Upper gastrointestinal tract immune‐related adverse events: Two cases of obstructive complications occurred in immune consolidation therapy after sequential chimeric antigen receptor T cell therapy with autologous hematopoietic stem cell transplantation for refractory/relapsed diffuse large B cell lymphoma

Abstract

Key Clinical Message Immune checkpoint inhibitors are a very popular method of treating malignant tumors. But its side effects cannot be ignored. This study revealed obstructive complications during immune consolidation therapy following sequential chimeric antigen receptor T cell therapy with autologous hematopoietic stem cell transplantation in two patients with diffuse large b cell lymphoma (DLBCL). Both our patients had the same symptoms of vomiting and inability to eat due to pyloric obstruction, it should be highlighted that this is a relatively rare and irreversible complication of upper gastrointestinal caused by immune consolidation therapy. Abstract Immune checkpoint inhibitors (ICIs) have become the standard therapy for many malignant tumors.However, ICIs are associated with unique immune‐related adverse events (irAEs) caused by dysregulated immune activation and associated complications have been observed in patients. Here, we report two cases of patients with pyloric obstruction and duodenal ulcers induced by the use of sintilimab, which provides some guidance for the widely used anti‐programmed death‐1 therapy. During the entire treatment progression for such patients, the correct differential diagnosis of adverse effects and the use of immunosuppressive agents such as glucocorticoids are essential to facilitate early prevention and intervention of irAEs.

Keywords

• chimeric antigen receptor T cell therapy
• duodenal ulcers
• immune checkpoint inhibitor
• sintilimab
• upper gastrointestinal tract irAE