Logo image
Back
MM-1432: Risk of Secondary Acute Myeloid Leukemia Following CAR-T Therapy in Multiple Myeloma
Abstract   Peer reviewed

MM-1432: Risk of Secondary Acute Myeloid Leukemia Following CAR-T Therapy in Multiple Myeloma

Ali Mohsin, Muhammad Furqan, Faiza Khan, Daniah Rizwan, Huzaifa Abeer, Ghulam Mustafa Mahmood, Hafiz Muhammad Majid Ilyas, Hasan Ilyas, Ghazia Rehman, Ishtiaq Ahmad, …
Clinical lymphoma, myeloma and leukemia, Vol.26(Suppl 1), pp.S1178-S1178
08/2026
DOI: 10.1016/S2152-2650(26)03042-9

View Online

Abstract

Background: Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the treatment landscape for relapsed/refractory multiple myeloma (MM), with anti-BCMA agents idecabtagene vicleucel and ciltacabtagene autoleucel now in clinical use. Real-world data on secondary neoplasm risk relative to MM patients not receiving CAR-T therapy is still limited. Methods: Using the TriNetX US Collaborative Network, we identified adult MM patients (ICD-10 C90.0) diagnosed on or after January 1, 2010, who were free of myelodysplastic syndromes (MDS) at baseline. Cohort 1 comprised MM patients who received CAR-T therapy (n = 1703); Cohort 2 comprised MM patients who never received CAR-T (n = 131157). Propensity score matching (1:1) on age, sex, race, and comorbidities yielded balanced cohorts of 1613 patients each. Outcomes included secondary acute myeloid leukemia (AML) (over 3 years), overall mortality, neutropenia, thrombocytopenia, and anemia. Risk ratios, odds ratios, and Kaplan-Meier survival analyses with Cox proportional hazards were performed. Results: Secondary AML: CAR-T–treated patients had a significantly lower risk of secondary AML over 3 years compared with matched controls (10.6% vs 20.3%; RR, 0.52; 95% CI, 0.44–0.62; OR, 0.47; 95% CI, 0.38–0.57; P < 0.001). AML-free survival at 3 years favored CAR-T therapy (85.7% vs 78.5%; HR, 0.48; 95% CI, 0.40–0.58; P < 0.001). Overall survival: CAR-T–treated patients demonstrated significantly improved overall survival (survival probability 48.6% vs 23.8%; HR, 0.79; 95% CI, 0.69–0.91; P = 0.001). Hematologic toxicity: CAR-T therapy was associated with significantly higher rates of neutropenia (RR, 2.11; HR, 3.23), thrombocytopenia (RR, 1.42; HR, 1.93), and anemia (RR, 1.15; HR, 1.51) compared with non–CAR-T MM patients (all P < 0.001). Conclusions: CAR-T therapy was associated with a significant overall survival benefit. However, increases in cytopenias underscore the ongoing hematologic burden of CAR-T therapy, which warrants vigilant post-treatment monitoring. BCMA: B-cell maturation antigen, HR: hazard ratio, OR: odds ratio, RR: risk ratio.
 CAR-T therapy ciltacabtagene autoleucel idecabtagene vicleucel secondary acute myeloid leukemia

Details

Metrics

1 Record Views
Logo image