Acute Lymphoblastic Leukemia(T-ALL)-04

Cellular acute lymphoblastic leukemia nekutanga post-transplant relapse uye yakasanganiswa yepakati tsinga system leukemia.

Murwere aive murume ane makore gumi nemashanu, akaonekwa aine T-cell acute lymphoblastic leukemia (T-ALL ine STIL-TAL1 positivity, yakashata prognostic gene) mukupera kwaZvita 2020, uye akarapwa muchipatara chemuno aine akawanda. kutenderera kwenguva dzose chemotherapy kuti uwane kuregererwa kwakakwana. baba-ku-mwanakomana hemizygous haematopoietic stem cell transplantation yakaitwa musi wa2 Chikumi 2021, asi zvinosuruvarisa kuti mwongo wepfupa udzoke zvakare wakaonekwa mumwedzi ye3 mushure mekuisirwa, uye 1 cycle yechemotherapy haina kushanda. Kumwe kutenderera kwechemotherapy kwakange kusingashande, uye panguva imwe cheteyo, akatanga kuputika matama uye kubuda kwemhepo, makona akakombama emuromo, uye kuputika kwechiuno kwakaratidza kukura kwepakati retsinga reukemia.

T-ZVESE ine STIL-TAL1 positivity, kudzoka kwekutanga mushure mekusimwa kweallogeneic, yakasanganiswa neyepakati tsinga reukemia, inyaya yakaoma kwazvo kurapa munguva isina CAR-T. Baba vemwana vakabvunza nezveMukuru Zhang Qian weLudoupe Hospital kuburikidza neshamwari dzake, uye mushure mekukurukurirana zvakadzama, vakauya kuYanda Ludoupe Hospital, vachida kurwira hupenyu hwavo nekunyoresa muCAR-T kiriniki yekuedza.

CAR-T yokutanga yakakundikana, masero ebundu akawedzera nokukurumidza zvikuru, uye upenyu hwake hwakanga huri mungozi.

Musi wa26 Gumiguru 2021, murwere akagamuchirwa muwadhi yekutanga yeDhipatimendi reHematology. Nekuda kwekukurumidza kuwanda kwebundu maseru, murwere aingokwanisa kurapwa nekemotherapeutic kuderedza bundu, uye ne lumbar puncture sheath jekiseni re chemotherapeutic mishonga. The cerebrospinal fluid was negative. Mushure mekunge mamiriro emurwere agadzikana, lymphocytes yababa vake yakaunganidzwa nokuda kweCAR-T cell tsika, uye musi wa 19 Mbudzi, masero eCD7 CAR-T akaiswa mumurwere.

Mazuva mashoma mushure mekuisirwa, kusati kwawedzera masero eCAR-T, masero emurwere ebundu akawedzera nekukurumidza zvakare, uye nhamba huru yemasero ekutanga aionekwa muropa reperipheral, saka yekutanga CAR-T yakakundikana.

Zvakazoitika kuti chipatara chedu chaiita ongororo yekiriniki yeCAR-T (CD7 UCAR-T) yeacute T-lymphoblastic leukemia panguva ino. Vabereki vakanetsekana chaizvo vakati vaida kumboedza mwana wavo chero paive nemukana we1%. Director Zhang Qin vakakurukura nemhuri zvakare uye vakafunga kunyoresa mwana wavo muchirongwa chedu cheCD7 UCAR-T chekiriniki.

# Kuregererwa kwakazara mushure mekunyoresa muCD7 UCAR-T kiriniki kuyedzwa, ikozvino mwedzi miviri mushure mekutapurirana

Musi wa 2 Zvita, murwere akapinzwa neCD7 U-CART masero, ayo akashandiswa kudzikisa bundu remutoro apo achipa symptomatic kutsigira kurapwa. Pana 2 Zvita, masero eCD7 U-CART akapinzwa mumurwere. Mushure mekuisirwa, murwere aive nefivha yakaramba ichienderera kwemazuva akati wandei uye akange aine mweya yakaipa. Zviratidzo zvakakosha zvemurwere zvakadzikama zvishoma nezvishoma uye tembiricha yemuviri zvishoma nezvishoma yakagadzikana mushure mekunge murwere arapwa nemishonga inodzivirira kutapukira uye rehydration inotsigira kurapwa nevashandi vekurapa.

Bone uye lumbar puncture pa18th uye 28th mazuva mushure mekunge CD7 UCAR-T infusion yakaratidza kuregererwa kwakakwana neMRD yakaipa. Pfungwa dzemwana dzakange dzave nani, havi yekudya yakadzoreredzwa uye akatanga kushanda zvakare, amai vake avo vaingochema zuva nezuva vakazoona nyemwerero yainge yave nguva refu isati yaonekwa.

Parizvino, murwere akawana yechipiri hemi-compatible HSCT muchipatara chedu kwemwedzi miviri, uye chirwere ichi chichiri mukuregererwa kwakakwana.