Leukemia e matla ea Lymphoblastic (T-ALL)-02

Likarolo tsa Bongaka:

- Tlhahlobo: Leukemia e matla ea lisele tsa T tsa lymphoblastic

- Qalo: Mafelong a Hlakubele 2018

- Matšoao a pele: Ho hola ha li-lymph node tse ngata tse ka holimo ho pholletsa le 'mele

- Mokhoa oa pele oa ho sebelisa mali: WBC: 39.46*10^9/L, Hb: 129g/L, PLT: 77*10^9/L

- Sebopeho sa moko oa masapo: 92% ea ho phatloha

-Phallo ea potoloho ea mali: 95.3% ea lisele tse sa tloaelehang tse hlahisang

TdT+CD99+CyCD3+CD7stCd5DdimCD4-CD8-mCD3-CD45dim

- Lijini tsa motsoako: Tse mpe

- Phetoho ea liphatsa tsa lefutso: Phetoho ea liphatsa tsa lefutso ea NOTCH1 e fumanoe

- Tlhahlobo ea chromosome: Karyotype e tloaelehileng

Nalane ea Kalafo:

- La 3 Mmesa, 2018: Kalafo ea ho kenya moriana ka mokhoa oa VDCP

- La 18 Mmesa, 2018: Ho phatloha ha moko oa masapo ho ne ho etsa 96%

- La 20 Mmesa, 2018: Ke fihletse pholiso kamora kemiso ea CAG

- Mots'eanong 18, 2018: Kalafo ea ho kopanya ka mokhoa oa CMG+VP

- Phuptjane 22, 2018: Ho phatloha ha moko oa masapo ho eketsehile ho fihla ho 40%, ho khutla ha leukemia hape

- Phupu 25, 2018: Mokhoa oa CLAM (clarithromycin+cyclophosphamide+amikacin)

- Ho fetisetsa sele ya motheo ya hematopoietic ho tswa ho ngwanabo ya tshwanang le HLA ho sebediswa FLU+BU conditioning ka la 14 Phato

- Ho beha leihlo kamora ho kenngwa ha lesapo: Ho fola ha sebopeho sa moko wa masapo ha le le kgwedi e le 1, dikgwedi tse 3, dikgwedi tse 6, dikgwedi tse 9, le dikgwedi tse 11.

- Sebopeho sa moko oa masapo se bontšitse pholiso likhoeling tse 16 kamora ho kenngoa ha lesea, 'me cytometry ea phallo e senola 0.02% ea li-lymphocyte tse sa butsoang tse kotsi.

- La 13 Pulungoana 2020: Ho tloswa ha mali ka hara peripheral blood chimerism ho tswa mohloding wa bafani e ne e le 97.9%

- Lisele tsa mali tsa pele tse ka ntle: 20%

- La 18 Tšitoe 2020: Sebopeho sa moko oa masapo: 60.6% ea ho phatloha

- Cytometry ea phallo: 30.85% ea li-lymphocyte tsa T tse sa holang tse kotsi

- Tlhahlobo ea chromosome: 46, XY (20)

- O fumane kalafo ea chemotherapy ea DA ka la 19 Pherekhong 2021

- Sebopeho sa moko oa masapo ka la 19 Pherekhong 2021: Hyperplasia ea Sehlopha sa III, 16% ea ho phatloha

- Tlhahlobo ea karyotype ea chromosome: 46, XY (20)

- Phallo ea potoloho: 7.27% ea lisele (har'a lisele tsa nyutlelie) tse hlahisitsoeng ke CD99bri, CD13, CD38, cbcl-2, cCD3, HLA-ABC bri, CD7bri, le CD5dim e hlahisitsoeng ka karolo e itseng, e bontšang li-lymphocyte tsa T tse sa holang hantle.

- Tlhahlobo ea liphatsa tsa lefutso tsa leukemia: Hase 'nete

- Tlhahlobo ea phetoho ea hlahala ea mali (mefuta e 86):

1. PHF6 K299Efs*13 phetoho e ntle

2. RUNX1 S322* phetoho e ntle

3. FBXW7 E471G e na le phetoho e ntle

4. Phetoho ea JAK3 M511I e na le tšoaetso

5. NOTCH1 Q2393* phetoho e ntle

Kalafo:

- La 22 Pherekhong: Pokello le setso sa li-lymphocyte tsa mali tse ka hare ho 'mele bakeng sa CD7-CART

- Pele ho enteloa CD7-CART, mokuli o ile a fuoa VLP (vincristine, l-asparaginase, prednisone) hammoho le chemotherapy ea bortezomib.

- La 3 Hlakola: Phekolo ea chemotherapy ea FC (Flu 50mg matsatsi a 3 + CTX 0.45g matsatsi a 3)

- La 5 Hlakola (pele ho kenngoa): Sebopeho sa moko oa masapo se bontšitse ho phatloha ha 23%.

- Flow cytometry e senotse lisele tse 4.05% tse hlahisang CD99bri, CD5dim, CD7bri, TDT, cCD3, tse bontšang li-lymphocyte tsa T tse sa holang tse kotsi.

- Tlhahlobo ea chromosome: 46, XY (20)

- Tlhahlobo ea Chimerism (kamora HSCT): Lisele tse nkiloeng ho bafani li ne li ikarabella bakeng sa 52.19%.

- La 7 Hlakola: Ho kenngoa ha lisele tsa CD7-CART tsa autologous ka tekanyo ea 5*10^5/kg.

- La 15 Hlakola: Lisele tse sa holang maling a ka thoko li fokotsehile ho fihlela ho 2%.

- La 19 Hlakola (Letsatsi la 12 kamora ho nooa): Mokuli o ile a ba le feberu, e ileng ea nka matsatsi a 5 pele ho fihlelloa taolo ea mocheso.

- La 2 Tlhakubele: Tlhahlobo ea moko oa masapo e bontšitse phokotso e felletseng ea sebopeho, ka cytometry ea phallo e sa boneng lisele tse sa holang tse kotsi.