Chirwere cheAcute Lymphoblastic Leukemia (T-ALL)-03

Zvimiro zveNyaya:

- Kuongororwa: Acute T-cell lymphoblastic leukemia

- Kutanga uye Zviratidzo: Kubvumbi 2020, airatidza dzungu, kuneta, uye kubuda ropa paganda. Akaonekwa aine chirwere cheT-cell lymphoblastic leukemia kuburikidza nekuongororwa kweMICM yemumaronda emapfupa.

- Kurapwa kwekutanga: Kuwana relieve yakakwana (CR) mushure meVDCLP regimen chemotherapy, zvichiteverwa nematanho maviri ekuwedzera chemotherapy.

- Chikunguru 19, 2020: Ndakagamuchira allogeneic hematopoietic stem cell transplantation kubva kumupi wechikadzi (HLA 5/10 A donor A). Nzira yekurapa yaisanganisira kupiswa kwemuviri wese (TBI), cyclophosphamide (CY), uye etoposide (VP-16). Masero emuviri akaisirwa musi wa24 Chikunguru, nekudzorerwa kwegranulocyte pazuva +10 uye kuisirwa kweplatelet pazuva +13. Kuongororwa kwevarwere vanobuda kunze kwemuviri nguva dzose mushure mezvo.

- Kukadzi 25, 2021: Kudzoka kwemubofu mumwongo kwakaonekwa panguva yekutevera.

- Kurapa: Takatanga kurapwa nemuromo nethalidomide.

- Kurume 8: Ndakapinda muchipatara chedu.

- Maumbirwo eBone Morrow: 61.5% kuputika.

- Kupatsanurwa kweRopa rePanze: 15% kuputika.

- Immunophenotyping: 35.25% masero ane CD99, CD5, CD3dim, CD8dim, CD7, cCD3, CD2dim, HLA-ABC, cbcl-2, CD81, CD38, zvichiratidza kuti T lymphocytes dzisina kukura zvakanaka.

- Kuongorora maChromosome: 46, XX [9].

- Leukemia Fusion Gene: SIL-TAL1 fusion gene yakanaka; chiyero chehuwandu: SIL-TA.

- Kuchinja kweBundu reRopa: Negative.

- Kuongororwa kweChimerism (post-HSCT): Masero anobva kune vanopa aisvika 45.78%.

- Kurume 11: Kuunganidzwa kwemasero eropa ega ega ega eCD7-CART.

- Kurapa: Mishonga yeVILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x mazuva mana, Dex 9mg q12h x mazuva mapfumbamwe) pamwe chete nethalidomide kudzora bundu.

- Kurume 19: Kurapwa kweFC regimen chemotherapy (Flu 50mg x mazuva matatu, CTX 0.4gx mazuva matatu).

- Kurume 24 (kusati kwaiswa mushonga): Maumbirwo emapfupa emubofu akaratidza giredhi V hyperplasia, ne22% yekuputika.

- Kuyerera kweBone Marrow Cytometry: 29.21% masero (emasero ane nucleated) anotsanangura CD3, CD5, CD7, CD99, anotsanangura cCD3 zvishoma, zvichiratidza masero eT asina kukura zvakanaka.

- Huwandu hweSIL-TAL1 Fusion Gene: 1.913%.