Editor's Note: Yanzhao brings together talented individuals while remaining true to its original mission for 14 years. On August 21, 2026, the 14th Lu Daopei Hematology Forum grandly opened at Hebei Yanda Lu Daopei Hospital. Building on 14 years of academic development, this year's conference focused on cutting-edge topics including hematopoietic stem cell transplantation, cellular immunotherapy, and precision diagnosis and treatment of hematologic diseases. Experts and scholars from across the field of hematology gathered to discuss advances in the discipline, making the conference an important academic platform for promoting progress in the diagnosis and treatment of hematologic diseases in China. During the conference, Oncology Frontier – Hematology Frontier invited Dongchu Wang of Lu Daopei Hospital for an exclusive interview. He shared his insights into the current landscape of CD7 CAR-T therapy for T-cell malignancies, research on the association between cytokine levels and graft-versus-host disease (GVHD) following bridge-to-transplantation therapy, and future directions for combining CAR-T therapy with transplantation.Oncology Frontier – Hematology Frontier: At this conference, you presented research on “the association between cytokine levels following CD7 CAR-T therapy and GVHD after bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT).” Could you introduce the current status of CD7 CAR-T therapy in T-cell malignancies? What is the rationale for bridging patients to transplantation after CAR-T therapy?
Dongchu Wang: CD7 CAR-T therapy has been shown to be a highly effective immunotherapy for T-cell malignancies. With conventional chemotherapy, patients with relapsed or refractory T-cell acute lymphoblastic leukemia (T-ALL) or T-lymphoblastic lymphoma (T-LBL) often have poor treatment outcomes and low long-term survival rates.
CD7 is a newly emerging target that is highly expressed on T cells while having very low expression on normal plasma cells, making it an ideal CAR-T target for T-ALL and T-LBL. Studies from China and abroad have demonstrated that CD7 CAR-T therapy can achieve high complete remission rates in patients with T-ALL and T-LBL, providing patients with a valuable therapeutic window.
However, unlike CD19 CAR-T therapy targeting B cells, CD7 CAR-T targets T cells. While eliminating malignant T cells, it also eliminates normal T cells and NK cells, resulting in prolonged hematopoietic suppression and delayed immune reconstitution. Patients may therefore remain in an immunodeficient state with a high risk of infection for an extended period.
CD7 CAR-T monotherapy is unlikely to maintain long-term disease-free survival in many patients. Therefore, the prevailing view is that patients who achieve complete remission following CD7 CAR-T therapy should undergo bridging allo-HSCT as consolidation therapy. The goal is to help restore hematopoiesis and rebuild a functional immune system, thereby providing the possibility of long-term survival.
Oncology Frontier – Hematology Frontier: How do changes in cytokine levels following CAR-T therapy affect the development of GVHD after subsequent transplantation? What important findings has your team made in this area, and how might these findings inform clinical bridging strategies?
Dongchu Wang: Our research focuses on cytokine changes during the window between CAR-T therapy and subsequent transplantation. We explored their associations with three outcomes: the occurrence of GVHD, GVHD severity, and overall survival. Overall, our findings showed statistically significant associations between cytokine levels during this window and all three outcomes.
First, regarding prediction of GVHD occurrence, we initially screened 24 cytokines across multiple time points. Several cytokines at different time points showed statistically significant associations with GVHD. After further analysis, we ultimately identified a six-cytokine panel measured on day 15 after CAR-T infusion—IL-1β, IL-10, IFN-γ, sCD25, ST2, and MIP-1α—which demonstrated strong predictive value for the occurrence of GVHD following transplantation.
Second, regarding prediction of GVHD severity, we divided patients into a mild group (grade 1–2 GVHD) and a severe group (grade 3–4 GVHD). After screening and analysis across multiple time points, we ultimately identified a four-cytokine panel measured on day 15—MIP-1α, IL-17A, MCP-1, and IFN-γ—which showed predictive value for severe GVHD.
It is noteworthy that day 15 was the optimal predictive time point for both GVHD occurrence and severity, and there was overlap between the two sets of predictive factors. Among them, MIP-1α demonstrated particularly strong predictive value, both as a component of the panel and as an independent factor, making it worthy of further investigation.
Third, regarding overall survival, we divided patients into a mortality group and a long-term survival group. We identified day 30 after CAR-T infusion as the optimal time point and found that four cytokines—sCD25, ST2, TNFR1, and IL-15—were strongly associated with overall survival.
TNF receptor 1 (TNFR1) showed statistically significant associations at multiple time points, including the early period after infusion (days 0, 4, and 7) and later time points (days 15, 20, and 30), suggesting considerable potential for further clinical research and application.
In terms of clinical implications, conventional transplantation management generally focuses on cytokine expression after transplantation. Our research, however, aims to use early pre-transplant time points to predict the risk and severity of acute GVHD as well as long-term survival outcomes after transplantation.
Based on such a predictive model, transplant physicians may be able to individualize the conditioning regimen and GVHD prophylaxis before transplantation. It should be emphasized that these are preliminary findings, and larger studies are needed for further validation.
Oncology Frontier – Hematology Frontier: What will be the future directions for combining CAR-T therapy with transplantation? How could cytokine monitoring be used to optimize transplantation timing and GVHD prophylaxis?
Dongchu Wang: I believe there are three major directions for the future development of CAR-T therapy combined with transplantation.
First, we need to optimize CAR-T manufacturing processes. For example, developing more off-the-shelf CAR-T products could make treatment more convenient. Compared with autologous CAR-T cells produced through patient-specific collection and expansion, universal CAR-T products could potentially be administered rapidly once treatment is indicated. Because these cells are derived from healthy donor T cells rather than the patient’s own T cells, their therapeutic efficacy may also be superior.
Second, we need to identify more specific CAR-T targets. CD7 CAR-T has demonstrated clear efficacy, but its major limitation is that it simultaneously eliminates normal T cells and NK cells, leaving patients at high risk of infection for an extended period. If we can identify a highly specific target expressed only on malignant cells and absent from normal cells, this problem could potentially be avoided.
Third, we need to develop controllable CAR-T designs. If a more ideal target cannot yet be identified, controllable elimination mechanisms could be incorporated into CAR-T cells—for example, suicide genes that allow CAR-T cells to be selectively eliminated after achieving therapeutic efficacy, such as around day 30 or day 45 after infusion. This could prevent prolonged CAR-T persistence and reduce delays in immune reconstitution.
Regarding how cytokine testing can optimize transplantation strategies, I believe there are two major applications.
The first is more precise selection of transplantation timing. Currently, clinicians primarily determine the timing of transplantation based on disease remission status and the patient’s overall clinical stability. Our predictive model may allow physicians to anticipate the risk of GVHD and post-transplant prognosis earlier, thereby helping to optimize transplantation timing or adjust the intensity and specific components of the conditioning regimen before transplantation.
The second is risk-adapted GVHD prophylaxis. At present, conventional immunosuppressive regimens are generally used for GVHD prevention. With cytokine-based risk prediction, patients could potentially be stratified according to their anticipated GVHD risk. For patients predicted to develop only mild GVHD, the intensity of immunosuppression could potentially be reduced to facilitate faster immune reconstitution. For patients predicted to be at high risk of severe GVHD, intensified immunosuppressive therapy could be initiated earlier to reduce the risk of severe GVHD.
In the future, we also hope to integrate genomic profiles, lymphocyte subsets, microbiome data, and other multidimensional measurements to construct more precise and comprehensive predictive models.
Expert Profile
Dongchu Wang
Lu Daopei Hospital
MSc, Assistant Researcher
Dongchu Wang is a member of the Expert Committee on Flow Cytometry Analysis and Diagnosis of the Laboratory Medicine Professional Committee of the Chinese Association of Integrative Medicine and a Young Committee Member of the Laboratory Medicine Professional Committee of the Beijing Association of Integrative Medicine.
As first author, with Professor Hui Wang as corresponding author, he has presented research at numerous major international conferences, including the 2020 International Clinical Cytometry Society (ICCS) Annual Meeting, 2020 European Hematology Association (EHA) Congress, 2020 American Society of Hematology (ASH) Annual Meeting, 2021 EHA Congress, 2021 ICCS Annual Meeting, 2022 International Society for Laboratory Hematology (ISLH) Meeting, 2024 European Society for Blood and Marrow Transplantation (EBMT) Congress, 2025 ASH Annual Meeting, and 2026 EHA Congress. His work has been presented through posters as well as oral presentations and invited online discussions.
He received his bachelor’s and master’s degrees from the University of Greenwich in the United Kingdom, with degrees in biomedical science and biotechnology. He previously participated in research related to the human genome and has focused on the production, analysis, and tracking of recombinant proteins in biomedicine, including studies tracking the intracellular transport of antisense drugs through endocytosis.
Since joining Hebei Yanda Lu Daopei Hospital in 2017, he has primarily worked in laboratory medicine and clinical testing for immunotherapy. His research focuses on novel laboratory methods for immunotherapy and hematologic diseases. His research findings have been presented and discussed at multiple international conferences.
He has extensive experience in laboratory monitoring of various cellular immunotherapies, including dual- and single-target CAR-T, TCR-T, CAR-NK, and NK/CIK therapies, with a focus on monitoring and tracking in vivo cellular expansion and changes in cytokine levels.
His recent work has focused primarily on the application of CBA-based high-throughput flow cytometry for the detection of 24 cytokines in clinical trials of immunotherapy and in the treatment and transplantation of hematologic diseases.
