Comparison of Allo-HSCT outcomes after CAR-T therapy versus chemotherapy in pediatric patients with relapsed/refractory B-ALL: a retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a curable treatment for refractory/relapse B-cell acute lymphoblastic leukemia (R/R B-ALL).Traditional chemotherapy or Chimeric antigen receptor T-cell (CAR-T) therapy are both important methods to achieve MRD negativity before HSCT. However, which treatment is preferred needs to be clarified. PATIENTS AND METHODS: In this study, 269. PATIENT: s with R/R B-ALL who underwent allo-HSCT after CAR-T cell therapy (CAR-T, n = 142) or chemotherapy (CT, n = 127) were enrolled from multicenters. RESULTS: The 3-year overall survival (OS) after transplantation was 66.8% in the CAR-T group and 72.3% in the chemotherapy (CT) group. The 3-year relapse-free survival (RFS) was 65.3% in the CAR-T group and 65.9% in the CT group. The 3-year graft-versus-host disease, relapse-free survival (GRFS) and cumulative incidence of relapse (CIR) were also similar between the two groups. Among patients who achieved first complete remission (CR1) before transplantation, the proportion receiving chemotherapy was significantly higher than that receiving CAR-T therapy (37.5% vs. 13.6%; P < 0.001). In this CR1 subgroup, the CT group demonstrated superior outcomes, including improved OS, RFS, and GRFS. CONCLUSION: In pediatric R/R B-ALL, CAR-T bridging to HSCT appears to yield post-transplant survival comparable to chemotherapy, though a higher rate of moderate to severe chronic GVHD was observed. CAR-T may be a reasonable option, but closer GVHD monitoring seems warranted.
Source: The Oncologist
Authors: Bohan Li, Chengjuan Luo, Jun Lu, Jiaoyang Cai, Yiping Zhu, Chi-kong Li, Ye Guo, Hua Jiang, Xiaohang Huang, Yifei Cheng, Jing Pan, Zimin Sun, Xiaoqin Feng, Xuan Liu, Kai Chen, Jie Yu, Guangcui He, Jingbo Wang, Aiguo Liu, Xiaoyan Wu, Liping Wan, Hongmei Wang, Xia Xiao, Maoquan Qin, KaiLi Pan, Jing Lu, Peifang Xiao, Jing Chen, Ruijuan Sun, Shaoyan Hu
Institutions: Soochow University, Children's Hospital of Suzhou University, Shanghai Jiao Tong University, Shanghai Children's Medical Center, First Affiliated Hospital of Soochow University, Sichuan University, West China Second University Hospital of Sichuan University, Chinese University of Hong Kong, Hong Kong Children's Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Institute of Hematology & Blood Diseases Hospital, State Key Laboratory of Experimental Hematology, Guangzhou Women and Children Medical Center, Peking University, Peking University People's Hospital, University of Science and Technology of China, Nanfang Hospital, Southern Medical University, Shanghai Children's Hospital, Children's Hospital of Chongqing Medical University, Chongqing Medical University, Aerospace Center Hospital, Tongji Hospital, Huazhong University of Science and Technology, Wuhan Union Hospital, Shanghai First People's Hospital, Shandong Normal University, Tianjin First Center Hospital, Capital Medical University, Beijing Children’s Hospital, Northwest Women's and Children's Hospital, Hebei Yanda Ludaopei Hospital
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,852
OpenAlex ID: W7166545553
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