Case Report: ITP Treatment After CAR-T Cell Therapy in Patients With Multiple Myeloma.

Abstract

Chimeric antigen receptor T (CAR-T) cell therapy is an attractive strategy for patients with relapsed or refractory hematological malignancies including multiple myeloma (MM). T cells are engineered to attack malignant cells that express tumor-associated antigens and better efficacy could be achieved. However, cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and hematologic toxicity are still challenges for CAR-T cell therapy. Among them, hematologic toxicity including thrombocytopenia has a longer duration and lasting effect during and after the treatment for some patients. Here, we present 3 cases of hematologic toxicity manifested as refractory thrombocytopenia with platelet autoantibodies positive and plasma thrombopoietin (TPO) concentration elevated after bispecific CAR-T cell therapy in relapsed/refractory (R/R) MM patients who were successfully treated with standard therapy of immune thrombocytopenia (ITP). Without clear pathogenesis or guidance on therapy published, our cases provide a reference for the treatment of thrombocytopenia after CAR-T cell therapy and inspire exploration of the underlying pathophysiological mechanisms.

• Authors: Mengyi Du, Linlin Huang, Haiming Kou, Chenggong Li, Yu Hu, Heng Mei
• Journal: Frontiers in immunology (Front Immunol) Vol. 13 Pg. 898341 ( 2022) ISSN: 1664-3224 [Electronic] Switzerland
• PMID: 35784357 (Publication Type: Case Reports, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Du, Huang, Kou, Li, Hu and Mei.

Chemical References

• Receptors, Chimeric Antigen

Topics

• Cell- and Tissue-Based Therapy
• Humans
• Leukopenia
• Multiple Myeloma (therapy)
• Purpura, Thrombocytopenic, Idiopathic (therapy)
• Receptors, Chimeric Antigen
• Thrombocytopenia