A patient from Italy received CAR-T treatment for myeloma 8 months after her diagnosis.
In October 2018, 66-year-old Cinty was diagnosed with “multiple myeloma, λ light chain type, ISS stage I” in Italy. Subsequently, she received 4 cycles of VTD chemotherapy, during which she developed a fracture of the lateral third of the clavicle and peripheral neuropathy. For more effective treatment, the patient received 2 autologous stem cell transplants in May 2019 and November 2019, and after complete remission, the patient has been maintained on oral lenalidomide. However, in August 2020, the patient developed new bone destruction on repeat PET/CT, and serum free light chains increased rapidly. The results of bone puncture indicated disease progression, and the results of bone marrow FISH showed: t(11; 14), which was a new cytogenetic abnormality. In September 2020, after receiving 4 cycles of DVD chemotherapy, his disease was not controlled and progressed after evaluation. After changing chemotherapy regimen PCd for 3 cycles, the patient’s bone pain symptoms still did not improve, and the edema of both lower extremities aggravated after exercise. After multiple chemotherapy and two autologous hematopoietic stem cell transplants, the patient had developed resistance to a variety of internationally recognized effective drugs at this time.
The patient learned through the Internet that the CAR-T clinical trial carried out by Lu Daopei Hospital had a considerable effect on the treatment of multiple myeloma, so he applied for a visa and came to China in March 2021. After one month of isolation, he was admitted to Yanda Lu Daopei Hospital on April 22, 2021. After a series of related examinations and condition evaluation, in May of the same year, after pretreatment with FC chemotherapy, Lu Daopei Hospital infused the patient with BCMA CAR-T cells , After the infusion, his vital signs were stable, and there were no other obvious side effects except low-grade fever. The patient’s lower extremity edema gradually subsided, and he was pleased to find that his physical condition gradually improved.
One month after CAR-T, Cinty examination results showed: 24-hour urine protein quantitative detection: urine protein quantitative 50 (mg/d), which was significantly lower than that at admission; serum: FLC-κ 4.58 mg/L, FLC-λ 0. 61 mg/L; bone marrow assessment: no obvious plasma cells; clinical assessment was CR (complete remission).
At present, it has been 8 months since Cinty returned to Italy, and she is still in good physical condition. The symptoms of back pain and edema of both lower extremities have completely disappeared. Thousands of miles away, the patient expressed sincere gratitude to Lu Daopei Hospital and Chief Physician Zhang Xian’s team.