Ke keiki e hakakā nei me ka maʻi leukemia lymphoblastic koʻikoʻi

ʻIke Kumu o ka Mea Maʻi

He kāne 16 makahiki i ʻike ʻia me ka leukemia lymphoblastic acute (B-ALL), nāna i hana i ka chemotherapy mua, ka CD19/22 CAR-T cell therapy, salvage chemotherapy, a me ka haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) mai kahi makua i hāʻawi ʻia.

Ke kūlana ma mua o ka mālama ʻana o ka mea maʻi

Ma mua o ka allo-HSCT, ua ʻike ka mea maʻi i ka ulu wikiwiki ʻana o nā keena koko keʻokeʻo a me ka maʻi mau ʻoiai he nui nā hana i hana ʻia. Ma hope o ka hoʻokomo ʻia ʻana o CD19/22 CAR-T ma ʻApelila 21, 2025 (nā keena CAR-T holoʻokoʻa: 6.5 × 10 ^ 7), ua hoʻonui mua ʻia ka helu o nā keena CAR-T i 3.95 × 10 ^ 6 / L ma ka lā 7 akā ua emi iho i 0.82 × 10 ^ 6 / L ma ka lā 14, me nā keena pahū koko peripheral e piʻi ana mai 28.6% a i 87.1%. Ua hōʻike ka nānā ʻana o ka iwi iwi ma Mei 15, 2025, i ka emi nui ʻana o ka ulu ʻana me 37.42% mau lymphoblast B maʻamau ʻole (e hōʻike ana iā CD34, hapa CD38 / CD22, nāwaliwali CD81 / CD19 / CD33, ʻaʻohe CD10 / CD20 / CD79b), e hōʻoia ana ʻaʻohe hoʻomaha. ʻAʻole i hōʻike ka wai Cerebrospinal i nā keena maʻamau ʻole, akā ua mau ka maʻi holoʻokoʻa.

Ke kūlana o ka mea maʻi ma hope o ka mālama ʻana

Ma hope o ka allo-HSCT ma Mei 29-30, 2025 (nā pūnaewele CD34+: 8.6 × 10 ^ 6 / kg; nā pūnaewele mononuclear: 8 × 10 ^ 8 / kg), ua hoʻokō ka mea maʻi i ka neutrophil engraftment ma ka lā 11 a me ka platelet engraftment ma ka lā 18. Ma ka lā 28 (Iune 27, 2025), ua hoʻomaikaʻi nui ʻia ka helu koko: hemoglobin 99 g / L (mai nā pae haʻahaʻa ma mua), nā pūnaewele koko keʻokeʻo 11.73 × 10 ^ 9 / L, neutrophils 9.81 × 10 ^ 9 / L, a me nā platelets 79 × 10 ^ 9 / L. Ua hōʻike ke ʻano o ka iwi iwi i ka hoʻonui ʻana me ka ʻole o nā pūnaewele primitive maʻamau, ua hōʻoia ka cytometry kahe ʻaʻohe anomalies, ua hōʻike ka biopsy i ka hoʻonui haʻahaʻa akā ʻike ʻia nā pūnaewele trilineage me ka ʻole o nā lymphocytes immature, a ua hōʻea ka STR chimerism i 100%, e hoʻokō ana i ka hoʻokuʻu piha (CR) me ka liʻiliʻi o ka maʻi koena maikaʻi ʻole (MRD-). I ka lā 49 (Iulai 18, 2025), ua noho ikaika ka iwi iwi me nā pūnaewele ʻē ʻole, e hoʻomau ana i ka CR a me MRD-. Ua loaʻa ka maʻi graft-versus-host intestinal grade 1 akā ua mālama ʻia me nā lāʻau lapaʻau, e hōʻike ana i ka kaohi ʻana i ka maʻi a me ka hoʻōla ʻana i hoʻohālikelike ʻia me nā blasts mau loa ma mua o ka hoʻoili ʻana (mai 37.42% a i 0%) a me ka nele o ke kala ʻana.