A New Start After Leukemia Relapse: CAR-T Followed by Transplant, and Five Years Later, Back to a Bright Teenage Life

Article summary: Xixi (pseudonym) was diagnosed with B-cell acute lymphoblastic leukemia at age 6 in 2017 and was able to return to everyday life after treatment. Three years later, however, the leukemia relapsed with central nervous system (CNS) involvement. In 2020, after a recommendation from another patient family, Xixi and her parents traveled to Beijing GoBroad Boren Hospital. Under the close care of the teams led by Dr. Tong WU and Dr. Yanzhi SONG, she achieved remission with CD19 CAR-T cell therapy and then underwent a related-donor haploidentical hematopoietic stem cell transplant. Over the five years that followed, she faced infections, graft-versus-host disease (GVHD), and other challenges, gradually recovering with the support of her medical team and family. Today, at 15, she has successfully completed her five-year post-transplant evaluation. Her bone marrow remains in remission and donor chimerism remains at 100%. The little girl who once battled leukemia has grown into a quiet, confident teenager looking ahead with hope.

In 2017, when Xixi was only 6, she was diagnosed with B-cell acute lymphoblastic leukemia. After treatment at another hospital, she briefly returned to normal life, only for the disease to relapse three years later. In November 2020, on the recommendation of another family from their hometown, Xixi and her parents came to Beijing GoBroad Boren Hospital. With treatment from the teams led by Dr. Tong WU and Dr. Yanzhi SONG, she successfully underwent a related-donor haploidentical hematopoietic stem cell transplant. Now, five years after transplant, her comprehensive follow-up results are reassuring: her bone marrow remains in remission and donor chimerism is still 100%. Over a nine-year leukemia journey, the little girl who once had bleeding spots all over her legs has grown into a calm, cheerful, and hopeful teenager.

Photo from Xixi's five-year post-transplant follow-up

A Few Tiny Red Spots Marked the Start of a Life-Changing Journey

In 2017, my daughter Xixi was 6 years old and still in kindergarten. One day, I noticed a few small red spots on her legs. They didn't hurt or itch, so I assumed it was a simple skin allergy and took her to a dermatologist for some ointment. The spots faded after a few days, and I felt relieved. I had no idea that this was the beginning of something much more serious.

That March, a few days after we took her to a hot spring, the red spots appeared again - this time with nosebleeds. My heart sank, and I took her to see a doctor right away. As soon as the blood test results came back, the doctor became very serious and told us to take her to a major hospital as soon as possible.

At a hospital in Kunming, MICM testing soon confirmed that Xixi had B-cell acute lymphoblastic leukemia, classified as intermediate risk. Hearing the diagnosis felt like being struck by lightning. Leukemia was something I had only ever heard about on television. I couldn't understand how it had suddenly happened to my little girl.

Chemotherapy was incredibly hard on her. Xixi had severe nausea and vomiting and could barely eat. But she was far more resilient than I had imagined. She quietly endured each treatment without crying or complaining and cooperated with everything the doctors asked of her. Watching such a young child be so brave broke my heart, but I kept telling myself that the hardest days would eventually pass.

She made it through 12 courses of chemotherapy, one after another. During the next three years of maintenance therapy, she was eating and sleeping well and remained stable. For a while, I truly believed the storm had passed and our lives were finally getting back on track.

Relapse Changes Everything: Traveling to Beijing for Another Chance

But the disease returned. In May 2020, a routine bone marrow examination brought devastating news: MRD was 25.63%. My daughter's leukemia had relapsed.

I didn't want to believe it. We held on until another evaluation that October, but the result was even harder to hear: hematologic relapse. Her treating doctor told us that conventional chemotherapy was unlikely to offer much benefit at that point and recommended CAR-T therapy. But CAR-T was not yet well established at the hospital where she was being treated, and we had no idea what to do next.

When our family felt completely lost, a phone call from another patient family from our hometown gave us a new direction. Their child also had B-ALL and had successfully undergone transplantation at Beijing GoBroad Boren Hospital. They told us the specialists there had extensive experience and encouraged us to go and seek another opinion.

In November 2020, carrying all of our hope and anxiety with us, we boarded a flight to Beijing to look for another chance for our daughter.

CAR-T Followed by Transplant: A New Path Forward

After arriving at Beijing GoBroad Boren Hospital, the immunotherapy team carried out a comprehensive assessment. The results were difficult to take in: Xixi had an overt leukemia relapse, a high disease burden, and CNS involvement. With concurrent leukoencephalopathy, she needed repeated lumbar punctures every other day for a period of time. She gritted her teeth and cooperated each time. Standing beside her, I could only wish I could take some of that pain for her.

On November 17, 2020, Xixi received an infusion of CD19 CAR-T cells and achieved sustained bone marrow remission. Before we could fully relax, the medical team explained that because her leukemia burden had been so high, proceeding to transplantation promptly would offer the best chance of consolidating the response and reducing the risk of the disease returning.

We had originally come to Boren for CAR-T and had never expected transplantation to be the next step. But at that point, we didn't hesitate. We had chosen to trust the team. I told the doctor, "We're not going anywhere else. We want to continue her treatment here."

Dr. Tong WU's transplant team soon developed an individualized plan for Xixi, using a TBI-based myeloablative conditioning regimen and selecting her father as the related haploidentical donor. In mid-to-late December 2020, she began pre-transplant conditioning. I still remember watching her small figure enter the transplant unit. She wasn't even 10 years old and had to face so much on her own. In early January 2021, she received her father's hematopoietic stem cells in two infusions. With close care from the transplant team, platelet engraftment was achieved on day +13 and white blood cell engraftment on day +15. She had made it through another major milestone.

After leaving protective isolation, skin GVHD, diarrhea, and a pulmonary infection followed one after another. Dr. WU's team adjusted treatment carefully and managed each complication as it arose. Eventually, Xixi's clinical indicators stabilized and she was discharged, continuing regular medications and scheduled follow-up visits.

For the most part, Xixi remained stable afterward. The most frightening episode came at the end of 2022, when a viral infection left her with profound weakness in her arms and legs and her condition became critical. Once again, the medical team treated her intensively and helped her through the crisis. Each time she recovered from a setback, our trust in the team grew stronger.

When we were treated in Yunnan, we rarely had much opportunity to communicate directly with the doctors, let alone stay in touch after leaving the hospital. At Boren, the experience felt very different. Dr. Tong WU was thorough during every ward round and patient whenever we asked questions. Dr. Yanzhi SONG was equally attentive; even after we went home, she would message us to ask how Xixi was doing and remind us about follow-up visits and medications. Once, after returning from a business trip, Dr. Qi Wang brought Xixi a Frozen doll. She was so happy and still treasures it today.

Xixi often says, "Dr. Wu, Dr. Song, and everyone here are so gentle." Whenever she felt frightened during treatment, the doctors and nurses would speak softly to her, encourage her, and tell her what a brave little fighter she was.

Ms. Xinxin, a teacher at the ward school, organized crafts and activities for the children every week. Xixi loved going while she was in the hospital and still remembers those classes fondly.

Treating our daughter had used up nearly all of our family's savings. The hospital proactively helped us apply for financial assistance for major illness, which came at a time when we desperately needed it. Xiaobai Chuntian, a patient-family support charity, also provided practical help and a warm community for families going through treatment.

Those small acts of kindness and steady support meant that our nine-year leukemia journey was not defined only by pain and uncertainty. They also gave us the strength and hope to keep going.

Five Years After Transplant: A Milestone Worth Celebrating

Xixi is 15 now, almost as tall as I am. The fragile little girl I remember has grown into a calm, bright teenager. She loves quietly working on crafts and sometimes shares small moments from her everyday life on social media, one post at a time. Things that once felt impossibly far away have now become ordinary parts of her life - and that makes them all the more precious.

Her five-year post-transplant evaluation brought the news we had been hoping for: all of her results met the expected targets. She had passed this major five-year milestone. I asked what she wanted to say to her doctors. She didn't use many words. She simply looked at me and said sincerely, "Thank you for taking care of me all these years - and most of all, thank you for giving me a second chance at life."

From 2017 to 2026, nine full years and more than 3,000 days have passed. Only our family truly knows how much fear, exhaustion, disappointment, and hope were packed into that time. But if I could pass one thing on to families who are still going through leukemia treatment, it would be this: please keep going. The nights that feel endless and the challenges that seem impossible will eventually pass, and there can still be light ahead.

My greatest wish for the years ahead is that Xixi can finally set aside the identity of a "leukemia fighter" and simply live like other girls her age - return to school, make friends who share her interests, pursue the things she loves, and experience all the ordinary joys of being a teenager. I hope life is gentler with her from here on, and that she can keep growing toward the light.