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ORIGINAL RESEARCH article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1654096

This article is part of the Research TopicUnderstanding and Controlling Adverse Effects in Myeloma Patients treated with T Cell Redirecting ImmunotherapiesView all articles

MACROPHAGE ACTIVATION SYNDROME-LIKE IN MULTIPLE MYELOMA PATIENTS TREATED WITH THE ACADEMIC CAR-T AGAINST BCMA ARI0002H

Provisionally accepted
Daniel MunárrizDaniel Munárriz1Luis Gerardo Rodríguez-LobatoLuis Gerardo Rodríguez-Lobato1,2Lucia Pérez-CorralLucia Pérez-Corral3Cristina Arnaldos-PérezCristina Arnaldos-Pérez1Valentín CabañasValentín Cabañas4Nieves López-MuñozNieves López-Muñoz5Aina Oliver-CaldesAina Oliver-Caldes1Juan Carlos PonceJuan Carlos Ponce6Juan Luis RegueraJuan Luis Reguera7Ana África MartinAna África Martin3Núria Martínez-CibrianNúria Martínez-Cibrian1Natalia Tovar GomisNatalia Tovar Gomis1Julio DelgadoJulio Delgado1Elena GuillenElena Guillen1Sara VareaSara Varea1Paula Rodríguez-OteroPaula Rodríguez-Otero6Alvaro UrbanoAlvaro Urbano1,8Jose M MoraledaJose M Moraleda4Joaquin Martinez-LopezJoaquin Martinez-Lopez5María-Victoria MateosMaría-Victoria Mateos3Verónica González De la CalleVerónica González De la Calle3Europa Azucena González-NavarroEuropa Azucena González-Navarro1Carlos Fernandez De LarreaCarlos Fernandez De Larrea1,2,8*
  • 1Hospital Clinic de Barcelona, Barcelona, Spain
  • 2Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
  • 3Hospital Universitario de Salamanca, Salamanca, Spain
  • 4Hospital Clinico Universitario Virgen de la Arrixaca, El Palmar, Spain
  • 5Hospital Universitario 12 de Octubre, Madrid, Spain
  • 6Clinica Universidad de Navarra, Pamplona, Spain
  • 7Hospital Universitario Virgen del Rocio, Seville, Spain
  • 8Universitat de Barcelona, Barcelona, Spain

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ABSTRACT: Background: Chimeric antigen receptor T-cell (CAR-T) therapy targeting B-cell maturation antigen (BCMA) has revolutionized multiple myeloma treatment (MM). However, managing its immune-mediated adverse events, particularly macrophage activation syndrome-like (MAS-like), remains challenging due to underreporting. Methods: This multicentre, retrospective, analytical study evaluated MM patients treated with the anti-BCMA academic product ARI0002h. MAS-like was defined using the University of California San Francisco (UCSF) consensus criteria. Primary endpoints included baseline characteristics, predictive factors, and survival outcomes associated with MAS-like. Results: Of 80 patients, 12 (15%) met the UCSF criteria for MAS-like. These patients presented higher ISS scores (ISS III: 54.5% vs. 15.2%; p = 0.006), elevated serum monoclonal components (31.3 g/L vs. 6.8 g/L; p = 0.004), and a higher prevalence of extramedullary disease (41.7% vs. 16.2%; p = 0.057). MAS-like typically emerged 9 days post-infusion, with elevated ferritin, followed by LDH (median 11.5 days) and

Keywords: Myeloma, Anti-BCMA CAR T, MAS-like syndrome, IEC-HS, Immunotherapy

Received: 25 Jun 2025; Accepted: 02 Oct 2025.

Copyright: © 2025 Munárriz, Rodríguez-Lobato, Pérez-Corral, Arnaldos-Pérez, Cabañas, López-Muñoz, Oliver-Caldes, Ponce, Reguera, Martin, Martínez-Cibrian, Tovar Gomis, Delgado, Guillen, Varea, Rodríguez-Otero, Urbano, Moraleda, Martinez-Lopez, Mateos, González De la Calle, González-Navarro and Fernandez De Larrea. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Carlos Fernandez De Larrea, cfernan1@clinic.cat

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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