Abstract IA001: T-cell lymphomas after CAR-T

Abstract

Chimeric antigen receptor–modified T-cell (CAR-T) therapy has transformed the management of relapsed or refractory lymphoid and plasma cell malignancies. However, its curative potential is limited by well-described toxicities, including cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. More recently, the development of T-cell lymphomas following CAR-T therapy has emerged as a rare (<1% of recipients) but serious complication. This risk appears particularly alarming in cases in which the CAR construct is expressed by malignant T-cell clones, indicating a contributory role of genetic modification in lymphomagenesis. Over the past decade, the number of patients treated with commercially approved CAR-T therapies has increased exponentially, from a few hundred annually to more than 6,000 per year by 2025. Moreover, ongoing efforts to extend CAR-T therapies to solid tumors and autoimmune diseases are expected to substantially expand the treated population, thereby increasing the absolute number of CAR-T–associated T-cell lymphomas. This presentation aims to review the diagnostic criteria, clinical features, molecular drivers, and emerging strategies to manage and mitigate CAR-T–related T-cell lymphomas.