Mukomana ari kurwisana nechirwere chekenza chemudumbu chinonzi acute lymphoblastic leukemia

Ruzivo Rwekutanga rweMurwere

Murume ane makore gumi nematanhatu ekuberekwa akaonekwa aine chirwere che acute lymphoblastic leukemia (B-ALL), uyo akatanga kurapwa ne chemotherapy, CD19/22 CAR-T cell therapy, salvage chemotherapy, uye akazobva apihwa haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) kubva kumubereki akamupa mushonga.

Mamiriro Emurwere Asati Apihwa Rubatsiro

Asati apiwa allo-HSCT, murwere aikurumidza kuwanda kwemasero machena eropa uye chirwere chinoramba chiripo pasinei nekupindira kwakawanda. Mushure mekuiswa CD19/22 CAR-T musi wa21 Kubvumbi, 2025 (masero ese eCAR-T: 6.5×10^7), huwandu hwemasero eCAR-T hwakatanga kuwedzera kusvika pa3.95×10^6/L pazuva rechinomwe asi hwakaramba kusvika pa0.82×10^6/L pazuva regumi nemana, nemasero eropa aibuda muropa aikwira kubva pa28.6% kusvika pa87.1%. Kuongororwa kweBone Morrow musi wa15 Chivabvu, 2025, kwakaratidza kudzikira kwakanyanya kwekuwanda kwemasero eB asina kujairika ne37.42% (anoratidza CD34, CD38/CD22 isina simba, CD81/CD19/CD33 isina simba, isina CD10/CD20/CD79b), zvichiratidza kusavapo kwekuregererwa. Cerebrospinal fluid haina kuratidza masero asina kujairika, asi chirwere chose hachina kupera.

Mamiriro Emurwere Mushure Mekurapwa

Mushure me allo-HSCT musi wa29-30 Chivabvu, 2025 (masero eCD34+: 8.6×10^6/kg; masero enuclear: 8×10^8/kg), murwere akawana neutrophil engraftment pazuva rechi11 uye platelet engraftment pazuva rechi18. Pakazosvika zuva rechi28 (Chikumi 27, 2025), huwandu hweropa hwakavandudzika zvakanyanya: hemoglobin 99 g/L (kubva pamazinga akaderera ekare), masero machena eropa 11.73×10^9/L, ma neutrophils 9.81×10^9/L, uye maplatelet 79×10^9/L. Muviri wemapfupa wakaratidza kuwanda kwemasero asina kujairika, flow cytometry yakasimbisa kuti hapana anomalies, biopsy yakaratidza kuwanda kwakaderera asi masero etrilineage anoonekwa asina ma lymphocytes asina kukura, uye STR chimerism yakasvika 100%, ichiwana complete remission (CR) ine chirwere chisina kusara (MRD-). Pakazosvika zuva rechi49 (Chikunguru 18, 2025), mupfupa wakaramba uchishanda pasina masero asina kujairika, zvichiramba zvichichengetedza CR neMRD-. Chirwere chegramu 1 chemudumbu chakakura zvishoma chakaitika asi chakarapwa nemishonga, zvichiratidza kudzora kwechirwere uye kupora zvinobudirira zvichienzaniswa nekuputika kusingaperi kusati kwaiswa mudumbu (kubva pa37.42% kusvika 0%) uye kusakwanisa kupora.