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CART-CD123 is a chimeric antigen receptor (CAR) T-cell therapy engineered to target CD123 (interleukin-3 receptor alpha chain), an antigen highly expressed on the surface of leukemic blasts and leukemic stem cells in acute myeloid leukemia (AML) and blastic plasmacytoid dendritic cell neoplasm (BPDCN). The therapy involves the genetic modification of a patient's T cells to express a CAR comprising an anti-CD123 single-chain variable fragment (scFv) fused to intracellular signaling domains, typically including CD3-zeta and a costimulatory molecule such as 4-1BB (CD137) or CD28. Upon re-infusion, these engineered cells recognize and bind to CD123-expressing cells, leading to T-cell activation, expansion, and targeted cytotoxicity. While CART-CD123 has shown potent anti-leukemic activity in preclinical and early clinical studies, its development faces challenges regarding 'on-target, off-tumor' toxicity, as CD123 is also expressed on normal hematopoietic stem and progenitor cells, potentially necessitating the use of safety switches or subsequent hematopoietic stem cell transplantation.
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