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MULTIPLE MYELOMA, GAMMOPATHIES

Patterns of relapse in patients with multiple myeloma receiving chimeric antigen receptor T cell therapy: a multi-center analysis

Leukemia volume 39, pages 2289–2291 (2025)Cite this article

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To the Editor:

Extramedullary disease (EMD) is a risk factor for poor outcomes in multiple myeloma (MM) [1,2,3], including amongst recipients of chimeric antigen receptor T-cell therapy (CAR-T) [4, 5]. With CD-19 CAR-T, discordant responses have also been observed, with clearance of disease in the marrow and persistence of disease in extramedullary sites, highlighting how CAR-T activity may be limited in extramedullary sites [6]. While patterns of progression at relapse have been studied, no prior work has specifically examined relapse patterns in CAR-T recipients with MM [7, 8]. Most early disease progressions are biochemical, highlighting the importance of routine bloodwork [7, 8]. The percentage of biochemical relapses that precede a clinical relapse in the post-CAR-T setting remains to be determined, as does the frequency of relapses with EMD or end-organ damage despite extensive surveillance.

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Fig. 1: Kaplan-Meier curve showing overall survival after progression following CAR-T stratified by type of progression, with time zero representing date of progression following CAR-T.

Data availability

The dataset may be sent upon reasonable request to the corresponding author.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Kritika Yadav, Meera Mohan, Binod Dhakal & Anita D’Souza

  2. Division of Hematology, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA

    Charlotte Wagner, Douglas Sborov, Amandeep Godara, Brian McClune & Ghulam Rehman Mohyuddin

  3. Multiple Myeloma and Amyloidosis Program, Columbia University, Herbert Irving Comprehensive Cancer Center, New York, NY, USA

    Rajshekhar Chakraborty

  4. Myeloma Center, University of Arkansas for Medical Science, Little Rock, AR, USA

    Carolina Schinke

  5. Division of Biostatistics, Data Science Institute, Medical College of Wisconsin, Milwaukee, WI, USA

    Aniko Szabo

Authors
  1. Kritika Yadav
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  2. Meera Mohan
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  12. Ghulam Rehman Mohyuddin
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Contributions

Ghulam Rehman Mohyuddin conceived the study idea. Kritika Yadav, Meera Mohan, Charlotte Wagner, and Carolina Schinke collected the data. Aniko Szabo, Kritika Yadav, and Ghulam Rehman Mohyuddin performed the analysis. Ghulam Rehman Mohyuddin and Kritika Yadav wrote first draft of manuscript. Rajshekhar Chakraborty, Douglas Sborov, Amandeep Godara, Brian McClune, Binod Dhakal, Anita D’Souza provided critical input, refined manuscript, and approved the final version of manuscript.

Corresponding author

Correspondence to Ghulam Rehman Mohyuddin.

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Competing interests

Dr. Sborov has reported consulting or advisory roles for Sanofi, GlaxoSmithKline, Bristol Myers Squibb, Legend Biotech, Janssen, Pfizer, Bioline, AstraZeneca, Arcellx, Abbvie, and Genentech, Inc.; research funding from Pfizer; honoraria from Binaytara Foundation; and membership on the Board of Directors or advisory committees for Society of Utah Medical Oncology. Dr. Godara has reported consulting relationships with Janssen and Sanofi, and honoraria from Janssen. Dr. Chakraborty has reported consulting or advisory roles for Adaptive, Janssen, and Sanofi. Dr. D’Souza has reported consulting or advisory roles for Pfizer, Janssen Oncology, Akcea Therapeutics, Bristol Myers Squibb/Celgene, and Prothena. Dr. Mohyuddin reports research funding to institution from Janssen. Drs. Yadav, Mohan, Wagner, Schinke, Dhakal, McClune, and Szabo have no specific conflicts of interest to disclose.

Ethical approval

The study was approved by the Ethics Committee of each hospital (IRB-00179264) and conducted in compliance with the Declaration of Helsinki.

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Informed consent was obtained in accordance with local ethical and legal requirements.

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Yadav, K., Mohan, M., Wagner, C. et al. Patterns of relapse in patients with multiple myeloma receiving chimeric antigen receptor T cell therapy: a multi-center analysis. Leukemia 39, 2289–2291 (2025). https://doi.org/10.1038/s41375-025-02702-7

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