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

Ukuthethelelwa Kwesiguli Esibuyele Emuva Se-T-ALL Esine-Central Nervous System Leukemia Ngemva Kokwelashwa Nge-CAR-T

Leli cala lihilela umfana oneminyaka engu-16 ubudala waseNyakatho-mpumalanga yeShayina, ohambo lwakhe olune-leukemia lube nezinselele eziningi selokhu atholakala enalo esikhathini esingaphezu konyaka odlule.

Ngomhlaka-8 Novemba 2020, uDawei (igama elingelona elakhe) wavakashela isibhedlela sendawo ngenxa yokuqina kobuso, ukuqubuka, kanye nomlomo ogobile. Watholakala ene-"acute lymphoblastic leukemia (uhlobo lwe-T-cell)." Ngemva kwesifundo esisodwa se-induction chemotherapy, i-MRD (isifo esincane esisele) ayizange itholakale, kwalandela i-chemotherapy ejwayelekile. Phakathi nalesi sikhathi, ukubhoboza umnkantsha wamathambo, ukubhoboza i-lumbar, kanye nokujova ngaphakathi kwe-thecal akubonisanga ukuphazamiseka.

Ngomhlaka-6 Meyi 2021, kwenziwa ukubhoboza i-lumbar ngomjovo wangaphakathi kwe-thecal, kwathi ukuhlaziywa koketshezi lwe-cerebrospinal (CSF) kwaqinisekisa "i-central nervous system leukemia." Lokhu kwalandelwa yizifundo ezimbili ze-chemotherapy ejwayelekile. Ngomhlaka-1 Juni, ukubhoboza i-lumbar ngokuhlaziywa kwe-CSF kwabonisa amangqamuzana angavuthiwe. Kwanikezwa ukubhoboza i-lumbar okwengeziwe ngomjovo wangaphakathi kwe-thecal, kanti ukuhlolwa kokugcina kwe-CSF akubonisanga amangqamuzana esimila.

Ngomhlaka-7 kuJulayi, uDawei walahlekelwa umbono esweni lakhe lokunene, okwancipha kwaba ukubona okukhanyayo kuphela. Ngemva kokwelashwa ngamakhemikhali okukodwa okunamandla, umbono wakhe weso lokunene wabuyela esimweni esijwayelekile.

Ngomhlaka-5 Agasti, umbono wakhe wesokudla waphinde waba mubi, okwaholela ekubeni yimpumputhe ngokuphelele, futhi iso lakhe lesobunxele laba lufifi. Kusukela ngomhlaka-10 kuya ku-13 Agasti, wenziwa i-radiotherapy yobuchopho bonke kanye nomgogodla (TBI), okwabuyisela umbono esweni lakhe lesobunxele, kodwa iso lesokudla lahlala lingaboni. Ngomhlaka-16 Agasti, ukuhlolwa kwe-MRI kobuchopho kwabonisa ukuthuthuka okuncane ekuqineni kwe-optic nerve kanye ne-chiasm yesokudla, kwabonakala ukuthuthukiswa. Azikho izimpawu noma ukuthuthukiswa okungavamile okutholakale ku-brain parenchyma.

Ngalesi sikhathi, umndeni wawusulungiselele ukufakelwa umnkantsha, ulinde umbhede kuphela ewadini lokufakelwa. Ngeshwa, ukuhlolwa okuvamile kwangaphambi kokufakelwa kwembule izinkinga ezenza ukufakelwa kwesisu kube nzima.