EHA 2025 | A real-world analysis of risk factors for neurotoxicities in patients with RRMM receiving cilta-cel

At EHA 2025, we are presenting the analysis for risk factors with the delayed neurotoxicities from the CARTITUDE studies. So these are the clinical trials using cilta-cel. At Mayo Clinic, we also looked at patients who received the FDA-approved cilta-cel in standard of care practice because we know that these patients may have broader demographics than the patients who enroll on a trial and we wanted to see what are the risk factors that we can identify in the real world. So we compared patients who received these CAR-T cells and didn’t develop these side effects versus those who did and really found a lot of similar risk factors as what we saw in the clinical trial. So certainly, a relatively higher myeloma disease burden coming into treatment can be a risk factor. Features of more inflammatory state post-infusion, such as more prolonged cytokine release syndrome, needing to receive more than one dose of tocilizumab for management of cytokine release syndrome. But the strongest associated factor is really that expansion of the absolute lymphocyte count, typically around week two post-infusion, which we know also correlates with expansion of CAR T-cells. So in our standard of care practice, we’re also trying a similar approach that is being used in a clinical trial as well, with a very short, limited duration, three days of dexamethasone, and seeing if that may help reduce the incidence or severity of the cranial nerve palsy and Parkinsonism post-infusion. So more on that to come in the future Congresses.

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