Article
作者: Franke, Georg-Nikolaus ; Heyn, Simone ; Herling, Marco ; Merz, Maximilian ; Baber, Ronny ; Platzbecker, Uwe ; Weiss, Ronald ; Hell, Saskia ; Boldt, Andreas ; Kubasch, Anne Sophie ; Wang, Song Yau ; Ussmann, Jule ; Vucinic, Vladan ; Weidner, Heike ; Fischer, Luise ; Born, Patrick ; Franz, Paul ; Schwind, Sebastian ; Köhl, Ulrike ; Hoffmann, Sandra ; Jentzsch, Madlen ; Bach, Enrica ; Metzeler, Klaus H ; Kirchberg, Janine ; Reiche, Kristin ; Grieb, Nora ; Fricke, Stephan ; Seiffert, Sabine ; Sack, Ulrich
AbstractB-cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T cells revolutionized the treatment of relapsed/refractory multiple myeloma (RRMM). However, data on cellular (CAR) T cell dynamics and the association with response, resistance or the occurrence of cytokine release syndrome (CRS) are limited. Therefore, we performed a comprehensive flow cytometry analysis of 27 RRMM patients treated with Idecabtagene vicleucel (Ide-cel) to assess the expansion capacity, persistence and effects on bystander cells of BCMA-targeting CAR T cells. Additionally, we addressed side effects, like cytokine release syndrome (CRS) and cytopenia. Our results show that in vivo expansion of CD8+ CAR T cells is correlated to response, however persistence is not essential for durable remission in RRMM patients. In addition, our data provide evidence, that an increased fraction of CD8+ T cells at day of leukapheresis in combination with successful lymphodepletion positively influence the outcome. We show that patients at risk for higher-grade CRS can be identified already prior to lymphodepletion. Our extensive characterization contributes to a better understanding of the dynamics and effects of BCMA-targeting CAR T cells, in order to predict the response of individual patients as well as side effects, which can be counteracted at an early stage or even prevented.