Systematic and dynamic humoral immune reconstitution is little-known for patients with relapsed/refractory (R/R) multiple myeloma (MM) who received anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy. We investigated the kinetics of B-cell, normal plasma cell, and immunoglobulin recovery in 40 patients who achieved ongoing response after anti-BCMA CAR T-cell therapy. All patients developed B-cell aplasia and the median duration of B-cell aplasia was 70 days (range, 23-270). The B-cell count reached its nadir on median day 7 and returned to baseline level on median day 97. BCMA(+) cells in bone marrow turned undetectable on median day 28 (13-159) in 94.87% (37 of 39) of patients. Normal plasma cells in bone marrow were first redetected on median day 212. All patients developed a significant decrease in serum IgG, IgA, and IgM on median day 60. At year 1, recovery of serum IgG, IgM, and IgA was observed in 53.33% (8 of 15; non-IgG MM), 73.08% (19 of 26; non-IgM MM), and 23.81% (5 of 21;non-IgA MM) of the patients, respectively. Median time to IgG, IgM, and IgA recovery were days 386, 254, and not reached during follow-up, respectively. Virus-specific IgG levels decreased with loss of protection. Twenty-three of 40 (57.5%) patients had a total of 44 infection events. There were no infection-related deaths. These results reveal a 7-month aplasia of bone marrow normal plasma cells and longer period of hypogammaglobulinemia, suggesting a profound and lasting humoral immune deficiency after anti-BCMA CAR T-cell therapy, especially for IgA.
基金:
Program of National Natural Science Foundation of China [81930005, 81970159, 81700177]; Research and Practice Innovation Program for Postgraduates of Jiangsu Province [KYCX20_2457]
第一作者单位:[1]Xuzhou Med Univ, Blood Dis Inst, Xuzhou, Jiangsu, Peoples R China[2]Xuzhou Med Univ, Affiliated Hosp, Dept Hematol, 99 West Huaihai Rd, Xuzhou 221002, Jiangsu, Peoples R China[3]Key Lab Bone Marrow Stem Cells, Xuzhou, Jiangsu, Peoples R China
通讯作者:
通讯机构:[1]Xuzhou Med Univ, Blood Dis Inst, Xuzhou, Jiangsu, Peoples R China[2]Xuzhou Med Univ, Affiliated Hosp, Dept Hematol, 99 West Huaihai Rd, Xuzhou 221002, Jiangsu, Peoples R China[3]Key Lab Bone Marrow Stem Cells, Xuzhou, Jiangsu, Peoples R China
推荐引用方式(GB/T 7714):
Wang Ying,Li Chunrui,Xia Jieyun,et al.Humoral immune reconstitution after anti-BCMA CAR T-cell therapy in relapsed/refractory multiple myeloma[J].BLOOD ADVANCES.2021,5(23):5290-5299.doi:10.1182/bloodadvances.2021004603.
APA:
Wang, Ying,Li, Chunrui,Xia, Jieyun,Li, Ping,Cao, Jiang...&Xu, Kailin.(2021).Humoral immune reconstitution after anti-BCMA CAR T-cell therapy in relapsed/refractory multiple myeloma.BLOOD ADVANCES,5,(23)
MLA:
Wang, Ying,et al."Humoral immune reconstitution after anti-BCMA CAR T-cell therapy in relapsed/refractory multiple myeloma".BLOOD ADVANCES 5..23(2021):5290-5299