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To the Editor, Relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) continues to have a relatively high treatment-failure rate, and patients with high-risk relapse often require HSCT to achieve durable remission [1, 2]. Although HSCT offers curative potential, post-HSCT relapse and transplant-related complications continue to limit long-term survival [2]. Immunotherapy has emerged as a novel treatment approach and has improved outcomes in patients with R/R B-ALL [3,4,5].
Abstract Epstein-Barr virus (EBV) reactivation after haploidentical stem cell transplant (haplo-HSCT) is a serious complication, which sometimes progresses to post-transplant lymphoproliferative disorder (PTLD). We retrospectively analyzed 448 pediatric patients ( ≤ 18 years) undergoing anti-thymocyte globulin (ATG)-based haplo-HSCT with letermovir prophylaxis at Peking University People’s Hospital (Oct 2022–Oct 2025), using a 1:3 propensity score-matched design.
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