Khansa ya m'magazi ya Lymphoblastic (T-ALL)-03

Zinthu Za Mlandu:

- Kuzindikira: Matenda a khansa ya m'magazi ya T-cell lymphoblastic

- Kuyamba ndi Zizindikiro: Epulo 2020, adakumana ndi chizungulire, kutopa, komanso kutuluka magazi pakhungu. Adapezeka ndi khansa ya m'magazi ya T-cell lymphoblastic kudzera mu kafukufuku wa MICM wa m'mafupa.

- Chithandizo Choyamba: Anapeza mpumulo wathunthu (CR) pambuyo pa chithandizo cha VDCLP, kenako analandira ma chemotherapy awiri amphamvu.

- Julayi 19, 2020: Analandira allogeneic hematopoietic stem cell transplantation kuchokera kwa mkazi wopereka (HLA 5/10 A donor A). Njira yochiritsira matenda inali kuphatikizapo kuunikira thupi lonse (TBI), cyclophosphamide (CY), ndi etoposide (VP-16). Maselo oyambira a m'mphepete mwa thupi adalowetsedwa pa Julayi 24, ndi kuchira kwa granulocyte pofika tsiku +10 ndi kulowetsedwa kwa ma platelet pofika tsiku +13. Kutsatira nthawi zonse kwa odwala omwe akupita kuchipatala pambuyo pake.

- February 25, 2021: Kubwereranso kwa mafuta m'mafupa kunapezeka panthawi yotsatiridwa.

- Chithandizo: Ndinayamba kumwa mankhwala a thalidomide.

- Marichi 8: Analowa m'chipatala chathu.

- Maonekedwe a Bone Bone Morophology: 61.5% ya kuphulika.

- Kugawa Magazi Ozungulira: 15% ya kuphulika.

- Immunophenotyping: 35.25% ya maselo omwe ali ndi CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, zomwe zikusonyeza ma T lymphocytes osakhwima omwe ali ndi khansa.

- Kusanthula kwa Chromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene positive; muyeso wochuluka: SIL-TA.

- Kusintha kwa Chotupa cha M'magazi: Choyipa.

- Kusanthula kwa Chimerism (pambuyo pa HSCT): Maselo otengedwa ndi opereka anali 45.78%.

- Marichi 11: Kusonkhanitsa ma lymphocyte a magazi a autologous kuti apeze maselo a CD7-CART.

- Chithandizo: Mankhwala a VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x masiku 4, Dex 9mg q12h x masiku 9) ophatikizidwa ndi thalidomide kuti athetse chotupacho.

- Marichi 19: Chithandizo cha mankhwala a FC regimen (Flu 50mg x masiku atatu, CTX 0.4gx masiku atatu).

- Marichi 24 (asanalowetsedwe): Kapangidwe ka mafupa a m'mafupa kanasonyeza kuchuluka kwa shuga m'magazi (grade V hyperplasia), ndipo 22% ya kuphulika kwake inali yofanana.

- Kuchuluka kwa Marrow Flow Cytometry: 29.21% ya maselo (a maselo okhala ndi nucleotide) omwe amatulutsa CD3, CD5, CD7, CD99, omwe amatulutsa pang'ono cCD3, zomwe zikusonyeza maselo a T osakhwima omwe ali ndi khansa.

- Chiwerengero cha SIL-TAL1 Fusion Gene: 1.913%.