P08.18.B PROSPECTIVE EVALUATION OF NEUROLOGICAL SAFETY AFTER ANTI-BCMA CAR T-CELL THERAPY IN A SINGLE-CENTRE COHORT
Bibliographic record
Abstract
Abstract BACKGROUND Anti-BCMA (B-cell maturation antigen) chimeric antigen receptor (CAR) T-cell therapy has demonstrated high efficacy in patients with relapsed/refractory multiple myeloma (R/R MM). Acute toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), typically occur within two weeks of infusion and resolve promptly. However, data on long-term neurological safety remain scarce. Emerging evidence suggests the possibility of movement and neurocognitive treatment-emergent toxicities (MNTs), characterised by irreversible parkinsonism, cognitive impairment, and personality changes, typically arising a median of 36 days [range: 14-914] after CRS/ICANS resolution. This study aims to prospectively assess the long-term neurological safety of ide-cel in R/R MM patients, using standardized cognitive and motor evaluations. MATERIAL AND METHODS We conducted a prospective, systematic neurological evaluation in a cohort of R/R MM patients treated with ide-cel between November 2021 and December 2024 at our center. Only progression-free patients were included. Neurological assessments were performed by a neurologist at baseline (≤2 months before infusion) and at follow-up visits up to 18 months [range 10.5-17.3} post-infusion. Assessments included the Montreal Cognitive Assessment (MoCA) for global cognitive function and the motor subscale of the Unified Parkinson’s Disease Rating Scale (UPDRS) for extrapyramidal symptoms. Pre-treatment brain MRI (<3 months) excluded structural abnormalities. CRS and ICANS were retrospectively recorded. Neurotoxicity triggered further neurological assessment. RESULTS Among 88 patients treated with ide-cel, 40 were excluded due to early relapse, death, or loss to follow-up. Of the 48 eligible patients, 27 remain in follow-up, and 21 have completed full neurological assessments. At baseline, the median MoCA score was 26/30. The highest UPDRS motor score was 4/56, observed in two patients. ICANS was reported in three patients (two Grade 1 and one Grade 4 requiring ICU care). Cognitive and motor scores remained stable between baseline and follow-up assessments, including in those with initially elevated UPDRS scores. CONCLUSION In this real-world, prospective cohort of ide-cel-treated R/R MM patients, no long-term cognitive or motor deterioration was observed up to 18 months post-infusion. Despite the limited number of patients evaluable at this time point, these preliminary findings support the long-term neurological safety of ide-cel when patients are systematically assessed using standardized tools such as the MoCA and UPDRS. Updated results will be presented at the EANO meeting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".