M cutar sankarar bargo ta Lymphoblastic (T-ALL) -03

Mai haƙuri: Huang XX

Jinsi: Namiji

Shekaru: shekara 42

Dan kasa: Sinanci

BincikeCutar sankarar bargo ta Lymphoblastic (T-ALL)

Tuntube mu

Siffofin Harka:

- Ganewa: Cutar sankarar bargo ta T-cell lymphoblastic

- Farko da Alamun: Afrilu 2020, wanda aka gabatar da dizziness, gajiya, da maki zubar jini na fata. An gano cutar sankarar bargo ta T-cell lymphoblastic cutar sankarar bargo ta hanyar gwajin MICM na kasusuwa.

- Jiyya na farko: An sami cikakkiyar gafara (CR) bayan tsarin chemotherapy na VDCLP, wanda ke biye da zagayowar 2 na haɓakar cutar sankara.

- Yuli 19, 2020: An sami allogeneic hematopoietic stem cell transplantation daga mace mai ba da gudummawa (HLA 5/10 A mai bayarwa A). Tsarin tsari ya haɗa da jimlar iska mai guba (TBI), cyclophosphamide (CY), da etoposide (VP-16). An shigar da sel masu tushe a ranar 24 ga Yuli, tare da farfadowar granulocyte da rana +10 da kuma ƙarar platelet da rana +13. Biyan marasa lafiya na yau da kullun bayan haka.

- Fabrairu 25, 2021: An gano koma bayan kasusuwa yayin bin diddigin.

- Jiyya: An fara maganin thalidomide na baka.

- Maris 8: An kwantar da shi a asibitin mu.

- Ilimin Halittar Kashi: 61.5% fashewa.

- Rarrabawar Jini: 15% fashewa.

- Immunophenotyping: 35.25% Kwayoyin bayyana CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, yana nuna m m m m m m m m.

- Binciken Chromosome: 46, XX [9].

- cutar sankarar bargo Fusion Gene: SIL-TAL1 fusion gene tabbatacce; ma'aunin ƙididdiga: SIL-TA.

- Tumor Jini: Mara kyau.

- Binciken Chimerism (bayan-HSCT): Kwayoyin da aka samu masu bayarwa sun kai 45.78%.

- Maris 11: Tarin nau'in lymphocytes na jini mai sarrafa kansa don al'adun sel CD7-CART.

- Jiyya: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 days, Dex 9mg q12h x 9 days) tsarin hade da thalidomide don sarrafa ciwon daji.

- Maris 19: FC tsarin chemotherapy (Flu 50mg x 3 days, CTX 0.4gx 3 days).

- Maris 24 (pre-jiko): Kwayoyin halittar kasusuwa na kasusuwa sun nuna hyperplasia na V, tare da fashewar 22%.

- Kashi Marrow Flow Cytometry: 29.21% Kwayoyin (na kwayoyin halitta) suna bayyana CD3, CD5, CD7, CD99, wani ɓangare na bayyana cCD3, yana nuna ƙwayoyin T marasa girma.

- Yawan SIL-TAL1 Fusion Gene: 1.913%.

Jiyya:

- Maris 26: Jiko na sel CD7-CART (5*10^5/kg)

- Abubuwan da ke da alaƙa da CAR-T: CRS grade 1 (zazzabi), babu neurotoxicity

- Afrilu 12 (Ranar 17): Bibiyar ya nuna ilimin halittar jiki na kasusuwa a cikin remission, babu ƙwayoyin da ba su da girma da aka gano ta hanyar cytometry mai gudana, da kuma SIL-TAL1 (STIL-SCL) fusion gene quantification a 0