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We present a case study on pulmonary flare-up after Idecabtagen Vicleucel (Ide-cel), a BCMA targeting CAR T-cell therapy, and used single-cell RNA-seq (scRNA-seq) to identify a Th17.1 driven autoimmune mechanism as the biological underpinning of this phenomenon. By integrating datasets of various lung pathological conditions, we revealed transcriptomic similarities between post CAR T pulmonary lesions and sarcoidosis. Furthermore, we explored a noninvasive PET based diagnostic approach and showed that tracers binding to CXCR4 complement FDG PET imaging in this setting, allowing discrimination between immune-mediated changes and true relapse after CAR T-cell treatment. 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HE has participated in scientific advisory boards for Janssen, Celgene\/Bristol-Myers Squibb, Amgen, Novartis, and Takeda, has received research support from Janssen, Celgene\/Bristol-Myers Squibb, Amgen, and Novartis, and has received honoraria from Janssen, Celgene\/Bristol-Myers Squibb, Amgen, Novartis, and Takeda. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The patient gave written informed consent for scientific evaluations. The study was approved by the internal review board of the University of W\u00fcrzburg (reference # 8\/21) and adhered to the tenets of the Declaration of Helsinki of 2008.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}