The earliest pivotal CAR-T trial for R/R DLBCL, utilizing CD19-targeted CAR-T with CD28 costimulatory domain. The ZUMA series has advanced to ZUMA 9 and real-world research, enrolling over 295 patients. Key findings: CD28-based CAR-T triggers rapid, severe cytokine release syndrome (CRS); 32% of patients required ICU admission for CRS. Re-administering identical CAR-T cells to partial response (PR) patients fails to boost efficacy.

A Pakistani patient with relapsed refractory diffuse large B-cell lymphoma received only palliative care at home. He traveled to Shanghai Jiahui International Hospital for CAR-T therapy. The treatment successfully shrank tumors, relieved severe pain and normalized tumor markers. Despite language and cultural barriers, the medical team provided thoughtful care including customized halal meals. He returned home with a one-year follow-up plan and regained hope for recovery.