Acute Lymphoblastic Leukemia(T-ALL)-03

Mwoyo murefu: Huang XX

Gender:Murume

Age: ane makore 42

Urudzi: ChiChinese

Kuongororwa:Acute Lymphoblastic Leukemia (T-ALL)

Taura nesu

Case Features:

- Kuongororwa: Acute T-cell lymphoblastic leukemia

-Kutanga uye Zviratidzo: Kubvumbi 2020, yakaunzwa nedzungu, kuneta, uye ganda kubuda ropa. Kuongororwa neacute T-cell lymphoblastic leukemia kuburikidza nemwongo wemapfupa MICM kuongororwa.

- Kurapa Kwekutanga: Kuwana kuregererwa kwakakwana (CR) mushure meVDCLP regimen chemotherapy, inoteverwa ne2 cycles of intensified chemotherapy.

- Chikunguru 19, 2020: Yakagamuchira allogeneic hematopoietic stem cell transplantation kubva kumunhukadzi anopa (HLA 5/10 A donor A). Conditioning regimen yaisanganisira yakazara muviri irradiation (TBI), cyclophosphamide (CY), uye etoposide (VP-16). Peripheral stem masero akaiswa muna Chikunguru 24, nekupora granulocyte nezuva +10 uye platelet engraftment nezuva +13. Nguva dzose kuteverwa kwevarwere vekunze mushure mezvo.

- Kukadzi 25, 2021: Bone marrow kudzokazve kwakawanikwa panguva yekutevera.

- Kurapa: Yakatanga nemuromo thalidomide kurapwa.

- Kurume 8: Kugamuchirwa kuchipatara chedu.

- Bone Marrow Morphology: 61.5% kuputika.

- Peripheral Ropa Classification: 15% kuputika.

- Immunophenotyping: 35.25% masero anoratidza CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, inoratidza yakaipa immature T lymphocytes.

- Chromosome Analysis: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene yakanaka; kuwanda kuyerwa: SIL-TA.

- Ropa Tumor Mutation: Negative.

- Chimerism Analysis (post-HSCT): Masero evanopa-anobva ku45.78%.

- Kurume 11: Kuunganidzwa kwe autologous peripheral blood lymphocytes yeCD7-CART cell tsika.

- Kurapa: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 mazuva, Dex 9mg q12h x 9 mazuva) chirongwa chakabatanidzwa nethalidomide kudzora bundu.

- Kurume 19: FC regimen chemotherapy (Flu 50mg x 3 mazuva, CTX 0.4gx mazuva matatu).

- Kurume 24 (pre-infusion): Bone marrow morphology yakaratidza giredhi V hyperplasia, ine 22% kuputika.

- Bone Marrow Flow Cytometry: 29.21% masero (e nucleated cells) anoratidza CD3, CD5, CD7, CD99, zvishoma zvichiratidza cCD3, zvichiratidza masero eT akashata asina kukwana.

- Quantitative SIL-TAL1 Fusion Gene: 1.913%.

Kurapa:

- Kurume 26: Kuiswa kwe autologous CD7-CART masero (5 * 10 ^ 5 / kg)

- CAR-T Inoenderana Nemativi Migumisiro: CRS giredhi 1 (fivha), hapana neurotoxicity

- Kubvumbi 12 (Zuva 17): Kutevera kwakaratidza bone marrow morphology mukuregererwa, hapana masero asina kunaka anoonekwa nekuyerera cytometry, uye SIL-TAL1 (STIL-SCL) fusion gene quantification pa0