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Cancers
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Stem Cell Transplant and Cellular Therapies on Multiple Myeloma
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Stem Cell Transplant and Cellular Therapies on Multiple Myeloma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 1796

Special Issue Editor

Dr. Albert Oriol

E-Mail Website
Guest Editor
Institut Josep Carreras and Institut Català d’Oncologia, Hospital Germans Trias I Pujol, 08916 Badalona, Spain
Interests: multiple myeloma; pembrolizumab; lenalidomide; dexamethasone; multiple myeloma therapy; relapsed multiple myeloma; QoL; quality of life; haematopoietic stem cell transplantation; biochemistry and molecular biology

Special Issue Information

Dear Colleagues,

Stem cell transplant remains a cornerstone in multiple myeloma treatment. Cellular therapies are emerging as promising treatments in the relapsed and refractory setting and may even challenge frontline treatment options. The use of a patient's own stem cells or immune cells is key to obtaining long-lasting remission in different parts of the multiple myeloma treatment journey. 

Recent trials have confirmed the role of autologous stem cell transplantation to deepen the response in the course of first-line treatment, even after optimized induction treatment combinations. The role of allogeneic stem cell options is controversial; however, it is still a preferred option for ultra-high-risk patients, including those with plasma cell leukemia. 

The use of genetically modified T or NK cells from the patient or from healthy donors has also shown dramatic activity in the relapse and refractory setting. Autologous CAR-T cells directed against the B cell maturation antigen (BCMA) have been marketed after the outstanding results of recent phase 2 trials. Furthermore, phase 3 results support the use of CAR-T cells in earlier lines. CAR-T therapy is likely to challenge consolidation and maintenance strategies or even autologous stem cell transplantation in the near future. Allogeneic CAR-T cells are the ideal method to achieving the “off-the-shelf” availability of cellular immunotherapy. The clinical results of allogeneic CAR-T cells do not match those of autologous products yet, but technology continues to evolve rapidly.

In this Special Issue, original reviews and articles that focus on the current use of stem cell transplant and cellular therapies on multiple myeloma are welcome. 

Dr. Albert Oriol
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stem cell transplant
  • cellular therapy
  • CAR T cell
  • multiple myeloma
  • T or NK cells

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Published Papers (2 papers)

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Research

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15 pages, 7564 KiB  
Article
Gender-Specific Prognostic Impact of Treosulfan Levels in High-Dose Chemotherapy for Multiple Myeloma
by Alexander D. Heini, Karin Kammermann, Ulrike Bacher, Barbara Jeker, Michael Hayoz, Yolanda Aebi, Carlo R. Largiadèr, Henning Nilius and Thomas Pabst
Cancers 2024, 16(19), 3364; https://doi.org/10.3390/cancers16193364 - 1 Oct 2024
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Abstract
Introduction: The growing body of evidence around sexual and gender dimorphism in medicine, particularly in oncology, has highlighted differences in treatment response, outcomes, and side effects between males and females. Differences in drug metabolism, distribution, and elimination, influenced by factors like body composition [...] Read more.
Introduction: The growing body of evidence around sexual and gender dimorphism in medicine, particularly in oncology, has highlighted differences in treatment response, outcomes, and side effects between males and females. Differences in drug metabolism, distribution, and elimination, influenced by factors like body composition and enzyme expression, contribute to these variations. Methods: We retrospectively analyzed data of 112 multiple myeloma (MM) patients treated with first-line high-dose chemotherapy (HDCT) with treosulfan and melphalan (TreoMel) followed by autologous stem cell transplantation (ASCT) at a single academic center between January 2020 and August 2022. We assessed response rate, progression-free survival (PFS), overall survival (OS), and toxicities in relation to gender and treosulfan exposure. Results: Our analysis revealed significant gender-specific differences in treosulfan exposure. Females had higher peak levels (343.8 vs. 309.0 mg/L, p = 0.0011) and area under the curve (AUC) (869.9 vs. 830.5 mg*h/L, p = 0.0427) compared to males. Higher treosulfan exposure was associated with increased mortality in females but not in males. Females with treosulfan AUC > 900 mg*h/L had significantly shorter overall survival, while PFS was unaffected by treosulfan exposure. Conclusion: Our study demonstrates that female patients undergoing TreoMel HDCT have higher treosulfan exposure than males and that females with higher levels are at increased risk for toxicity and adverse outcomes. These data suggest that higher treosulfan doses do not confer a benefit in terms of better outcomes for females. Therefore, exploring lower treosulfan doses for female MM patients undergoing TreoMel HDCT may be warranted to mitigate toxicity and improve outcomes. Full article
(This article belongs to the Special Issue Stem Cell Transplant and Cellular Therapies on Multiple Myeloma)
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Review

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24 pages, 853 KiB  
Review
Cellular Therapies for Multiple Myeloma: Engineering Hope
by Sarah Vera-Cruz, Maria Jornet Culubret, Verena Konetzki, Miriam Alb, Sabrina R. Friedel, Michael Hudecek, Hermann Einsele, Sophia Danhof and Lukas Scheller
Cancers 2024, 16(22), 3867; https://doi.org/10.3390/cancers16223867 - 19 Nov 2024
Viewed by 532
Abstract
Multiple myeloma (MM) treatment remains challenging due to its relapsed/refractory disease course as well as intra- and inter-patient heterogeneity. Cellular immunotherapies, especially chimeric antigen receptor (CAR)-T cells targeting B cell maturation antigen (BCMA), mark a major breakthrough, achieving long-lasting remissions and instilling hope [...] Read more.
Multiple myeloma (MM) treatment remains challenging due to its relapsed/refractory disease course as well as intra- and inter-patient heterogeneity. Cellular immunotherapies, especially chimeric antigen receptor (CAR)-T cells targeting B cell maturation antigen (BCMA), mark a major breakthrough, achieving long-lasting remissions and instilling hope for a potential cure. While ongoing clinical trials are increasingly driving approved cellular products towards earlier lines of therapy, novel targets as well as advanced approaches employing natural killer (NK) cells or dendritic cell (DC) vaccines are currently under investigation. Treatment resistance, driven by tumor-intrinsic factors such as antigen escape and the intricate dynamics of the tumor microenvironment (TME), along with emerging side effects such as movement and neurocognitive treatment-emergent adverse events (MNTs), are the major limitations of approved cellular therapies. To improve efficacy and overcome resistance, cutting-edge research is exploring strategies to target the microenvironment as well as synergistic combinatorial approaches. Recent advances in CAR-T cell production involve shortened manufacturing protocols and “off-the-shelf” CAR-T cells, aiming at decreasing socioeconomic barriers and thereby increasing patient access to this potential lifesaving therapy. In this review, we provide an extensive overview of the evolving field of cellular therapies for MM, underlining the potential to achieve long-lasting responses. Full article
(This article belongs to the Special Issue Stem Cell Transplant and Cellular Therapies on Multiple Myeloma)
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