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December 8, 2025Blood

Pre-transplant CAR T-cell therapy is associated with inferior survival and increased non-relapse mortality in pediatric B-ALL: A single-center retrospective analysis

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Authors

RCRozalyn ChokMHMinxuan HuangDSDavid C. Shyr

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Overview

Retrospective analysis shows worse survival rates in pediatric B-ALL following CAR T-cell therapy prior to transplant, indicating higher non-relapse mortality.

Key Points

  • Pre-transplant CAR T-cell therapy resulted in significantly worse survival outcomes compared to HSCT alone, impacting overall survival and disease-free survival.
  • In this cohort of 74 pediatric B-ALL patients, 51% received CAR T therapy before HSCT, with a 2-year overall survival of 66.9% versus 94.4% for HSCT-only recipients.
  • The analysis applied Cox proportional hazard models to examine survival, finding that CAR T therapy was associated with increased non-relapse mortality at 16.8% versus 2.9%.
  • Results emphasize the need for enhanced risk stratification and supportive care for pediatric patients undergoing CAR T therapy prior to HSCT, especially regarding viral infections and immune challenges.

Cite This Study

Chok et al. (2025) studied this question.

synapsesocial.com/papers/69362f7d4fa91c937236e431https://doi.org/10.1182/blood-2025-6077
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hematopoietic cell transplantation after CD19-directed CAR T-cell therapy for remission consolidation or relapse treatment in pediatric acute lymphoblastic leukemia2025
  2. 2Pre-transplant MRD negativity predicts favorable outcomes of CAR-T therapy for pediatirc relapsed and Refractory Acute lymphoblastic leukemia followed by TCRαβ-depleted haplo-HSCT2025
  3. 3CAR T-cell therapy versus autologous HSCT in patients with large B-cell lymphoma in complete remission: An analysis from the EBMT lymphoma working party2025 · 1 citations
  4. 4Transplantation in combination with CAR T-cell therapy for refractory/relapsed aggressive B-cell lymphoma after failure of CD19 CAR-T cell therapy2025
  5. 5Efficacy and safety of CAR T-cell therapy in hematologic malignancies: A systematic review and meta-analysis.2026