- Jiyya
- Shaidun
- Neuroblastoma
- Ciwon daji mai ƙarfi
- Shaidun
- TILS
- Maganin Kwayoyin NK
- Myasthenia Gravis (MG)
- Ciwon sankarar lymphoblastic mai tsanani (B-ALL)
- Tsarin Lupus Erythematosus (SLE)
- Ciwon sankarar lymphoblastic mai tsanani (T-ALL)
- Lymphoma na Non-Hodgkin (NHL)
- Myeloma da yawa (MM)
- Babban Lymphom na B-cell da aka Yaɗu
- B-lymphocytic Leukemia
- Myeloma
Ciwon sankarar lymphoblastic mai tsanani (B-ALL)-03
Fasaloli na Shari'a:
- An gano cutar sankarar jini ta B-cell lymphoblastic a ƙarshen watan Mayu na 2020.
- Tsarin jini: WBC 5.14x10^9/L, HGB 101.60g/L, PLT 6x10^9/L.
- Tsarin ƙashi: Hypocellular tare da kashi 67% na ƙwayoyin lymphocytes na asali.
- Tsarin kwararar jini: 82.28% na ƙwayoyin halitta suna bayyana CD38, HLA-DR, CD19, CD10, CD105, TDT, CD22, cCD79a, suna bayyana CD9 kaɗan, suna bayyana CD13 ƙasa da haka.
- Binciken kwayar halittar haɗuwa mara kyau; WT1 57.3%; babu wani kwayar halittar haɗuwa mai alaƙa da PH kamar DUK.
- KIFI: TP53 maye gurbi mai kyau.
- Kwayoyin halittar jini: 63-58, XXY, +Y, +1, +del(1)(q41q42), -2, -3, +6, -7, +8, -9, +10, -12, -13, +14, +15, -17, +18, -20, +22(cp16)/46, XY[4].
- Na karɓi tsarin VCDLP na kwasa-kwasan 2 ba tare da an yi min afuwa ba.
- Tsarin CAM-VL (CTX 2gx2, Arac 200mgx6, 6-MP 100mgx14, VDS 4mgx2, L-ASP 10,000 IUx7) a ranar 22 ga Yuli, 2020, har yanzu ba a sami gafara ba.
- Tsarin kwararar ƙashi a ranar 25 ga Satumba, 2020: 7.35% na ƙwayoyin halitta suna bayyana CD81, CD19, CD10, CD38, CD33, suna bayyana CD20, CD45 a hankali.
- Binciken sauye-sauyen ciwon daji na jini: TP53 maye gurbi.
- Kwayoyin Halitta: 46, XY[20].
- An fara maganin CD19-CART.
- Tsarin FLU (FLU 62.7mg x kwana 4, CTX 1045mg x kwana 2) chemotherapy.
- 1 ga Oktoba, 2020: Jikowar ƙwayoyin CD19-CART ta atomatik a 4.7x10^7/kg.
- CRS aji na 2 tare da gubar jijiyoyi na aji na 1, an inganta shi bayan an yi masa magani mai kyau.
- Oktoba 29, 2020: Cikakken sassauci a cikin yanayin ƙashin ƙashi, babu ƙwayoyin halitta masu cutarwa a kan cytometry na kwarara.
- Disamba 31, 2020: Tari busasshe, tashin zuciya, amai, rauni gaba ɗaya.
- Tsarin jini: WBC 15.53x10^9/L, HGB 134g/L, PLT 71x10^9/L.
- Bukatar ƙashi na nuna komawa baya.
- Janairu 2, 2021: An kwantar da ni a asibiti.
- Tsarin jini: WBC 20.87x10^9/L, HGB 118.30g/L, PLT 58.60x10^9/L.
- Creatinine 134umol/L, hawan jini mataki na 3, tarihin lafiya na shekaru 4.
- Rarraba jini a gefen jiki: 62% ƙwayoyin halitta na asali.
- Tsarin Immunophenotyping: Kashi 28.48% na ƙwayoyin halitta (ƙwayoyin da aka haɗa) suna bayyana CD10, CD38dim, HLA-DR, CD20dim, CD24, CD81, cCD79a, CD22, CD268dim, CD58, suna bayyana CD123, TDT, ba sa bayyana CD34, CD19, MPO, CD117, CD13, CD33, CD11b, clgM, CD79b, CD7, cCD3, kappa, lambda, wanda ke nuna ƙwayoyin lymphocytes na farko na B.
- Binciken sauye-sauyen ciwon daji na jini: TP53 R196P maye gurbi mai kyau.
Magani:
- An yi amfani da maganin VLP chemotherapy, tare da maganin hauhawar jini, rage creatinine, da kuma alkalinization na ruwa.
- Janairu 19: An nuna tsarin jinin WBC 1.77x10^9/L, HGB 71g/L, PLT 29.8x10^9/L.
- Rarraba jini a gefen jiki: Babu ƙwayoyin lymphocytes na asali.
- Tsarin ƙashi: Haɓaka ƙwayoyin halitta (matakin V), wuraren da aka fi mayar da hankali a kansu na matakin IV, tare da kashi 42% na ƙwayoyin lymphocytes na asali.
- Tsarin kwararar ƙwayoyin halitta: 13.91% na ƙwayoyin halitta suna bayyana CD10, cCD79a, CD38, CD81, CD22, ba sa bayyana CD20, CD34, CD19, wanda ke nuna mummunan ƙwayoyin B na farko.
- Karyotype na chromosomal:
- 35,XY,-2,-3,-4,-5,-7,-9,-12,-13,-16,-17,-20[8]/35,XY+X,-2,-3,-4,-5,-7,-9,-10,-12,-13,-16,-17,-20[1]/36,XY,ƙara(1)(q42),-2,-3,-4,-7,-9,-12,-13,-16,-17,-20[1]/46,XY[20].
- Janairu 20: An tattara ƙwayoyin lymphocytes don haɓaka ƙwayoyin CD22-CART.
- Janairu 21: An yi huda a cikin lumbar, an yi amfani da maganin chemotherapy a cikin jiki don hana cutar sankarar jijiyoyin tsakiya; gwajin ruwan cerebrospinal bai nuna wata matsala ba.
- Janairu 22: An yi masa maganin Arac, 6MP, L-ASP chemotherapy, da kuma maganin FC (Flu 50mg x 3, CTX 0.5gx 3) chemotherapy.
- 7 ga Fabrairu (kafin jiko): Siffar ƙashi ta nuna kashi 93% na ƙwayoyin lymphocytes na asali.
- Tsarin kwararar jini: kashi 76.42% na ƙwayoyin halitta suna bayyana CD38, cCD79a, CD22, cbcl-2, CD123, CD10bri, CD24, CD81, ba sa bayyana CD4, CD3, CD13+33, CD34, CD20, CD19, CD279 (PD1), CD274 (PDL1), wanda ke nuna mummunan ƙwayoyin B na farko.
- An samu kamuwa da cutar fata da ta laushi tare da zazzabi; an inganta bayan an yi maganin antibiotics.
- 9 ga Fabrairu: Jikowar ƙwayoyin CD22-CART ta atomatik (5x10^5/kg).
- Illolin da suka shafi CAR-T: CRS aji 1, zazzabi a Rana ta 6 tare da Tmax 40°C, zafin jiki mai sarrafawa a Rana ta 10; babu guba a jijiyoyi.
- Maris 11: Kimanta bargon ƙashi ya nuna cikakkiyar sassaucin siffa, kuma cytometry na kwarara bai nuna wani mummunan ƙwayoyin halitta na asali ba.
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