含有环胺的强化多剂桥梁治疗对Idecabtagene Vicleucel在多发性骨髓瘤治疗后的结果的影响
Taku Kikuchi1, Ukyo Kondo1, Shotaro Sugita1
1Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
在治疗多发性骨髓瘤的CAR-T细胞治疗之前,强化桥梁疗法 (BT) 可能会延迟血液细胞计数的恢复,但不会恶化生存结果. 这种方法可以考虑对侵袭性疾病,没有增加CRS或ICANS的风险.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 桥梁疗法 (BT) 对于在复发性/耐药性多发性髓瘤 (RRMM) 中制造BCMA导向的CAR-T疗法至关重要.
- 含有环胺的强化多剂化学疗法作为BT对CAR-T后结局的影响尚不清楚,尤其是在侵袭性疾病中.
研究的目的:
- 为了评估含有环胺的强化多剂BT在idecabtagene vicleucel (ide-cel) 输液后对临床结果的实际影响.
- 评估在接受CAR-T治疗的RRMM患者中不同强度的BT的安全性和有效性.
主要方法:
- 在接受ide-cel.的94名RRMM患者的回顾性单中心队列研究中.
- 强度BT定义为VTD-PACE或DCEP,根据周期号 (0/1/2) 进行分析.
- 使用卡普兰-梅尔和考克斯模型分析的无进展生存率 (PFS);评估了血液学恢复,感染,CRS和ICANS.
主要成果:
- 密集的BT患者更频繁地患有侵袭性疾病;无论周期数,BT应答率为75.5%.
- 在调整疾病攻击性后,强烈的BT并没有独立地与较低的PFS相关 (HR1.68,p=0.44).
- 在密集的BT中观察到的血小板和中性粒细胞恢复延迟;CRS (95.7%) 和ICANS (5.3%) 率在桥梁强度之间是相似的.
结论:
- 含有环胺的强化BT与血液恢复延迟有关,但在RRMM中ide-cel后的PFS并不劣.
- 在没有显著增加CRS或ICANS的情况下,可以考虑对精选的侵略性RRMM患者进行密集的桥梁治疗.
- 在白血病发生时的疾病攻击性仍然是PFS的关键独立预测指标.
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