芦可替尼是多发性骨髓瘤中西达基奥仑赛相关帕金森综合征的有效治疗

After ciltacabtagene autoleucel (cilta-cel) in multiple myeloma, 5% of patients can develop parkinsonism, with a high fatality rate. The pathogenesis and optimal therapy of parkinsonism from B-cell maturation antigen chimeric antigen receptor T-cell (CAR T-cell) therapy are unknown. Parkinson's disease occurs from the loss of dopaminergic neurons in the substantia nigra.

However, in cilta-cel-associated parkinsonism, dopamine transporter imaging is normal, rendering traditional agents such as carbidopa/levodopa ineffective.

Thus, the pathogenesis of cilta-cel-associated parkinsonism and Parkinson's disease is distinct. As CAR T-cell therapy for multiple myeloma is expanding and moving to earlier lines, the need to optimize therapy for parkinsonism, a potentially life-threatening complication, becomes more urgent. This report presents the first documented cases of two patients with immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome and cilta-cel-associated parkinsonism, effectively treated with ruxolitinib.