{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:17:23Z","timestamp":1793139443615,"version":"4.5.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"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>Introduction<\/jats:title>\n                    <jats:p>Testicular relapse constitutes one of the most frequent extramedullary recurrences in pediatric acute lymphoblastic leukemia (ALL), yet its clinical management remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study assessed treatment outcomes and long-term survival in children with testicular relapse following initial therapy under the CCCG-ALL-2015 study (ChiCTR-IPR-14005706, http:\/\/www.chictr.org.cn). In total, 66 patients from 13 medical centers were retrospectively analyzed. Clinical characteristics and survival outcomes were compared across salvage treatment modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median interval from initial diagnosis to testicular relapse was 37 months. Among 59 patients who received post-relapse therapy, the 2-year overall survival (OS) rate was 86.1% after a median follow-up of 33 months. Patients treated with chimeric antigen receptor T-cell (CAR-T) therapy showed a 2-year OS of 90.7%, compared to 81.7% in those managed with conventional regimens, such as chemotherapy, orchiectomy, or hematopoietic stem-cell transplantation (P &amp;gt; 0.05). Among 37 children with isolated testicular relapse, 18 underwent CAR-T therapy and 10 underwent orchiectomy, achieving 2-year OS rates of 92.3% and 100%, respectively (P &amp;gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Testicular relapse typically emerged approximately 3 years after initial diagnosis. CAR-T therapy proved to be both safe and effective, providing survival comparable to conventional regimens and offering potential advantages in preserving life quality among long-term survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1766494","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:50:59Z","timestamp":1770792659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of chimeric antigen receptor T-cell therapy in testicular relapse of pediatric acute lymphoblastic leukemia: a multicenter retrospective study"],"prefix":"10.3389","volume":"17","author":[{"given":"Ning","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of 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