{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:59:49Z","timestamp":1753891189180,"version":"3.41.2"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"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:p>We report a case of acute B-cell leukemia complicated by central nervous system (CNS) post-transplant lymphoproliferative disorder (PTLD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient achieved sustained disease stabilization following therapeutic dose modification of orelabrutinib, representing the first evidence-based documentation that Bruton\u2019s tyrosine kinase (BTK) inhibitor down-titration confers clinical efficacy in PTLD. Epstein-Barr virus (EBV)-associated PTLD is a serious complication following allogeneic HSCT, with frequent CNS involvement. Effective treatment for CNS involvement is often hampered by the challenge of drug penetration across the blood-brain barrier. This case highlights the potential benefit and safety of dose-adjusted orelabrutinib in controlling CNS PTLD, suggesting a promising therapeutic approach.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1597119","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T04:10:20Z","timestamp":1750911020000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: dose adjustment of orelabrutinib for managing central nervous system post-transplant lymphoproliferative disorder following acute lymphoblastic leukemia transplantation"],"prefix":"10.3389","volume":"16","author":[{"given":"Wenwen","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianlin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingsu","family":"Guan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18763","article-title":"Post-transplant lymphoproliferative disorder: update on treatment and novel therapies","volume":"201","author":"Atallah-Yunes","year":"2023","journal-title":"Br J Haematol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00649-6","article-title":"Tabelecleucel for allogeneic haematopoietic stem-cell or solid organ transplant recipients with epstein-barr virus-positive 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