Anti-CD19 CAR-T Therapy for Central Lymphoma: A Case Study of Ocular Follicular Lymphoma and Emerging Therapeutic Strategies

Background: Central lymphomas, including rare and anatomically complex subtypes such as ocular follicular lymphoma (OFL), pose substantial therapeutic challenges due to their localization and unique microenvironment promoting immune evasion. OFL, a rare manifestation of follicular lymphoma (FL), often exhibits resistance to standard therapies, necessitating innovative approaches. Methods: This case report highlights the application of anti-CD19 CAR-T therapy in a patient with OFL. Treatment outcomes, including safety, cytokine release syndrome (CRS), and durability of remission, were assessed during an 18-month follow-up. Results: The patient achieved complete metabolic remission with no evidence of systemic relapse or significant long-term toxicities. Transient grade 1–2 CRS was observed but resolved with supportive care. No neurological toxicities were reported, and the patient has remained disease-free. Conclusions: Anti-CD19 CAR-T therapy demonstrated sustained efficacy and a favorable safety profile in this case of OFL, underscoring its potential as an innovative therapeutic approach for central lymphomas. Further research is warranted to explore its integration into first-line treatment settings and optimize its applicability across broader lymphoma subtypes.