قد 2022: Matthew is a 27-year-old patient with سرطان الدم الليمفاوي الحاد who was diagnosed in 2015. Unfortunately, the standard treatment of chemotherapy and bone marrow transplantation failed. He qualified for a clinical trial at London’s Kings College Hospital, where he underwent العلاج CAR-T. Matthew shares his personal story about how this groundbreaking treatment saved his life. “I’m concerned that blast cells make up almost half of your bone marrow.” After undergoing UKALL14 induction, two rounds of FLAG-Ida, and a non-related donor bone marrow transplant to treat your acute lymphoblastic leukaemia, that’s not exactly the news you want to hear.
وبغض النظر عن ذلك، كانت هذه هي الكلمات التي سمعتها. بدلًا من الانزعاج، بدأت على الفور بالتفكير في كيفية حل هذا التحدي. بينما كان الناس من حولي مذهولين ومستاءين، اعتبرت هذا تحديًا.
Except for the pioneering العلاج CAR-T I had heard so much about in the press, I disregarded all of my options after being presented with them. This was not only the treatment I desired, but it was also the treatment I required! The only issue was that it was still in phase one and two clinical trials, the majority of which were in the United States and cost roughly £500,000, all of which had to be paid for by the patient!
I was recommended to two doctors who were conducting clinical trials, but neither of them were appropriate for me. Meanwhile, I was taking vincristine and prednisone to keep the disease at bay. My consultant worked hard to put together a protocol and ensure the proper care was in place for me to receive بليناتوماب, but it was not to be.
I found a link to the Leukemia & سرطان الغدد الليمفاوية Society in the United States after doing a lot of research and contacting many relevant people. I went to the website and discovered that there was an immediate chat facility. I typed in a message describing my condition and my desire for CAR-T therapy. I received a response within a few minutes, much to my amazement. A trial was running in London, according to the message, and there was a link to the experiment on the clinical trials website! It was unbelievable!
The study was headquartered in London, and I appeared to be eligible based on the description. I recognized the lead doctor’s name and emailed him.
لقد كتبت البريد الإلكتروني بعد ظهر يوم السبت، لذلك لم أتوقع الرد حتى الأسبوع التالي، لكنني فوجئت بسرور بتلقي الرد في نفس اليوم! وذكرت أنني أبدو مناسبًا، ولكن لا يمكن تقديم أي ضمانات، وأن العلاج كان تجريبيًا للغاية لأنه استخدم الخلايا التائية المانحة بدلاً من العلاجات الأخرى.
I got a bone marrow biopsy and various blood tests to confirm I met the study criteria after some conversation between the trial doctor and my specialists. All of the tests revealed that I was eligible for the trial, which gave me great relief.
ولكن كان هناك حجر عثرة آخر. تم إعطائي علاجًا وقائيًا مضادًا للفطريات عندما كنت أتناول عقار فينكريستين وبريدنيزون. ارتفعت إحدى قراءات إنزيمات الكبد الخاصة بي فوق النطاق المسموح به في التجربة. لسوء الحظ، فقدت مكاني، لكن مستويات إنزيمات الكبد تحسنت خلال الأسبوعين التاليين، وكنت محظوظًا بما يكفي ليُعرض عليّ منصب آخر.
عندما وصلت إلى مستشفى كينغز كوليدج في لندن، خضعت للعلاج الكيميائي لمدة خمسة أيام لإعداد جسدي لخلايا CAR-T. بعد ذلك، أخذت يوم إجازة قبل أن أحصل على الخلايا في اليوم التالي. لقد كانت لحظة مذهلة بالنسبة لي بعد كل هذا البناء. وبينما كنت أشاهد تلك الخلايا التي يتم حقنها في خط القسطرة المركزية المدخلة طرفيًا (PICC)، شعرت بموجة من الأمل في أنها قد تكون مجرد المفتاح لاستعادة حياتي.
There had been no trace of activity from the cells for about a week. Then, about a week after the infusion, I had a fever. Only paracetamol was able to reduce the fever, which lasted for several days. When my temperature began to rise as the paracetamol wore off, I remember it being uncomfortable but not unbearable.
After experiencing pain in my lower abdomen a few days later, I was referred for an ultrasound. I developed appendicitis, to everyone’s surprise! I was anaemic, neutropenic, and had a low platelet count at this point, so operating was dangerous, but a ruptured appendix was also not ideal.
The surgeons and the haematology physicians had a brief chat. Haematology wanted to give me antibiotics to see if it would help my appendix settle down because they thought it was a side effect of the CAR-T cells, but the surgeons wanted to operate.
تم نقلي إلى العناية المركزة. أتذكر الذهاب إلى هناك بدفء شديد ومحاولة البقاء هادئًا باستخدام مناشف ورقية مبللة. كنت نائمًا عندما وصلت إلى العناية المركزة، متوقعًا تمامًا أن أستيقظ خلال ساعات قليلة مع ارتفاع درجة حرارتي. لكن درجة حرارتي ظلت طبيعية. اندهش الأطباء عندما لاحظوا أن درجة حرارتي لم تعد مرتفعة وأن الألم في جانبي قد زال عندما جاءوا لزيارتي في صباح اليوم التالي؛ لقد تعافى بأعجوبة!
لقد تم إطلاق سراحي من العناية المركزة بعد بضعة أيام. لقد أصبت بطفح جلدي على ظهر يدي بعد حوالي أسبوع. وبعد بضعة أيام أخرى، بدأ الطفح الجلدي ينتشر في جميع أنحاء جسدي. تم وصف كريمات الستيرويد، لكن يبدو أنها لم تساعد كثيرًا. كنت غير مرتاح تمامًا بسبب الطفح الجلدي، وكان من الصعب علي ألا أخدش.
I noticed the lower area of my back was swollen and felt full of fluid one weekend. I called the on-call haematologist, who recommended that I go to A&E. I was admitted to the hospital after being examined by a doctor, just a few days ahead of schedule for my second bone marrow transplant. I was given oral steroids, which helped to reduce the rash.
I was finally able to return home after another arduous bone marrow transplant. Since then, I’ve continued to restore my mental and physical health and vigour. I was fortunate enough to avoid significant infections until 11 months after the second transplant, when I acquired a fungal chest infection that required me to return to the hospital for 10 days. Aside from that, I’ve continued to reconstruct my life, returning to work, beginning to exercise, and finding my new normal, which is different from my previous one but equally fantastic!
Finally, I want to express my gratitude to everyone mentioned in this narrative. Everyone that helped me, including my family and friends,. All of the doctors, nurses, and medical personnel who looked after me. All of the scientists and researchers who contributed to the development of the drugs and therapies I received. All blood donors, my two stem cell donors, and those who donate to and work for the organizations that create the stem cell registry.
