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This therapy is a combination of two advanced cellular treatments used primarily for certain cancers and, more recently, autoimmune diseases. The first component, autologous hematopoietic stem cell transplantation (auto-HSCT), involves collecting a patient's own blood-forming stem cells, administering high-dose chemotherapy to eradicate diseased or malignant cells, and then reinfusing the harvested stem cells to restore bone marrow function. The second component is CD19 chimeric antigen receptor T-cell (CAR-T) therapy. In this approach, T-cells are collected from the patient and genetically engineered in the laboratory to express a synthetic receptor (CAR) that specifically targets the CD19 antigen found on B-cells. These modified T-cells are expanded in number and infused back into the patient where they seek out and destroy CD19-expressing malignant or autoreactive B-cells through direct cytotoxicity (via perforin/granzyme release), cytokine secretion (e.g., IL-2, IFN-γ), Fas/FasL-mediated apoptosis pathways, and other immune mechanisms[1][4][5]. This combination aims to achieve deep depletion of pathogenic B-cells while reconstituting healthy hematopoiesis[6][8]. It has been investigated for relapsed/refractory B-cell lymphomas as well as severe autoimmune diseases.
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