Ciwon sankarar lymphoblastic mai tsanani (T-ALL)-03

Fasaloli na Shari'a:

- Ganewar asali: Cutar sankarar lymphoblastic mai tsanani ta T-cell

- Farko da Alamomin: Afrilu 2020, an gabatar da shi da jiri, gajiya, da kuma zubar jini a fata. An gano cutar sankarar lymphoblastic mai tsanani ta hanyar gwajin MICM na ƙashi.

- Maganin Farko: An sami cikakkiyar sassauci (CR) bayan tsarin VDCLP na chemotherapy, sannan aka biyo baya da zagaye biyu na ingantaccen chemotherapy.

- 19 ga Yuli, 2020: An karɓi dashen ƙwayoyin halittar jini na allogeneic daga mace mai bayarwa (HLA 5/10 A mai bayarwa A). Tsarin kula da lafiya ya haɗa da cikakken hasken jiki (TBI), cyclophosphamide (CY), da etoposide (VP-16). An jiƙa ƙwayoyin halittar jijiyoyin jiki a ranar 24 ga Yuli, tare da murmurewa daga granulocyte da rana +10 da kuma sanya platelet a rana +13. Bayan haka, ana ci gaba da bin diddigin marasa lafiya akai-akai.

- 25 ga Fabrairu, 2021: An gano sake dawowar ƙashi a lokacin bin diddigin cutar.

- Magani: Fara maganin thalidomide ta baki.

- Maris 8: An kwantar da mu a asibiti.

- Tsarin Maƙogwaro na Kashi: fashewar kashi 61.5%.

- Rarraba Jini na Gefe: 15% na fashewa.

- Tsarin Immunophenotyping: 35.25% ƙwayoyin da ke bayyana CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, suna nuna ƙwayoyin T marasa ƙarfi.

- Binciken Kwayoyin Halitta: 46, XX [9].

- Haɗakar kwayar cutar sankarar jini: Haɗakar kwayar halittar SIL-TAL1 mai kyau; ma'aunin adadi: SIL-TA.

- Canjin Tumor na Jini: Mara kyau.

- Binciken Chimerism (bayan HSCT): Kwayoyin da aka samo daga masu bayarwa sun kai kashi 45.78%.

- Maris 11: Tarin ƙwayoyin lymphocytes na jini na gefe don haɓaka ƙwayoyin CD7-CART.

- Jiyya: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x kwana 4, Dex 9mg q12h x kwana 9) tare da thalidomide don magance ciwon.

- Maris 19: Maganin chemotherapy na FC (Mai fama da mura 50mg x kwana 3, CTX 0.4gx kwana 3).

- Maris 24 (kafin a yi amfani da shi): Siffar ƙashi ta nuna matakin V hyperplasia, tare da fashewar kashi 22%.

- Tsarin kwararar ƙashi na ƙashi: 29.21% ƙwayoyin halitta (na ƙwayoyin nucleated) waɗanda ke bayyana CD3, CD5, CD7, CD99, waɗanda ke bayyana cCD3 a wani ɓangare, suna nuna ƙwayoyin T marasa ƙarfi.

- Tsarin Haɗakar SIL-TAL1 mai ƙima: 1.913%.