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CD19-targeted chimeric antigen receptor-modified T (CAR-T) cell therapy is a revolutionary immunotherapy for relapsed or refractory B-cell acute lymphoblastic leukemia (r/r B-ALL), with 60%–80% response rates [ 1 ]. However, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) remain life-threatening toxicities in CAR-T therapy, constraining its wider clinical adoption [ 1 , 2 , 3 ]. In the ZUMA-3 study of KTE-X19 for r/r B-ALL, 93% of patients developed CRS, with 31% graded ≥3, and 78% developed ICANS, with 38% being grade 3 or worse [ 1 ].
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Xue et al. (2025) studied this question.
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