On the CHOPping block? Rethinking initial therapy for PMBCL

including logistical barriers to suitable donor identification, short remission duration in the absence of subsequent HCT, and undue risk for late and serious toxicities.Further research is required to establish CD7 CAR-T as a stand-alone, safe, and curative cellular therapy for T-ALL.Accordingly, the field is rapidly advancing to meet this challenge.Reports of base editing of allogeneic CD7 CARs to eliminate TRBC, CD7, and CD52 5 ; autologous CD7 CARs modified to block CD7 protein expression and downregulate CD7 6 ; and off-the-shelf CD7 CARs using CRSPR-Cas9 editing to delete CD7 and TRAC 4 have all shown promising results.In addition, ongoing early-phase investigations are exploring CAR-T directed against other T-cell antigens such as CD1a, CD2, CD5, and CD21, offering promising avenues for the treatment of patients who relapse after CD7-directed therapy.The advent of CD7 CAR-T has generated long-awaited enthusiasm for extending cellular therapy to patients with T-ALL/ LBL.However, cellular immunotherapy for T-ALL still lags far behind the incredible progress observed in B-ALL.Future efforts can improve outcomes by focusing on extending durability, reducing toxicity, and addressing CD7-negative relapses, an increasingly recognized mechanism of CD7 CAR resistance.