Acute Lymphoblastic Leukemia (T-ALL)-03

Woleza mtimaMtundu: XX

Jenda: Mwamuna

Zaka: wazaka 42

Utundu: China

MatendaAcute Lymphoblastic Leukemia (T-ALL)

Lumikizanani nafe

Nkhani Zake:

- Kuzindikira: Acute T-cell lymphoblastic leukemia

- Kuyamba ndi Zizindikiro: Epulo 2020, wowonetsedwa ndi chizungulire, kutopa, komanso kutuluka magazi pakhungu. Anapezeka ndi pachimake T-cell lymphoblastic leukemia kudzera m`mafupa MICM kufufuza.

- Chithandizo Choyambirira: Kukhululukidwa kwathunthu (CR) pambuyo pa VDCLP regimen chemotherapy, kutsatiridwa ndi 2 cycles of intensified chemotherapy.

- Julayi 19, 2020: Analandira allogeneic hematopoietic stem cell transplantation kuchokera kwa wopereka wamkazi (HLA 5/10 A donor A). Makhalidwe abwino akuphatikizapo kuwotcha thupi lonse (TBI), cyclophosphamide (CY), ndi etoposide (VP-16). Maselo a tsinde ozungulira adalowetsedwa pa Julayi 24, ndikuchira kwa granulocyte masana +10 ndi kulowetsedwa kwa mapulateleti masana +13. Kutsatira odwala omwe akudwala pambuyo pake.

- February 25, 2021: Kubwereranso kwa mafupa kumadziwika pakutsata.

- Chithandizo: Anayambitsa oral thalidomide therapy.

- Marichi 8: Adalandiridwa kuchipatala chathu.

- Bone Marrow Morphology: 61.5% kuphulika.

- Gulu la Magazi Ozungulira: 15% kuphulika.

- Immunophenotyping: 35.25% maselo akuwonetsa CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, kuwonetsa ma lymphocyte owopsa a T.

- Kusanthula kwa Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene positive; muyeso wa kuchuluka: SIL-TA.

- Kusintha kwa Chotupa cha Magazi: Zoipa.

- Chimerism Analysis (post-HSCT): Maselo opangidwa ndi opereka amawerengera 45.78%.

- Marichi 11: Kusonkhanitsa kwa autologous zotumphukira magazi lymphocyte kwa CD7-CART cell chikhalidwe.

- Chithandizo: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 masiku, Dex 9mg q12h x 9 masiku) regimen pamodzi ndi thalidomide kuti athetse chotupacho.

- March 19: FC regimen chemotherapy (Chimfine 50mg x 3 masiku, CTX 0.4gx masiku 3).

- Marichi 24 (kulowetsedwa kusanachitike): Mafupa a mafupa adawonetsa hyperplasia ya grade V, ndi kuphulika kwa 22%.

- Bone Marrow Flow Cytometry: 29.21% maselo (a maselo a nucleated) akuwonetsa CD3, CD5, CD7, CD99, kufotokoza pang'ono cCD3, kusonyeza maselo owopsa a T osakhwima.

- Kuchuluka kwa SIL-TAL1 Fusion Gene: 1.913%.

Chithandizo:

- Marichi 26: Kulowetsedwa kwa ma CD7-CART cell autologous (5 * 10 ^ 5 / kg)

- Zotsatira Zogwirizana ndi CAR-T: CRS giredi 1 (malungo), palibe neurotoxicity

- Epulo 12 (Tsiku la 17): Kutsatira kunawonetsa morphology ya mafupa pakukhululukidwa, palibe maselo owopsa omwe adadziwika ndi flow cytometry, ndi SIL-TAL1 (STIL-SCL) fusion gene quantification pa 0