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December 8, 2025BloodOpen Access

BCMA CAR T-cell expansion dynamics and toxicity after idecabtagene vicleucel and ciltacabtagene autoleucel for multiple myeloma

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Authors

MGMahmoud R. GaballaJCJessica ChenMHMisha Hawkins

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Overview

Retrospective analysis shows peak CAR-T levels correlate with cytokine release syndrome in multiple myeloma, indicating toxicity differences between therapies.

Key Points

  • This research investigates the early expansion dynamics of BCMA CAR T-cells and their association with toxicities in multiple myeloma treatments.
  • Retrospective analysis of 76 patients with relapsed/refractory multiple myeloma
  • Compared two treatments: idecabtagene vicleucel and ciltacabtagene autoleucel
  • Quantified BCMA CAR T-cells via flow cytometry
  • Assessed associations between CAR-T levels and treatment-related toxicities
  • Analyzed inflammatory markers like ferritin and C-reactive protein
  • Identified median peak CAR-T levels of 600 cells/µL for ide-cel and 1281 cells/µL for cilta-cel
  • Found peaks in ALC significantly associated with grade ≥2 cytokine release syndrome and ICANS in cilta-cel patients
  • Noted specific trends linking peaks in ferritin and CAR-T levels with delayed toxicities
  • Observed no significant correlation between CAR-T levels and most toxicities within subgroups
  • Highlighted potential for other immune mechanisms contributing to toxicity beyond CAR expansion

Cite This Study

Gaballa et al. (2025) studied this question.

synapsesocial.com/papers/693624d74fa91c937236d16ahttps://doi.org/10.1182/blood-2025-5850
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