Nnukwu ọrịa leukemia Lymphoblastic (T-ALL) -03

Onye ọrịa: Huang XX

okike: Nwoke

Afọ: 42 afọ

Obodo: Chinese

Nchọpụta nchọpụtaNnukwu ọrịa leukemia Lymphoblastic (T-ALL)

Kpọtụrụ anyị

Akụkụ ikpe:

- Nchọpụta: nnukwu ọrịa leukemia lymphoblastic T-cell

- Mmalite na akara ngosi: Eprel 2020, gosipụtara isi ọwụwa, ike ọgwụgwụ na isi ọbara ọgbụgba. Achọpụtara ya na nnukwu ọrịa leukemia lymphoblastic T-cell site na nyocha ụmị ọkpụkpụ MICM.

- Ọgwụgwọ mbụ: enwetara mgbaghara zuru oke (CR) ka usoro ọgwụgwọ VDCLP chemotherapy gasịrị, usoro 2 nke chemotherapy siri ike na-esote.

- Julaị 19, 2020: Anatara transplantation cell hematopoietic allogeneic site n'aka onye nyere nwanyị (HLA 5/10 A onye inyeaka A). Usoro nhazi gụnyere mkpokọta irradiation ahụ (TBI), cyclophosphamide (CY), na etoposide (VP-16). A na-etinye mkpụrụ ndụ sel dị n'akụkụ na Julaị 24, yana mgbake granulocyte kwa ụbọchị +10 yana ntinye platelet n'ụbọchị +13. Nlebanya ndị ụlọ ọgwụ mgbe niile ma emechaa.

- Febụwarị 25, 2021: achọpụtara nlọghachi ụmị ọkpụkpụ n'oge nleba anya.

- Ọgwụgwọ: Malitere ọgwụgwọ thalidomide ọnụ.

- Machị 8: Anabatara n'ụlọ ọgwụ anyị.

- Ọkpụkpụ ụmị ọkpụkpụ: 61.5% mgbawa.

- Nhazi Ọbara dị n'akụkụ: 15% mgbawa.

- Immunophenotyping: 35.25% mkpụrụ ndụ na-egosipụta CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, na-egosi na-adịghị mma T lymphocytes.

- Nyocha chromosome: 46, XX [9].

- Ọrịa leukemia Fusion Gene: SIL-TAL1 fusion gene nti; nha nha: SIL-TA.

- Mgbanwe Ọbara Tumor: adịghị mma.

- Nyocha Chimerism (post-HSCT): sel ndị nyere onyinye nwetara 45.78%.

- Maachị 11: Mkpokọta nke lymphocytes ọbara dịpụrụ adịpụ maka ọdịbendị cell CD7-CART.

- Ọgwụgwọ: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 ụbọchị, Dex 9mg q12h x 9 ụbọchị) usoro jikọtara ya na thalidomide iji chịkwaa etuto ahụ.

- Maachị 19: FC usoro ọgwụgwọ chemotherapy (Flu 50mg x 3 ụbọchị, CTX 0.4gx ụbọchị 3).

- Machị 24 (tupu infusion): morphology ụmị ọkpụkpụ gosipụtara hyperplasia ọkwa V, yana mgbawa 22%.

- Ọkpụkpụ ọkpụkpụ na-agba ọsọ Cytometry: 29.21% sel (nke sel nucleated) na-egosipụta CD3, CD5, CD7, CD99, na-egosipụta akụkụ nke cCD3, na-egosi mkpụrụ ndụ T na-eto eto.

- Ọnụ ọgụgụ SIL-TAL1 Fusion Gene: 1.913%.

Ọgwụgwọ:

- Maachị 26: Ntinye nke sel CD7-CART nke akpaaka (5*10^5/kg)

- Mmetụta metụtara CAR-T: ọkwa CRS 1 (ọkụ), enweghị neurotoxicity

- Eprel 12 (Ụbọchị 17): Nlebanya gosipụtara morphology ọkpụkpụ na mgbagha, ọ nweghị mkpụrụ ndụ na-eto eto na-adịghị mma nke cytometry na-asọpụta achọpụtara, yana SIL-TAL1 (STIL-SCL) fusion gene quantification na 0