{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T19:33:04Z","timestamp":1768937584415,"version":"3.49.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"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. Oncol."],"abstract":"<jats:p>Burkitt lymphoma (BL) with TP53 mutations is characterized by strong chemoresistance and poor prognosis, posing significant challenges in clinical treatment. Chimeric antigen receptor T-cell (CAR-T) therapy has shown promise in refractory\/relapsed (r\/r) BL, but its efficacy in TP53-mutated cases remains to be further validated. This case report describes a 16-year-old male adolescent diagnosed with TP53-mutated BL, whose initial presentation with recurrent abdominal pain led to a misdiagnosis of high-grade B-cell lymphoma. The disease was refractory to two cycles of chemotherapy (DA-EPOCH-R and AZA + R-CDOP) and even progression after third-line R-CODOX-M therapy. Following reevaluation confirming BL, the patient received CD19-directed CAR-T cell therapy (Axicabtagene Ciloleucel infusion, Axi-cel) and achieved complete metabolic response (CMR). Baseline lactate dehydrogenase (LDH) was markedly elevated at 1,343 U\/L. As of the latest follow-up in March 2025, the patient remains in remission at 30 months after CAR-T infusion with full functional recovery, including resumption of normal academic life. This case, among the youngest reported uses of commercial Axi-cel for BL, highlights the diagnostic complexity in adolescent lymphoma and demonstrates that CD19 CAR-T therapy can overcome TP53-associated chemoresistance in adolescent BL. It also suggests that integrating molecular profiling and immunotherapy may provide new strategies for managing high-risk, treatment-refractory cases in the adolescent and young adult population.<\/jats:p>","DOI":"10.3389\/fonc.2026.1702660","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:28:09Z","timestamp":1768886889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: CD19 CAR-T therapy induces durable remission in a pediatric patient with TP53-mutated, refractory Burkitt lymphoma: a 30-month follow-up"],"prefix":"10.3389","volume":"16","author":[{"given":"Yong","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuerong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Internal, Shanghang County Hospital","place":["Longyan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Xiamen Cell Therapy Research Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2025746","article-title":"Burkitt\u2019s lymphoma","volume":"387","author":"Roschewski","year":"2022","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1038\/s41408-024-01153-0","article-title":"MYC-rearranged mature B-cell lymphomas in children and young adults are molecularly Burkitt Lymphoma","volume":"14","author":"Mato","year":"2024","journal-title":"Blood Cancer 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