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病例报告:抗 BCMA CAR-T 细胞治疗成功治愈继发于多发性骨髓瘤的浆细胞白血病

英文原题:Case report: Plasma cell leukemia secondary to multiple myeloma successfully treated with anti-BCMA CAR-T cell therapy.

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Case report: Plasma cell leukemia secondary to multiple myeloma successfully treated with anti-BCMA CAR-T cell therapy.

PubMed 2022/09/21(内容时间) Front Oncol Q2 · IF 3.4(JCR 2025)

研究概要

BCMA CAR-T 疗法可能是 PCL 患者一种有前景的治疗方法。

中文摘要

嵌合抗原受体(CAR)-T细胞疗法为复发/难治性多发性骨髓瘤(RRMM)患者提供了一种有效的挽救治疗。伴有浆细胞白血病(PCL)转化的终末期RRMM具有高度侵袭性,且对常规治疗耐药。迫切需要新的治疗手段,而CAR-T疗法可能发挥重要作用。我们报告一例继发于RRMM的PCL患者,经靶向B细胞成熟抗原(BCMA)的CAR-T细胞疗法成功治疗。一名女性4年前被诊断为MM,在接受包括蛋白酶体抑制剂、免疫调节剂、细胞毒性药物和抗CD38单克隆抗体在内的五线治疗后进展为继发性PCL(sPCL)。在接受BCMA CAR-T疗法后,她获得了严格完全缓解,持续9个月。随后,由于FLC浓度略高但未达到进展标准,患者不规律地每日服用venetoclax 10 mg。在接下来的7个月中,她维持完全缓解。总之,BCMA CAR-T疗法可能是PCL患者一种有前景的治疗方法。需要更多研究来评估抗BCMA CAR-T疗法在PCL患者中的获益。临床试验注册:www.chictr.org.cn,ChiCTR1900024388,注册日期2019年7月9日。

展开英文摘要原文

Chimeric antigen receptor (CAR)-T cell therapy provides an effective salvage treatment for relapsed/refractory multiple myeloma (RRMM) patients. End-stage RRMM with plasma cell leukemia (PCL) transformation is highly aggressive and resistant to conventional therapy. There is an urgent need for new therapeutics and CAR-T therapy may play an important role. We report a case of PCL secondary to RRMM successfully treated with CAR-T cell therapy targeting B-cell maturation antigen (BCMA). A woman was diagnosed as having MM 4 years ago and progressed to secondary PCL (sPCL) of five prior lines of treatment including proteasome inhibitors, an immunomodulatory agent, cytotoxic drugs, and an anti-CD38 monoclonal antibody. After receiving a BCMA CAR-T therapy, she achieved a stringent complete response that lasted 9 months. Then, the patient irregularly took venetoclax 10 mg per day due to a slightly higher FLC concentration, which did not meet the criteria for progression. She maintained a complete response for the following 7 months. In conclusion, BCMA CAR-T therapy may be a promising therapeutic approach in PCL patients. More studies are needed to evaluate the benefit of anti-BCMA CAR-T therapy in PCL patients. Clinical Trial Registration: www.chictr.org.cn, ChiCTR1900024388, Registered 9 July 2019.

论文信息

作者
Deng J、Lin Y、Zhao D、Tong C、Chang AH、Chen W、Gao W
单位
Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.China
文献类型
病例报告
期刊
Frontiers in oncology2022
原文标识
PubMed 36212423 · DOI 10.3389/fonc.2022.901266