- Daaweyn
- Markhaatiyada
- Neuroblastoma
- Buro adag
- Markhaatiyada
- TILS
- Daaweynta Unugyada NK
- Myasthenia Gravis (MG)
- Leukemia-da Lymphoblastic ee Ba'an (B-ALL)
- Lupus Erythematosus oo nidaamsan (SLE)
- Leukemia-da Lymphoblastic ee Ba'an (T-ALL)
- Lymphoma-ka aan Hodgkin ahayn (NHL)
- Myeloma badan (MM)
- Lymphom-ka Unugga B-B ee Kala-baxa
- Leukemia-da B-lymphocytic
- Myeloma
Leukemia-da Lymphoblastic ee daran (B-ALL)-03
Astaamaha Kiiska:
- Waxaa lagu ogaaday cudurka 'B-cell lymphoblastic leukemia' dhammaadka Maajo 2020.
- Jadwalka dhiigga: WBC 5.14x10^9/L, HGB 101.60g/L, PLT 6x10^9/L.
- Qaab-dhismeedka dhuuxa lafta: Unugyada yaryar oo leh 67% lymphocytes-ka asalka ah.
- Cytometry-ga socodka: 82.28% unugyada ayaa muujiya CD38, HLA-DR, CD19, CD10, CD105, TDT, CD22, cCD79a, qayb ahaan muujiya CD9, si daciif ah u muujiya CD13.
- Baaritaanka hidda-wadaha isku-dhafka ah ee taban; WT1 57.3%; lama helin hiddo-wadeyaal isku-dhafan oo la xiriira PH-sida DHAMMAAN.
- KALLUUN: Isbeddelka TP53 ee togan.
- Koromosoomyada: 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].
- Waxaan helay nidaamka VCDLP ee 2 koorso iyada oo aan la cafin.
- Nidaamka CAM-VL (CTX 2gx2, Arac 200mgx6, 6-MP 100mgx14, VDS 4mgx2, L-ASP 10,000 IUx7) Luulyo 22, 2020, wali lama cafin.
- Cytometry socodka dhuuxa lafta Sebtembar 25, 2020: 7.35% unugyada ayaa muujiya CD81, CD19, CD10, CD38, CD33, si daciif ah u muujiya CD20, CD45.
- Falanqaynta isbeddelka burooyinka dhiigga: isbeddelka TP53.
- Koromosoomyada: 46, XY[20].
- Waxaa la bilaabay daawaynta CD19-CART.
- Daaweynta FC (DUFKA 62.7mg x 4 maalmood, CTX 1045mg x 2 maalmood) kiimoterabiga.
- Oktoobar 1, 2020: Ku-shubidda unugyada CD19-CART ee otomaatiga ah oo ah 4.7x10^7/kg.
- CRS heerka 2aad oo leh sunta neerfaha ee heerka 1aad, oo la wanaajiyay ka dib daaweyn taageero ah.
- Oktoobar 29, 2020: Daafitaan dhammaystiran oo ku saabsan qaab-dhismeedka dhuuxa lafta, ma jiraan unugyo hore oo halis ah oo ku jira cytometry socodka.
- Diseembar 31, 2020: Qufac qalalan, lallabbo, matag, daciifnimo guud.
- Jadwalka dhiigga: WBC 15.53x10^9/L, HGB 134g/L, PLT 71x10^9/L.
- Rabitaanka dhuuxa lafta oo muujinaya dib u dhac.
- Janaayo 2, 2021: Waxaa la dhigay isbitaalkayaga.
- Jadwalka dhiigga: WBC 20.87x10^9/L, HGB 118.30g/L, PLT 58.60x10^9/L.
- Creatinine 134umol/L, dhiigkarka heerka 3aad, taariikhda caafimaad ee 4 sano.
- Kala soocidda dhiigga ee hareeraha: 62% unugyada asalka ah.
- Immunophenotyping: 28.48% unugyada (unugyada nucleated) waxay muujiyaan CD10, CD38dim, HLA-DR, CD20dim, CD24, CD81, cCD79a, CD22, CD268dim, CD58, qayb ahaan waxay muujiyaan CD123, TDT, ma muujiyaan CD34, CD19, MPO, CD117, CD13, CD33, CD11b, clgM, CD79b, CD7, cCD3, kappa, lambda, taasoo muujinaysa unugyada B ee asalka ah ee malignant.
- Falanqaynta isbeddelka burooyinka dhiigga: Isbeddelka TP53 R196P ee togan.
Daaweynta:
- Waxaan helay kiimoterabiga VLP, oo ay weheliso daawaynta dhiigkarka, yaraynta creatinine, iyo alkalinaynta fuuq-celinta.
- Janaayo 19: Jadwalka dhiigga ayaa muujiyay WBC 1.77x10^9/L, HGB 71g/L, PLT 29.8x10^9/L.
- Kala soocidda dhiigga ee hareeraha: Ma jiraan lymphocytes asal ah.
- Qaab-dhismeedka dhuuxa lafta: Unugyada sare (heerka V), meelaha diiradda la saarayo ee heerka IV, oo leh 42% lymphocytes-ka asalka ah.
- Cytometry-ga socodka: 13.91% unugyada ayaa muujiya CD10, cCD79a, CD38, CD81, CD22, ma muujiyaan CD20, CD34, CD19, taasoo muujinaysa unugyada B ee asalka ah ee halista ah.
- Karyotype-ka koromosoomka:
- 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,ku dar(1)(q42),-2,-3,-4,-7,-9,-12,-13,-16,-17,-20[1]/46,XY[20].
- Janaayo 20: Unugyada Lymphocytes-ka ayaa loo ururiyay si loogu sameeyo unugyada CD22-CART.
- Janaayo 21: Waxaa la sameeyay dalool dhabarka ah, kiimoterabiga gudaha ayaa la siiyay si looga hortago leukemia-ga habdhiska neerfaha dhexe; baaritaanka dareeraha maskaxda ma uusan muujin wax cillado ah.
- Janaayo 22: Waxaa la siiyay kiimoterabiga Arac, 6MP, L-ASP, iyo kimoterabiga FC (Flu 50mg x 3, CTX 0.5gx 3).
- Febraayo 7 (kahor inta aan la gelin): Qaab-dhismeedka dhuuxa lafta wuxuu muujiyay 93% lymphocytes-ka asalka ah.
- Cytometry-ga socodka: 76.42% unugyada ayaa muujiya CD38, cCD79a, CD22, cbcl-2, CD123, CD10bri, CD24, CD81, ma muujiyaan CD4, CD3, CD13+33, CD34, CD20, CD19, CD279 (PD1), CD274 (PDL1), taasoo muujinaysa unugyada B ee asalka ah ee halista ah.
- Caabuqa maqaarka iyo unugyada jilicsan oo soo ifbaxay oo qandho wata; ka dib daaweynta antibiyootigga, way fiicnaatay.
- Febraayo 9: Ku-shubidda unugyada CD22-CART ee otomaatiga ah (5x10^5/kg).
- Waxyeellooyinka la xiriira CAR-T: CRS heerka 1aad, qandho Maalinta 6aad oo leh Tmax 40°C, heerkulka la xakameeyey Maalinta 10aad; ma jiro sun ku ah neerfaha.
- Maarso 11: Qiimaynta dhuuxa lafta waxay muujisay cafis dhammaystiran oo qaab-dhismeedka ah, cytometry-ga socodka ma muujinin unugyo hore oo halis ah.
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