Targeting CD19 expression can overcome relapses in autoimmune patients treated with CD20 targeted therapy


“Can autoimmune disease be cured by deep CD19+ cell depletion?” Dan Suan, John Moore, Christopher C Goodnow. J Immunol. 2025 Jun 1;214(6):1075-1092. doi: 10.1093/jimmun/vkaf008. PMID: 40116909

The Authors review encouraging data from B cell autoimmune patients in relapse after CD20 treatments who were given CD19 CAR T cell treatment, or blinumomab anti-CD19 bispecific T cell (BiTE) engagement.
They determined that bone marrow human plasma cells can maintain potential for differentiation due to expression of PAX5 master transcription factor. These CD19+ CD20- cells are one potential source of relapse. Also, CD20 depletion may not have been sufficient in some cases.

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