髓外疾病与多发性骨髓瘤患者b细胞成熟抗原CAR - t细胞治疗后的严重毒性相关。

IF 7.9 1区医学 Q1 HEMATOLOGY

Haematologica Pub Date : 2025-06-19 DOI:10.3324/haematol.2025.287985

Andrew J Portuguese,Emily C Liang,Jennifer J Huang,Yein Jeon,Danai Dima,Rahul Banerjee,Mary Kwok,Kara I Cicero,Alexandre V Hirayama,Ryan Basom,Christy Khouderchah,Mazyar Shadman,Lawrence Fong,Andrew J Cowan,Jordan Gauthier

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引用次数: 0

摘要

多发性骨髓瘤（MM）患者髓外疾病（EMD）与b细胞成熟抗原（BCMA）靶向CAR-T治疗后的不良预后相关，但其对治疗相关毒性的影响尚不清楚。本研究评估了活性EMD对MM患者的毒性、疗效和生存的影响，这些患者接受了西他tagene微核（ide-cel）或西他tagene自核（cilta-cel）治疗。我们对2021年8月至2024年10月期间在我院接受ide-cel （n=32）或cilta-cel （n=76）作为标准治疗的所有MM患者进行了回顾性队列研究。EMD被定义为在骨外位置存在软组织肿块，并根据EMD状态比较结果。108例患者中有26例（24%）发生EMD。EMD患者的(G)1+级（38%比17%，p=0.022）和G3+ ICANS（19%比1.2%,p=0.003）以及G1+（96%比78%，p=0.041）和G3+ eICAHT（31%比0%，p=0.041）的发生率更高。

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Extramedullary disease is associated with severe toxicities following B-cell maturation antigen CAR T-cell therapy in multiple myeloma.

Extramedullary disease (EMD) in multiple myeloma (MM) is associated with poor outcomes following B-cell maturation antigen (BCMA)-targeted CAR-T therapy, yet its impact on treatment-related toxicity remains unclear. This study evaluates the impact of active EMD on toxicity, efficacy, and survival in patients with MM treated with idecabtagene vicleucel (ide-cel) or ciltacabtagene autoleucel (cilta-cel). We conducted a retrospective cohort study of all patients with MM who received ide-cel (n=32) or cilta-cel (n=76) as standard-of-care therapy at our institution from August 2021 to October 2024. EMD was defined as the presence of soft tissue masses in extraosseous locations, and outcomes were compared based on EMD status. Among 108 patients, 26 (24%) had EMD. Patients with EMD experienced higher rates of grade (G)1+ (38% vs. 17%, p=0.022) and G3+ ICANS (19% vs. 1.2%, p=0.003), as well as G1+ (96% vs. 78%, p=0.041) and G3+ eICAHT (31% vs. 0%, p.

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来源期刊

Haematologica 医学-血液学

CiteScore

14.10

自引率

2.00%

发文量

349

审稿时长

3-6 weeks

期刊介绍： Haematologica is a journal that publishes articles within the broad field of hematology. It reports on novel findings in basic, clinical, and translational research. Scope: The scope of the journal includes reporting novel research results that: Have a significant impact on understanding normal hematology or the development of hematological diseases. Are likely to bring important changes to the diagnosis or treatment of hematological diseases.