The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2

Abstract The emergence of abnormal protein bands (APBs), also known as oligoclonal protein bands, has been documented in patients with multiple myeloma (MM) post hematopoietic stem cell transplantation. However, the incidence rate and clinical significance of APBs remain contentious. Few studies hav...

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Main Authors: Rui Liu, Gongzhizi Gao, Hongli Chen, Ruijun Dong, Wanggang Zhang, Wanhong Zhao, Jie Liu, Jianli Wang, Bo Lei, Baiyan Wang, Jiali Liu, Xuezhu Xu, Zujie Lin, Ruoyu Yang, Yiwen Wang, Aili He, Fangxia Wang, Ju Bai
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:HemaSphere
Online Access:https://doi.org/10.1002/hem3.70054
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author Rui Liu
Gongzhizi Gao
Hongli Chen
Ruijun Dong
Wanggang Zhang
Wanhong Zhao
Jie Liu
Jianli Wang
Bo Lei
Baiyan Wang
Jiali Liu
Xuezhu Xu
Zujie Lin
Ruoyu Yang
Yiwen Wang
Aili He
Fangxia Wang
Ju Bai
author_facet Rui Liu
Gongzhizi Gao
Hongli Chen
Ruijun Dong
Wanggang Zhang
Wanhong Zhao
Jie Liu
Jianli Wang
Bo Lei
Baiyan Wang
Jiali Liu
Xuezhu Xu
Zujie Lin
Ruoyu Yang
Yiwen Wang
Aili He
Fangxia Wang
Ju Bai
author_sort Rui Liu
collection DOAJ
description Abstract The emergence of abnormal protein bands (APBs), also known as oligoclonal protein bands, has been documented in patients with multiple myeloma (MM) post hematopoietic stem cell transplantation. However, the incidence rate and clinical significance of APBs remain contentious. Few studies have explored the occurrence and prognostic implications of APBs in patients with MM treated with B‐cell maturation antigen (BCMA)–specific chimeric antigen receptor (CAR)‐T therapy. In this retrospective study, we examined the frequency, isotypes, and duration of APBs, as well as their correlation with MM disease characteristics, treatment response, clinical outcomes, and immune signature in patients with relapsed/refractory MM who had received LCAR‐B38M therapy at the Xi'an site of the phase 1 LEGEND‐2 trial. Among 47 patients assessed, 23 (48.9%) developed APBs following CAR‐T therapy, with IgG being the most common isotype. The median onset and duration of APBs post‐CAR‐T infusion were 3.6 and 5.8 months, respectively. Patients with APBs demonstrated significantly improved response to LCAR‐B38M therapy, along with longer overall and progression‐free survival. Furthermore, those with APBs exhibited enhanced recovery rates of immunoglobulins and higher absolute counts of white blood cells, neutrophils, and lymphocytes post‐CAR‐T treatment compared to those without APBs. However, no significant differences were observed between the two groups in the percentages of various T‐cell subsets and natural killer cells. Overall, the presence of APBs in patients with MM following CAR‐T treatment was associated with deeper remission and a more favorable prognosis, suggesting a robust humoral response and subsequent immune reconstitution.
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spelling doaj-art-a02a12b7eb194cb58cbb2ee9e92e299f2024-11-26T10:54:29ZengWileyHemaSphere2572-92412024-11-01811n/an/a10.1002/hem3.70054The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2Rui Liu0Gongzhizi Gao1Hongli Chen2Ruijun Dong3Wanggang Zhang4Wanhong Zhao5Jie Liu6Jianli Wang7Bo Lei8Baiyan Wang9Jiali Liu10Xuezhu Xu11Zujie Lin12Ruoyu Yang13Yiwen Wang14Aili He15Fangxia Wang16Ju Bai17Department of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Clinical Laboratory The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaDepartment of Hematology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an Shaanxi ChinaAbstract The emergence of abnormal protein bands (APBs), also known as oligoclonal protein bands, has been documented in patients with multiple myeloma (MM) post hematopoietic stem cell transplantation. However, the incidence rate and clinical significance of APBs remain contentious. Few studies have explored the occurrence and prognostic implications of APBs in patients with MM treated with B‐cell maturation antigen (BCMA)–specific chimeric antigen receptor (CAR)‐T therapy. In this retrospective study, we examined the frequency, isotypes, and duration of APBs, as well as their correlation with MM disease characteristics, treatment response, clinical outcomes, and immune signature in patients with relapsed/refractory MM who had received LCAR‐B38M therapy at the Xi'an site of the phase 1 LEGEND‐2 trial. Among 47 patients assessed, 23 (48.9%) developed APBs following CAR‐T therapy, with IgG being the most common isotype. The median onset and duration of APBs post‐CAR‐T infusion were 3.6 and 5.8 months, respectively. Patients with APBs demonstrated significantly improved response to LCAR‐B38M therapy, along with longer overall and progression‐free survival. Furthermore, those with APBs exhibited enhanced recovery rates of immunoglobulins and higher absolute counts of white blood cells, neutrophils, and lymphocytes post‐CAR‐T treatment compared to those without APBs. However, no significant differences were observed between the two groups in the percentages of various T‐cell subsets and natural killer cells. Overall, the presence of APBs in patients with MM following CAR‐T treatment was associated with deeper remission and a more favorable prognosis, suggesting a robust humoral response and subsequent immune reconstitution.https://doi.org/10.1002/hem3.70054
spellingShingle Rui Liu
Gongzhizi Gao
Hongli Chen
Ruijun Dong
Wanggang Zhang
Wanhong Zhao
Jie Liu
Jianli Wang
Bo Lei
Baiyan Wang
Jiali Liu
Xuezhu Xu
Zujie Lin
Ruoyu Yang
Yiwen Wang
Aili He
Fangxia Wang
Ju Bai
The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
HemaSphere
title The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
title_full The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
title_fullStr The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
title_full_unstemmed The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
title_short The incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after BCMA–CAR‐T cell therapy: A retrospective study based on LEGEND‐2
title_sort incidence and clinical significance of monoclonal and oligoclonal protein bands in multiple myeloma patients after bcma car t cell therapy a retrospective study based on legend 2
url https://doi.org/10.1002/hem3.70054
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