Macrophage activation syndrome-like in multiple myeloma patients treated with the academic CAR-T against BCMA ARI0002h
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Chimeric antigen receptor T-cell (CAR-T) therapy targeting B-cell maturation antigen (BCMA) has revolutionized multiple myeloma treatment (MM). However, managing its immune-mediated adverse events, particularly macrophage activation syndrome- like (MAS- like ), remains challenging due to underreporting. Methods This multicentre, retrospective, analytical study evaluated MM patients treated with the anti-BCMA academic product ARI0002h. MAS- like was defined using the University of California San Francisco (UCSF) consensus criteria. Primary endpoints included baseline characteristics, predictive factors, and survival outcomes associated with MAS- like . Results Of 80 patients, 12 (15%) met the UCSF criteria for MAS- like . These patients presented higher ISS scores (ISS III: 54.5% vs. 15.2%; p = 0.006), elevated serum monoclonal components (31.3 g/L vs. 6.8 g/L; p = 0.004), and a higher prevalence of extramedullary disease (41.7% vs. 16.2%; p = 0.057). MAS- like typically emerged 9 days post-infusion, with elevated ferritin, followed by LDH (median 11.5 days) and hypofibrinogenemia (median 14 days). One-third of patients met all UCSF criteria, and all exhibited hypertriglyceridemia, hypertransaminasemia, and cytopenias. Histopathological examination was positive in 63% of evaluated patients. Patients who developed MAS- like had poorer responses (CR: 25% vs. 68%; p = 0.008) and shorter median PFS and OS (7 months vs. 21.4 months and 18 months vs. not reached, respectively; p = 0.004). Those meeting all UCSF criteria had even inferior outcomes. Conclusions MAS- like is associated with poorer responses, reduced PFS and OS, especially in patients meeting all UCSF criteria. High tumour burden, including elevated monoclonal component, high ISS and extramedullary disease, seems to contribute to MAS- like development.
Source: Frontiers in Immunology
Authors: Daniel Munárriz, Luis Gerardo Rodríguez-Lobato, Lucía López-Corral, Cristina Arnaldos-Pérez, Valentín Cabañas, Nieves López-Muñoz, Aina Oliver-Caldés, Juan Carlos Ponce, Juan Luis Reguera, Ana África Martín, Núria Martínez-Cibrián, Natalia Tovar, Julio Delgado, Elena Guillen, Sara Varea, Paula Rodríguez-Otero, Álvaro Urbano-Ispizua, José María Moraleda, Joaquín Martínez-López, María-Victoria Mateos, Verónica González De la Calle, Europa Azucena González-Navarro, Carlos Fernández de Larrea
Institutions: Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Consejo Superior de Investigaciones Científicas, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer de Salamanca, Instituto Murciano de Investigación Biosanitaria, Universidad de Murcia, Spanish National Cancer Research Centre, Hospital Universitario 12 De Octubre, Navarre Institute of Health Research, Centro de Investigación Biomédica en Red, Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Awards: G2417794953, Ensayo clínico fase II sobre el uso de un CART humanizado dirigido contra BCMA (ARI0002h) en pacientes con mieloma múltiple recaído/refractario a inhibidores del proteasoma, inmunomoduladores y anticuerpos anti-CD38, G3024517585, G3356704022, G3375147258, G4053627959, G5697690356, G6432452231, G8227040326, G8248449418, Estrategias novedosas de ingeniería avanzada para optimizar la función y la persistencia de las células CAR-T en el mieloma múltiple, G8531242526
OpenAlex ID: W4415237280