Leukemia Lymphoblastic Acute (T-ALL)-04

ʻO ka maʻi maʻi lymphoblastic acute cellular me ka hoʻihoʻi ʻana o ka maʻi ma hope o ka hoʻololi ʻana a me ka maʻi leukemia ʻōnaehana waena

ʻO ka mea maʻi he kāne 15 makahiki, ua ʻike ʻia me ka T-cell acute lymphoblastic leukemia (T-ALL me STIL-TAL1 positivity, kahi ʻano prognostic maikaʻi ʻole) i ka hopena o Dekemaba 2020, a ua mālama ʻia i loko o kahi haukapila kūloko me ka nui. nā pōʻai o ka chemotherapy maʻamau e loaʻa i ke kala piha. Ua hana ʻia ka hoʻololi ʻana o ka cell cell hemizygous haematopoietic makua kāne i ka makua kāne i ka lā 2 Iune 2021, akā naʻe, ua ʻike ʻia ka hoʻihoʻi ʻana o ka iwi iwi i loko o 3 mau mahina ma hope o ka hoʻololi ʻana, a ʻaʻole pono ka 1 pōʻai o ka chemotherapy. ʻAʻole maikaʻi kekahi pōʻaiapuni o ka chemotherapy, a i ka manawa like, ua ulu ʻo ia i nā papalina puʻupuʻu a me ka leaka ʻana o ka ea, nā kihi kekee o ka waha, a ʻo ka lumbar puncture ua manaʻo ʻia ka ulu ʻana o ka maʻi leukemia ʻōnaehana waena.

ʻO T-ALL me ka STIL-TAL1 positivity, ka hoʻihoʻi mua ʻana ma hope o ka hoʻololi ʻana o allogeneic, i hui pū ʻia me ka maʻi leukemia ʻōnaehana waena, he maʻi paʻakikī loa e mālama i ka wā me ka ʻole o CAR-T. Ua nīnau ka makua kāne o ke keiki e pili ana i ka Luna Hoʻokele ʻo Zhang Qian o ka Halemai Ludoupe ma o kāna mau hoaaloha, a ma hope o ke kamaʻilio kikoʻī, hele mai lākou i ka Halemai ʻo Yanda Ludoupe, me ka makemake e hakakā no ko lākou ola ma ke kau inoa ʻana i ka hoʻokolohua lapaʻau CAR-T.

ʻAʻole i hāʻule ka CAR-T mua, ʻoi aku ka wikiwiki o ka nui o nā pūnaewele tumora, a ua pilikia kona ola.

Ma ka 26 ʻOkakopa 2021, ua hoʻokomo ʻia ka mea maʻi i ke keʻena mua o ka 'Oihana Hema. Ma muli o ka hoʻonui wikiwiki ʻana o nā cell tumor, hiki ke mālama ʻia ka mea maʻi me ka chemotherapy e hōʻemi ai i ka haʻahaʻa o ka maʻi maʻi, a me ka lumbar puncture sheath injection o nā lāʻau chemotherapeutic. ʻAʻole maikaʻi ka wai cerebrospinal. Ma hope o ka paʻa ʻana o ke kūlana o ka mea maʻi, ua hōʻiliʻili ʻia nā lymphocytes o kona makuakāne no ka moʻomeheu cell CAR-T, a ma ka lā 19 Nowemapa, ua hoʻokomo ʻia nā mea hāʻawi CD7 CAR-T i loko o ka mea maʻi.

He mau lā ma hope o ka hoʻokomo ʻia ʻana, ma mua o ka hoʻonui ʻia ʻana o nā pūnaewele CAR-T, ua hoʻonui hou ʻia nā ʻōpū o ka mea maʻi me ka wikiwiki, a ua ʻike ʻia ka nui o nā pūnaʻi progenitor i loko o ke koko peripheral, no laila ua hāʻule ka CAR-T mua.

Ua hana ko mākou haukapila i kahi hoʻokolohua lapaʻau o ka honua holoʻokoʻa CAR-T (CD7 UCAR-T) no ka maʻi leukemia T-lymphoblastic acute i kēia wā. Ua hopohopo nui nā mākua a ua makemake lākou e ho'āʻo i kā lākou keiki inā he 1% ka manawa. Ua kūkākūkā hou ʻo Luna Hoʻokele ʻo Zhang Qin me ka ʻohana a ua hoʻoholo e hoʻopaʻa inoa i kā lākou keiki i kā mākou CD7 UCAR-T hoʻokolohua lapaʻau.

# Hoʻopau i ke kala ʻana ma hope o ke kau inoa ʻana i ka hoʻokolohua lapaʻau CD7 UCAR-T, i kēia manawa 2 mau mahina ma hope o ka hoʻololi ʻana.

Ma ka lā 2 Dekemaba, ua hoʻokomo ʻia ka mea maʻi me nā pūnae CD7 U-CART, i hoʻohana ʻia e hōʻemi i ka ukana maʻi ʻoiai e hāʻawi ana i ka lāʻau kākoʻo kākoʻo maʻi. Ma ka lā 2 o Kekemapa, ua hoʻokomo ʻia nā cell CD7 U-CART i loko o ka mea maʻi. Ma hope o ka hoʻokomo ʻana, ua loaʻa i ka mea maʻi ke kuni kiʻekiʻe mau no kekahi mau lā a me ka ʻuhane ʻino. Ua hoʻopaʻa mālie ʻia nā hōʻailona koʻikoʻi o ka mea maʻi a ua maʻamau ka wela o ke kino ma hope o ka mālama ʻia ʻana o ka mea maʻi me ka anti-infective a me ka rehydration supportive therapy e nā limahana lapaʻau.

ʻO ka iwi a me ka lumbar puncture ma ka lā 18 a me 28 ma hope o ka CD7 UCAR-T infusion hōʻike i ke kala piha me ka MRD maikaʻi ʻole. Ua ʻoi aku ka maikaʻi o ka noʻonoʻo o ke keiki, ua hoʻihoʻi ʻia kona ʻai ʻana a ua hoʻoikaika hou ʻo ia, a ʻo kona makuahine i uē i ka waimaka i kēlā me kēia lā, ʻike ʻo ia i kahi minoʻaka i ʻike ʻole ʻia no ka manawa lōʻihi.

I kēia manawa, ua loaʻa i ka mea maʻi ka lua hemi-compatible HSCT i loko o ko mākou haukapila no 2 mau mahina, a ke kala ʻia nei ka maʻi.