Case Report
Clinical and immunologic status of a child conceived following maternal administration of CD19 CAR T-cells for systemic lupus erythematosus
N. Kramer1, E.D. Rosenstein2, M. Cherry3
- Institute for Rheumatic & Autoimmune Diseases, Overlook Medical Center, Summit, NJ; and AMG-Rheumatology, Atlantic Health System, Morristown, NJ, USA. neil.kramer@atlantichealth.org
- Institute for Rheumatic & Autoimmune Diseases, Overlook Medical Center, Summit, NJ; and AMG-Rheumatology, Atlantic Health System, Morristown, NJ, USA.
- Department of Hematology Oncology, Carol Simon Cancer Center, Atlantic Health System, Morristown, NJ, USA.
CER19669
Case Report
PMID: 41841658 [PubMed]
Received: 07/01/2026
Accepted : 02/03/2026
In Press: 12/03/2026
Abstract
OBJECTIVES:
To report pregnancy outcome and neonatal immune parameters following early conception after maternal CD19 chimeric antigen receptor T-cell (CAR-T) therapy for refractory systemic lupus erythematosus (SLE).
METHODS:
Maternal and neonatal CAR-T cells were assessed by transgene polymerase chain reaction (PCR) at delivery. CD19+ B-cell counts and immunoglobulin levels were measured in maternal and neonatal blood at birth. Infant health outcomes were assessed during the first year of life.
RESULTS:
Conception occurred approximately seven weeks after CD19 CAR-T infusion. CAR-T cells were not detected in maternal peripheral blood or cord blood at delivery. Neonatal CD19+ B-cell counts and IgG levels were within age-appropriate reference ranges and exceeded maternal values, which remained subnormal. During one year of follow-up, the infant experienced no recurrent or severe infections.
CONCLUSIONS:
This case represents the earliest reported pregnancy following CD19 CAR-T therapy for SLE and the first to include neonatal immune assessment at birth. No evidence of transplacental CAR-T transfer or clinically significant neonatal immunodeficiency was observed. Additional cases and long-term follow-up are required to guide reproductive counseling after CAR-T therapy.
