Shawn [Isibongo Asinikeziwe]----Acute B-lymphocytic Leukemia (B-ALL)

Isilingo esihle kakhulu somtholampilo se-CAR-T sisindisa isiguli sase-Hong Kong B-ALL.

UShawn, insizwa eneminyaka engu-29 ubudala yaseHong Kong. Ngo-March 2017, unezimpawu zomkhuhlane, ukukhathala nokuphaphatheka. Watholakala ene-acute B-lymphocytic leukemia esibhedlela i-Prince of Wales futhi wathola ukwelashwa ngamakhemikhali okungeniswa. Ngo-April wangena ekuxolelweni okuphelele nge-chemotherapy kanye ne-radiotherapy. Futhi akukho okungavamile okutholakele embikweni wokulungiswa kwe-CSF.

Kodwa-ke, kuze kube umhla ziyi-19 kuMbasa wezi-2018, i-morphology yomnkantsha wakhe yabonisa u-10% we-gonorrhoea eyinhloko kanye nentsha. Odokotela baseHong Kong bacabanga ukuthi ukwelapha ngamakhemikhali kunzima ukumenza akhululeke ngokuphelele, yi-CAR-T kuphela enethuba elihle lokuyenza. Ngemva kokuncoma kodokotela nokuqhathanisa izinga lempumelelo nomzamo, u-Shawn weza esibhedlela sase-Lu Daopei e-China ukuze abambe iqhaza ocwaningweni lomtholampilo lwe-CAR-T ngomhla zingama-23 kuMbasa wezi-2018.

Ukuhlolwa kwe-biopsy yethambo lomnkantsha kwabonisa ukuthi wayengekho ekuxolelweni okuphelele futhi i-CD19, i-CD20 ine-positive. Ngemva kokubonisana okuhlukahlukene, izazi zethu ze-hematologists ziphakamisa ukuthi abambe iqhaza ocwaningweni lwe-CD19+CD20 CAR-T ngaphambi kokufakelwa komnkantsha. Emacaleni ethu angu-300 e-CAR-T, izinga lokuxolelwa okuphelele licishe libe ngu-90%.

Ngomhla zingama-25 kuMbasa, ama-T-cell ka-Shawn aqoqwa futhi athunyelwa elabhorethri ye-GMP CAR-T ukuze kwenziwe ubunjiniyela bofuzo. Ngemva kokuguqulwa kofuzo, ama-T-cell aguqulwa abe ama-"chimeric antigen receptor (CAR) T-cells". Ama-CAR angamaprotheni asiza ama-T-cell abone i-antigen kumaseli wesimila okuhlosiwe. Ngemuva kokuthi amaseli e-CAR T esekhulile abe nenani elanele lokwelashwa, amaseli e-CAR T afakwa kuwo ukuze aqede amaseli wesimila.

UShawn uthole inkambo ye-chemotherapy e-1 ngomhlaka-6 Meyi, okuyizinsuku ezi-5 ngaphambi kokujova iseli le-CAR-T. NgoMeyi. Ngomhla ziyi-11 kuNhlaba, ukufakwa kwamaseli e-CD19 CAR-T kwanikezwa njenge-cellular immunotherapy. Ngemva kwamaviki angu-4 okunakekelwa okusekelayo nokuphathwa kwemiphumela emibi, akukho okungavamile okutholakele embikweni wokulungiswa kwe-CSF, i-cytometry yokugeleza, i-bone marrow cell morphology, ukuhlolwa kwe-DNA kanye nombiko we-CAR-T wabonisa ukuthi uthole ukuxolelwa okuphelele.

Ukukhululeka ngokuphelele kuyindlela engcono kakhulu yokuba abuyele eHong Kong ukuze athathe isinyathelo esilandelayo—ukufakelwa igazi nomnkantsha.