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| 001 | 305463 | ||
| 005 | 20251028091155.0 | ||
| 024 | 7 | _ | |a 10.1038/s41408-025-01384-9 |2 doi |
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| 100 | 1 | _ | |a Korenkov, M. |0 0000-0002-2988-8483 |b 0 |
| 245 | _ | _ | |a Chronic inflammatory demyelinating polyneuropathy (CIDP) after cilta-cel therapy. |
| 260 | _ | _ | |a [London] |c 2025 |b Springer Nature |
| 336 | 7 | _ | |a article |2 DRIVER |
| 336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
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| 520 | _ | _ | |a Ciltacabtagene-autoleucel (cilta-cel) is a CAR-T cell therapy highly active in relapsed/refractory multiple myeloma but can induce severe immune-mediated toxicities. We describe two patients who developed chronic inflammatory demyelinating polyneuropathy (CIDP) after cilta-cel. Patient 1 presented with rapidly progressive gait ataxia, flaccid paraparesis, and oculomotor palsy 112 days post infusion; Patient 2 developed an analogous syndrome on day 19. In both patients, electromyography and nerve-conduction studies confirmed sensorimotor axonal-demyelinating neuropathy; brain MRI and CSF infection panels were unremarkable. CAR-T cells were detectable in blood and CSF, yet a predominance of CD8⁺ non-CAR-Tcells was observed. TCR-β sequencing revealed a hyper-expanded clone (~30% of all reads) in patient 1 versus a polyclonal repertoire in patient 2. High-dose dexamethasone plus intravenous immunoglobulin failed to improve neurologic symptoms and prompted T-cell-depleting cyclophosphamide, which lowered CAR- and non-CAR-T cells. Patient 1 died from respiratory failure, whereas patient 2 improved and could be discharged. These observations indicate that CIDP is a severe complication of cilta-cel therapy and may arise from bystander expansion of autoreactive CD8⁺ T-cells rather than direct CAR-T cell activity. Timely escalation to T-cell-depleting therapy may improve outcomes. |
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| 650 | _ | 2 | |a Humans |2 MeSH |
| 650 | _ | 2 | |a Polyradiculoneuropathy, Chronic Inflammatory Demyelinating: etiology |2 MeSH |
| 650 | _ | 2 | |a Polyradiculoneuropathy, Chronic Inflammatory Demyelinating: diagnosis |2 MeSH |
| 650 | _ | 2 | |a Male |2 MeSH |
| 650 | _ | 2 | |a Middle Aged |2 MeSH |
| 650 | _ | 2 | |a Immunotherapy, Adoptive: adverse effects |2 MeSH |
| 650 | _ | 2 | |a Female |2 MeSH |
| 650 | _ | 2 | |a Aged |2 MeSH |
| 700 | 1 | _ | |a Liebaert, J. |0 0009-0009-7547-1222 |b 1 |
| 700 | 1 | _ | |a Yousefian, S. |b 2 |
| 700 | 1 | _ | |a Schwartz, Christian |0 P:(DE-He78)9491a48ddeefc5a4faaec8c2f50a5782 |b 3 |
| 700 | 1 | _ | |a Demel, U. M. |b 4 |
| 700 | 1 | _ | |a Braune, J. |0 0000-0003-2026-2641 |b 5 |
| 700 | 1 | _ | |a Odabasi, M. C. |b 6 |
| 700 | 1 | _ | |a Herzberg, L. |b 7 |
| 700 | 1 | _ | |a Böckle, D. |b 8 |
| 700 | 1 | _ | |a Görür, N. C. |0 0000-0001-7857-2461 |b 9 |
| 700 | 1 | _ | |a V Landenberg-Roberg, V. |b 10 |
| 700 | 1 | _ | |a Bohl, S. |b 11 |
| 700 | 1 | _ | |a Tregel, E. |b 12 |
| 700 | 1 | _ | |a Hennig, S. |b 13 |
| 700 | 1 | _ | |a Franke, C. |b 14 |
| 700 | 1 | _ | |a Haas, Simon |0 P:(DE-He78)a5ec4e2fef99022a37a6b07c2fdd6325 |b 15 |
| 700 | 1 | _ | |a Keller, U. |0 0000-0002-8485-1958 |b 16 |
| 700 | 1 | _ | |a Krönke, J. |0 P:(DE-HGF)0 |b 17 |
| 700 | 1 | _ | |a Busse, Christian |0 P:(DE-He78)89561eed326f2693d5f674319709d2ba |b 18 |u dkfz |
| 773 | _ | _ | |a 10.1038/s41408-025-01384-9 |g Vol. 15, no. 1, p. 168 |0 PERI:(DE-600)2600560-8 |n 1 |p 168 |t Blood cancer journal |v 15 |y 2025 |x 2044-5385 |
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