Clinical and lab evolution across lines of treatment
| Diagnosis (September 2014) | First relapse (October 2017) | Second relapse (December 2019) | ||||||
| BCMA–CART ARI0002h (screening) | +1 month ARI0002h | +6 months ARI0002h | +12 months ARI0002h | |||||
| CRAB (other symptoms) | Present (anemia, bone disease) | Present (anemia) | Absent, bilateral lower extremity edema | |||||
| Serum M-protein (g/L) | 59.7 | 0 | 0 | 17.6 | 20.7 | 4.7 | 0 | 0 |
| Serum lambda FLC (5.71–26.3 mg/L) | 1070 | 7 | 7 | 93 | 231 | <0.05 | <0.05 | 14 |
| Proteinuria Urine M-protein (mg/24 hours) | 2043 1052 | 268 0 | 144 0 | 94 0 | 2626 307 | 1777 0 | 1185 0 | 797 0 |
| Creatinine (<1.3 mg/dL) eGFR (>60 mL/min/1.73 m2) | 0.81 75 | 0.52 >90 | 0.55 >90 | 0.67 >90 | 0.60 >90 | 0.67 >90 | 0.81 75 | 0.91 66 |
| NT-proBNP (<125 pg/mL) Troponine I (<45.2 ng/L) | ND ND | ND ND | ND ND | ND ND | 211 7.2 | ND ND | 250 8.6 | ND ND |
| Serum and urine immunofixation | IgA lambda IgA lambda | IgA lambda Negative | IgG kappa Negative | IgA lambda IgA lambda | IgA lambda IgA lambda | IgA lambda IgA lambda | Negative Negative | IgG kappa Kappa FLC |
| Plasma cells (%) in bone marrow aspiration before treatment | 82 Abnormal phenotype | 1 Negative MRD | 1 Negative MRD | 25 Abnormal phenotype | 23 Abnormal phenotype | 0 Negative MRD | 0 Negative MRD | 1 Negative MRD |
| Treatment | Induction VRD ×6 | ASCT | Consolidation VRD ×2+maintenance I-Rd (CT) ×19 | D-Kd x14, since February 2019 D alone. | BCMA–CART ARI0002h | |||
| Best response (IMWG criteria) after treatment | VGPR | VGPR (at 3 months) | sCR | VGPR | N/A | PR | sCR | sCR |
CRAB includes multiple myeloma-related symptoms.
ASCT, autologous stem cell transplantation; BCMA, B-cell maturation antigen; CRAB, hypercalcemia, renal failure, anemia and bone fracture; CT, clinical trial; D, daratumumab; eGFR, estimated glomerular filtration rate; I, ixazomib; IMWG, International Myeloma Working Group; K, carfilzomib; MRD, minimal residual disease; N/A, not applicable; ND, data not available; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; PR, partial response; sCR, stringent complete response; VGPR, very good partial response; VRD, bortezomib, lenalidomide and dexamethasone.