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Objective <p>Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.</p> Methods <p>We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.</p> Results <p>Thirteen patients (12.1%) developed AKI within 1&#xa0;month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.</p> Conclusion <p>AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.</p>

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Nephrotoxicity of CAR-T therapy in patients with relapsed and refractory multiple myeloma

  • 期刊论文

  • 发表日期：

    2025年5月1日

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  • Zihan Chen,
  • Yegan Chen,
  • Jiaying Liu,
  • Yingjun Sun,
  • Xiaoxue Zhang,
  • Lingyan Shao,
  • Dandan Wang,
  • Xue Wang,
  • Wei Chen,
  • Wei Sang,
  • Kunming Qi,
  • Zhenyu Li,
  • Cai Sun,
  • Ming Shi,
  • Jianlin Qiao,
  • Qingyun Wu,
  • Lingyu Zeng,
  • Junnian Zheng,
  • Kailin Xu,
  • Li Li,
  • Hai Cheng,
  • Jiang Cao

摘要

Objective

Chimeric antigen receptor T (CAR-T) cell therapy has achieved impressive efficacy in treating relapsed and refractory multiple myeloma (R/R MM). Nephrotoxicity after CAR-T cell therapy has rarely been reported.

Methods

We investigated the occurrence and clinical outcomes of acute kidney injury (AKI) in 111 patients with R/R MM after CAR-T cell therapy.

Results

Thirteen patients (12.1%) developed AKI within 1 month of CAR-T cell therapy, of which 11 had grade 1 AKI, 1 had grade 2, and 1 had grade 3. Eleven (84.6%) cases resolved within 1 month after CAR-T cell therapy. The baseline tumor burden was an independent risk factor for the development of AKI. The finding of a high baseline tumor burden or hyponatremia after CAR-T cell therapy and close monitoring of lactate dehydrogenase, uric acid, interleukin (IL)-5 and IL-10 levels were helpful in predicting the development of AKI. The incidence of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between the AKI and non-AKI groups. There was also no significant difference in clinical efficacy between the two groups.

Conclusion

AKI is a mild severity and reversible complication. It has no impact on clinical outcomes in R/R MM patients receiving CAR-T cell therapy.