{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:02:08Z","timestamp":1784523728234,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"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>Despite being a standard consolidation treatment, allogeneic hematopoietic stem cell transplantation (allo-HSCT) for B-cell acute lymphoblastic leukemia (B-ALL) in remission is still hampered by relapse and complications. While CAR-T therapy is revolutionizing later-line treatment, its role as a consolidation strategy in remission, particularly for patients ineligible for transplantation, remains unexplored. This study compared the efficacy of CAR-T therapy with that of allo-HSCT as consolidation for B-ALL patients in complete remission (CR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, propensity-score matched study was performed from September 1, 2012 to December 31, 2024, including 75 B-ALL patients treated with CAR-T or allo-HSCT as consolidation therapy. Firth penalized likelihood Cox models and restricted mean survival time (RMST) models were built for time-to-event outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 2-year progression-free survival (PFS) and 2-year overall survival (OS) rates showed no significant differences between the CAR-T and HSCT cohorts (CR1: 2-year PFS rate: 65.8% vs. 88.9%, P\u00a0=\u00a00.146, 2-year OS rate: 83.6% vs. 91.3%, P\u00a0=\u00a00.512; CR2: 2-year PFS rate: 42.2% vs. 64.3%, P\u00a0=\u00a00.360). The RMSTs of PFS and OS also have no significant differences (CR1: RMST of PFS difference = -7.738, P\u00a0=\u00a00.496, RMST of OS difference = -2.257, P\u00a0=\u00a00.788; CR2: RMST of PFS difference = -6.176, P\u00a0=\u00a00.700, RMST of OS difference = -8.391, P\u00a0=\u00a00.477) truncated at the minimum of the largest follow-up times in each cohort (CR1, 74.6 months; CR2, 75.0 months). In multivariate analysis, patients treated with allo-HSCT had better PFS in CR1 group (HR\u00a0=\u00a04.579, 95%CI, 1.020-20.563, P\u00a0=\u00a00.038). High risk stratification was an independent factor associated with worse OS for B-ALL patients in CR (CR1: HR\u00a0=\u00a08.010; 95%CI, 1.744-36.781, P\u00a0=\u00a00.048; CR2 HR\u00a0=\u00a05.110, 95%CI, 1.167-22.378, P\u00a0=\u00a00.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results indicated that CAR-T consolidation regimen showed comparable survival to that of allo-HSCT in matched B-ALL patients, which might support its potential as a consolidation alternative for B-ALL patients ineligible for allo-HSCT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1858385","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:21:12Z","timestamp":1784521272000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["CAR-T versus allogeneic transplantation as consolidation for B-cell acute lymphoblastic leukemia in remission: a propensity-score matched study"],"prefix":"10.3389","volume":"17","author":[{"given":"Fangfei","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuangguo","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, 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