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There are limited data on the safety of chimeric antigen receptor (CAR) T-cells with the CD28 co-stimulatory domain (CD28 CAR T-cells), such as axicabtagene ciloleucel (Axi-cel) or brexucabtagene autoleucel (Brexu-cel), in patients with active or prior central nervous system (CNS) involvement. Due to concerns over the risk of immune effector cell-associated cytotoxicity (ICANS), patients with CNS disease were largely excluded from the pivotal ZUMA trials that led to the approval of CD28 CAR T-cells for diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), and B-cell acute lymphoblastic leukemia (B-ALL). 1 Although anecdotal and small retrospective reports have been published, 2-6 the safety of CD28 CAR T-cell therapy in patients with CNS involvement has not been adequately evaluated. Furthermore, the safety and feasibility of outpatient administration of CAR T-cells for patients with active or prior CNS involvement remain unclear. Herein, we report on our institutional experience with outpatient CD28 CAR T-cell administration in 10 consecutive patients with CNS involvement. We performed a retrospective analysis of outcomes for all patients who received commercially available CD28 CAR T-cells at Johns Hopkins Hospital between January 2019 and November 2022 for B-cell malignancies with previously treated or active CNS involvement. The study was approved by the Institutional Review Board of Johns Hopkins. Patients were considered to have active CNS disease if they had radiographic evidence of CNS involvement or malignant B-cells detectable by flow cytometry in the cerebrospinal fluid (CSF)