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While there is intense interest in the production of allogeneic CAR‐T cells from umbilical cord units, little is known about the reactivity and persistence of CAR‐T cells of umbilical origin. We report the case of a patient at our hematological center with multiple relapsing Ph+ B‐ALL, notably a Blinatunomab non‐responder, who underwent therapy with Brexucabtagene Autoleucel following relapse on Ponatinib post‐allogeneic hematopoietic stem cell transplantation. The patient achieved a rapid CAR‐T expansion and durable remission presenting in good clinical conditions 6 months post‐CAR‐T infusion, without manifestations of graft‐versus‐host disease. The case report provides insight into the reactivity and persistence of CAR‐T cells of umbilical origin, confirming the potential promise of allogeneic umbilical cord‐derived CAR‐T cells. [ABSTRACT FROM AUTHOR]

Impaired function of hematopoiesis after treatment with chimeric antigen T‐cells (CAR‐T) is a frequent finding and can interest a wide range of patients, regardless of age and underlying disease. Trilinear cytopenias, as well as hypogammaglobulinemia, B‐cell aplasia, and T‐cell impairment, can severely affect the infectious risk of CAR‐T recipients, as well as their quality of life. In this review, we provide an overview of defects in hematopoiesis after CAR‐T, starting with a summary of different definitions and thresholds. We then move to summarize the main pathogenetic mechanisms of cytopenias, and we offer insight into cytomorphological aspects, the role of clonal hematopoiesis, and the risk of secondary myeloid malignancies. Subsequently, we expose the major findings and reports on T‐cell and B‐cell quantitative and functional impairment after CAR‐T. Finally, we provide an overview of current recommendations and leading experiences regarding the management of cytopenias and defective B‐ and T‐cell function. [ABSTRACT FROM AUTHOR]