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Humoral immune reconstitution after anti-BCMA CAR T-cell therapy in relapsed/refractory multiple myeloma

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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 [4]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Hematol, Tongji Hosp, Wuhan 430030, Hubei, Peoples R China [5]Tongji Univ, Tongji Hosp, Dept Hematol, Sch Med, Shanghai 200065, Peoples R China [6]Army Med Univ, Xinqiao Hosp, Med Ctr Hematol, Chongqing, Peoples R China [7]Xuzhou Med Univ, Canc Inst, Xuzhou, Jiangsu, Peoples R China [8]Xuzhou Med Univ, Jiangsu Ctr Collaborat & Innovat Canc Biotherapy, Canc Inst, Xuzhou, Jiangsu, Peoples R China [9]Xuzhou Med Univ, Ctr Clin Oncol, Affiliated Hosp, Xuzhou, Jiangsu, Peoples R China [10]iCARTAB Biomed Co Ltd, Suzhou, Jiangsu, Peoples R China
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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.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 2 区 血液学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 血液学
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出版当年[2019]版:
Q1 HEMATOLOGY
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Q1 HEMATOLOGY

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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
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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
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