A retrospective analysis of 109 patients reports that CD19-directed CAR T cells reduced lymphoma tumor size in nodal and extranodal sites to a similar degree, but survival differed sharply by anatomical location. The work highlights that achieving initial tumor shrinkage does not automatically translate into comparable long-term outcomes across disease compartments. The study design focuses on real-world patterns rather than randomized comparisons, but the core message is clinically actionable: trial endpoints and patient selection may need to account for disease geography, not just overall response rate. For sponsors and transplant/oncology teams, the findings support ongoing refinements in how response durability is stratified and managed after CAR T infusion.