B 细胞成熟抗原靶向 CAR-T 细胞治疗在复发/难治性多发性骨髓瘤合并轻链淀粉样变性患者中的安全性与疗效

Clinical trials evaluating chimeric antigen receptor (CAR) T-cell therapy in relapsed/refractory multiple myeloma (RRMM) have typically excluded patients with AL amyloidosis. As a result, there are limited data on the safety and efficacy of CAR T-cell therapy in this patient population.

We retrospectively reviewed eight consecutive patients with RRMM and AL amyloidosis who were treated with standard of care CAR T-cell therapy. Cytokine release syndrome was seen in 75% of patients (grade 3: 0%) and immune effector cell-associated neurotoxicity syndrome (grade 1) in only one patient.

Low-grade cytopenias were common (any grade/grade 3: neutropenia 62. 5%/37. 5%, anemia 37. 5%/0%, thrombocytopenia 25%/0%). CAR T-cell therapy led to rapid and deep responses with a median time to best response of 43 days and a hematologic very good partial response or better rate of 62. 5%.

Overall, we found that commercial CAR T-cell therapy was feasible, and effective in patients with RRMM and concurrent AL amyloidosis.