{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:21:01Z","timestamp":1784647261733,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Burkitt lymphoma (BL) is the most common tumor of non-Hodgkin\u2019s lymphoma (NHL) in children, accounting for about 40% of cases. Although different combined short-course chemotherapies have achieved a good effect, refractory\/relapsed BL has a poor prognosis with cure rates less than 30%. Chimeric antigen receptor T cell (CAR-T) therapy has developed rapidly in recent years and achieved excellent results in acute lymphoblastic leukemia (ALL). However, in some cases, there is a failure to produce autologous CAR-T cells because of T-cell dysfunction. In such cases, allogeneic CAR-T therapy has to be considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 17-year-old boy with stage II BL did not respond to extensive chemotherapy and sequential autologous CAR-T therapy. Lentiviral vectors containing anti-CD20-BB-\u03b6 (20CAR) and anti-CD22-BB-\u03b6 (22CAR) transgenes were used to modify the T cells from an HLA-identical matched unrelated donor. Flow cytometry was used to assess the cytokine analyses and CAR-T cell persistence in peripheral blood, enumerated by qPCR as copies per ug DNA. Informed consent for autologous\/allogeneic CAR-T therapy was obtained from the patient and his legal guardian.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Unedited HLA-matched allogeneic CD20 and CD22 CAR-T cells were infused after lymphodepletion chemotherapy with cyclophosphamide and fludarabine. The patient experienced Grade IV cytokine release syndrome (CRS) and went into complete remission (CR) after anti-inflammatory treatment including tocilizumab. Because of persistent pancytopenia and full donor chimerism, the same donor\u2019s conditioning-free peripheral blood stem cells were successfully transplanted 55 days post CAR-T. Neutrophils were engrafted at day +11 and platelets were rebuilt at day +47 without obvious acute graft-versus-host disease (GVHD), but there was mild chronic GVHD in the skin and eyes. Currently, active anti-rejection therapy is still underway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unedited HLA-matched allogeneic CAR-T cell therapy could be an innovative, effective, and safe treatment for children with refractory\/relapse BL without obvious acute GVHD. Conditioning-free allogeneic hematopoietic stem cell transplantation (HSCT) from the same donor is feasible for a patient with full donor T-cell chimerism after allogeneic CAR-T. It cannot be ignored that close GVHD monitoring is needed post HSCT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1219872","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T14:24:03Z","timestamp":1694010243000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case Report: Unedited allogeneic chimeric antigen receptor T cell bridging to conditioning-free hematopoietic stem cell transplantation for a child with refractory Burkitt lymphoma"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaomin","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjuan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changying","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benshang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16461","article-title":"Treatment of relapsed\/refractory paediatric aggressive B-cell non-Hodgkin lymphoma","volume":"189","author":"Moleti","year":"2020","journal-title":"Br J Haematol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915315","article-title":"Rituximab for high-risk, mature B-cell non-Hodgkin's lymphoma in children","volume":"382","author":"Minard-Colin","year":"2020","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27873","article-title":"Outcome of relapse in children and adolescents with B-cell non-Hodgkin lymphoma and mature acute leukemia: A report from the French LMB study","volume":"66","author":"Rigaud","year":"2019","journal-title":"Pediatr Blood Cancer"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61403-3","article-title":"T cells expressing CD19 chimeric antigen receptors for acute lymphoblastic leukaemia in children and young adults: a phase 1 dose-escalation trial","volume":"385","author":"Lee","year":"2015","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0094-0","article-title":"Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study","volume":"32","author":"Sun","year":"2018","journal-title":"Leukemia"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1708566","article-title":"Chimeric antigen receptor T cells in refractory B-cell lymphomas","volume":"377","author":"Schuster","year":"2017","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-020-03198-7","article-title":"Sequential anti-CD19, 22, and 20 autologous chimeric antigen receptor T-cell (CAR-T) treatments of a child with relapsed refractory Burkitt lymphoma: a case report and literature review","volume":"146","author":"Du","year":"2020","journal-title":"J Cancer Res Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019002008","article-title":"Early response observed in pediatric patients with relapsed\/refractory Burkitt lymphoma treated with chimeric antigen receptor T cells","volume":"135","author":"Zhang","year":"2020","journal-title":"Blood"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0235-0","article-title":"CAR T cells induce a complete response in refractory Burkitt Lymphoma","volume":"53","author":"Avigdor","year":"2018","journal-title":"Bone Marrow Transpl"},{"key":"B10","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1007\/s11095-018-2436-z","article-title":"Chimeric antigen receptor T-cells (CAR T-cells) for cancer immunotherapy - 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