@article {Lie005403, author = {Dan Li and Yimei Que and Shengnan Ding and Guang Hu and Wen Wang and Xia Mao and Ying Wang and Chunrui Li and Liang Huang and Jianfeng Zhou and Wei Zhang and Min Xiao}, title = {Anti-BCMA CAR-T cells therapy for a patient with extremely high membrane BCMA expression: a case report}, volume = {10}, number = {9}, elocation-id = {e005403}, year = {2022}, doi = {10.1136/jitc-2022-005403}, publisher = {BMJ Specialist Journals}, abstract = {B cell maturation antigen (BCMA)-directed CAR-T cell therapy is a disruptive approach for treating relapsed/refractory multiple myeloma (R/R MM); however, optimization is necessary to maximize patient benefit. We report the case of a 61-year-old woman with primary refractory MM who presented with high expression of membrane BCMA and low expression of soluble BCMA (sBCMA), experienced grade 4 cytokine release syndrome, and died fromsevere pneumonia after receiving anti-BCMA CAR-T (CT103A) therapy. This case highlights the importance of assessing the expression range of BCMA for its efficacy and safety in patients receiving BCMA CAR-T therapy. For patients who present with extremely high membrane BCMA expression and extremely low sBCMA expression, the presence of γ-secretase-related gene mutations should be considered. Special attention should also be paid to the prevention and treatment of cytokine release syndrome in such patients.}, URL = {https://jitc.bmj.com/content/10/9/e005403}, eprint = {https://jitc.bmj.com/content/10/9/e005403.full.pdf}, journal = {Journal for ImmunoTherapy of Cancer} }