Decoding Post-CD7 CAR-T EBV-Positive Lymphoproliferative Disorder: Insights from Multi-Omics and Spatial Profiling

Highlight

• Post-CD7 CAR-T therapy lymphoproliferative disorder (PCLD) is characterized by CD7-negative dysfunctional T cells and emergence of EBV-positive B cell proliferation.
• Spatial multi-omics identify immunosuppressive macrophage populations expressing IDO1 that form niches limiting effective T-cell infiltration in PCLD.
• EBV-driven B cells in PCLD acquire plasmacytic features with ongoing proliferation, remodeling the local microenvironment favoring malignant transformation.
• The study elucidates mechanisms underpinning EBV reactivation and lymphoproliferation after CD7 CAR-T, suggesting therapeutic avenues targeting macrophage suppression and inhibitory pathways.

Study Background