CD19-directed chimeric antigen receptor (CAR) T cell therapy can produce durable remission in patients with lymphoma, but persistent hematological toxicities remain poorly understood. We show that clonal expansion of mutated hematopoietic clones (clonal hematopoiesis) in an inflamed bone marrow environment is linked to prolonged cytopenias, impaired immune recovery and treatment-related myeloid malignancies.
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References
Schuster, S. J. et al. Chimeric antigen receptor T cells in refractory B-cell lymphomas. N. Engl. J. Med. 380, 45–56 (2019). A landmark clinical study demonstrating the efficacy of CAR19 therapy in relapsed and refractory large B cell lymphoma.
Rejeski, K. & Hudecek, M. Hematotoxicity of CAR T-cell therapy: mechanisms, ma...