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As for limitations, the researchers noted it cannot be ruled out that chemotherapy contributed to the short-term effects of CD19 CAR T-cell treatment, though they wrote that it was unlikely to have induced the complete B-cell depletion, abrogation of autoantibodies and sustained drug-free remission. They called for controlled clinical studies to investigate further

whether synergistic effects reduce immunosuppressant doses or potential antagonism (e.g., immunosuppressants altering iron metabolism/ferroptosis) exists remains unknown