Umuhungu urwaye kanseri y'amaraso ikabije (Acute lymphoblastic Leukemia)

Amakuru y'ibanze y'umurwayi

Umusore w'imyaka 16 yasanze afite kanseri y'amaraso ikabije (B-ALL), wabanje guhabwa imiti igabanya ubukana bw'amaraso, CD19/22 CAR-T cell therapy, salvage chemotherapy, hanyuma aterwa uturemangingo tw'amaraso duto (allo-HSCT) n'umubyeyi we.

Imiterere y'umurwayi mbere yo kuvurwa

Mbere yo guhabwa allo-HSCT, umurwayi yahuye n’ubwiyongere bwihuse bw’uturemangingo tw’amaraso yera ndetse n’indwara zidakira nubwo hari uburyo bwinshi bwo kuyifata. Nyuma yo guhabwa CD19/22 CAR-T ku ya 21 Mata 2025 (uturemangingo twose twa CAR-T: 6.5×10^7), umubare w’uturemangingo twa CAR-T watangiye kwiyongera ugera kuri 3.95×10^6/L ku munsi wa 7 ariko ugabanuka ugera kuri 0.82×10^6/L ku munsi wa 14, aho uturemangingo tw’amaraso two mu gice cy’imbere cy’umubiri twiyongereye kuva kuri 28.6% kugera kuri 87.1%. Isuzuma ry’umusemburo w’amagufwa ku ya 15 Gicurasi 2025, ryagaragaje ko ukwiyongera kwagabanutse cyane aho 37.42% by’uturemangingo tw’amaraso two mu bwoko bwa B lymphoblasts (tugaragaza CD34, CD38/CD22 igice, CD81/CD19/CD33 idakomeye, nta CD10/CD20/CD79b yagaragaye, byemeza ko nta kwisubiraho. Amazi yo mu bwonko nta turemangingo twagaragaye, ariko indwara muri rusange ntiyakize.

Imiterere y'umurwayi nyuma yo kuvurwa

Nyuma yo kuvura indwara ya allo-HSCT ku ya 29-30 Gicurasi 2025 (uturemangingo twa CD34+: 8.6×10^6/kg; uturemangingo tw’ingirabuzimafatizo tubiri: 8×10^8/kg), umurwayi yageze ku rugero rwa neutrophil ku munsi wa 11 n’urugero rwa platelet ku munsi wa 18. Ku munsi wa 28 (27 Kamena 2025), umubare w’amaraso wariyongereye cyane: hemoglobine 99 g/L (uhereye ku rugero rwo hasi rwabanje), uturemangingo tw’amaraso twera 11.73×10^9/L, uturemangingo 9.81×10^9/L, na platelets 79×10^9/L. Imiterere y’umusemburo w’amagufwa yagaragaje ko ukwirakwira kw’amagufwa nta turemangingo tw’ibanze tudasanzwe, flow cytometry yemeje ko nta busembwa buhari, biopsy yagaragaje ko ukwirakwira guke ariko uturemangingo twa trilineage tugaragara tudafite lymphocytes zidakuze, na STR chimerism yageze ku kigero cya 100%, igera ku rugero rwuzuye (CR) hamwe n’indwara nke zisigaye zidahari (MRD-). Ku munsi wa 49 (Ku ya 18 Nyakanga 2025), umwongo w'amagufwa wakomeje gukora nta turemangingo tudasanzwe, bituma habaho CR na MRD. Indwara yoroheje yo mu mara yo mu rwego rwa mbere yabayeho ariko yavuwe n'imiti, igaragaza uburyo bwo kurwanya no gukira indwara neza ugereranije n'indwara zabaye mbere yo guterwa (kuva kuri 37.42% kugeza kuri 0%) no kutagira ubushobozi bwo kugarura ububabare.