透析依赖的多发性骨髓瘤患者中的 CAR-T 细胞治疗：来自 5 例病例系列的启示

Chimeric antigen receptor (CAR) T-cell therapy has emerged as a transformative treatment for multiple hematologic malignancies, including multiple myeloma.

However, patients with advanced chronic kidney disease, particularly those who are dialysis-dependent, have generally been excluded from clinical trials, leaving a significant gap in evidence regarding the safety and feasibility of CAR T-cell therapy in these patients.

Concerns in this patient population include potential toxicity from lymphodepleting chemotherapy regimens and increased susceptibility to immune-related adverse events such as cytokine release syndrome and neurotoxicity. While limited case reports suggest feasibility in patients with lymphoma and kidney impairment, data on CAR T-cell use in dialysis-dependent patients with multiple myeloma remain scarce.

We present a case series of 5 dialysis-dependent patients with relapsed/refractory multiple myeloma who were successfully treated with ciltacabtagene autoleucel. This series highlights the potential for safe and effective administration of CAR T-cell therapy in dialysis-dependent patients, supporting the need for broader inclusion of this population in future studies.