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CD4 chimeric antigen receptor natural killer (CAR NK) cells are an allogeneic, "off-the-shelf" cellular immunotherapy designed for the treatment of CD4-positive T-cell malignancies, such as T-cell leukemias and lymphomas (TCL). These cells are engineered from healthy donor peripheral blood natural killer (NK) cells using retroviral transduction to express a second-generation CAR. The CAR construct typically consists of an scFv binding domain derived from the anti-CD4 monoclonal antibody MAX.16H5, a CD28 costimulatory domain, and a CD3ζ signaling domain. A key advantage of using NK cells as effectors is that they do not naturally express CD4, which prevents the effector cell fratricide and product contamination often encountered with CD4-targeted CAR T-cell therapies. Preclinical data indicates that these cells can be expanded efficiently using G-Rex culture systems and exhibit potent cytotoxic activity against a wide range of TCL subtypes, including T-cell acute lymphoblastic leukemia (T-ALL), cutaneous T-cell lymphoma (CTCL), and anaplastic large cell lymphoma (ALCL).
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