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目的:探讨抗B细胞成熟抗原(BCMA)嵌合抗原受体T细胞(CAR-T)再次治疗复发难治多发性骨髓瘤(RRMM)的疗效和安全性。方法:回顾性分析2017年1月至2021年6月因首次抗BCMA CAR-T治疗(CART1)失败或复发,在河南省中医院接受抗BCMA CAR-T再次治疗(CART2)的10例RRMM患者临床资料。总结CART2患者的治疗情况、疗效及不良事件,并与CART1的客观缓解率(ORR)、中位持续缓解时间(DOR)及不良反应发生率进行比较。结果:10例患者中,男性8例,女性2例,中位年龄57岁(41~70岁)。CART1患者3个月ORR为90%,中位DOR为16.0个月(3.0~27.0个月)。CART2使用人源抗BCMA CAR-T治疗6例,鼠源抗BCMA CAR-T治疗4例。CART2患者3个月ORR为40%,中位DOR 8.5个月(3.0~11.0个月)。CART1用鼠源抗BCMA CAR-T的9例患者中,CART2仍用鼠源抗BCMA CAR-T再治疗的4例患者无一例有效;用人源抗BCMA CAR-T再次治疗的6例患者中,4例(66.7%)达到部分缓解(PR)及以上缓解。CART1的10例患者发生1~2级细胞因子释放综合征(CRS),7例出现不同程度的白细胞计数、中性粒细胞绝对计数(ANC)和血小板计数减少;CART2有效的4例患者均发生1~2级CRS,均出现不同程度的白细胞计数、ANC和血小板计数减少,无一例发生免疫效应细胞相关神经毒性综合征。结论:抗BCMA CAR-T再次治疗RRMM有效、安全。CART2的ORR和DOR低于CART1,常见不良反应为CRS和血细胞减少。“,”Objective:To explore the efficacy and safety of anti-B cell maturation antigen (BCMA) chimeric antigen receptor T-cell (CAR-T) for the retreatment of relapsed and refractory multiple myeloma (RRMM).Methods:The clinical data of 10 RRMM patients who received anti-BCMA CAR-T therapy for the second time (CART2) in Henan Province Hospital of Traditional Chinese Medicine due to failure or recurrence after their first anti-BCMA CAR-T (CART1) therapy from January 2017 to June 2021 were retrospectively analyzed. The treatment, efficacy and adverse events of patients receiving CART2 therapy were summarized; and the objective response rate (ORR), median duration of response (DOR) and incidence of adverse reactions were compared between CART1 and CART2.Results:Among 10 patients, 8 were males and 2 were females, with a median age of 57 years (41-70 years). Patients\' 3-month ORR after CART1 therapy was 90%, and the median DOR was 16.0 months (3.0-27.0 months). CART2 used human-derived anti-BCMA CAR-T to treat 6 cases and mouse-derived anti-BCMA CAR-T to treat 4 cases. The 3-month ORR of patients receiving CART2 therapy was 40%, and the median DOR was 8.5 months (3.0-11.0 months). Among 9 patients who received mouse-derived anti-BCMA CAR-T in CART1 therapy, 4 of them received the same product again and none of them showed curative effect. Among 6 patients retreated with human-derived anti-BCMA CAR-T, 4 patients (66.7%) of them achieved partial remission (PR) or better. During CART1 therapy, 10 patients developed grade 1-2 cytokine release syndrome (CRS), and 7 patients developed different degrees of decrease in leukocyte, neutrophil absolute count (ANC) and platelet. Among patients who achieved effective outcomes after receiving CART2 therapy, 4 patients of them developed grade 1-2 CRS, and different degrees of decrease in white blood cell, ANC and thrombocytopenia. Immune effector cell-related neurotoxicity syndrome was not observed.Conclusions:Anti-BCMA CAR-T is effective and safe to retreat RRMM. The ORR and DOR of patients receiving CART2 therapy are lower than those of patients receiving CART1 therapy. CRS and cytopenia are common adverse reactions.