PT  - JOURNAL ARTICLE
AU  - Dan Li
AU  - Yimei Que
AU  - Shengnan Ding
AU  - Guang Hu
AU  - Wen Wang
AU  - Xia Mao
AU  - Ying Wang
AU  - Chunrui Li
AU  - Liang Huang
AU  - Jianfeng Zhou
AU  - Wei Zhang
AU  - Min Xiao
TI  - Anti-BCMA CAR-T cells therapy for a patient with extremely high membrane BCMA expression: a case report
AID  - 10.1136/jitc-2022-005403
DP  - 2022 Sep 01
TA  - Journal for ImmunoTherapy of Cancer
PG  - e005403
VI  - 10
IP  - 9
4099  - http://jitc.bmj.com/content/10/9/e005403.short
4100  - http://jitc.bmj.com/content/10/9/e005403.full
SO  - J Immunother Cancer2022 Sep 01; 10
AB  - 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.