{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T21:29:15Z","timestamp":1789248555181,"version":"build-2803163510"},"reference-count":49,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Key Project of Science and Technology Department of Zhejiang Province","award":["2021C03010"],"award-info":[{"award-number":["2021C03010"]}]},{"name":"Key Project of Science and Technology Department of Zhejiang Province","award":["2023C03060"],"award-info":[{"award-number":["2023C03060"]}]},{"name":"the Key Research and Development Program of Zhejiang Province","award":["2024SSYS0023"],"award-info":[{"award-number":["2024SSYS0023"]}]},{"name":"the Key Research and Development Program of Zhejiang Province","award":["2024SSYS0024"],"award-info":[{"award-number":["2024SSYS0024"]}]},{"name":"the Key Research and Development Program of Zhejiang Province","award":["2024SSYS0025"],"award-info":[{"award-number":["2024SSYS0025"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82130003"],"award-info":[{"award-number":["82130003"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270234"],"award-info":[{"award-number":["82270234"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82425002"],"award-info":[{"award-number":["82425002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2025,3,6]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>B-cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T-cell immunotherapy has shown promising results in the treatment of relapsed or refractory multiple myeloma (R\/RMM). This study presents the updated long-term outcomes from our center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Between July 30, 2018, and September 27, 2023, 141 patients with R\/RMM who received BCMA CAR-T therapy were enrolled. Patients underwent conditioning chemotherapy with cyclophosphamide and fludarabine, followed by BCMA CAR-T cell infusion at a median dose of 2.36\u00d710\n                      <jats:sup>6<\/jats:sup>\n                      cells\/kg. The study evaluated overall response rates, long-term efficacy, safety profiles, and their associations with clinical and disease characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At a median follow-up of 20.2 months, the safety profile of the therapy was manageable. Grade 3\/4 cytokine release syndrome occurred in 36.2% of patients, with no cases of severe neurotoxicity reported. 1-month post-infusion, grade \u22653 anemia persisted in 39.6% of patients, while neutropenia (43.3%) and thrombocytopenia (52.2%) were observed. The objective response rate (ORR) among evaluable patients was 94.8%, with 50.7% achieving a complete response (CR). The 4-year progression-free survival and overall survival rates were 37.4% (95% CI, 29.1% to 48.1%) and 63.2% (95% CI, 54.8% to 72.8%), respectively, with survival curves showing gradual flattening over time. Patients with a history of autologous stem cell transplantation (ASCT) and those with extramedullary disease demonstrated significantly inferior efficacy and survival outcomes. Peak CAR-T cell expansion was positively correlated with ORR (p&lt;0.001) and CR (p&lt;0.001). Notably, patients with prior ASCT exhibited significantly lower CAR-T cell expansion compared with those without prior ASCT (p&lt;0.001). Immunophenotypic analysis of infused CAR-T cells demonstrated impaired fitness in patients who received ASCT in the past year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BCMA CAR-T therapy in patients with R\/RMM results in significant and sustained responses, with a manageable safety profile on a large scale. Prior ASCT and extramedullary disease represent adverse prognostic factors. Patients with a history of ASCT demonstrate limited peak CAR-T cell expansion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2024-010687","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T07:12:49Z","timestamp":1743145969000},"page":"e010687","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Long-term follow-up of BCMA CAR-T cell therapy in patients with relapsed\/refractory multiple myeloma"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05430945","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8379-9434","authenticated-orcid":false,"given":"Chunxiang","family":"Jin","sequence":"first","affiliation":[{"name":"Bone Marrow Transplantation Center of The First Affiliated Hospital and Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 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