Updated: Oct 15
Medically reviewed by ChinaCureLink Team
Table of Content
Why This Case Matters
At 19, Ayan (alias) was a Pakistani student whose plans for a career in medical science had already been interrupted by leukemia. When his B-cell acute lymphoblastic leukemia relapsed and continued progressing despite chemotherapy in Pakistan, his family looked overseas for another treatment option. They ultimately traveled to China, where a treatment strategy combining dual-target CAR-T therapy with a subsequent stem cell transplant brought his leukemia into remission and allowed him to proceed to potentially curative consolidation.
For international patients with relapsed or refractory B-cell acute lymphoblastic leukemia, ChinaCureLink can help coordinate a specialist case review, identify appropriate treatment options in China, and manage the practical steps involved in traveling for advanced hematology treatment.
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Patient Background
Ayan(alias) was studying Medical Science in Pakistan when he was diagnosed with acute B-cell lymphoblastic leukemia in May 2014. His illness forced him to put his education on hold while he underwent treatment locally for more than two years.
In January 2018, the disease returned. He developed widespread bone pain, and bone marrow evaluation confirmed that his leukemia had relapsed. Further chemotherapy in Pakistan failed to control the disease, and his local doctors had few remaining options.
His family began researching treatment centers abroad. Through online consultations, they learned about advanced CAR-T treatment available in China. They were particularly encouraged after learning about another Pakistani patient with relapsed B-ALL who had undergone CAR-T treatment in China earlier that year and subsequently proceeded to stem cell transplantation.
That experience gave the family a reason to pursue treatment overseas.
The Care Team and Approach
Ayan arrived in China with his family on March 26, 2018, and was admitted for evaluation and treatment at a top hematology hospital in China.
His case was assessed by Dr. Daniel Qian (pseudonym), Dr. Maya Yang (pseudonym), and their clinical team. Testing showed that his bone marrow tumor burden was exceptionally high at 69%. He also had a fungal infection affecting his lungs.
Before CAR-T treatment could proceed, the infection needed to be brought under control. The medical team treated the infection and stabilized his condition, creating a safer window for cellular therapy.
On April 24, he received CD19+CD22+ dual-target CAR-T cells. Rather than targeting only one leukemia-associated antigen, this approach directed CAR-T cells against both CD19 and CD22 on the malignant B cells.
Two weeks after the infusion, bone marrow assessment found zero detectable tumor cells, marking a major response to the CAR-T treatment.
The treatment strategy did not end with CAR-T. Because CAR-T-induced remission was intended to provide a bridge to longer-term disease control, the team planned an allogeneic hematopoietic stem cell transplant.
On June 25, Dr. Lucas Lu (pseudonym) and Dr. Felix Xu (pseudonym) led the transplant team in performing an allogeneic hematopoietic stem cell transplant using Ayan's brother as the donor.
The donor's peripheral blood stem cells were infused on July 6. By day +17, his white blood cells had engrafted sufficiently for him to leave the protective isolation environment. On day +24, testing showed complete donor chimerism and negative measurable residual disease.
Treatment Timeline/ Process
In Pakistan
May 2014: Diagnosed with acute B-cell lymphoblastic leukemia while studying Medical Science.
Underwent more than two years of treatment in Pakistan.
January 2018: Developed widespread bone pain and was found to have relapsed leukemia.
Received additional chemotherapy, but the disease continued to progress.
His family began exploring advanced treatment options overseas.
In China — CAR-T Treatment
March 26, 2018: Traveled to China with his family and was admitted for specialist evaluation.
Testing showed a 69% bone marrow tumor burden.
A concurrent fungal lung infection was identified and treated until his condition stabilized.
April 24, 2018: Received CD19+CD22+ dual-target CAR-T cell therapy.
Two weeks later: Bone marrow evaluation showed zero detectable leukemia cells.
In China — Stem Cell Transplant
June 25, 2018: Underwent allogeneic hematopoietic stem cell transplantation using his brother as the donor.
July 6, 2018: Received the donor's peripheral blood stem cells.
Day +17: White blood cell engraftment was achieved and he was transferred out of the protective isolation ward.
Day +24: Bone marrow testing showed complete donor chimerism and negative measurable residual disease.
August 6, 2018: Discharged from hospital for outpatient follow-up.
Outcome
Ayan's treatment produced a rapid response to CAR-T therapy. Two weeks after receiving the CD19+CD22+ CAR-T cells, his bone marrow contained zero detectable tumor cells.
That response allowed the treatment team to move forward with allogeneic stem cell transplantation using his brother as the donor. Following transplant, his white blood cells successfully engrafted, testing showed complete donor chimerism, and measurable residual disease was negative.
He was discharged on August 6, 2018, after nearly six months of treatment in China and continued outpatient follow-up.
His case demonstrates the role CAR-T therapy can play as a bridge to allogeneic transplantation in selected patients with relapsed B-cell acute lymphoblastic leukemia. Modern research has also supported dual CD19/CD22 targeting as an approach designed to address one of the challenges of CAR-T therapy: leukemia cells can sometimes lose the antigen targeted by treatment.
How ChinaCureLink Can Help International Patients to Access This Treatment
For international patients with relapsed or refractory B-cell acute lymphoblastic leukemia, ChinaCureLink can coordinate the process of seeking advanced treatment in China.
The process can begin with a review of the patient's medical records, pathology, bone marrow results, previous treatment history, and current condition. ChinaCureLink then helps identify an appropriate specialist team and coordinate hospital admission, treatment scheduling, translation, accommodation, and other logistics involved in receiving care overseas.
For patients who have exhausted conventional chemotherapy options, a specialist assessment can determine whether approaches such as CAR-T therapy, stem cell transplantation, or a combination of treatments may be appropriate.
Get a Second Opinion Before Fly to China
For suitable cases, ChinaCureLink can then coordinate an online consultation with the specialist to discuss the technical treatment details directly. The purpose is to help the patient understand which treatment option and which specialist center may be most appropriate before making an international treatment decision.
What Patients Say About ChinaCureLink & Medebound HEALTH
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Frequently Asked Questions
Can a patient with relapsed B-cell ALL travel to China for CAR-T treatment?
Potential eligibility depends on the leukemia subtype, antigen expression, previous treatments, disease burden, current health, infections, and the specific treatment program available. International patients can submit their medical records for specialist assessment before traveling.
Can CAR-T therapy be followed by a stem cell transplant for relapsed B-ALL?
In selected patients, CAR-T therapy can produce a remission that creates an opportunity for subsequent allogeneic hematopoietic stem cell transplantation. Whether transplantation is appropriate depends on the patient's response, overall condition, donor availability, and treating team's assessment.
How can a Pakistani leukemia patient arrange treatment in China?
The process typically starts with a medical record review, including pathology, bone marrow reports, imaging, previous chemotherapy records, and current laboratory results. ChinaCureLink can coordinate specialist review, hospital matching, treatment planning, travel arrangements, and ongoing communication with the treating team.
About ChinaCureLink
ChinaCureLink helps patients across the world access the best cancer treatment at China's top hospitals, without the delays, language barriers, and administrative confusion that typically come with seeking care abroad.
We connect patients directly with China's top cancer hospitals, ensuring that from the first case submission through to treatment and follow-up, every step is guided, translated, and coordinated by a team experienced in cross-border patient care.
ChinaCureLink is proudly affiliated with Medebound HEALTH — founded by US physicians, with over 10 years of experience and more than 3,000 patients served worldwide, Medebound HEALTH is recognized by Forbes and it is one of the most trusted patient cross-border concierge service company across North America and the Asia Pacific.
Disclaimer
This account reflects one patient's individual experience, which will vary by case, diagnosis stage, and other clinical factors. ChinaCureLink facilitates access to hospitals and treatment coordination — we do not provide medical care ourselves, and this content is not medical advice. Patients and families should consult a qualified hematologist-oncologist before making treatment decisions.
