Mob Lymphoblastic Leukemia (B-ALL)-01

Kev kuaj pom muaj mob B-cell lymphoblastic leukemia thaum lub Kaum Ib Hlis 28, 2017.

Kev kho mob nrog VDLP kev tswj hwm thawj zaug, ua tiav ib nrab ntawm cov pob txha pob txha tshem tawm (cov ntsiab lus tsis qhia).

Lub Ob Hlis 2018: Hloov mus rau VLCAM kev tswj hwm. Cov pob txha pob txha ntws cytometry pom 60.13% malignant B hlwb tsis paub qab hau.

Lub Peb Hlis 2018: Tso npe rau hauv kev sim tshuaj BiTE. Morphological remission nyob rau hauv cov pob txha pob txha, tsis muaj malignant immature hlwb kuaj pom los ntawm ntws cytometry.

Lub Tsib Hlis 8, 2018: Tau txais TBI / CY + VP16 kev kho mob ua raws li kev hloov pauv ntawm cov qia cell los ntawm cov kwv tij sib raug zoo (AB + pub dawb rau tus neeg txais A+). Neutrophil rov qab rau hnub +11, megakaryocyte rov qab rau hnub +12.

Kaum Ob Hlis 5, 2018: Ua kom tiav morphological tshem tawm hauv cov pob txha pob txha, tsis muaj cov hlwb tsis paub qab hau pom los ntawm kev ntws cytometry. Tau txais kev pub dawb lymphocyte infusion (DLI) thiab kev kho mob prophylactic nrog dasatinib thiab imatinib los tiv thaiv kev rov qab los.

Lub Ob Hlis 2, 2019: Morphology pom 6.5% cov hlwb tsis paub qab hau, ntws cytometry pom 0.08% malignant B lymphoblasts. Tau txais kev kho DLI. Lub Peb Hlis 28, 2019: Flow cytometry tsis pom muaj qhov txawv txav.

Lub Yim Hli 11, 2019: Cov pob txha pob txha rov qab, kho nrog dasatinib.

Lub Cuaj Hlis 2, 2019: Morphology pom 3% cov hlwb tsis paub qab hau, ntws cytometry pom 0.04% malignant hlwb tsis paub qab hau. Kev kho txuas ntxiv nrog dasatinib, ua raws li 2 lub voj voog ntawm methotrexate chemotherapy.

Lub Tsib Hlis 11, 2020: Pob txha pob txha rov ua dua.

Tau txais 2 autologous CD19-CAR-T cell therapies thiab 2 allogeneic CD19-CAR-T cell kho nyob rau hauv 2020, tsis muaj ib qho ua tiav kev zam txim.

Lub Kaum Hli 26, 2020: Nkag mus rau peb lub tsev kho mob.

Laboratory Nrhiav:

Cov ntshav niaj hnub: WBC 22.75 x 10^9 / L, HGB 132 g / L, PLT 36 x 10^9 / L

Peripheral cov ntshav tsis paub qab hau: 63%

Pob txha pob txha morphology: Hypercellular (qib II), 96% tsis paub tab lymphoblasts.

Immunophenotyping: Cells nthuav qhia CD19, cCD79a, CD38dim, CD10bri, CD34, CD81dim, CD24, HLA-DR, TDT, CD22, CD72; ib feem ntawm CD123. Pom tau tias yog malignant immature B lymphoblasts.

Ntshav qog mutation: Tsis zoo.

Leukemia fusion noob: NUP214-ABL1 fusion noob zoo.

Chromosome analysis: 46, XX, t(1;9)(p34;p24), add(11)(q23)[4]/46, XX, t(1;9)(p34;p24), add(11) (q23)x2 [2]/46, XX[3]

Chimerism: Cov hlwb pub dawb suav nrog 7.71%.

Kev kho mob:

- VDS, DEX, LASP chemotherapy regimen tswj hwm.

- Kaum Ib Hlis 20: Peripheral cov ntshav tsis paub tab 0%.

- Sau cov autologous peripheral ntshav lymphocytes rau CD19/22 dual CAR-T cell kab lis kev cai.

- Kaum Ib Hlis 29: FC regimen chemotherapy (Flu 50mg x 3, CTX 0.4gx 3).

- Kaum Ob Hlis 2 (ua ntej CAR-T cell infusion):

- Cov ntshav niaj hnub: WBC 0.44 x 10^9 / L, HGB 66 g / L, PLT 33 x 10^9 / L.

- Pob txha pob txha morphology: Hypercellular (qib IV), 68% lymphoblasts tsis paub qab hau.

- Kev ntsuas ntau ntawm NUP214-ABL1 fusion gene: 24.542%.

- Flow cytometry: 46.31% ntawm cov hlwb qhia CD38dim, CD22, BCL-2, CD19, CD10bri, CD34, CD81dim, CD24, cCD79a, qhia tias malignant B lymphoblasts.

- Kaum Ob Hlis 4: Infusion ntawm autologous CD19/22 dual CAR-T hlwb (3 x 10^5 / kg).

- CAR-T cuam tshuam txog kev mob tshwm sim: Qib 1 CRS, kub taub hau rau Hnub 6 nrog Tmax ntawm 40 ° C, kub taub hau tswj los ntawm Hnub 10. Tsis pom muaj neurotoxicity.

- Kaum Ob Hlis 22 (Hnub 18 kev ntsuam xyuas): morphological ua tiav kev tshem tawm hauv cov pob txha pob txha, tsis muaj cov hlwb tsis paub qab hau kuaj pom los ntawm kev ntws cytometry. Kev ntsuas ntau ntawm NUP214-ABL1 fusion noob: 0%.