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@ARTICLE{Frenking:300648,
      author       = {J. H. Frenking and X. Zhou and K. Rejeski and V. Wagner and
                      P. Costello and T. Hielscher$^*$ and L. Gatti and J. Kauer
                      and O. Nadeem and E. K. Mai and C. S. Michel and M. J.
                      Friedrich and D. N. Sedloev and N. Weinhold and H.
                      Goldschmidt and K. Herfarth and A. Schmitt and M. Hundemer
                      and M. Schmitt and C. Müller-Tidow and M. S. Topp and H.
                      Einsele and P. Dreger and N. C. Munshi and A. S. Sperling
                      and L. Rasche and S. Sauer and M. S. Raab},
      title        = {{B}ridging intensity is associated with impaired
                      hematopoietic recovery following {BCMA} {CAR}-{T} therapy
                      for multiple myeloma.},
      journal      = {Blood advances},
      volume       = {9},
      number       = {16},
      issn         = {2473-9529},
      address      = {Washington, DC},
      publisher    = {American Society of Hematology},
      reportid     = {DKFZ-2025-00859},
      pages        = {4151-4166},
      year         = {2025},
      note         = {2025 Aug 26;9(16):4151-4166},
      abstract     = {Chimeric antigen receptor (CAR) T-cell therapy represents a
                      major advance in the treatment of relapsed/refractory
                      multiple myeloma (RRMM). However, the long time span from
                      leukapheresis to actual CAR T-cell infusion often
                      necessitates bridging therapies. Due to limited knowledge
                      about the effects of bridging on post-CAR-T clinical course
                      and outcomes, the selection of treatment options is
                      challenging. In this multicenter international observational
                      study, we explored the impact of bridging therapy on
                      hematopoietic reconstitution in 158 patients with RRMM
                      treated with B-cell maturation antigen (BCMA)-directed CAR
                      T-cell therapy. Based on exposure to classical cytotoxic
                      (CTX) chemotherapy, we classified bridging regimens as
                      non-CTX, intermediate CTX (1-2 CTX agents) or intensive CTX
                      (≥ 3 CTX agents or high-dose therapy with stem cell
                      transplantation). We found associations between the number
                      of cytotoxic agents used and impaired post-CAR-T
                      hematopoietic reconstitution, evident across hematopoietic
                      cell lineages and particularly manifesting during the late
                      post-CAR-T period. Intensive CTX bridging was associated
                      with a prolonged time to neutrophil and platelet recovery,
                      distinct patterns of hematopoietic recovery (e.g., an
                      intermittent phenotype characterized by a second drop), an
                      increased susceptibility to severe infections and a
                      significantly increased risk for severe late cytopenias in
                      uni- and multivariate models. Taken together, these results
                      highlight that bridging intensity distinctly shapes the
                      trajectory of hematopoietic recovery after BCMA CAR-T.
                      Targeted and novel immunotherapies could provide
                      alternatives for bridging, and high-risk patients may
                      particularly benefit from enhanced monitoring, prophylaxis
                      and supportive care.},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40267180},
      doi          = {10.1182/bloodadvances.2024015732},
      url          = {https://inrepo02.dkfz.de/record/300648},
}