Posted on 07/27/2024 9:17:57 PM PDT by ConservativeMind
A simple blood test that measures the number of lymphocytes, a type of white blood cell in the body, may predict whether people who have relapsed multiple myeloma are going to respond well to CAR-T immunotherapy, according to research.
The paper found patients who had an increase in absolute lymphocyte count (ALC) during the first 15 days after receiving a CAR-T infusion had a higher chance of a complete response and better progression-free survival than patients with a lower ALC at day 15. Knowing the treatment may not work allows doctors to try other options more quickly.
Multiple myeloma is a blood cancer that originates in plasma cells, a type of white blood cell found in the bone marrow. Nearly all patients who have multiple myeloma relapse at some point, meaning after an initial positive treatment outcome, the cancer returns and requires further therapy.
Chimeric antigen receptor T-cell immunotherapy used to treat relapsed multiple myeloma after other drugs have failed involves collecting a patient's own immune cells and genetically modifying them to find and kill cancer cells. The souped-up immune cells, called CAR-T cells, are infused back into the patient where they home in on BCMA, a protein found on multiple myeloma cells.
"This highly active FDA-approved treatment is widely used, but until now there's really been nothing to tell us whether BCMA CAR-T is going to work or not," said Dr. Mateo Mejia Saldarriaga.
The researchers analyzed data at three medical institutions from 156 patients who had received BCMA-CAR-T therapy between 2017 and 2023 for relapsed multiple myeloma.
Patients with higher ALC at day 15 had significantly better response to treatment with their cancer under control for an average of 30 months whereas those who had lower ALC only had six months of progression-free survival on average.
(Excerpt) Read more at medicalxpress.com ...
If it doesn’t look good at that point, immediately start a different therapy.
You may already get this blood test as part of your annual physical. There’s no need to wait a lot of precious months, now.
Thanks for your medical post I appreciate it
It seems pretty clear from your comment you don't know what you're talking about.
CAR-T is not a front-line therapy. By the time you might possibly get to this therapy as a patient, you've had multiple failed attempts at other treatments. So, there is so much more than a simple blood test to make that determination. So much more!
In fact, it's a therapy that is incredibly complex and expensive (approximately $500,000) and is performed by only a few centers around the country. By the time a patient gets to CAR-T treatment, they've had multiple failed treatments and have been exposed to the best screening and analysis that modern medicine can offer.
A "simple/cheap blood test with an annual physical" for a rare disease and as a screening mechanism for the use of an incredibly complex treatment is just plain foolish beyond understanding.
Don't mislead us.
Icclearly, don’t be stupid.
The standard Complete Blood Count test include the absolute lymphocyte count (ALC). Take a look at yours. I just looked at my CBCs from my normal annual physical and my wife’s, and it’s right there. I have them going back years.
It is a very basic part of a normal basic routine blood test for everyone.
More on the Complete Blood Count test:
It’s pretty clear you don’t know what you are talking about.
Icclearly, this study was meant for people already taking, or expecting to take, CAR-T therapy.
Rather than wait six months and see a progression, they can start a different therapy at 15 days, thanks to the results of a cheap blood test that everyone already gets.
I'm sorry, but you don't know what you are talking about!
A patient does not "take" CAR-T. CAR-T is a medical procedure that includes extracting T cells from the patient, genetically engineering those cells, and reinserting them back into the patient to fight the disease (cancer). The reinsertion takes place in a hospital setting over a short period of time (hours), and the modified T cells then seek out and destroy the cancer cells (usually a blood cancer) over a period of a few days. It is not a simple procedure and is about as modern as medicine can be. It also has possible AEs (adverse effects) that can potentially be lethal.
To equate CAR-T assessment to a blood test is ludicrous.
You should be careful about promoting such crazy notions.
You are having a severe comprehension problem.
This study is for those on, or soon to take, CAR-T therapy. They are already known to have an issue requiring that.
Their doctors did not know that the ALC test could determine efficacy at 15 days, until now.
Get your head out so you can say, “icclearly,” icclearly.
Yes. There is a comprehension problem -- and it's you, my friend!
Let's take a close look at your rant/comments/misstatements about the article here.
A very available, cheap blood test can tell you or your doctor that your multiple myeloma immunotherapy is working 15 days after starting it.....If it doesn’t look good at that point, immediately start a different therapy.
That's ludicrous. The treatment protocol involves the single infusion of engineered T cells back into the patient that takes place in a hospital setting and lasts for the time it takes to empty the bag that holds the infused cells.
You don't start another therapy! Get it. Please explain how you stop the infusion that lasts for minutes and then start some other from of treatment. When the infusion is complete, it's over. Done. There is no possible way to "stop and immediately start a different strategy." Your words -- not mine.
Further, CAR-T is usually followed by at least two previous treatments that have failed over months or years. You don't just stop and try another treatment -- 'cause at that point you may be out of options.
You may already get this blood test as part of your annual physical. There’s no need to wait a lot of precious months now.
There you go again! It's just another foolish statement by someone who knows not of what he speaks. Any lame-brain knows that there is a common set of blood panels taken at an annual physical. There is no way that the test described by MSK is performed by a local clinician. Don't believe me, ask your doc to run me "that there CAR-T test, will 'ya?"
Sure. I can see that conversation with my doc every year. "Now, doc, be sure you run that CAR-T test for me." HUH??
This is just more of your nonsense of misleading people on a subject that you are clueless about.
You don't start another therapy! Get it. Please explain how you stop the infusion that lasts for minutes and then start some other from of treatment. When the infusion is complete, it's over. Done. There is no possible way to “stop and immediately start a different strategy.” Your words — not mine.
Directly from the write up:
The paper found that patients who had an increase in absolute lymphocyte count (ALC) during the first 15 days after receiving a CAR-T infusion had a higher chance of a complete response and better progression-free survival than patients with a lower ALC at day 15. Knowing that the treatment may not work allows doctors to try other options more quickly.
“If doctors can identify patients who are more likely to have a poor response to BCMA CAR-T, other treatments can be explored or given earlier,” said Dr. Mejia Saldarriaga.
I never said the test was to determine that you should get CAR-T therapy. You seem to be getting that from somewhere else. I did say that a simple ALC test at 15 days determines if the CAR-T therapy you got from your doctor will work for you. Your doctor can help find other treatments. Your doctor will need to know that he can run an ALC test to determine that his CAR-T will work, or will be destined to fail, at just 15 days after the therapy. Until now, no one knew failure could be known at just 15 days. Get it?
What I am saying is straight from the write up.
It's not hard to understand, “icclearly.”
Oh, my. I can see you're really struggling to understand. Yep. Really struggling -- just like your naive notion about CAR-T.
CAR-T is not a pill you take. It is on the level of a major organ transplant. It is not something a local doc may even understand -- much less run a simple blood test at an "annual physical." Those are YOUR words -- not words from the report.
Your reply does not address my comments. I never said anything about the report from Weill Cornell. What I did reference is your flippant and misleading comments. It is quite clear you have no clue what you're talking about.
May I repeat your words.....
A very available, cheap blood test can tell you or your doctor that your multiple myeloma immunotherapy is working 15 days after starting it.....If it doesn’t look good at that point, immediately start a different therapy.
Where exactly can I get this cheap blood test? Is my family doctor at my annual visit going to run this test -- when he may not even know what CAR-T is (like you), much less the test?
You may already get this blood test as part of your annual physical. There’s no need to wait a lot of precious months now.
What? So I can get this at my annual physical by my local family doc? Really?
No need to wait precious months?? What wait? The infusion lasts minutes. The doctors who administer this treatment are the best of the best, and I know a few. None of these docs are going to wait months! There are many other tests that can be run in the period from 15 days to a month, and those docs may use the new test, but there are much more proven tests that will indicate the treatment worked or didn't work.
So, you see. It's not the words from the reports. It's your words and a total lack of understanding of what you are talking about. Any fool with a computer can find out about that test without being misled by your useless comments.
That's the deal. Get it?
I never said CART-T is a pill you can take, or even anything that is simple or can be done by a patient.
I said a current cheap blood test can help determine if that CAR-T you got will work, in as little as 15 after being treated. That doctor will need to know this new finding and perform the test, but the test is very available to everyone. Thankfully, this study shows it provides much more insight, quicker, than any other way of determine if the CAR-T therapy is going to work or not.
You definitely do not “cclearly,” icclearly!
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