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CAR-NK-CD19 is a chimeric antigen receptor-natural killer cell (CAR-NK) therapy genetically engineered to target CD19, a surface antigen found on nearly all B-cell malignancies. In CAR-NK therapies, NK cells are modified to express a CAR, typically containing an extracellular single-chain antibody fragment (scFv) specific for CD19, a spacer, a transmembrane domain, and NK-cell appropriate activation domains (such as DAP10 or DAP12 rather than only T-cell signaling domains). Some constructs also include membrane-bound IL-15 to support cell proliferation, persistence, and anti-tumor activity. These cells are derived from healthy donors, umbilical cord blood, or induced pluripotent stem cells, and administered to patients as an allogeneic, "off-the-shelf" product without the need for HLA matching. The main therapeutic indication is relapsed/refractory CD19-positive B-cell malignancies, such as non-Hodgkin lymphoma, chronic lymphocytic leukemia, and acute lymphoblastic leukemia, with additional efforts in other B-cell cancers. The primary mechanism is targeted lysis of CD19-expressing tumor cells via NK cell cytotoxicity and enhanced immunologic anti-tumor responses. Clinical studies demonstrate promising efficacy and safety, with lower risks of cytokine release syndrome and neurotoxicity compared to CAR-T cell therapies[1][2][3][5][7][9][10].
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