Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan, Hubei 430030, China.
Thromb Res. 2023 Jul;227:62-70. doi: 10.1016/j.thromres.2023.05.016. Epub 2023 May 22.
Patients with multiple myeloma (MM) treated with anti-B cell maturation antigen (BCMA) and chimeric antigen receptor (CAR) T-cell therapy tend to show delayed platelet recovery.
This single-center retrospective observational study included a cohort of patients with MM treated with anti-BCMA CAR-T cells in ChiCTR-OPC-16009113, ChiCTR1800018137, and ChiCTR1900021153.
Fifty-eight patients with MM treated with anti-BCMA CAR-T cells were included. Delayed platelet recovery (platelet count not recovering to 50 × 10/L within 28 days) was observed in 36 % of patients. Regression analysis identified several factors that influenced platelet recovery, and accordingly, a Recovery-Model was developed. A high Recovery-Model score indicates a greater risk of delayed platelet recovery after CAR-T cell infusion and reflects the risk of hematologic toxicity. The model's predictive biomarkers included baseline platelet count, baseline hemoglobin level, logarithm of baseline Ferritin level, and cytokine release syndrome grade. Finally, survival analysis showed a significant relationship between overall survival, delayed platelet recovery (p = 0.0457), and a high Recovery-Model score (p = 0.0011).
Inflammation-related factors and bone marrow reserves are associated with delayed platelet recovery. Therefore, we developed a model to predict the risk of delayed platelet recovery and hematological toxicity in relapsed/refractory patients with MM after anti-BCMA CAR-T cell treatment.
接受抗 B 细胞成熟抗原（BCMA）和嵌合抗原受体（CAR）T 细胞疗法治疗的多发性骨髓瘤（MM）患者往往表现出血小板恢复延迟。
本单中心回顾性观察研究纳入了在 ChiCTR-OPC-16009113、ChiCTR1800018137 和 ChiCTR1900021153 中接受抗 BCMA CAR-T 细胞治疗的 MM 患者队列。
共纳入 58 例接受抗 BCMA CAR-T 细胞治疗的 MM 患者。36%的患者出现血小板恢复延迟（血小板计数在 28 天内未恢复至 50×10/L）。回归分析确定了影响血小板恢复的几个因素，并据此建立了一个 Recovery-Model。高 Recovery-Model 评分表示 CAR-T 细胞输注后血小板恢复延迟的风险较大，反映了血液学毒性的风险。该模型的预测生物标志物包括基线血小板计数、基线血红蛋白水平、基线铁蛋白水平的对数和细胞因子释放综合征分级。最后，生存分析显示总生存期、血小板恢复延迟（p=0.0457）和高 Recovery-Model 评分（p=0.0011）之间存在显著相关性。
炎症相关因素和骨髓储备与血小板恢复延迟有关。因此，我们开发了一种模型来预测复发/难治性 MM 患者接受抗 BCMA CAR-T 细胞治疗后延迟血小板恢复和血液学毒性的风险。
