Anterior chamber infiltration of CAR T-cells

A unique image of anterior chamber infiltration in a 2-year-infant with leukemia, treated with CD19 CAR T cells. Despite significant lymphopenia and resemblance of fungal infection initially, biopsy and cytologic analysis from anterior chamber fluid confirmed that this was CAR T-cell infiltration, likely targeting microscopic leukemia, unknown to us treating physicians. This is a unique case in 2 aspects: first, to state the high quality of CAR T-cell trafficking; and second – given the wide use of these cells currently, this image may help educate clinicians regarding this potential diagnosis.