May 2022: Matthew is a 27-year-old patient with Akut Lenfoblastik Lösemi 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 CAR-T terapiyası. 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.
Nə olursa olsun, eşitdiyim sözlər bunlar idi. Əsəbiləşmək əvəzinə, dərhal bu problemi necə həll edə biləcəyimi düşünməyə başladım. Ətrafımdakı insanlar heyrətə və əsəbiləşsələr də, mən bunu bir problem kimi qəbul etdim.
Except for the pioneering CAR-T terapiyası 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 blinatumomab, but it was not to be.
I found a link to the Leukemia & Lenfoma 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.
Mən e-poçtu şənbə günü günorta yazdım, ona görə də gələn həftəyə qədər cavab gözləmirdim, amma eyni gün məktubu aldığım üçün çox təəccübləndim! Bu, mənim uyğun göründüyümü, lakin heç bir zəmanətin verilməyəcəyini və müalicənin çox eksperimental olduğunu, çünki digər müalicələrdən daha çox donor T-hüceyrələrindən istifadə edildiyini bildirdi.
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.
Ancaq daha bir maneə var idi. Mən vinkristin və prednizon qəbul edərkən mənə antifungal profilaktika verildi. Qaraciyər fermenti göstəricilərimdən biri sınağın icazə verilən diapazonundan yuxarı qalxmışdı. Təəssüf ki, mən öz yerimi itirdim, lakin sonrakı iki həftə ərzində qaraciyər fermenti səviyyələrim yaxşılaşdı və mənə başqa vəzifə təklif olundu.
Londondakı Kings College Xəstəxanasına gələndə bədənimi CAR-T hüceyrələrinə hazırlamaq üçün beş günlük kimyaterapiyadan keçdim. Bundan sonra ertəsi gün hüceyrələri almadan əvvəl bir gün istirahət etdim. Bütün qurulmadan sonra mənim üçün heyrətamiz bir an idi. Həmin hüceyrələrin PICC xəttimə yeridilməsini izlədikcə, onların həyatımı bərpa etmək üçün açar ola biləcəyinə dair bir ümid dalğası hiss etdim.
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.
Mən reanimasiyaya köçürüldüm. Yadımdadır, ora isti bir isti ilə getdim və nəm kağız dəsmallarla sərin qalmağa çalışdım. Reanimasiyaya gələndə yatmışdım, bir neçə saatdan sonra hərarətimin yüksəlməsi ilə oyanacağımı gözləyirdim. Ancaq temperaturum normal olaraq qaldı. Həkimlər ertəsi gün səhər mənə baş çəkməyə gələndə artıq hərarətimin olmadığını və böyrümdəki narahatlığın getdiyini görüb heyrətləndilər; Möcüzəvi bir sağalma etdim!
Bir neçə gündən sonra ağır müalicədən çıxdım. Təxminən bir həftədən sonra əlimin arxasında döküntü yarandı. Bir neçə gündən sonra səpgi bütün bədənimə yayılmağa başladı. Steroid kremlər təyin olundu, amma çox kömək etmədi. Səpgilər üzündən olduqca narahat idim və cızmamaq mənim üçün çətin idi.
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.
