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CD19-CD28 chimeric antigen receptor T cells (also known as CD19.28.z CAR-T cells) are an investigational autologous cell therapy developed by Baylor College of Medicine for the treatment of B-cell malignancies, specifically non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). The therapy involves genetically modifying a patient's own T cells to express a second-generation chimeric antigen receptor (CAR). This CAR consists of an extracellular single-chain variable fragment (scFv) derived from an anti-CD19 antibody, a CD28 transmembrane and costimulatory domain, and a CD3-zeta intracellular signaling domain. Upon re-infusion, these engineered T cells recognize and bind to the CD19 antigen on the surface of malignant B cells, triggering T-cell activation, proliferation, and targeted cytotoxicity. In the ATECRAB clinical trial context, these cells were evaluated to determine safety and efficacy, often in comparison with EBV-specific T cells modified with the same CAR construct to explore the impact of viral-specific memory on CAR-T persistence.
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