TY - JOUR
T1 - Absolute Lymphocyte Count and Outcomes of Multiple Myeloma Patients Treated with Idecabtagene Vicleucel
T2 - The US Myeloma Immunotherapy Consortium Real- World Experience
AU - Khouri, Jack
AU - Dima, Danai
AU - Li, Hong
AU - Hansen, Doris
AU - Sidana, Surbhi
AU - Shune, Leyla
AU - Anwer, Faiz
AU - Sborov, Douglas
AU - Wagner, Charlotte
AU - Kocoglu, Mehmet H.
AU - Atrash, Shebli
AU - Voorhees, Peter
AU - Peres, Lauren
AU - Hovanky, Vanna
AU - Simmons, Gary
AU - Williams, Louis
AU - Raza, Shahzad
AU - Afrough, Aimaz
AU - Anderson, Larry D.
AU - Ferreri, Christopher
AU - Hashmi, Hamza
AU - Davis, James
AU - McGuirk, Joseph
AU - Goldsmith, Scott
AU - Borogovac, Azra
AU - Lin, Yi
AU - Midha, Shonali
AU - Nadeem, Omar
AU - Locke, Frederick L.
AU - Baz, Rachid
AU - Hamilton, Betty
AU - Alsina, Melissa
AU - Sauter, Craig
AU - Patel, Krina
AU - Kaur, Gurbakhash
N1 - Publisher Copyright:
© 2024 The American Society for Transplantation and Cellular Therapy
PY - 2024/8
Y1 - 2024/8
N2 - Idecabtagene vicleucel (ide-cel) has shown impressive efficacy in relapsed/refractory multiple myeloma (RRMM). This study aimed to investigate the impact of absolute lymphocyte count (ALC) on the survival outcomes of RRMM patients treated with standard of care (SOC) ide-cel. Data were collected retrospectively from 11 institutions in the U.S. Impact of ALC parameters including pre-apheresis (pre-A), pre-lymphodepletion (pre-LD), absolute and percent difference from pre-A to pre-LD on clinical outcomes after ide-cel were examined using survival analysis. A new ALC profile was created based on univariate analysis that comprises 3 groups: normal (≥1 × 109/L) pre-LD ALC (LDN), low (<1 × 109/L) pre-LD ALC (LDL) + percent reduction <37.5 (%RL), and LDL ALC + percent reduction ≥37.5 (%RH). A total of 214 SOC ide-cel recipients were included in this analysis. The median patient age was 64 years (interquartile range [IQR], 57 to 69 years), median number of prior therapies was 6 (IQR, 5 to 9), and median duration of follow-up was 5.4 months (IQR, 2.1 to 8.3 months). Most patients had both low pre-A ALC (75.3%) and pre-LD ALC (77.2%), and the reduction from pre-A to pre-LD (median, .65 to .55 × 109/L) was statistically significant. Univariate analysis showed that the LDL + %RH group had significantly worse progression-free survival (PFS) and overall survival (OS) compared to the LDL + %RL and LDN ALC groups (6-month PFS: 40% versus 67.6% and 60.9%; 6-month OS: 69.5% versus 87% and 94.3%). In multivariable analysis, after adjusting for age, performance status, cytogenetic risk, use of bridging therapy, and extramedullary disease, PFS did not maintain its statistical significance; however, OS remained significantly worse for LDL + %RH group compared to the LDN ALC group (hazard ratio [HR], 4.3; 95% confidence interval [CI], 1.1 to 17), but the difference between the LDL + %RH versus %RL groups was not statistically significant (HR, 1.7; 95% CI, .8 to 4.0). Our findings indicate that low pre-LD ALC with high %R from pre-A to pre-LD was associated with inferior survival outcomes, particularly OS, in patients who received SOC ide-cel.
AB - Idecabtagene vicleucel (ide-cel) has shown impressive efficacy in relapsed/refractory multiple myeloma (RRMM). This study aimed to investigate the impact of absolute lymphocyte count (ALC) on the survival outcomes of RRMM patients treated with standard of care (SOC) ide-cel. Data were collected retrospectively from 11 institutions in the U.S. Impact of ALC parameters including pre-apheresis (pre-A), pre-lymphodepletion (pre-LD), absolute and percent difference from pre-A to pre-LD on clinical outcomes after ide-cel were examined using survival analysis. A new ALC profile was created based on univariate analysis that comprises 3 groups: normal (≥1 × 109/L) pre-LD ALC (LDN), low (<1 × 109/L) pre-LD ALC (LDL) + percent reduction <37.5 (%RL), and LDL ALC + percent reduction ≥37.5 (%RH). A total of 214 SOC ide-cel recipients were included in this analysis. The median patient age was 64 years (interquartile range [IQR], 57 to 69 years), median number of prior therapies was 6 (IQR, 5 to 9), and median duration of follow-up was 5.4 months (IQR, 2.1 to 8.3 months). Most patients had both low pre-A ALC (75.3%) and pre-LD ALC (77.2%), and the reduction from pre-A to pre-LD (median, .65 to .55 × 109/L) was statistically significant. Univariate analysis showed that the LDL + %RH group had significantly worse progression-free survival (PFS) and overall survival (OS) compared to the LDL + %RL and LDN ALC groups (6-month PFS: 40% versus 67.6% and 60.9%; 6-month OS: 69.5% versus 87% and 94.3%). In multivariable analysis, after adjusting for age, performance status, cytogenetic risk, use of bridging therapy, and extramedullary disease, PFS did not maintain its statistical significance; however, OS remained significantly worse for LDL + %RH group compared to the LDN ALC group (hazard ratio [HR], 4.3; 95% confidence interval [CI], 1.1 to 17), but the difference between the LDL + %RH versus %RL groups was not statistically significant (HR, 1.7; 95% CI, .8 to 4.0). Our findings indicate that low pre-LD ALC with high %R from pre-A to pre-LD was associated with inferior survival outcomes, particularly OS, in patients who received SOC ide-cel.
KW - Absolute lymphocyte count
KW - Idecabtagene vicleucel
KW - Multiple myeloma
KW - Relapsed-refractory
UR - http://www.scopus.com/inward/record.url?scp=85196510371&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85196510371&partnerID=8YFLogxK
U2 - 10.1016/j.jtct.2024.05.025
DO - 10.1016/j.jtct.2024.05.025
M3 - Article
C2 - 38834151
AN - SCOPUS:85196510371
SN - 2666-6375
VL - 30
SP - 790.e1-790.e16
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 8
ER -