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December 8, 2025Blood

Earlier use of ciltacabtagene autoleucel (cilta-cel) is associated with better immune fitness and stronger immune effects as shown by correlative analysis of peripheral blood and the bone marrow tumor microenvironment (TME) from the CARTITUDE-4 study

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Authors

NDNiels W.C.J. van de DonkSHShuo HanMSMahipal Suraneni

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Overview

Correlative analysis shows cilta-cel enhances immune fitness and prolongs progression-free survival in lenalidomide-refractory myeloma, implying benefits of earlier intervention.

Key Points

  • This research investigates the correlation between immune fitness and clinical outcomes in patients treated with cilta-cel for multiple myeloma.
  • Correlative biomarker analyses performed on peripheral blood and bone marrow samples from CART-1 and CART-4 studies.
  • Flow cytometry used for immunophenotyping of peripheral blood samples.
  • Gene expression data analyzed using mixed-effects models for associations with progression-free survival.
  • Higher levels of CD4+ naïve T cells at baseline correlate with longer progression-free survival.
  • B-cell depletion was observed shortly after cilta-cel infusion, with partial recovery after 6 months.
  • Elevated expression of genes related to tumor-associated macrophages and T-cell activation at D28 indicates robust immune response.

Cite This Study

Donk et al. (2025) studied this question.

synapsesocial.com/papers/693624d44fa91c937236d04chttps://doi.org/10.1182/blood-2025-92
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term progression-free survival benefit with ciltacabtagene autoleucel in standard-risk relapsed / refractory multiple myeloma2025 · 4 citations
  2. 2CARTITUDE-1 final results: Phase 1b/2 study of ciltacabtagene autoleucel in heavily pretreated patients with relapsed/refractory multiple myeloma.2023 · 117 citations
  3. 3Comparative Effectiveness of Ciltacabtagene Autoleucel in CARTITUDE-4 Versus Real-World Physician’s Choice of Therapy from the Flatiron Registry in Lenalidomide-Refractory Multiple Myeloma2025 · 3 citations
  4. 4Bridging therapy response and low pre-lymphodepletion plasma cell burden are associated with improved safety and efficacy outcomes of ciltacabtagene autoleucel in multiple myeloma2025 · 5 citations
  5. 5Effectiveness of bridging therapy corresponds to improved outcomes after ciltacabtagene autoleucel: Phase 3 CARTITUDE-4 study of patients with relapsed, lenalidomide-refractory multiple myeloma2025 · 10 citations