Isolated oral CD30⁺/CD4⁺ CAR⁺ T cell lymphoma in long-term remission after radiotherapy

A chimeric antigen receptor (CAR)⁺ CD30⁺/CD4⁺ T cell lymphoma (TCL) manifested as a single oral ulceration 22 months after treatment with tisagenlecleucel (tisa-cel), an anti-CD19 CAR T cell-based therapy. The TCL showed lentiviral integration in ANKHD1-EIF4EBP3, loss of function of TET2, and NTRK1 copy number gain, suggesting that genetic alterations unrelated to insertional mutagenesis contributed to lymphomagenesis. The patient remains in remission 2 years after radiotherapy. This is the only CAR⁺TCL case reported at the Ohio State University James Comprehensive Cancer Center out of 288 patients treated with CAR-T cells.