Acute Lymphoblastic Leukemia(T-ALL)-03

Te manawanui: Huang XX

Ira tangata：Tane

Te tau: 42 tau

Nationality: Hainamana

Te tātaritanga:Acute Lymphoblastic Leukemia(T-ALL)

Whakapā mai

Ahuatanga Take:

- Tatautanga: kano kano lymphoblastic pūtau T whakapeka

- Te timatanga me nga tohu: Paenga-whāwhā 2020, ka puta te mangere, te ngenge, me te kiri toto. I whakamohiotia he kanisa lymphoblastic T-cell whakapeka na roto i te whakamatautau MICM hinu hinu wheua.

- Maimoatanga Tuatahi: Kua tutuki i te murunga katoa (CR) i muri mai i te mahi a te VDCLP i te chemotherapy, whai muri i nga huringa e 2 o te whakamaarama haumanu.

- Hūrae 19, 2020: I whakawhiwhia ki te whakawhiti i te pūtau pūtau hematopoietic allogeneic mai i tetahi kaituku wahine (HLA 5/10 A kaituku A). Ko te tikanga whakamaarama ko te katoa o te irradiation tinana (TBI), cyclophosphamide (CY), me te etoposide (VP-16). Ko nga pūtau kakau i te taha o te taha i whakauruhia i te Hūrae 24, me te whakaora i te granulocyte i te ra +10 me te whakauru platelet i te ra +13. Whai muri i nga mahi a te hunga mate waho.

- Hui-tanguru 25, 2021: I kitea te hokinga mai o te hinu wheua i te wa e whai ana.

- Maimoatanga: I timata te rongoa thalidomide waha.

- Maehe 8: I whakauruhia ki to maatau hohipera.

- Bone Marrow Morphology: 61.5% nga pupuhi.

- Te Whakar

- Immunophenotyping: 35.25% nga pūtau e whakaatu ana i te CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, e tohu ana i nga lymphocytes T korekore.

- Chromosome Analysis: 46, XX [9].

- Ira Whakakotahitanga Leukemia: SIL-TAL1 ira whakakotahitanga pai; ine ine: SIL-TA.

- Huringa Tumor Toto: He kino.

- Chimerism Analysis (post-HSCT): E 45.78%.

- Poutū-te-rangi 11: Kohinga o nga lymphocytes toto peripheral autologous mo te ahurea pūtau CD7-CART.

- Maimoatanga: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 ra, Dex 9mg q12h x 9 ra) te tikanga kua honoa me te thalidomide hei whakahaere i te puku.

- Maehe 19: FC regimen chemotherapy (Rewharewha 50mg x 3 ra, CTX 0.4gx 3 ra).

- Poutū-te-rangi 24 (i mua i te whaowhia): Ko te ahua o te hinu wheua i whakaatu i te hyperplasia o te reanga V, me te 22% nga pupuhi.

- Bone Marrow Rere Cytometry: 29.21% ngā pūtau (o ngā pūtau karihi) e whakaatu ana i te CD3, CD5, CD7, CD99, e whakaatu ana i tetahi wahanga cCD3, e tohu ana i nga pūtau T pakeke kore.

- Ira Whakakotahitanga SIL-TAL1 Ine: 1.913%.

Maimoatanga:

- Poutū-te-rangi 26: Te whaowhia o nga pūtau CD7-CART autologous (5*10^5/kg)

- CAR-T Paanga taha: CRS grade 1 (kirika), kaore he neurotoxicity

- Paenga-whāwhā 12 (Ra 17): Ko te whai i muri i whakaatu i te ahua o te hinu wheua i roto i te murunga, karekau he pūtau pakeke kino kino i kitea e te cytometry rere, me te ine ira whakakotahitanga SIL-TAL1 (STIL-SCL) i te 0