Mob Lymphoblastic Leukemia (T-ALL)-03

Tus neeg mob: Huang XX

Poj niam txiv neej: Txiv neej

Hnub nyoog:42 xyoo

Haiv neeg: Suav

Kev kuaj mob: Mob Lymphoblastic Leukemia (T-ALL)

Tiv tauj peb

Case Features:

- Kev kuaj mob: Mob T-cell lymphoblastic leukemia

- Pib thiab Cov tsos mob: Lub Plaub Hlis 2020, nthuav tawm nrog kiv taub hau, qaug zog, thiab cov ntsiab lus los ntshav ntawm daim tawv nqaij. Kev kuaj mob mob T-cell lymphoblastic leukemia los ntawm kev kuaj mob pob txha MICM.

- Kev Kho Mob Thaum Ntxov: Tau ua tiav kev tshem tawm (CR) tom qab VDCLP kev siv tshuaj khomob, ua raws li 2 lub voj voog ntawm kev siv tshuaj kho mob hnyav.

- Lub Xya hli ntuj 19, 2020: Tau txais allogeneic hematopoietic qia cell hloov los ntawm ib tug poj niam pub dawb (HLA 5/10 A pub A). Conditioning regimen suav nrog tag nrho lub cev irradiation (TBI), cyclophosphamide (CY), thiab etoposide (VP-16). Peripheral qia hlwb tau infused rau Lub Xya hli ntuj 24, nrog granulocyte rov qab los ntawm hnub +10 thiab platelet engraftment los ntawm hnub +13. Cov neeg mob sab nraud tsis tu ncua tom qab ntawd.

- Lub Ob Hlis 25, 2021: Pob txha pob txha rov qab kuaj pom thaum rov qab los.

- Kev kho mob: pib kho qhov ncauj thalidomide.

- Lub Peb Hlis 8: Nkag mus rau peb lub tsev kho mob.

- Pob txha Marrow Morphology: 61.5% blasts.

- Peripheral Blood Classification: 15% blasts.

- Immunophenotyping: 35.25% hlwb uas qhia CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, qhia malignant tsis paub tab T lymphocytes.

- Kev Ntsuam Xyuas Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion noob zoo; Kev ntsuas qhov ntsuas: SIL-TA.

- Ntshav Tumor Mutation: Tsis zoo.

- Chimerism Analysis (post-HSCT): Cov hlwb pub dawb suav txog 45.78%.

- Lub Peb Hlis 11: Sau cov autologous peripheral ntshav lymphocytes rau CD7-CART cell kab lis kev cai.

- Kev kho mob: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 hnub, Dex 9mg q12h x 9 hnub) kev tswj hwm nrog thalidomide los tswj cov qog.

- Lub Peb Hlis 19: FC regimen chemotherapy (Flu 50mg x 3 hnub, CTX 0.4gx 3 hnub).

- Lub Peb Hlis 24 (pre-infusion): Pob txha pob txha morphology pom qib V hyperplasia, nrog 22% blasts.

- Pob txha Marrow Flow Cytometry: 29.21% hlwb (ntawm nucleated hlwb) qhia CD3, CD5, CD7, CD99, ib feem qhia cCD3, qhia malignant immature T hlwb.

- Quantitative SIL-TAL1 Fusion Gene: 1.913%.

Kev kho mob:

- Lub Peb Hlis 26: Infusion ntawm autologous CD7-CART hlwb (5 * 10^5 / kg)

- CAR-T Cov Kev Phem Tseem Ceeb: CRS qib 1 (ua npaws), tsis muaj neurotoxicity

- Lub Plaub Hlis 12 (Hnub 17): Kev soj ntsuam xyuas pom cov pob txha pob txha morphology hauv kev tso tawm, tsis muaj cov hlwb tsis paub qab hau kuaj pom los ntawm kev ntws cytometry, thiab SIL-TAL1 (STIL-SCL) fusion gene quantification ntawm 0