From Age 1 to 76, from CAR-T Bridging to Second Transplant: The Full-Course Transplant Care Behind Nearly 1,500 HSCTs at Beijing GoBroad Boren Hospital
Summary: Since establishing its transplant program in 2017, the hematopoietic stem cell transplantation team at Beijing GoBroad Boren Hospital has completed nearly 1,500 transplants in patients ranging from 1 to 76 years old. Across complex treatment settings including CAR-T bridging to transplant, second transplantation, salvage transplantation, and transplantation in older adults, the team has developed a full-course management approach covering pre-transplant assessment, donor selection, individualized conditioning, prevention and management of post-transplant complications, and maintenance therapy. This allows transplant pathways to be tailored for patients with leukemia, lymphoma, aplastic anemia, hemophagocytic lymphohistiocytosis, and other hematologic diseases.
Stable Six Months After Transplant at Age 76
In May 2026, Ms. Xiao (pseudonym), a 76-year-old patient from Shaanxi Province, returned for her six-month follow-up after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Her clinical indicators remained stable and her overall condition continued to improve.
Ms. Xiao had chronic myelomonocytic leukemia (CMML) that transformed into acute myeloid leukemia (AML). She also had several underlying conditions, including diabetes, hypertension, and hypertrophic cardiomyopathy. After a comprehensive assessment, she proceeded with allogeneic hematopoietic stem cell transplantation.
Her case is not an isolated example of transplantation in an older adult.
At Beijing GoBroad Boren Hospital, patients undergoing hematopoietic stem cell transplantation have ranged in age from 1 to 76 years. The program treats both malignant and non-malignant hematologic diseases, including leukemia, lymphoma, aplastic anemia, and hemophagocytic lymphohistiocytosis (HLH). Clinical settings include first transplantation, second transplantation, CAR-T bridging to transplant, salvage transplantation, and transplantation in older adults.
Since the transplant program was established in 2017, the team at Beijing GoBroad Boren Hospital has completed nearly 1,500 transplants and developed a full-course management system spanning pre-transplant assessment, donor selection, conditioning-plan design, prevention and management of complications, and post-transplant maintenance therapy.
What Sets the Transplant Team at Beijing GoBroad Boren Hospital Apart?
The Department of Hematology II (Hematopoietic Stem Cell Transplantation) at Beijing GoBroad Boren Hospital is led by Dr. Tong WU and brings together specialists with extensive adult and pediatric transplant experience across clinical care, teaching, and research.
Dr. Tong WU has 40 years of experience in hematologic disease care and hematopoietic stem cell transplantation and has completed several thousand allogeneic transplants. Her team has built extensive clinical experience in several key areas:
· Assessing transplant indications and choosing the right timing
· Donor selection
· Designing individualized conditioning regimens
· Preventing and managing post-transplant complications
· Post-transplant maintenance therapy
Since 2017, the team has completed nearly 1,500 transplants in patients ranging from 1 to 76 years old.
The team reports comparable outcomes across matched sibling, unrelated-donor, and haploidentical related-donor transplantation. It has also accumulated substantial experience in second allogeneic transplantation, transplantation in older adults, and transplantation for relapsed or refractory hematologic malignancies.
Which Complex Transplant Settings Does the Team Focus On?
CAR-T Bridging to Allogeneic Hematopoietic Stem Cell Transplantation
For some patients with relapsed or refractory acute lymphoblastic leukemia (ALL), whether to proceed to allogeneic HSCT after CAR-T therapy depends on factors such as the depth of remission and the risk of relapse.
The Beijing GoBroad Boren Hospital team has completed CAR-T followed by allogeneic HSCT in more than 300 patients with B-cell acute lymphoblastic leukemia (B-ALL). The reported 3-year overall survival (OS) rate is 74.5%, and the 3-year disease-free survival (DFS) rate is 64.0%.
T-ALL patients have undergone CAR-T followed by allogeneic HSCT in more than 100 cases, with a reported 2-year OS of 60.4% and a 2-year DFS of 60.0%.
These data provide additional clinical evidence supporting the potential for long-term disease-free survival in selected patients with ALL that is resistant to conventional chemotherapy.
Second Allogeneic Hematopoietic Stem Cell Transplantation
A second allogeneic hematopoietic stem cell transplant generally carries higher risks of transplant-related mortality and disease relapse.
Using strategies such as reduced-intensity conditioning (RIC), family-based analysis of inherited susceptibility variants to help optimize donor selection, and post-transplant maintenance therapy, the team reports a 1-year OS of 80.6%, a 1-year DFS of 72.5%, and transplant-related mortality of 2.3% after second allogeneic HSCT.
Salvage Transplantation
For relapsed or refractory acute myeloid leukemia (AML), the team uses individualized conditioning and post-transplant maintenance strategies. The reported 2-year OS and DFS after salvage transplantation are 56.4% and 48.6%, respectively.
For relapsed or refractory NK/T-cell lymphoma treated with an appropriate allogeneic HSCT strategy, the reported 2-year OS and DFS are 57.6% and 52.1%, respectively.
Hematopoietic Stem Cell Transplantation in Older Adults
The team has been performing transplantation in older adults for many years, using individualized reduced-intensity conditioning and post-transplant maintenance to balance treatment effectiveness with safety.
More than 100 older adult patients have undergone transplantation. The reported overall DFS is 65.0%; among patients who were in remission before transplant, DFS is 74.1%.
Which Diseases May Be Considered for Hematopoietic Stem Cell Transplantation?
The transplant program at Beijing GoBroad Boren Hospital mainly covers two broad groups of diseases:
Hematologic Malignancies
Including:
Acute myeloid leukemia (AML)
Acute lymphoblastic leukemia (ALL)
Myelodysplastic syndromes (MDS)
Chronic myeloid leukemia (CML)
Chronic myelomonocytic leukemia (CMML)
Juvenile myelomonocytic leukemia (JMML)
Primary myelofibrosis
B-cell, T-cell, and NK/T-cell lymphomas
Multiple myeloma
Bone Marrow Failure and Immune-Related Disorders
Including:
Acquired and inherited aplastic anemia
Paroxysmal nocturnal hemoglobinuria (PNH)
Hemophagocytic lymphohistiocytosis (HLH)
Chronic active Epstein-Barr virus infection (CAEBV)
Primary immunodeficiency disorders
Whether transplantation is appropriate, when it should be performed, and which transplant approach should be used all require individualized assessment based on the disease type, remission status, age, underlying health conditions, donor availability, and other factors.
What Does “Full-Course” Transplant Management Mean?
Hematopoietic stem cell transplantation is much more than the stem cell infusion itself. To improve transplant outcomes, the Beijing GoBroad Boren Hospital team focuses on four key stages:
Achieving the Best Possible Disease Control Before Transplant
For patients whose disease has responded inadequately to conventional treatment, immunotherapy, targeted therapy, or other approaches may be used according to disease characteristics to achieve a better remission before transplantation and reduce the risk of post-transplant relapse.
Selecting the Most Appropriate Donor for the Individual Patient
The team evaluates both related and unrelated donors using tools that may include family-based analysis of inherited susceptibility variants, with the goal of identifying a donor who is better suited to the individual patient, supporting stable hematopoietic and immune reconstitution and potentially reducing certain complications.
Designing an Individualized Conditioning Regimen
Conditioning is tailored according to factors such as age, disease type, previous treatment, and organ function, with the aim of balancing disease control against treatment-related toxicity.
Continuing Relapse and Complication Management After Transplant
For some patients, individualized maintenance therapy may be needed after transplantation according to relapse risk, with the aim of further reducing the chance of disease recurrence.
At the same time, post-transplant complications such as infection, graft-versus-host disease (GVHD), and transplant-associated thrombotic microangiopathy (TMA) require ongoing monitoring and management.
How Is Precision Monitoring Used Throughout the Transplant Process?
Before transplantation, the team routinely performs pharmacogenomic testing and combines it with therapeutic drug monitoring to support safer and more effective medication planning.
For disease monitoring, methods such as flow cytometry, RT-PCR, next-generation sequencing (NGS), and digital PCR may be used to assess measurable residual disease (MRD), helping the team identify changes early and intervene when needed.
For infection management, NGS-based testing may be used to help identify infectious pathogens and guide subsequent treatment.
For GVHD and other abnormal immune responses, relevant laboratory parameters are assessed to help determine the type and severity of the problem and guide targeted treatment.
In managing post-transplant complications such as GVHD, infection, and TMA, the team emphasizes prevention, early recognition, and timely intervention.
Academic Research: Findings Presented Repeatedly at Major International Hematology Meetings
Research from the Beijing GoBroad Boren Hospital transplant team has been presented more than 40 times as oral presentations or posters at major international hematology and transplantation meetings, including:
Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT)
European Hematology Association (EHA) Congress
American Society of Hematology (ASH) Annual Meeting
Asia-Pacific Blood and Marrow Transplantation Group (APBMT) Annual Congress
The team has published more than 10 studies on topics including B-ALL CAR-T bridging to transplant, long-term follow-up after T-ALL CAR-T bridging to transplant, second allogeneic HSCT, and allogeneic HSCT for relapsed or refractory NK/T-cell lymphoma. Publications have appeared in journals including British Journal of Haematology, Frontiers in Immunology, Frontiers in Oncology, Transplantation and Cellular Therapy, Chinese Journal of Hematology, and Blood Advances.
What Support May Patients Need Beyond the Transplant Itself?
Hematopoietic stem cell transplantation often involves a long period of treatment, recovery, and follow-up. In addition to medical needs, patients and families may also face practical challenges such as donor searches, day-to-day caregiving, children's education, and treatment costs.
Beijing GoBroad Boren Hospital has a Patient Services Department that assists with unrelated-donor searches, HLA-matching coordination, and other transplant-related services.
Dr. Tong WU also holds two free video consultation sessions each month, while the medical and nursing teams provide ongoing information support through online patient education and health-information programs.
For day-to-day support, the hospital's community kitchen and patient-family support services benefit more than 5,000 people each year. The ward school provides nearly 1,000 regular classes annually and has served more than 25,000 pediatric patients in total.
The hospital also works with Beijing Puhui Health Insurance, local inclusive supplementary health-insurance programs in other regions, and multiple commercial insurers to provide additional support for patients and families
From a Single Transplant to Full-Course Management
From age 1 to 76, from first transplant to second transplant, and from CAR-T bridging to transplantation in older adults, the experience gained from nearly 1,500 transplants at Beijing GoBroad Boren Hospital goes beyond technical expertise in the transplant procedure itself.
For patients with complex hematologic diseases, what matters is the entire treatment pathway: when to proceed to transplant, how to control disease beforehand, which donor to choose, what conditioning regimen to use, how to reduce post-transplant relapse and complications, and how to plan long-term follow-up. Together, these steps form full-course hematopoietic stem cell transplant management.
Frequently Asked Questions
Q: Does being older mean I cannot have a hematopoietic stem cell transplant?
Age alone does not determine transplant eligibility. The decision requires an overall assessment of disease status, heart and lung function, other underlying conditions, physical fitness and treatment tolerance, and the expected benefits and risks of transplantation.
At Beijing GoBroad Boren Hospital, transplant patients have ranged in age from 1 to 76 years, and the team has completed more than 100 transplants in older adults.
Q: Do all patients need a hematopoietic stem cell transplant after CAR-T therapy?
No. Not every patient needs to proceed to transplantation after CAR-T.
For some patients with relapsed or refractory acute lymphoblastic leukemia, the decision to bridge from CAR-T to allogeneic HSCT is based on factors such as the depth of remission after CAR-T, the risk of relapse, and previous treatment history.
Q: If the disease relapses after a first transplant, can a second transplant still be considered?
For some patients, a second allogeneic hematopoietic stem cell transplant may be considered after a comprehensive evaluation.
Suitability for a second transplant depends on factors including disease status after the first transplant, the timing of relapse, the patient's overall condition, donor options, and complications from the previous transplant.
Q: What is the single most important part of a hematopoietic stem cell transplant?
There is no single step that determines the outcome on its own.
Disease control before transplant, donor selection, conditioning, and post-transplant management of infection, GVHD, relapse monitoring, and maintenance therapy are all interconnected and require continuous, full-course management.
Q: Is long-term follow-up still needed after hematopoietic stem cell transplantation?
Yes.
Even after transplantation is complete, patients still need ongoing monitoring of the underlying disease, measurable residual disease, donor chimerism, immune recovery, and transplant-related complications such as infection and GVHD. The timing and content of follow-up should be individualized by the treating physician according to the patient's recovery.