{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:07:12Z","timestamp":1777298832081,"version":"3.51.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Recent advances in chimeric antigen receptors have provided an alternative approach for treating relapsed acute lymphocyte leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, relapsed patients who had undergone allogeneic umbilical cord blood transplantation (UCBT) have no chance of having CAR-T cells derived from donors due to lacking UCB. We present a case of a patient with Ph+ ALL who relapsed after UCBT and achieved complete morphological and molecular remission following treatment with CD19 CAR-T cells derived from the recipient post-UCBT. The patient had only grade I CRS. GVHD or neurotoxicity was not observed. More than 6 years after CAR-T cell infusion, the patient was still in hematologic and molecular complete remission with negative minimal residual disease (MRD). This case is the first to show a new strategy of practicality, efficacy, and safety of CD19 CAR-T cells derived from UCBT recipients for treating relapsed ALL after UCBT.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1586349","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T04:10:47Z","timestamp":1747627847000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: CD19 CAR-T cells derived from recipient of umbilical cord blood transplantation effectively treated relapsed acute lymphoblastic leukemia after UCBT"],"prefix":"10.3389","volume":"16","author":[{"given":"Hua","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Xian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gangxiong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nainong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.7836","article-title":"Genetic basis of acute lymphoblastic leukemia","volume":"35","author":"Iacobucci","year":"2017","journal-title":"J Clin Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e577","DOI":"10.1038\/bcj.2017.53","article-title":"Acute lymphoblastic leukemia: a comprehensive review and 2017 update","volume":"7","author":"Terwilliger","year":"2017","journal-title":"Blood Cancer J"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.04.004","article-title":"NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: report from the Committee on the Epidemiology and Natural History of Relapse following Allogeneic Cell Transplantation","volume":"16","author":"Pavletic","year":"2010","journal-title":"Biol Blood Marrow Transpl"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2011.351","article-title":"Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT","volume":"26","author":"Spyridonidis","year":"2012","journal-title":"Leukemia"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2016.05.011","article-title":"Donor lymphocyte infusion after allogeneic stem cell transplantation","volume":"54","author":"Castagna","year":"2016","journal-title":"Transfus Apher Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s13045-016-0319-5","article-title":"Minimal residual disease- and graft-vs.-host disease-guided multiple consolidation chemotherapy and donor lymphocyte infusion prevent second acute leukemia relapse after allotransplant","volume":"9","author":"Yan","year":"2016","journal-title":"J Hematol Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e2024010","DOI":"10.4084\/MJHID.2024.010","article-title":"CAR-T cell therapy in B-cell acute lymphoblastic leukemia","volume":"16","author":"Testa","year":"2024","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407222","article-title":"Chimeric antigen receptor T cells for sustained remissions in leukemia","volume":"371","author":"Maude","year":"2014","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"235","DOI":"10.21037\/atm.2018.05.35","article-title":"The promise and challenges of chimeric antigen receptor T cells in relapsed B-cell acute lymphoblastic leukemia","volume":"6","author":"Ding","year":"2018","journal-title":"Ann Transl Med"},{"key":"B10","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":"B11","doi-asserted-by":"publisher","first-page":"102377","DOI":"10.1016\/j.eclinm.2023.102377","article-title":"Donor-derived Anti-CD19 CAR T cells GC007g for relapsed or refractory B-cell acute lymphoblastic leukemia after allogeneic HSCT: a phase 1 trial","volume":"67","author":"Luo","year":"2024","journal-title":"EClinicalMedicine"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103849","article-title":"Chimeric antigen receptor-modified T cells in chronic lymphoid leukemia","volume":"365","author":"Porter","year":"2011","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-08-519413","article-title":"Donor-derived CD19-targeted T cells cause regression of Malignancy persisting after allogeneic hematopoietic stem cell transplantation","volume":"122","author":"Kochenderfer","year":"2013","journal-title":"Blood"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26160","article-title":"Combination of CD19 and CD22 CAR-T cell therapy in relapsed B-cell acute lymphoblastic leukemia after allogeneic transplantation","volume":"96","author":"Liu","year":"2021","journal-title":"Am J Hematol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709919","article-title":"Long-term follow-up of CD19 CAR therapy in acute lymphoblastic leukemia","volume":"378","author":"Park","year":"2018","journal-title":"N Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"224ra225","DOI":"10.1126\/scitranslmed.3008226","article-title":"Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia","volume":"6","author":"Davila","year":"2014","journal-title":"Sci Transl Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-019-0184-6","article-title":"Mechanisms of resistance to CAR T cell therapy","volume":"16","author":"Shah","year":"2019","journal-title":"Nat Rev Clin Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/CM9.0000000000001491","article-title":"CD19-targeted chimeric antigen receptor-modified T cells induce remission in patients with relapsed acute B lymphoblastic leukemia after umbilical cord blood transplantation","volume":"135","author":"Xu","year":"2022","journal-title":"Chin Med J (Engl)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.v113.1","article-title":"CAR-T from cord blood in a patient with Ph+ acute lymphoblastic leukemia relapsing after hematopoietic stem cell transplantation","volume":"113","author":"Marra","year":"2024","journal-title":"Eur J Haematol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3390\/cancers14133168","article-title":"Umbilical cord blood as a source of less differentiated T cells to produce CD123 CAR-T cells","volume":"14","author":"Cael","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.944248","article-title":"Umbilical cord blood: A promising source for allogeneic CAR-T cells","volume":"12","author":"Liu","year":"2022","journal-title":"Front Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2018.1431119","article-title":"Use of cord blood derived T-cells in cancer immunotherapy: milestones achieved and future perspectives","volume":"11","author":"Lo Presti","year":"2018","journal-title":"Expert Rev Hematol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-05-552729","article-title":"Current concepts in the diagnosis and management of cytokine release syndrome","volume":"124","author":"Lee","year":"2014","journal-title":"Blood"},{"key":"B24","doi-asserted-by":"publisher","first-page":"297","DOI":"10.3324\/haematol.2019.229781","article-title":"Management of adults and children undergoing chimeric antigen receptor T-cell therapy: best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE)","volume":"105","author":"Yakoub-Agha","year":"2020","journal-title":"Haematologica"},{"key":"B25","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13045-018-0571-y","article-title":"Grading of cytokine release syndrome associated with the CAR T cell therapy tisagenlecleucel","volume":"11","author":"Porter","year":"2018","journal-title":"J Hematol Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.758","article-title":"ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells","volume":"25","author":"Lee","year":"2019","journal-title":"Biol Blood Marrow Transpl"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.v94.S1","article-title":"Chimeric antigen receptor T cells for acute lymphoblastic leukemia","volume":"94","author":"Frey","year":"2019","journal-title":"Am J Hematol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0564-6","article-title":"Clinical lessons learned from the first leg of the CAR T cell journey","volume":"25","author":"Majzner","year":"2019","journal-title":"Nat Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-793141","article-title":"Kinetics and biomarkers of severe cytokine release syndrome after CD19 chimeric antigen receptor-modified T-cell therapy","volume":"130","author":"Hay","year":"2017","journal-title":"Blood"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.omto.2020.06.016","article-title":"Efficacy and safety of CD28- or 4-1BB-based CD19 CAR-T cells in B cell acute lymphoblastic leukemia","volume":"18","author":"Zhao","year":"2020","journal-title":"Mol Ther Oncolytics"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0403-2","article-title":"A retrospective comparison of allogenic and autologous chimeric antigen receptor T cell therapy targeting CD19 in patients with relapsed\/refractory acute lymphoblastic leukemia","volume":"54","author":"Hu","year":"2019","journal-title":"Bone Marrow Transpl"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-752121","article-title":"Posttransplant chimeric antigen receptor therapy","volume":"131","author":"Smith","year":"2018","journal-title":"Blood"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1586349\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T04:10:49Z","timestamp":1747627849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1586349\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":32,"alternative-id":["10.3389\/fimmu.2025.1586349"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1586349","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]},"article-number":"1586349"}}