{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:22:50Z","timestamp":1762327370193,"version":"build-2065373602"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute myeloid leukemia (AML)-M2b with t(8;21)(q22;q22)\/RUNX1::RUNX1T1 (AML1-ETO) is associated with a high risk of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Post-transplant lymphoproliferative disorder (PTLD), particularly involving the central nervous system (CNS), confers a poor prognosis. Although CD19 chimeric antigen receptor T-cell (CAR-T) therapy is established in B-cell malignancies, its application in acute myeloid leukemia (AML) or CNS-PTLD has rarely been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>A 24-year-old male with AML-M2b showed persistent RUNX1::RUNX1T1 (AML1-ETO) positivity after allo-HSCT. He developed an extramedullary relapse (presacral mass) at 7 months, followed by CNS-PTLD with limb palsy at 9 months post-HSCT. The disease subsequently progressed to bone marrow relapse (RUNX1::RUNX1T1 94.42%, MRD &amp;gt;5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Given the co-expression of CD19 on both the AML and PTLD cells, the patient was treated with donor-derived CD19 CAR-T cells. He experienced manageable grade 1 cytokine release syndrome (CRS) and grade 3 Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>The patient achieved a complete response (CR) with negative MRD, disappearance of the fusion gene, reduction of PTLD and extramedullary lesions, and recovery of limb strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates the efficacy and feasibility of CD19 CAR-T therapy for concomitant post-transplant AML-M2b relapse and CNS-PTLD, leveraging their shared CD19 expression. It provides clinical evidence that targeting a shared antigen with a single CAR-T product can effectively treat heterogeneous malignancies, offering a promising new strategy for such complex cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1672392","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:24:59Z","timestamp":1762323899000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: CD19 CAR-T therapy induces dual remission in AML-M2b patient with CNS-PTLD and relapse"],"prefix":"10.3389","volume":"16","author":[{"given":"Yu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibo","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingfeng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-626671","article-title":"Genome-wide studies identify a novel interplay between AML1 and AML1\/ETO in t(8;21) acute myeloid leukemia","volume":"127","author":"Li","year":"2016","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ejca.2021.04.042","article-title":"CD19-specific CAR-T cell therapy for relapsed\/refractory non-B-cell acute leukaemia with CD19 antigen expression","volume":"153","author":"Liu","year":"2021","journal-title":"Eur J Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.retram.2024.103471","article-title":"Point of care CD19 chimeric antigen receptor (CAR) T-cells for relapsed\/refractory acute myeloid leukemia (AML) with aberrant CD19 antigen expression","volume":"72","author":"Danylesko","year":"2024","journal-title":"Curr Res Transl Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s13045-025-01708-z","article-title":"CD19 CAR-T in relapsed t(8;21) AML: a single-center prospective phase II clinical trial","volume":"18","author":"Yin","year":"2025","journal-title":"J Hematol Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11247542","article-title":"Post-transplant lymphoproliferative disease (PTLD) after allogeneic hematopoietic stem cell transplantation: biology and treatment options","volume":"11","author":"Clerico","year":"2022","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-013-0162-5","article-title":"Post-transplant lymphoproliferative disease (PTLD): risk factors, diagnosis, and current treatment strategies","volume":"8","author":"Al-Mansour","year":"2013","journal-title":"Curr Hematol Malig Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1702693","article-title":"Post-transplantation lymphoproliferative disorders in adults","volume":"378","author":"Dierickx","year":"2018","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11684-012-0206-6","article-title":"AML1-ETO driven acute leukemia: insights into pathogenesis and potential therapeutic approaches","volume":"6","author":"Hatlen","year":"2012","journal-title":"Front Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V77.10.2242.2242","article-title":"Prognostic value of lymphocyte surface markers in acute myeloid leukemia","volume":"77","author":"Ball","year":"1991","journal-title":"Blood"},{"key":"B10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1111\/ijlh.12916","article-title":"The immunophenotypic characteristics and flow cytometric scoring system of acute myeloid leukemia with t(8;21) (q22;q22); 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