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CAR T-Cell Therapy and Multiple Myeloma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Immunology and Immunotherapy".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 1666

Special Issue Editor


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Guest Editor
Department of Hematology, Centre Hospitalier Universitaire de Liège,Liège, Belgium
Interests: malignant hematology; multiple myeloma; immunotherapy; CAR-T; clinical and translational research

Special Issue Information

Dear Colleagues,

As in many cancers, immunotherapy is revolutionizing the treatment of multiple myeloma (MM). MM is characterized by the clonal proliferation and accumulation of malignant plasma cells in bone marrow. Although therapeutic advances have been made, there is a high, unmet therapeutic need regarding this relapsing disease. To address this clinical need, potent immunotherapies have been developed and consist of monoclonal antibodies, bispecific T-cell-engaging antibodies, and chimeric antigen receptor T-cells (CAR-T). Different parameters such as T-cell fitness, the number of previous treatment lines, disease aggressiveness and disease extension may predict the efficacy of these treatments. CAR-T therapy is the most potent anti-myeloma treatment, but its clinical application is limited by its high costs, restricted access, and potential side effects.

This Special Issue welcomes research articles and review articles, from preclinical to clinical studies, in the field of CAR-T development and ways of improving their cytotoxic effects while limiting their side effects.

Dr. Jo Caers
Guest Editor

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Keywords

  • multiple myeloma
  • CAR-T immunotherapy
  • toxicity
  • efficacy
  • tumor models
  • safety

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Published Papers (1 paper)

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Research

13 pages, 610 KB  
Article
High Rate of Cytokine Release Syndrome-Related Coagulopathy with Low Incidence of Bleeding and Thrombosis in Patients Treated with B-Cell Maturation Antigen (BCMA)-Targeted Chimeric Antigen Receptor T-Cells (CAR-T)
by Ariela Arad, Maya Katz, Eyal Lebel, Yosef Kalish, Miri Assayag, Batia Avni, Shlomo Elias, Sigal Grisariu, Ela Shai, Shlomit Kfir-Erenfeld, Nathalie Asherie, Moshe E. Gatt, Polina Stepensky and Eran Zimran
Cancers 2025, 17(21), 3551; https://doi.org/10.3390/cancers17213551 - 2 Nov 2025
Cited by 1 | Viewed by 1128
Abstract
Background: B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor T-cell (CAR-T) therapy has demonstrated substantial efficacy in relapsed and/or refractory multiple myeloma. While toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) have been well characterized, the incidence [...] Read more.
Background: B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor T-cell (CAR-T) therapy has demonstrated substantial efficacy in relapsed and/or refractory multiple myeloma. While toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) have been well characterized, the incidence and clinical consequences of the coagulopathy associated with CRS remain underexplored. Methods: We conducted a prospective analysis of 108 adult patients with multiple myeloma or light chain amyloidosis treated with the academic anti-BCMA CAR-T HBI0101 in a single-center trial (NCT04720313). Coagulopathy was evaluated via serial fibrinogen measurements, with hypofibrinogenemia defined as <200 mg/dL and severe coagulopathy as <100 mg/dL. Laboratory markers, tocilizumab and blood product use, and thrombotic and bleeding complications were recorded. Patients received a short (3-day) or extended course of enoxaparin thromboprophylaxis as well as fresh frozen plasma in cases of severe coagulopathy. Results: CRS grades 1–3 occurred in 100 patients (93%). Hypofibrinogenemia was observed in 79 patients (73%), including 20 (19%) with severe coagulopathy. Fibrinogen levels were significantly associated with CRS severity (p < 0.001), number of tocilizumab doses (p < 0.001), peak levels of the inflammation markers LDH (p = 0.001) and ferritin (p = 0.006), and neutropenia (p = 0.33). Five thrombotic events (4.6%) and three minor bleeding events (2.7%) occurred within 3 months post-CAR-T infusion and were not associated with degree of coagulopathy or CRS. No cases of major bleeding or fatal thrombosis occurred. Conclusions: CRS-related coagulopathy is common following BCMA-targeted CAR-T treatment and correlates closely with CRS severity. Despite the high rate of laboratory coagulopathy, thrombosis and bleeding events were infrequent, suggesting the benefit of the prophylactic strategies used. Full article
(This article belongs to the Special Issue CAR T-Cell Therapy and Multiple Myeloma)
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