Spectrum, pathobiology, mechanistic insights and diagnostic challenges of post-CAR T cell therapy lymphoproliferative disorders

A comprehensive review published in Nature Reviews Clinical Oncology characterizes the spectrum of rare lymphoproliferative and lymphomatous disorders that can arise following chimeric antigen receptor (CAR) T cell therapy. The authors highlight recurrent pathological and molecular features of these post-treatment complications and identify factors that may drive clonal expansion and malignant transformation. Although these secondary disorders remain rare, they have attracted growing regulatory and clinical scrutiny, particularly after FDA safety investigations into T cell malignancies reported in CAR-T recipients. The review proposes a diagnostic and management framework that could help clinicians recognize these complications earlier and intervene more effectively.