Dude, where’s my CAR (T cell) ?

Hyphenating “CAR T cell”  
20 April 2021
WMW Editorial Team

The use of a hyphen within the phrase “CAR T cell” (or “chimeric antigen receptor T cell”) varies throughout the titles of roughly 1450 articles on PubMed (as of April 2021). We’ve crunched the numbers on this one, and there is no clear majority. “CAR T cell” (~39.25%) and “CAR-T cell” (~38.63%) share a plurality among two other primary variations: “CAR T-cell” (~21.15%), and to a far lesser extent, “CAR-T-cell” (0.97%). As an editor, one must ask themselves: “What’s with all these disparities? Is there a ‘correct’ way to hyphenate ‘CAR T cell?’”

Let’s first take a step back and look at how we hyphenate “T cell.” From a grammatical perspective, a hyphen should be used if “T cell” describes the noun that follows it, eg, “T-cell receptor.” However, the phrase “T cell” alone should not include a hyphen. Indeed, some of the search results we mentioned above include instances where a hyphen after the “T” is warranted, such as “CAR T-cell therapy” or “CAR T-cell function.” On the other hand, our PubMed search reveals many instances of grammatically “incorrect” usage, that is, where “T cell” should be hyphenated but it is not. Since this is an advancing topic in the medical field, there exists a need for standardization, and although our research leads us to believe that either punctuation is currently acceptable, at Wiesen Medical Writing (WMW) we opt for the grammatically “correct” usage of “T cell” or “T-cell.”

All that being said, we are still left with the question of whether to put a hyphen between “CAR” and “T cell.” One could argue that “CAR” describes “T cell,” and thus, warrants the punctuation “CAR-T cell.” However, it is also worth considering that, when textually defined, different types of T cells are usually not hyphenated, for example: cytotoxic T cells, memory T cells, regulatory T cells, natural killer T cells, gamma delta T cells, etc. In addition, it’s important to look back at the data we collected from our PubMed search; if “CAR T cell” is the current trend, should we stick to that punctuation as a standard in medical communications?

As a group of medical writers and editors who are serious about advancing their craft, we think there should be some standardization to the way we format certain terms. Thus, we ask our clients and colleagues to keep in mind the questions we’ve presented here, such as, Dude, where’s my CAR (T cell)?

Stay tuned in!

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