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EHA 2025 | Incidence & management of cytopenias & infections in patients with R/R myeloma receiving cilta-cel
In this interview, Doris Hansen, MD, Moffitt Cancer Center, Tampa, FL, provides insight into a study investigating cytopenias and infections associated with ciltacabtagene autoleucel (cilta-cel) treatment in patients with relapsed/refractory (R/R) multiple myeloma (MM). As infection is the leading cause of non-relapse mortality (NRM) in patients with myeloma receiving CAR T-cell therapy, Dr Hansen emphasizes the importance of optimizing supportive care management in this setting. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
Another study that was led by my colleague Danai Dima and myself was looking at cytopenias, infections, as well as immune reconstitution following CAR T-cell therapy. This was a study from the U.S. Myeloma Immunotherapy Consortium. Over 100 patients treated with cilta-cel and essentially what we saw there is that you know you still have severe cytopenias grade 3 or higher at day 30 in about 40% of patients...
Another study that was led by my colleague Danai Dima and myself was looking at cytopenias, infections, as well as immune reconstitution following CAR T-cell therapy. This was a study from the U.S. Myeloma Immunotherapy Consortium. Over 100 patients treated with cilta-cel and essentially what we saw there is that you know you still have severe cytopenias grade 3 or higher at day 30 in about 40% of patients. As we move on to day 90 and six months, about 13-14%. And the patients who are most likely to develop these cytopenias had evidence of high disease burden, high CAR-HEMTATOTOX, extramedullary disease, etc. So kind of a pre-existing inflammatory profile in cytopenias to begin with. From an infection standpoint, day 30 we saw mostly bacterial and viral infections, day 30 and beyond, mostly viral infections. Commonly, this consisted of respiratory viruses, so things like RSV, COVID, rhinovirus. But generally speaking, about 10% of the patients used stem cell boost, TPO agonist, and over 50% received IVIG. So why is this important? Because as we move CAR T-cell therapies earlier in lines of treatment, you know, it’s paramount that we think about optimizing supportive care management as best as possible because infection is the leading cause of non-relapse mortality for our patients.
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