4.7 Article

First report of CART treatment in AL amyloidosis and relapsed/refractory multiple myeloma

期刊

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/jitc-2021-003783

关键词

receptors; chimeric antigen; hematological neoplasms; immunotherapy

资金

  1. Instituto de Salud Carlos III, Spanish Ministry of Health [FIS PI18/00775, PI19/00669, ICI19/00025, CONCORD--023]
  2. Fondo Europeo de Desarrollo Regional [2017SGR00792]
  3. 'La Caixa' Foundation [CP042702]
  4. resident grant 'Ajut Clinic-La Pedrera' 2019 - Hospital Clinic de Barcelona
  5. European Union [754550]
  6. 'La Caixa' Foundation
  7. Marie Curie Actions (MSCA) [754550] Funding Source: Marie Curie Actions (MSCA)

向作者/读者索取更多资源

Despite being incurable, multiple myeloma may benefit from CART therapy in patients with concomitant AL amyloidosis, even when the predominant symptoms are caused by the amyloidosis itself.
Multiple myeloma (MM) remains incurable despite the number of novel therapies that have become available in recent years. Occasionally, a patient with MM will develop an amyloid light-chain (AL) amyloidosis with organ dysfunction. Chimeric antigen receptor T-cell (CART) therapy has become a promising approach in treating hematological malignancies. Our institution has developed a second-generation B-cell maturation antigen (BCMA)-CART which is currently being tested in a clinical trial for relapsed/refractory MM. We present the first reported case, to our knowledge, of a patient with AL amyloidosis and renal involvement in the course of an MM, successfully treated with CART therapy targeting BCMA. The patient received a fractioned dose of 3x10(6)/kg BCMA-CARTs after lymphodepletion. At 3 months from infusion, the patient had already obtained a deep hematological response with negative measurable residual disease by flow cytometry in the bone marrow. After 12 months, the patient remains in hematological stringent complete remission and has achieved an organ renal response with a decrease of 70% of proteinuria. This case suggests that concomitant AL amyloidosis in the setting of MM can benefit from CART therapy, even in patients in which predominant symptoms at the time of treating are caused by AL amyloidosis.

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