Multiple Myeloma(MM)-02

Italian Patient Seeks Treatment and Is Cured of Multiple Myeloma with CAR-T Therapy

Cinty, a 66-year-old woman, was diagnosed with lambda light chain multiple myeloma, ISS stage I, in Italy in October 2018. After receiving 4 cycles of VTD regimen chemotherapy, she developed a fracture in the lateral third of the clavicle and peripheral neuropathy. Seeking more effective treatment, she underwent two autologous stem cell transplants in May 2019 and November 2019, achieving complete remission, and was maintained on oral lenalidomide.

However, in August 2020, a follow-up PET/CT scan revealed new bone destruction and a rapid increase in serum free light chains. Bone marrow biopsy indicated disease progression, and FISH testing showed a new cytogenetic abnormality: t(11;14). After 4 cycles of DVD regimen chemotherapy starting in September 2020, her disease was uncontrolled and progressed further. Despite switching to 3 cycles of the PCd regimen, her bone pain persisted and bilateral lower limb edema worsened. Having exhausted many internationally recognized effective treatments and undergone two autologous stem cell transplants, she developed resistance to multiple drugs.

Upon learning about the significant efficacy of the CAR-T clinical trial at Ludaopei Hospital through online information, she applied for a visa and arrived in China in March 2021. After a month of quarantine, she was admitted to Yanda Ludaopei Hospital on April 22, 2021. Following a series of examinations and disease assessments, she received an infusion of BCMA CAR-T cells after FC chemotherapy preconditioning in May of the same year. Post-infusion, her vital signs were stable, and she experienced no significant side effects except for low-grade fever. Her bilateral lower limb edema gradually subsided, and she was pleased to notice her overall health improving.

One month after CAR-T infusion, Cinty’s test results showed: 24-hour urine protein quantification at 50 mg/day, significantly reduced from admission levels; serum free light chains: FLC-κ at 4.58 mg/L and FLC-λ at 0.61 mg/L; and bone marrow evaluation showed no significant plasma cells. She was clinically assessed as being in complete remission (CR).

Currently, eight months after returning to Italy, Cinty’s back pain and bilateral lower limb edema have completely disappeared, and she is in good health. From thousands of miles away, Cinty expressed her sincere gratitude to the team at Yanda Ludaopei Hospital and Director Zhang Xian.

These two clinical cases from Ludaopei Hospital demonstrate that even patients with low or no BCMA expression in multiple myeloma can achieve good efficacy with BCMA CAR-T cell therapy. This represents a breakthrough in CAR-T treatment for multiple myeloma, bringing new hope to patients with advanced plasma cell disorders and multiple myeloma.