Khanam Razwana, Faiman Beth, Batool Saba, Najmuddin Mohammed Musa, Usman Rana, Kuriakose Kiran, Ahmed Arooj, Rehman Mohammad Ebad Ur, Roksana Zinath, Syed Zain, Anwer Faiz, Raza Shahzad
Department of Hospital Medicine, Baystate Medical Center, Springfield, MA 01199, USA.
Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44106, USA.
J Clin Med. 2023 Aug 25;12(17):5539. doi: 10.3390/jcm12175539.
Anti-B-cell maturation antigen therapies consisting of bispecific antibodies, antibody-drug conjugates, and chimeric antigen receptor T cells have shown promising results in relapsed refractory multiple myeloma (RRMM). However, the severe side effects include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenia(s), infections, hemophagocytic lymphohistiocytosis, and organ toxicity, which could sometimes be life-threatening. This review focuses on these most common complications post-BCMA therapy. We discussed the risk factors, pathogenesis, clinical features associated with these complications, and how to prevent and treat them. We included four original studies for this focused review. All four agents (idecabtagene vicleucel, ciltacabtagene autoleucel, teclistamab, belantamab mafodotin) have received FDA approval for adult RRMM patients. We went through the FDA access data packages of the approved agents to outline stepwise management of the complications for better patient outcomes.
由双特异性抗体、抗体药物偶联物和嵌合抗原受体T细胞组成的抗B细胞成熟抗原疗法在复发难治性多发性骨髓瘤（RRMM）中已显示出有前景的结果。然而，严重的副作用包括细胞因子释放综合征、免疫效应细胞相关神经毒性综合征、血细胞减少、感染、噬血细胞性淋巴组织细胞增生症和器官毒性，这些有时可能危及生命。本综述聚焦于BCMA治疗后的这些最常见并发症。我们讨论了与这些并发症相关的危险因素、发病机制、临床特征，以及如何预防和治疗它们。我们纳入了四项原始研究进行本聚焦综述。所有四种药物（idecabtagene vicleucel、ciltacabtagene autoleucel、teclistamab、belantamab mafodotin）均已获得FDA批准用于成年RRMM患者。我们查阅了已批准药物的FDA准入数据包，以概述并发症的逐步管理，从而实现更好的患者预后。
