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

Izici Zecala:

- Ukuxilongwa: I-Acute T-cell lymphoblastic leukemia

- Ukuqala kanye Nezimpawu: Ephreli 2020, kwavela isiyezi, ukukhathala, kanye namaphuzu okopha esikhumbeni. Kutholakale ukuthi une-acute T-cell lymphoblastic leukemia ngokuhlolwa kwe-bone marrow MICM.

- Ukwelashwa Kokuqala: Uthole ukuxolelwa okuphelele (CR) ngemuva kokwelashwa ngamakhemikhali kwe-VDCLP, kulandelwa imijikelezo emibili yokwelashwa ngamakhemikhali okuqinisiwe.

- Julayi 19, 2020: Kwatholwa ukufakelwa kwe-allogeneic hematopoietic stem cell kusuka kumnikeli wesifazane (HLA 5/10 A donor A). Uhlelo lokulungisa isimo luhlanganisa ukushiswa komzimba wonke (TBI), i-cyclophosphamide (CY), kanye ne-etoposide (VP-16). Amaseli e-peripheral stem afakwa ngoJulayi 24, kanye nokululama kwe-granulocyte ngosuku +10 kanye nokuxhunyelelwa kwama-platelet ngosuku +13. Ukulandelela njalo kweziguli zangaphandle ngemva kwalokho.

- 25 Nhlolanja 2021: Kutholakale ukuphinda kubuye umnkantsha ngesikhathi sokulandelela.

- Ukwelashwa: Ngaqala ukwelashwa nge-thalidomide ngomlomo.

- Mashi 8: Ungeniswe esibhedlela sethu.

- Ukwakheka kwe-Bone Marrow: ukuqhuma okungu-61.5%.

- Ukuhlukaniswa Kwegazi Okungaphandle: ukuqhuma okungu-15%.

- I-Immunophenotyping: amaseli angu-35.25% aveza i-CD99, i-CD5, i-CD3dim, i-CD8dim, i-CD7, i-cCD3, i-CD2dim, i-HLA-ABC, i-cbcl-2, i-CD81, i-CD38, okubonisa ama-T lymphocyte angakavuthwa ayingozi.

- Ukuhlaziywa kwe-Chromosome: 46, XX [9].

- I-Leukemia Fusion Gene: I-SIL-TAL1 fusion gene positive; isilinganiso sobuningi: I-SIL-TA.

- Ukuguquka Kwesimila Segazi: Okubi.

- Ukuhlaziywa kwe-Chimerism (ngemuva kwe-HSCT): Amaseli atholakala kubanikeli abalelwa ku-45.78%.

- Mashi 11: Ukuqoqwa kwama-lymphocyte egazi angaphandle kwe-autologous ukuze kukhuliswe amangqamuzana e-CD7-CART.

- Ukwelashwa: I-VILP (VDS 4mg, IDA 10mg, L-asparaginase 10,000 IU qd x izinsuku ezi-4, Dex 9mg q12h x izinsuku eziyi-9) ehlanganiswe ne-thalidomide ukulawula isimila.

- Mashi 19: Ukwelashwa ngamakhemikhali kwe-FC (Umkhuhlane 50mg x izinsuku ezi-3, i-CTX 0.4gx izinsuku ezi-3).

- Mashi 24 (ngaphambi kokufakwa): Ukwakheka komnkantsha wethambo kubonise i-grade V hyperplasia, kanye nokuqhuma okungu-22%.

- I-Bone Marrow Flow Cytometry: amaseli angu-29.21% (amaseli ane-nucleated) aveza i-CD3, i-CD5, i-CD7, i-CD99, aveza i-cCD3 ngokwengxenye, okubonisa amaseli e-T angakavuthwa ayingozi.

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