TY - JOUR T1 - Anti-BCMA CAR-T cells therapy for a patient with extremely high membrane BCMA expression: a case report JF - Journal for ImmunoTherapy of Cancer JO - J Immunother Cancer DO - 10.1136/jitc-2022-005403 VL - 10 IS - 9 SP - e005403 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 Y1 - 2022/09/01 UR - http://jitc.bmj.com/content/10/9/e005403.abstract N2 - 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. ER -