I-Acute Lymphoblastic Leukemia (T-ALL)-03

Iimpawu zeTyala:

- Uxilongo: I-Acute T-cell lymphoblastic leukemia

- Ukuqala kunye neempawu: Ngo-Epreli 2020, kwabonakala isiyezi, ukudinwa, kunye neendawo zokopha ulusu. Wafunyaniswa ene-acute T-cell lymphoblastic leukemia ngovavanyo lwe-bone marrow MICM.

- Unyango Lokuqala: Ufumene uxolelo olupheleleyo (CR) emva kwe-VDCLP regimen chemotherapy, kulandele imijikelo emibini ye-chemotherapy eqinisiweyo.

- Julayi 19, 2020: Kufunyenwe ukufakelwa kwe-allogeneic hematopoietic stem cell transplantation evela kumntu obhinqileyo onikelayo (HLA 5/10 A donor A). Inkqubo yokulungisa imeko yayiquka ukukhanyiswa komzimba wonke (TBI), i-cyclophosphamide (CY), kunye ne-etoposide (VP-16). Ii-peripheral stem cells zafakwa ngoJulayi 24, kunye nokubuyiselwa kwe-granulocyte ngosuku +10 kunye nokufakelwa kweplatelet ngosuku +13. Ukulandelela rhoqo emva koko.

- Nge-25 kaFebruwari 2021: Ukubuyela kwakhona komongo wethambo kwafunyanwa ngexesha lokulandelela.

- Unyango: Uqalise unyango lwe-thalidomide yomlomo.

- Matshi 8: Ungeniswe esibhedlele sethu.

- Imbonakalo yeBone Marrow: 61.5% yeeqhushumbo.

- Udidi lweGazi oluPheleleyo: 15% ukuqhuma.

- I-Immunophenotyping: iiseli ezingama-35.25% eziveza i-CD99, i-CD5, i-CD3dim, i-CD8dim, i-CD7, i-cCD3, i-CD2dim, i-HLA-ABC, i-cbcl-2, i-CD81, i-CD38, ezibonisa ii-lymphocytes ze-T ezingavuthwanga kakuhle.

- Uhlalutyo lweChromosome: 46, XX [9].

- I-Leukemia Fusion Gene: I-SIL-TAL1 fusion gene positive; umlinganiselo wobungakanani: I-SIL-TA.

- Utshintsho lweTumor egazini: Olubi.

- Uhlalutyo lweChimerism (emva kweHSCT): Iiseli ezifunyenwe ngabanikeli zibalwa kwi-45.78%.

- Matshi 11: Ukuqokelelwa kwee-lymphocytes zegazi eziphuma emzimbeni ukuze kufunyanwe inkcubeko yeeseli ze-CD7-CART.

- Unyango: I-VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x iintsuku ezi-4, Dex 9mg q12h x iintsuku ezi-9) idityaniswe ne-thalidomide ukulawula ithumba.

- Matshi 19: I-FC regimen chemotherapy (Umkhuhlane 50mg x iintsuku ezi-3, i-CTX 0.4gx iintsuku ezi-3).

- Matshi 24 (ngaphambi kokufakwa): Imo yethambo lomongo ibonise i-grade V hyperplasia, kunye ne-22% yokuqhuma.

- I-Bone Marrow Flow Cytometry: iiseli ezingama-29.21% (zeeseli ezineenucleated) eziveza i-CD3, i-CD5, i-CD7, i-CD99, eziveza i-cCD3 kancinci, nto leyo ebonisa iiseli ze-T ezingavuthwanga kakuhle.

- I-Quantitative SIL-TAL1 Fusion Gene: 1.913%.