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Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • CAR-T • University of Chicago • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma
How would you approach BCMA-directed therapy in a patient with myeloma and renal failure on dialysis?
Would you prefer CAR-T or bi-specific or neither? If CAR-T, how do you approach lymphodepletion?
Answer from: Medical Oncologist at Academic Institution
The short answer: Very carefully. Lots of anecdotes and theoretical fears out there, but very little real data to guide us as of July 2023 as I write this. The largest experience with BCMA CAR-T with CKD is this TCT abstract by Sidana and colleagues that I don't think has been published yet:Sidana e...
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Answer from: Medical Oncologist at Academic Institution
No right answer.One approach is lymphodepleting with cyclophosphamide + dose reduced Flu with HD, 12 hours after each dose to limit toxicity. Hunter et al., PMID 35227310