Hello, I'm Dr. Mohan from the Medical College of Wisconsin. So we're discussing our work on the use of stem cell boost in patients who experience immune-affected cell-associated hematotoxicity or cytopenias as we call after BCMA-directed CAR-T therapy in multiple myeloma. So we know that immune-affected cell-associated hematotoxicity or ICATs or cytopenias are very common after CAR-T cell therapy. This can result in significant morbidity. It can result in profound cytopenia, increasing the risk of infection, bleeding risk, increased utilization of healthcare resources such as growth factor support, transition requirements, and more importantly, it can result in financial and time toxicity for our patients. The delivery of anti-myeloma therapy in the post-CAR-T relapse setting can also be challenging if the patient is cytopenic. So that's why ICATs are pretty important and it's now recognized as one of the most common problems that we see following BCMA-CAR-T cell therapy. So in this study, we included patients who received BCMA-CAR-T therapy in the relapse both on a clinical trial setting and standard of care, IDC or CELTA cell. So we included about 108 patients. This is again a heavily pre-treated patient population with 90% of patients receiving a prior oculogous stem cell transplant. The median line of therapy was about six. So we note that cytopenias like neutropenia, anemia, and thrombocytopenia is pretty common 21 days post-CAR-T cell infusion. The numbers, actually the cell count actually recovers at the three and six month mark. However, even at the six month mark, roughly 6% of patients continues to be neutropenic. If you look at ICATs, which is either neutropenia, anemia, or thrombocytopenia, 60% of our patients have ICATs at day 21, that's three weeks after CAR-T cell therapy. These numbers improve at three and six month with roughly a third of the patient continuing to be cytopenic at that point. So we looked into the utilization of stem cell boost, which is stem cells that were collected and that were in storage in patients who developed cytopenias. In our study, nearly every patient who had cytopenia had stem cells in storage. So thus, and a third of the patients received stem cell boost about 116 days after CAR-T cell therapy. We note that the cell count recovery post-stem cell boost was durable and it was prompt. Interestingly, we also found in our study that cytopenias or ICATs three weeks after CAR-T cell therapy was associated with a poor outcome. So overall, this study really establishes that we should keep in mind that cytopenias are pretty common after BCMA-CARTY cell therapy and perhaps we should be collecting upfront stem cells if CAR is planned in the future, either on earlier lines or in the lab setting. Thank you.
HealthTree • December 10, 2023