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Successful treatment of ultra-high-risk refractory multiple myeloma with anti-BCMA CAR-T therapy followed by allogeneic hematopoietic stem cell transplantation: a case report 抗bcma CAR-T治疗后异基因造血干细胞移植成功治疗超高高危难治性多发性骨髓瘤1例

Hematology and Oncology Discovery Pub Date : 2023-01-01 DOI: 10.15212/hod-2023-0003

Yi Wang, Shuhua Yi, Yan Xu, Rongli Zhang, Aiming Pang, Sizhou Feng, Erlie Jiang, Lugui Qiu, Dehui Zou

{"title":"Successful treatment of ultra-high-risk refractory multiple myeloma with anti-BCMA CAR-T therapy followed by allogeneic hematopoietic stem cell transplantation: a case report","authors":"Yi Wang, Shuhua Yi, Yan Xu, Rongli Zhang, Aiming Pang, Sizhou Feng, Erlie Jiang, Lugui Qiu, Dehui Zou","doi":"10.15212/hod-2023-0003","DOIUrl":"https://doi.org/10.15212/hod-2023-0003","url":null,"abstract":"Recently, chimeric antigen receptor T cell (CAR-T) therapy targeting B cell maturation antigen (BCMA) has produced unprecedented and encouraging results in relapsed and/or refractory multiple myeloma (RRMM) after multiple lines of treatment, especially among high-risk patients; however, most patients inevitably relapse after CAR-T therapy. Exploring therapeutic strategies followed by CAR-T therapy has attracted increasing attention that warrants continued investigation. Herein, we present a young patient with RRMM and ultra-high-risk genetic abnormalities and refractoriness to a proteasome inhibitor (bortezomib), immunomodulatory drugs (lenalidomide and pomalidomide), a cytotoxic drug (liposomal doxorubicin), and anti-CD38 monoclonal antibody. After three lines of treatment, the patient underwent CAR-T therapy targeting BCMA for salvage treatment, then achieved a very good partial response with good tolerability. Subsequently, we performed an allogeneic hematopoietic stem cell transplantation (allo-HSCT) from an HLA-matched unrelated donor as consolidation therapy. The efficacy was evaluated as a stringent complete response 42 days after the allo-HSCT. The patient has achieved progression-free survival for > 9 months after transplantation. The success of our case demonstrated that for carefully selected patients, anti-BCMA CAR-T therapy followed by allo-HSCT is effective and feasible in treating RRMM. A longer duration of follow-up and additional studies are needed to affirm this therapeutic strategy.","PeriodicalId":484027,"journal":{"name":"Hematology and Oncology Discovery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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