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Long-term analysis of cellular immunity in patients with RRMM treated with CAR-T cell therapy.
- Source :
-
Clinical & Experimental Medicine . Dec2023, Vol. 23 Issue 8, p5241-5254. 14p. - Publication Year :
- 2023
-
Abstract
- Chimeric antigen receptor T (CAR-T) cell therapy exhibits remarkable efficacy against refractory or relapsed multiple myeloma (RRMM); however, the immune deficiency following CAR-Ts infusion has not been well studied. In this study, 126 patients who achieved remission post-CAR-Ts infusion were evaluated for cellular immunity. Following lymphodepletion (LD) chemotherapy, the absolute lymphocyte count (ALC) and absolute counts of lymphocyte subsets were significantly lower than baseline at D0. Grade ≥ 3 lymphopenia occurred in 99% of patients within the first 30 days, with most being resolved by 180 days. The median CD4+ T-cell count was consistently below baseline and the lower limit of normal (LLN) levels at follow-up. Conversely, the median CD8+ T-cell count returned to the baseline and LLN levels by D30. The median B-cell count remained lower than baseline level at D60 and returned to baseline and LLN levels at D180. In the first 30 days, 27 (21.4%) patients had 29 infections, with the majority being mild to moderate in severity (21/29; 72.4%). After day 30, 44 (34.9%) patients had 56 infections, including 20 severe infections. One patient died from bacteremia at 3.8 months post-CAR-Ts infusion. In conclusion, most patients with RRMM experienced cellular immune deficiency caused by LD chemotherapy and CAR-Ts infusion. The ALC and most lymphocyte subsets gradually recovered after day 30 of CAR-Ts infusion, except for CD4+ T cells. Some patients experience prolonged CD4+ T-cell immunosuppression without severe infection. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15918890
- Volume :
- 23
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Clinical & Experimental Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 174266790
- Full Text :
- https://doi.org/10.1007/s10238-023-01232-9