Indwara ya Lymphoblastique ikaze (T-BYOSE) -03

Mwihangane: Huang XX

Uburinganire： Umugabo

Imyaka: Imyaka 42

Ubwenegihugu: Igishinwa

Gusuzuma: Indwara ya Lymphoblastique ikaze (T-BYOSE)

Twandikire

Ibiranga urubanza:

- Gusuzuma: Indwara ya T-selile lymphoblastique leukemia

- Gutangira n'ibimenyetso: Mata 2020, byerekanwe no kuzunguruka, umunaniro, hamwe no kuva amaraso. Yasuzumwe na T-selile lymphoblastique leukemia ikoresheje igufwa ryamagufwa MICM.

- Ku ya 19 Nyakanga 2020: Yakiriye allogeneic hematopoietic stem selile transplantation yatanzwe numuterankunga wumugore (HLA 5/10 Umuterankunga A). Muri gahunda harimo gushyiramo imirasire yumubiri wose (TBI), cyclophosphamide (CY), na etoposide (VP-16). Utugingo ngengabuzima twa periferique twashyizwemo ku ya 24 Nyakanga, hamwe na granulocyte yakira ku munsi +10 hamwe na platel ku munsi +13. Gukurikirana kwa muganga buri gihe nyuma.

- 25 Gashyantare 2021: Gusubiramo amagufwa yongeye kugaragara mugihe cyo gukurikirana.

- Umuti: Gutangira kuvura umunwa thalidomide.

- 8 Werurwe: Yinjiye mu bitaro byacu.

- Amagufwa ya Morphology: 61.5% yaturika.

- Amaraso ya Periferique Itondekanya: guturika 15%.

- Immunophenotyping: 35,25% selile zigaragaza CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, byerekana lymphocytes T idakuze.

- Isesengura rya Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene nziza; gupima ingano: SIL-TA.

- Guhinduranya Amaraso Kumubiri: Bibi.

- Isesengura rya Chimerism (nyuma ya HSCT): Ingirabuzimafatizo zikomoka ku baterankunga zingana na 45,78%.

- Tariki ya 11 Werurwe: Ikusanyirizo rya autologique peripheral maraso lymphocytes kumico ya CD7-CART.

- Umuti: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x iminsi 4, Dex 9mg q12h x iminsi 9) gahunda ihujwe na thalidomide kugirango igenzure ikibyimba.

- 19 Werurwe: FC regimen chimiotherapie (ibicurane 50mg x iminsi 3, CTX 0.4gx iminsi 3).

- 24 Werurwe (pre-infusion): Amagufwa ya marrow morphologie yerekanaga hyperplasia yo mu cyiciro cya V, hamwe na 22%.

- Amagufa ya marrow Flow Cytometrie: 29.21% selile (ya selile nucleated selile) yerekana CD3, CD5, CD7, CD99, igaragaza igice cCD3, byerekana selile T idakuze.

- Umubare SIL-TAL1 Fusion Gene: 1.913%.

Umuti:

- 26 Werurwe: Kwinjiza CD7-CART selile (5 * 10 ^ 5 / kg)

- CAR-T Ingaruka Zifitanye isano: CRS icyiciro cya 1 (umuriro), nta neurotoxicity

- Tariki ya 12 Mata (Umunsi wa 17): Gukurikirana byerekanaga morfologiya yo mu magufa mu gukira, nta selile zidakuze zagaragajwe na cytometrike, na SIL-TAL1 (STIL-SCL) ingano ya gene ya 0