Ueda Yayoi, Terao Toshiki, Fujii Nobuharu, Mino Tatsuji, Kubota Saya, Hayashino Kenta, Fujiwara Kanako, Kondo Takumi, Seike Keisuke, Fujiwara Hideaki, Asada Noboru, Ennishi Daisuke, Fujii Keiko, Tanaka Hideo, Maeda Yoshinobu
Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan.
Division of Transfusion and Cell Therapy, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan.
Int J Hematol. 2025 Jun 14. doi: 10.1007/s12185-025-04016-x.
A 50-year-old Japanese man with penta-drug refractory multiple myeloma (MM) was found to have stage IIIa cardiac immunoglobulin light-chain amyloidosis before idecabtagene vicleucel (ide-cel) therapy. Ide-cel therapy was started after careful consideration and hospital ethics committee approval. Grade 3 cytokine release syndrome and atrial flutter occurred in the acute phase after ide-cel infusion, but these were well-tolerated with supportive care in the intensive care unit. The patient achieved stringent complete response at day 60 and cardiac response at 9 months after ide-cel infusion with the addition of catheter ablation for sustained atrial flutter on day 133. He has maintained both hematological and cardiac remission for over 1 year since ide-cel therapy. This case highlights the effectiveness of ide-cel for disease control in heavily pretreated MM with cardiac amyloidosis.
一名50岁的日本男性，患有五药难治性多发性骨髓瘤（MM），在接受idecabtagene vicleucel（ide-cel）治疗前被发现患有IIIa期心脏免疫球蛋白轻链淀粉样变性。经过仔细考虑并获得医院伦理委员会批准后，开始了ide-cel治疗。ide-cel输注后的急性期出现了3级细胞因子释放综合征和心房扑动，但在重症监护病房进行支持治疗后，这些症状得到了良好的耐受。患者在第60天达到严格完全缓解，在ide-cel输注后9个月出现心脏反应，并在第133天对持续性心房扑动进行了导管消融。自接受ide-cel治疗以来，他的血液学和心脏缓解状态已维持了1年多。该病例突出了ide-cel在治疗伴有心脏淀粉样变性的高度预处理MM中对疾病控制的有效性。
