Long-term efficacy and factors influencing BCMA chimeric antigen receptor-T cell treatment in relapsed or refractory multiple myeloma
10.12354/j.issn.1000-8179.2024.20240398
- VernacularTitle:BCMA CAR-T治疗复发/难治性多发性骨髓瘤患者的长期疗效和影响因素分析
- Author:
Yu MIN
1
;
Kong FANCONG
;
Zhou YULAN
;
Qi LING
;
Li FEI
Author Information
1. 南昌大学第一附属医院血液科(南昌市 330006)
- Keywords:
chimeric antigen receptor-T cell(CAR-T);
relapsed/refractory(R/R);
multiple myeloma(MM)
- From:
Chinese Journal of Clinical Oncology
2024;51(7):342-347
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the long-term efficacy and safety of B cell maturation antigen(BCMA)-chimeric antigen receptor-T(CAR-T)cells in the treatment of recurrent/refractory multiple myeloma(R/R MM).Methods:A retrospective analysis was conducted on the clinical data of 20 patients with R/R MM who received BCMA CAR-T-cell therapy at The First Affiliated Hospital of Nanchang University between July 2018 and July 2023.The follow-up period was up to December 31,2023.Overall survival and progression-free survival(PFS)rates were eval-uated using Kaplan-Meier analysis,and adverse effects were recorded.Results:Of all 20 cases with R/R MM,the median number of previ-ous treatment lines was three(range:two to six),total objective response rate(ORR)was 75%,and complete response(CR)rate was 50%.The median follow-up duration was 29 months,with a median PFS of 26 months.Among ten patients with CR,five were still in remission at the last follow-up,with the shortest duration of remission being 6 months and the longest being 48 months.In the subgroup analysis,PFS was significantly worse in patients with extramedullary infiltration,high tumor burden,and 17p deletion high-risk cytogenetic features(P<0.05).Cytokine release syndrome(CRS)was the most common(90%)adverse event,and it was mostly mild,with an incidence rate of grade 3 or higher of 35%.Few long-term adverse effects occurred and no CAR-T cell treatment-related deaths were observed.Conclusions:BCMA CAR-T-cell therapy was effective and safe for patients with R/R MM.Patients with extramedullary diseases and high tumor burden can also benefit from this treatment;however,their persistent response is not satisfactory.It is worth exploring the differences and design-ing prospective clinical studies to consolidate and maintain the efficacy in these patients.
