Bendamustine vs. fludarabine/cyclophosphamide lymphodepletion prior to BCMA CAR-T cell therapy in multiple myeloma - Summary - MDSpire

Bendamustine vs. fludarabine/cyclophosphamide lymphodepletion prior to BCMA CAR-T cell therapy in multiple myeloma

  • By

  • Surbhi Sidana

  • Hitomi Hosoya

  • Alexandria Jensen

  • Lawrence Liu

  • Anmol Goyal

  • Vanna Hovanky

  • Bita Sahaf

  • Sushma Bharadwaj

  • Theresa Latchford

  • Sally Arai

  • Sheryl Leahy

  • Matthew Mei

  • Lihua E. Budde

  • Lori S. Muffly

  • Matthew J. Frank

  • Saurabh Dahiya

  • Myo Htut

  • David Miklos

  • Murali Janakiram

  • October 13, 2023

  • 0 min

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Objective:

To evaluate the safety and efficacy of bendamustine lymphodepletion compared to fludarabine/cyclophosphamide (Flu/Cy) prior to BCMA CAR-T cell therapy in multiple myeloma patients, emphasizing the comparative aspect.

Key Findings:
  • Bendamustine achieved effective lymphodepletion with median absolute lymphocyte count (ALC) of 0.15 × 10^9/L on the day of infusion (p-value needed).
  • Flu/Cy group had lower ALC on the day of infusion (0.02 × 10^9/L) and nadir ALC (0.01 × 10^9/L) (p-value needed).
  • No significant differences in CAR-T expansion were observed between the two groups within the first month post-infusion.
  • Patients receiving Flu/Cy had lower nadir absolute neutrophil count (ANC) in the first 30 days post-infusion (p-value needed).
Interpretation:

Bendamustine lymphodepletion is effective and may provide comparable outcomes to Flu/Cy in terms of CAR-T expansion and safety profiles, specifically noting the safety aspects.

Limitations:
  • Small sample size for the bendamustine group (n=14) compared to Flu/Cy (n=42) may introduce bias.
  • Short follow-up duration for some patients may limit long-term efficacy assessments.
Conclusion:

Bendamustine is a viable alternative for lymphodepletion prior to BCMA CAR-T therapy, showing comparable safety and efficacy to Flu/Cy, which is significant for clinical practice.

Original Source(s)

Bendamustine vs. fludarabine/cyclophosphamide lymphodepletion prior to BCMA CAR-T cell therapy in multiple myeloma

  • by Surbhi Sidana, Hitomi Hosoya, Alexandria Jensen, Lawrence Liu, Anmol Goyal, Vanna Hovanky, Bita Sahaf, Sushma Bharadwaj, Theresa Latchford, Sally Arai, Sheryl Leahy, Matthew Mei, Lihua E. Budde, Lori S. Muffly, Matthew J. Frank, Saurabh Dahiya, Myo Htut, David Miklos, Murali Janakiram

  • October 13, 2023

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