Acute Lymphoblastic Leukemia(T-ALL)-02

Likarolo tsa Clinical:

- Tlhahlobo: Acute T-cell lymphoblastic leukemia

- Ho qala: Qetellong ea Hlakubele 2018

- Matšoao a pele: Ho atolosoa ha lymph node ka holim'a 'mele ka bongata

- Ts'ebetso ea pele ea mali: WBC: 39.46*10^9/L, Hb: 129g/L, PLT: 77*10^9/L

- Morpholoji ea moko oa masapo: 92% ea ho phatloha

-Flow cytometry: 95.3% lisele tse sa tloaelehang tse hlalosang

TdT+CD99+CyCD3+CD7stCd5DdimCD4-CD8-mCD3-CD45dim

- Fusion liphatsa tsa lefutso: Negative

- Phetoho ea liphatsa tsa lefutso: NOTCH1 phetoho ea liphatsa tsa lefutso e fumanoe

- Tlhahlobo ea chromosome: Karyotype e tloaelehileng

Histori ea Kalafo:

- La 3 Mmesa, 2018: Phekolo ea ho kenya letsoho ka VDCP regimen

- La 18 Mmesa, 2018: Ho phatloha ha moko oa masapo ho ne ho e-na le 96%

- La 20 Mmesa, 2018: O fihletse tšoarelo ka mor'a mokhoa oa CAG

- May 18, 2018: Phekolo ea ho kopanya ka mokhoa oa CMG + VP

- La 22 Phuptjane 2018: Ho phatloha ha moko oa masapo ho eketsehile ho fihla ho 40%, ho khutlela mokhoeng oa leukemia

- Phupu 25, 2018: CLAM regimen (clarithromycin+cyclophosphamide+amikacin)

- Ho fetisoa ha lisele tsa "hematopoietic stem cell" ho tsoa ho ngoan'abo ea tšoanang le HLA a sebelisa FLU+BU conditioning ka la 14 Phato.

- Ho beha leihlo ka mor'a ho fetisoa: Phomolo ea 'mala oa masapo ka khoeli e le 1, likhoeli tse 3, likhoeli tse 6, likhoeli tse 9 le likhoeli tse 11.

- Bone marrow morphology e bontšitse phokolo likhoeling tse 16 ka mor'a ho fetisoa, 'me phallo ea cytometry e senola 0.02% malignant immature lymphocyte

- La 13 Pulungoana 2020: peripheral blood chimerism ho tsoa mohloling oa mofani e ne e le 97.9%

- Lisele tsa pele tsa mali: 20%

- La 18 Tšitoe 2020: Morphology ea moko oa masapo: ho phatloha ha 60.6%

- Phallo cytometry: 30.85% malignant immature T lymphocyte

- Tlhahlobo ea chromosome: 46, XY (20)

- E fumane DA regimen chemotherapy ka la 19 Pherekhong 2021

- Bone marrow morphology ka la 19 Pherekhong 2021: Hyperplasia ea Kereiti ea III, ho phatloha ha 16%

- Tlhahlobo ea karyotype ea chromosome: 46, XY (20)

Flow cytometry: 7.27% ea lisele (har'a lisele tsa nyutlelie) li hlahisa CD99bri, CD13, CD38, cbcl-2, cCD3, HLA-ABC bri, CD7bri, le CD5dim e hlalositsoeng ka mokhoa o itseng, e bontšang li-lymphocyte tsa T tse kotsi.

- Tlhahlobo ea lefutso la leukemia fusion: e mpe

- Tlhahlobo ea phetoho ea hlahala ea mali (mefuta e 86):

1. PHF6 K299Efs*13 phetoho e ntle

2. RUNX1 S322* phetoho e ntle

3. FBXW7 E471G phetoho e ntle

4. JAK3 M511I phetoho e ntle

5. NOTCH1 Q2393* phetoho e ntle

Kalafo:

- La 22 Pherekhong: Pokello le setso sa autologous peripheral blood lymphocyte bakeng sa CD7-CART

- Pele ho kenngoa ha CD7-CART, mokuli o ile a amohela VLP (vincristine, l-asparaginase, prednisone) hammoho le chemotherapy ea bortezomib.

- February 3: FC regimen chemotherapy (Flu 50mg bakeng sa matsatsi a 3 + CTX 0.45g bakeng sa matsatsi a 3)

- Hlakola 5 (pele ho infusion): Morpholoji ea moko oa masapo e bontšitse ho phatloha ho 23%.

- Flow cytometry e senotse lisele tsa 4.05% tse hlalosang CD99bri, CD5dim, CD7bri, TDT, cCD3, e bontšang li-lymphocyte tse kotsi tsa T.

- Tlhahlobo ea chromosome: 46, XY (20)

- Tlhahlobo ea Chimerism (post-HSCT): Lisele tse nkiloeng ho bafani li ne li le 52.19%.

- February 7: Ho kenngoa ha lisele tsa CD7-CART tse ikemetseng ka tekanyo ea 5 * 10 ^ 5 / kg.

- Hlakola 15: Lisele tse sa itekang tsa mali li fokotsehile ho isa ho 2%.

- February 19 (Letsatsi la 12 ka mor'a ho tšeloa): Mokuli o ile a tšoaroa ke feberu, e ileng ea nka matsatsi a 5 pele taolo ea mocheso e finyelloa.

- La 2 Hlakubele: Tekolo ea moko oa masapo e bonts'itse phokotso e felletseng ea morphological, ka phallo ea cytometry e sa boneng lisele tse mpe tse sa holang.