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CAR T-cell therapy is being explored in these patients with encouraging results. Specifically, CD1a-directed CAR T-cells are being explored in clinical trials to treat cortical T-ALL (CD1a+), but there are no data on outcome in this subgroup of patients before this therapy. This retrospective, observational study aimed to describe the characteristics and outcomes of patients with R\/R CD1a\u2009+\u2009T-ALL. We included pediatric and adult patients diagnosed with R\/R CD1a\u2009+\u2009T-ALL in 25 sites of Spain between March 2006 and May 2022. The primary outcome of the study was overall survival (OS). Forty-three patients, 28 adults and 15 children, with R\/R CD1a\u2009+\u2009T-ALL were included. Median (range) age at inclusion was 24 years (5\u201357), and 82.5% were male. After a median (range) follow-up of 7.0 years (5.1\u201313.6), 6 (14.0%) patients were alive and in complete remission (CR) and 37 (86.0%) had died. Five-year OS was 16% (95% CI; 7\u201329%). Bone marrow relapse, an interval\u2009&lt;\u200912 months between first CR and relapse, and lack of allogeneic hematopoietic stem cell transplantation during salvage treatment were associated with worse OS. Our results confirm that patients with R\/R CD1a\u2009+\u2009T-ALL have a very poor prognosis, highlighting the need for new treatment alternatives in these patients.<\/jats:p>","DOI":"10.1007\/s00277-026-06956-8","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T06:45:54Z","timestamp":1774334754000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of pediatric and adult patients with relapsed\/refractory cortical (CD1a+) T-cell acute lymphoblastic leukemia. The Spanish experience from SEHOP and PETHEMA groups"],"prefix":"10.1007","volume":"105","author":[{"given":"Cristina","family":"Rivera-P\u00e9rez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Morgades","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Alonso-Saladrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"Montesinos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais","family":"Murciano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Ad\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Esteve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Fuentes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luz","family":"Amigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Gonz\u00e1lez-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Coll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Dapena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Paz Queipo","family":"de Llano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Fuster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Garc\u00eda-Cadenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Tasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Barba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5658-1831","authenticated-orcid":false,"given":"Susana","family":"Rives","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Maria","family":"Ribera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"6956_CR1","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1056\/NEJMRA1400972","volume":"373","author":"SP Hunger","year":"2015","unstructured":"Hunger SP, Mullighan CG (2015) Acute Lymphoblastic Leukemia in Children. 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A A-S has received honoraria and\/or travel support from Novartis, JazzPharma, MSD, and OneChain Immunotherapeutics. P B has received Advisory Board and consultancy fees from Allogene, Amgen, Autolus, BMS\/Celgene, Kite\/Gilead, Incyte, Miltenyi Biomedicine, Novartis, Nektar, Pfizer, and Pierre Fabre. S R has received honoraria and\/or travel support from Novartis, Servier, Celgene\/ Bristol Myers Squibb, Kite\/ Gilead, Pfizer, Clinigen, OneChain Immunotherapeutics, and Amgen, and reports being part of DMSB in clinical trial sponsored by Novartis and of a DMC in a clinical trial sponsored by Autolus. JM R reports consulting\/advisory roles at Incyte, Pfizer, Bristol Myers Squibb, Novartis, and Takeda, and research funding from Amgen, Pfizer, and Incyte.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"The study was approved by the Institutional Review Board (IRB) of Hospital Sant Joan de D\u00e9u (PIC 98\u2009\u2212\u200922, available upon request) and Hospital Germans Trias i Pujol, which were the IRBs of reference for this study in Spain for pediatric and adult patients, respectively. Patients (or, alternatively, their legal representatives) signed the informed consent form before inclusion in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval<!--Emphasis Type='Bold' removed-->and informed consent"}}],"article-number":"203"}}