ArticleFrontiers in immunology2025
Prognostic significance of hematological parameters and albumin in BCMA-targeted CAR-T therapy for multiple myeloma.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Multiple myeloma is an incurable hematologic malignancy, and CAR-T therapy can benefit some patients with relapsed or refractory disease. However, due to individual variations, treatment outcomes vary significantly among different patients. We retrospectively analyzed 77 relapsed/refractory MM patients receiving BCMA-targeted CAR-T therapy. Baseline and dynamic hematological/nutritional parameters were assessed at four time points: prior to CAR-T cell collection, before pre-lymphodepletion therapy, before CAR-T cell infusion, and within the 7-day post-infusion. Prognostic groups were stratified by progression-free survival (PFS ≤ 10 vs. > 10 months). The results demonstrate that patients in the poor prognosis group consistently exhibited significantly lower levels of HGB, RBC, and HCT throughout the treatment period(p<0.05). Before pre-lymphodepletion ALB level in the poor prognosis group was significantly lower than that in the good prognosis group (p<0.05). LDH, creatinine, calcium ions, and β2-microglobulin showed no differences at the four observation time points(p>0.05). ROC analysis confirmed prognostic value for HGB (AUC = 0.693), RBC (AUC = 0.669), HCT (AUC = 0.691), and ALB (AUC = 0.756) (all p < 0.05). Kaplan-Meier analysis linked low HGB (≤92.5 g/L), RBC (≤3.26 ×10¹²/L), HCT (≤32.05%), and ALB (≤35.3 g/L) to inferior PFS (p = 0.011, 0.014, 0.0033, and 0.0001, respectively). Low ALB (≤35.3 g/L) before pre-lymphodepletion is a practical biomarker for risk stratification, reflecting compromised bone marrow reserve and immune-nutritional status. These accessible parameters may optimize patient selection and supportive care strategies.
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