B-cell maturation antigen chimeric antigen receptor-T therapy alleviated heart failure in patients with multiple myeloma

ESC Heart Fail. 2024 Feb;11(1):574-580. doi: 10.1002/ehf2.14554. Epub 2023 Nov 1.

Abstract

Patients with multiple myeloma (MM) are likely to achieve poor therapeutic response when organs are involved. We produced anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR)-T cells, which are in a trial for patients with relapsed/refractory MM. One enrolled patient developed severe heart failure, highly suspected as light chain cardiac amyloidosis. He exhibited increased N-terminal pro-brain natriuretic peptide with a peak of 32 299 ng/mL and heart failure with an ejection fraction of 30%. Anti-BCMA CAR-T cells were administered following lymphodepletion. The patient achieved cardiac response within 1 week with a decrease in N-terminal pro-brain natriuretic peptide by 80%, an increase in ejection fraction from 30% to 56%, and a haematological response with negative minimal residual disease at 1 month and a complete response at 1 year. To date, this patient has maintained good health without heart failure or haematological relapse. Herein, we show the efficacy of anti-BCMA CAR-T cells in patients with MM and severe heart failure.

Keywords: Anti-B-cell maturation antigen; Chimeric antigen receptor-modified T cells; Light chain cardiac amyloidosis; Multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • B-Cell Maturation Antigen / therapeutic use
  • Heart Failure* / drug therapy
  • Heart Failure* / therapy
  • Humans
  • Male
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / therapy
  • Natriuretic Peptide, Brain
  • Neoplasm Recurrence, Local / drug therapy
  • Receptors, Chimeric Antigen* / therapeutic use

Substances

  • Receptors, Chimeric Antigen
  • B-Cell Maturation Antigen
  • Natriuretic Peptide, Brain