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CAR-T CELLS FATE AFTER INFUSION: CELLULAR KINETICS AND MOLECULAR MONITORING.

Luisa Anelli¹, Cosimo Cumbo¹, Angela Minervini²

¹Hematology and Stem Cell Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.

Transplantation and Cellular Therapy

|June 24, 2026

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This summary is machine-generated.

Chimeric antigen receptor (CAR) T-cell therapy shows promise for blood cancers but has variable efficacy and risks. Molecular monitoring is crucial to manage toxicities and potential adverse events like secondary cancers.

Area of Science:

Immunotherapy
Gene Therapy
Hematologic Oncology

Background:

Chimeric antigen receptor (CAR) T-cell therapy genetically modifies T lymphocytes to target specific antigens.
CAR-T therapy has demonstrated success in treating relapsed/refractory B-cell malignancies, with six FDA-approved products.
Despite efficacy, CAR-T therapy is associated with significant toxicities, including cytokine release syndrome and neurological toxicity, limiting its use to advanced-stage patients.

Purpose of the Study:

To review the efficacy and safety of CAR-T cell therapy.
To highlight factors influencing CAR-T cell therapy outcomes.
To focus on molecular monitoring and potential adverse events post-infusion.

Main Methods:

Literature review of CAR-T cell therapy.

Keywords:

CAR-T cells clonal expansion digital PCR kinetics molecular monitoring vector insertion

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Analysis of factors affecting CAR-T cell efficacy and toxicity.

Discussion of molecular monitoring strategies and safety concerns.

Main Results:

CAR-T cell therapy efficacy is variable, with relapse rates of 30-50% observed.
Factors influencing outcomes include CAR construct, manufacturing, infusion parameters, T-cell quality, and tumor burden.
Potential uncontrolled events include insertional mutagenesis, clonal T-cell expansion, and secondary T-cell lymphomas.

Conclusions:

CAR-T cell therapy requires careful patient selection due to associated toxicities and variable efficacy.
Molecular monitoring is essential for managing CAR-T cell therapy and detecting adverse events.
Further research is needed to optimize CAR-T cell therapy and mitigate risks for improved patient outcomes.