Colitis After CAR T-Cell Therapy for Refractory Large B-Cell Lymphoma Responds to Anti-Integrin Therapy

To the editors, We present a female patient aged 51 years with new-onset profuse watery diarrhea 3 weeks after infusion of axicabtagene ciloleucel CD19 chimeric antigen receptor (CAR) T-cells for refractory transformed follicular lymphoma. The infusion was promptly followed by cytokine release syndrome and neutropenic sepsis requiring admission to the intensive care unit. The diarrhea gradually increased to reported stool frequency of up to 20 times per day. While her day-28 positron emission tomography scan showed complete metabolic response, it showed features of colitis more pronounced in the ascending colon and cecum. A computed tomography scan 1 week later showed a diffuse colitic pattern. Fecal calprotectin was elevated (286 mcg/g),...