtholampilo zaseSibhedlela i-Ludaopei zibonisa ukuthi ngisho neziguli ezine-BCMA ephansi noma ezingenakho ukuvezwa kwe-myeloma eminingi zingazuza ukusebenza kahle ngokwelashwa kweseli ye-BCMA CAR-T. Lokhu kumelela impumelelo ekwelashweni kwe-CAR-T kwe-myeloma eminingi, okuletha ithemba elisha ezigulini ezinokuphazamiseka okuthuthukile kwe-plasma cell kanye ne-myeloma eminingi.