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Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
Nephrotoxicity of CAR-T therapy in patients with relapsed and refractory multiple myeloma
Zihan Chen1, Yegan Chen1, Jiaying Liu1
1Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, No.99 West Huaihai Road, Xuzhou, 221002, Jiangsu, China.
Objective:
Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.
Methods:
We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.
Results:
Thirteen patients (12.1%) developed AKI within 1 month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.
Conclusion:
AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.
