CAR transgenic T-cell lymphoproliferative neoplasm: malignant transformation of cellular immunotherapy.

CAR transgene-bearing T-cell lymphoproliferative neoplasms are a rare but serious genomic safety signal after CAR-T therapy, linked to a multistep emergence model.

• Why it matters: As engineered T-cells expand in hematooncology, rare malignant transformations involving CAR transgenes create a need for clearer diagnostics and surveillance strategies.
• What they did: The authors review reported CAR-transgenic T-cell lymphoproliferative neoplasms cases and propose practical diagnostic criteria plus a proportionate genomic surveillance framework.
• The result: The proposed approach aims to standardize detection and monitoring, reflecting contributions from factors such as clonal fitness, vector integration, construct biology, and post-infusion selection.

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