Efficacy of sequential CAR T-cell infusion in 9 patients with bulky disease. (A) The median PFS rate was not reached with an estimated 18-month PFS rate of 78% (95% CI, 37%-94%) in the patients with bulky disease, and no significant difference was observed in the estimated 18-month PFS rate between the group of patients with bulky disease and the group of patients with non-bulky disease (P = .97). (B) Magnetic resonance imaging (MRI) scans for P18 demonstrated CR of the mass on day 30 after edema of the mass on day 15 following mCD19 CAR T-cell infusion. (C) Positron emission tomography/computed tomography scans of P18 revealed the emergence of new lesions at multiple sites on day 60 after mCD19 CAR T-cell infusion and then CR2 through sequential hCD22 and hCD20 CAR T-cell infusions. ADC, apparent diffusion coefficient; DWI, diffusion weighted imaging; T2WI, T2-weighted imaging.