Kab mob qog ntshav Lymphoblastic mob hnyav (T-ALL)-02

Cov yam ntxwv kho mob:

- Kev kuaj mob: Mob ntshav qab zib T-cell lymphoblastic mob hnyav

- Pib: Thaum kawg ntawm lub Peb Hlis 2018

- Cov tsos mob thaum pib: Ntau lub qog ntshav sab nraud loj hlob thoob plaws lub cev

- Cov ntshav pib ua haujlwm: WBC: 39.46 * 10 ^ 9 / L, Hb: 129 g / L, PLT: 77 * 10 ^ 9 / L

- Cov qauv ntawm cov pob txha pob txha: 92% blasts

-Flow cytometry: 95.3% cov hlwb tsis zoo uas qhia tawm

TdT+CD99+CyCD3+CD7stCd5DdimCD4-CD8-mCD3-CD45dim

- Cov noob sib xyaw ua ke: Tsis zoo

- Kev hloov pauv ntawm cov noob caj noob ces: Kev hloov pauv ntawm cov noob caj noob ces NOTCH1 tau pom

- Kev tshuaj xyuas Chromosome: karyotype ib txwm muaj

Keeb Kwm Kev Kho Mob:

- Plaub Hlis Ntuj Tim 3, 2018: Kev kho mob nrog VDCP regimen

- Plaub Hlis 18, 2018: Kev tawg ntawm cov pob txha hauv pob txha muaj 96%

- Plaub Hlis 20, 2018: Tau txais kev zam txim tom qab CAG regimen

- Tsib Hlis 18, 2018: Kev kho mob sib xyaw nrog CMG + VP regimen

- Lub Rau Hli 22, 2018: Cov pob txha tawg nce mus txog 40%, rov qab muaj mob leukemia dua

- Lub Xya Hli 25, 2018: Kev kho mob CLAM (clarithromycin + cyclophosphamide + amikacin)

- Kev hloov pauv hlwb ntawm cov qe ntshav los ntawm cov kwv tij HLA-matched siv FLU + BU conditioning rau lub Yim Hli 14

- Kev soj ntsuam tom qab hloov pob txha: Kev ploj ntawm cov pob txha pob txha thaum muaj 1 hlis, 3 hlis, 6 hlis, 9 hlis, thiab 11 hlis

- Cov qauv ntawm cov pob txha hauv lub cev tau pom tias zoo li qub tom qab 16 lub hlis tom qab hloov hlwb, nrog rau kev ntsuas cov ntshav ntws qhia txog 0.02% cov lymphocytes tsis loj hlob zoo.

- Kaum Ib Hlis 13, 2020: Cov ntshav ntws los ntawm cov neeg pub dawb yog 97.9%

- Cov qe ntshav dawb uas tseem muaj nyob rau sab nraud: 20%

- Lub Kaum Ob Hlis 18, 2020: Cov qauv ntawm cov pob txha hauv pob txha: 60.6% blasts

- Kev ntsuas cov ntshav ntws: 30.85% cov T lymphocytes uas tsis loj hlob zoo

- Kev tshuaj xyuas Chromosome: 46, XY (20)

- Tau txais kev kho mob chemotherapy DA regimen rau lub Ib Hlis 19, 2021

- Cov qauv ntawm cov pob txha hauv lub Ib Hlis 19, 2021: Qib III hyperplasia, 16% blasts

- Kev tshuaj xyuas chromosome karyotype: 46, XY (20)

- Kev ntsuas cov kab mob hauv lub cev: 7.27% ntawm cov hlwb (ntawm cov hlwb nuclear) tau qhia CD99bri, CD13, CD38, cbcl-2, cCD3, HLA-ABC bri, CD7bri, thiab CD5dim tau qhia ib nrab, qhia tias cov T lymphocytes tsis loj hlob zoo.

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

- Kev tshuaj xyuas kev hloov pauv ntawm cov qog ntshav (86 hom):

1. PHF6 K299Efs*13 mutation zoo

2. RUNX1 S322* mutation zoo

3. FBXW7 E471G mutation zoo

4. Kev hloov pauv JAK3 M511I zoo

5. NOTCH1 Q2393* mutation zoo

Kev Kho Mob:

- Lub Ib Hlis 22: Kev sau thiab kev cog qoob loo ntawm cov lymphocytes ntshav peripheral autologous rau CD7-CART

- Ua ntej CD7-CART infusion, tus neeg mob tau txais VLP (vincristine, l-asparaginase, prednisone) ntxiv rau bortezomib chemotherapy.

- Lub Ob Hlis 3: Kev kho mob FC regimen chemotherapy (Kab mob khaub thuas 50mg rau 3 hnub + CTX 0.45g rau 3 hnub)

- Lub Ob Hlis 5 (ua ntej txhaj tshuaj): Cov qauv ntawm cov pob txha hauv pob txha qhia tau tias muaj 23% ntawm cov kab mob tawg.

- Kev ntsuas cov kua dej hauv lub cev (flow cytometry) qhia tau 4.05% cov hlwb uas qhia txog CD99bri, CD5dim, CD7bri, TDT, cCD3, qhia tias cov T lymphocytes tsis loj hlob zoo.

- Kev tshuaj xyuas Chromosome: 46, XY (20)

- Kev tshuaj xyuas Chimerism (tom qab HSCT): Cov hlwb uas tau los ntawm tus neeg pub muaj txog 52.19%.

- Lub Ob Hlis 7: Kev txhaj tshuaj ntawm cov qe ntshav CD7-CART autologous ntawm qhov koob tshuaj ntawm 5 * 10 ^ 5 / kg.

- Lub Ob Hlis 15: Cov qe ntshav tsis loj hlob ntawm cov hlab ntsha sab nraud txo qis mus rau 2%.

- Lub Ob Hlis 19 (Hnub 12 tom qab txhaj tshuaj): Tus neeg mob tau kub taub hau, uas kav ntev li 5 hnub ua ntej tswj tau qhov kub.

- Lub Peb Hlis 2: Kev ntsuam xyuas cov pob txha qhia tau tias cov morphological ploj mus tag, nrog rau flow cytometry tsis pom cov hlwb malignant uas tsis tau loj hlob.