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CD33-BBz CAR T refers to a second-generation chimeric antigen receptor (CAR) T-cell therapy designed to target CD33 (Siglec-3), a surface antigen expressed on approximately 90% of acute myeloid leukemia (AML) blasts. The construct typically incorporates a CD33-specific single-chain variable fragment (scFv) linked to a 4-1BB (CD137) costimulatory domain and a CD3ζ signaling endodomain. This architecture is intended to enhance T-cell activation, metabolic fitness, and persistence compared to first-generation or CD28-based constructs. While these therapies have shown potent antileukemic activity in preclinical models, early-phase clinical trials in adult patients with relapsed or refractory AML have reported limited efficacy and transient persistence. Research is ongoing to optimize this platform, including the development of adjunctive signaling modifications like the ALA-CART platform to improve metabolic resiliency and clinical outcomes.
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