A new study from Weill Cornell Medicine, NewYork-Presbyterian, Columbia University, and Icahn School of Medicine at Mount Sinai reveals that a simple blood test may predict the success of CAR-T immunotherapy in patients with relapsed multiple myeloma. Published in Blood Advances, the research indicates that measuring the absolute lymphocyte count (ALC)—a type of white blood cell—during the first 15 days post-CAR-T infusion can provide insights into treatment efficacy.
Multiple myeloma, a blood cancer originating in plasma cells, often relapses, necessitating further therapy. CAR-T immunotherapy, an FDA-approved treatment, involves genetically modifying a patient's immune cells to target and destroy cancer cells. These modified cells, known as CAR-T cells, are reintroduced into the patient to attack the BCMA protein prevalent on multiple myeloma cells.
The study found that patients with an increased ALC at day 15 post-infusion had a higher likelihood of complete response and better progression-free survival compared to those with lower ALC. Specifically, patients with higher ALC had an average progression-free survival of 30 months, while those with lower ALC had only six months. This suggests that ALC can serve as a predictive marker, allowing doctors to identify patients who may not respond well to CAR-T therapy and consider alternative treatments sooner.
The research analyzed data from 156 patients across three medical institutions between 2017 and 2023, ensuring a diverse patient population and reducing bias. The study also indicated that higher ALC was linked to better proliferation and activity of CAR-T cells in the body, contributing to improved cancer control.
Dr. Mateo Mejia Saldarriaga and Dr. Ruben Niesvizky of Weill Cornell Medicine, along with their colleagues, emphasized that identifying patients with lower ALC could help explore other treatment options early. Additionally, strategies to enhance CAR-T cell activity in patients with lower ALC are being considered to improve treatment outcomes. This study underscores the potential of a simple blood test to guide and optimize CAR-T therapy for multiple myeloma patients.
Source: Weill Cornell Medicine
