Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
Autor: | Yiyun Wang, Linqin Wang, Yifan Zeng, Ruimin Hong, Cheng Zu, Elaine Tan Su Yin, Houli Zhao, Guoqing Wei, Li Yang, Aiyun Jin, Yongxian Hu, He Huang |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Pathology
medicine.medical_specialty Cancer Research Central nervous system Cell Cauda equina syndrome Lesion Cell therapy Nucleated cell medicine cauda equina syndrome RC254-282 Multiple myeloma Original Research business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens central nervous system medicine.disease chimeric antigen receptor (CAR T) Chimeric antigen receptor multiple myeloma medicine.anatomical_structure Oncology immunotherapy medicine.symptom business |
Zdroj: | Frontiers in Oncology, Vol 11 (2021) Frontiers in Oncology |
ISSN: | 2234-943X |
DOI: | 10.3389/fonc.2021.755584 |
Popis: | Multiple myeloma (MM) with central nervous system (CNS) involvement is rare with only 1% incidence. So far, there is no standard or effective treatment for CNS MM, and the expected survival time is fewer than 6 months. Here, we report a case of MM with CNS involvement presented with cauda equina syndrome (CES) who achieved complete remission after anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T (CAR-T) cell therapy (Chictr.org.cn, ChiCTR1800017404). The expansion of BCMA CAR-T cells was observed in both peripheral blood (PB) and cerebrospinal fluid (CSF). The CAR-T cells peaked at 2.4 × 106/l in CSF at day 8 and 4.1 × 109/l in PB at day 13. The peak concentration of interleukin (IL)-6 in CSF was detected 3 days earlier, and almost five times higher than that in PB. Next, morphological analysis confirmed the elimination of nucleated cells in CSF 1 month after CAR-T cell treatment from 300 cells/μl, and the patient achieved functional recovery with regressed lesion shown in PET-CT. The case demonstrated that BCMA CAR-T cells are effective and safe in this patient population. |
Databáze: | OpenAIRE |
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