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CD33 CAR-iNK cells are an experimental adoptive cell therapy consisting of natural killer (NK) cells derived from human pluripotent stem cells (hPSCs) or induced pluripotent stem cells (iPSCs) that have been genetically engineered to express a chimeric antigen receptor (CAR) targeting the CD33 antigen. CD33 is a myeloid-specific transmembrane protein highly expressed on the surface of leukemic blasts in the majority of patients with acute myeloid leukemia (AML), while being absent from normal hematopoietic stem cells. The use of an hPSC-derived (iNK) platform allows for the production of a homogeneous, scalable, and "off-the-shelf" therapeutic product, potentially overcoming the variability and logistical challenges associated with primary donor-derived NK cells. A primary hurdle for CD33-targeted NK therapies is "fratricide," a process where the CAR-NK cells eliminate each other due to the endogenous expression of CD33 on the NK cells themselves, which is often upregulated during expansion. In preclinical research, these cells serve as a benchmark for evaluating more advanced iterations, such as CD33-knockout (CD33KO) iNK cells or dual-targeting "Loop CAR" designs (e.g., CD33-MSLN), which are engineered to overcome fratricide and improve anti-leukemic persistence and efficacy.
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