{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T20:45:42Z","timestamp":1774817142187,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001736","name":"German-Israeli Foundation for Scientific Research and Development","doi-asserted-by":"publisher","award":["SPP \u00b5bone"],"award-info":[{"award-number":["SPP \u00b5bone"]}],"id":[{"id":"10.13039\/501100001736","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Chimeric antigen receptor (CAR) T\u2010cell therapy has transformed the treatment of relapsed or refractory multiple myeloma (RRMM), yet outcomes remain heterogenous. The prognostic role of body composition in this context is unknown. We retrospectively analyzed 108 RRMM patients treated with anti\u2010B\u2010cell maturation antigen (BCMA) CAR T\u2010cell therapy. Pre\u2010treatment Computed tomography imaging was utilized to quantify total adipose tissue (TAT), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle area to assess sarcopenia. Longitudinal flow cytometric and single\u2010cell multi\u2010omic analyses were conducted to characterize the quantitative and qualitative influences of body composition on the immune microenvironment. Patients with BMI\u2009&lt;\u200925\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    experienced significantly worse overall survival (OS) compared to high\u2010BMI patients. Reduced TAT, primarily driven by low SAT, was associated with inferior OS, diminished response, and elevated soluble BCMA. Sarcopenia independently predicted poorer OS, while progression\u2010free survival was unaffected by the respective parameters. Low SAT and sarcopenia correlated with lower bystander T\u2010cell counts at leukapheresis. Longitudinal T\u2010cell receptor sequencing and single\u2010cell transcriptomics revealed diminished cytotoxic and interferon signaling, reduced T\u2010cell clonality, and increased oxidative phosphorylation activity following CAR T\u2010cell infusion. Our findings identify low SAT and sarcopenia as prognostic biomarkers that influence survival, therapeutic response, and immunometabolic profiles. Their quantification through standard imaging techniques offers a cost\u2010effective strategy for early risk stratification and individualized management in CAR T\u2010cell therapy.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70314","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:27:06Z","timestamp":1774362426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body composition predicts poor outcomes and reveals immunometabolic dysfunction via single\u2010cell profiling in anti\u2010BCMA CAR T\u2010treated myeloma"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2053-3857","authenticated-orcid":false,"given":"Thomas C.","family":"Wiemers","sequence":"first","affiliation":[{"name":"Department of Visceral, Transplantation, Vascular and Thoracic Surgery University Hospital Leipzig Leipzig Germany"},{"name":"Department of 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Leipzig Leipzig Germany"},{"name":"Fraunhofer Institute for Cell Therapy and Immunology IZI Leipzig Germany"},{"name":"Center for Scalable Data Analytics and Artificial Intelligence (ScaDS.AI) University of Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tihomir","family":"Dermendzhiev","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fandrei","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology University Hospital Leipzig Leipzig Germany"},{"name":"Fraunhofer Institute for Cell Therapy and Immunology IZI Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Born","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luise","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Seiffert","sequence":"additional","affiliation":[{"name":"Institute of Clinical Immunology, Medical Faculty University of Leipzig Leipzig Saxony Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Grahnert","sequence":"additional","affiliation":[{"name":"Institute of Clinical Immunology, Medical Faculty University of Leipzig Leipzig Saxony Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maik","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Institute of Clinical Immunology, Medical Faculty University of Leipzig Leipzig Saxony Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronny","family":"Baber","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Medicine Clinical Chemistry and Molecular Diagnostics University Hospital Leipzig Leipzig Germany"},{"name":"Leipzig Medical Biobank University of Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Kreuz","sequence":"additional","affiliation":[{"name":"Fraunhofer Institute for Cell Therapy and Immunology IZI Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus H.","family":"Metzeler","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology University Hospital Leipzig Leipzig 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg\u2010Nikolaus","family":"Franke","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostaseology, Cellular Therapy and Infectiology University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Boldt","sequence":"additional","affiliation":[{"name":"Institute of Clinical Immunology, Medical Faculty University of Leipzig Leipzig Saxony Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Neumuth","sequence":"additional","affiliation":[{"name":"Innovation Center Computer Assisted Surgery (ICCAS) University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urvi A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Myeloma Service Memorial Sloan Kettering Cancer Center New York New York 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