Anti-B Cell Maturation Antigen Chimeric Antigen Receptor T Cell Therapy for the Treatment of AL Amyloidosis and Concurrent Relapsed/Refractory Multiple Myeloma: Preliminary Efficacy and Safety.

Abstract

While immunotherapies, such as CAR T therapy and bi-specific antibodies, have revolutionized the treatment of multiple myeloma (MM), patients with AL amyloidosis have been excluded from trials with these agents due to concerns of underlying autonomic, cardiac, and renal dysfunction, leading to potentially fatal toxicities from these therapies. In this communication, we described the outcomes of two patients with AL amyloidosis and concurrent MM with underlying cardiac and/or renal dysfunction who underwent anti-BCMA CAR T cell therapy with ide-cel or cilta-cel, received cytokine release syndrome prophylaxis, and tolerated therapy well with manageable toxicities and achieved a MRD-negative state. We described the preliminary efficacy and safety of CAR T in patients with AL amyloidosis and highlighted the importance of patient selection and medical optimization of cardiac and renal function prior to CAR T.

• Authors: Saurav Das, Sikander Ailawadhi, Taimur Sher, Vivek Roy, Andre Fernandez, Ricardo D Parrondo
• Journal: Current oncology (Toronto, Ont.) (Curr Oncol) Vol. 30 Issue 11 Pg. 9627-9633 (Oct 31 2023) ISSN: 1718-7729 [Electronic] Switzerland
• PMID: 37999117 (Publication Type: Case Reports)

Chemical References

• Receptors, Chimeric Antigen
• B-Cell Maturation Antigen

Topics

• Humans
• Multiple Myeloma (therapy, drug therapy)
• Immunotherapy, Adoptive (adverse effects)
• Receptors, Chimeric Antigen (therapeutic use)
• Immunoglobulin Light-chain Amyloidosis (complications, therapy)
• B-Cell Maturation Antigen (therapeutic use)
• Cell- and Tissue-Based Therapy
• Kidney Diseases (etiology)