Inkwenkwe elwa ne-acute lymphoblastic leukemia

Ulwazi oluSisiseko lwesigulana

Indoda eneminyaka eli-16 ubudala eyafunyaniswa ine-acute lymphoblastic leukemia (B-ALL), eyafumana i-chemotherapy yokuqala, unyango lweeseli ze-CD19/22 CAR-T, i-salvage chemotherapy, kunye nokufakelwa kweeseli ze-hematopoietic stem cell emva koko (i-allo-HSCT) evela kumxhasi ongumzali.

Imeko Yesigulana Ngaphambi Konyango

Ngaphambi kokuba i-allo-HSCT ifumaneke, isigulana safumana ukwanda ngokukhawuleza kweeseli ezimhlophe zegazi kunye nesifo esiqhubekayo nangona kukho iindlela ezininzi zokungenelela. Emva kokufakwa kwe-CD19/22 CAR-T ngomhla wama-21 ku-Epreli 2025 (iiseli ze-CAR-T zizonke: 6.5×10^7), inani leeseli ze-CAR-T ekuqaleni landa laya kwi-3.95×10^6/L ngomhla wesi-7 kodwa lehla laya kwi-0.82×10^6/L ngomhla we-14, kunye neeseli zokuqhuma kwegazi ezingaphandle zinyuka ukusuka kwi-28.6% ukuya kwi-87.1%. Uvavanyo lwe-bone marrow ngomhla we-15 kuMeyi 2025, lwabonisa ukwehla okukhulu kokukhula nge-37.42% ye-B lymphoblasts engaqhelekanga (eveza i-CD34, i-CD38/CD22 engaphelelanga, i-CD81/CD19/CD33 ebuthathaka, i-CD10/CD20/CD79b), eqinisekisa ukuba akukho kukhululwa. Ulwelo lwe-cerebrospinal alubonisanga ziseli ezingaqhelekanga, kodwa isifo siphela asizange siphumelele.

Imeko Yomguli Emva Konyango

Emva kwe-allo-HSCT ngoMeyi 29-30, 2025 (iiseli ze-CD34+: 8.6×10^6/kg; iiseli ze-mononuclear: 8×10^8/kg), isigulana sifumene i-neutrophil engraftment ngomhla we-11 kunye ne-platelet engraftment ngomhla we-18. Ngomhla wama-28 (Juni 27, 2025), inani legazi liphucuke kakhulu: i-hemoglobin 99 g/L (ukusuka kumanqanaba aphantsi ngaphambili), iiseli ezimhlophe zegazi 11.73×10^9/L, ii-neutrophils 9.81×10^9/L, kunye neeplatelets 79×10^9/L. Imo ye-bone marrow ibonise ukwanda okusebenzayo ngaphandle kweeseli zokuqala ezingaqhelekanga, i-flow cytometry iqinisekisile ukuba akukho zimo zingaqhelekanga, i-biopsy ibonise ukwanda okuphantsi kodwa iiseli ze-trilineage ezibonakalayo ezingenazo ii-lymphocytes ezingavuthwanga, kwaye i-STR chimerism ifikelele kwi-100%, ifikelela kwi-complement remission (CR) ene-minimal residue disease negative (MRD-). Ngomhla wama-49 (nge-18 kaJulayi, 2025), umongo wethambo wawusebenza ngaphandle kweeseli ezingaqhelekanga, nto leyo eyayigcina i-CR kunye ne-MRD-. Isifo esincinci se-intestinal graft-versus-host senzeke kodwa salawulwa ngamayeza, nto leyo eyabonisa ulawulo olusebenzayo lwesifo kunye nokuchacha xa kuthelekiswa nokuqhuma okuqhubekayo ngaphambi kokufakelwa (ukusuka kwi-37.42% ukuya kwi-0%) kunye nokungabikho kokukhululwa.