I-Acute Lymphoblastic Leukemia (T-ALL)-05

Ukuxolelwa kwesigulana se-T-ALL esibuyele kwisimo saso esine-Central Nervous System Leukemia Emva koNyango lwe-CAR-T

Eli tyala libandakanya inkwenkwe eneminyaka eli-16 ubudala evela kuMantla-mpuma eTshayina, enengxaki enkulu ukusukela oko yafunyaniswa ukuba ine-leukemia kunyaka ophelileyo.

Ngomhla wesi-8 kweyeNkanga, ngo-2020, uDawei (igama elingelolakhe) watyelela isibhedlele sasekuhlaleni ngenxa yokuqina kobuso, ukurhawuzelela, kunye nomlomo ogobileyo. Wafunyaniswa ukuba une-"acute lymphoblastic leukemia (uhlobo lwe-T-cell)." Emva kwekhosi enye ye-induction chemotherapy, i-MRD (isifo esincinci esisele) ayizange ifumaneke, yalandelwa yi-chemotherapy eqhelekileyo. Ngeli xesha, ukubhobozwa komongo wethambo, ukubhobozwa kwe-lumbar, kunye nokufakwa ngaphakathi kwe-thecal akubonisi ziphazamiso.

Ngomhla wesi-6 kuCanzibe, ngo-2021, kwenziwa utyando lwe-lumbar puncture nge-intrathecal injection, kwaye uhlalutyo lwe-cerebrospinal fluid (CSF) lwaqinisekisa "i-central nervous system leukemia." Oku kwalandelwa ziikhosi ezimbini ze-chemotherapy eqhelekileyo. Ngomhla woku-1 kuJuni, utyando lwe-lumbar puncture nge-CSF puncture lwabonisa iiseli ezingavuthwanga. Utyando lwe-lumbar punctures ezintathu ezongezelelweyo nge-intrathecal injections lwenziwa, kwaye uvavanyo lokugqibela lwe-CSF alubonisanga ziseli ze-tumor.

Ngomhla wesi-7 kweyeKhala, uDawei wabona iliso lakhe lasekunene liphelelwa kukubona, nto leyo eyabangela ukuba lingaboni kakuhle kuphela. Emva kokusebenzisa i-chemotherapy enzulu, umbono wakhe wasekunene wabuyela kwimeko yesiqhelo.

Ngomhla wesi-5 ku-Agasti, umbono wakhe weliso lasekunene waphinda waba mandundu, nto leyo eyakhokelela ekubeni angaboni ngokupheleleyo, kwaye iliso lakhe lasekhohlo laba luzizi. Ukususela ngomhla we-10 ukuya kowe-13 ku-Agasti, wenziwa unyango lwe-radiotherapy (TBI) olusebenzisa ingqondo yonke kunye nomqolo, nto leyo eyabuyisela umbono kwiliso lakhe lasekhohlo, kodwa iliso lasekunene lahlala lingaboni. Ngomhla we-16 ku-Agasti, i-MRI scan yobuchopho yabonisa ukuphucuka okuncinci ekuqineni kwe-optic nerve yasekunene kunye ne-chiasm, kwaza kwabonwa ukuphucuka. Akukho zimpawu okanye ukuphucuka okungaqhelekanga okufunyenweyo kwi-brain parenchyma.

Ngeli xesha, usapho lwalulungiselele ukufakelwa umongo wethambo, lulinde ibhedi kuphela kwigumbi lokufakelwa. Ngelishwa, uhlolo oluqhelekileyo lwangaphambi kokufakelwa lutyhile iingxaki ezenza ukuba ukufakelwa kube nzima.