University of Miami Miller School of Medicine, United States
Background/Case Studies: CAR T-cell therapies represent a ground-breaking advancement in the treatment of malignant diseases, leveraging genetically modified T-cells to target and eliminate cancer cells. Chemotherapy-based conditioning regimens are routinely used to prepare patients for both CAR T-cell therapy and hematopoietic progenitor cell (HPC) transplantation. While essential for these purposes, these regimens significantly suppress the hematopoietic system, often leading to severe cytopenias that require red blood cell (RBC) and platelet (Plt) transfusions (txns). In this study, we evaluate blood product transfusion needs following the infusion of the FDA-approved CAR-T product Carvykti® (ciltacabtagene autoleucel) in patients with multiple myeloma.
Study
Design/Methods: With the approval of the institution’s IRB, we performed a retrospective chart review for the period spanning June 2023 to July 2024. We collected data from patients who received CAR-T (Carvykti®) product infusion and assessed the usage of RBC and platelet transfusions post-infusion.
Results/Findings: A total of 26 CAR-T (Carvykti®) products were infused into 26 patients with multiple myeloma. Among the 26 patients evaluated from their treatment date up to six months later, 13 did not require any transfusions (neither RBC nor platelet transfusions). Of the remaining 13 transfused patients, one required only platelet transfusions, while two needed only RBC transfusions. Further details on RBC and platelet transfusions following infusion are provided in Table 1 below. Conclusions: We conclude that only a limited number of patients required RBC or platelet transfusions, indicating lower risks for ongoing cytopenias after CAR-T (Carvykti®) infusion. Additional studies with a larger sample size are essential to confirm these results and investigate the transfusion needs, as well as other transfusion-related complications, such as alloimmunization and immunomodulation, compared to those receiving standard HPC transplantation, with the goal of providing clearer insights into the differences in transfusion requirements between the two treatment modalities.
