{
  "abstract": "Relapse remains the primary cause of treatment failure and death in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Novel therapeutic approaches are imperative for those who are refractory to blinatumomab and chimeric antigen receptor T (CAR-T) cell therapy. CAR-natural killer (NK) cells have emerged as promising candidates for novel cancer immunotherapies, with enhanced antitumor activity and low rates of adverse events. However, data on the efficacy of CAR-NK cells for treating pediatric relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL) are lacking.We report a challenging case of a boy with relapsed B-ALL after blinatumomab who failed to respond to autologous CD19-targeted CAR-T cell therapy and mitoxantrone-based reinduction chemotherapy. The patient achieved a complete remission after donor-derived CD19-targeted CAR-NK cell infusion, experiencing a grade 3 immune effector cell-associated neurotoxicity syndrome (ICANS), which was completely controlled by timely treatment. Then, the patient received the same donor-derived hematopoietic stem cell transplantation (HSCT) and remains in complete remission for a year post-HSCT.Our case provides an example of the utility of CAR-NK cell therapy as a bridge to HSCT in treating pediatric R/R B-ALL, despite the occurrence of ICANS as a manageable toxicity.",
  "authors": [
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Ning Wang"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Lipeng Liu"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Luyang Zhang"
    },
    {
      "affiliations": [
        "Hebei Goldencel Biotechnology Co., Ltd, Shijiazhuang, Hebei, China"
      ],
      "name": "Jianqiang Li"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Yang Wan"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Xiaolan Li"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Xia Chen"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Zixi Yin"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Aoli Zhang"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Xiaoyan Zhang"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Yumei Chen"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Tianyuan Hu"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Yingchi Zhang"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Fang Liu"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Xiaofan Zhu"
    },
    {
      "affiliations": [
        "Division of Pediatric Blood Diseases Center, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Hematology and Blood Diseases Hospital, Tianjin, China",
        "Tianjin Institutes of Health Science, Tianjin, China"
      ],
      "name": "Wenyu Yang"
    }
  ],
  "title": "Donor-derived CD19-targeted CAR-NK cells induce complete remission in a child with relapsed B-ALL after failure of blinatumomab and autologous CD19-targeted CAR-T",
  "uid": "d229748f-facd-5223-b45e-32577e26c7a0"
}