Liu Liqiong, Zhu Wenxiang, Liu Ning, Gong Shiting, Ma Qihong, Zhou Huanhuan, Zhong Nan, Dai Wei, Zhao Lijun, Sun Rui, Wang Jianxun, Shi Yuanyuan, Guo Zhi
Department of Hematology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, China.
Shenzhen Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Shenzhen, 518033, China.
Heliyon. 2024 Aug 27;10(17):e36955. doi: 10.1016/j.heliyon.2024.e36955. eCollection 2024 Sep 15.
Chimeric antigen receptor T (CAR-T)-cell therapy targeting B-cell maturation antigen (BCMA) is currently one of the promising treatment methods for relapsed/refractory multiple myeloma (MM). Herein, this study is a case report on a 41-year-old male patient with MM. Unfortunately, he still developed multidrug-resistant, refractory, and bone marrow suppression after receiving multiline high-intensity chemotherapy. After a detailed evaluation, the physician recommended autologous hematopoietic stem cell transplantation (ASCT) support, followed by sequential immunotherapy with autologous anti- BCMA CAR-T cells. The CAR-T product is a novel anti-BCMA CAR-T based on Retrovirus vectors (RV). It was worth noting that the patient achieved VGPR (very good partial remission) one month after infusion of anti-BCMA CAR-T cells. Recent tests have found that the M protein was no longer detectable and the patient has achieved CR (complete response). Although grade 3 cytokine release syndrome (CRS) appeared, the symptom was well controlled and immune effector cell-associated neurotoxicity syndrome (ICANS) did not occur. This was the first case report of RV prepared anti-BCMA CAR-T cells combined with ASCT for the treatment of MM patient in clinical practice, indicating that the RV-based anti-BCMA-CAR-T cells with ASCT have excellent therapeutic efficacy and high safety in triple-refractory MM patients.
靶向B细胞成熟抗原(BCMA)的嵌合抗原受体T(CAR-T)细胞疗法是目前复发/难治性多发性骨髓瘤(MM)颇具前景的治疗方法之一。在此,本研究是一例41岁男性MM患者的病例报告。不幸的是,他在接受多线高强度化疗后仍出现多药耐药、难治性及骨髓抑制。经过详细评估,医生建议给予自体造血干细胞移植(ASCT)支持,随后序贯自体抗BCMA CAR-T细胞免疫治疗。该CAR-T产品是一种基于逆转录病毒载体(RV)的新型抗BCMA CAR-T。值得注意的是,患者在输注抗BCMA CAR-T细胞1个月后达到了VGPR(非常好的部分缓解)。近期检查发现M蛋白不再可检测到,患者已达到CR(完全缓解)。虽然出现了3级细胞因子释放综合征(CRS),但症状得到了良好控制,且未发生免疫效应细胞相关神经毒性综合征(ICANS)。这是临床实践中首例关于RV制备的抗BCMA CAR-T细胞联合ASCT治疗MM患者的病例报告,表明基于RV的抗BCMA-CAR-T细胞联合ASCT在三重难治性MM患者中具有优异的治疗效果和高安全性。