CAR-T 细胞治疗后的细胞动力学与复发/难治性骨髓瘤的缓解和毒性相关

B-cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T cells revolutionized the treatment of relapsed/refractory multiple myeloma (RRMM).

However, data on cellular (CAR) T cell dynamics and the association with response, resistance or the occurrence of cytokine release syndrome (CRS) are limited.

Therefore, we performed a comprehensive flow cytometry analysis of 27 RRMM patients treated with Idecabtagene vicleucel (Ide-cel) to assess the expansion capacity, persistence and effects on bystander cells of BCMA-targeting CAR T cells.

Additionally, we addressed side effects, like cytokine release syndrome (CRS) and cytopenia.

Our results show that in vivo expansion of CD8 + CAR T cells is correlated to response, however persistence is not essential for durable remission in RRMM patients.

In addition, our data provide evidence, that an increased fraction of CD8 + T cells at day of leukapheresis in combination with successful lymphodepletion positively influence the outcome.

We show that patients at risk for higher-grade CRS can be identified already prior to lymphodepletion.

Our extensive characterization contributes to a better understanding of the dynamics and effects of BCMA-targeting CAR T cells, in order to predict the response of individual patients as well as side effects, which can be counteracted at an early stage or even prevented.