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CD33-specific CAR-T cells are an investigational class of chimeric antigen receptor (CAR) T-cell therapies designed to target CD33 (also known as Siglec-3), a transmembrane protein predominantly expressed on the surface of acute myeloid leukemia (AML) cells and leukemic stem cells. These therapies involve engineering a patient's or donor's T cells to express a CAR that recognizes the CD33 antigen, leading to T-cell activation and the subsequent lysis of CD33-positive tumor cells. Various iterations of this technology are under development, including those utilizing single-domain antibodies (nanobodies), rapamycin-regulated dimerization systems (e.g., DARIC33), and different costimulatory domains (CD28 or 4-1BB) to optimize efficacy and safety. A major challenge in the development of CD33-targeted CAR-T cells is the potential for on-target, off-tumor toxicity against normal hematopoietic progenitor cells, which also express CD33.
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