Feasibility of post-induction consolidation with BCMA CAR-T cell therapy in newly diagnosed multiple myeloma not proceeding to ASCT: A preliminary case series.

B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T cell therapy has demonstrated promising efficacy in relapsed/refractory multiple myeloma (MM). However, evidence supporting its use in earlier treatment settings remains limited. This study presents a preliminary case series evaluating the feasibility of BCMA CAR-T cell therapy as post-induction consolidation in newly diagnosed multiple myeloma (NDMM) patients who did not proceed to autologous stem cell transplantation (ASCT). Four patients were included in this analysis. After induction therapy, all patients achieved very good partial response or better and did not proceed to ASCT due to ineligibility or personal preference. They subsequently received BCMA CAR-T cell therapy as consolidation treatment. All patients tolerated the BCMA CAR-T cell infusion well. Cytokine release syndrome occurred in all cases, but was limited to grades 1-2, and no immune effector cell-associated neurotoxicity syndrome was observed. Following therapy, patients maintained or further deepened responses and ultimately reached stringent complete response (sCR) and minimal residual disease (MRD) negativity. During a median follow-up period of 17.8 months, all patients remained in sCR status and MRD negativity without the need for additional anti-tumor therapy, and none experienced relapse or disease progression. These preliminary results suggest that BCMA CAR-T cell therapy as post-induction consolidation is feasible and associated with manageable toxicity in NDMM patients not proceeding to ASCT, warranting further evaluation in larger prospective studies.