From Palliative Care to a Second Chance at Life:
A Pakistani Lymphoma Patient's CAR-T Journey to China

For 36-year-old Muhammad ZAKRIA, the word "health" had become an unreachable luxury over the past few years. Muhammad is from Quetta, a city in southwestern Pakistan known as the "Fruit Garden." He worked as a logistics staff member at a local public hospital.

In 2021, a diagnosis changed his life completely — Muhammad was diagnosed with diffuse large B-cell lymphoma (DLBCL), an aggressive type of blood cancer. In the years that followed, he endured multiple rounds of chemotherapy, suffering through pain that most could scarcely imagine.

In 2024, Muhammad underwent a bone marrow transplant at Aga Khan Hospital in his home country. He pinned all his hopes on the procedure, believing that life would gradually return to normal after surgery. But fate delivered its cruelest blow — just 20 days later, the cancer relapsed.

"At that moment, it was not just a physical setback — it was the complete collapse of hope. The only option left in Pakistan was palliative care — using medication only to ease the pain, with no curative intent."

A Glimmer of Light in Despair

His attending doctor was clear:

"We can do no more. You need to seek medical treatment abroad. We can prepare a referral letter, but you must find a hospital yourself."

After obtaining official approval from the Pakistan National Medical Commission, Muhammad, with a sliver of hope, began his cross-border medical journey.

The destinations he researched spanned half the globe — Germany, Singapore, Austria, India, the United States, and Australia. Every inquiry email he sent was like a message in a bottle, not knowing who would see it, when they would reply, or what they would say.

"The hospitals in Germany replied very slowly. The treatment plans from Singapore and India were not clear. But one hospital replied quickly, communicated efficiently, and even provided preliminary treatment recommendations — it was Jiahui International Hospital in Shanghai."
— Muhammad recalls

Driven by urgency and his positive first impression of Jiahui, he made his decision quickly.

In early 2026, 36-year-old Muhammad, exhausted and in pain, arrived in Shanghai with his family by his side.

Receiving CAR-T Therapy at Jiahui

Upon admission, examination results confirmed the severity of his condition. He was diagnosed with Stage 4B lymphoma, with cancer cells spread to his lungs, pleura, and bones. Because the relapse occurred only 20 days after transplant, his cancer was definitively classified as "relapsed/refractory" — no longer sensitive to conventional treatments.

Adding to the challenge, the massive tumor was pressing against his lungs and bones. The pain kept Muhammad awake at night; only high-dose painkillers and multiple strong analgesics could bring him fleeting relief. He also suffered from frequent high fevers, night sweats, and weight loss.

Fortunately, Muhammad had come to a country that is now a global leader in CAR-T therapy. According to a recent article in the authoritative journal Frontiers in Pharmacology, China has led the world in the CAR-T field since 2016. As of October 2025, China ranks first globally in the number of clinical trials in this field. China also has the second-most approved CAR-T products worldwide, after only the United States.【1】

Another study notes that China's domestically developed CAR-T therapies have achieved internationally competitive clinical outcomes in hematologic cancers. Since 2021, four Chinese-developed CAR-T products have been approved for marketing, used in the treatment of lymphoma and myeloma, with efficacy reaching global standards.【2】

A Personalized Treatment Plan

In early April, Muhammad began several weeks of CAR-T treatment at the Jiahui International Cancer Center: from collecting his own T cells, to bridging therapy to control the tumor, to lymphodepleting chemotherapy, and finally CAR-T cell reinfusion.

Dr. Hao Siguo (郝思国), Chief Hematologist at Jiahui, specially designed Muhammad's CAR-T treatment plan based on his tumor burden, using chemotherapy + local radiation as bridging therapy to shrink the tumor before reinfusion and effectively control reinfusion risks.

Encouraging Results

In early May, preliminary PET-CT scans showed encouraging treatment effects — lymph node lesions had shrunk, and the tumor marker lactate dehydrogenase (LDH) had normalized.

Beyond the numbers, the excruciating pain that Muhammad had struggled to endure was significantly relieved. At admission, he needed high-dose painkillers and multiple sedatives just to manage the pain. At discharge, he only needed to take two or three low-dose painkiller tablets every 12 hours, with no "breakthrough pain" episodes.

"I have confidence!" — Muhammad, in the CAR-T dedicated isolation ward

Given that Muhammad's visa was about to expire, the oncology team also developed a one-year follow-up plan and subsequent medication recommendations, so that he could continue monitoring his condition and taking the correct medications after returning to Pakistan.

Communication Beyond Language, Care Beyond Culture

Throughout the treatment process, physical pain was only part of the challenge. The greater obstacle was communication difficulties caused by language barriers.

Muhammad's native language is Urdu, and his English proficiency is limited. Yet English was the only language he could use to communicate with doctors. The entire treatment process involved a large number of English medical terms, which often left him confused. Even subtle physical sensations were difficult for the patient to convey accurately.

"Communication was the biggest difficulty. Often, after we finished speaking, he was completely lost — the information gap was enormous."
— Dr. Dong Yan, attending physician

But the Jiahui team did not let language become a barrier to treatment. Doctors used translation software to convert every important sentence into Urdu. When the translator could not fully resolve the issue, doctors even resorted to the most primitive communication methods — hand gestures, eye contact, and repeated confirmation. Furthermore, all important medical orders, treatment plans, and precautions were compiled into written text, so that Muhammad could translate them himself using a translator.

Halal Meals with Care

If communication gaps could be bridged through effort, dietary requirements — dictated by the patient's religious beliefs — allowed no room for error.

Muhammad made it clear from the beginning that he hoped the hospital would provide food using dry cooking methods, presented with the best possible taste. To meet this need, the restaurant team specially customized Halal meals for him.

Fortunately, Muhammad maintained a good appetite throughout his hospital stay and insisted on eating six eggs every day — which undoubtedly pressed the "accelerator" on his recovery.

A Precious Bag of Memories

On May 8, Muhammad boarded his flight home.

Although this overseas medical journey was not without its challenges, what comforted him was not only the treatment's effectiveness and the significantly reduced pain, but also the countless moments of inclusion, understanding, and encouragement.

Every kind smile, every carefully prepared Halal meal, every repeated confirmation through the translator, and the body-language interactions beyond the translator — these sincere and simple connections ultimately bridged the language gap.

Perhaps these precious moments themselves are part of the healing.

"After returning home, I will follow the plan the Jiahui doctors gave me for follow-up and recovery. Once I've fully recovered, I'll go back to work. I hope everything goes well.
Inshallah — as God wills it."
— Muhammad ZAKRIA

---

References

[1] Wang M, et al. Global panoramic analysis of clinical research in cell therapy: clinical trial landscape, marketed products, and regulatory trends. Frontiers in Pharmacology. vol. 17, 2026.

[2] Yan, L., et al. CAR-T cell therapy in China: innovations, challenges, and strategic pathways. Discover Oncology 16, 1593, 2025.