Janisch-Hanzlik's June 2025 infusion at Nebraska Medicine marks an early data point in CAR-T's pivot from oncology, where it achieved durable remissions in B-cell malignancies since the 2017 FDA approval of tisagenlecleucel. Yet the MedicalXpress account underplays the mechanistic leap: by targeting CD19+ B cells, CAR-T may induce a deeper reset than rituximab or other depleters, potentially eliminating autoreactive clones and allowing naive reconstitution. Peer-reviewed evidence remains thin. Schett et al. (Nature Medicine, 2022; n=5 lupus patients, single-arm observational) reported drug-free remission lasting >1 year post-infusion, but lacked controls and long-term follow-up. A 2024 Lancet Rheumatology phase 1/2 trial (n=14, mixed autoimmune) showed similar B-cell aplasia and symptom relief, again observational with industry funding from Kite Pharma noted as a conflict. No RCTs exist yet for MS or most indications; sample sizes stay under 50, limiting generalizability. The source omits scalability barriers—manufacturing costs exceed $400k per dose—and neurotoxicity risks amplified in patients with preexisting CNS involvement like MS. Broader patterns suggest this shift could extend to Graves' or vasculitis, but only if durability exceeds the 6-18 months seen in cancer relapses. Missing from coverage: potential for antigen-loss escape and secondary malignancies, documented in 5-10% of oncology cases per FDA surveillance.