CD19 CAR T-cell therapy is feasible for patients with pemphigus vulgaris treated without lymphodepletion in the RESET-PV trial.

CD19 CAR T-cell therapy without lymphodepletion shows promising safety and efficacy in pemphigus vulgaris patients, with significant disease improvement in all four cases.

• Why it matters: Lymphodepleting preconditioning is typically necessary for CAR T-cell therapy effectiveness, but its role in autoimmune diseases remains uncertain, prompting exploration of less intensive approaches.
• What they did: The study involved four pemphigus vulgaris patients receiving fully human CD19 CAR T-cells (rese-cel) without lymphodepletion, monitoring safety, disease activity, and immune responses.
• The result: All patients experienced B-cell depletion and disease improvement, with minimal adverse effects, indicating that lymphodepletion may not be essential for CAR T-cell efficacy in autoimmune conditions.