- Uburyo bwo kuvura
- Ubuhamya
- Neuroblastoma
- Indwara ikomeye
- Ubuhamya
- TILS
- Ubuvuzi bwa Selile za NK
- Myasthenia Gravis (MG)
- Leukemia ikabije ya Lymphoblastic (B-ALL)
- Indwara ya Lupus Erythematosus yo mu mubiri (SLE)
- Leukemia ikabije ya Lymphoblastic (T-ALL)
- Lymphoma itari iya Hodgkin (NHL)
- Myeloma nyinshi (MM)
- Lymphom nini ya B-cell ikwirakwira
- Leukemia ya B-lymphocytic
- Myeloma
Leukemia ikabije ya Lymphoblastic (B-ALL)-03
Ibiranga Urubanza:
- Yasuzumwe afite kanseri y'amaraso ya B-cell lymphoblastic mu mpera za Gicurasi 2020.
- Gahunda y'amaraso: WBC 5.14x10^9/L, HGB 101.60g/L, PLT 6x10^9/L.
- Imiterere y'umusemburo w'amagufwa: Hypocellular ifite 67% bya lymphocytes z'umwimerere.
- Ingano y'amaraso mu mubiri: 82.28% by'uturemangingo tugaragaza CD38, HLA-DR, CD19, CD10, CD105, TDT, CD22, cCD79a, CD9 igaragara igice, CD13 igaragara gito.
- Gusuzuma jeni ya Fusion byagaragaye ko ari bibi; WT1 57.3%; nta jeni za fusion zifitanye isano na ALL zisa na PH zabonetse.
- AMAFI: Impinduka za TP53 zagaragaye.
- Chromosomes: 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].
- Nahawe gahunda ya VCDLP mu masomo 2 nta kuruhuka.
- Gahunda ya CAM-VL (CTX 2gx2, Arac 200mgx6, 6-MP 100mgx14, VDS 4mgx2, L-ASP 10,000 IUx7) ku ya 22 Nyakanga 2020, nta kibazo cyabayeho.
- Isuzuma ry'urusobe rw'amaraso mu magufwa ku ya 25 Nzeri 2020: 7.35% by'uturemangingo tugaragaza CD81, CD19, CD10, CD38, CD33, CD20 na CD45 zigaragaza buhoro buhoro.
- Isesengura ry'impinduka mu maraso: impinduka mu maraso ya TP53.
- Chromosomes: 46, XY[20].
- Yatangije uburyo bwo kuvura CD19-CART.
- Imiti ya kanseri ya FC (ibicurane 62.7mg x iminsi 4, CTX 1045mg x iminsi 2).
- 1 Ukwakira 2020: Gutera selile za CD19-CART Autologous kuri 4.7x10^7/kg.
- CRS yo mu cyiciro cya 2 ifite uburozi bw'ubwonko bwo mu cyiciro cya 1, yarushijeho kuba myiza nyuma yo kuvurwa neza.
- 29 Ukwakira 2020: Kugabanuka burundu mu miterere y'umusemburo w'amagufwa, nta turemangingo tw’ibanze twangiza ku buryo amaraso atangira kugenda.
- Ukuboza 31, 2020: Inkorora yumye, isesemi, kuruka, intege nke rusange.
- Gahunda yo gupima amaraso: WBC 15.53x10^9/L, HGB 134g/L, PLT 71x10^9/L.
- Kurya umworo w'amagufwa bigaragaza ko usubira inyuma.
- 2 Mutarama 2021: Yakiriwe mu bitaro byacu.
- Gahunda y'amaraso: WBC 20.87x10^9/L, HGB 118.30g/L, PLT 58.60x10^9/L.
- Creatinine 134umol/L, umuvuduko ukabije w'amaraso mu cyiciro cya 3, amateka y'ubuzima bw'umuntu y'imyaka 4.
- Ishyirwa mu byiciro ry'amaraso yo ku nkengero: 62% by'uturemangingo tw'umwimerere.
- Immunophenotype: 28.48% by'uturemangingo (uturemangingo tw’ingirabuzimafatizo) tugaragaza CD10, CD38dim, HLA-DR, CD20dim, CD24, CD81, cCD79a, CD22, CD268dim, CD58, CD123 igaragara igice, TDT, ntabwo igaragara CD34, CD19, MPO, CD117, CD13, CD33, CD11b, clgM, CD79b, CD7, cCD3, kappa, lambda, bigaragaza limfomete za B zisanzwe zitera kanseri.
- Isesengura ry'impinduka mu maraso: Impinduka mu maraso ya TP53 R196P yagaragaye.
Uburyo bwo kuvura:
- Nahawe imiti ya VLP, hamwe n'ubuvuzi bw'umuvuduko ukabije w'amaraso, kugabanya creatinine, no gukoresha amazi mu mubiri.
- 19 Mutarama: Gahunda yo gupima amaraso yagaragaje WBC 1.77x10^9/L, HGB 71g/L, PLT 29.8x10^9/L.
- Gushyira mu byiciro amaraso yo ku nkengero: Nta lymphocytes z’umwimerere.
- Imiterere y'umusemburo w'amagufwa: Ubwinshi bw'uturemangingo (urwego rwa V), ibice by'ingenzi by'urwego rwa IV, hamwe na 42% bya limfozeti z'umwimerere.
- Ingano y'amaraso mu mubiri: 13.91% by'uturemangingo tugaragaza CD10, cCD79a, CD38, CD81, CD22, ntabwo tugaragaza CD20, CD34, CD19, bigaragaza ko hari uturemangingo twa mbere twa B twibasiwe n'amaraso.
- Karyotype ya chromosome:
- 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,ongeraho(1)(q42),-2,-3,-4,-7,-9,-12,-13,-16,-17,-20[1]/46,XY[20].
- 20 Mutarama: Lymphocytes zakusanyijwe kugira ngo habeho ubwiyongere bw'uturemangingo twa CD22-CART.
- 21 Mutarama: Batoboye ikibuno, batanga imiti ivura indwara yo mu bwonko kugira ngo hirindwe kanseri y'imitsi yo mu mutwe; isuzuma ry'amazi yo mu bwonko nta kibazo ryagaragaje.
- 22 Mutarama: Nahawe Arac, 6MP, L-ASP chemotherapy, na FC (Flu 50mg x 3, CTX 0.5gx 3) chemotherapy.
- Ku ya 7 Gashyantare (mbere yo guterwa): Imiterere y'umusemburo w'amagufwa yagaragaje 93% bya limfozeti z'umwimerere.
- Ingano y'amaraso mu mubiri: 76.42% by'uturemangingo tugaragaza CD38, cCD79a, CD22, cbcl-2, CD123, CD10bri, CD24, CD81, ntabwo tugaragaza CD4, CD3, CD13+33, CD34, CD20, CD19, CD279 (PD1), CD274 (PDL1), bigaragaza ko hari uturemangingo twa mbere twa B twibasiwe n'amaraso.
- Kwandura indwara z'uruhu n'imitsi yoroshye bitera umuriro; byarushijeho kuba byiza nyuma yo kuvurwa na antibiyotike.
- Ku ya 9 Gashyantare: Gutera selile za CD22-CART mu buryo bwa Autologous (5x10^5/kg).
- Ingaruka mbi zijyanye na CAR-T: CRS yo mu cyiciro cya 1, umuriro ku munsi wa 6 hamwe na Tmax 40°C, ubushyuhe bugenzurwa ku munsi wa 10; nta burozi bw'ubwonko.
- 11 Werurwe: Isuzuma ry'umusemburo w'amagufwa ryagaragaje ko habayeho kugabanuka burundu kw'imiterere y'umubiri, kandi ko nta tunyangingo tw'umubiri twagaragaye ko ari tuzima.
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