Chimeric antigen receptor and bispecific T-cell engager therapies in multiple myeloma patients with prior allogeneic transplantation.
Lindsay HammonsShabi HaiderAndrew Jay PortugueseRahul BanerjeeAniko SzaboMarcelo C PasquiniSaurabh ChhabraSabarinath RadhakrishnanMeera MohanRavi NarraJing DongSiegfried JanzNirav N ShahMehdi HamadaniAnita D SouzaParameswaran HariBinod DhakalPublished in: British journal of haematology (2023)
Chimeric antigen receptor T-cell (CAR-T) therapy and bispecific T-cell engagers (BsAb) have emerged as promising immunotherapeutic modalities in patients with relapsed and/or refractory multiple myeloma (RRMM). However, there is limited data on the safety and efficacy of CAR-T and BsAb therapies in MM patients with a prior history of allogeneic transplantation (allo-HCT). Thirty-three MM patients with prior allo-HCT received CAR-T (n = 24) or BsAb (n = 9) therapy. CAR-T therapy demonstrated an ORR of 92% (67% ≥ CR), and 73% were MRD negative. BsAb therapy resulted in an ORR of 44% (44% ≥ CR) and 44% MRD negative. Safety analysis showed grade ≥3 AEs in 92% of CAR-T and 56% of BsAb patients. Cytokine release syndrome (CRS) occurred in 83% of CAR-T and 78% of BsAb recipients, while immune effector cell-associated neurotoxicity syndrome (ICANS) was observed in three CAR-T patients. Infections of grade ≥3 were reported in 50% of CAR-T and 44% of BsAb recipients. No exacerbation of graft-versus-host disease occurred except in one BsAb recipient. CAR-T and BsAb therapies appear to be feasible, safe and provide deep and durable responses in MM patients with prior allo-HCT.
Keyphrases
- multiple myeloma
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- cell therapy
- bone marrow
- stem cells
- chronic obstructive pulmonary disease
- prognostic factors
- acute lymphoblastic leukemia
- immune response
- mesenchymal stem cells
- deep learning
- electronic health record
- high dose
- cell proliferation
- hematopoietic stem cell
- mechanical ventilation