History
When he was 20 years old, Norberto consulted for dyspnea and fever. For the last two months, he has been pale and exhausted for no apparent reason, has lost weight unintentionally and noticed he was easily bruising. Chest X-ray revealed acute pneumonia; while blood cell counts showed high lymphocytosis and pancytopenia (anemia, neutropenia, thrombocytopenia); bone marrow smears and flow cytometry analysis established the diagnosis of CD19+ B-ALL. Despite achieving a complete remission (CR) after frontline chemotherapy, the patient experienced relapse of his B-ALL after two years. Subsequently, he was treated by rituximab, ifosfamide, carboplatin, and etoposide (RICE) chemotherapy. A second CR was achieved. An allogeneic hematopoietic cell transplantation could not be performed because of there was no a suitable HLA-matched donor. A second relapse occurred 8 months later, for which he was enrolled in a clinical trial investigating a new combined chemotherapy to which he only partially responded.
After this new therapeutic failure, he was admitted to the transplantation unit of the department of hematology to receive a dose of 1.2 x 106/kg autologous CD19 CAR-T cells after a conditioning regimen comprising fludarabine and cyclophosphamide. Afterwards, Norberto then remained hospitalised for monitoring and surveillance of short-term complications.
Past medical history
- Mild asthma to dust mite
Surgical history
- Appendectomy at the age of 14
Family history
- Mother has mild endometriosis
- Father has hypertension but has this under control thanks to treatment
Social history
- Lives alone in a flat
- Employed as a computer scientist
- No history of smoking
- Occasional alcohol intake
