Kab mob qog ntshav Lymphoblastic mob hnyav (T-ALL)-01

Cov yam ntxwv kho mob:

- Kev kuaj mob: T-cell lymphoblastic lymphoma/leukemia

- Lub Peb Hlis Ntuj xyoo 2020: Tau muaj hnoos qeev thiab mob qog hauv lub ntsws, tau kuaj pom tias muaj T-cell lymphoblastic lymphoma los ntawm kev siv mediastinal mass puncture biopsy.

- Tau txais 8 lub voj voog ntawm kev kho mob chemotherapy thiab ntau tshaj 20 zaug ntawm kev kho mob radiotherapy, ua rau qhov hnyav ntawm mediastinal txo qis ntau.

- Lub Ib Hlis 16, 2021: Tau mob hauv sab ceg sab xis.

- Cov ntshav niaj hnub: WBC 122.29 x 10^9/L, HGB 91 g/L, PLT 51 x 10^9/L

- Cov qauv ntawm cov pob txha pob txha: 95.5% cov lymphoblasts qub.

- Kev ntsuas cov ntshav ntws ntawm cov pob txha: 91.77% ntawm cov hlwb yog cov T-cell lymphoblasts uas tsis tau loj hlob.

- Kev txheeb xyuas cov noob caj noob ces: Pom muaj kev hloov pauv hauv cov noob caj noob ces NOTCH1, IL7R, thiab ASXL2.

- Tau txais kev kho mob Hyper-CVAD/B, kev kho mob ESHAP tom qab ntawd, ob qho tib si tsis ua haujlwm nrog rau qhov kub taub hau tas li.

- Lub Ob Hlis 18, 2021: Tau nkag mus rau hauv peb lub tsev kho mob.

- Qhia tias muaj kub taub hau, lub hauv siab CT qhia tau tias muaj mob ntsws.

- Cov ntshav niaj hnub: WBC 2.89 x 10^9/L, HGB 57.7 g/L, PLT 14.9 x 10^9/L

- Cov qe ntshav tsis loj hlob: 90%

- Cov qauv ntawm cov pob txha hauv pob txha: Hypercellular (qib IV), 85% cov lymphoblasts qub.

- Kev ntsuam xyuas kab mob immunophenotyping: 87.27% ntawm cov hlwb yog cov malignant primitive T-cell lymphoblasts.

- Kev tshuaj xyuas Chromosome: 46,XX [24]; pom peb lwm yam karyotypes txawv txav.

- Cov noob hloov pauv:

1. IL7R T244_I245insARCPL mutation zoo

2. NOTCH1 E1583_Q1584dup mutation zoo

3. ASXL2 Q602R mutation zoo

- Kev kuaj mob qog ntshav hauv lub cev: Tsis muaj

- Cov txiaj ntsig ntawm PET/CT: Tsis muaj qhov tseem ceeb ntawm cov qog nqaij hlav hypermetabolic hauv tag nrho cov pob txha thiab cov pob txha pob txha.

Kev Kho Mob:

- Pib siv tshuaj kho mob VP regimen, piav qhia raws li nram no: Vincristine (VDS) 3mg ib zaug, Dexamethasone (Dex) 7mg txhua 12 teev rau 9 hnub, nrog rau kev kho mob tiv thaiv kab mob.

- Lub Peb Hlis 1: Cov qe ntshav tsis loj hlob ntawm cov hlab ntsha sab nraud txo qis mus rau 7%.

- Lub Peb Hlis 4: Sau cov lymphocytes autologous rau kev cog qoob loo CD7-CAR T cell.

- Lub Peb Hlis 8: Pib siv VLP ua ke nrog kev kho mob Sida benzamine.

- Lub Peb Hlis 14: Tau txais FC regimen chemotherapy (Fludarabine 0.35g rau 3 hnub, Cyclophosphamide 45mg rau 3 hnub).

- Lub Peb Hlis 17 (ua ntej kev txhaj tshuaj rau hauv lub hlwb):

- Kev ntsuam xyuas cov hlwb pob txha seem: 15.14% cov hlwb qhia CD7 kaj, CD3 tsaus, cytoplasmic CD3, T cell receptor residual delta (TCRrd), qhia txog CD99 ib nrab, qhia txog cov hlwb T malignant primitive.

- Lub Peb Hlis 19: Muab cov qe ntshav CD7-CAR T uas twb muaj lawm (1 x 10^6/kg).

- Cov kev mob tshwm sim ntawm CAR-T: Qib 1 CRS (kub taub hau), tsis muaj tshuaj lom rau lub paj hlwb.

- Plaub Hlis 6 (Hnub 17): Cov qauv ntawm cov pob txha hauv lub cev qhia tau tias lawv tau zoo lawm, kev ntsuas cov qe ntshav dawb tsis pom cov qe ntshav dawb phem.