Acute Lymphoblastic Leukemia(B-ALL)-01
E fumanoe ka acute B-cell lymphoblastic leukemia ka la 28 Pulungoana 2017.
Kalafo ka mokhoa oa VDLP qalong, ho fihlela phokotso e sa fellang ea moko oa masapo (lintlha tse sa tlalehoang).
Hlakola 2018: Fetolela ho mofuta oa VLCAM. Cytometry ea ho phalla ha moko oa masapo e bontšitse 60.13% ea lisele tsa B tse sa pheleng tse kotsi.
Hlakubele 2018: O Ingolisetse tekong ea bongaka ea BiTE. Phokotso ea Morphological mokong oa masapo, ha ho na lisele tse sa pheleng tse kotsi tse bonoang ke flow cytometry.
La 8 Mots'eanong, 2018: Ho amohetsoe mofuta oa boemo ba TBI/CY+VP16 o lateloang ke allogeneic stem cell transplant ho tsoa ho banab'abo ba tšoanang ka botlalo (AB+ mofani ho moamoheli A+). Ho hlaphoheloa ha Neutrophil ka letsatsi la +11, ho hlaphoheloa ha megakaryocyte ka letsatsi la +12.
La 5 Tšitoe, 2018: Phomolo e felletseng ea morphological mokong oa masapo, ha ho na lisele tse mpe tse sa itekang tse bonoang ke phallo ea cytometry. E amohetse donor lymphocyte infusion (DLI) le phekolo ea prophylactic ka dasatinib le imatinib ho thibela ho khutlela morao.
La 2 Hlakola 2019: Morphology e bonts'itse 6.5% ea lisele tse immature, flow cytometry e bonts'itse 0.08% ea malignant immature B lymphoblasts. E fumane phekolo ea DLI. La 28 Hlakubele 2019: Flow cytometry ha e bonts'a liphoso.
La 11 Phato, 2019: Ho khutla ha moko oa masapo, ho phekoloa ka dasatinib.
La 2 Loetse 2019: Morphology e bonts'itse 3% ea lisele tse sa itekang, phallo ea cytometry e bonts'itse 0.04% ea lisele tse mpe tse mpe. Kalafo e tsoelang pele ka dasatinib, e lateloa ke li-cycle tsa 2 tsa methotrexate chemotherapy.
La 11 Mots'eanong 2020: Mongobo oa masapo o khutla hape.
E amohetse liphekolo tse 2 tsa autologous tsa CD19-CAR-T le liphekolo tse 2 tsa allogeneic tsa CD19-CAR-T ka 2020, ha ho le e 'ngoe e fihletseng tšoarelo.
La 26 Mphalane 2020: O ile a amoheloa sepetleleng sa rona.
Liphetho tsa laboratori:
Tloaelo ea mali: WBC 22.75 x 10^9/L, HGB 132 g/L, PLT 36 x 10^9/L
Lisele tse sa phethahalang tsa mali: 63%
Bone marrow morphology: Hypercellular (sehlopha sa II), 96% ea lymphoblasts e sa tloaelehang.
Immunophenotyping: Lisele li hlalosa CD19, cCD79a, CD38dim, CD10bri, CD34, CD81dim, CD24, HLA-DR, TDT, CD22, CD72; tlhaloso e sa fellang ea CD123. E khetholloa e le malignant immature B lymphoblasts.
Phetoho ea hlahala ea mali: E mpe.
Lekemia fusion gene: NUP214-ABL1 fusion gene positive.
Tlhahlobo ea chromosome: 46, XX, t(1;9)(p34;p24), eketsa(11)(q23)[4]/46, XX, t(1;9)(p34;p24), eketsa(11) (q23)x2 [2]/46, XX[3]
Chimerism: Lisele tse nkiloeng ho bafani li etsa 7.71%.
Kalafo:
- VDS, DEX, LASP chemotherapy regimen e tsamaisoang.
- La 20 Pulungoana: Lisele tsa peripheral mali tse sa itekang 0%.
- Pokello ea autologous peripheral blood lymphocyte bakeng sa CD19/22 dual CAR-T cell culture.
- 29 November: FC regimen chemotherapy (Flu 50mg x 3, CTX 0.4gx 3).
- La 2 Tšitoe (pele ho infusion ea sele ea CAR-T):
- Tloaelo ea mali: WBC 0.44 x 10^9/L, HGB 66 g/L, PLT 33 x 10^9/L.
- Bone marrow morphology: Hypercellular (grade IV), 68% ea lymphoblasts e sa tloaelehang.
- Tekanyetso ea palo ea liphatsa tsa lefutso tsa NUP214-ABL1: 24.542%.
- Flow cytometry: 46.31% ea lisele tse hlalosang CD38dim, CD22, BCL-2, CD19, CD10bri, CD34, CD81dim, CD24, cCD79a, e bontšang malignant immature lymphoblasts ea B.
- December 4: Ho kenngoa ha autologous CD19/22 lisele tse peli tsa CAR-T (3 x 10 ^ 5 / kg).
- Litla-morao tse amanang le CAR-T: Sehlopha sa 1 CRS, feberu ka Letsatsi la 6 le Tmax ea 40 ° C, feberu e laoloang ke Letsatsi la 10. Ha ho neurotoxicity e hlokometsoeng.
- December 22 (Tlhahlobo ea Letsatsi la 18): Phokotso e feletseng ea Morphological mokong oa masapo, ha ho na lisele tse sa pheleng tse kotsi tse fumanoang ke phallo ea cytometry. Tekanyetso ea palo ea mofuta oa motsoako oa NUP214-ABL1: 0%.
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