Simple Blood Test Identifies Multiple Myeloma Patients Likely to Benefit from CAR-T Immunotherapy

In a multicenter collaborative study by several notable institutions including Weill Cornell Medicine (New York, NY, USA), researchers observed that patients experiencing an increase in their absolute lymphocyte count (ALC) within the first 15 days post-CAR-T infusion showed a greater likelihood of complete response and extended progression-free survival compared to those with lower ALCs on day 15. This study, published in the journal Blood Advances on May 22, analyzed data from 156 patients treated with BCMA-CAR-T therapy between 2017 and 2023 for relapsed multiple myeloma across three medical centers. The patients’ ALCs were measured five days prior to and throughout the first 15 days following BCMA CAR-T treatment.

The findings indicated that patients with higher ALC at day 15 had a significantly better response to treatment with their cancer under control for an average of 30 months, whereas those with lower counts typically experienced only six months of progression-free survival. Laboratory analyses suggested that a higher ALC might indicate more effective proliferation and activity of BCMA CAR-T cells in the body, potentially explaining why the cancer was kept in check. The researchers are now investigating strategies to boost BCMA CAR-T cell performance in patients presenting lower ALCs to enhance treatment outcomes.

“If doctors can identify patients who are more likely to have a poor response to BCMA CAR-T, other treatments can be explored or given earlier,” said lead author Dr. Mateo Mejia Saldarriaga, assistant professor of medicine in the Division of Hematology and Medical Oncology at Weill Cornell Medicine and an oncologist at NewYork-Presbyterian/Weill Cornell Medical Center. “The treatment has been a great tool, but there is still room for improvement.”

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