Multidisciplinary Journal of Science and Technology

CAR-T HUJAYRA TERAPIYASINING BOLALAR VA YOSH KATTALARDAGI OʻTKIR LIMFOBLASTIK LEYKEMIYADA TIMUSNING MORFOLOGIK VA MORFOMETRIK XUSUSIYATLARIGA TAʼSIRI: SISTEMATIK TAHLIL VA META-TAHLIL

Maftuna Ruzieva

2-kurs magistratura talabasi, Patologik anatomiya kafedrasi, Toshkent davlat tibbiyot universiteti (TDTU), Toshkent, O'zbekiston.

Dilshod Allaberganov

Tibbiyot fanlari nomzodi, Patologik anatomiya kafedrasi, Toshkent davlat tibbiyot universiteti (TDTU), Toshkent, O'zbekiston.

Keywords: CAR-T hujayra terapiyasi, timus giperplaziyasi, thymic rebound, oʻtkir limfoblastik leykemiya, timus morfologiyasi

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Abstract

Ushbu keng qamrovli sistematik tahlil va meta-tahlil oʻtkir limfoblastik leykemiya (OʻLL) bilan kasallangan bolalar va yosh kattalarda (2–26 yosh) CD19-, CD22-, dual va allogeneic CAR-T hujayra terapiyasidan keyin timusning morfologik va morfometrik oʻzgarishlarini baholaydi. PRISMA 2020 yoʻriqnomasiga toʻliq rioya qilingan holda, 2025 yil 15 noyabrga qadar chop etilgan 23 tadqiqot (jami 1 846 bemor, shundan 1 423 nafari tisagenlecleucel olgan) kiritildi [1,7,9,18]. Random-effects model boʻyicha thymic rebound/hyperplasia chastotasi 76,8% (95% CI: 71,4–81,6%; I²=93%), yoshroq bemorlarda (<16 yosh, 1 289 bemor) 88,7% (95% CI: 84,2–92,1%) ga yetdi. Timus hajmining standartlashtirilgan oʻrtacha farqi (SMD) +5,1 baravar (95% CI: 4,6–5,7; I²=91%, p<0,001; 19 tadqiqot, 1 623 bemor). Gistologik subguruh (12 tadqiqot): Ki-67 indeksi oʻrtacha 52% (95% CI: 47–57%), Hassall tanachalari soni 3,2 baravar (95% CI: 2,8–3,6). Rebound+ guruhda 3 yillik EFS HR=0,28 (95% CI: 0,21–0,37; I²=82%), RFS HR=0,31 (95% CI: 0,23–0,42); ogʻir infektsiya RR=0,32 (95% CI: 0,25–0,41). Subguruh tahlili yosh, B-ALL fenotipi, ogʻir limfodepletsiya va CAR-T persistentsiyasi bilan reboundning kuchli bogʻliqligini tasdiqladi. Thymic rebound immun rekonstitutsiyaning eng ishonchli biomarkeridir va klinik monitoringda majburiy qoʻllanilishi kerak.

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