Te Mate Pūkahukahu Lymphoblastic Whakapeka (T-ALL)-05

Te Whakamarietanga o te Tūroro T-ALL kua Hoki Mai me te Leukemia Pūnaha Io Matua i muri i te Whakaora CAR-T

E pā ana tēnei take ki tētahi tamaiti 16-tau te pakeke nō te raki-mā-rāwhiti o Haina, ā, he maha ngā wero i roto i tana haerenga me te mate toto mai i tana tātaritanga i te mate nei i te tau kua hipa.

I te 8 o Noema, 2020, i toro atu a Dawei (he ingoa huna) ki tētahi hōhipera o te rohe nā te pakari o tōna mata, te ponana, me te waha piko. I kitea tōna mate "acute lymphoblastic leukemia (momo pūtau-T)." Whai muri i tētahi akoranga chemotherapy whakauru, kāore he MRD (minimal residual disease), ā, i muri mai ka puta te chemotherapy auau. I roto i tēnei wā, kāore he rerekētanga i kitea i roto i te pokanga wheua, i te pokanga hope, me ngā weronga intrathecal.

I te 6 o Mei, 2021, i mahia he werohanga lumbar me te werohanga intrathecal, ā, i whakaūtia e te tātaritanga wai cerebrospinal (CSF) te "mate toto o te pūnaha io matua." I whai ake ko ngā akoranga chemotherapy e rua. I te 1 o Hune, i whakaatuhia e te werohanga lumbar me te tātaritanga CSF he pūtau kāore anō kia pakari. E toru atu ngā werohanga lumbar me ngā werohanga intrathecal i tukuna, ā, ko te whakamātautau CSF whakamutunga kāore i whakaatu i ngā pūtau pukupuku.

I te 7 o Hūrae, i ngaro te tirohanga o Dawei i tōna kanohi matau, ā, ko te kitenga mārama anake i kitea. Whai muri i te kotahi akoranga o te chemotherapy kaha ake, ka hoki te tirohanga o tōna kanohi matau ki te āhua noa.

I te 5 o Ākuhata, ka heke anō te tirohanga o tōna kanohi matau, ā, ka matapo rawa, ā, ka pōuriuri tōna kanohi maui. Mai i te 10 ki te 13 o Ākuhata, i whiwhi ia i te rongoā irahiko (TBI) mō te roro katoa me te taurakira, ā, i whakahokia mai ai te tirohanga o tōna kanohi maui, engari i noho matapo tonu te kanohi matau. I te 16 o Ākuhata, i whakaatuhia e te matawai MRI o te roro he paku whakapainga i te matotoru o te io whatu matau me te chiasm, me te whakapainga i kitea. Kāore i kitea he tohu rerekē, he whakapainga rānei i roto i te parenchyma roro.

I tēnei wā, kua rite te whānau mō te whakawhitinga wheua, ā, ko te moenga anake i te wāhanga whakawhitinga e tatari ana. Engari, nā ngā whakamātautau i mua i te whakawhitinga i kitea ai ngā raruraru i kore ai e taea te whakawhitinga.