Te Mate Pūkahukahu Lymphoblastic Koretake (T-ALL)-04

He tāne 15 tau te pakeke o te tūroro, i kitea he mate toto toto nui (T-ALL me te STIL-TAL1 positivity, he ira matapae ngoikore) i te mutunga o Hakihea 2020, ā, i rongoatia i roto i tētahi hōhipera ā-rohe me ngā huringa maha o te chemotherapy auau kia tutuki ai te murunga katoa. I mahia he whakawhitinga pūtau take hematopoietic hemizygous mai i te matua ki te tama i te 2 o Hune 2021, engari heoi anō i kitea he hokinga mai o te hinu wheua i roto i ngā marama e 3 i muri i te whakawhitinga, ā, kāore i whai hua te huringa chemotherapy kotahi. I taua wā anō, i puta he paparinga pupuhi me te turuturu o te hau, he kokonga piko o te waha, ā, i kī te werohanga o te hope i te whanaketanga o te mate toto toto o te pūnaha io matua.

Ko te T-ALL me te STIL-TAL1 pai, te hokinga wawe i muri i te whakawhitinga allogeneic, me te mate toto nui o te pūnaha io matua, he take tino uaua ki te rongoā i te wā kāore he CAR-T. I pātai te matua o te tamaiti mō te tari toto i te Tianjin Cancer Hospital Airport Hospital mā roto i ana hoa. Whai muri i te whakawhitiwhiti kōrero taipitopito, ka tae mai rātou ki te Tianjin Cancer Hospital Airport Hospital, e whai ana kia whakauru atu ki tētahi whakamātautau haumanu CAR-T hei mahi whakamutunga.

I rahua te CAR-T tuatahi. I tere te whakaputa uri o ngā pūtau pukupuku, ā, i mōrearea ai tōna ora.

I te 26 o Oketopa 2021, i whakaurua te tūroro ki te wāhanga tuatahi o te Tari Hematology. Nā te tere o te tipu o ngā pūtau pukupuku, i tukuna te rongoā chemotherapy ki te tūroro hei whakaiti i te kawenga pukupuku, ā, i whiwhi rongoā chemotherapy intrathecal. Kāore i kitea he mate toenga i roto i te wai cerebrospinal. I muri i te whakaū, i kohia ngā lymphocytes o tōna matua mō te ahurea pūtau CAR-T. I te 19 o Noema, i werohia ngā pūtau CD7 CAR-T kaituku ki roto i te tūroro.

I ngā rā i muri i te werohanga, i mua i te horapa o ngā pūtau CAR-T, ka tere anō te horapa o ngā pūtau pukupuku, ā, ka kitea he nui ngā pahūtanga i roto i te toto ā-taha, e tohu ana i te korenga o te rongoā CAR-T tuatahi.

I tēnei wā, kei te whakahaerehia e te Hōhipera Taunga Rererangi o Tianjin te whakamātautau haumanu o te CAR-T whānui (CD7 UCAR-T) mō te mate pukupuku T-lymphoblastic acute. I whakapuaki ngā mātua i te hiahia nui, me te kī ka whai rātou i te whai wāhitanga ahakoa 1% mō tā rātou tamaiti. I kōrero te tīma hauora ki te whānau, ā, i whakatau kia whakaurua te tūroro ki te whakamātautau haumanu CD7 UCAR-T.

Te murunga katoa i muri i te CD7 UCAR-T. Inaianei e 2 marama i muri i te whakawhitinga tipu.

I te 2 o Hakihea, i whiwhi te tūroro i te werohanga pūtau CD7 U-CART me te rongoā whakaiti-puku me te tiaki tautoko. Whai muri i te werohanga, i pāngia ia e te kirika nui mō te wā roa me te ngenge. Nā te tautoko ārai-mate me te wai, i taurite ōna tohu ora, ā, i hoki anō te pāmahana o te tinana ki te āhua noa.

I ngā aromatawai o te hinu wheua me te wai roro i ngā rā 18 me te 28 i muri i te CAR-T, i whakaūtia te murunga katoa me te korenga o te MRD. I tino pai ake te āhua o te tamaiti, i hoki mai tōna kaha, i ora ake te hiahia kai, ā, i hoki mai anō te tumanako ki tōna whaea—i pouri i mua.

I tēnei wā, kua whiwhi te tūroro i te tuarua o ngā tātaritanga haploidentical HSCT i te Tianjin Cancer Hospital Airport Hospital, ā, e rua marama i muri i te whakawhitinga wheua, kei te tino marino tonu ia.