Zihan Chen, Yegan Chen, Jiaying Liu, Yingjun Sun, Xiaoxue Zhang, Lingyan Shao, Dandan Wang, Xue Wang, Wei Chen, Wei Sang, Kunming Qi, Zhenyu Li, Cai Sun, Ming Shi, Jianlin Qiao, Qingyun Wu, Lingyu Zeng, Junnian Zheng, Kailin Xu, Li Li, Hai Cheng, Jiang Cao
{"title":"CAR-T治疗复发和难治性多发性骨髓瘤患者的肾毒性。","authors":"Zihan Chen, Yegan Chen, Jiaying Liu, Yingjun Sun, Xiaoxue Zhang, Lingyan Shao, Dandan Wang, Xue Wang, Wei Chen, Wei Sang, Kunming Qi, Zhenyu Li, Cai Sun, Ming Shi, Jianlin Qiao, Qingyun Wu, Lingyu Zeng, Junnian Zheng, Kailin Xu, Li Li, Hai Cheng, Jiang Cao","doi":"10.1007/s11255-025-04503-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.</p><p><strong>Methods: </strong>We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.</p><p><strong>Results: </strong>Thirteen patients (12.1%) developed AKI within 1 month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.</p><p><strong>Conclusion: </strong>AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nephrotoxicity of CAR-T therapy in patients with relapsed and refractory multiple myeloma.\",\"authors\":\"Zihan Chen, Yegan Chen, Jiaying Liu, Yingjun Sun, Xiaoxue Zhang, Lingyan Shao, Dandan Wang, Xue Wang, Wei Chen, Wei Sang, Kunming Qi, Zhenyu Li, Cai Sun, Ming Shi, Jianlin Qiao, Qingyun Wu, Lingyu Zeng, Junnian Zheng, Kailin Xu, Li Li, Hai Cheng, Jiang Cao\",\"doi\":\"10.1007/s11255-025-04503-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.</p><p><strong>Methods: </strong>We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.</p><p><strong>Results: </strong>Thirteen patients (12.1%) developed AKI within 1 month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.</p><p><strong>Conclusion: </strong>AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.</p>\",\"PeriodicalId\":14454,\"journal\":{\"name\":\"International Urology and Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Urology and Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11255-025-04503-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urology and Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11255-025-04503-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Nephrotoxicity of CAR-T therapy in patients with relapsed and refractory multiple myeloma.
Objective: Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.
Methods: We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.
Results: Thirteen patients (12.1%) developed AKI within 1 month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.
Conclusion: AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.
期刊介绍：
International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
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