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When CAR T Cells Linger in the Gut

  • By

  • Mouj Hijazi

  • October 7, 2026

  • 2 min

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  • 1

    CAR T-associated enterocolitis after BCMA-directed therapy involved inflammatory changes across intestinal T cells, myeloid cells, stromal cells, and epithelium.

  • 2

    Some patients without enterocolitis had similarly profound B-cell and plasma-cell depletion, suggesting depletion alone did not explain the complication.

  • 3

    Intestinal CAR T cells showed highly cytotoxic and inflammatory profiles, with activation of interferon and JAK–STAT signaling.

  • 4

    In one patient, intestinal CAR T cells remained detectable more than 2 years after infusion despite being undetectable in blood and bone marrow.

  • 5

    Two patients treated with upadacitinib had improvements in symptoms, fecal calprotectin, and body weight within 4 weeks.

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