- Ọgwụgwọ
- Ihe akaebe
- Neuroblastoma
- Ọrịa siri ike
- Ihe akaebe
- TILS
- Ọgwụgwọ NK Cell
- Myasthenia Gravis (MG)
- Ọrịa kansa ọbara Lymphoblastic dị oke njọ (B-ALL)
- Ọrịa Lupus Erythematosus Sistemụ (SLE)
- Ọrịa kansa ọbara Lymphoblastic dị oke njọ (T-ALL)
- Ọrịa Lymphoma na-abụghị Hodgkin (NHL)
- Ọtụtụ Myeloma (MM)
- Lymphom B-cell buru ibu nke gbasaara agbasa
- Ọrịa kansa ọbara B-lymphocytic
- Myeloma
Ọrịa kansa ọbara Lymphoblastic dị oke njọ (B-ALL)-03
Atụmatụ ikpe:
- Achọpụtara ya na ọrịa leukemia nke mkpụrụ ndụ B-cell lymphoblastic na njedebe nke Mee 2020.
- Usoro ọbara: WBC 5.14x10^9/L, HGB 101.60g/L, PLT 6x10^9/L.
- Ọdịdị nke ụmị ọkpụkpụ: Hypocellular nwere 67% nke lymphocytes mbụ.
- Cytometry mmiri: 82.28% nke mkpụrụ ndụ na-egosipụta CD38, HLA-DR, CD19, CD10, CD105, TDT, CD22, cCD79a, na-egosipụta CD9 n'ụzọ ụfọdụ, na-egosipụta CD13 n'ụzọ na-adịghị ike.
- Nchọpụta mkpụrụ ndụ ihe nketa ngwakọta adịghị mma; WT1 57.3%; achọpụtaghị mkpụrụ ndụ ihe nketa njikọta PH dị ka ihe niile.
- Azụ̀: Mgbanwe TP53 dị mma.
- Krọmosọm: 63-58, XXY, +Y, +1, +del(1)(q41q42), -2, -3, +6, -7, +8, -9, +10, -12, -13, +14, +15, -17, +18, -20, +22(cp16)/46, XY[4].
- Ana m enweta usoro VCDLP maka ọmụmụ ihe abụọ na-enweghị mgbaghara.
- Usoro CAM-VL (CTX 2gx2, Arac 200mgx6, 6-MP 100mgx14, VDS 4mgx2, L-ASP 10,000 IUx7) na Julaị 22, 2020, ka na-enweghị mgbaghara.
- Cytometry nke mmiri ọkpụkpụ na Septemba 25, 2020: 7.35% nke mkpụrụ ndụ na-egosipụta CD81, CD19, CD10, CD38, CD33, na-egosipụta CD20, CD45 n'ụzọ na-adịghị ike.
- Nnyocha mgbanwe mkpụrụ ndụ ọbara: mgbanwe TP53.
- Krọmosọm: 46, XY[20].
- Amalitere ọgwụgwọ CD19-CART.
- Usoro ọgwụgwọ FC (FLU 62.7mg x ụbọchị 4, CTX 1045mg x ụbọchị 2) chemotherapy.
- Ọktoba 1, 2020: Ntinye mkpụrụ ndụ CD19-CART nke onwe ya na 4.7x10^7/kg.
- CRS ọkwa nke abụọ nwere nsogbu neurotoxicity nke ọkwa nke 1, emelitere mgbe ejiri ọgwụgwọ nkwado mee ya.
- Ọktoba 29, 2020: Mbelata zuru oke na ọdịdị ọkpụkpụ, enweghị mkpụrụ ndụ ochie dị njọ na cytometry flow.
- Disemba 31, 2020: Ụkwara kpọrọ nkụ, ọgbụgbọ, ọgbụgbọ, adịghị ike zuru oke.
- Usoro ọbara: WBC 15.53x10^9/L, HGB 134g/L, PLT 71x10^9/L.
- Ọchịchọ nke ụmị ọkpụkpụ na-egosi nlọghachi azụ.
- Jenụwarị 2, 2021: E tinyere ya n'ụlọ ọgwụ anyị.
- Usoro ọbara: WBC 20.87x10^9/L, HGB 118.30g/L, PLT 58.60x10^9/L.
- Creatinine 134umol/L, ọbara mgbali elu nke ọkwa 3, akụkọ ahụike nke afọ 4.
- Nkewa ọbara dị n'akụkụ: 62% mkpụrụ ndụ mbụ.
- Immunophenotyping: 28.48% nke mkpụrụ ndụ (mkpụrụ ndụ nucleated) na-egosipụta CD10, CD38dim, HLA-DR, CD20dim, CD24, CD81, cCD79a, CD22, CD268dim, CD58, na-egosipụta CD123, TDT n'otu akụkụ, anaghị egosipụta CD34, CD19, MPO, CD117, CD13, CD33, CD11b, clgM, CD79b, CD7, cCD3, kappa, lambda, nke na-egosi lymphocytes B dị njọ.
- Nnyocha mgbanwe mkpụrụ ndụ ọbara: mgbanwe TP53 R196P dị mma.
Ọgwụgwọ:
- Anatara m ọgwụ VLP, tinyere ọgwụgwọ maka ọbara mgbali elu, mbelata creatinine, na hydration alkalinization.
- Jenụwarị 19: Usoro ọbara gosiri WBC 1.77x10^9/L, HGB 71g/L, PLT 29.8x10^9/L.
- Nhazi ọbara dị n'akụkụ: Enweghị lymphocytes mbụ.
- Ọdịdị nke ụmị ọkpụkpụ: Hypercellularity (ọkwa V), mpaghara focal nke ọkwa IV, yana 42% nke primary lymphocytes.
- Cytometry mmiri: 13.91% nke mkpụrụ ndụ na-egosipụta CD10, cCD79a, CD38, CD81, CD22, anaghị egosipụta CD20, CD34, CD19, nke na-egosi mkpụrụ ndụ B mbụ dị njọ.
- Karyotype nke chromosomal:
- 35,XY,-2,-3,-4,-5,-7,-9,-12,-13,-16,-17,-20[8]/35,XY+X,-2,-3,-4,-5,-7,-9,-10,-12,-13,-16,-17,-20[1]/36,XY,tinye(1)(q42),-2,-3,-4,-7,-9,-12,-13,-16,-17,-20[1]/46,XY[20].
- Jenụwarị 20: A na-anakọta mkpụrụ ndụ lymphocytes maka mkpụrụ ndụ CD22-CART.
- Jenụwarị 21: Emere mpịpụ akwara dị n'ime azụ, e nyere ọgwụ chemotherapy n'ime ahụ iji gbochie leukemia nke sistemu akwara etiti; nyocha mmiri cerebrospinal egosighi nsogbu ọ bụla.
- Jenụwarị 22: E nyere m ọgwụ Arac, 6MP, L-ASP, na ọgwụ FC (Flu 50mg x 3, CTX 0.5gx 3) maka ọgwụgwọ.
- Febụwarị 7 (tupu a gbanye ya): Ọdịdị ọkpụkpụ gosiri na lymphocytes mbụ dị pasent 93.
- Cytometry mmiri: 76.42% nke mkpụrụ ndụ na-egosipụta CD38, cCD79a, CD22, cbcl-2, CD123, CD10bri, CD24, CD81, anaghị egosipụta CD4, CD3, CD13+33, CD34, CD20, CD19, CD279 (PD1), CD274 (PDL1), nke na-egosi mkpụrụ ndụ B ochie dị njọ.
- Ọrịa akpụkpọ ahụ na anụ ahụ dị nro malitere ịpụta site na ahụ ọkụ; eme ka ọ ka mma mgbe ejiri ọgwụ nje mee ya.
- Febụwarị 9: Ntinye mkpụrụ ndụ CD22-CART nke onwe (5x10^5/kg).
- Mmetụta ọjọọ ndị metụtara CAR-T: CRS ọkwa 1, ahụ ọkụ n'ụbọchị nke 6 yana Tmax 40°C, okpomọkụ a na-achịkwa n'ụbọchị nke 10; enweghị nsí na-adịghị mma.
- Machị 11: Nnyocha ụmị ọkpụkpụ gosiri na e wepụrụ morphological kpamkpam, cytometry mmiri egosighi mkpụrụ ndụ mbụ dị njọ.
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