John Lukas, Sauer Sandra, Hegenbart Ute, Dreger Peter, Hundemer Michael, Müller-Tidow Carsten, Schmitt Anita, Schmitt Michael, Raab Marc S, Schönland Stefan O
Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany; Clinical Cooperation Unit Molecular Hematology/Oncology, Department of Internal Medicine V, Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany.
Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
Transplant Cell Ther. 2023 Oct;29(10):609.e1-609.e6. doi: 10.1016/j.jtct.2023.06.010. Epub 2023 Jun 20.
BCMA-specific chimeric-antigen receptor (CAR-) T cell therapy has led to high response rates and durable remissions in patients with relapsed refractory multiple myeloma. However, little data are available for patients after prior allogeneic stem cell transplantation (allo-SCT) in whom T cells are chimeric. In this study, we aimed to assess the safety and efficacy of patient-derived donor CAR-T therapy in myeloma patients with prior allo-SCT, particularly with regard to graft-versus-host disease (GVHD). We report a comprehensive clinical analysis of 3 patients who had previously undergone allo-SCT for high-risk myeloma and were treated with idecabtagene vicleucel (ide-cel) at our institution. Ide-cel was well tolerated, with no clinically relevant immune effector cell-associated neurotoxicity syndrome or cytokine release syndrome observed in any patient. Importantly, no new GVHD was observed, even though all patients had a history of GVHD. All patients responded to treatment with at least a very good partial remission. Two patients relapsed within 6 months, and 1 patient was still in stringent complete remission at the time of this report. Our findings demonstrate that treatment with ide-cel is feasible, very well tolerated, and effective in patients with relapsed/refractory multiple myeloma after prior allo-SCT.
靶向B细胞成熟抗原（BCMA）的嵌合抗原受体（CAR）-T细胞疗法已使复发难治性多发性骨髓瘤患者获得了较高的缓解率和持久缓解。然而，对于先前接受过同种异体干细胞移植（allo-SCT）且T细胞为嵌合状态的患者，相关数据却很少。在本研究中，我们旨在评估在先前接受过allo-SCT的骨髓瘤患者中，患者来源的供体CAR-T疗法的安全性和有效性，尤其是关于移植物抗宿主病（GVHD）方面。我们报告了3例先前因高危骨髓瘤接受allo-SCT并在我们机构接受idecabtagene vicleucel（ide-cel）治疗的患者的全面临床分析。Ide-cel耐受性良好，所有患者均未观察到临床相关的免疫效应细胞相关神经毒性综合征或细胞因子释放综合征。重要的是，即使所有患者都有GVHD病史，也未观察到新的GVHD。所有患者对治疗均有反应，至少达到非常好的部分缓解。2例患者在6个月内复发，1例患者在本报告撰写时仍处于严格完全缓解状态。我们的研究结果表明，对于先前接受过allo-SCT的复发/难治性多发性骨髓瘤患者，使用ide-cel治疗是可行的、耐受性非常好且有效的。
