Gastrointestinal manifestations following chimeric antigen receptor T-cell (CAR-T) 19 therapy in pediatric patients with CD19+ acute lymphoblastic leukemia.

Pediatric patients with CD19+ acute lymphoblastic leukemia (ALL) undergoing chimeric antigen receptor T-cell (CAR-T) therapy frequently experience gastrointestinal (GI) complications. A retrospective study analyzed 13 patients (median age: 8 years) treated between January 2020 and January 2024. Seventy percent of patients experienced symptoms such as diarrhea (46%), abdominal pain (30%), and nausea/vomiting (38%). Despite adequate nutritional tolerance in 70% of cases, 31% required parenteral nutrition. Chronic malnutrition prevalence increased from 23% at baseline to 30% 6 months after therapy. These findings highlight the significant impact of CAR-T therapy on GI health and nutritional status in pediatric patients. The high incidence of GI side effects and the associated nutritional challenges underline the importance of implementing multidisciplinary care and close monitoring to mitigate these complications. Optimizing nutritional management could improve patient outcomes and inform strategies for future treatments in this vulnerable population. Further research is needed to refine supportive care approaches.