{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:57:54Z","timestamp":1792166274396,"version":"4.4.0"},"reference-count":21,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2021-I2M-1-003 to WY"],"award-info":[{"award-number":["2021-I2M-1-003 to WY"]}]},{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2021-I2M-1-040 to YZ"],"award-info":[{"award-number":["2021-I2M-1-040 to YZ"]}]},{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2022-I2M-1-022 to XZ"],"award-info":[{"award-number":["2022-I2M-1-022 to XZ"]}]},{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2023-I2M-2-007 to YZ"],"award-info":[{"award-number":["2023-I2M-2-007 to YZ"]}]},{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2025-I2M-C&T-B-077 to LL"],"award-info":[{"award-number":["2025-I2M-C&T-B-077 to LL"]}]},{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences grants","award":["2025-I2M-KJ-027 to YZ"],"award-info":[{"award-number":["2025-I2M-KJ-027 to YZ"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82200193 to AZ"],"award-info":[{"award-number":["82200193 to AZ"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270144 to XZ"],"award-info":[{"award-number":["82270144 to XZ"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Science and Technology of the People\u2019s Republic of China grant","award":["2021YFA1101603 to YZ"],"award-info":[{"award-number":["2021YFA1101603 to YZ"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Relapse remains the primary cause of treatment failure and death in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Novel therapeutic approaches are imperative for those who are refractory to blinatumomab and chimeric antigen receptor T (CAR-T) cell therapy. CAR-natural killer (NK) cells have emerged as promising candidates for novel cancer immunotherapies, with enhanced antitumor activity and low rates of adverse events. However, data on the efficacy of CAR-NK cells for treating pediatric relapsed\/refractory B-cell acute lymphoblastic leukemia (R\/R B-ALL) are lacking.<\/jats:p>\n                  <jats:p>We report a challenging case of a boy with relapsed B-ALL after blinatumomab who failed to respond to autologous CD19-targeted CAR-T cell therapy and mitoxantrone-based reinduction chemotherapy. The patient achieved a complete remission after donor-derived CD19-targeted CAR-NK cell infusion, experiencing a grade 3 immune effector cell-associated neurotoxicity syndrome (ICANS), which was completely controlled by timely treatment. Then, the patient received the same donor-derived hematopoietic stem cell transplantation (HSCT) and remains in complete remission for a year post-HSCT.<\/jats:p>\n                  <jats:p>Our case provides an example of the utility of CAR-NK cell therapy as a bridge to HSCT in treating pediatric R\/R B-ALL, despite the occurrence of ICANS as a manageable toxicity.<\/jats:p>","DOI":"10.1136\/jitc-2025-013714","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T16:50:27Z","timestamp":1771606227000},"page":"e013714","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Donor-derived CD19-targeted CAR-NK cells induce complete remission in a child with relapsed B-ALL after failure of blinatumomab and autologous CD19-targeted CAR-T"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1036-8172","authenticated-orcid":false,"given":"Ning","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lipeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Hebei Goldencel Biotechnology Co., Ltd, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixi","family":"Yin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases 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Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China"},{"name":"Tianjin Institutes of Health Science, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical 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