Ben Derman/X
May 11, 2025, 09:16
Ben Derman: Intrathecal Chemotherapy as an Effective Treatment for Cilta-cel–Associated MNT
Ben Derman, Assistant Professor at University of Chicago, shared a post on X about recent article he and his colleagues authored:
“Cilta-cel associated Parkinsonism remains a challenge. Instead of going right to high dose Cy which can be toxic to circulating CAR T cells, we opted to try intrathecal chemotherapy in 5 consecutive cases. 4/5 patients had a response and 3 complete resolution! IT chemo seemed to be most effective in those with CSF lymphocytosis.
This strategy may help to preserve circulating CAR T cells and duration of response. See our paper here!
The median peak absolute lymphocyte count post-CAR T for patients experiencing MNTs was 2.93 x10^9/L (range 1.75-3.74) compared to 1.45×10^9/L (range 0.33-37.7) in those who did not (p=0.2). Time from symptom onset to treatment is probably important as well.”
Rahul Banerjee, Assistant Professor at Fred Hutchinson Cancer Center at the University of Washington, shared this post, adding:
“I think the timing of intervention is probably more important than the exact type when these MNTs develop after BCMA CAR-T in MM… But jumping to high-dose Cy makes us nervous as Ben said, so good to see another effective option here! Now published in Blood Advances.”
Title: Intrathecal chemotherapy for ciltacabtagene autoleucel-associated movement and neurocognitive toxicity
Journal: Blood Advances
Authors: Kaitlin Kelly, Jennifer Cooperrider, Michael R. Bishop, Satyajit Kosuri, Andrzej Jakubowiak, Benjamin A. Derman
Read Full Article.
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