Acute Lymphoblastic Leukemia(T-ALL)-03

Mea Fa'apitoa:

- Su'esu'ega: T-cell lymphoblastic leukemia

- Amata ma Fa'ailoga: Aperila 2020, fa'aalia i le niniva, vaivai, ma le pa'u toto. Ua maua ile T-cell lymphoblastic leukemia e ala ile su'ega MICM ole ga'o ponaivi.

- Togafitiga Muamua: Ausia le fa'amagaloga atoatoa (CR) ina ua mae'a le VDCLP regimen chemotherapy, soso'o ai ma ta'amilosaga e 2 o le fa'amalosiina o le chemotherapy.

- Iulai 19, 2020: Maua allogeneic hematopoietic stem cell transplantation mai se fafine foaʻi (HLA 5/10 A foaʻi A). Fa'atonu fa'atonuga e aofia ai le fa'amaina o le tino atoa (TBI), cyclophosphamide (CY), ma le etoposide (VP-16). O sela pito pito i luga na faʻapipiʻiina ia Iulai 24, faʻatasi ai ma le toe faʻaleleia o le granulocyte i le aso +10 ma le faʻapipiʻiina o platelet i le aso +13. Su'esu'e faifaipea ole gasegase ile fafo mulimuli ane.

- Fepuari 25, 2021: Na maua le toe fa'afo'i o le ga'o ponaivi a'o tulitatao.

- Togafitiga: Na amata togafitiga o le thalidomide oral.

- Mati 8: Faʻafeiloaʻi i le matou falemaʻi.

- Su'i o Ponaivi: 61.5% fa'ao.

- Fa'avasegaina o le toto pito i luga ole toto: 15% fa'ao.

- Immunophenotyping: 35.25% sela o loʻo faʻaalia le CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, e faʻaalia ai lymphocytes T mamaʻi.

- Su'esu'ega Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene lelei; fua fa'atatau: SIL-TA.

- Suiga Tumor toto: Le lelei.

- Su'esu'ega o le Chimerism (post-HSCT): O sela na maua mai i le Donor e 45.78%.

- Mati 11: Aoina o lymphocytes toto peripheral autologous mo CD7-CART aganuʻu sela.

- Togafitiga: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 aso, Dex 9mg q12h x 9 aso) faʻatonuga faʻatasi ma le thalidomide e pulea ai le tuma.

- Mati 19: FC regimen chemotherapy (Flu 50mg x 3 aso, CTX 0.4gx 3 aso).

- Mati 24 (a'o le'i fa'ainu): O le su'esu'e o ponaivi na fa'aalia ai le hyperplasia o le vasega V, fa'atasi ai ma le 22% o le pa.

- Ponaivi Fa'asolo Cytometry: 29.21% sela (o sela nucleated) fa'aalia CD3, CD5, CD7, CD99, fa'aalia se vaega o le cCD3, e fa'aalia ai sela T e matua leaga.

- Aofa'i SIL-TAL1 Fusion Gene: 1.913%.