Leukemia Lymphoblastic Acute (T-ALL)-03

Hoomanawanui: Huang XX

kāne kāne：Kane

Makahiki: 42 makahiki

ka lāhui: Pākē

ʻIkepili: Leukemia Lymphoblastic Acute (T-ALL)

Kāhea iā mā˚ou

Nā hiʻohiʻona:

- Hōʻoia: ʻO ka maʻi leukemia lymphoblastic T-cell

- Hoʻomaka a me nā hōʻailona: ʻApelila 2020, hōʻike ʻia me ka noʻonoʻo, luhi, a me nā wahi koko koko. Ua ʻike ʻia me ka maʻi leukemia lymphoblastic T-cell ma o ka hoʻokolokolo MICM iwi iwi.

- Hoʻomaʻamaʻa mua: Loaʻa i ke kala piha (CR) ma hope o ka hoʻomaʻamaʻa ʻana o VDCLP i ka chemotherapy, a ukali ʻia e 2 mau manawa o ka hoʻoikaika ʻana i ka chemotherapy.

- Iulai 19, 2020: Loaʻa iā allogeneic hematopoietic stem cell transplantation mai kahi wahine hāʻawi (HLA 5/10 A hāʻawi A). Hoʻokomo ʻia ka hoʻoponopono ʻana i ke kino holoʻokoʻa (TBI), cyclophosphamide (CY), a me etoposide (VP-16). Ua hoʻokomo ʻia nā cell stem peripheral ma Iulai 24, me ka hoʻihoʻi ʻana o ka granulocyte ma ka lā +10 a me ka hoʻopaʻa ʻana i ka platelet ma ka lā +13. Ma hope o ka mālama mau ʻana o ka maʻi ma waho.

- Pepeluali 25, 2021: Ua ʻike ʻia ka hoʻihoʻi ʻana o ka iwi i ka wā o ka hahai ʻana.

- Lapaʻau: Hoʻomaka ka lāʻau thalidomide waha.

- Malaki 8: Hoʻokomo ʻia i ko mākou haukapila.

- Ka Moʻoʻiʻo Iwi: 61.5% pahū.

- Hoʻokaʻawale ʻana i ke koko ʻaoʻao: 15% pahū.

- Immunophenotyping: 35.25% mau keena e hōʻike ana i ka CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, e hōʻike ana i nā lymphocytes T makua ʻole.

- Nānā Kromosoma: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene positive; ana nui: SIL-TA.

- Hoʻololi ʻana i ke koko koko: ʻino.

- ʻIkepili Chimerism (post-HSCT): He 45.78%.

- Malaki 11: ʻOhi ʻana o nā lymphocytes koko peripheral autologous no ka moʻomeheu cell CD7-CART.

- Lapaʻau: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 lā, Dex 9mg q12h x 9 mau lā) hui pū ʻia me ka thalidomide e hoʻomalu i ka ʻōpū.

- Malaki 19: FC regimen chemotherapy (Flu 50mg x 3 lā, CTX 0.4gx 3 lā).

- Malaki 24 (pre-infusion): Ua hōʻike ʻia ka maʻi o ka iwi i ka hyperplasia papa V, me 22% pahū.

- ʻO ka Cytometry kahe o ka iwi: 29.21% mau pūnaewele (o nā pūnaewele nucleated) e hōʻike ana i ka CD3, CD5, CD7, CD99, e hōʻike ana i kahi cCD3, e hōʻike ana i nā pūnaewele T oʻo ʻole.

- Ka nui SIL-TAL1 Fusion Gene: 1.913%.

Lapaʻau:

- Malaki 26: Infusion o nā pūnaewele CD7-CART autologous (5*10^5/kg)

- Nā hopena ʻaoʻao pili i ka CAR-T: CRS grade 1 (fever), ʻaʻohe neurotoxicity

- ʻApelila 12 (La 17): ʻO ka hahai ʻana i hōʻike ʻia i ka morphology o ka iwi iwi i ke kala ʻana, ʻaʻohe mea ʻino i ʻike ʻia e ka cytometry kahe, a me SIL-TAL1 (STIL-SCL) fusion gene quantification ma 0