ʻO ka maʻi leukemia lymphoblastic koʻikoʻi (T-ALL)-03

Nā Hiʻohiʻona Hihia:

- Hōʻike: Leukemia lymphoblastic T-cell koʻikoʻi

- Hoʻomaka a me nā Hōʻailona: ʻApelila 2020, i hōʻike ʻia me ka poniuniu, ka luhi, a me nā kiko kahe koko o ka ʻili. Ua ʻike ʻia me ka leukemia lymphoblastic T-cell acute ma o ka hoʻokolokolo ʻana o ka iwi MICM.

- Lapaʻau Mua: Ua hoʻokō ʻia ke kala piha ʻana (CR) ma hope o ka chemotherapy VDCLP regimen, a ukali ʻia e 2 mau pōʻaiapuni o ka chemotherapy i hoʻoikaika ʻia.

- Iulai 19, 2020: Ua loaʻa i ka hoʻoili ʻana o nā cell kumu hematopoietic allogeneic mai kahi mea hāʻawi wahine (HLA 5/10 A donor A). ʻO ka papa hana hoʻomaʻamaʻa e komo pū ana me ka irradiation kino holoʻokoʻa (TBI), cyclophosphamide (CY), a me etoposide (VP-16). Ua hoʻokomo ʻia nā cell kumu peripheral ma Iulai 24, me ka hoʻōla ʻana o ka granulocyte i ka lā +10 a me ka platelet engraftment i ka lā +13. Nā hahai maʻamau ma waho ma hope.

- Pepeluali 25, 2021: Ua ʻike ʻia ka hoʻi hou ʻana o ka iwi i ka wā o ka nānā ʻana.

- Lapaʻau: Ua hoʻomaka ka lāʻau lapaʻau thalidomide waha.

- Malaki 8: Ua hoʻokomo ʻia i ko mākou haukapila.

- ʻAno o ka iwi iwi: 61.5% pahū.

- Ka Hoʻokaʻawale ʻana o ke Koko Peripheral: 15% pahū.

- Immunophenotyping: 35.25% o nā pūnaewele e hōʻike ana i ka CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, e hōʻike ana i nā lymphocytes T ʻōpiopio ʻino.

- Ka Nānā ʻana i nā Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene maikaʻi; ana helu: SIL-TA.

- Hoʻololi ʻana o ka puʻupuʻu koko: Maikaʻi ʻole.

- Ka Nānā ʻana i ka Chimerism (ma hope o HSCT): Ua helu ʻia nā pūnaewele i loaʻa mai ka mea hāʻawi no 45.78%.

- Malaki 11: Hōʻiliʻili ʻana o nā lymphocytes koko peripheral autologous no ka moʻomeheu cell CD7-CART.

- Lapaʻau: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 lā, Dex 9mg q12h x 9 lā) regimen i hui pū ʻia me ka thalidomide e kāohi i ka puʻupuʻu.

- Malaki 19: Kemokalama FC regimen (Flu 50mg x 3 lā, CTX 0.4gx 3 lā).

- Malaki 24 (ma mua o ka hoʻokomo ʻana): Ua hōʻike ke ʻano o ka iwi iwi i ka hyperplasia papa V, me 22% blasts.

- Ka Cytometry o ke kahe ʻana o ka iwi iwi: 29.21% o nā pūnaewele (o nā pūnaewele nucleated) e hōʻike ana iā CD3, CD5, CD7, CD99, e hōʻike hapa ana iā cCD3, e hōʻike ana i nā pūnaewele T ʻōpiopio ʻino.

- Ka nui o ka hoʻohui ʻana o ka SIL-TAL1 Gene: 1.913%.