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Anti-BCMA CAR-T cells therapy for a patient with extremely high membrane BCMA expression: a case report

B cell maturation antigen (BCMA)-directed CAR-T cell therapy is a disruptive approach for treating relapsed/refractory multiple myeloma (R/R MM); however, optimization is necessary to maximize patient benefit. We report the case of a 61-year-old woman with primary refractory MM who presented with hi...

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Detalles Bibliográficos
Autores principales: Li, Dan, Que, Yimei, Ding, Shengnan, Hu, Guang, Wang, Wen, Mao, Xia, Wang, Ying, Li, Chunrui, Huang, Liang, Zhou, Jianfeng, Zhang, Wei, Xiao, Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511648/
https://www.ncbi.nlm.nih.gov/pubmed/36137648
http://dx.doi.org/10.1136/jitc-2022-005403
Descripción
Sumario:B cell maturation antigen (BCMA)-directed CAR-T cell therapy is a disruptive approach for treating relapsed/refractory multiple myeloma (R/R MM); however, optimization is necessary to maximize patient benefit. We report the case of a 61-year-old woman with primary refractory MM who presented with high expression of membrane BCMA and low expression of soluble BCMA (sBCMA), experienced grade 4 cytokine release syndrome, and died fromsevere pneumonia after receiving anti-BCMA CAR-T (CT103A) therapy. This case highlights the importance of assessing the expression range of BCMA for its efficacy and safety in patients receiving BCMA CAR-T therapy. For patients who present with extremely high membrane BCMA expression and extremely low sBCMA expression, the presence of γ-secretase-related gene mutations should be considered. Special attention should also be paid to the prevention and treatment of cytokine release syndrome in such patients.