Te Mate Pūkahukahu Lymphoblastic Whakapeka (T-ALL)-03

Ngā Āhuatanga o te Pūkoro:

- Tātaritanga: Te mate pukupuku toto pūtau-T whakapeka

- Te Tīmatanga me ngā Tohu: Paenga-whāwhā 2020, i puta mai me te whanoke, te ngenge, me ngā tohu toto kiri. I kitea he mate toto toto pūtau-T acute mā te whakamātautau MICM hinu wheua.

- Maimoatanga Tuatahi: I tutuki te murunga katoa (CR) i muri i te rongoā chemotherapy VDCLP, ā, i muri mai ka rua ngā huringa o te rongoā chemotherapy kaha ake.

- 19 o Hūrae, 2020: I whiwhi i te whakawhitinga pūtau take hematopoietic allogeneic mai i tētahi kaituku wahine (HLA 5/10 A kaituku A). Ko te tikanga whakapakari tinana i uru atu ki te whakamātao i te tinana katoa (TBI), te cyclophosphamide (CY), me te etoposide (VP-16). I whakauruhia ngā pūtau take taha i te 24 o Hūrae, me te whakaora granulocyte i te rā +10 me te whakawhitinga platelet i te rā +13. Whai muri i tēnā, ka tirotirohia ngā pūtau i waho o te hōhipera.

- 25 o Pēpuere, 2021: I kitea te hokinga mai o te hinu wheua i te wā o te arotake.

- Maimoatanga: I tīmata te rongoā thalidomide ā-waha.

- 8 o Poutū-te-rangi: I whakaurua ki tō mātou hōhipera.

- Te āhua o te hinu wheua: 61.5% ngā pahūtanga.

- Te Whakarōpūtanga Toto Āpiti: 15% ngā pahūtanga.

- Te Tātaritanga Ārai Mate: 35.25% ngā pūtau e whakaatu ana i te CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, e tohu ana i ngā pūtau toto T kino kāore anō kia pakari.

- Tātaritanga Ira Tangata: 46, XX [9].

- Ira Hanumitanga Matepukupuku: He pai te ira hanumitanga SIL-TAL1; inenga tau: SIL-TA.

- Ngā Huringa Puku Toto: Kāore i te pai.

- Tātaritanga Kimerisma (whai muri i te HSCT): Ko ngā pūtau i ahu mai i te kaituku ko te 45.78%.

- 11 Maehe: Kohikohi i ngā pūtau toto ā-rohe autologous mō te ahurea pūtau CD7-CART.

- Maimoatanga: VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x 4 rā, Dex 9mg qd x 9 rā) me te thalidomide hei whakahaere i te pukupuku.

- Maehe 19: Te rongoā FC mō te chemotherapy (Rewharewha 50mg x 3 rā, CTX 0.4gx 3 rā).

- Maehe 24 (i mua i te werohanga): I whakaatuhia e te āhua o te hinu wheua te hyperplasia taumata V, me te 22% o ngā pahūtanga.

- Te Ine Rere o te Huango Wheua: 29.21% o ngā pūtau (o ngā pūtau whai pūtake) e whakaatu ana i te CD3, CD5, CD7, CD99, e whakaatu ana i te cCD3 i tētahi wāhanga, e tohu ana i ngā pūtau-T kino kāore anō kia pakari.

- Ira Hononga SIL-TAL1 Tauanga: 1.913%.