EHA 2025 | The impact of extramedullary disease on outcomes of CAR T-cell therapy in multiple myeloma

So we did a single-center retrospective chart review of 134 patients who had been through CAR-T. 34 of them had extramedullary disease. At a median follow-up of 30 months, what we saw was that patients who had extramedullary disease did much less well in terms of both progression-free survival and overall survival. So what we saw was that in patients who had extramedullary disease, the median progression-free survival was nine months versus 24 months in those who did not. Also in terms of overall survival, for patients who had extramedullary disease, the median overall survival was 24 months versus not reached for those who did not. We didn’t see the same association for periskeletal disease, so this was for true extramedullary disease. What we also saw was that in patients who had high-volume extramedullary disease of over 50 centimeters squared compared to a lower volume of less than 25 centimeters squared, the difference again was quite profound with the response rates being 81% for the lower volume versus 57% for the higher volume. What we also saw was that relapses post-CAR-T had half of them being with extramedullary disease. So again, this is very impactful. Extramedullary disease has always been a poor player in patients with relapsed/refractory myeloma, but this clearly shows that even post-CAR-T, these are still a problematic group.

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