Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission

Multiple myeloma (MM) with central nervous system (CNS) involvement is rare with only 1% incidence. So far, there is no standard or effective treatment for CNS MM, and the expected survival time is fewer than 6 months. Here, we report a case of MM with CNS involvement presented with cauda equina syn...

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Autores principales:	Yiyun Wang, Linqin Wang, Yifan Zeng, Ruimin Hong, Cheng Zu, Elaine Tan Su Yin, Houli Zhao, Guoqing Wei, Li Yang, Aiyun Jin, Yongxian Hu, He Huang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	multiple myeloma central nervous system chimeric antigen receptor (CAR T) immunotherapy cauda equina syndrome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/cbd20a4390f643e0b766499414165902
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spelling	oai:doaj.org-article:cbd20a4390f643e0b7664994141659022021-11-17T05:44:22ZSuccessful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission2234-943X10.3389/fonc.2021.755584https://doaj.org/article/cbd20a4390f643e0b7664994141659022021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.755584/fullhttps://doaj.org/toc/2234-943XMultiple myeloma (MM) with central nervous system (CNS) involvement is rare with only 1% incidence. So far, there is no standard or effective treatment for CNS MM, and the expected survival time is fewer than 6 months. Here, we report a case of MM with CNS involvement presented with cauda equina syndrome (CES) who achieved complete remission after anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T (CAR-T) cell therapy (Chictr.org.cn, ChiCTR1800017404). The expansion of BCMA CAR-T cells was observed in both peripheral blood (PB) and cerebrospinal fluid (CSF). The CAR-T cells peaked at 2.4 × 106/l in CSF at day 8 and 4.1 × 109/l in PB at day 13. The peak concentration of interleukin (IL)-6 in CSF was detected 3 days earlier, and almost five times higher than that in PB. Next, morphological analysis confirmed the elimination of nucleated cells in CSF 1 month after CAR-T cell treatment from 300 cells/μl, and the patient achieved functional recovery with regressed lesion shown in PET-CT. The case demonstrated that BCMA CAR-T cells are effective and safe in this patient population.Yiyun WangYiyun WangYiyun WangYiyun WangLinqin WangLinqin WangLinqin WangLinqin WangYifan ZengRuimin HongRuimin HongRuimin HongRuimin HongCheng ZuCheng ZuCheng ZuCheng ZuElaine Tan Su YinElaine Tan Su YinElaine Tan Su YinElaine Tan Su YinHouli ZhaoHouli ZhaoHouli ZhaoHouli ZhaoGuoqing WeiGuoqing WeiGuoqing WeiGuoqing WeiLi YangLi YangLi YangLi YangAiyun JinAiyun JinAiyun JinAiyun JinYongxian HuYongxian HuYongxian HuYongxian HuHe HuangHe HuangHe HuangHe HuangFrontiers Media S.A.articlemultiple myelomacentral nervous systemchimeric antigen receptor (CAR T)immunotherapycauda equina syndromeNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	multiple myeloma central nervous system chimeric antigen receptor (CAR T) immunotherapy cauda equina syndrome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	multiple myeloma central nervous system chimeric antigen receptor (CAR T) immunotherapy cauda equina syndrome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yiyun Wang Yiyun Wang Yiyun Wang Yiyun Wang Linqin Wang Linqin Wang Linqin Wang Linqin Wang Yifan Zeng Ruimin Hong Ruimin Hong Ruimin Hong Ruimin Hong Cheng Zu Cheng Zu Cheng Zu Cheng Zu Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Houli Zhao Houli Zhao Houli Zhao Houli Zhao Guoqing Wei Guoqing Wei Guoqing Wei Guoqing Wei Li Yang Li Yang Li Yang Li Yang Aiyun Jin Aiyun Jin Aiyun Jin Aiyun Jin Yongxian Hu Yongxian Hu Yongxian Hu Yongxian Hu He Huang He Huang He Huang He Huang Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
description	Multiple myeloma (MM) with central nervous system (CNS) involvement is rare with only 1% incidence. So far, there is no standard or effective treatment for CNS MM, and the expected survival time is fewer than 6 months. Here, we report a case of MM with CNS involvement presented with cauda equina syndrome (CES) who achieved complete remission after anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T (CAR-T) cell therapy (Chictr.org.cn, ChiCTR1800017404). The expansion of BCMA CAR-T cells was observed in both peripheral blood (PB) and cerebrospinal fluid (CSF). The CAR-T cells peaked at 2.4 × 106/l in CSF at day 8 and 4.1 × 109/l in PB at day 13. The peak concentration of interleukin (IL)-6 in CSF was detected 3 days earlier, and almost five times higher than that in PB. Next, morphological analysis confirmed the elimination of nucleated cells in CSF 1 month after CAR-T cell treatment from 300 cells/μl, and the patient achieved functional recovery with regressed lesion shown in PET-CT. The case demonstrated that BCMA CAR-T cells are effective and safe in this patient population.
format	article
author	Yiyun Wang Yiyun Wang Yiyun Wang Yiyun Wang Linqin Wang Linqin Wang Linqin Wang Linqin Wang Yifan Zeng Ruimin Hong Ruimin Hong Ruimin Hong Ruimin Hong Cheng Zu Cheng Zu Cheng Zu Cheng Zu Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Houli Zhao Houli Zhao Houli Zhao Houli Zhao Guoqing Wei Guoqing Wei Guoqing Wei Guoqing Wei Li Yang Li Yang Li Yang Li Yang Aiyun Jin Aiyun Jin Aiyun Jin Aiyun Jin Yongxian Hu Yongxian Hu Yongxian Hu Yongxian Hu He Huang He Huang He Huang He Huang
author_facet	Yiyun Wang Yiyun Wang Yiyun Wang Yiyun Wang Linqin Wang Linqin Wang Linqin Wang Linqin Wang Yifan Zeng Ruimin Hong Ruimin Hong Ruimin Hong Ruimin Hong Cheng Zu Cheng Zu Cheng Zu Cheng Zu Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Elaine Tan Su Yin Houli Zhao Houli Zhao Houli Zhao Houli Zhao Guoqing Wei Guoqing Wei Guoqing Wei Guoqing Wei Li Yang Li Yang Li Yang Li Yang Aiyun Jin Aiyun Jin Aiyun Jin Aiyun Jin Yongxian Hu Yongxian Hu Yongxian Hu Yongxian Hu He Huang He Huang He Huang He Huang
author_sort	Yiyun Wang
title	Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
title_short	Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
title_full	Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
title_fullStr	Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
title_full_unstemmed	Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission
title_sort	successful bcma car-t therapy for multiple myeloma with central nervous system involvement manifesting as cauda equina syndrome—a wandering road to remission
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/cbd20a4390f643e0b766499414165902
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Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome—A Wandering Road to Remission

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